Parkinson’s With Dementia

Parkinson’s dementia is closely related to Lewy Bodies dementia.

Studies have found LBD and Parkinson’s disease may be linked to the same underlying abnormalities in the brain processing of alpha-synuclein. LBD and Parkinson’s disease dementia are similar except for the order in which the symptoms develop.

The timing of when symptoms occur may determine which diagnosis a person receives. If thinking problems appear within a year of movement difficulties, doctors diagnose Lewy body dementia. If dementia develops a year or more after Parkinson’s disease symptoms begin, doctors diagnose Parkinson’s disease dementia.

Common symptoms of Parkinsons with dementia include:

Sofly spoken muffled speech

Misnaming objects

Trouble understanding complex sentences

Difficulty focusing

Memory loss

Confusion

Moodiness

Change in appetite

Delusions

Change in energy level

Sleep disturbances ( vivid dreams)

Vision issues like difficulty spotting objects in a cluttered space.

Trouble planning and staying on task

Language challenges

This list may be alarming at first. Remember that changes occur over time. Always remember that the person is not acting out; however, the disease is. Here are ideas to assist in caring for someone with these behaviors

establish and follow a routine when possible
being extra comforting and patient
limiting distractions and avoid crowds
try to maintain a consistent sleep schedule
declutter your living space
learn all you can about Parkinsons dementia
Join a support group

Keep a journal of behavior changes, dels]usions, nighttime disturbances, etc. This will help you when speaking with physicians. Log all medication changes as well.

I know a family dealing with this dementia and have watched them make adjustments. Their family members have had police show up in the night because he called and reported someone had broken into their home. Now, he has taken to roaming around partially clothed. Recently he heard my voice as someone was listening to me speak on a recording. He told them that sounded like someone I know. He then tried to remember my name but could only come up with my husband’s name. He referred to me as his person.

Be calm. Be patient. Allow them to try to communicate and try to interpret what they are trying to say. As far as the police calls, most law enforcement departments now have a data base that contains information you provide alerting them that a family member at your address has dementia. This can allow them to have a mental health officer available. For the other issue, just close your blinds.

Take a deep breath. You can do this. When things become difficult, step away for a few minutes and try a new approach. If you read through previous posts you will find other helpful information. Many of the behaviors and symptoms are similar with all forms of dementia.

Word for Today

Psalm 31:24

Be strong and take heart, all you who hope in the Lord.

Song for Today

Prayer for Today

Dear God,

Thank you for being faithful. There are days I feel like the battle will not end. On those days that I struggle to stand on hope, hold me as I wait on you to move on my behalf. You are the only thing I have that is always true. Help me to be able to say “It is well with my soul”.

Amen

Make the Most of Your Time

Alzheimer’s disease erases many memories for the person living with the disease. Memories for family members will live on and be cherished. We have technology now to save voices, laughter, stories and visuals of our family and friends. If you have a family member in the early stages of dementia please use that technology. I left messages on my phone for years just to hear my parents voices.

Even if you do not have Alzheimer’s in your family now, you may someday. Listening to the spousal caregivers talk about what they miss the most is causing me to be more deliberate about making and saving memories that I and my husband can hang on to should one of us be left alone.

I changed phones and lost a video that I treasured. My mom was dancing and laughing with her youngest grandson. Prior to having Alzheimer’s she would never have acted this silly. We all sat watching in awe. We were in awe over the fact that she was truly happy and in the moment with him. I was pondering about how much longer we would be able to hear her laugh.

Years later I watched that same grandson see my dad wiggle his ears. Every grandchild, niece and nephew loved watching dad do this little trick. Dad had been so busy taking care of mom that he hadn’t thought to show this youngest grandchild his ear wiggling. My nephew sat trying his best to master this for himself while dad smiled. Dad passed away one week later.

Don’t put off taking small trips, watching sunsets, sharing hugs and expressing love to each other. Make the most of your time. Life moves at a fast pace and it is way to easy to get caught up in the busyness. My heart hurts when a senior citizen is the sole caregiver for their spouse. They look at me and tell me they cannot ask their children to help. They have their own lives and are busy.

Allow me to speak for these caregivers. Find the time to honor your parents. You are robbing yourself of something you can never get back. You can find time to meet a friend for coffee or attend a sporting event. You can find time for social media. You can find time to check on mom and dad.

