Ways to Help Your Aging Parent

As a member of the “Sandwich Generation”, whereby having an adult daughter living at home after college due to the economy and a 12 year old son with Tourette’s, along with managing my aging father from a distance, I truly understand the difficulty both on a personal level as well as a professional level as a Geriatric Care Manager Elder Care Consultant. I can only imagine how difficult this process is for those with little or no experience in navigating through the confusing maze of health care. In managing your aging parent, there are some recommendations to help you understand the aging process and what you can do to help.

1. Recognize sudden changes. Quick onset of confusion or falling frequently is likely an acute episode indicating possibly an infection, medication side effect or even a heart attack or stroke. Be aware of their baseline behavior so you’re more in tune to the changes that occur.

2. Find the source of the decline. To often, a person with dementia symptoms are mis-diagnosed with Alzheimer’s. Some easily treatable medical conditions such as urinary tract infection, plugged ears, vitamin B12 deficiency or underactive thyroid can mimic the signs and symptoms of Alzheimer’s. Note the ways the decline has presented itself such as short term memory impairment, loss of appetite, or poor hygiene and how long these changes have been going on. Share this information with their physician at their next appointment.

3. Familiarize yourself with their medicines. Note medication name, dosage, frequency, what it’s prescribed for and the prescribing doctor. Many times medications are prescribed for a secondary effect rather than the most common one. Find out about the potentially dangerous side effects to be on the alert for. Inform their doctor of your parent’s other substance use such as alcohol, tobacco, caffeine and even vitamins, supplements and nutritional drinks.

4. Curb ageist attitudes. Don’t assume all that anguish your parent is experiencing is age related. For instance left hip pain in an 87 year old may not be from age if there’s no discomfort in the right hip. Also, not every elderly person becomes depressed. And avoid saying things like “What do you expect at your age?” (Which is something my daughter says to me in jest, and I’m only pushing 50!)

5. Address the symptoms but don’t ignore the emotions. During the aging decline comes all the emotions of insecurity, fear, grief, boredom, sadness and embarrassment. Emotional distress can exacerbate dis-ease symptoms and even spark new illnesses. Uncover what causes the most stress and find solutions to help ease their concerns.

6. Maximize quality of life. Help your parent to find ways to enjoy life to its fullest and have the capability to do the things they want to do. Helping them through a problem or providing them with companionship and love. As they experience loss of loved ones coupled with their loss of some of their functional abilities, they may feel lonely or isolated. Help them meet new people and develop new interests through senior centers, adult day care or even through their local retirement or as-sisted living communities.

7. Know when to ask for help. You cannot assist your parent with the aging process alone. Your own immediate family support is a must and even with that, you may need to call for some professional guidance.

Call us today for help 727-443-2273

Learning how to talk to a person with dementia

People with dementia often find it hard to remember the meaning of words that you are using, or to think of the words they want to say. You may both become frustrated. The following tips can help you communicate more effectively with a person who has dementia:

  • It is understandable that you may feel angry; but showing your anger can make the agitation worse. If you are about to lose you temper try “counting to ten,” remembering that the person has a disease and is not deliberately trying to make things difficult for you.

Try and talk about feelings rather than arguing over facts. For example, if the person with dementia is mistakenly convinced you didn’t see him yesterday, focus on his feelings of insecurity today: “I won’t forget you.”

  • Identify yourself by name and call the person by name. The person may not always remember who you are; don’t ask “Don’t you remember me?”
  • Approach the person slowly from the front and give him or her time to get used to your presence. Maintain eye contact. A gentle touch may help.
  • Try to talk in a quiet place without too much background noise such as a television or other people in conversation.
  • Speak slowly and distinctly. Use familiar words and short sentences.
  • Keep things positive. Offer positive choices like “Let’s go out now,” or “Would you like to wear your red or blue cap?”
  • If the person seems frustrated and you don’t know what he or she wants, try to ask simple questions that can be answered with yes or no or one-word answers.
  • Use gestures, visual cues, and verbal prompts to help. For example, if suggesting a walk, get out the coats, open the door, and say “Time for a walk.” Set up needed supplies in advance for tasks such as bathing and getting dressed; have a special signal for needing to go to the bathroom. Try to break up complicated tasks into simple segments; physically start doing what you want to happen.
  • If a subject of conversation makes a person more agitated or frustrated, it may help more if you drop the issue rather than keep on trying to correct a specific misunderstanding. He or she will probably forget the issue and be able to relax in a short while.

