Pattern for Someone with Alzheimers

The following blog post really builds off of thr last article we posted, which discussed trying new approaches with the ones we love who suffer from Alzheimer's. In the article that follows, the author discusses replacing bad patterns with good ones, an idea that we have discussed at length during some of the dementia conferences we've attended. Let's be creative and try to implement some of these ideas. They might not all "stick," but you'll never know if you don't try. 

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Did you ever think to yourself, I wonder if I could replace the "bad" patterns of behavior that are driving me crazy with "new' positive patterns of behavior? I did.

By +Bob DeMarco
+Alzheimer's Reading Room 

Alzheimer's Disease Changing Patterns of Behavior

Did you ever think to yourself, I wonder if I could replace the "bad" patterns of behavior that are driving me crazy with "new' positive patterns of behavior? I did.

I wonder if Alzheimer's caregivers think about patterns of behavior when it comes to caring for someone living with Alzheimer's disease.

Many persons living with dementia evidence patterns of behavior that drive Alzheimer's caregivers "nuts" or worse. 

Did you ever think to yourself, I wonder if I could replace the "bad" patterns with "new and good" patterns of behavior? 

I did.

Patterns.

All Alzheimer's patients evidence patterns of behavior.

Some of the patterns are simple -- like asking over and over what day it is. Others are more complex. One reader told us her husband was shaving four times a day and his face was getting "raw". Others pace. The list goes on and on.

My mother was evidencing all kinds of patterns of behavior -- doing the same crazy things at the same time of day or night -- over and over.

At approximately 9:37 PM, at night,  my mother would get up and announce that she needed to start cleaning the house. I am talking every night.

Imagine trying to explain to someone living with Alzheimer's disease that it is night time and you don't clean at bed time.

I'm not sure how many times I did this, more then I want to remember -- it didn't work.

My mother would wake up at approximately 1:29 AM, get out of bed, open up our front door, take a few steps and look around. After a few minutes she would come back in and get in bed.

Same thing at 4:29 AM. Each and every time, I would get up out of bed, stand back, and watch her do it. I did not intervene. After a year or so I finally started to understand why she was doing this.
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After a year or so of reading research about Alzheimer's disease and dementia, I came to a conclusion -- exercise was the single most important variable in caring for someone with Alzheimer's disease. I enrolled my mother in a gym for the first time when she was 87 years old. At first I put her in the class for seniors -- the Silver Sneakers class. It helped. 

One day when she came out of the class I decided to put her on the treadmill. She resisted, but she did it. 

Then something started happening that changed our lives. 

My mother would start walking on the treadmill and at the 6 minute and 30 second mark she would bend over like she was going to fall. She would grab the side rail on the treadmill and more or less hang over it. Her feet, however, would keep moving. At the seven minute mark she would stand back up, straight, and start walking. This happened every time. It amazed me.
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Patterns of behavior. I came to a conclusion through these observations.

First, most Alzheimer's patients have patterns of behavior -- some good, some bad. Second, most people without Alzheimer's have patterns of behavior -- they do the same kinds of things around the same time of day, over and over.

Patterns of behavior bring homeostasis into our lives. 

Having well defined patterns of behavior brings comfort, organization, and a sense of stability into our lives. The fact that we live a life of patterns also helps explain why most of us don't like change. And, why we resist change.

I thought to myself, what if I could change my mother's bad patterns of behavior and channel her energy into more positive patterns. 

I decided to introduce an entirely new set of behaviors and actions into our lives.

Over time I introduced one new behavior after another until we reached the point where our day was organized in a way that made each day very similar to the one that came before it.

Our day had a very well defined pattern and so did our daily actions and activities. A Pattern.
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Here is a simple example of how it worked.

Instead of waiting for my mother to ask me. "what day is it". Meaning what day of the week. I put the newspaper in front of her each morning and asked her, "what day it is it". Then, what is today's date? She would read this to me from the top of the newspaper.

I also bought a great big clock and put it on the wall right in front of her seat where she couldn't miss it. I also asked what time it is? I did this two or three times a day. It helped cured a couple of her repetitive behaviors.

Over the years I cured my mother of meanness, getting up in the middle of the night, urinary incontinence, and the dreaded bowel movement problem. I did this by introducing new patterns of behavior and news tools into our daily equation. 