“Family is not an important thing. It’s everything.” —Michael J. Fox

A huge excuse we often hear is “It’s Complicated”. When someone has Alzheimer’s their life and their caregiver’s life are complicated. Family can find a way to work through all of the complications and help each other survive. Asking God to make a way for you to do life together is a great first start.

Personally, there was a lot of travel and expense involoved during our time as caregivers. I gave up a job. God has abundantly blessed us along the way. It was an honor to be with my parents in their final days.

Caregivers, speak up. Give your children an opportunity to find ways they can help. Give them opportunities to make memories while they can.

Word for Today

1 John 3:18

Dear children, let us not love with words or speech but with actions and in truth.

Song for Today

This song refers to when we allow walls to form between us and God.

Prayer for Today

Dear God,

We need you to tear down walls and heal our hearts so that we can share life with those in our family. Show us how to build bridges instead of walls. Draw us closer to each other as we draw closer to you. Teach us to find balance in this life. Give us moments of genuine love as we show compassion and grace to those around us.

Amen

Alzheimer’s Language

I am far from being bilingual. This makes it difficult when I am around someone who’s native language is not the same as mine. Caregiving for someone with Alzheimer’ disease has forced me to face the stark reality that I had no choice but to learn to speak and understand a language that my parents now spoke. One parent lived in a new territory that I refer to as Alzheimer’s World. My other parent was residing in a territory I will call Mild Cognitive Decline World. To travel to their world, I sometimes felt like the one who was confused and lost. The most challenging part was having two parents living in different worlds at once. While neither was fun and exciting like Disney World, both provided excessive amount of adventure.

Once upon a time, I lived in “Normal World” with my parents. They were great parents and did their best to provide a nourishing and loving environment for my brother and I. They were active in their church, jobs, Lions club, Band Boosters and Atheletic Boosters. Steady and dependable are words that describe them the best. No family is perfect, but we grew up thinking ours was close. My brother and I were busy with our own families after becoming adults. Life was good.

Skip ahead several years and we began to see cracks in the armor of our parents. This happens as we become adults. This was different though. Slight personality changes were obvious in our mom. Dad was doing a wonderful job of hiding this from us in the beginning. Eventually, it could be hidden no longer. We were faced with seeing that “Happily Ever After” was not going to be the ending of their story.

Dad needed help navigating the progression of Mom’s Alzheimer’s. Stress was mounting as he floundered. He was giving a major effort to care for her. This once young athletic guy with no sisters even learned how to apply her makeup and assist with her hair. He cooked, cleaned and gave it his best.

That is when my quest to learn all I could about this disease began. I bought books, searched online and found a caregivers support group. In a sense immersing myself in this was a boot camp. Much was learned quickly. I want to share a brief amount of helpful information to help you learn Alzheimer’s language.

Rules for the Caregiver

Do not argue.
Do not try to talk them out of anything.
Do not try to make them remember.
Enter their reality.
Do not try to reason with them.
Stay calm

The disease is in control and not the person you are caring for. Try to separate the two.

Speak slowly and give them time to process short sentences
Rather than give an order, ask for a favor
Monitor your own emotional state
Redirect and distract with music and other activities such as snacks or taking a walk
Release your expectations of them to be who they were in the past.
Remember that their new reality is just as real to them as yours is to you

Facial expressions and your tone of voice speak volumes!

When dad began to have unexplained falls I suspected mini strokes. While he was mom’s primary care giver, he was beginning to show a loss of judgement. I would observe and make suggestions. Dad would get upset and walk away from conversations. I learned to let it go and wait. He would call me a couple of day’s later with a wonderful idea of how to handle a situation. I would listen as he told me the exact idea I had given him. I would then let him know that I thought it was a wonderful idea. This preserved his dignity and it worked. One day he ws mad and informed me that my brother and I were trying to control his life so were no longer his power of attorney. The next day he called wanting me to come and explain insurance papers to him. I told him I was no longer his power of attorney. He replied, “Oh, yes you are”.

Learning the best way to communicate with him was to allow him to think everything was his idea. You will learn to speak a language that they understand through trial and error. It can occur though if you are persistant.

You can do this! God will be your constant help when you feel anxious, sad or ill equipped.

