Sunday, July 15, 2012

Seeing the 'Whole Person' in people with Dementia

This article offers a great and positive ways of viewing your loved one with Alzheimer and see them as a ‘whole person’ and not someone with diseased brain. Seeing them as a whole person gives us the chance to relate to them in other ways than just through their brain, we can communicate through their senses (touch) and through their emotions like their warmth, friendliness, love… Alzheimer person may not remember names and faces but they remember warm touch, caring attitude, loving interaction, positive surroundings, enjoyable routine… We can think of our loved one having attributes to relate to and when we communicate with them with other alternative ways, we are confirming their wholeness as an individual thereby counteracting automatic loss of their self-esteem. This writer articulated that this can be the start of togetherness and good feelings between the person with dementia and the caregiver (family member).

Seeing the Whole Person with Dementia 

When you look for alternative ways to communicate with a person who is deeply forgetful, you are in effect confirming their wholeness as a individual, and counteracting the automatic loss of self esteem one suffers when one see’s oneself as "less than" others.

By Carole B. Larkin
Alzheimer's Reading Room

“Guess what -- you are not your brain. You may think you're your brain. You're not your brain just as much as you're not your stomach.

When you're hungry, you feel hunger in your stomach and you say, "I need to eat."”

This quote of Dr. Rudy Tanzi’s from the article
“What is the Relationship between the Brain and the Soul?”
struck a chord with in me.

I don’t know about you, but when I’m in the dentist’s chair and they are doing something in my mouth (cleaning the
, putting on a crown, etc…) the rest of my body seems to melt away and I feel that all there is to me is my teeth. That’s my whole focus at that moment probably because it’s the dentist’s whole focus at the moment.

The same thing happens at my gynecologists office (you know what I mean ladies!) I mean, intellectually I know that there is more to me than just the area that’s being concentrated on, but it feels like I’m really nothing but a big xxx (fill in the body part as you need to).

In Alzheimer’s and other dementias the body part under examination is our brain.

Now, intellectually we know that our brain controls everything in our body. Right? That’s where Dr. Tanzi’s statement “You may think you’re your brain” relates.

If you think that all there is to you is your brain, with Alzheimer’s or another dementia all you can see is “LOSS” in yourself or in the person you are caring for. Immediately you are mired in the negative mindset, which will eventually lead you to negative emotions such as anger and frustration.

As a caregiver negative emotions in relation to the person with the disease will be telegraphed to them, and they will mirror your negative emotions back to you. Now you are caught up in the downward spiral of pain and resentment which eventually will land both you and your loved one in the mental sewer of life. Phew! That Stinks!

Conversely, if you view yourself or the person with Alzheimer’s or another dementia as MORE THAN just your brain than you can begin to think in terms other than “LOSS”.

You can think of the person having other attributes to relate to, other than just memory or thought process. That opens up the door to more POSITIVE ways of viewing your loved one and brings more opportunities to see them as a whole person.

Seeing them as a whole person with a disease affecting one part of their body (the brain) is completely opposite of seeing them as a disease with a person attached to the disease, as sort of an afterthought.

Viewing them as a whole person gives you the chance to relate to them in other ways than just through their brain (logic, reason, memory, etc…) you can communicate through their senses (touch) and through their emotions (warmth, friendliness, love, etc…).

When you look for alternative ways to communicate with them, you are in effect confirming their wholeness as a individual, and counteracting the automatic loss of self esteem one suffers when one see’s oneself as “less than” others. That is the
of an upward spiral of togetherness and good feelings between the person with dementia and you (the caregiver).

You as caregiver have the tools to change your view of the person with dementia by practicing seeing them as a whole person, not just as a diseased brain.

I believe Bob refers to this by using the term “more there”. Judy Berry and Richard Taylor refer to this in their writings as well. Finding and practicing using this view of the person will inevitably result in more happy moments for both of you.

Monday, July 9, 2012

Why hire a Caregiver directly...?

Why hire a caregiver directly and get all the problems of checking reference and criminal background yourself, compute deductions for state & federal taxes, look for a reliever when your caregiver does not show up, handle their workers compensation & run the risk of getting sued if they hurt themselves, interview 5-10 applicants & check their employment background, handle caregivers by yourself without any help…?

