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. It is important to listen.

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.

Listen with your whole being. Smile, make eye contact, and lean in to catch each nuance.
Listen with your whole being. Smile, make eye contact, and lean in to catch each nuance.

Later, she began living in a world that was rather disconnected to reality. She would speak, but it wasn’t in a conversation manner – 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?

Sing, sing, singing the blues away

Are you feeling blue? Overwhelmed? Take heart – or take up singing.

The almost magical affect music has on those suffering from dementia are well established, but what about those who care for them?

Here’s some good news: I just read about a study that showed a wonderful side-benefit to music therapy. It seems that it does more than enhance the quality of life of dementia patients – it also appears to improve the mood and emotions of caregivers.

Another surprise, according to this five-month study conducted in the UK, was that the benefit lasted well after the trial ended, measurements taken two months later showing continued improvement.

Music is the language of the soul. It appears to enter the brain differently than words alone or other noise. To gain the most benefit from musical therapy, it is important to be engaged in the music somehow, rather than just having it play in the background.

A few ways to really engage are:

Singing, humming or whistling is the best way to connect to the music. Also, the use of headphones can be helpful as well as viewing a music video. The most effective songs seem to be the tunes from a persons ‘formative years’. For my Mama, who was born in 1931, the top hits of the 1940s as well as hymns had the most impact on her. A variety of online sites such as www.youtube.com  can provide easy access to a variety of music videos.

Not sure what music is best? Try a song and watch for a positive reaction. Develop a playlist. If it turns out that the list is short, it is okay. If someone has dementia, songs can be played over and over again as long as they are helpful to the listener.

Have you noticed this to be true in your experience?

For Want of a Word

While feeding Mama her thickened juice today, I suddenly wanted to hear her voice. I wanted her to say something—anything. It has been several months since she has uttered a single word.

I even tried to ask her some easy ‘yes’ questions to try to see if she would give me one of those automatic responses. With a smile, I words-finishing-well-in-lifelooked into her eyes and asked, “Do you like your juice? Is it tasty? Would you like some more?”

She tried to answer. I could tell by the almost imperceptible movement of her lips as well as the sweet expression on her face that she really wanted to say something. She looked at me intently as I continued to ask her questions. I finally gave up and began singing to her as she finished up her juice.

I got to thinking about words. Words are great. Words hold so much power—so much potential for both good and evil. Kind words are gifts we can give each other; to our spouses, family and friends.

Proverbs 25:11 states, “The right word at the right time is like a custom-made piece of jewelry,” (The Message Bible)

On the other hand, words that are wanted, but not received are heartbreaking. I wish I had a recording of Mama’s voice from when she could talk. But though I don’t have her voice, I still have her and I give her the gift of hearing my voice as often as I am able.

Later, as I was thinking about it, the words to an old nursery rhyme floated through my head:

For want of a nail the shoe was lost.
For want of a shoe the horse was lost.
For want of a horse the rider was lost.
For want of a rider the battle was lost.
For want of a battle the kingdom was lost.
And all for the want of a horseshoe nail.

Words are like that nail. They are building blocks of both relationships and memories. They can bring joy, provide hope and offer second chances. We would all benefit from a ‘word at the right time’.

Instead of a nail, the rhyme could be rephrased:

For want of a word the joy was lost
For want of a joy the chance was lost
For want of a chance the time was lost
For want of a time the hope was lost
For want of a hope the memory was lost
All for the want of a word

With the prevalence of phones, tablets and computers we can instantly give timely and thoughtful words to anyone we know, no matter where they are in the world.

Is there someone who needs to hear your voice today?

Jingles

 

  • “I am stuck on Band-Aid brand, cause band aid’s stuck on me.”
  • “Oh, I’d love to be an Oscar Meyer wiener, that is what I’d truly like to be, cause if I were an Oscar Meyer wiener, everyone would be in love with me.”
  • “In the valley of the jolly-ho, ho, ho. Green Giant”radio-finishing-well-in-life
  • “Like a good neighbor, State Farm is there.”
  • “I’d like to teach the world to sing in perfect harmony, I’d like to buy the world a Coke and keep it company. It’s the real thing.”
  • “Wouldn’t you like to be a Pepper too?”
  • “My bologna has a first name, its O-S-C-A-R, my bologna has a second name it’s M-E-Y-E-R, I love to eat it every day and if you ask me why I’d say, cause Oscar Meyer has a way with B-O-L-O-G-N-A.”

Are these jingles ringing any bells? Any get stuck in your head? That’s exactly what they were designed to do.

