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Masking Memory Loss

As children grow up and leave the nest, they often spread out to different cities and even states. Career opportunities, a desire to live in a different environment, or the location of spouse’s family are just some of the reasons for moving away from their home town. Sometimes, they just need a little breathing room from their siblings or an overbearing parent. Family relations don’t ease with distance but may possibly soften over time. That is until, family members are confronted with a difficult situation.

Let’s say for example Joe, the oldest son, moved to the East Coast shortly after graduating from college. He made a point to visit twice a year, until the demands of his own family and job prevented him from making regular trips back to California. The youngest daughter Julia became a nurse and remained close to her parents in their home town. She and Joe had opposite temperaments and often did not get along. Julia is a natural caregiver and realizes how much she needs to compensate for her mom’s lapses in memory and ability to complete complex tasks. This has been taking its toll on her energy and is affecting her relationship with her own husband and kids. When Joe comes to visit, Mom is on her best behavior.  He doesn’t understand why Julia is so concerned about their mom’s decline. He resists any notion that mom has slipped.  Julia accuses him of being in denial. She becomes angry with Joe because he doesn’t see the sacrifices Julia is making for their mom.

Often times, those who are closest to the person experiencing memory loss are more likely to accurately assess the situation. Family members who are more remote, either physically and/or emotionally don’t seem to accept that there is a problem.

Those in the earlier stages of memory loss often practice a phenomenon I like to call “performing.” They realize they are expected to respond in a certain way while in a familiar situation. In the example above, Mom seems perfectly fine because she is performing. Conversations seem to flow easily because she is in complete agreement with Joe’s comments. She may not be able to articulate that it is hot outside, so she replies “Isn’t that the case.” when Joe remarks on the summertime. She will cover up the fact that she shoes are on the wrong feet because they are so comfortable that she didn’t even notice. She will ask Joe to set the table because he is so good at it, rather than reveal she can’t remember which side to place the fork.

The best way to get a remote sibling to see the real behavior of their parent is to identify the times when, in Joe’s case, mom is performing. He could make a statement that is clearly nonsensical and listen to mom agree. By gently challenging mom to do something spontaneously,  Joe could observe that lost look in her eyes, and perhaps frozen body language. When mom doesn’t know that he is watching, she is likely to reveal herself the way Julia sees her.

When family members can work together to accurately assess memory loss in a parent, they are in the best position to seek the appropriate level of care. Denying or delaying medical treatment for the parent and support for the caregiver is an injustice to the entire family.

 

 

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Reversing Roles between Parent and Child

Age related illnesses often cause parents to depend on their children for care. Roles become reversed. This is a confusing time to shift orientation from the self sufficient parent who guided and supported their children, to a parent who is dependent and needy.

Adults are faced with uncertainty on how to relate to their aging parents. Feelings of guilt, regret, and incompetence accompany the role reversal. No matter how much the adult is compelled by love, decency and gratitude for their parents, it feels strange to  become the caregiver.

Adults of aging parents are often in the stage of their life that is incredibly demanding. They are working long hours and caring for their own offspring. How do they add another time consuming role of caregiving for their own parents? The response we frequently hear is “You do what you have to do.” They squeeze in the time to try to do it all.

There are only 24 hours in a day, so something has to give when dividing time between work, spouse, parents and children. Activities which support well being such as hobbies, fitness activities and socializing are let go. Despite cutting back on time for themselves, there is still not enough time in the day. Adults doubt their effectiveness on the job, in their marriage, at caregiving and parenting.

We offer these tips to those who feel overwhelmed when caring for their parents while managing all of the other responsibilities of their current roles:

  • Acknowledge your feelings, then move on. You may have regrets that you didn’t do enough for your parents, spouse and children. If you realize that no one can please everybody all the time, you might just give yourself a well-deserved break.
  •  Slow down and take a breath. Breathing will calm you down and improve your ability to think with a clear head.
  •  Let go of the notion that no one can do it as well as you. Let others help when offered. Ask for help when needed. Allow your children to help their grandparents within their abilities.
  •  Explore opportunities for respite. There are home health agencies which offer respite services on an hourly basis, and many assisted living communities will provide care for several days/weeks. If there is no money to pay for respite, ask another family member or trusted friend to give you a break.
  •  Realize that you are not alone. Confide in your friends and clergy about your doubts and fears.

Caring for others without short-changing yourself can be tremendously rewarding. It is the greatest honor to help those whom you love.

