All Is Well

Mark had a hip replacement surgery yesterday. This decision of whether to have the surgery or not has been weighing heavily on our minds since January. Over the past several months he has had many test to help us decide if he was a good candidate for the surgery. The surgeon was not sure and was worried that he might break a bone in the surgery due to his osteoporosis. After Mark’s bone scan he asked the doctor if he was “dense enough.” We had a good laugh at Mark’s humor and then he told us he was a high risk for a break. We decided to take the risk and it has felt like a huge elephant ride waiting for the surgery date. On day it’s on and the next day we’re swayed to the other side and maybe it’s off.  We were happy to finally slide down the elephants trunk and get off of that ride.

All went well and the surgeon is so pleased and is as relieved as we are. Now we face three days in the hospital and at least three weeks in rehab where the hard and painful work will begin. Unfortunately, Mark will have to do this again in October for the left hip to get full benefit. Mark jokes that he’s a basket case—because he has a basket full of complicated health issues. I love this man and his humor. He has the ability to make me laugh even, or most importantly, under stressful times. I feel so fortunate to have him in my life!

Just what I needed to remember today.
All is Well1

Ideas for Dealing with Cognitive Issues

Since I wrote A New Routine, I’ve been thinking about some of the strategies our family  and therapists used in dealing with cognitive issues.

From the beginning:

  1. Caregiver-handsUse normal tone of voice, staying calm and reassuring.
  2. Talk to the person as if they understand everything you’re saying. Never discuss subjects that may be upsetting in front of the person.
  3. Keep comments and questions short and simple.
  4. Let them know what you’re going to do before you do it.
  5. Allow the person extra time to respond.
  6. It’s okay if responses are inconsistent or don’t occur.
  7. Have only one person speak at a time.
  8. Tell the person who you are if you’re not sure they know.
  9. Remind the person of the day, date, name and location of where they are.

To stimulate memory:

  1. If they’re in the hospital, bring favorite belongings, pictures of family members and friends.
  2. Play their favorite music.
  3. Read familiar books and magazines to them.
  4. Watch their favorite TV shows or movies.
  5. Talk to them about family, friends and activities they previously enjoyed.
  6. Keep a notebook nearby for family and friends to sign so the person can read and remember who visited. If they can’t read, you can use it to remind them of who had been there.
  7. Write down improvements so they can read it or you can remind them of the changes.
  8. Don’t assume the person will remember what you tell them. Frequent repetition is often required.

To stimulate senses:

  1. Gently massage lotion on their arms, hands, legs, feet, face, back and stomach. It also helps prevent skin breakdown.
  2. Use a variety of soaps and lotions to stimulate smell. Talk about what they smell like.

If the person is agitated:

  1. Make sure they are getting the rest they need.
  2. Keep the room calm and quiet.
  3. Limit the number of visitors to two or three at a time.
  4. Allow them to move as much as safely possible.
  5. Moving them to a different location might help.
  6. Take them for a ride if permitted.
  7. Don’t force the person into activities.
  8. Listen to them and follow their lead if safely possible.
  9. Don’t laugh at, play into or reward inappropriate behavior.
  10. If reasoning is not successful, try redirection and distraction to stop inappropriate behavior.

If conversation is confused, unusual, insistent or bizarre:

  1. Tell them where they are and reassure them they are safe.
  2. Help the person get organized for tasks and activities.
  3. Provide a rest time.
  4. Be careful with humor, teasing, or using slang. Sometimes it works and other times it’s misunderstood.

Other useful hints:

  1. Expect the person to be unaware of their deficits and the need for increased supervision and/or rehabilitation.
  2. They may insist nothing is wrong with them and that they can resume their usual activities.
  3. Realize that redirection is not always effective and arguments can be frequent and prolonged.
  4. Encourage the person to participate in activities. Help with starting and continuing.
  5. Treat the person with respect while providing guidance and assistance in decision making.
  6. Talk through problems about the person’s thinking skills, problem solving or memory challenges without criticizing.
  7. Encourage the person to improve cognitive skills with games and/or therapy.
  8. Check with the physician regarding any restrictions such as driving, sports or drinking. Let them be the bad guy.
  9. Encourage the person to use note taking and recorders to help with memory deficits.
  10. Discuss situations where the person may have had difficulty controlling emotions.
  11. Talk with the person about yours and their feelings and offer outside support such as counseling and/or support groups.
  12. Make sure you have the help, support and respite care you need.