Behavior Management Strategies

Caring for a loved one with dementia poses many challenges for family caregivers and health care service providers. Bizarre behaviors and memory problems make it difficult to leave the impaired person alone, even for a short time. These behaviors can cause embarrassment, frustration, and exhaustion in those providing the care. You will probably need to explore what works best for you and your impaired relative.

This fact sheet provides some practical suggestions and strategies for dealing with common behavior problems in dementia patients.
Communication
  • Eliminate distractions. Turn off the TV or radio when talking to the confused person and maintain eye contact to help keep his/her attention.
  • Use short, simple sentences and give only one directive at a time. Avoid sentences phrased in the negative. Instead of saying: “Don’t go outside” say: “Stay inside.”
  • Monitor the tone and level of your voice while talking to the person with dementia. Gestures, pantomime, and pictures can help you get the point across. Use nonverbal cues like exaggerating a smile or a nod.
  • Avoid speaking down to your loved one. Speak slowly and clearly, but in an adult manner. Don’t be afraid to repeat what you say several times.
  • Refrain from discussing topics your relative can no longer remember. Encourage him/her to talk about familiar places, interests, and past experiences.
Wandering
  • You may want to change the locks on your doors. Consider a lock where a key is required for exit and entry. A sliding bolt installed at floor level may be effective.
  • Try a barrier like a curtain or colored streamer to mask the door. A “stop” sign or “do not enter” sign also may help. Another technique is to place a black mat or paint a black space on your front porch; this may appear to be an impassable hole to the dementia patient.
  • Child-safe” plastic door knob covers are available at children’s departments. Special electronic devices also are sold by private companies to prevent wandering.
  • Put away essential items such as the confused person’s coat, purse, or glasses. Some individuals will not go out without certain articles.
  • Have your relative wear an identification bracelet. Maintain a current photo should you need to report your loved one missing. Consider leaving a copy on file at the police department.
  • Tell neighbors about your relative’s wandering behavior and make sure they have your phone number.
  • Allow for regular exercise to minimize restlessness.
Incontinence
  • Establish a routine for using the toilet. Try reminding the person or assisting him/her to the bathroom every two hours.
  • Schedule fluid intake to ensure the confused person does not become dehydrated. However, avoid drinks with a diuretic effect like coffee, tea, cola, or beer. Limit fluid intake in the evening before bedtime.
  • A commode, obtained at any medical supply store, can be left in the bedroom at night for easy access.
  • Incontinence pads can be purchased at the pharmacy or supermarket. A urologist may be able to prescribe a special product or treatment.
  • Use signs (with illustrations) to indicate which door leads to the bathroom.
  • Use easy-to-remove clothing such as elastic waistbands, full skirts, and clothes that are easily washable.
Angry/Agitated Behavior
  • Obtain a doctor’s evaluation to determine if there is a medical cause, or if medications are causing adverse side-effects. Reducing caffeine intake may be helpful as well. In severe cases, medication can be prescribed by a neurologist to keep a dementia patient calm.
  • Reduce outside noise, clutter, or number of persons in the room. Maintain structure by keeping the same routines. Keep objects and furniture in the same places. Help orient the confused person with calendars and clocks. Familiar objects and photographs offer a sense of security and can facilitate pleasant memories.
  • Try gentle touch, soothing music, reading, or walks to quell agitation. Speak in a reassuring voice. Do not try to restrain the person during a catastrophic reaction. Keep dangerous objects out of reach.
  • If agitation increases at night, a night light may reduce confusion.
  • Limit choices to minimize confusion. Instead of asking “What would you like for lunch, soup or a sandwich?” say: “Here’s some soup.
  • Acknowledge the confused person’s anger over the loss of control in his/her life. Tell them you understand their frustration.
  • Distract the person with a snack or an activity. Allow him/her to forget the troubling incident. Confronting a confused person may increase anxiety.
Perseveration (repetitive speech/actions)
  • Reassure or try to distract the person. Avoid reminding the person that he/she just asked the same question. Ignoring the behavior or question may work in some cases.