According to Wikipedia: A jingle is a short tune used in advertising and for other commercial uses. The jingle contains one or more hooks and meaning that explicitly promote the product being advertised, usually through the use of one or more advertising slogans.  Jingles are a form of sound branding.

Was your loved one raised on radio? Or TV? It’s likely that some of the  jingles and theme songs played regularly on radio and television shows will be more than memorable. And anything that stirs a memory is helpful to activate something wonderful and pleasant inside your person.

Some of the older radio show theme songs are: The Lone Ranger, The Green Hornet, Turn your Radio On, Yukon King, NBC News and Bill Stern Sports Newsreel.

TV show theme songs such as Mr. Ed, Rawhide, Bonanza,  The Beverly Hillbillies and, of course, the very memorable I Love Lucy show may also stir something up.

These old tunes had a profound effect on people, and with a little effort and computer time you can easily discover just  the right ones from your loved one’s earlier years. Many are free to download for you to create a play list that might just awaken a memory or two.

Here’s a few more for the road…

  • “Plop, plop, fizz, fizz, oh what a relief it is.”
  • Once upon a time there was an engineer. Choo Choo Charlie was his name, we hear. He had an engine and he sure had fun. He used Good & Plenty candy to make his train run.
  • See the USA in your Chevrolet, America’s asking you to call.”
  • “Halo everybody, Halo. Halo is the shampoo that glorifies your hair.”
  • There’s just one Schlitz, yeah, yeah—nothing else comes near. When you’re out of Shlitz—you’re out of beer.
  • Lets All Go to A and W. Food’s more fun at A and W. We’ll have a mug of rootbeer, or maybe 2 or3, make the perfect size from the burger family.

‘Till next time, “Happy trails to you, until we meet again.”

What jingles do you remember fondly?

The way the ball bounces

Sitting on the floor playing ‘roll-the-ball’ with my little granddaughters, I realized the fun of playing with a ball is an activity that has really stood the test of time.

When my Mama lived with us she was in around the mid to late stage of dementia. One day she and I were in the living room visiting. Mama was sitting on the couch and I was sitting on my exercise ball–I’ve heard some actually use them for exercise, but mine is predominantly used as a chair.  She seemed particularly alert and focused that day, so I decided to see if she would be able to play a little two-square.

I stood up, got her attention and gently bounced the ball her way. She caught it. The look on her face was a mixture of surprise and delight. Since she was in a good place, at that moment, she bounced it back to me. We had a blast bouncing the ball back and forth for about 20 minutes. I could tell she was tiring of the game when she quit returning the ball.

We played that game on a regular basis while Mama lived with us. It was fun to have an activity we could do together. On a real good day, when she was really ‘clicking’ I would even bounce the ball a bit off of center to see if she could adjust –which she usually did quite well.

Even if someone does not have the strength to bounce a ball, a balloon can be just as fun. For a group,  ‘balloon’ volleyball can be delightful—even batting it in the air by using a pool noodle can be enjoyed by many. Anything that bounces or can be bopped or rolled never seems to go out of style, and can play a part in the joy of life no matter what the age or ability.

What activities do you find that your loved one particularly enjoys?

Happy Birthdays

Today, my Mama is 84 and 1/3. It got me thinking about birthdays and how many she has had. The carehome where she resides holds a birthday party each month for all of the residents who have had a birthday in that month.

Everyone loves it. The festivity always includes music, cake, party hats and of course singing “Happy Birthday”. Only a handful of folks in the room know what day of the week it is, let alone when it’s their birthday. That however, does not stop anyone from having a wonderful time.

I realized, that the elements that go along with a birthday celebration have got to be one of the most repeated, and therefore ingrained aspects of our culture.

Many studies as well as our own experiences have shown that heart songs (such as “Happy Birthday”) live in a place other than the part of our brain we use for general memories. How else could it be explained that my Mama, who hasn’t recognized me for years, can’t remember anything about her life or even the previous three minutes could still sing songs with me from her younger life. Even when she was unable to speak, there were days I could pull one of her ‘heart songs’ out of her – at those times we would live in the moment.

The songs we sung were the ones we knew from her childhood and teenage years. If any qualifies for a life or heart song, “Happy Birthday” would certainly make the list.

I have decided not to wait for Mama’s next birthday to sing to her. Since she is in the final stages of dementia, the Happy Birthday song alone will have to do for her.

But may I suggest that if there is any possibility of your loved one wearing a party hat, eating birthday cake (even if it’s angel food), and blowing out a candle accompanied with a hearty round of “Happy Birthday to you…..”. Give it a try.

Why wait? Have a party as often as you’d like—your loved one won’t realize the repetition, and really, you never know how many birthdays are left.

Great starts are easy, the goal is to finish well