Resource: http://www.jhsmh.org

What ideas can you add to this list? Please share what has or hasn’t worked for you.

 

 

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Caregiving Memories of My Grandmothers

Written by, Julie Brown

My name is Julie Brown and I have 3 young Grandmother 3kids. We live in little rambler in a regular neighborhood and I am blessed to be a stay at home mom. I enjoyed my growing up years in a close knit family with both sets my grandparents living close by. When my grandfathers passed away, my mother was a caregiver to both my grandmothers. I assisted my mother in caring for my sweet grandmothers even before I had children.

During the summer of 2013, as both of my grandmothers aged and my own mother’s health was less than desirable, my role as their caregiver took on more responsibilities. I went daily for a few hours to help my father’s mother, who still lived in her own home across the street from my parents. I worked hard getting her home back in shape including washing her drapes, windows and other deep cleaning that hadn’t been done in years. I also went to the store for her and did yard care. I enjoyed helping her this way because I was so close to her growing up and when there was trouble at my own home, I had her shoulder to go cry on.

After about a month, my grandmother fell and broke her pelvis. She had to go to a rehab center to get back on her feet again. I kept up my daily routine of visiting her and taking her laundry home to wash. There was not a lot I could do, but I knew it was important to show her I cared. I would rub her feet, brush her hair and sometimes just sit and hold her hand. I hoped she would be able to come home, but after a month and a half it became apparent to me that she was not going to make it. It was hard to see her struggle so much to get better. At the end of September grandmother passed away in the night. She was such an amazing example to me and I was so happy that I was able to spend time with her before her death.

both grandmas

2010 – Maternal Grandma, Julie with her two oldest children and Paternal Grandmother

At age ninety, my mom’s mother had diabetes. She used a walker to get around and required help dressing, bathing, and having her food prepared for her. Back in her day, she was a great mother who had 10 kids and was a wonderful seamstress. I remember going to Grandma as a young girl for help on all of my sewing projects. I also learned how to knit and make covered hangers from her. It was difficult to see how hard it was for Grandma to do anything in her later years, knowing the independent and self-sufficient lady she had been.

My mother became unable to take care of Grandma, so I told her she could come and live at my house and I would take care of her. Being blessed as a stay at home mom, I am home most of the time anyway. I knew it would be more work than I was used to, but was happy to do this for Grandma. I felt like her time here would be short and having her live with us would provide an opportunity for my children to get to know their great- grandma even better and a chance to build cherish memories of her.

I can’t say it was easy. Every morning I felt like by the time I had everyone ready in the house it was time to make lunch. I also felt like I couldn’t go places much because I needed to make arrangements for my grandma. However, the hardest part of it all was how picky she was with her food. Many times I would give her options of what she could eat and would make the meal of her choice just to present it to her and have her change her mind, or think it didn’t taste good. Knowing that she needed to eat, I would fix her something else. Of course I would never let my kids get away with that, and they couldn’t understand why I was happy to make something else for Grandma and not them. I would tell them, “When you are 90 years old, you can be picky too.”

Many times in the night she would get up for one reason or other and I would quickly get out of bed to help her back into bed. She would sometimes think she wasn’t dressed for bed when she was, or she wanted to put her teeth in the cup to soak and they already were. I would just gently tell her that everything was taken care of and she should go back to bed. It made some days hard when I ran on so little sleep—especially coupled with nights when I also needed to get up with my small children.

To get though the hard times, such as cleaning up after an accident all over the floor, I would use humor. She would apologize when she made messes that needed cleaning and I would say, “How did you know I needed to mop the floor?” I also reminded myself often that she was not going to be here much longer and I was honored to take care of her.

GrandmaLast month, after taking care of Grandma for about 3 and half months, she passed away. I miss her so much and I miss taking care of her. I am so very thankful I had the chance. Every night she would squeeze my hand and tell me how much she loved me and was thankful for me for taking care of her. I would not change that for the world. In the last days of her life, I felt strongly that my grandfather was very pleased with how lovingly I took care of her, which made it all worth it. What a great blessing and I would do it all over again in a heartbeat!

 

Thank you Julie for sharing your inspiring story and tribute to your grandmothers. I added quotes that reminded me of mine and your grandmothers. What a wonderful granddaughter you are!