  • Do not discuss plans with a confused person until immediately prior to an event.
  • You may want to try placing a sign on the kitchen table stating “Dinner is at 6:30” or “Lois comes home at 5:00” to remove anxiety and uncertainty about anticipated events.
  • Learn to recognize certain behaviors. An agitated state or pulling at clothing, for example, could indicate a need to use the bathroom.
  • Check with the demented person’s doctor. Make sure the person is not in pain or suffering any side effects from prescription medications.
Paranoia
  • Check out paranoid behaviors with the person’s doctor. Adjustments may be needed in prescription medications.
  • If the confused person suspects money is “missing,” allow him/her to keep small amounts of money in a pocket or handbag for easy inspection.
  • Assist the person in looking for a missing object. Avoid arguing. Try to learn where the confused person’s favorite hiding places are for storing objects which are frequently assumed to be “lost.”
  • Take time to explain to other family members and home helpers that suspicious accusations are a part of the dementing illness.
  • Respond to the feeling behind the accusation. If the accusation involves hurting or killing someone who has passed away, you might try saying “You really miss your mother; tell me about her.”
  • Try non-verbal reassurances like a gentle touch or hug.
Traveling
  • Do not negotiate an outing with a confused person. Instead of asking, “Are you ready to go out?” Limit what he/she must remember by announcing “Here’s your coat” and “We’re getting into the car now.”
  • Reassure the person. New and different surroundings can be anxiety-producing and disorienting for someone with dementia.
  • Plan your route as carefully as you can, know about parking, elevators, stairs, etc. Leave plenty of time so you will not need to rush.
  • If taking a vacation or weekend away with the dementia patient, consider bringing along another adult to help out.
  • Bring something to help keep the confused person occupied if you must wait somewhere. Try a package of snacks, cards, or a picture book.
Additional Problem Areas
  • If bathing is a problem, realize that you can skip a day, if need be. Be aware that loss of ability to determine temperature may make the water seem too hot or too cold. Safeguard hot water so that the person does not get burned. Supervise showers or baths, particularly if the person’s balance is unsteady. Remove the bathroom door lock for safety. Concern over modesty also may increase agitation, so be reassuring. Try varying the time of day to better suit the person’s prior bathing habits.
  • Loss of control over appetite can occur and the person may not remember just having eaten. Keep food out of sight during non-meal times. Serve food pre-cut, if using utensils becomes difficult. Respond to the emotion by reassuring the person that you will make sure he/she is well fed. Distract the person with a different activity.
  • Dressing is difficult for most dementia patients. Choose loose-fitting, comfortable clothes which have easy zippers or snaps with minimal buttons. Reduce the person’s choices by removing seldom-worn clothes from the closet. To facilitate dressing, lay out one article of clothing at a time, in the order it is to be worn. Remove soiled clothes from the room. Don’t argue if the person insists on wearing the same thing again.
  • If the confused person suffers sleep disturbances or night-time agitation, make sure the house is safe: block off stairs with gates, lock kitchen door or put away dangerous items. Try soothing music or a massage to induce relaxation. If agitation increases after dark, keep the house well lit and close curtains to shut out darkness. If the person remains awake or restless at night, consider hiring someone for the night shift or find a way to share night-time supervision with others so you can get your own rest. Use sleeping medications only as a last resort.
  • When hallucinations are a problem, keep the house well lit to decrease shadow effects which can be confusing. Reassure the person during or after a loud noise such as a storm, siren, or airplane. Give a simple, truthful explanation of the noise, but avoid arguing or trying to convince the person. A distraction may be useful. Check with the person’s doctor.
  • Other problems may include sexually-inappropriate behaviors, driving a car, stubbornness or violent outbursts.

Support groups for caregivers

When people suffer hardships, sharing the pain almost always helps. A support group is a gathering of individuals to explore a common cause or problem. Members of the group discuss their experiences, exchange information and provide encouragement and friendship. They also offer shoulders to lean on when times are tough and allow each other to express anger, frustration, resentment and other troubling emotions.

