Name that NOUN

Have you ever been in the middle of a conversation with someone and blanked on a person’s name or the name of a place or thing? It seems to be a common occurrence among older adults.

For example, I recently heard a story about a lady who had just received an annual delivery of salmon filets. She was relieved to see that each fish was intact, as the prior year’s shipment had some fillets with chunks cut out due to sea lions attacking and biting the salmon in the nets. While telling a friend how happy she was to get the fish in such good condition this year, her friend asked what had happened to them the year before. As she began to reply, she blanked on the word ‘sea lions’. So instead she said, “They were bitten by ground squirrels.finishing-well-in-life-squirrel1

I can relate.

The significant difference between normal lapses – such as forgetting someone’s name and worrisome memory loss is determined by the impact it has on your ability to function—your ability to do the things you want to do.

Normal age-related forgetfulness

According to helpguide.org, the following types of memory lapses are normal among older adults and generally are not considered warning signs of dementia:

  • Occasionally forgetting where you left things you use regularly, such as glasses or keys.

  • Forgetting names of acquaintances or blocking one memory with a similar one, such as calling a grandson by your son’s name.

  • Occasionally forgetting an appointment.

  • Having trouble remembering what you’ve just read, or the details of a conversation.

  • Walking into a room and forgetting why you entered.

  • Becoming easily distracted.

  • Not quite being able to retrieve information you have “on the tip of your tongue.”

On a good note, it turns out that our brains seem to be capable of producing new cells at any age, so just as physical exercise helps strengthen muscles, there are a variety of ways to strengthen our brains to improve cognitive skills as well as prevent memory loss.

My sister and I have developed our own test for determining whether or not a lapse indicates normal forgetfulness, or impending dementia. (Although we don’t remember ever forgetting anything.)

It’s okay to forget where your keys are, it’s not okay to forget what your keys do.”

So remember, although frustrating, most age-related memory lapses
finishing-well-in-life-squirrel2 are not the same as dementia. I’ve decided that the next time I can’t remember what to call a particular noun, I believe will call it a 
ground squirrel’.

Laughter…..

The onset of dementia brought about a surprising change in Mama. She developed a love for slapstick comedy.  My genteel Mama who had always loved Broadway shows and Classical music suddenly enjoyed watching someone get a pie in the face. Of course, the masters of slapstick themselves, the “Three Stooges” zoomed to the top of our movie stack.

There is one particularly entertaining scene where one of them is playing a violin and the bow keeps catching on the toupee of the guy standing next to him.  That particular bit caused Mama to almost roar with laughter. So, of course we played it over and over. And over. It was ALWAYS a surprise to her when the wig came off and she loved it. We loved watching her laugh and be happy.

We also began watching “Laurel and Hardy” as well as “Shirley Temple”. The nice thing about slapstick is that it is a sudden action that doesn’t have to be explained.

When Mama watched her funny movies, it lightened her mood and the rest of the evening usually went smoother. It seems that the saying is true, “If Mama’s happy, everyone is happy”.

The Bible tells us in Proverbs “A joyful heart is good medicine” Laughter may be especially good medicine for dementia patients – and best of all, it doesn’t have any unpleasant side effects.

A recent ‘SMILE Study’   conducted by the University of New South Wales in Sydney, Australia appears to agree. They used humor therapy on 400 residents at 36 different nursing homes to discover whether humor could improve the lives of people living with dementia. The results showed a 20 per cent reduction in agitated behavior such as aggression, wandering, screaming and repetitive actions.

Even Shakespeare recognized the value in growing older with joy. In “The Merchant of Venice”, he wrote: “With mirth and laughter let old wrinkles come.”

Some of the well-known Benefits of laughter include:

  • Lower stress hormones
  • Ease of anxiety and fear
  • Easing tension and lightening the mood
  • Strengthened lungs/immune system
  • Increase in social interaction

Find ways to laugh. Be silly, make silly faces or even pretend to laugh-which at times can be enough to prime the laughter pump.

