Alzheimer’s Confused with Too Much Change

francy Dickinson                             www.seniorcarewithspirit.com

Dear Francy;My husband is starting to forget who I am, he seems to be able to do tasks and is comfortable, but occasionally he asks me if I come in every day? We are leaving for a week to our cabin and I am hoping some rest away from the house will calm him and help.

I can understand your hurt feelings with your husband’s confusion. There is nothing as frightening as the stage of Dementia/ Alzheimer’s that moves the mind into forgetting close loved ones. I do also understand that one day he may be confused to the max and the next day he may be clear and able to function quite well. You are on track with knowing that keeping him calm and rested can help – but the change of pace to the cabin is not the answer.

Here are some tips to keep Dementia/Alzheimer’s at their maximum clear and calm:

1. Clear your home of clutter. Your mind can view a room and see the couch, the chair and the front door. But a mind that is confused with dementia sees all the little things on the same level or as just as important as the big things in the room.  Like the foot stool, the table, the papers on the floor, the coffee cup and dessert plate on the table are all on par with the favorite chair and the TV. It’s a different view of the same room. Your job- pare down your clutter around the house. So when a dementia senior is sitting in the room their mind can rest, not be constantly moving from item to item.
2. Clean up kitchen cabinets, make the cabinet for glasses and cups just that – glasses and cups. It is easier for them to remember what is in the cupboard and then when they open the cupboard what they were looking for is right there. A bottle of aspirin or cup filled with toothpicks will take the dementia mind off of their need for a glass and they will often close the cupboard and forget their task.
3. Remove anything that could harm the dementia senior. Extra medications- get them out of the easy to find area. If you have been storing your pills in the bathroom cabinet, remove them. You do not want your senior to take your pills in a moment of confusion. Just like you protect toddlers from medications or anything that could harm them, you need to protect the dementia senior, too.
4. Remove things from the kitchen table, it’s a place to eat, not store bills and papers. Once again, the dementia mind can take one task or chore at a time. To keep their mind active and working well keep the table a place to rest the mind, eat and talk. Not a place filled with boxes, papers and confusion. Clean the area and the mind will rest and see the table as a relaxing place, not a place for them to be distracted with other tasks and not want to eat.
5. 1-2 days out a week. It depends on how advanced the dementia is for your senior, but going out and about is fine for a day or two a week. It is not good on a daily basis. Take a few days at home, then a day out. Make the day out simple tasks and low people contact. Dementia mind can get tired very easily, what the senior could do last year, is not what they can do today. Keep them down to a short trip with familiar sights. Would you take a toddler out for four hours of running around and then to a big birthday party? NO, it would be way to much for them to handle, that is now the same way your dementia senior is thinking.
6. Trips to the cabin, to visit family in another city, sightseeing, new places, new people they are all very confusing. Dementia does best with people, places and things that are repeated each day and feel safe. My husband has a sister in Oregon and children in California, he often says he wants to go and visit. On his last visit he got lost and he took about three weeks to calm down and be able to sleep and have good days on his return. Our days of travel are over; his daily routine and happiness are far more important to me than trips to say hi that pull him out of his security zone. I know that retirement means visiting and travel, but dementia means that the mind functions better with familiar and safe surroundings.
7. Limit the people contact to friends, family and neighbors. George does so well in his daily life, then last month I took him to a family memorial for my cousin. He walked into a church he had never been, surrounded by people he rarely saw and he just blanked out. He was confused, upset, did not know immedite family members and was a fish out of water. We left as soon as possible and did not go to the family home event. I took him out to a quiet lunch, changed the subject to talk about something we do everyday and we went home. I got him calm and in his chair and listening to a new audio-book on his MP3 player. I made an error in judgement, I did not think about his comfort zone and he suffered for it. I should have gone to the memorial by myself and so I have learned a lesson. My life with my husband by my side has now changed and I have to understand and learn to accept that fact, not with joy, but with inner strength.
8. Keep like with like. If the drawer is for knives, keep it knives, if the pot is for pens and pencils keep it that way. No mixing, no putting off items in with other items. They will be forever lost to you and your dementia senior. Repeat over and over again. Cell phones charges by the entry door. Keys go in the bowl on the counter. One day George will not remember any of those details, but for now while he is in mid stage Alzheimer’s he is comforted by repeated tasks and repeated placement of items he uses often like his cell phone and MP3 player. George lost his garage door opener and we have not found it, I know it is tucked away in an odd place somewhere, but where? I have become quite the cleaning girl now, but it has paid off for me to get rid of items that have not been used in ages and are of no meaning to George.
9. Doctor told me his dementia patients do better longer when the senior keeps their weight in a healthy range. Alzheimer’s medications often have a side effect of reducing the appetite and the senior starts to not remember or want to eat. So, I have added a routine of 3 meals around the same time each day. I have added desserts back into our life, so there is homemade cookies, pies and cakes ready for his snacks. Yogurt, applesauce and puddings for taking pills. Ensure and Boost for adding protein when he has not eaten lunch. I keep him on schedule and he responds with better eating and better days. If I am busy, out of the house, not feeling well myself – then he goes off his schedule, he forgets to eat and his pills are left on the counter. That is a lot of pressure for me, but I try my best and move on if the day has not worked out well. Life is not perfect and I have to live too.
10. George needs rest, some days he rests all day, some days he is up and ready for life early. A man made for schedules -is no longer on schedule, I just know I give him his meds and food no later than 9AM so they go to work to help him feel calm and comforted during his day. If he stays in bed after the meal, fine – I will then continue my day and the next day he is up and at um. I ride with life, but I try to stick to the schedule and routine so George feels the days in order and is able to adjust his mind easily to an important day. Because dementia means that each day is important, the next day may be of less abilities and less memory, so today is the day to tackle and enjoy.