Or just hire Caregiver Services & Homecare Inc. ( and get all the benefit of hiring a professional caregiver service and still spend almost the same budget every month & save a lot of money & time on a long term. Have ‘Peace of Mind’, call 805-338-8100 / 310-779-6254 / 562-412-2420 / 213-351-9100 and have the best caregivers take care of your family member with proven and success record in the senior community for 10 years.

Sunday, July 8, 2012

Does Alzheimer's disease lead to incontinence?

RLC looks forward to this research study that would provide some answers whether Alzheimer’s disease causes incontinence. Enabling the family members to understand the disease further and care for their loved ones may help Federal Medicare program to reduce the $200 billion a year cost on managing the disease. Urinary incontinence, common in Alzheimer's patients, often influences families into sending their loved ones into a nursing home. See article below and let’s await its forthcoming results.

Does Alzheimer's disease lead to incontinence? Roughly 53 percent of Alzheimer's patients suffer from incontinence.

Alzheimer's Reading Room

By Karen Rose

Urinary incontinence often leads to urinary tract infections. Infections hasten memory loss, and lead to agitation and moodiness. This increases the burden on both the Alzheimer's caregiver and the Alzheimer's patient.

Is urinary incontinence a part of Alzheimer's disease? Does urinary incontinence cause mood swings and agitation? What can be done about it?

study described below could provide answers to these questions.

U.Va. Nursing Professor To Study Link Between Alzheimer's, Incontinence

Does Alzheimer's disease lead to incontinence? Not necessarily, asserts a University of Virginia researcher.

A new $428,269 grant from the National Institutes of Health will help School of Nursing professor Karen Rose determine whether people living with Alzheimer's are incontinent because of the disease, or whether their incontinence and nighttime agitation – common symptoms of the progressive brain disease – are connected and might be, therefore, better and more thoughtfully managed.

"People assume that incontinence is part of the disease, that 'that's the way it goes,' but that may not be, in fact, true," said Rose, who will lead the two-year study. "The answer isn't necessarily just putting a diaper on someone."

Between 70 percent and 90 percent of those living with Alzheimer's are cared for by family members in their homes, and many who are treated for agitation – another common occurrence among this population – are given sedating medication which may have an effect on their continence. Roughly 53 percent of Alzheimer's patients suffer from incontinence, Rose said.

Nearly 5.5 million Americans, including one in eight people 65 and older, are living with the degenerative brain disease, which robs victims of
memory, cognitive function and physical control.

Urinary incontinence, common in Alzheimer's patients, often means families feel cornered into sending their loved ones into a nursing home. The study's goal, Rose said, is to offer solutions to families caring for their loved ones.

"It's very intimate, very personal, these things," Rose said, "and it can be a tipping point for institutionalization."

Rose, along with U.Va. School of Engineering and Applied Science colleagues and professors John Stankovic and John Lach, and collaborator Janet Specht from the University of Iowa, will study a group of 50 local individuals with Alzheimer's who are at least 65 years old who receive care at U.Va.'s Memory and Aging Care Clinic.

Those with Alzheimer's will wear a wrist actigraph at night – a device created by Lach and Stankovic that measures physical movement and agitation – and will sleep on beds with wetness sensors. They will also be recorded for verbal agitation between the nighttime hours of 9 p.m. and 7 a.m.

Data will be collected over five days and nights, and tabulated to see whether physical and verbal agitation precedes bed-wetting and whether there are timing issues to consider – whether a person is incontinent early in the evening or in the morning, for example – that might help families better keep ahead of the problem.

Rose said the study could ultimately inform the way families manage incontinence by offering a template for home study of Alzheimer's patients and their continence patterns.

Enabling more people with this disease to be cared for by their families will, she said, help to lessen the strain on the already overtaxed federal Medicare program, which currently spends some $200 billion a year on managing the disease. The amount is expected to exceed $1 trillion by 2050.

"From a financial perspective, this disease is set to break the bank for Medicare, so figuring out how to keep people at home longer helps all around," Rose said. "And most importantly, people want to stay home, be cared for by their families."

She said her study will bring a difficult topic better into the light.

"There's a stigma attached to all of this – the disease, the incontinence, the burden on families," Rose said. "But we still don't know whether some very basic things are linked. We don't know that urinary incontinence is just part of the disease. Are they agitated because they're incontinent? Are there things we can do to relieve that?"

