Last year while I was actively caring for my mom, I attended a special presentation for caregivers at an Alzheimer’s Family Services Center.  The coordinator for the three workshops started off the morning with a brief overview and asked the audience, “How many of you are care partners?”

The audience didn’t respond.

I thought to myself, “What are care partners?”

Then he said, “How many of you are the primary person in charge of caring for someone with Alzheimer’s disease?”

Oh, he was talking about me! Then many of us raised our hands.

“Care partner” instead of “caregiver.”

Hmmm. I like the sound of that phrase, and especially what it implies. It gives the patient (or care recipient) so much more power and dignity in the relationship.

I first heard the words “care recipient” several years ago.  I also prefer to use that phrase instead of “patient” which sounds clinical and detached, especially when we’re talking about a loved one we are caring for.

I wonder if the use of the phrases “care partner” and “care recipient” will catch on in our culture and the mainstream media?

Subtle Yet Powerful Distinctions

Some people probably don’t think the words we use matter, but I beg to differ.  The words we say out loud, and even in our own heads, can make a huge difference in how we think and feel about others, ourselves and our actions.  How we behave is influenced by what we’re thinking . . . and words are a direct reflection of our thoughts.

While  on the frontline of caregiving, I heard some nurses use the word “declining” rather than “deteriorating” when describing their care recipient.  A small difference in words, yet clearly a different description.  If they were describing you, or someone you love, which term would you prefer they chose?  One is such a kinder word to use than the other.

My strong belief that words matter also led me to adopt the use of the term “Golden Oldies” when writing or talking about senior citizens.

Some Parting Words . . .

Here is a new phrases I heard recently that I hope leaves you with a smile!

A “silver surfer” is a Golden Oldie who uses the internet!

What do you think about these caregiving words?  Can you add other words or phrases to our discussion here?

We’re all human.   We’ve probably all felt the guilt and remorse after losing our cool with our aging parents, relatives or care recipients.

Aside from feeling badly, what can we actively do to make amends after we’ve blown up at them?  How do we begin to repair the relationship after a hurtful incident?

Making up may be hard, but not impossible, to do. Here are several steps to take:

1.  Have a cooling off period.  Let the dust settle before you engage them again.  It gives everyone involved time to gain some perspective on what the issues were that set off a disagreement.  This could mean several hours, days or even weeks depending upon your caregiving situation.

2.  Change your mode of contact.  If you visit regularly, you may want to simply touch base via phone a few times before another face-to-face visit.  Or ask a sibling, spouse or adult child to take a turn or two with the caregiving duties.  If you live with your care recipient, get away from home for a little while, provided they are safe to be alone for this period of time.

3.  Before you visit your Golden Oldies again, resolve to arrive with a pleasant attitude and open mind about talking over the issues that caused the argument.  Otherwise, it’s not time to visit them yet.  You may also want to role play with a friend or colleague the scenario before you go there, to figure out how to calmly discuss the issue(s) with them. It’s best not to involve another family member in your role playing, as they may have their own emotional bias on the topic.

What If You Start Losing Your Cool All Over Again?

When you re-establish contact and visit with the intention of making amends, be tuned in and aware of your own internal signals.  Are your Golden Oldies beginning to push your buttons?  Do you feel your stress level rising again?  If so, before the same argument starts over, it would be better to either leave or change the subject, rather than have it lead to another blow up!  Try to remain cool, calm and collected as the issues are being discussed.

At the very first sign things aren’t going well however,  either change the subject (“I think we all need to think about these ideas more.  Can we continue this discussion another day?”) or leave gracefully (“I have to pick up XYZ before dinner — can we continue this tomorrow?”).

Then repeat the steps given above, until you can control your reactions more effectively.

I also suggest that if you sense your aging parents are becoming upset again, it may be wise for you to bail.  You don’t have control over their emotional reactions, but you do not have to be subjected to any verbal abuse they may throw at you.  If the same issues are starting to upset them, just stop and let it go for the time being.

As I left my parents’ home after a visit, I would often ask myself, if this was our final goodbye, would I be happy with it?  I think parent-adult child relationships would be vastly improved if more family members asked this question of themselves.

