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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Alzheimer's Association Disease Facts & Figures 2013

These are the latest Alzheimer's statistics for the year 2013. 

The numbers are staggering and powerful. See for yourself: 

The more we understand, the more we can help.

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.”

You Are Someone I Love - By Mary Phillips

Mary Phillips is the Life Enrichment Coordinator at one of our Memory Care Communities. She works daily with our residents who suffer from Alzheimer’s and other forms of Dementia. She “knows” all about this terrible disease. This story, however, is written from her perspective as a daughter. What she discovers as she “sees” and “feels” the effects of this devastating disease is recorded in her story.

You are someone I love...

A Story Worth Reading - One Many of You Know

A shortened diary of a visit with my mom. This past month, I traveled “home” to visit my mom. It had been several months since I saw her last. But when I walked into her care home and saw her walking in the hall, it seemed just like yesterday, for a fleeting moment. She looked up as her sister and I entered and a huge smile spread across her face. 

“How wonderful to see you”, she said. “You just missed Pa. He came to visit me and we talked and talked. I don't know where Ma was, though, do you?” My Aunt and I

exchanged glances because “Pa” had been gone since the 1980's. It didn't matter, though, because she had obviously had a wonderful visit with her dad that day. She then turned to the aide and introduced us as her two sisters. That was on Monday. 

Tuesday, I arrived to see her still in bed at noon. She was drowsy and disoriented but sure was glad to see me, her mother. She let everyone know we were going out to lunch. And I do mean everyone. It warmed my heart to see the responses she solicited and all called

her by name. We went to lunch, returned to play a spirited game of Bingo, with my mom repeating each and every number for the caller, and then shared some ice cream sundaes with mom ending up wearing more than she ate. It took some doing to tuck her in that night, but she asked me dreamily to stay with her until she went to sleep. “I love you, mom,” I said. “Leave me alone” she answered. 

Wednesday, we were treated to a fabulous outing at Mom's favorite Italian restaurant. I decided it would be fun for mom to be seated next to the fountain. I didn't realize that every child in the place came to the fountain to make a wish by throwing in a penny. She soon had me and everyone else at the table digging in the bottoms of our purses for change to hand out – for the cost of a hug. Yes, my mom demanded and got hugs from each child in the restaurant. And her warmth carried over, because each table stopped to chat with mom as they entered or left. It was so joyous. That night, she fell asleep as soon as her head hit the

pillow.

Thursday was interesting. My aunt and four cousins joined us for a long lunch and then a visit at my aunt's home. At the restaurant, we laughed about old times, with mom contributing much to the reminiscing and conversation. When we got to the house, she quietly sat on the couch next to me. Every

five minutes or so, she had me introduce her to the ladies in the room, and then asked me my name. Reality, mine that is, hit me like an arrow to the heart. I had to go into the kitchen and shed a few tears, then go back in the living room and just continue to show my mom the love I had for her. When I took her back to the care home that evening, she was frightened and confused. What had I done wrong? Over

stimulization will do that, the aide said, as she helped me get her to bed. I left and sat in the car crying, ashamed of myself for not recognizing that.

On Friday, I kept it low key. We spent time in the solarium listening to music. Mom addressed EVERYONE with a cheery “hi” and EVERYONE responded to her by name. I didn't take mom out that day. Instead I followed her daily routine. It was a pleasant and sunny day, and my mom seemed content. She called me Susie all day, my sister's name. 

On Saturday, we knew we would have a tiring day for mom and us. Susie and I arrived to get mom ready for her granddaughter's wedding. Poor mom – she was tired before we even got there and slept during most of the wedding ceremony. We worried about the reception. We shouldn't have. Mom came alive as soon as the music started and danced, and danced, and danced with all her family. 

I would be leaving before dawn the next morning. It was difficult to say good night to mom, not knowing when I could come out again. I sat at her bedside stroking her hair and just watching her face. I realized she had not once called me by name all week. I asked her

quietly, “Mom, do you know who I am?” Just as quietly, she said “I know you are someone I love.” That was good enough.

by Mary Phillips

Life Enrichment Coordinator at Hawthorne House