I am not a cargiver at this present season in my life. Sometimes I sit and reflect on what I experienced during the season I was a caregiver. This pushes me to continue learning and sharing with you and the other caregivers in my life.
Today I want to look at the issues that you face when someone is showing signs of Alzheimer’s and related dementias. You may notice these signs before a physician gives you a diagnosis. They can be unnerving. You feel like the person you know has turned into someone else. My well dressed and organized mom was misplacing important things due to feeling a need to hide them.
Her choice of clothing was way off. Things were mismatched. Anyone who knew her knew that she always matched or coordinated down to her jewelry and shoes. I look back at photos and realize I missed a huge clue that something was wrong. Mom loved babies. She always held them close and snuggled them on her shoulder. When my first grandchild was born, Mom and Dad came to visit. In the photos Dad has her snuggled close. Mom placed her across her lap and patted her there. In my excitement over the baby, I failed to observe this. It should have been my biggest clue that something was wrong.
Do not ignore these little clues. Everyone ages and changes but pay close attention to clues that this may be more than normal aging. The changes may start happening slowly, like a rainfall begins. You will see one drop fall and then another. Soon the ripple effect will be noticed.
You may be asking yourself what do I look for. The guy shown below is disheveled, frustrated and angry. Don’t let things get this out of hand before learning more. I would like to introduce you to cognitive symptoms and neuropsychatric symptoms.
What are these?
Cognitive symptoms include
- memory loss
- trouble finding words
- getting lost
- not recognizing people and places
- loss of the ability to make decisions
- handling finances
Most people realize these symptoms occur with Alzheimer’s or related dementias.
Neuropsychiatric symptoms include
- Loss of motor activity such as buttoning a shirt
- Wandering
- Apathy
- Depression
- Agitation and Aggression
- Irritability
- Delusions
- Hallucinations
- Sleeping disorders
- Eating disorders
Most people are surprised and even shocked by these symptoms. These symptoms can occur at any stage of the disease. I witnessed all of the above as I helped care for my mother with Alzheimer’s disease and my mother-in-law with vascular dementia. The delusions and hallucinations were stronger in my mother-in-law.
I had to educate myself through research to build my skill set to deal with some of these symptoms. There were times I failed. For instance, I was trying to keep my mother-in-law on the bed because she was in the hospital due to a fall. She was a fall risk. I was sitting at the foot of the bed blocking her exit route. She was yelling, hitting and kicking. I had rang the nurse for assistance. While I waited she yelled that I was the most demanding person she had ever met. In frustrationa and exhaustion, I replied, “No, you are”. Fortunately, she quickly forgot this and help arrived. I slipped into the hall and cried. I had to always be careful to remember who she was before the disease and remind myself that the words and actions were a result of the disease.
If you have seen any of the above symptoms, please consult with a geriatric physician, psychiatrist or neurologist for an evaluation if you have not already.
The best option for treatment when the symptoms are mild is not with medication. Sometimes you can change the environment and redirect attention.
Always attempt to remain calm as a caregiver. Do not argue! It always results in frustration for you and the one you are caring for.
Here are a few ideas of things you can try when symptoms appear.
- Music therapy
- Aroma therapy
- Exercise
- Animal or pet therapy
These can be simple and inexpensive. Simply play their favorite music in the home. Dispense essential oils through a diffuser. Lavender may help them relax. Citrus helps in making them more alert at meal time. Take a walk or do exercises in a chair. If they love pets, have friends bring pets to visit.
These may or may not work. Music calmed my mom. When my mom refused to eat things that were not sweet she would stick the tip of her tongue out to taste what was on the spoon. If it was sweet, she would open her mouth. It is amazing how many pureed meals were eaten because we learned to dip the end of the spoon in yogurt or ice cream.
My mother-in-law loved pets dearly. In her last days she had become very withdrawn. I scrambled to find her a robotic cat. I turned it on and walked into her room with it. Just as I placed it in her lap, it meowed and lifted a paw. She instantly began talking to it and rubbing it.
Get creative. You may be surprised by how little things can ease the tension.
There may come a time that medications are necessary. Work with the doctor. Keep them informed of changes. Ask questions. All medications carry a risk.
Some medications can cause confusion and make the patient a fall risk.
Inform friends and family when these symptoms begin to occur. Everyone needs to be prepared. I received a call one morning from my mother-in-law. She wanted me to know someone was visiting her. She said they knocked on the window and waved. She was waiting for them to come to her room. My husband texted the friend. She was not even in the same city at the moment. If I did not already know mom was having issues, I would have believed her. The delusions are very real for them. They can be quite convincing.
Neighbors need to know as well. My mom actually went in through a neighbor’s basement door, walked through the house and into the bathroom where the neighbor was in a towel after showering. She looked up into her mirror to see my mom standing there. Imagine that shock!
A caregiver in my support group left his wife watching the television while he bathed. The house was empty when he finished. He grabbed his clothes and shoes quickly. As he opened his door to search for her, an officer was on his porch to ask if he was looking for a woman. She had wandered down the block. A man had called 911 and they were about to leave with her in an ambulance.
Here is an important thing to remember. Suddenly, a gentle lamb can turn into a roaring lion. It can be scary. Step one should be to get them checked for a urinary tract infection.
My support group members share what has worked and not worked for them. Please find a support group online or in your area. Here are a few clever ideas they have come up with.
- Use shaving cream to clean dirty bottoms
- Remove and hide stove knobs so the stove cannot be turned on
- Tie the faucet to the cabinet so it cannot be turned around and flood the kitchen.
- Hide the liquid dishwashing detergent…imagine an “I Love Lucy” episode
- Crush pills and mix them in the the cream of a Little Debbie oatmeal cake
- Buy kids blocks to keep hands busy
- Give mom a broom and make sure someone “accidentally” keeps blowing leaves on the porch.
- Never trust that they swallow all pills. They are skilled at swallowing water and then spitting pills out when you turn your back.
- Ice cream solves everything!
The symptoms above are not shared to scare you. They are shared to prepare you.
Be strong. Continue to seek information. Trust God for ideas.
Word for Today
A gentle answer turns away wrath, but a harsh word stirs up anger.
Song for Today
Prayer for Today
Heavenly Father,
I know that you see my situation. Equip me with creativity to handle symtoms that arise. Give me compassion and understanding when I deal with behaviors brought on by disease. Give me courage as I find my way each day.
Amen
Walking Them Home 