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    Angela Lunde

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  • Alzheimer's blog

  • Jan. 11, 2011

    Wellness, chocolate and caregiving: Best wishes for 2011

    By Angela Lunde

32 comments posted

Alzheimer's Caregiving

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Happy new year to those of you loyal followers of this blog, as well as those of you who tune in every once in a while, and to those of you who are finding us for the first time.

The number of you who have been a part of this blog community over the past year has been remarkable. The compassion and support you provide one another through your words is more valuable than you know.

Over the past week, a couple of important and timely pieces of information and articles have crossed my desk that I thought I'd pass along.

First a new Medicare Benefit went into effect on January 2, 2011. Under the Affordable Care Act (the healthcare reform law), Medicare will now pay for an annual wellness visit.  This visit will include a personalized prevention plan including an assessment of cognitive function.

This is a big victory for those of us advocating for early diagnosis of a cognitive disorder due to Alzheimer's or other dementia. Details are included in this fact sheet:

Medicare Update: Annual Wellness Visit (PDF file requiring Adobe Reader)

Also, a few days ago, Karen made a comment on the blog that I think is true for most caregivers. She wrote:

"I realize that I (caregiver and daughter) may be the one grieving more than her (Karen's mother with dementia) because as long as she feels secure, she seems to be happy. One of the basic universal needs each of us has is to feel secure. Consequently, one of the most loving things we can do for a person with Alzheimer's disease is to figure out what provides them with a sense of security and contentment. This approach may essentially be Alzheimer's 'therapy' at its best. The 'therapy' is connecting the person with dementia with a familiar object, touch or activity; it may be soft music, a particular aroma or even chocolate!"

A great article in the "New York Times" came out on December 31. "The Vanishing Mind: Giving Alzheimer's Patients Their Way, Even Chocolate", stated "with virtually no effective medical treatment for Alzheimer's yet, most dementia therapy is the caregiving performed by families and nursing homes." The article provides an overall philosophy of care that I wholeheartedly embrace. It's worth reading and sharing your thoughts.

"Laugh when you can,
Apologize when you should,
And let go of what you can't change.
Life's too short to be anything ... but happy."

- Anonymous

32 comments posted

blog index
  • September 27, 2011 5:06 p.m.

    Has anyone tried a stuffed animal to comfort your loved one? My mother had a calico stuffed cat for 3 years before she passed away this past February. Her name was Caldonia and she brought so much joy to my mother! They were inseperable. Mom died with Caldonia in her arms and all of us kids by her side.

    - bettina

  • March 22, 2011 1:47 a.m.

    My friends and i enjoy utilising Twitter and also Facebook also, My friends and i seem to dedicate the majority of my free time after job checking these websites! medical treatment abroad,dental treatment in india,knee replacement in india

    - lilymedical

  • February 28, 2011 2:30 p.m.

    I want to share something about incontinence that is working for us. My husband has been soaking the bed with urine nightly despite depends with a heavy duty Poise inside. I do have a plastic zippered cover on the entire mattress (found them at walmart) and big waterproof pads on top of the sheets. This week, I put spandex bicycle shorts like you would work out in, also known as dri-fits over his depends & they hold the depends snugly in place so there is no leaking. Also the material wicks moisture, so that helps too. Hope this saves someone else some laundry!

    - Nancy

  • February 28, 2011 2:25 p.m.

    Leah, When we added Namenda to my husband's Aricept, he improved some by singing from the hymnbook in church again & reading words again. It has not hurt his appetite any.

    - Nancy

  • February 23, 2011 10:49 p.m.

    I am 75 and without any medical opinion I feel I may be suffering from 'mild' alz. When conversing, I fairly commonly search for a name or a word; I feel as if a tiny 'arrow' moving around in my brain to find that name or word which does not come to me presently but after a day or two. What mental exercise can I do regularly to avoid falling prey to this terrible disease?.. any suggestions will be appriciated.

    - Girish

  • February 11, 2011 3:37 p.m.

