One of the biggest challenges facing long-term care centers is the “behaviors” challenge.  It is often those “behaviors” which begin prior to placement in our nursing homes that cause loved ones to admit family members.  Behaviors have a major impact on the quality indicators generated with each MDS. 

One example is a gentleman we met who continually hit staff members and scared other residents in the Alzheimer’s center where he was residing.  Caregivers felt they could resolve the behavior by providing him with a structured routine, meeting unmet needs, and encouraging him to participate in activities throughout the day. What the staff didn’t understand, however, was that these particular activities were not part of his normal life prior to nursing home placement.  Also, unbeknownst to the staff, the gentleman had been through a traumatic event in his twenties and the darkness of his room caused him to become frightened each afternoon as the sun set.  The nursing staff, feeling they had no choice, requested anti-anxiety medication, an anti-psychotic and an anti-depressant.  The resident soon became very unsteady, slept many hours throughout the day, lost his appetite and began losing weight.  One set of problems was traded for another.  ADL care actually became more difficult. 

After thoroughly interviewing the family, it was discovered that the gentleman had been severely beaten by a group of men in a dark alley after work one evening.  Better lightening was placed in his room so the dark shadows no longer existed.  The interview also uncovered that he previously had been involved in maintenance at his church. The maintenance director at the nursing facility was asked to create small opportunities for the gentleman to “do rounds” each day. His life now had some purpose!  Based upon interests in his earlier life, realistic activity kits such as a fishing kit, a tool kit, and a photography kit were developed.  He was occupied with personally meaningful activities daily and eventually all of his psyche meds were eliminated.

For more information call 317-218-5111 or www.alzcaregroup.com

For specific ideas or suggestions:  Call 317-218-5113  or check out www.alzcaregroup.com

 This week we honor the care givers who work hard each day to make the lives of our seniors living in long term care meaningful and rewarding.

 Many of these individuals see their work as a career – a part of their mission in life to help others. Consider the story of Mary:

 “Mary cared for my mother with such love and kindness.  When I had to place Mom in the nursing home, it was Mary who sat with me and held my hand; assuring me that everything would work out.  Mary always made sure to provide Mom with opportunities throughout the day to enjoy her past hobbies by adapting them to what she was able to do at that time.  Mary and Mom planted gardens, cooked Mom’s favorite dishes, enjoyed the holidays, painted ceramics, and many other rewarding activities.  Mary’s attention to each of the residents on the Alzheimer’s Center did not go unnoticed!  The families who came to visit often commented on how much the Center felt like home.”

 There are many examples of care givers who go the extra mile for their residents – CNAs, nurses, activity, dietary, maintenance, housekeeping staff, and the administration all working to achieve the perfect balance between meeting the medical needs of their residents and providing opportunities for success throughout the day.  Long term care is a demanding job with endless rewards. 

 Take time out this week to thank a care giver working in long term care.

 Thank you Mary, and to the others just like you, for your dedication to our loved ones.

For more information call:  317-218-5111 or www.alzcaregroup.com

I received this information today in the Alzheimer’s Association’s ENewsletter.  Please join all caregivers to make a difference in the lives of those who are battling this difficult disease.

Advocate Impact: Forum 2009 

Last month, over 600 advocates from around the country marched on Capitol Hill to demand that our lawmakers make Alzheimer’s a national priority.

During meetings with advocates, members of Congress made the following commitments:

       188 indicated support to end the two-year waiting period for Medicare;

       181 indicated support for a $250 million increase in Alzheimer research funding; and

       83 indicated support the creation of an Alzheimer’s Solutions Project Office.

       65 members indicated support for all 3 issues!

You can catch a glimpse of the action at: http://www.alz.org/forum

We have great momentum and now is the time to “seal the deal”. Read on…

What Can I Do Now?

Ask your members to co-sponsor the End the Medicare Two-year Wait Bill!
People under age 65 with dementia who lose their jobs are likely to lose job-related health insurance. Many become uninsured and uninsurable. Just when they need coverage the most, federal law requires them to wait two years to become eligible for Medicare. Because of this wait, families face soaring out-of-pocket costs for health care or completely forego care. http://alz.kintera.org/endthewait 

Email your members of Congress now. Ask them to co-sponsor the Ending the Medicare Disability Waiting Period Act of 2009 (S.700 / H.R.1708).

Go to:

For more information on how you can impact the lives of those with Alzheimer’s contact www.alzcaregroup.com or 317-218-5113

            As Alzheimer’s disease progresses it can impact the way a person may communicate.  Communication is vital in the care giving process.  It is the way we express our ideas, feelings, and wants.  In order to maintain a quality life, this basic need must be met.   