Did it work perfectly -- no. But it worked.
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I Tried a New Approach

One of our favorite blogs we follow is the +Alzheimer's Reading Room. Recently, Marilyn Raichle shared a wonderful story about trying a different approach with her mother. We wanted to pass it along. Enjoy!

The Art of Alzheimer's

Mother has some major preoccupations – with two questions that she asks me over and over and over. 

What do I think Seattle will be like in 50 (or 55 or 250 or 500) years?

Do I think that women will begin wearing skirts again instead of pants?

I always answer by taking the question seriously and trying to come up with interesting answers.

This week I tried something new. I turned the table and asked her the questions.

“What do you think Seattle will be like in 50 years?” I ask

“Well, I won’t be here,” she laughs.

“I wonder what it will be like,” I persist
Now she’s interested.

“Well, I think women will be wearing skirts again."

“I don’t’ think there will be any room – the streets will be full with people everywhere.”

“My grandmother would be so amazed.”

“Do you think we will still drive cars?” I ask.

“There won’t be room. Maybe we will all fly.”

“Things change. That just what happens – there is nothing you can do to stop it.”

And then – out of the blue…

“I want to live to be 100.”

I always tell her I want her to live to 100, but this is the first time she has ever expressed that desire herself.

Mom’s family tends to be very long-lived. Since the 1850’s, a surprising number have lived into their mid to late 90’s – announcing when they will die and, right on schedule, doing so.

I’ve always thought that Mom would reach 100 by forgetting to tell herself to die.

But – just perhaps – she will tell herself to keep living.

Hope so.

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By Marilyn Raichle 

+Alzheimer's Reading Room 

+Marilyn Raichle writes The Art of Alzheimer’s – How Mother Forgot Nearly Everything and Began to Paint – a blog about her mother Jean, art and Alzheimer’s. Marilyn also works as an arts management consultant in the Greater Seattle area.

Ray

Ray is a Resident at Easthaven Villa's Assisted Living Community. His wife, who is suffering from dementia, is a resident there too. Ray talks about his experience living at Easthaven, and Ray's daughter, Wendy, discusses the care that her parents receive.

Easthaven Villa is located on Cullens Road, a quiet, picturesque street that's just a turn off of SR 510/Yelm Highway. We have 52 assisted living studios and 4 one-bedroom assisted living apartments, all with their own, private entrance and patio. We also have a secure, 12-resident memory care neighborhood. The food our residents are served at Easthaven Villa is exceptional, and with specialties like Italian meatloaf and homemade snickerdoodle cookies, they look forward to every meal.


Drop in for a tour and a meal, and we'll answer all the questions you have. We know that choosing the right assisted living community is an important and sometimes difficult decision and we're here to help in any way we can.

Easthaven Villa Facebook Page

Youtube Page

You Are Not Alone - An Alzheimer's Function

If you are in the neighborhood on Monday, November 4, head over to the Pierce County Library to learn more about dementia and Alzheimer's Disease with Lon Cole, a published poet currently living with Alzheimer's.

The event is free to the public. More information is available on the flyer below:

For more information, visit the Facebook event page here: You Are Not Alone

Memory Boosting Superfoods That Fight Alzheimer’s

In order to get enough of these brain boosters, you’ll want to make sure your loved one stocks up on these foods:

Vegetables, especially leafy greens like spinach, kale and turnip greens and cruciferous vegetables like broccoli, have been strongly linked with lower levels of cognitive decline in older age, according to a study in the Annals of Neurology.

Salmon and other cold-water fish such as halibut, tuna, mackerel and sardines are rich in omega-3 fatty acids. Other omega-3 sources include beans, some nuts, flax seeds and healthy oils like olive oil.

Berries and dark-skinned fruits are rich in antioxidants. According to the Alzheimer’s Association, some of the fruits that pack the most punch are blueberries, blackberries, strawberries, raspberries, plums, oranges, red grapes and cherries.

Coffee and chocolate are surprisingly good for you. Recent studies have shown that caffeine and coffee can be used as therapeutics against Alzheimer’s disease. The caffeine and antioxidants in these two tasty treats may help ward off age-related memory impairment, along with cinnamon, olive oil and curry.

Extra virgin olive oil contains a substance called oleocanthal that helps boost the production of key proteins and enzymes that help break down the amyloid plaques associated with Alzheimer’s disease.

