Puzzles are an excellent way to stimulate your brain. When putting together a puzzle, your brain produces a chemical known as dopamine that is chiefly responsible for learning and memory. If you are caring for an elder, pull out your puzzles and initiate some brain stimulating family time.
At Vista Gardens, with Dr. Jacqueline DuPont, we are continuously finding fun, well-researched ways to keep our residents engaged with memory-benefiting activities.
BEFORE TALKING WITH SOMEONE WITH DEMENTIA OR ALZHEIMER’S DISEASE:
1.Know the older adult first! (know their likes, dislikes and names – the name they like to be called).
2.If you are a caregiver, read their chart or history. Are they a morning person or are they up at night? Know as much about them as you possibly can.
3.Think about how you are presenting yourself
4.Try a CALM, gentle, matter of fact approach
5.Use a non-demanding approach – try humor, cheerfulness
6.Try using a gentle touch, from the front (if appropriate) to communicate your message
Begin the conversation socially (i.e., “Hi, my name is Michelle”). Use your name often and wear a nametag, if possible.
WHILE TALKING WITH SOMEONE WITH DEMENTIA OR ALZHEIMER’S DISEASE
1.Approach from the front and talk to the person in a place with no distractions. It may sound obvious, but make sure hearing aids are turned on and have batteries.
2.Begin by identifying yourself and addressing the person by the “best” name
3.Look directly at the person and make sure you have his/her attention
4.Make sure you are at eye level with the person (not looking down). Get at their level.
5.Speak slowly and say words clearly and in a soft low pitch voice – gentle tone
6.Ask only one thing at a time and do not rush
7.Use short, simple sentences and questions (e.g., “are you cold?”)
8.Use very concrete terms and familiar words
9.Use actual names, instead of he and she, when referring to others
10.Talk in a warm, easy-going, pleasant way
11.Talk in a quiet, calm voice.
12.Speak in positive terms
13.Ignore harmless hallucinations or delusions
14.Treat the person with RESPECT
WHEN YOU ARE HAVING TROUBLE BEING UNDERSTOOD
1.Be patient; allow enough time
2.Demonstrate visually what you are saying by pointing, touching or drawing
3.Use short simple terms
4.Be repetitive and consistent (if you need to repeat 3 times)
5.Try a less difficult, more simple way to say it
6.Try a hug and a change of subject
7.Do not rush the person. Allow plenty of time for a response. If there is none, repeat the question, exactly as it was phrased the first time. If there still is no answer, reword the phrase.
8.If possible, change who is asking the question or making the request. Someone else may have more success.
WHEN YOU ARE HAVING TROUBLE UNDERSTANDING
1.Listen actively and carefully to what the person is trying to say
2.Try to focus on a word or phrase that makes sense
3.Respond to the emotional tone of the statement
4.Experiment with supplying words
5.Encourage the person to point or gesture
6.Stay calm and be patient
7.Ask family members about possible meanings for words, names, phrases
8.Listen to their voice and gestures which may give clues to understanding
THINGS NOT TO DO
1.Don’t argue and don’t give orders to the person.
2.Don’t tell the person what he/she can’t do.
3.Don’t “talk down” or appear superior to the person.
4.Don’t treat them like a child.
5.Don’t ask questions that require the person to remember facts.
6.Don’t talk about people with the disease in front of them.
7.Don’t use sarcasm or inappropriate humor. Alzheimer’s patients misinterpret humor.
8.Don’t orient the person to person, place and time – validate their feelings and statements.
WHEN VERBAL COMMUNICATION JUST DOESN’T WORK
1.Try distracting the person.
2.Ignore angry or agitated statements if you can’t think of a positive response.
3.Try other forms of communicating (songs, massage, favorite foods, walking, etc.)
4.Give the person something to do. Try activities, a walk, giving them food or something to hold.
6.Again, try someone else. The Alzheimer or Dementia patient may just not like what you are wearing that day.
7.Try again later.
COPING WITH CHALLENGING BEHAVIORS
1.Build a positive, trusting relationship. You are familiar, you are safe.
2.Use effective verbal and nonverbal communication techniques.
3.Encourage independence in the person. Try to help the resident build a sense of control and competence over his/her life.
4.Avoid arguing, yes/no battles, rational or logical explanations, and debates.
5.Tell “therapeutic fibs” or “bent facts” to save a patient grief and reduce problem behaviors (i.e., validation therapy). Validate their hallucinations or delusions.
6.Redirect or divert the person’s attention to a positive topic, activity, or object.
7.When a behavior requires intervention, act quickly with positive techniques and activities.
A total solar eclipse only happens about once in a person’s lifetime. Our residents experienced history today! They watched the moon cover the sun for a few brief minutes from indoors in order to stay safe.
News reports state that the sun’s rays during this time are extremely harmful and could potentially blind your eyes if you look directly towards the sun. Please use the proper precautions during this time to make sure that you’re eyes are protected and safe.
Red flags are quite different from “what to look for” while touring an assisted living, memory care or board and care. They are a “things” not to miss!
1. Most of the residents are seated in wheel chairs. The excellent standard of care is to transfer the residents frequently to a normal chair or recliner throughout the day, (if safe). No one wants to sit in a wheel chair all day!
2. A lack of activities: look for a live interactive activity, such as music, art, or even games. This would not be a movie with an assistant sitting there watching it.
3. A diabetic program: what does it include? Do they serve a real diabetic menu? Can you see one? For the insulin dependent, there must be at least licensed nurse over the course of 16 hours in order to give excellent care and injections, as well as checking sugar levels.
4. Who is assisting with medications? A red flag, is when a caregiver is giving medications! It is best for a medical technician to dispense medications. Also, are
the medical technicians trained? Are they tested?
5. In memory care, is there still a resident counsel for them or their families to voice their concerns or suggestions? To be informed of their rights?
Are the state approved “resident rights” posted or given out?
6. How do the nurses or staff communicate a resident’s change of condition? Do they send a monthly report? Do they call or communicate often? A red flag is if you read the state report and there are lots of real care complaints rather than non-care complaints.
Many times, former employees can make complaints to form a case against the facility. They are “lead complaints” leading to help their “case” which are not always in the best interest of care. A real compliant has to do with the food, care or even a lack of care.
7. Another red flag: A lack of spiritual care. If a facility does not have a chaplain, pastor or priest, it shows another lack of a comprehensive program. Residents still want to worship or have friendly visitors.
8. No newsletter? A facility should have a fun way to list activities and inform families and caregivers or trips, activities and special events!
9. A lack of parties, or fun celebrations on the holidays. Ask for a list. If there is nothing, don’t expect anything fun, like a special meal etc. You may have to make your own arrangements for the holidays.
10.Another red flag would be a lack of excellent visiting experts who the facility contracts with on a daily basis. Ask for a list of geriatricians, hospice agencies, home health and even psychiatrists who visit to care for the residents.
If none of the red flags appear when touring a facility, you should expect a smooth transition.