            An individual with Alzheimer’s may have trouble finding the right words, may misunderstand statements that are made, may repeat the same words or statements, or may revert to speaking a native tongue.  As the disease progress, caregivers may also see the person relying more on gestures than words.  For example, it may be easier to point to an object such as a cup of water, than to ask for a drink.  She may pat the sides of her waist to indicate she needs to go to the bathroom.  Some people may have trouble speaking in coherent statements where the phrases sound more like “word salad.”  Word salad is an incomprehensible mixture of incoherent words or phrases.    Caregivers must rely on gestures and other forms of nonverbal communication in order to understand what the person is trying to communicate.

            Despite the fact that communication may become more challenging as Alzheimer’s disease progresses, sensitive ongoing communication is important.  Although the person with Alzheimer’s may not respond to each statement, she still benefits from continued communication.

Tips to enhance communication:

·         Identify yourself by name and what you are going to do for/with the person. Even if you have known the person for years, it is still important to identify yourself and the task.

·         Call the person by his/her familiar name.

·         Use short, simple, one step instructions

·         Give the person plenty of time to respond to questions and statements

·         Limit available choices to two (2) for the person to decide from ( i.e. the blue dress or the red dress, a brownie or ice cream)

·         Don’t ask questions that rely on memory (remember when you ate eggs for breakfast last week?).

·         Speak in a strong clear voice; don’t yell unless the person has a hearing impairment.

·         Don’t talk down or childlike.

·         Turn negatives into positives. Say “Let’s go here” instead of “Don’t go in there.”

·         Turn questions into statement.  Say “Let’s go eat” instead of “Are you ready for lunch?”

·         Be aware of your tone of voice.  Convey an easy going attitude.

·         Approach from the front and never from behind.

·         Use positive, friendly facial expressions.

·         Be aware of your stance – avoid standing with hands on the hip or crossed arms.

·         Focus on feelings not on facts.

·         Validate feelings and help put those feelings into words.

·         Be patient, flexible and understanding.

            Good communication will bolster self worth, validate feelings, stimulate memories, and calm and reassure.

            As Alzheimer’s disease progresses it can impact the way a person may communicate.  Communication is vital in the care giving process.  It is the way we express our ideas, feelings, and wants.  In order to maintain a quality life, this basic need must be met.   

            An individual with Alzheimer’s may have trouble finding the right words, may misunderstand statements that are made, may repeat the same words or statements, or may revert to speaking a native tongue.  As the disease progress, caregivers may also see the person relying more on gestures than words.  For example, it may be easier to point to an object such as a cup of water, than to ask for a drink.  She may pat the sides of her waist to indicate she needs to go to the bathroom.  Some people may have trouble speaking in coherent statements where the phrases sound more like “word salad.”  Word salad is an incomprehensible mixture of incoherent words or phrases.    Caregivers must rely on gestures and other forms of nonverbal communication in order to understand what the person is trying to communicate.

            Despite the fact that communication may become more challenging as Alzheimer’s disease progresses, sensitive ongoing communication is important.  Although the person with Alzheimer’s may not respond to each statement, she still benefits from continued communication.

Tips to enhance communication:

·         Identify yourself by name and what you are going to do for/with the person. Even if you have known the person for years, it is still important to identify yourself and the task.

·         Call the person by his/her familiar name.

·         Use short, simple, one step instructions

·         Give the person plenty of time to respond to questions and statements

·         Limit available choices to two (2) for the person to decide from ( i.e. the blue dress or the red dress, a brownie or ice cream)

·         Don’t ask questions that rely on memory (remember when you ate eggs for breakfast last week?).

·         Speak in a strong clear voice; don’t yell unless the person has a hearing impairment.

·         Don’t talk down or childlike.

·         Turn negatives into positives. Say “Let’s go here” instead of “Don’t go in there.”

·         Turn questions into statement.  Say “Let’s go eat” instead of “Are you ready for lunch?”

·         Be aware of your tone of voice.  Convey an easy going attitude.

·         Approach from the front and never from behind.

·         Use positive, friendly facial expressions.

·         Be aware of your stance – avoid standing with hands on the hip or crossed arms.

·         Focus on feelings not on facts.

·         Validate feelings and help put those feelings into words.

·         Be patient, flexible and understanding.

            Good communication will bolster self worth, validate feelings, stimulate memories, and calm and reassure.

What are you going to do to make a difference in the lives of those with Alzheimer’s and their caregivers? 

So often we become stuck in the mindset that people with dementia have no hope.  The media often reports the stories of heart ache and despair, but we never hear the heroic stories of people making a difference for others being afflicted with this devastating disease.

Who are those heroes?

·         Families who continue to make life the life of the loved one valuable even when that means adapting past interests to current abilities

·         Families who continue to visit their loved one even when it appears she doesn’t remember them any longer

·         Family members who regularly rotate care and responsibility to ensure the primary caregiver receives some respite

·         Caregivers in long term care who engage their residents in dementia with personally meaningful activities

·         Caregivers who provide care despite  Congress cutting Medicare/Medicaid benefits

·         Owners of nursing homes who put Person Centered Care before the dollar

·         Innovators who continue to find new ways to bring quality of life to some who can no longer remember

Are you making a difference?  Do you know where to begin? 