I think the fact of the spouse or family of a dementia/Alzheimer’s senior has the ability to give the senior a full and rich life – is a big thing. On certain days it overwhelms me. I try to keep my mind focused on today, to deal with whatever today brings my way. I try to make little jokes about forgetting where George’s coffee cup is ( it has become a continual struggle to find it during the day.) I tell him how much I love him, all day long. If he forgets, I remind him- he is loved. I tell him how nice he looks, how well he did a task and how great it is he finished his meal and brought me the plate. I make a point to touch him and dance with him around the kitchen. I even squeeze his hand or kiss him in public – just to keep him connected. Lately, I stop on a dime and ask him to give me a hug or a kiss, he does it with love – but not without my request. I give him constant reassurance I am here for him and I am not leaving. Each month our life changes, his mind changes and we have to readjust to his new challenges. I get frightened of the changes ahead, so I try hard to deal with the daily change and stay on a pattern and routine that brings my own feeling of safety and comfort as well as George’s.

I know you are feeling very similar things, and I know that tears and heartache are close to the surface of your daily life. But we can do it, we can escort our loved ones on this journey and still be a functioning person at the end. We can find honor and love in our senior even on their worst days and we can find peace and calm in our own hearts in midst of total chaos around us. We are stronger than we ever knew and I am proud of myself and of you.

Please do go to my website at www.seniorcarewithspirit.com for more ideas. I have a great e-book called Care Giving 101 Workbook that will help you with giving care in your own home or in the senior’s home. It has all the basic home nursing tips and gives you ideas to support yourself as well as your spouse or loved one. These books are very popular with care givers and I encourage you to buy one so you can feel more in power of your situation as the care giver. It can be very lonely out there all alone when you are giving care – I want to make the experience more comforting for you.

I write these blogs to share information that I have gathered in my many years of care giving. I am now tending to my husband with Alzheimer’s and my books and services are how I’m able to stay at home and care for him. Thanks for all you are doing for your own loved one, blessings. francy

PS I am on Twitter @seniorcaretips and I would love to have you listen to my talk radio show on senior care issues just click the radio button on my home page. The show is on demand so you can listen whenever you have time.