Rose, an associate professor of nursing and director of the Bachelor of Science in Nursing program, has taught acute and specialty care courses at the school since 2006.

Friday, July 6, 2012

How to Hire a Caregiver for an Elderly Parent...

How to Hire a Caregiver for an Elderly Parent...

As your parents age, they may need some assistance with personal care or household chores. If you are trying to balance a job and other family responsibilities, You may need assistance taking care of an elderly parent. Hiring someone to come into the house/home and be a caregiver is one option.


• Determine what your parent’s needs are. Some elderly people may need help with cooking meals, doing errands or other housework. Be clear on your expectations of a caregiver before you hire one.• Consider gender. If your elderly parent is modest and personal care duties are needed, consider hiring the same gender as your parent. This will make your parent feel more comfortable.

• Contact Home Care Agencies which will provide caregivers. Keep in mind that hiring a caregiver through an agency will have more advantages over hiring a caregiver yourself. Caregivers from an agency are usually pre-screened, have a criminal background checked and are bonded.

• Interview the potential caregiver with you parent present. Depending on your parent’s medical condition, she may be able to participate in the interview. Encourage your parent to ask questions.

• Look for specific qualifications as needed. For example, if lifting will be part of the duties. If your parent has Dementia, Alzheimer etc., look for a caregiver who has the knowledge and experience with this case.

Ask for CPR and first aid certifications.

• Check references. Ask each potential caregiver for at least 2 references.

• Pay competitive rates. Once you found a caregiver who is dependable, caring and your parent wants, do your best to keep him/her. Determine going rates for caregivers for the elderly in your area.

Consider paying a bit more. Let your caregiver know that his / her work is appreciated.


Thursday, July 5, 2012

Senior Care at its best...

Caregiver Services at its best! Caring endlessly with a compassionate heart…

Video featured, click & watch..

Tuesday, July 3, 2012

How Alzheimer's Destroy the Brain (video)

RLC writes:

CSHI’s Continuing Health Education Program would like to share a video on how Alzheimer’s disease destroy the brain. This was written & directed by Dr. David Shenk, author of “The Forgetting”.

How Alzheimer's Destroys the Brain –Video (click & watch)

Sunday, July 1, 2012


CSHI Case Management department would like to share a great story of a person diagnosed with Alzheimer’s disease and how it has given him Direction and Purpose in life. He had been advocating that awareness about the disease can benefit the whole family involved. Lee Sneller is now an Alzheimer’s Ambassador, volunteer and an advocate of strong belief that “There is life after a diagnosis of Alzheimer’s Disease”.  


By Lee and Pat Sneller

LEE: Hello, we’re Lee and Pat Sneller.

I was initially diagnosed in 2005 with Mild Cognitive Impairment. We received the word that I have Alzheimer’s Disease in 2009. Not a day I’ll easily forget!

Here we were, both enrolled in
clinical trials as healthy volunteers, and we’re told less than a third
of the way through the testing that I have Alzheimer’s.

I don’t think I’ll ever forget the impact of that announcement – out of the blue – completely not expecting it – I was devastated.

Before February 6, 2009, I was Lee Sneller, father, husband, businessman, son.

After February 6th, I became Lee Sneller who has Alzheimer’s.

It became an identifier, whether I liked it or not.

PAT: And Lee wasn’t the only one impacted. Learning news like this is like throwing a boulder into a pond – the ripples are immediate and powerful.

We both felt like we’d been punched in the stomach, it left us breathless – shocked – in disbelief. And devastated.

Because, we knew already that Alzheimer’s disease is not curable, can’t be delayed, and can’t even be stopped. The diagnosis happened to both of us, not just Lee.

We have been married for 46 years. I’m here to tell you, when you’re married, you forge a partnership of equals who work to make the best versions of ourselves. For better, for worse…

Alzheimer’s is now a part of both our lives.

It isn’t OK that my wife worries about me, and that my kids worry about me. Heck, I worry about me! It’s not good that at the age of 71, when I should be thinking about traveling and playing with my grandchildren, Pat and I are worrying about the next drug therapies and insurance claims and deductibles.

However, I decided to accept the changes in my life because I refuse to lose myself in grief and anger. I choose not to waste one moment of my life.