Special Circumstances Apply

If your Golden Oldie has any type of memory loss,  dementia or Alzheimer’s disease you must always be the one to apologize.  This is due to the fact that they most likely

• won’t remember the blow up; and

• even if they do, they may not have the brain processing function to take the initiative to apologize

You must accept the blame when something’s wrong, even if it is a fantasy existing only in their minds.  It is the kindest thing to do under the circumstances.

What techniques have you used to make amends after a blow up with your Golden Oldies or care recipients?  Please leave your words of wisdom in the comments section below.

In a prior post I acknowledged that in our role as family caregivers, we’ve all  probably lost our patience with our aging parents or care recipients at some point. I also promised to share with you my own experience, so here goes.

I Never Lost My Patience (Part One of Two)

I was a long distance caregiver to my parents during the years my mom was in the early stages of Alzheimer’s disease. It’s easy to keep your patience when you live three thousand miles away and the caregiving consists mainly of supportive phone calls and a few short visits a year.

About two years after her diagnosis, when my parents moved to an assisted living facility in my town, my mom was at the start of the middle stage of this horrible disease.  Through the excellent free resources of my local Alzheimer’s Association, I had educated myself via workshops and lots of reading about caregiving for dementia patients.  I was also attending a support group for adult children of Alzheimer’s patients on a regular basis which provided more insight and other people to share experiences with.

The knowledge I gained from the time my mom was diagnosed until the time she and my dad moved here armed me with an understanding and deep compassion for people struck by any memory-impairing disease.  And while I saw my parents multiple times a week once they lived nearby, I do not remember a single time when I lost patience and blew up at either one or them, face-to-face or by phone.  (I just checked with my husband and he couldn’t think of any incidences like that either.)

So How Did I Keep from Losing It?

OK, this was probably a wimpy way out (or at best, passive-aggressive behavior), but I would rely completely on my husband to interact with my parents for me when I needed some space as a caregiver.  As their only child, I was their sole source of emotional support, and I thought it could be extremely hurtful if I was nasty, mean or rude to them.  I truly didn’t want to hurt them in any way at this stage in their lives.

I did two things that stopped me from losing patience with my parents:

1.  I vented to my husband . . . a lot!  I would whine and complain whenever I felt the caregiving issues and duties were overwhelming me.  As an only child, one comment I often made was, “This is just too much for one person to handle!” (Of course, there are pros and cons about being a caregiver and an only child, but that’s another post.)

I must also point out, my parents were always very independent and considerate!  They never expressed a desire to live with my family and only did so for a few weeks when they were moving.  I always had our own home as my sanctuary to retreat to.  I don’t know how I would have managed had we all lived under the same  roof — which makes me sympathize even more with family caregivers who do accomplish this incredible feat with aplomb!

2.  I would have my husband “run interference” for me when I was reaching my caregiving breaking point.  Jeff is an absolutely extraordinary man, and I have to publicly thank him again for being such a vital part of my caregiving “village.”  There were times my father would call and I just couldn’t bear to deal with whatever question or problem they had.  Jeff would return the call and handle everything for me when I just couldn’t do it myself.

One particular incident really stands out in my mind.  I had just arrived at Disneyland to meet a group of friends (we’re locals and had an annual pass at the time) and spend the evening dancing to a favorite band playing there.  (As I’ve written here before, dance is one of my major ways to relieve stress!) My pager beeped and I saw it was my parents’ phone number.  I immediately called Jeff at home and he willingly returned my Dad’s phone call, explained I was gone for the evening, and helped them in my absence.  Thankfully, I didn’t have to turn around and leave the Happiest Place on Earth as soon as I had arrived.  I know how lucky I am to have had such a reliable and caring backup person on my caregiving team.

Do you have a family member, friend or neighbor you can ask to be your back up for those times you just need to have some time away from caregiving?  And don’t feel guilty arranging for this assistance!

I Never Lost my Patience . . . Yeah, Right (Part Two of Two)

Ironically, I would lose my patience on the telephone multiple times with my parents years before I ever became their family caregiver!

I moved out to California in my mid-20’s and we’d talk on the phone about once a week to catch up.  I would find myself very upset or angry with my parents by the end of many conversations.  I remember wishing they would just leave me alone and stop telling me what to do!

These negative emotions, along with some other issues, led me to get counseling for a few months to gain a better understanding of myself.  My therapist taught me a very important life lesson which I know helped me become a more patient caregiver when I took on that role.