 
 

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Breaking the News

Breaking the news to a parent that it is time to move from their home into an assisted living facility is one of the most difficult tasks according to most of the families we meet. While some individuals welcome the benefits of living into a senior community, many fear their loss of independence and are not ready to face their inability to care for themselves. We have seen many approaches, and just as individual personalities and situations vary, so do the successful ways in breaking the news.

It is helpful to bring up the idea on several occasions. Mom or Dad will likely resist at the first mention of assisted living, but may warm up to the thought over time. We recommend that you do some research before bringing up the subject. Pre-screen a few communities you think would fit Mom or Dad’s needs. Then, talk to them about their preferences for living arrangements and explore options together. Most communities have web sites where you can take a “virtual tour.” Check out the community’s reputation with their licensing agency, the local Ombudsman’s office and the Alzheimer’s Association. Once you have selected a few, make an appointment for a tour and bring your parent with you. By encouraging their participation, they will become more invested in the idea. Once your parent learns about their living arrangements, activities and comforts of care, they may look forward to moving.

Decorate their new room or apartment before the move. Many communities will encourage bringing bedding, furniture, pictures, and memorabilia. Familiar belongings will trigger feelings of comfort and security. Do not bring valuables or items that you won’t mind getting misplaced or damaged.

Perhaps your parent is very stubborn and absolutely refuses to talk about the idea of moving into assisted living. The idea may become more acceptable if it is based on the recommendation of a trusted doctor. Further, constantly reassure your parent that you and other family members will remain involved in their life, and follow through on that promise.

We definitely do not recommend dropping off them for “lunch,” moving their belongings into their bedroom while they are dining and making a quick get-away. We have witnessed this approach and it always results in a great deal of emotional trauma. Residents of assisted living facilities do not give up their personal rights, and cannot be prevented from leaving if they absolutely refuse to stay there.

Respite care is an option to temporarily try assisted living. Just as a daunting task can be more manageable by breaking it down into smaller steps, respite care allows an individual to stay for a few days, or up to a month, to see if it is the right environment. In our experience, many residents want to stay longer, once they get settled in.

In other cases, the individual’s impaired mental capacity prevents them from being actively involved in the decision making. Many of the same recommendations apply for those with dementia, plus:

  • Carefully research communities and select one which has a dementia program.
  • Speak with the staff about your parent’s background and any special needs.
  • Make the move during their best time of day when they are calmest.
  • Stay positive – your attitude is infectious. Do not communicate any feelings of guilt or anxiety.
  • Provide constant reassurance that Mom or Dad is in a safe place.

 

 

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The difference between Alzheimer’s Disease and Dementia

There are many misconceptions about Alzheimer’s Disease (AD) and dementia. Dementia is actually a set of symptoms which arises from a number of conditions or diseases. AD is one of those diseases. In fact, it is the most common cause of dementia . Other diseases include vascular dementia, Parkinson’s Disease, Lewy Body and Pick’s Disease. Brain disorders such as Huntington’s Disease and AIDS can also result in dementia. The diseases are degenerative, meaning the symptoms will get worse over time.

Some causes of dementia are reversible. Reactions to prescription medications, chronic alcohol abuse, thyroid conditions, vitamin deficiencies, brain tumors or water on the brain (hydrocephalus) when successfully treated, can result in the return of brain function.

Dementia symptoms involve more than just difficulty remembering things. The symptoms have to be strong enough to get in the way of accomplishing normal daily tasks. Memory loss, a short attention span, inability to plan or follow a sequence of instructions, finding the right words, and personality changes are just some of the problems faced by a person with dementia. The symptoms cause a change in the person’s abilities compared to what they could do befor.

When a doctor diagnoses a person with AD, it means that the person’s symptoms and test results show that it is highly likely the brain will show the pathological features (plaques and tangles) of AD.

There is no cure for AD, but treatment of the disease and the symptoms of dementia are advancing over time. It is important to consult a physician as early as possible if there a suspicion that a change in the ability to think and recall are getting in the way of handling demands of everyday living. Medications such as the Exelon patch, Namenda and Aricept can be prescribed to slow the progression of the disease.

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Forgetfulness vs. Memory Loss

Dementia is a growing disease among our elderly population. Most of us know someone who has dementia or is dealing with a loved one afflicted by the disease. It is natural to be concerned when you can’t recall a name or misplace something important.

It is scary to think about the possibility that dementia could happen to you.

There is a difference between forgetfulness and memory loss. You probably forgot to do things and misplaced your stuff when you were younger and didn’t think much about the implications.  As you get older, it may be hard to tell if moments of forgetfulness are normal and simply inconvenient, or the start of something more serious.