Above all, successful support groups ? also called self-help groups ? create an environment where people grappling with difficult issues feel understood and accepted by those in similar circumstances. As a caregiver you may need a support group, especially if you feel isolated, believe your situation is unique and think no one around you understands what you are going through.Support groups can offer caregivers:

Encouragement. Caregiving is a demanding task that can drain your emotional, physical and spiritual energy. Support groups provide a safe place to recharge your batteries.
Information. Support group members can glean ideas and suggestions from others in the trenches. Other caregivers are often the best source for helpful tips about community resources, medical developments, support services and other key issues.
Emotional support. Sometimes caregivers simply need to vent. Support groups provide a space to unload pent-up frustrations while others in similar circumstances empathize and counsel without judgment.

What should you look for in a support group?

Support groups cover a broad spectrum. Some may be only for people taking care of someone with a particular illness, such as Alzheimer?s, Parkinson?s or cancer. Others may be for anyone caring for a parent or anyone involved in long-distance caregiving.Some support groups are open-ended, with new people joining periodically. Others continue for a defined length of time ? 10 weeks or six months, for example ? and don?t admit new members after the first or second week. Some groups schedule regular lectures or presentations on topics of mutual interest. Others are less structured, with members offering the floor to those who request it.

Think about the kind of group you would prefer. You may need to check out several before settling on one that suits your purposes. To find out about support groups in your area, inquire at community centers, fraternal associations and religious organizations. Hospitals and nonprofit agencies associated with specific diseases or conditions also sponsor them. Check local Web sites, newspapers? community listings, classified ads or bulletin boards for privately organized support groups.

As you evaluate a support group, consider these qualities:

Comfort. Support groups are about relationships. Do you feel at ease with the people? Are they welcoming? Are smiles and hugs freely available? Or do you feel as though you?ve stepped into an refrigerator?
Convenience. Does the group meet at a time and place convenient to you? How far are you willing to drive? If you?re a morning person, does the group meet early enough in the evening for you to get home without falling asleep at the wheel?
Confidentiality. Does everything discussed stay within the group, or does information leak out? If you don?t feel safe, you?re likely to clam up ? which would defeat the purpose of joining.
Sometimes professionals ? social workers, therapists and nurses ? run support groups. Sometimes one group member takes charge, or leadership responsibilities rotate among the participants. All approaches have their advantages, but a designated leader can help keep the group productive and moving forward.Leading a support group is an emotional, draining and challenging task. A support group facilitator should show:

Empathy. An ability to sympathize deeply with others is a prerequisite. An empathetic leader will make people feel welcome and draw out even the most reluctant group member.
Poise. Those who feel comfortable in front of groups, articulate their feelings well and demonstrate grace under pressure can help sustain a group?s spirit in times of crisis.
Enthusiasm. People often share their darkest emotions and fears in support groups. Leaders who firmly believe in the goals and mission of the group will be the most successful in encouraging participants to speak openly. A sense of humor helps, too.
 Focus. A good leader will have a sense of what members are feeling, where the group needs to go and how to guide discussions to get there.

Starting your own support group

If you can?t find a group to meet your needs, start one yourself. It?s not as difficult as it sounds. People who perceive a gap and are determined to fill it make the best support group founders. To organize a support group:
 Start with a mission. Maybe you want to focus on serving caregivers taking care of people with dementia or caregivers coping with difficult family relationships. If you need a particular kind of support group, undoubtedly others do, too.
Locate others. When you have defined your target group, enlist the aid of doctors or hospitals to help you find other caregivers grappling with the same issues. Give the health care professionals your name and phone number and have them share that information with others in similar situations.
 Advertise. Let the community know that the support group is available. Post notices on community bulletin boards. Many newspapers publish public service announcements free. Or try low-cost classifieds.
Find a meeting place. Churches, synagogues and other religious establishments often open their doors to support groups. So do hospitals, libraries and corporate conference rooms. Make sure the meeting place is accessible to all. If necessary, negotiate a price for renting the facility.
Decide whether to enlist a professional to lead the group. The leader could be a health care professional from a local agency, a therapist or someone with support group and caregiving experience.