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

Visual Changes and Driving

Before we tackle the issue of taking the car keys, we will explore why it is so critical to do it.

An abnormal build-up of proteins in the brain that kills cells and damages connections between neurons is a result of Alzheimer’s disease. Most people are aware of symptoms such as confusion, memory loss, personality changes and other kinds of cognitive decline. Some lesser known symptoms can include visual problems. Trouble areas are spatial relationships, narrowing periphial vision and depth perception. Some patients develop trouble reading, following moving objects, or have problems with contrast.

Driving requires having great vision. Imagine driving in traffic without having the ability to judge distance. Take away your peririphial vision. Stop at a red light with no depth perception. Now remove the abilty to read and process trafiic signs. I can see red lights and hear sirens in my head now especially having spent 22 years navigating traffic in a large city.

A fender bender would be a blessing. What if a child ran in front of the car and you did not see them coming. Could you live with the horror of hitting that child? No one wants that. The independence of an adult driver with dementia is never worth the life of a child. Take time to let this scenario to sink in. Now think about how fast this stress would escalate the person with dementia’s decline.

Getting lost is not the real problem. We can track phones and vehicles now. There may be hours of crying and praying but technology is available to help locate a lost loved one. Recently, I was traveling home from the city. Our farm is just ten miles from the state line. A car was moving at about 15 miles per hour in a 45 zone. Cars were changing lanes and zipping by. I slowed as I passed and glanced over. A white haired woman was looking around as if lost. I pulled over at a gas station. My plan was to get behind her and call 911 to come. Amazingly, she pulled over at the same station. I watched as she pulled out her phone. I slowly approached her car and tapped on the window. When she opened it she was already talking to her son. I asked if she was alright. She informed me that she was talking to Rick as if I knew Rick, I asked if Rick was her son. She said yes. I asked to talk to Rick. He informed me that his mother was supposed to be at a doctor appointment. I had him tell her to follow me and led her back to the appoinment.

She lived three counties away and was a few minutes from being in another state! God placed me in her path that day. When she never returned from the appointment, a family would be frantically trying to find her.

Hopefully, I have your full attention now. Take the keys for everyones safety.

There are things to consider now that you understand the visual changes. If a person tends to wander, this gives you knowledge. Place a black mat in front of exterior doors. Many perceive this as a hole and will avoid it. Add a lock at the top or bottom of the door. They tend to just focus on the handle. Paint the door the same color as the wall. It works as camoflauge.

If you go read the previous post on meals, the placement of food on plates may make more sense when you know that visual changes occur. To help navigation in your home declutter. Simplify decor to create a calmer enviornment for them.

Some visual skills may sharpen. They will read your facial expressions like a pro. Your stress will be reflected back because they can tell when you are angry or irritated with them.

They will see people and things you do not see. The woman in the mirror that she sees may not be her. She may think it is a stranger in the home. These things occur and it is their reality. Cover the mirror if it becames a huge issue. Agree that the non existing cat on the sofa is cute. My mother-in-law called to tell us a lion was in her flowers in her room. We thought maybe she saw the petals as a mane. The next day she called to tell us a fairy was dancing in the flowers. She was known to have delusions so we went to visit. Upon arriving she informed us a lady was in the flowers.

Promptly I commented that the flowers were drying out and needed to be tossed. We promised to bring new ones the next visit. I passed a nurse on the way to the trash can. She laughed when she saw me. She had been having to look for animals and people in that bouquet too.

If you just saw a monkey in the flowers, maybe you should get tested. Hey, I couldn’t resist. It is Saturday, and we all need a little humor.

Word for Today

Matthew 5:16

In the same way, let your light shine before others, that they may see your good deeds and glorify your Father in heaven.

Song for Today

Prayer for Today

Dear God,

I praise you for the many times I have seen you in my life. Your faithfulness remains the same as my life changes. Help me to trust more that you will be with me on the darkest nights and the brightest mornings. Help my loved one who struggles with dementia to always see you in the hearts and soul.

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

Men Fix Things

Today I am addressing the men who are caregivers. Most men by nature are fixers. Give them a problem and they immediately begin making plans to fix the problem. Sometimes they don’t even stop to listen to the fine print details you need to express to them.

I am married to one of those men. He is amazing, He truly is a jack of all trades. He has a shop full of tools. He has backups for backups when it comes to being prepared. Now that you tube is available, he keeps expanding his knowledge. While I am inside writing, he is outside repairing pvc pipes on our rain catchment system.

I could continue to expound upon how much money we have saved because he doesn’t need to call a repairman. Having said all of this, even he had to face reality when he was caring for his mom with vascular dementia. He simply could not fix things for her. There were days that I observed as he applied every tool in his caregiver toolbox. He proofreads my blog. He listens to my lessons when I teach. He hears me counseling caregivers on the phone. He attends seminars with me. He has a vast amount of knowledge in this area. There are days that no tool works. You have to accept that it is in God’s hands and just be present and show love in any way you can.

Women, we face days that we just can’t fix it as well. I felt like a complete failure one day at my mother-in-law’s side while she was determined to get out of her hospital bed. She was a serious fall risk and was struggling with me as I blocked her way while calling for assistance. The dementia began to speak loud and clear in words I had never heard from her. She was kicking, shoving and doing her best to win this battle. She yelled this to me “you are the most demanding person I have ever met”. Instead of biting my tongue, I exhaustedly replied. “no, you are”.

Nurses arrived and I excused myself from the room and dissolved into tears. I tell all of you to remain calm and compassionate. There are times that it is very difficult. I knew she had always been used to getting her way. I didn’t expect the dementia to make determination her super power.

Men and women struggle. There will be days when you feel helpless and frustated. You have ridden and emotional rollercoaster that just never seems to stop. The ups and downs, the twists and turns have left you exhausted and hurting. You finally collapse into bed and tears fall. This is not the end. You must get up and go again tomorrow. The only thing I found that allowed me to keep going was to place the person I could not fix into God’s hands and then climb into those same hands so God could comfort both of us.

Each day of caregiving brings surprises through hearing words come out of a loved one’s mouth that shock you or losing your loved one who slipped out the door. Objects in your home may decide to hide in new places. A shoe may show up in the refrigerator. You are left with a choice to make. Try to correct the behavior or accept that today has brought a new adventure. Word of advice offered here. Trying to correct the new behavior is the wrong choice!

The only thing we can truly fix is our own reactions to the behaviors. If all dad will eat is ice cream, let him eat ice cream and try healthier choices later. If your wife refuses a bath, try again tomorrow. Choose your battles.

Word for Today

Isaiah 40:29

He gives strength to the weary and increases the power of the weak.

Song for Today

Prayer for Today

Dear God,

It has been one of those weeks where I tried to do things in my own wisdom and power. I so want to fix the behaviors and changes in my loved one. My heart is filled with pain while I mess things up and sit idly by. I need you to take control and give me the faith and peace to trust in you being in control.

Give me strength when I feel weak. I thank you for hloding me together when I feel as if I am faling apart.

Amen