    This is my first visit to this site. I've never blogged before and even though we're all invisible, it still makes me a little nervous; however, in this case we all have something huge in common. I just brought my 86 year old father here to live with and be loved and cared for by me and my family. He has advanced Alzheimer's. He has made the adjustment to this dramatic change in his circumstances well. My family is also still undergoing that process, as well. I haven't checked out whether or not there is a local support group so thought I'd at least start with the blogging experience to see if that fills the bill. There are days when my father and I share great laughter and there are days when I wonder what I've gotten myself into; particularly in regard to watching this disease destroy the man he was. It's heartbreaking. I've only had him with me a month. It's quite different to have full time care of him vs going out to where he lived once a month for a week. My whole life is reoriented around him and I'm still figuring out how that's going to work the most smoothly in terms of my own activities. This is a ginormous undertaking but it is a labor of unadulterated love. I cannot abide the thought of strangers taking care of my father. The most pressing question I have at the moment is how do some of you handle the sundowning and/or sleeplessness at night? There are nights when my dad can't stay in bed. Thanks so much.

    - Lisa

  • January 24, 2011 5:11 p.m.

    My hucband was taking aricept 10mg, now the dr. want him to take also namenda twice a day with some improvement in 12 weeks, has anyone taken that or given it to a family member and seen some improvement i dont want to give him anything that will take his appetite again just as he is starting to eat well again

    - Leah

  • January 23, 2011 1:28 p.m.

    this my frist time on this site .my father is 77yrs.old and he is bing treated for dementia, off and through previse months we noticed his memory was getting, he is also hard of hearing so alot of times its hard talking with to with getting loud .he is the type thats is very strong willed and loves being busy, well n a nutshell it happen so fast for us one week he was driving the next n va hosptial not knowing anyone, its just him and my mom that live together and she has bad health as well, im the babygirl of 4 my oldest bro.passed away very sudden a hard shock on us all,i have another bro.and sister,for whatever reasons they mayb my sister and i are the one that really take care of mom&dad and me just because of how iam i seam to b the rock of the family i dont so my feeling to others so to say all of that is to say (HELP) we are a family thats lives paycheck to paycheck country raised so something like this is hard, my sister&myself take turns at nite stayn with mom&dad workn on getting help n daytime momis is on oxg.24hrs.and can dobut so much but things she can handle dad,but she cant so what is some tips u guys have .so if i rambled but not really a typer.thanks ,patrica

    - patricia

  • January 17, 2011 6:46 p.m.

    Ms. Angela, my wife of 63 years was diagnosed with early ALZHEIMERS in 2001. We did as advise moved from a lovely home we built in NC and moved to Mount Joy, PA., to be closer to our two sons. My wife lost control of all mechanics but still has a very good mind. Thus I made a decision to keep her in our home with nurses from an IN HOME CARE CO. For many years Doctors questioned whether or not she has ALZHEIMERS. We treat her with medications, etc as if she has. Have you heard of this from others with "A"?

    - ROBERT

  • January 16, 2011 8:03 p.m.

    Jerry, even though there seems to be a truism that no two people with AD follow an identical pattern ... in my support group we tend to say that if you know one person with AD, then you know one person with AD ... depression, sleeping longer, and not wanting to eat are fairly common symptoms. Same with losing interest in hobbies and activities that previously provided joy. So I would suggest the following: discuss the depression with your doctor; perhaps a different anti-depressant, or a higher dosage of her current med, would make a difference. It took 3 different anti-depressants till we found the right one for my wife; then when it seemed to become less effective, the doctor increased the dosage and it made another dramatic positive difference. Also, you said you and your wife exercise at your Y. See if your Y also offers cultural programs that your wife could attend. My wife goes to our Y once a week for 3 hours to attend different classes. My wife also now has severe problems using the computer, but discovered the game "Super Text Twisters' (basically, scrambled words!) and now plays that one game online for hours each day. Hope some of these suggestions help!

    - Allan

  • January 15, 2011 7:47 p.m.

    I took care of an elderly who had dementia. She used to enjoy eating ice cream and she would perk up. However, it got so bad that she didn't want to eat unless her family serves her. She became extremely aggressive to the caregivers including me and can say the meanest thing to a person day in and out. Her family thought they were helping but they make it worse when they kept on changing the dosage of her medicine the doctor's prescribed. They took it upon themselves to diagnose her when they weren't with her all the time. They go online and read what everyone says then they copy. What they don't realize is that what works for someone else doesn't mean it will work for their mom. It was frustrating since they don't have to deal with their mom 24 hours.

    - Nichelle

  • January 15, 2011 7:38 p.m.

    My wife has early Alzheimers. At age 64 she has a great deal of problems with depression. Throught the holidays, depression has been a constant companion of both of us even though she is on an anti-depressant. Our winter here has not allowed for much outside exercise. We have begun to exercise 3 to 5 days a week at our local Y--it seems to be helping. My wife too, enjoys ice cream very much, but she is beginning to not want to eat an evening meal and she is sleeping much more than she has in the past. Do others find their loved one not wanting to eat? She no longer is able to handle computer communication, needle work, and other time passing activities. Gardening has been her only respite and in the winter, that is not available, Are there any suggestions? Thanks for your comments they make me realize others have trod this path before, I am not alone.