The lesson was for me to change my perception of what they said.

It was to recognize that the words my parents were actually saying, which I perceived as criticism or telling me how to run my life, were only one surface layer. What I needed to learn and embrace 100% was the understanding that beneath whatever “negative” words I was hearing, what my parents were really saying to me was, “We love you!”

They cared about and loved me deeply.  They weren’t criticizing me; they were suggesting ways I could make my life even better.  It was all in my perception of the intent behind their words, not what their words were!  It was the unspoken message they were sending that I needed to focus on.

Once I learned this important lesson, it made all the difference in the world when communicating with them in a patient and loving manner, both long distance and while up close and personal.  And I think this basic understanding also kept me from losing patience with them when I later shouldered the responsibility and stress of caregiving.

True Confessions are now officially over.

In a future post, we’ll talk about practical ways we can smooth things over when we do blow our cool with our Golden Oldies.

Last week’s post about having patience with our aging parents (aka Golden Oldies), caused me to think about the exact opposite experience.  Despite our best efforts, each of us has probably lost our patience and blown up at our care recipients at one time or another, in some way or other.  We wouldn’t be human if we didn’t.

My question to you is, “Then what?”

How did you handle repairing any hurt you may have caused by lashing out at someone you’re caring for and, most likely, care deeply about?  What steps did you take to make things right? What did you do or not do? How did they react?

It’s true confessions time.

I promise to share my story in next week’s post, but you go first in the comment section below. 

Slow down, you move too fast.

You got to make the morning last.

Just kicking down the cobble stones.

Looking for fun and feelin’ groovy.

~  Paul Simon & Art Garfunkel

Lately I’m more aware than ever of how fast our society moves, and how we are living at an ever-accelerating pace.  People want and expect instant action, access and/or results in so many realms of life!

We eat at fast food restaurants.  We buy ready-made food at the market.  We watch movies at home “on demand.”  We drive 70 mph on freeways and pay tolls electronically via “FastTrack” devices.  TV news broadcasts nearly always start with “Breaking News.”  At Disneyland, the “happiest place on earth,” we purchase a “Fast Pass” to avoid waiting in long lines.  Immediacy and speed define our world.

We can be reached by phone, whether home or away — and now even in foreign countries.  Cell phones allow us to be forever connected . . . and the people who are calling us are asking for a fast response back.   If they reach an answering machine at our home or office, instead of leaving a message, they’ll call our cell phone — if they even called our land line to begin with.   And if leaving a phone message won’t suffice,  they’ll then attempt to reach us by text, email, or Facebook chat — thanks to iPhones, Blackberries and other PDA’s.  Immediate connections rule.

I fear as a society we are losing an important character trait called “patience.”

In business the same frenetic rules apply.  People have learned many companies are reachable 24/7 thanks to the internet, and customers expect answers to their questions or problems as soon as possible. A business person recently told me they answer all customer queries within 24 hours — and this is in an industry that is not “life or death” by any means!

As these business owners stay in constant contact with their customers, they are thereby training these customers to expect instant replies from other businesses as well, and not to be satisfied if they don’t get them.  An ever-increasing cycle of higher expectations and faster responses grows.

How does all of this relate to being a family caregiver?

As caregivers we need to realize our aging parents (aka Golden Oldies) don’t live in a world ruled by this accelerated pace of life.  While they may use computers or cell phones (although many don’t), they aren’t tied to them, and the instant gratification gained by using technology, in the same way baby boomers, Gen X, Gen Y and the millenial generations are.

As family caregivers, we need to be mindful of this and adjust accordingly when caring for or even just visiting our aging parents.  We must embrace the character trait of patience when we’re with them, caring for them and during our interactions with them.  It is necessary to shift into a lower gear when entering their world.  It is unkind, and creates tension in our relationships with them, if we try to force them to function in our much faster moving world.

It really won’t be harmful to our health to slow down for a day, or even for just a few hours, when spending quality time with them.  Enjoy slipping into their world  — where you can still find phones with cords, analog clocks, an AM/FM radio and TV’s that are large boxes that don’t hang on the living room wall.  Shut your cell phone off for a few hours when you’re together and enjoy the peace it affords.