Word for Today

Colossians 3:12

Therefore, as God’s chosen people, holy and dearly loved, clothe yourselves with compassion, kindness, humility, gentleness and patience.

Song for Today

Prayer for Today

God,

I praise you for the love and kindness you show to me. Give me the ability to share that kindness as I learn to communicate with others, especially those with dementia. Help me to listen more and speak to them in a way they understand. My greater desire is for you to continue to speak to their hearts and souls through their confusion.

Amen

Physical Touch Matters

Tactile has to do with the sense of touch. Dipping your hand into cool water is tranquil. Think of your favorite memories involving touch. I have many. One was walking barefoot through a freshly tilled field and digging my toes into the warm soft dirt. Another was sitting on the sofa and rubbing my grandfather’s head. He loved this and would often request it. I loved him too much to ever say I would rather be outside playing. That same love connected us as he lay in a hospital bed and made the same request. I pulled my chair close and wondered how many times will I have left to express my love in his love language.

Alzheimer’s disease often robs people of their fine motor skills. Activities they once enjoyed become a struggle. Opt to put together puzzle with larger pieces rather than small ones. I was able to find puzzles adults can enjoy with a smaller number of pieces and larger size. I avoided puzzles labeled for dementia. The person may still be able to read and feel ashamed or embarrassed. Be sensitive to this please.

Ask them to assist you and assign them simple task that don’t really matter. Let them fold towels and washcloths. Let them match socks. If they get it wrong no harm is done. They still feel needed and productive. Just consider what they can do safely, and ask them to help.

In prepping food let them tear the lettuce for a salad. You chop the veggies and let them arrange them in a salad or platter.

When presenting food, peel their orange before serving it. Just think of what you would serve a toddler. This can be done in a way that preserves their dignity. Prepare your own snack to look like what you serve them.

My mom loved pretty clothes. She struggled with buttons and zippers in the early stages. This ususally happens later for most people. It depends where plaque forms in the brain. We moved to pull on tops and pants without zippers. That was quite an adjustment for her. Thankfully, the local mall had a store that carried a line of beautiful clothing the she liked and it laundered easily. Then one day we had to replace the beautiful clothing with simple gowns that made life easier for caregivers who had to bath and change her.

When someone has dementia they may forget what to do with a hairbrush, comb or toothbrush. This is when you need to offer tactile cues. Please visit the following link to see this demonstrated. https://www.dementiacarecentral.com/video/hand_under_hand/#:~:text=This%20video%20clip%20shows%20how%20to%20use%20tactile,are%20also%20important%20%28time%3A%201%20minute%2030%20seconds%29.

Another thing you may face is how to handle inappropiate touchs. I was volunteering one day and had a new necklace on. It was a large flower and I was so grateful I had it on. A gentleman approached me with his hands extended toward my chest. I quickly took his hands, moved them to my necklace and asked if he liked it. The nurse who witnessed this action hid a smile but her eyes were dancing. Later she complimented me on my quick thinking.

Physical touch can be accomplished with ease once you observe and find what is comfortable for the person with dementia. I often take hand lotion with me on visits. No one refuses a massage of their hands and fingers as I talk quietly with them and rub the lotion in. Often a hug is appreciated. Hug from the side when possible. Ask if they would like a hug. Remember the above story and be careful! Many times a person with dementia and their caregiver need physical touch to remind them they they are loved.

Ladies love manicures. You never know how much your kindness means.

Touch sensitivity can be lowered. This can make it hard to sense pain or temperature, which can pose potential safety risks. They may not realize how hot or cold an item is. They may not feel pain from a small cut. Pay attention to their skin.

I know a man who refused to shower. His daughter questioned him about why he wasn’t taking a shower. He finally admitted that he could not adjust the water temperature right. The simple solution was for him to ask for assistance in turning the shower on. After showering he could step out and ask for assistance turning the water off. He could have been confused about how to control the shower handles or he could be sensing the water temperature differently than he had before. Sometimes it takes a little investigative work to discover the real problem. Others may refuse to shower because the water hitting their skin feels different.

I cannot discuss touch without mentioning how important spiritual touch is both to the caregiver and the person with dementia. Turning to God is a choice the caregiver makes. Reminding the person with dementia that God loves them is so important. Listen to music, read the Bible together. Pray together. Allow friends and family to be included in these activities.