    - Jerry

  • January 14, 2011 5:21 p.m.

    Thank you, Marilyn, and I agree with all you wrote. In fact, I've made that point of how important it is for doctors to listen to spouses/caregivers in my article, "Alzheimer's and Baby Boomers," published in the September issue of the American Journal of Alzheimer's Disease and otther Dementias. Doctors simply MUST pay more careful attention the observations of those who are with someone 24/7 ... spouses/significant others/caregivers will often observe worrisome symptoms that will not present themselves during brief office visits with doctors, nor on quick AD screening tests such as the commonly used Mini Mental State Examination (MMSE). So I think it is very prudent for seniors to be accompanied by someone who knows them well during any doctor visit that will involve a screening for dementia.

    - Allan

  • January 13, 2011 7:40 p.m.

    Happy New Year to you all!!!I think I am understanding my mothers condition a little better as we go I am attending support groups so that I can be more informed and educated on what to do when my mom starts to fight with my 11 year old son.She is so helpful she makes me laugh and cry at some of the things she says and does I am just so thankful that I am able to care for her,today I am sick and it is hard to watch her when I don't feel good so I just listen to her and ya she loves candy she is like a child at this point.A curious child she has her good days and her bad moments I am so glad for all the support I have received from the day center where she goes and the best Dr.who has helped me come to terms with this role reversal that is happening in our lives.The other day the pastor at my church raised his voice and she got scared.I put my arm around her and comforted her she is just like a little girl she talks so much about her dad my grandfather who I don't remember. I hope to take her to Texas soon to see my sister and her sisters.she loves to be out and about

    - sylvia

  • January 13, 2011 12:32 p.m.

    This is in support of a comment by Allan. My father was given a questionaire by the memory clinic when we were looking for a diagnosis of her worrisome symptoms. After reading it, I made copies and each of us children also answered it. The clinic was so impressed, they made it part of their program to have the entire family answer the questions. The answers came from different perspectives; but, reinforced the early signs that pointed to early dementia. Also, please remember caregivers, you know your loved ones better than anyone. You take the suggestions that best work for you to keep your loved ones safe and secure and feeling loved. Don't feel insecure about your decisions. Yes, you will re-evaluate decisions and even change directons; but, that is normal. There are no absolutes with this disease except that your loved one will die from it. Like the poem, that you cannot change.

    - Marilyn

  • January 13, 2011 9:37 a.m.

    My sister has alzheimer and some days are very difficult for her (and me). Sometimes I think she knows who I am but not other times. She mostly just wants to sleep now. Sometimes she is aggressive and other times she will actually tell me that she loves me. I come home crying everyday after my visits. My two consolations are prayer and being able to share my feelings with friends. My readers here are considered my friends also.

    - Lorraine

  • January 13, 2011 9:18 a.m.

    DOES ANYONE HAVE ANY SUGGESTIONS? I TAKE CARE OF MY SISTER AND SHE COMPLAINS ABOUT "WARMTH".FOR THE LONGEST TIME HER MEDS: EXCELON PATCH,NAMENDA,& DEPAKOTE HELPED HER, BUT AS THE MEDS ARE BECOMING LESS EFFECTIVE HER DISCOMFORT IS INCREASING. HER DOCTOR TRIED TO INCREASE HER MEDS,BUT SHE WASN'T ABLE TO TOLERATE A HIGHER DOSE. I DON'T KNOW HOW TO HELP HER, EXCEPT TO USE A FAN AND A COLD CLOTH.

    - MARY

  • January 13, 2011 6:32 a.m.

    I am concerned that chocolate is not good for diabetics & in my husband at least causes diarrhoea so some caution should be taken

    - anne

  • January 12, 2011 6:37 p.m.

    Gail made a good point. Chocolates or ice cream alone cannot solve the problems of aggressive or confused behavior.My Mom was delighted with the nightly ice cream ritual but she also was receiving psychiatric medications to help her confusion and aggressive tendencies. It was only with expert medical treatment and loving care at home that she managed to lead the illusion of a "normal' life. A life that was supervised from morning until night to keep her safe and to give her the dignity that she deserved. I learned alot. Safety and dignity came first. Tools to achieve theset goals can encompass many things: color coding things with red standing for danger or giving chocolate/ice cream for calm happy moments when they able to accept those moment. One cannot force it .. the ice cream will then just be flushed down the toilet and all the effort of the caregiver are for nothing. In the case of my Mom, she needed medical help in the form of prescriptions to help her regain her life and not just chocolates and ice cream.