Cold-pressed virgin coconut oil is a heart-healthy oil that is free of cholesterol and trans-fats, and boosts ketones. Coconut oil has been shown to improve the body’s use of insulin, increase HDL (good cholesterol), boost thyroid function and acting as an antioxidant and natural antibiotic.

• Chelsia Hart - Alzheimer's.net

Memory Care Takes Proactive Approach to Manage Aggressive Behavior

Memory Care Takes Proactive Approach to Manage Aggressive Behavior

Written by Alyssa Gerace for ALFA Update Senior living providers practice a variety of innovative techniques when managing aggressive behaviors that can be typical of residents with dementia, and they agree one of the biggest components is pro-activity. Know Your Residents This typically means knowing each resident and being familiar with their history and their patterns of behavior, says Janet Haynes, RN, director of clinical services at Endicott, N.Y.-based senior living and memory care management company Hearth Management. “It’s important to know the resident themselves; it’s basically a traffic light of their behavior,” she says. “What gives you the ‘green light’ to be able to provide services and care for them? What is something you see change [that can be] a ‘yellow light’ or cautious sign? Or is there a ‘red light’ (or danger) where residents start exhibiting different patterns of behavior?” At Silverado Senior Living, which exclusively operates memory care communities, each behavior is seen as a form of communication—including aggressive outbreaks.  “As professionals, it’s our job to try and understand [their] behavior and distinguish changes in it,” says Anne Ellett, NP, MSN, a senior clinical specialist with Silverado Senior Living. Silverado staff, from executive directors to kitchen workers to housecleaners to caregivers and nurses, meet together to compile a history on each resident’s behavior and fill out ‘behavior intervention worksheets.’ “What’s the pattern? What initiates it? What are the successful techniques for changing that behavior or altering it?” says Ellett as examples of how staff can understand what motivates certain behaviors. The challenge, says Haynes, is consistent staffing, to help ensure the more subtle signs that might occur each day are communicated through a reporting system that channels information from day staff to evening and overnight staff. That’s key at Silverado, as well, where an interdisciplinary approach is taken. Common Causes of Aggression and Treatments “We all try to contribute information. Our nurses are very active in looking for acute illnesses or sources of pain, because it’s common that the elderly in general might be having pain, whether it’s a chronic condition like arthritis or they’re starting to get an upper respiratory infection or urinary tract infection,” Ellett says. “Be proactive rather than reactive.” Often, what motivates an aggressive outbreak cannot be communicated by the resident, but sometimes it can be simple to address. “You’ve got to find the trigger and remove it. Let’s say there is music playing during the meal, and someone gets agitated during mealtime, which can be very overstimulating for residents,” says Haynes. “If you see agitation, start decreasing some of their stimulus.”  That can be accomplished by eliminating the music, or by staff making sure they’re not talking too much. But it can be a longer process than merely removing a trigger, says Haynes. Another strategy is for caregivers to redirect a resident’s attention through distraction. One common source of agitation among residents with dementia is the desire to ‘go home.’ While a typical response could be to say, ‘No, this is your home, you live here now,’ it’s better to counter the behavior by asking other questions, Haynes says, avoiding the use of ‘why’ in favor of ‘how, where, what, and who,’ as dementia patients aren’t able to reason their behavior. The conversation could be redirected by asking a resident, ‘Where is your home?’ to ‘What color is your house?’ to ‘Who lives with you? Do you have any pets?’ to guide the resident into past memories and distract them from their current agitation. “You can usually de-escalate their aggression and anger, and redirect the conversation into a different topic that will diffuse their behavior,” says Haynes. No "One Size Fits All" Solution A plan formulated by Silverado staff was able to resolve recurring agitation for one resident who didn’t want to be at the community. “Every time she started [displaying agitated behavior], we’d say, ‘We love you, Betty. You’re safe here, we’re so glad you’re here. We’re going to take good care of you.’ She started hearing that from everyone that walked by, and while she may not have comprehended all of that, she got the body language and the sense that she was safe and secure,” Ellett recalls. Other distraction techniques include knowing each resident’s “rewards” and being able to offer it to them, whether it’s a piece of chocolate or going for a walk.  Putting together, analyzing, and understanding each resident’s behavioral patterns to come up with an appropriate plan of action can be time consuming, but it’s worth it, says Haynes. “It sounds like a lot of work, but once you get to know the individual, it gets easier,” she says. “Once you figure out their triggers, then your success story starts: you can start programming around that resident’s mood and lift them out of it.”