Word for Today

Colossians 3:12

Therefore, as God’s chosen people, holy and dearly loved, clothe yourselves with compassion, kindness, humility, gentleness and patience.

Song for Today

Prayer for Today

Dear God,

It is good to sing your praise. We join hands today and reach for yours. Touch our hearts and reassure that your love is eternal.

Amen

Are You Even Listening?

Did you think I was addressing almost everyone who has earbuds in or maybe teens with messy rooms? Oh, it could be applied so easily to these. My husband listens to podcast while working on our farm. He walks into the house and ignores me because he forgets to turn the podcast off. Nothing is more frustrated than feeling unheard.

When a person has Alzheimer’s disease they can still hear. It takes their mind longer to process the information. When speaking with them you should slow your speech down. Use simple language with words that are easier to understand. In a conversation wait and let them attempt to reply to you.

This will take an effort on your part to restrain yourself from moving at the pace you are used to. Many of us are already thinking of our response when someone else is speaking. Perhaps, having to break that habit will help us become better listeners. The person you are now communicating with deserves your full attention.

Spouses are guilty of answering for their husband or wife when with others. This is their attempt to protect their spouse from embarassment. It becomes second nature. It happens especially when other family members are around. That is why children are shocked when they finally realize their parent has mild cognitive impairment. Often a caregiver passes away first and the children scramble making decisions about the other parent’s care. They got blind sided because the disease had been hidden so well.

Pay attention when you sense the smallest mental decline. Take the parent you are concerned about out for a walk or drive and pay close attention to their communication with you.

It is a wonderful gift that hearing is not the first sense to go with Alzheimer’s because music becomes an amazing tool. Please watch this video clip. It shows you what words have a hard time explaining. Grab a tissue.

Music can be extremely effective with people who have Alzheimer’s. Choose the music you use carefully. Remember to use their preferred songs and artists. Make selections from decades ago. My mom was nonverbal. I taught my granddaughter a song that mom had listened to as a teenager. When my granddaughter got to the chorus my mom said a few syllables while smiling. We had a breakthrough and they connected. I will always cherish that memory.

Many pianist still have muscle memory and can sit down and play. While volunteering in a memory care unit one day, I heard hymns coming from a baby grand piano. I turned to see one of the residents playing with total contentment on her face. The director of the facility informed me that her husband moved their piano there when she moved in.

Loud noises will startle someone with dementia. It is absolutely vital for you to stay in the hospital room when the patient has dementia. Constant voices in the hall, staff going in and out, beeping machinery, and sirens outside create fear and only add to the confusion of being in a strange place. Your touch and voice can be reassuring.

They are always listening. Do not talk about them and their condition in their presence. Show respect and honor them. Never ask them a do you remember question. Instead, you could say I loved our vacations with the children to the beach. We had long strolls as the sunset and collectied seashells. The seagulls surrounded us when the kids threw them snacks. Just hearing the story may spark a memory in them. They may then join in the conversation. Taking a photo to share while you recall the memory would be nice.

Even when they tire and their eyes close, they may be listening. Just the sound of your voice brings comfort. Talk about football, dancing or whatever topic they once enjoyed discussing.

When giving directions keep it simple.

Wrong Way –

We are going for a walk. Put your socks and shoes on then, grab a jacket from the closet.

Right Way –

Here are your shoes and socks. Put your socks on. Now put your shoes on. Let me help you get a jacket because it is cold outside.

When you ask them to make a choice keep it simple.

Wrong Way –

What doe you want to wear today?

Right Way –

Would like to wear the blue shirt or the red shirt?

Keep in mind that mutiple auditory inputs at once definitely become noise pollution. You may be able to hear two conversations at once, but they just hear lots of noise and struggle to keep up. Avoid crowds and parties when this becomes an issue. Each day is a struggle in processing all they hear. They get exhausted. Be patient.

Word for Today

Luke 8:15

But the seed on good soil stands for those with a noble and good heart, who hear the word, retain it, and by persevering produce a crop.

Song for Today

Prayer for Today

Dear God,

I praise you for giving us the gift of music. Help us to use it to brighten the lives of our family member with dementia. Help us to create moments for them that produces joy and they still feel vibrant and alive.

Amen