Don’t think that I accepted this diagnosis over night, because I didn’t – I had to learn to accept what has happened. But I’m NOT hiding any more.

I am learning as much as I can about the disease. For example, I decided to join an early Alzheimer’s support group called the Trailblazers, sponsored by the Alzheimer’s Association and this has helped me grow strong to meet the challenges I now face. I CHOOSE ACTION.

PAT: The Trailblazers support system also is for caregivers, so I, too, have a voice there. It has been extremely helpful to meet with other couples who are traveling this same road .

The group has allowed both Lee and I to learn from others, share our own experiences, and have the opportunity to speak with family caregivers in the community and professionals like you. We appreciate Carole Larkin’s invitation to speak with you today!

One question that Carole asked us to address with you is, “What kinds of routines have proved helpful so far?”

You may have heard that routines are good for people with Alzheimer’s, and I think that’s very true. Knowing what to expect during the course of a day adds a layer of comfort and security that allows me to function better.

For example, when I get up every morning, I go outside to retrieve the newspapers. Both Pat and I enjoy reading about the community and current events. Sometimes she will have questions for me about something I read, and this helps me focus and work harder to remember. We have always enjoyed a good give and take, and we see no reason to stop now.

I make my own breakfast and lunch – Pat teases me that I always make the same thing for these meals – but, what can I say, I’m an engineer, I like things to be the same!

After my shower, I like to go for a walk down the street around a pond that’s nearby. I treasure hearing the birds, feeling the sun on my skin, and interacting with nature. It’s a brisk walk that gives me some exercise and stimulation. I always carry my cell phone so I can call Pat if I need her; sometimes, SHE calls ME because I don’t return on time. Usually, I get sidetracked by visiting with neighbors on the way. Computers are still central to my life, and I frequently check messages. I have found that I can’t do two things at once, the way I used to – if I’m on the computer, it’s time to turn the radio or TV off. I still have a lot of email friends, whom I talk to a lot.

After lunch, I may doze off for a catnap – keep in mind, I DON’T take naps! – then I work crossword puzzles and spend more time on the computer. I actually don’t watch TV during the day.

PAT: Lee does a great job staying engaged with life. As a businessman, he always mentored people. He continues that today by coaching people who have their own small business or those who want to start a business. As a SCORE volunteer, he works as a counselor to provide guidance and advice. SCORE stands for: Service Corps of Retired Executives. It is an agency of the Small Business Administration. Lee meets with clients every week in the Flower Mound Chamber of Commerce offices. He also helps to organize monthly meetings, sends out emails, collects RSVPs, and helps the chapter stay on top of things. He does have some problems with this occasionally, sometimes forgetting to add something to a communication. He has decided to ask someone to review the emails before he sends them out so that he can continue to fill this role.

He finds this responsibility very satisfying, since it speaks to his strengths in organization.

Lee also enjoys playing solitaire on the computer – which, by the way, I also find very addicting! He is good about identifying his own frustration when a task becomes challenging. He is able to shift gears and work on something else when necessary, and can then return to the task once he’s taken a break. 

Right now he’s working on a really difficult DVD classification system for our collection of over 500 movies – it’s such a monster of a task that we may both need help to get it solved.

LEE: I would rather do it myself!
But Pat is great about understanding that I need to do things on my own, and she wants me to do as much for myself as I possibly can.

Carole also wanted to know if we had made any changes to our diet and exercise. We had already determined that we wanted to be healthier, but we’re doing even more now to take care of ourselves. We prefer our meals to be baked, broiled or grilled – we don’t like fried foods. We are eating more fish these days, and taking extra supplements for omega 3 oils and Vitamin D. In addition, we don’t eat much sugar, and we do each have one glass of red wine with dinner for the antioxidants.

Lee used to have high cholesterol, but in the last several years his numbers have improved and he needs only a very low dose of a statin drug to keep everything on target. From a medical standpoint, Lee remains on Namenda and Aricept, and he feels these have helped him.

LEE: Changing directions for a moment…you may be wondering what kinds of changes we may have noticed so far during the disease process. That’s a little hard to answer, as I originally was diagnosed with mild cognitive impairment – I’m not quite sure when the Alzheimer’s disease became predominant. However, I can give a concrete example.