When forgetfulness becomes consistent and produces strange things, it may be time to talk to your doctor. Here are some examples:

  • Losing your keys is OK. Finding your keys and not knowing its function is not.
  • Putting your hairbrush in the second drawer of your vanity instead of the top drawer is OK. Putting your hairbrush in the freezer  is not.
  • Getting lost in a new town or place is OK. Getting lost in your own neighborhood  is not.
  • Forgetting the name of an acquaintance you rarely see is OK. Forgetting the name of one your children is not.

Your doctor can do an assessment and involve specialists to make an informed diagnosis. If you do have memory loss, your doctor can determine the cause of your memory loss. Some causes are reversible (side effects of medications, poor nutrition, alcohol abuse, stress, anxiety, depression and other health issues) where strategies can be developed to cure the problem. Permanent memory loss can be slowed down with treatment. Like other medical issues, early intervention is key to optimize the outcome.

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Finding Balance in Caregiving

Caregivers understand that they face demanding, yet rewarding circumstances when caring for a family member. For adult children, it can be a way of giving back to a parent. For a spouse, it may be the expression of a love that never ends. In addition to knowing that they are fulfilling the needs and preferences of their family member, caregivers often express the feeling that they live a more purposeful life and are at peace with themselves.

The most successful caregivers are blessed with strength, endurance, compassion, patience and unselfishness. Not everyone is naturally endowed with these virtues, so we suggest making an honest assessment about your caregiving attributes and be realistic about the needs of your family member. Caregivers who understand their strengths and shortcomings can learn to find a balance between their role as a caregiver and their personal needs.

Caregivers need to embrace the notion that successfully caring for another also requires caring for themselves.

Rarely, can a single person fulfill all of the responsibilities needed by one who is suffering from a disease or disability. It usually takes a team of health care professionals, family members, care providers and support services. Caregivers can better manage such a demanding job by using the resources of others. Studies show that taking periodic breaks from the caregiving role (known as respite,) participating in support groups and/or counseling help caregivers remain successful, with less stress and greater satisfaction.

This may seem obvious, but in reality caregivers are more likely to get wrapped up in the role of caregiving to the extent they neglect their own health. According to the Family Caregiver Alliance, depression, coronary heart disease, hypertension, poor immune function, slower wound healing and increased risk of mortality are faced my many caregivers, especially women.

If you are a caregiver, how can you find balance, take care of yourself while providing the care that your family member needs? While the answer is simple, it may not be so simple to do. It is the act of letting go and acknowledging that others can help you from time to time with caregiving.

Options range from creating an informal support network of relatives, friends and neighbors to using organizations devoted to helping caregivers. Although you may not have received offers from relatives, friends and neighbors to help with caregiving, it doesn’t mean they are unwilling to lend a hand. They simply may not know how to offer or what to do. You may be surprised at their quickness to agree to help with a specific task.

Remember to take care of yourself, it’s the first step in taking care of the one you love.

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Seniors Helping Seniors

Entering stage right, are Jean and Howie Harris of the “Jeannie and Howie Show.” A Brand New Day had the honor of spending some fun and enlightening time with this couple. Dave had the opportunity to meet with these two lovely people for an hour and found their passion, love of people and giving was infectious. Howie and Jeannie have been married for four years and want to give back to their community. Howie is a retired marriage and family therapist and taught at Santa Rosa Community College. They both have had experience with assisted living communities and hospice services with loved ones in their lives.

They are a well known and popular singing couple that performs for seniors all over Shasta County and in assisted living facilities. The couple continues to entertain with permanent bookings at various locations throughout Redding. They will be performing again at A Brand New Day in July.

Jeannie and Howie have both competed in the Senior Idol competition at the Cascade Theater in 2009 and 2011. Jeannie placed third in 2009 and earned first place in 2011 at age 84, singing “Cabaret.” Howie, who is 79, closed the 2011 show with the Beatles song “Hey Jude.” Jeannie and Howie have has a warm spot in their heart for the Senior Idol competition, which is no longer in production. Because of this and their love for the audience they are now performing in Redding as volunteers. It is their way of giving back.

Jeannie said, “The Senior Idol was a thrilling experience. To sing for an audience of over one thousand at the sold out shows gave us our five minutes of fame. The show will be missed.” She added with a smile, “Singing keeps me feeling young and living with a purpose. It is very gratifying to see smiling faces as the audience recognizes an old song they remember.” Howie and Jeannie both sang for A Brand New Day Mother’s Day celebration this year; the residents loved them. Their volunteerism was paid in smiles and applause which is their fulfilling reward.

Since their focus is giving back to the Redding community they sing for seniors, and engage the audience with songs of days gone by. If you would like to see a performance, you can watch their video on YouTube.com by typing in Jeannie Harris.