Watch funny movies and read books that are humorous and take your mind off the situation. Mama also loved looking at a directory we happened to have that contained some faces with funny expressions.

Dementia is no laughing matter, but both caregivers and patients will fare much better if we remember to laugh. Find a way, seize a moment, and laugh every single day.

How has laughter benefited you or your loved one with dementia? Share your story about how laughter has made a difference.

Only the Lonely

I was visiting with a friend today. It turns out that his dad has dementia, and he was grieving about a very painful part of reality called loneliness when it comes to folks afflicted with this condition. Not only is it “The long goodbye”, but too often it also a “Journey of lonesomeness”.

Unfortunately, their forgetfulness tends to cause friends and family to forget about them. Not in the cold, unfeeling or hateful way. No! Rather in more of the “I don’t know what to sayway, or the “Why go? They won’t even know I’m thereway, or the “It’s too sad or depressing to see them in that situationway.

My heartbroken friend went on to say that it didn’t seem to matter what his father had achieved or accomplished, who he’d helped or the man he was, once dementia crept in and took over everything changed. Colleagues, friends, and even family began to avoid him.

He’s not the only one who has mentioned it. It seems to be a common complaint among caregivers.  At times, those who care for others begin to feel that they alone are shouldering the burden of care. Why is that?

I believe it’s because folks might feel unqualified, uncertain or afraid they might say the wrong thing. People honestly don’t know what to say. Or if their person is suffering from dementia, they won’t remember the visit. And, it can be a sad thing to see someone who was once vibrant and full of life to become frail and feeble.

Perhaps what is needed is a bit of coaching ahead of time to help folks know all that’s really needed is a smile, a touch, and a kind voice.

It really doesn’t matter what you say. Simply entering the room with a smile and taking their hand can create a connection. As far as what to say, try reciting scripture, reading poetry or the newspaper. Perhaps picking up a novel you were interested in and reading a few chapters each visit. Sing a few songs or use  youtube.com  on your phone/tablet to play some songs from when they were younger.

If eating is allowed, bring a special treat (definitely check with the caregiver first).  Allow your person to live in the past if that is where they are. A story listened to even if it’s repeated over and over can be considered conversation.

Yes, it can be depressing to see someone in that setting, but perhaps your visit can bring a bit of joy and create a connection that may just improve the quality of life for both of you.

Please share any other helpful tools and tips can be offered to those who have found themselves avoiding visits.

Managing Medications

Does your loved one take medications? A lot of them? This post just might help make it a bit more manageable

In my research for ‘all things dementia’, I came across the following site:  Managing Medications for People with Dementia  dementiameds.com

It is UK based, so some of the information might not apply, but there are quite a few great tips on how to manage the vast volumes of medications that some of our loved ones have to take.

When I was managing my Mama’s multitudes of meds, it was overwhelming at times. My sister created a fabulous Excel doc that charted all the information regarding each medication. Among other things, it included the frequency, the dose, when it was last ordered, the RX number and even price.  In spite of all the finger pokes, injections and pills (oh my), Mama remained fairly agreeable.

Mama’s general cooperation was something I was always very thankful for as I knew some had outright fights on their hands at times to give their loved-ones all the meds they needed. Even so, it was a challenge at times to get everything just right.

If you are on medication overload, check out this site and glean all the useful/helpful tidbits that can make meds aspect of caregiving a bit more manageable.

Please share any tips you have come across while attempting to conquer the medicine mountain.

The Visitor

I recognize the sound of her footsteps in the hallway. Is she going to visit me? She’s here!  I have to try to open my eyes or she’ll think I’m asleep.

“Hi Mama”, she says with a bright smile. I wish I could respond to her greeting. She’s placing her hand under my chin, and turning my head a little so I can look at her. Oh! I think I smiled!

She begins the visit with her usual question “How are you feeling today?”  How I wish I could tell her this time…I just don’t know how.

I try to reach out to her, but my hands won’t obey. They feel as if they are glued into a fist. I’ve been holding tightly to something, but I can’t remember what it is anymore, and can’t let go. Somehow my fingers have forgotten how to unfold. “What are you holding onto, Mama?” She asks as she slowly opens my hand. It takes a while and it feels a bit uncomfortable, but I love how she holds my hand and rubs my fingers as she talks to me.