    - Connie

  • January 12, 2011 6:20 p.m.

    I read the NYT article with much interest and could completely relate and agree with its fundamental argument. My Mom never liked sweets and hated ice cream. As her dementia progressed, one of her joys was a bowl of ice cream just before bed time. Every night, I would present her with a bowl of ice cream. She was surprised that I would think of this and thought it was a lovely present (not recalling that she got a bowl of ice cream every night). Her face would light up and she would say as if handed a big present "you made all this for me?" The sun downing was forgotten and like a child she was able to relax with her ice cream and go to sleep. Perhaps it was the routine of the day or the ice cream or my presence but I will never know for certain what gave her joy or at least comfort. Perhaps it was the ice cream. At least I feel some comfort in thinking I provided some happiness in that dark abyss known as dementia and alzheimers.

    - connie

  • January 12, 2011 4:58 p.m.

    My mother has Alzheimer's, another sister has Parkinson's, and the family of a third sister has been told that she has "Senior Dementia". She is in as assisted living program for others with senior dementia. I have never before heard this term. Can anyone help explain?

    - Jo

  • January 12, 2011 4:33 p.m.

    Responding to the blog of "let them eat chocolate". My husband of 60 years has had dementia the past 6. His greatest love is ice cream. Getting it out of the freezer is truly the only thing he can do for himself. I decided several months ago I would not even ask him to put it in a bowl instead of eating it out of the carton but I often find it in the refrigerator side all melted. Sometimes he forgets it for days and days, but I always keep lots of it on hand. Dementia patients have so little left to enjoy! We go out to movies, out to lunch, to church and to church dinner groups (our congregation knows he has this disease and are extremely sweet and supportive). I take him on long car trips, often for several days. He loves these excursions and it gives him great security to be by my side for long periods of time which he can't manage when I am busy doing household stuff. It is good for each of us as long as he is manageable. It's tedious, boring and hard for me to keep up with everything. I get frustrated and lose patience, but I am thankful that my health is good enough for me to face the challenge. And so thankful that he does not exhibit the anger I know that many dementia patients have. He knows how dependent he is on me and thanks me several times a day for taking care of him. I agree with Bob - whatever makes them happy, go for it!

    - Arabella

  • January 12, 2011 4:12 p.m.

    I started reading this colum early last year and I am enjoying it so much. There are so many things that I see now that even the Dr. had not forwarned me about being a caregiver for my husband who has dementia, I understand him so much better,when he does something wrong I realize he don't even know it and is so innocent, but always try to be helpful.I thank all of you for posting, and I look forward to reading this blog.my husband is so loving and I know he would do the same kind of care for me.

    - Leah...nNNT3G

  • January 12, 2011 3:32 p.m.

    Angela, thank you for bringing so many of us together who share the same concerns and challenges. I was caregiver for my wife for a little over a year. During that period I was on a number of boards of directors and had many meetings. I had a caregiver with her at home and I handled the night time and some days when I did not have meetings. To save my health I finally retained three wonderful ladies as her caregivers at home and there were two of them with her 24/7 because she required a lot of attention. I will not go into all of the creative methods they developed involving her bathroom, shower, medicines, and getting her out of the home for exercise and exposure to others. As to enjoying chocolate or whatever, I recommend enjoy whatever makes caregiver and/or patient happy. When the patient, my wife, was happy then the household was happy. She loved her strawberry ice cream and milk shakes. I slept in another room in our home. She was led to believe I was out of town or at work. Otherwise, I would have interfered with the caregivers' routines. She had the same three caregivers throughout her illness. Saying each one was the best caregiver and the most caring, loving, and understanding would be a major understatement. My wife passed away the first of this new year. The caregivers are as heartbroken as I. I worry about them and their grief. So, yes indeed, whatever brings fun and enjoyment to all involved with this horrible disease, go for it.

    - Bob

  • January 12, 2011 3:08 p.m.

    I appreciate the attention given to caregiving. With Denentia you are never going to see a return to good health. I care for my Dad. My Mom and I have been doing so for the past few years. I have a health care background. I am challenged by my circumstances. Seems as if I have underestimated caring for a dementia patient long term. The blogs and such resources are invaluable!

    - Robyn

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