Jeannie believes, “We need to keep the seniors engaged in life and to experience music, which I understand is a form of therapy.” It is said that music stimulates more areas of the brain than any other stimulus. It can conjure up, memories of a first date, getting married, or a terrific vacation. Remembering the words to the songs of the good ole days is engages the part of the brain known as the hippocampus.

Howie and Jeannie continue to entertain seniors with oldies but goodies and country songs. The couple believes seniors don’t want to be in the way, or “bother anyone.” They have turned that statement around with their willingness and passion to perform. The couple sings and performs for parties, bbq dinners, and just about any other celebration involving seniors. To check their performance schedule, give them a call at 229-1300.

 

 

 

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Its Time to Embrace Aging

When did you notice your appearance began to look older? As astonishing as this may seem, a survey of 4,000 women revealed they were worried about looking older at the age of 28. Perhaps it’s not so astonishing given our youth oriented culture and all of the companies which promise the fountain of youth in a pill or jar.

Even so, there comes a time when the mirror reveals unwanted spots, wrinkles, sagging skin, graying and thinning hair.

Aging is inevitable, yet it is something most of us try to resist. We become serious about using sunscreen, buying miracle creams and hair color. Still, time marches on and there is only so much you can do.

The lucky ones reach a turning point and decide that is it OK to look older. Wrinkles become character lines. Gray hair looks distinguished. Age becomes something to brag about: “I’m 75 years young and going strong!”

How do you get to the point where you stop worrying about what you see in the mirror, to embracing the notion that being good is better than looking good?

It starts first with letting go of appreciation for the superficial. This is good for any age. There is always going to be someone who looks younger, fitter, faster, stronger. Sooner or later, focusing on superficial qualities will lead to disappointment.

Second, it helps to change your perception of aging. Let go of “fighting every step of the way” as a skin care commercial suggests. Aging is not something to be battled. It is something to be embraced. Aging is evidence of a long list of memories, of purposeful work, of love, and making a difference in the lives of those around you. Age can bring wisdom drawn from a variety of experiences.

Third, understand that attractiveness is not dependent on meeting cultural standards of beauty. People are attracted to those who are confident and comfortable in their own skin, no matter if it is firm or wrinkled. People want to be around someone who shows confidence and poise.

Happiness and enthusiasm are also attractive. Seek out the things that make you happy and spread your joy when you find them. Look for others who share these traits and it will be easier to keep the good vibes going.

Beauty truly comes from within, especially as we age. But keep in mind that you can help it along by taking care of yourself. This includes getting plenty of sleep, managing your food and alcohol intake at a healthy level, exercising on a regular basis, and following your doctor’s orders for medications.

A little vanity is OK too. It helps to be confident in your appearance when you practice good grooming and wear clean clothes that fit. Don’t worry about the latest fashion trends. Fashion comes and goes, but the classic look sticks around. Most would agree that dressing like a teenager looks pathetic on adults, young or old.

Finally, try to smile more often. It’s the ultimate facelift.

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Helpful Information for Seniors

A Brand New Day – Redding writes a Senior Living column for the Record Searchlight which can also be seen online at Redding.com. We talk about a wide variety of subjects with common thread about topics relevant to Seniors and their families. To follow is a compilation of last month’s posts. We hope you enjoy them.

Senior Living: How to Determine if Someone is having a Stroke and Manage Risk Factors

25 Oct 2012

According to the National Stroke Association, stroke is the fourth leading cause of death in the United States. Stroke kills 133,000 people per year and is the leading cause of long-term disability in seniors. Close to 800,000 strokes will happen this year at a rate of one every 40 seconds. Someone will lose their life to a stroke about every four minutes. (click for the entire story)

Senior Living: A Primer on Patient’s Rights in a Skilled Nursing Facility

10 Oct 2012

Don’t believe you are at the mercy of the nurses and administration when you have to spend time recovering at a skilled nursing facility. Read more for a frank Q & A about your rights.  (click for the entire story)

Senior Living: Easy Ways to Prevent Falls while Bathing

5 Sept 2012

Falls are one of the leading reasons for hospitalization among seniors in the United States. Falls result in fractured hips, ribs and bruising, all of which are painful and some require surgery, physical and-or occupational therapy. Falls can happen to the elderly quite easily and can quickly turn into a devastating event. Read more for a way to learn how to make your bathroom safer and reduce your fall risk while bathing. (click for the entire story)

We are on Facebook

If you would like to become a Facebook fan and connect to others who share your interests, please check us out on our Facebook page at ABrandNewDayRedding. Every Friday we have a PhotoTeaser, (click for the entire story)

A Brand New Day is a 26 bed Memory Care assisted living facility in Redding, CA focusing on Alzheimer’s and dementia, respite and hospice care. Our license number is 455001567. We invite you to contact us with any questions when you are concerned about the safety of a loved one at 530.223.1538. We are happy to be your Senior Care resource.