Don’t expect your aging parents to move at a fast pace, eat quickly, or even think as  fast as we have become accustomed to doing.  We need to s-l-o-w down and embrace the easier, more gentle pace they live in when we’re around them. It gives us caregivers time to “stop and smell the roses.”  Yes, the amount of time we spend with them is important, but also how we spend that time together also counts.

Nike’s “Just Do It” slogan doesn’t cut it by Golden Oldie standards.  For their generation this is what mattered:  taking the time to make a decision, weighing the options, figuring out the best, most efficient and probably the most economical way to accomplish something.  Despite the fast-paced lives we lead, a slow and deliberate approach is still a good alternative to just doing it.

“We say we waste time, but that is impossible. We waste ourselves.”

~ Alice Bloch

Embrace the opportunity to relax and decompress with your Golden Oldies — don’t  avoid it.  They give you the time and space to do so when you’re with them — they are experts at it, so learn from them.    It gives you time to re-charge your batteries before heading back out into the  ever-accelerating, fast-paced world we live in.

And whatever you do, don’t make them speed up — ain’t gonna happen! Meet them in their world, appreciate and honor it.

You must have been warned against letting the golden hours slip by; but some of them are golden only because we let them slip by.

~ James Matthew Barrie

I’d love to get your thoughts on having patience in the comment section below.  For starters, do you or don’t you?

This article is Part 4 in a series on hospice care.  Please see the section below entitled “Related Posts” for links to Parts 1, 2, and 3 and to read more on this topic.

First Time Around It Was “No Go”

I was impressed with the way my dad’s final months were made more comfortable physically and emotionally via hospice care, as well as by the support I received from them. I wanted my mother to receive this same comfort care.  She was already in the middle stages of Alzheimer’s disease when my dad passed away, and I knew I really didn’t want to subject her to any more hospital stays in her lifetime, so placing her on hospice care was the answer for me.

I asked the hospice company to assess her, assuming they’d admit her to their service.  Wrong!  The hospice company told me she didn’t meet the strict criteria for admittance as a patient.  In one way I was glad that she didn’t qualify for hospice but, on the other hand, I was somewhat surprised and let down.  While disappointed, I learned their parameters, and also knew it was only going to be a matter of time before she would meet the criteria.  And in April of 2007, she did.

A Different Experience Due to Length of Time on Hospice

The difference between my mom’s and dad’s hospice experiences was due for the most part to the length of time they each received hospice care.  It was provided by the same hospice company, but my father was on hospice less than six months, while my mother was on hospice for approximately two years.

As a result of her extended time on hospice and her continuing decline, she utilized these additional services:

• The hospice company provided more medical equipment for my mom:  a hospital bed with an alternating pressure air mattress, a wheelchair, incontinence supplies, and a medical hoist to help the caregivers lift her from her bed to wheelchair and back again.

• The hospice company consulted with wound care specialists several times who assessed and suggested alternative treatments for the bedsores that appeared despite the excellent care she received. (Yes, bedsores can develop even when patients are very well-cared for. Read more about this subject here.)

• A dedicated hospice volunteer visited my mom once a week and helped my mom participate in arts & crafts or music as much as she could, read books to her, talked with her (even though it was pretty one-sided due to mom’s aphasia), brought flowers and little gifts, and just kept her company if she was sleeping.  These “quality time” visits were greatly appreciated by me, since I couldn’t be there every day.  The volunteer also got to know our whole family and we still are in touch months after my mom passed away.

• When my mom experienced her first ever tonic-clonic seizure, continuous care was provided by hospice for about the next 48 hours.  This means hospice staffers gave her intense around-the-clock care until she returned to “normal.”  This was only offered by hospice as a short term level of care and reevaluated each day, because it is also based on strict Medicare guidelines.

Caregivers vs. Hospice Staff in “Territorial Wars”

An interesting thing occurred during the treatment of my mom’s bedsores.  The board & care caregivers and the hospice RN’s pointed fingers at each other a few times, insinuating that it was the others’ fault that my mom’s bedsores weren’t healing quickly enough.  The caregivers felt the RN’s needed to provide more frequent wound care; while the hospice RN’s felt that the in-home caregivers didn’t turn or reposition my mom often enough since she was bedridden.  It was subtle verbal warfare that I heard both sides of.  Although it didn’t became a big brouhaha, and never went further than a few words spoken privately to me on occasion.