Grandma's Tweetin'

If lately, grandma and grandpa have been filling your Facebook feed with status updates or pictures from their latest vaction, you are not alone... According to Pew Research Center and Princeton Survey Research Associates International 53% of seniors are actively online, 34% are using social media of some form, and 86% are using email.

The following data was gathered by the Nielsen Company, and reflect online activity of people 65 or older, as of 2009:

This first table shows what seniors are most actively doing online. The most common activity was checking personal e-mail. Viewing or printing maps and checking the weather followed close behind.

Top 10 Online Activities Performed in the Last 30 Days by People 65+ (U.S.)
RANK	Profile Point: Internet Activities in Last 30 Days	Audience Composition Percent
1	Personal E-mail	88.6
2	Viewed or Printed Maps Online	68.6
3	Checked Weather Online	60.1
4	Paid/Viewed Bills Online	51.2
5	View/Posted Photos Online	50.1
6	Read General/Political News	49.2
7	Checked Personal Health Care Info	47.3
8	Planned Leisure Travel Trip Online	39
9	Searched Recipes/Meal Planning Suggestions	38.4
10	Read Business/Finance News	37.8
Source: The Nielsen Company, Nielsen @Plan Fall 2009 Release, Adults 18+

The No. 1 online destination for people over 65 in November 2009 was Google Search, with 10.3 million unique visitors. Windows Media Player and Facebook were No. 2 and No. 3, with 8.2 million and 7.9 million visitors, respectively. Interestingly, Facebook, which came in at No. 3 in 2009, ranked No. 45 in 2008 among sites visited by senior citizens.

Overall, the number of unique visitors who are 65 or older on social networking and blog sites has increased 53 percent in the last two years alone. 8.2% of all social network and blog visitors are over 65, just 0.1 percentage points less than the number of teenagers who frequent these sites. Again, this data was collected in 2009, and most certainly has continued to increase in the past 3 years.

Top 10 Online Destinations Visited by People 65+ in November 2009 (U.S., Home and Work)
RANK	Site	Unique Audience (000)	Unique Audience Composition (%)
1	Google Search	10,253	7.7
2	Windows Media Player	8,241	10.9
3	Facebook	7,946	7.2
4	YouTube	7,668	8.4
5	Amazon	5,679	9.3
6	Yahoo! Mail	5,638	7.8
7	Yahoo! Search	5,583	8.7
8	Yahoo! Homepage	5,383	6.8
9	Bing Web	4,510	10.1
10	Google Maps	4,397	8.4
Source: The Nielsen Company

So don't be surprised when you see grandma tweeting from her iPhone about the latest rose ceremony from "The Bachelorette." Seniors are becoming a bigger part of the online social media landscape, and it appears they are here to stay.

My wonderful grandmother with her great-granddaughter.

My grandma recently made the jump from living alone in her home in Chicago, Illinois, to living in a senior living community. On our recent visit, I could not help but notice an extra jump in her step. My grandma has always been sharp for her age, but the change of environment seemed to have magnified her usual witty self. The physical effects were readily noticeable too. She had lost a little weight and had much more energy. The social environment of being around new people and friends, instead of alone in her home, have seemed to have a wonderful effect on my sweet grandmother.

Senior living may not be for everyone, but, just as my family has recently seen with our grandma, it is a wonderful option for many seniors. The following was taken from an article written by Jeff Anderson of A Place for Mom, and discusses 8 different reasons why seniors prefer senior living to living alone: 

8 Reasons Why Many Seniors Prefer Senior Living to Living Alone

Most seniors who have moved to independent living or assisted living communities report that they prefer life at their new home to life alone. Here are some common reasons why:

1. The end of yard work and home maintenance:

Keeping up a home is hard, especially for those of us who have developed physical ailments. Mowing the lawn, climbing a ladder to change light bulbs, shoveling snow, pulling weeds, vacuuming- these become things of the past. But don’t worry green thumbs: Residents are more than welcome to adopt a garden.

2. Vanquishing boredom:

Residents need never be bored at a senior community. There’s something for everyone. All kinds of entertainment and activities are offered, both on-site and out in the local community. Entertainment can range from visiting musicians and performers, to day trips that might include local landmarks, forays into nature, or just an outing to the local art museum.