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A Day in the Life at A Brand New Day

I wake up to a sunshine filled room and there is a huge young man greeting me with a friendly “Good Morning Wilbur!” I have no idea where I am, or who he is, but figure that it can’t be that bad because he knows my name and he seems nice.  I fake it and reply “Good Morning to you.” As usual, my bones ache and my feet feel numb, so it is nice that the big guy is strong enough to help me out of bed.

I just wish I could figure out where I am. Oh, wait a minute… aren’t I needed in the barn to collect eggs? My dad and uncle will be so mad at me if they find out that I slept in. I’m going to be in such trouble! I can see that the big guy has a name tag on. It says Adam. I ask Adam for help to get to the barn, but he says we don’t have a barn. Oh my, what is going on?

Adam can see that I am upset so he attempts to comfort me. I don’t know what he is talking about but follow his lead to the bathroom to wash up for breakfast. What a relief, all of my stuff is laid out next to the sink so I know what to do next.

As I walk down the hall, I smell coffee brewing, and bacon and eggs on the stove.  I’ve always loved fresh eggs, but I have this vague feeling that eggs are a problem. I sit down at my spot, surrounded by people,  yet none of the faces are familiar. I am served my favorite breakfast, eat my fill and the plate is removed for me. Mom is such a good cook. Where is she? Where am I?

Adam is back and he is handing me a little paper cup of pills with a glass of water. “Here Wilbur, take your medicine. It will make you feel better.” I trust him and swallow the pills. Now I am following Adam to the living room to watch the morning news. How does he know that I want to look at the news each morning? I literally don’t know him from Adam.

Just as the news is ending, a lady greets me and asks me if I want to go to the Sun Room for Bible Study. I can’t remember when the last time I went to church, so I figured I should go. She walks me to the Sun Room where there are a group of old people sitting around listening to this old guy read from the Bible. How come there are so many old folks around? I sit down on a warm and cushy chair listening to a story about David and Goliath when I wake up with a start. No one is reading from the Bible any more. How long have I been asleep?

I notice a group of people playing a game outside in the courtyard. The lady catches my eye and encourages me to join them. What the heck, I’m good at games. You’d think I won the World Series the way the group cheered when I tossed the ring into the center hole. This feels good!

My stomach is grumbling just when the big guy comes around to help me wash up for supper. What is his name again? We’re having beef stroganoff over egg noodles, broccoli and mixed fruit. I hate broccoli and am relieved that I am not being treated  like a child when I don’t clean my plate. No one says a word when I start in on the cherry pie. We always had a big meal in the middle of the day on the farm, so I know everything is all right. I’m given more pills to swallow.

After the tables are cleared, the big guy and the lady start setting up for bingo. This is popular with the old folks, but I like it too. It seems like everyone else is winning prizes but me, so I get a little grumpy and announce that I’ve had enough. The lady persuades me to stay for one more game. Lo and behold, I win!

I wake up from my recliner and the light is dim outside. Oh, this is so confusing! Where the hell am I? Who are all these people around me? There’s another lady who wants me to swallow a pill but I swat it out of her hand. Where is that big guy? I see shadows through the windows and suspect they are coming right at me. “Get those bastards out of here!” I scream.

Everyone seems so concerned. I follow a younger lady into a brightly lit dining room. She hands me a cup of tea and asks me to tell her about my farm. We talk and fold napkins together. This ain’t so bad.

Now it’s time for dinner. Chicken noodle soup, warm yeast rolls, green salad and chocolate pudding. Mom is such a good cook. Where is she? I haven’t seen her all day.

I settle into my favorite recliner and watch Bonanza.  Another lady, the pretty one, offers me a glass of milk to wash down my night time pills. I’m glad they help me remember because that doctor has put me on so many pills that I couldn’t keep them straight on my own.

All in all, it’s been a good day. I’m tired and ready for bed. The pretty lady tucks me in. I feel safe and warm.

This is a story of an 87 year old man with Alzheimer’s Disease. His short term memory is gone, but his childhood days come back to him vividly. It is not uncommon for those who have Alzheimer’s Disease to experience “Sundowner’s Syndrome” in the late afternoon. While this is a fictional account of a day in his life, it is an accurate reputation of the rhythm of life at A Brand New Day.  

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