It’s important the staff of the board & care and the hospice nurses easily co-exist and communicate well with each other.  And they should not get into “territorial” wars over who the patient is getting “better” care from.  I knew they all wanted what was best for my mom, but they needed to stay focused on that and not start pointing fingers out of their frustrations over the bedsores.

If you notice this phenomena occurring during your loved one’s care and it’s getting to be more than you want to deal with, contact the hospice team manager and/or board & care administrator and let them get it ironed out.  With mom’s medical condition I believe her bedsores were lingering for any number of reasons, and I never blamed the caregivers nthe RN’s.  All of us were a “village” providing the best care possible for my mom.  Your family could find themselves in the middle of staff turf wars, too, over various caregiving issues, so please be aware.

More Lessons Learned from The Two Hospice Experiences

As I wrote previously, I might have interviewed other hospice companies if I had known in the beginning there were different types to choose from.  Some time after the first year of my mom’s hospice experience, I decided to interview a smaller “mom and pop” type of hospice company a close friend (who is also an RN) recommended.  One benefit was that the nurses’ caseloads with that company were  smaller, so their patients theoretically could receive more frequent or longer visits.  This benefit appealed to me and I thought over the pro’s and con’s of each company for several weeks.

I decided to stay with our original hospice company.  I didn’t want to invest the additional time and energy it would take for a whole new team of hospice workers to get to know and initiate care for my mom.  I realized no hospice company is perfect and it just didn’t seem worth it to make a change at that point.  It turns out this decision to keep the status quo was just a few months before my mom died, and that fact made it an even better decision in hindsight.

Every hospice patient and their family’s experience depends greatly on the individuals on the hospice staff.  Although the doctors, RN’s, social workers and home health aides that cared for my parents were all employed by the same company and therefore had the same goals and philosophy, they each brought their own personality and style to the job.  These can vary greatly and the patient’s family should be sure the staff’s style of communicating and caregiving match what you perceive your care recipient’s and your family’s needs are.

For example, the social worker assigned to my dad’s case was a treasure.  As I wrote in a prior post, she met me in person at the board & care several times and checked in by phone with me regularly to offer support to us on a continuing basis.  When my mom was admitted to hospice two years later, I was pleased to learn the same social worker was assigned to her case.  Later on she left the hospice company and the new hospice social worker approached her job very differently.

This new social worker never called to introduce herself nor made any contact with our family until I called the hospice company with a question that fell under her bailiwick.   She then promptly met me at my mom’s board & care and provided the needed information, but the “connection” and compassion I felt immediately from the prior social worker was missing.  Yes, she technically fulfilled her job duties by efficiently responding to my query, but that was it.  She seemed harried and her demeanor just wasn’t a good fit with mine.  If I needed more help from the social worker, I would have requested someone else on the hospice staff.  Like any paid service, we as consumers have the right to ask that our basic needs be met.

I recommend patients and their families be open to the concept of hospice care.  It is a scary word associated with death and hard to face, but it provides a positive end-of-life option.  Learn about it. Interview local hospice companies before making a decision on which one to use.  Talk with your aging parents about their end-of-life thoughts, plans and desires. Educate your whole family about this phase of life and how hospice can help manage so many facets of it.

I feel very fortunate that both of my parents were able to die with no pain, peacefully and with dignity.  I wish everyone could leave this world in that way.  Don’t you?

If you or your loved ones have had experience with hospice care, please share with us in the comment section below.

And check back soon for more articles in this series.

I could try to write a post about hospice and therapy dogs, but no words I write would come close to illustrating the intertwined human and dog worlds that are revealed in this beautiful video.

Kleenex Alert — this is sure to touch your heart!

If you have trouble viewing the video, click here.

Baxter has been referred to as the “Angel of Hospice” and the world’s greatest therapy dog and I can clearly see why.

Learn more about Baxter at his website Moments with Baxter.

Update 10/17/09: I’m sorry to have to share with you the message I found posted on Baxter’s Facebook profile today:

“Baxter, the world’s best, most devoted, and oldest therapy dog, 19 years and 6 months, eased peacefully from his life on Friday afternoon, October 16th.”

My heart goes out to Baxter’s loving family.  I am so sad, yet very glad I got to “know” him, even if from afar.  He is sure to be an inspiration to others for many years to come.