Seniors who experience declines while living alone often thrive in a more supportive environment.

3. Better family relationships:

Older folks frequently become dependent on their grown children, or other close family members, for help of all kinds. Unnatural role reversals can strain relationships and foster unhealthy feelings of resentment, both by parents and their sons and daughters. Younger family members are liberated from the role of full-time caregivers, and are able to assure that time with their older loved one is meaningful and high-quality. Older residents are glad to return to the role of family matriarch or patriarch and often pleased that their grown children no longer have to “parent the parent”.

4. Better food:

There are many residents at senior communities who used to live alone, and were not eating right. Some skipped meals, some were living on ice-cream alone, and one lady would put cat-litter in the coffee brewer. At senior living communities, residents don’t have to worry about grocery shopping, meal preparation, or even coffee brewing. Instead, they get to enjoy a fine dining experience every day of the week. The food tastes good, alternative meals are almost always offered and special diet needs can ordinarily be accommodated. It’s common for new residents, who had been eating poorly before they moved-in, to experience breathtaking improvements in their health and wellbeing just from three square meals per day.

5. No more stressful driving:

Driving can be a tense and stressful as we age, and our driving abilities may not be what they once were either. For these reasons, most residents prefer to take advantage of the free transportation that’s provided by independent and assisted living communities. There’s no need to rely on a car any longer, although parking is available for residents who still drive.

6. Feeling like myself again:

 Living alone, we may not be able to participate in games and activities we enjoyed, that were both fun, and helped keep us sharp. But senior communities offer a wealth of opportunities to keep engaged. This can include favorite games like chess, bridge and poker, engaging reading groups and discussion groups, and fascinating classes and lectures on every conceivable topic.

7. Making new friends:

Older adults who live alone often become isolated, which is unhealthy at any age. At senior communities we can make friends, share a meal, and enjoy festive occasions with one another. On the other hand, those of us who are more introverted appreciate that our privacy is respected, but are still glad to have folks around.

8. Finally feeling safe:

Residents can rest easy knowing that they are secured from thieves, con-men and ne’er-do-wells. Furthermore, residents enjoy the peace of mind that comes from the emergency response systems that are in each apartment, or sometimes on the resident’s person as a pendant. This alleviates fears about falling and becoming trapped for hours or even days, a scenario that’s all too common for senior’s residing alone.

Certainly, there are seniors who live alone and are just fine. We recognize that senior communities aren’t for everyone. But it’s without doubt that there are vast numbers of seniors living alone in unsafe or unhealthy situations who would benefit immensely from life at a senior community...

Understanding Dementia

Dementia is an umbrella term used to describe a number of conditions  that cause gradual loss of intellectual functioning. In other words, dementia is not a specific disease but a term that describes several symptoms associated with memory loss.
Alzheimer's disease accounts for 60-80% of dementia cases. 


Some of the statistics on alzheimer's disease may shock you. Here are some facts about Alzheimer's disease via alz.org:

Quick facts

• 5.4 million Americans are living with Alzheimer's disease.
• One in eight older Americans has Alzheimer's disease.
• Alzheimer's disease is the sixth-leading cause of death in the United States and the only cause of death among the top 10 in the United States that cannot be prevented, cured or even slowed.

The following is a short video from aboutalz.org that explains what Alzheimer's disease does to its victim.

Our Caring Places strive to maintain the leading edge and set the industry standard for specialized dementia care. We do this by keeping abreast of industry research and development, by providing continuing education, and by implementing a care approach which is focused on the individual. 

We view each day as a treasure hunt. Every one of our residents has treasures that have been buried by dementia, and our job is uncover them by getting to know who our residents are and were, and to understand their reality. 

Welcome to our blog!

Here at Caring Places Management, we are excited to introduce our new blog. We hope to use this blog as a source of information for our "caring places" senior communities, as well as the latest news in the dementia and assisted-living world. We will explore topics that affect the residents of our various communities, such as dementia, senior health, and alzheimers. 

We are also on Google+, Facebook, and Twitter! Please click on the boxes to the right to follow us on our various social media platforms and stay informed on all the latest Caring Places news.

If you are new to Caring Places, we invite you to watch "Our Story" below. 

We invite you to respond to any of our blog posts with comments or questions you may have, by either commenting below, or e-mailing us at info@acaringplace.net.