Yikes! She always seems to think it’s necessary to tickle my feet.  I wish I could move my feet to let her know I can feel it….oh well. I grimaced. At least I think I grimaced.

“Do you want to sing with me?” she asks. Yes! She’s singing my favorite song, “My wild Irish rose”. I want to sing too! I try, but my mouth doesn’t work right. I think she sees me trying because she is beginning again.

Am I singing now? I think I am…but it’s so hard to tell. She asks me again, “Come on, Mama, sing with me.” I must not be. She looks at me with anxious eyes; I desperately wish I could make my mouth work! Another song? I’m glad she doesn’t give up. I’m trying – really I am. I love listening to her sing; I wish she could know how loud I am singing on the inside.

My mouth is so dry that it doesn’t want to work right. I’ll try to tell her I’m thirsty. Oh, what’s this, grape juice? Maybe she understood. Yuck! It tastes so blah. She seems to think it’s my favorite. Okay, I’ll drink it. I think I’m drinking.  Wow, something cold is running down my neck – maybe it’s the juice.

Oh yeah, I need remember to swallow. Swallow, swallow, swallow – that’s better. Is it all gone? I think so! I guess I feel a bit better, but I wish I could tell her that grape is not my favorite.

Oh no, here comes the wet washcloth. I don’t like this part. She wipes with it all over my face; eyes, nose, mouth – even my neck where the juice was cold. Now comes the lipstick. It’s such a pretty color. Oh good, she’s putting it on me! I hope I look nice.

Now she’s praying. I love it when she prays for me. She says the words that I wish I could say out loud to God. I can feel God’s presence, I wonder if she notices? What’s this? Am I crying? It’s so hard to tell…

All done – she’s getting ready to leave, “Bye Mama”, she says. “I’ll see you when I come back.”Oh, how I hate to see her leave! I hope she’ll be back again soon.

Hmmm, I wonder who she is?

Listen Up

Listening is essential. Your loved one may be trying to tell you something.

The initial awareness of dementia brings to mind several concerns and fears both spoken and unspoken. Some are deep-seated and unconscious and others are at the surface. Not everyone is comfortable voicing their worries. Body language speaks volumes.  As soon as you become aware of an issue, listen purposefully for both the verbal and non-verbal messages.

When my Mama was at the beginning of her journey through dementia, she was able to talk. Even then, her thoughts and ideas were distorted by what we referred to as her “loop”. It was a statement that she grabbed onto and repeated over and over with increasing frequency as time went on. The “loop” eventually pushed out any other form of conversation.

Later, she began living in a world that was rather finishing-well-in-life-listendisconnected to reality. She would speak, but it wasn’t in a conversation manor – it was more like a series of statements that didn’t flow with the rest of the conversation. The loop was gone, but it was as if her words came from some automatic speech response area of her brain. For example, if you asked her how she was, she would reply, “I’m fine.” even when she clearly wasn’t. Or, if she was asked a ‘yes’ or ‘no’ question, she would reply, “Oh yes” the majority of the time.

As time when on, and her speech became even more limited, I relied on observations. Indicators such as wide swings in her blood sugar levels told me she wasn’t feeling well even when there was no fever.

Sudden agitation was also often an indicator of pain. If she said something over and over that didn’t make sense, and there wasn’t anything obviously wrong, I would try offering her a drink of water or a snack.

Now that Mama is nearing the end of her earthly journey. She now communicates with me with her eyes. They look at me when I smile and fill with tears when I sing.

At some point, your loved one’s ability to express thoughts and feelings with words may no longer be an option. Thankfully, words are not the only form of communication.

I believe there is an enduring willingness for our loved ones to communicate. Dementia creates a barrier to getting the message out.

Somewhere deep inside there seems to be a part that is aware, on some level what is going on around them. Listen. What do you see?

What non-verbal statements have you heard?