If you are concerned about seniors (or “Golden Oldies” as I call them) and their pets, here is an article I wrote about what to do if your Golden Oldies may not be able to care for their pets any longer.

This is Part 3 in a series on Hospice Care.  To read the first two parts, please click on the links under “Related Posts” below.

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To everyone in the TLeC community, have a great weekend!

On Wednesdays at TLeC I usually provide inspiring quotes, photos and/or stories for caregivers.  Today for a change of pace, I am presenting words of wisdom about aging from a 90 year old man to share with your pessimistic aging parents.  Because along with caregivers, our senior citizens (or Golden Oldies as I prefer to call them) need some uplifting thoughts to hang on to as well.

Rabbi Joshua O. Haberman delivered a candid speech in April 2009 about the pros and cons of being 90.  For starters, when a friend asked him, “How do you feel being 90?”  He replied, “Very surprised!”

Here is my summary (quoting heavily from Rabbi Haberman’s talk) giving his six reasons to look at aging in a positive way:

• First you gain tranquility.  All the important decisions have been made in earlier years. . . . I have walked the walk, had my failures and successes.  All the pressures have eased.  I am more relaxed than ever.

• Your passion cools or the doctrine of insignificance. If a matter is not truly significant or important, don’t fret, don’t worry and don’t get yourself worked up.  Ignore it!  We get less frantic, less pushy in advanced age. . . . the experience of a long life teaches us that not all problems can be solved; and certainly, not by ourselves . . . All we can do is endure.

• The third gain is ‘the art of submission.’ There are passages in life you cannot control . . . let go, accept the unalterable. . . . change your attitude. Stop fighting. Accept what must be; and strangely, this kind of surrender to the unchangeable is conducive to peace of mind.

• The fourth gift harvested in old age is liberation from the compulsion or urge of setting everyone else straight. I am no longer looking to win every argument.  The intensity of your conviction is no proof that you are right. More often than before, it occurs to me that I might be wrong, that I don’t have all the answers. I have learned to listen more and talk less.

• The fifth dividend of old age is greater appreciation and gratitude. I have become more attentive to old and new friends. More often than before I keep in touch with old friends and reach out to new, especially,  younger people. . . . Giving thanks is the most effective and harmless mood-changer — the best antidote to cynicism and pessimism. . . . I appreciate far more each day, each hour, every bit of new knowledge and every moment with people I care for.

• The sixth and most important gain is more involvement with three generations of my family — children, grandchildren and great-grandchildren. Best of all is my love affair with a married woman — Maxine, my wife; and, my severest critic and yet, unfailing support in almost sixty-five years of marriage.

In a previous post about communicating with negative-thinking seniors I raise this point:

After they’ve vented about their list of complaints, immediately say to them, “Now tell me something positive.” Some aging parents don’t know how negative they’ve become. At first they will be astonished at your request, but by repeatedly giving them this gentle reminder, they may realize they don’t want to be such negative people and start to be more positive — at least around you!

So if your parents can’t think of something positive to share, you can now hand them this article to jump start their thinking on the benefits of growing older. 

If you or your Golden Oldies have other benefits of aging to share, please add a comment below. The how-to’s for leaving comments are given here.

Outside Resources:

The New York Times, The New Old Age Blog, by Paula Span, June 22, 2009

The Dilemmas of Aging by Rabbi Joshua O. Haberman, April 3, 2009

This is Part 3 in a 3-part series.  Please click here to read Part 1 which contains the background ideas these lessons are built on. Also read my brief “Word of Warning” in Part 2 to keep from “shoulding” all over yourself and for a prior lesson in the language of dementia.

I hope you are starting to get the hang of communicating more effectively with your aging parents who have memory loss, dementia or Alzheimer’s disease (AD).  The very first step is becoming aware of what words we choose and how these words can help us reach the goal of making daily life with them as stress-free as possible.

Have you been practicing this “new language” in conversations with your Golden Oldies?  Can you see why we’ve identified some things as Don’ts because the words used can trigger anxiety and/or arguments with our care recipients? Are you starting to apply some of the Do’s that encourage peaceful and more fruitful verbal exchanges?

Remember, learning a new language takes time and repeated practice so be patient with yourselves.  Now on to a few more Do’s and Don’ts in this lesson.

Don’t Reason or Argue

It is hard to break our “normal” patterns of communication.  When someone asks you a question, you answer it logically — right?