For more information:  Call 317-218-5111 or www.alzcaregroup.com

Program Would Sound Alarm For Missing Senior Citizens

By Michelle Swartz 

In Florida last year, an 86-year-old woman went missing from her assisted living facility. Her disappearance drew widespread attention, especially when her body and submerged car were found a week later.
Florida enacted the Silver Alert system, which operates similarly to an Amber Alert for children.
Last month, the U.S. House of Representatives passed legislation that would provide funding for a national alert system to help find missing seniors diagnosed with dementia who might wander away.
Only a handful of states have adopted a Silver Alert law, but the bill would provide funding for all states to enact the program.
The measure would authorize $5.6 million a year for the next five years. Grants would be sent to states in amounts of at least $100,000, depending on the need.
The bill now goes to the Senate.
It’s an issue that local caregivers say is important.
Registered nurse Chezlynn  Chinavare in 2003 opened Elderly Solutions Inc., a Monroe senior care facility that specializes in care for residents with Alzheimer’s and dementia. She said she is pleased to see federal agencies supporting the alert system.
“We’ll be able to see their names and faces across the TV and people will be looking for them right away. It will save lives,” she said.
The Silver Alert would be modeled after the Amber Alert system, which uses media and highway message boards to alert the public of missing children. Detailed information of the missing person would be aired on local TV stations.
Last June, Michigan Congresswoman Candice Miller announced her co-sponsorship and support of the program.
“The Amber Alert System works, and it works well,” she said. “Our seniors deserve no less support, particularly those suffering from Alzheimer’s or dementia.”
According to the Alzheimer’s Foundation, more than 5 million Americans suffer from Alzheimer’s disease, and about 3 million will wander away at some point. The foundation also reports that nearly half of all wanderers could face serious illness or injury if not found within the first 24 hours.

For more information:  check out our website at www.alzcaregroup.com

The purpose of this activity is to provide residents with an opportunity to perform a past skill or responsibility and to stimulate reminiscence and socialization.

Materials:  egg carton, garden gloves, seeds, dirt, watering can, spray bottle, cookie sheet

Set-up

Find an indoor space with good lighting for seedlings and create an outdoor space for gardening.

Process

Getting Started

1. Decide what you will grow.  Ask the residents to help you choose what to plant.  Take time to reminisce and ask questions like,
   1. What vegetables did you grow from seeds?
   2. Where did you get your seeds?
   3. What vegetables did you grow from plants?
   4. What type of container did you start your plants in?

Seedlings

1. Ask families to donate seeds or buy them at a nursery.
2. Start seedlings at the beginning of spring.
3. Give each resident an egg carton.  Next, tell them to punch a couple of small holes in the bottom for draining.
4. Direct the residents to fill each egg holder halfway with dirt.  Next, tell them to add one seed to each egg holder.  Then, tell them to cover the seeds with dirt.
5. Give the first resident the spray bottle filled with water.  Next, direct the residents to spray water on top of each egg holder.
6. Place the egg cartons on the cookie sheet to catch any water that may drain out.  Next, follow the directions on the seed package to (1) decide where to put the cartons so the seeds will grow and (2) find out how often to water them.  Then, remind the residents in the coming weeks to water the seeds according to the directions.
7. Consider asking questions from Garden Trivia

 Copyright 2008             Alzheimer’s Care Group 

For more information:   www.alzcaregroup.com

In today’s edition of the McKnight’s Long-Term Care News and Assisted Living Newsletter I read this article on legislation that has been passed protecting our Seniors against abuse. 

“Economic stimulus legislation hasn’t been the only item on Congress’s plate lately. The House of Representatives Wednesday passed a bill that would fund elder abuse prosecution and establish education and therapy programs for victims and their families..”

The Elder Abuse Victims Act sailed through the House with a 397-25 vote. As part of the bill, Congress would direct the attorney general’s office to conduct research into current state and local elder abuse prevention programs. The legislation also would provide funding for elder abuse prosecution at local, state and federal levels, as well as law enforcement training and nurse-investigators to identify and evaluate elder abuse cases.

Between 1 million and 2 million seniors in the U.S. have suffered abuse, according to the bill’s sponsor, Rep. Joe Sestak (D-PA). There is currently no Senate companion bill, though Sestak has said the Senate would likely pass a bill soon.”

Call to Action:  Contact your Senator today.   Ask your Senator to pass a similar bill soon to protect those at risk for elder abuse. 

            Care giver stress often leads to elder abuse in all care giving settings.  Alzheimer’s Care Group can provide strategies and develop programs to enhance the quality of life for all care partners in long-term care settings.  For more information:   www.alzcaregroup.com