I still have a group of friends in the neighborhood called the “Geezers”. We go out for lunch once a week at different restaurants. I’ve noticed since my diagnosis that I have more trouble reading a menu – it’s like there are too many choices, which are confusing. My friends know I have some trouble with this, so one of them generally helps me go over the menu and make a choice.

Also, I have trouble calculating a tip now. It used to be, I could do any math problem you can think of in my head – but now, math is an abstract that is very difficult to understand. So, my friends help me out with that, too. Pat and I decided I should just take cash, not a credit card, and it seems to work out fine that way.

I also have trouble with a cell phone these days. It’s harder to remember numbers, so that’s an issue. But I still carry one, so Pat can call me even if I don’t remember how to call her.

I don’t drive any more. Both Pat and I felt that it would be safer for her to drive, or have one of my friends drive when I need to get somewhere. Sure, it can be frustrating, especially when I want to get somewhere in a hurry. It’s also upsetting sometimes to remember that I can’t just go somewhere when I want to – I have to wait until a ride is available. Pat and my friends are great at understanding this and trying their best to take me wherever I want to go, whenever they can.

Other changes – well, Lee is having more difficulty with word finding. Sometimes he’s able to count to 5, and the word will come. It may be less a matter of memory, and more that it’s taking longer for Lee to process incoming information. He eventually gets there, but it takes longer.

What he mentioned, about being able to calculate tips – the problem is more extensive than that. He actually cannot use a calculator any more. All we can think is that his ability to utilize abstract reasoning is now being affected by the disease.

We know there are eight components of cognition, as taught in The Savvy Caregiver class which
the Alzheimer’s Association offers:

·         Memory – the capacity that links the present to the past and provides a sense of connection and continuity to life

·         Language – an essential capacity for communication, both expressed and received

Abstraction – the power of thought that allows us to consider the world in non-material, non-concrete terms

·         Organization – understanding relationships between steps which leads to a desired outcome Reasoning – connecting thoughts, objects, events and actions Perception – receiving and interpreting information through one’s senses

·         Attention – the filter we use to make choices among all the competing stiumuli in our lives

·         Judgment – the capacity that allows us to think, abstractly, about a range of possibilities, assess them in terms of our values and the potential outcomes, and make choices that are to our best advantage.

Of these, Lee is having a little trouble with language and attention; a fair amount with abstract thinking; and a moderate amount of difficulty with memory.

His strengths include reasoning, perception, judgment, and organization.

Lee understands what is going on in his environment and within his relationships, and he’s still very much HERE.

LEE: You should be aware that Alzheimer’s disease doesn’t affect everyone the same way. As the saying goes, “If you know one person with Alzheimer’s, you know one person with Alzheimer’s.”

For me, I first became aware of issues when I realized I wasn’t always remembering everything that had happened recently.

The others with Alzheimer’s that I’ve met through Trailblazers are all unique individuals.

Each one has his or her own set of strengths and weaknesses, and they learn to compensate differently.

With Pat’s help, I’ve learned how to compensate to some extent.

Probably the biggest thing I worry about since I’ve received the diagnosis is, What does the future hold? Will I know how to compensate? My own feelings about the disease are largely positive, because I’ve chosen to take charge where I can.

I want to focus on the good things in my life, not because I’m in denial, but because I recognize that life still holds much that is good and worthwhile.

If I had to boil my feelings down to two points, they would be:

I do not want to be a burden to my family I want to be the best that I can be – for as long as I can--and I accept that as MY responsibility.

PAT: My feelings about Alzheimer’s a little different at this point. Of course I support Lee and his vision, and I’ll continue to do so.

I see, looking back, that Lee’s having Alzheimer’s disease has forced me to become someone who DOES, rather than someone who OBSERVES.

I’ve had to learn about goals and objectives and strategies, because this disease has forced me to.

If nothing else, Alzheimer’s disease has given me DIRECTION and PURPOSE. Besides trying to learn as much about this disease as I can, we both volunteer at the Alzheimer’s Association, Greater Dallas Chapter to help make a difference.

Here’s what we want people to know:

Knowing what Alzheimer’s disease is makes a difference. Learning how to help our loved ones makes caregiving easier. Advocating for all those affected by Alzheimer’s disease gives us all a voice. Helping to raise awareness benefits us all.