Well, not when it comes from a memory-impaired individual.  Here’s an example:

Golden Oldie with AD: “What doctor’s appointment? I don’t need to see the doctor.  There’s nothing wrong with me.”

One response:  “You’ve been seeing Dr. So-and-So every three months for the past year. It’s on the calendar and I told you about it yesterday and this morning.”

Instant Replay:  “It’s just a regular checkup.  I’m sorry if I forgot to tell you.”

Some Do’s illustrated by the above exchange are:

• Give short, one sentence explanations.

• Accept the blame when something’s wrong in the memory-impaired person’s mind, even if it’s a fantasy.

OK, it’s true confession time again.  Here’s a conversation I had with my mom when she was in the earlier stages of AD:

Mom:  “I can’t find my purse.  Someone must have stolen it from my apartment.”

My reply:  “What?  Don’t be ridiculous, Mom!  No one has burglarized your home. You must have misplaced your purse.  Let’s look for it.”

Instant Replay:  “That’s a scary thought, Mom.  I’ll make sure the alarm is working properly.  Would you help me fold the laundry?”

The Instant Replay response (if I only knew then what I know now) is preferable because I:

• Respond to feelings (fear or anxiety), rather than the words.

• Am being reassuring and patient.

• Distract them to a different subject or activity.

Simplify, Simplify, Simplify

Open-ended questions are very hard for a memory-impaired person to process as well as reply to, and can create anxiety in them. For example:

Son:  “Dad, where should we go today?”

No response.

It is wiser to give them a simple choice between two things, or even direct their choice, such as:

Instant Replay #1:  “Dad, should we go to the park or the library today?”  OR

Instant Replay #2:  “Dad, it’s so warm and sunny outside, let’s go get some ice cream.”

Allow lots of time for comprehension; then triple it in all conversations.

Try to repeat instructions or sentences in exactly the same way.  Even changing one or two words can confuse a person with dementia.

Spouse: “Please drink your milk. (pause) You need to drink all your milk.”

Instant Replay: “Please drink your milk. (pause) Please drink your milk.”

Keep in Mind

Our goal is to keep our dementia care recipients as calm and anxiety-free as possible every day. This will help to increase their quality of life tremendously.

Memory loss progresses daily, so please do not take it personally if your care recipient speaks hurtful words to you.  Try putting yourself in their place and imagine how afraid you would feel.

Practice compassion and generosity in your words and actions daily.

How are you progressing in mastering this new language?

If you have challenges you need help with or have examples of verbal exchanges you’d like to share, please leave them in the comment section below and I’ll be sure to reply.

Outside Resource:

Compassionate Communication with the Memory Impaired by Liz Ayres

Smiles for You

Smiling is infectious; you catch it like the flu,

When someone smiled at me today, I started smiling too.

I passed around the corner and someone saw my grin

When he smiled I realized I’d passed it on to him.

I thought about that smile then I realized its worth,

A single smile, just like mine, could travel round the earth.

So, if you feel a smile begin, don’t leave it undetected

Let’s start an epidemic quick, and get the world infected!

~ Anonymous

Photo Credit: HAMED MASOUMI’s photostream

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Smile

Lyrics by John Turner and Geoffery Parsons – 1954
Music by Charles Chaplin – for silent movie “Modern Times” 1936

Smile though your heart is aching,
Smile even though it’s breaking,
Though there are clouds in the sky, you’ll get by.
If you smile through your fears and sorrows,
Smile and maybe tomorrow,
You’ll see the sun come shining through for you.

Light up your face with gladness,
Hide every trace of sadness.
Although a tear may be ever so near,
That’s the time you must keep on trying.
Smile, what’s the use of crying?
You’ll find that life is still worthwhile,
If you just smile.

Photo Credit:  Lucas Jans’ photostream

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Smiles are powerful.  Here are a few questions for you to ponder.  I’d love it if you would share your thoughts in the Comment section below. If you want to learn how to comment click here.

As family caregivers, sometimes it’s very hard to keep smiling.  Do you do so even when you’re “down in the dumps?”

Do you find smiling at people around you in your daily life helps cheer you up?

How does your care recipient respond to your smiles?

How do you feel when your care recipient smiles at you?

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Everyone needs smiles.  Please pass this along to someone you know who can use a smile today!