ComForCare Home Care Serving Somerset & Northern Middlesex Countries

Posts Tagged Aging

How Dementia Affects the Ability to Complete Simple Everyday Activities

Monday , February 11 , 2019

How Dementia Affects the Ability to Complete Simple Everyday Activities

I felt a cleaving in my mind
As if my brain had split;
I tried to match it seam by seam,
But could not make it fit.

The thought behind I strove to join
Unto the thought before
But sequence ravelled out of reach
Like balls upon a floor.

I’ve always loved this marvelously precise description by Emily Dickinson of the experience of losing your train of thought. It’s an experience I think we can all immediately relate to, and one that reminds us that our brain is a tremendously complicated machine that sometimes misfires.

Most of the time, of course, the sequence of our daily activities is something we don’t have to give any conscious thought. The socks must go on before the shoes. We have to put water in the kettle before turning on the stove and wait for it to boil before pouring it in the cup.

But for people with dementia, planning out activities that must be done in sequence becomes overwhelming.

Dementia’s impact on executive function

According to the National Institutes of Health, Executive functions (EFs) make it possible to

  • Mentally play with ideas
  • Take the time to think before acting
  • Meet novel, unanticipated challenges
  • Resist temptation
  • And stay focused

In those with dementia, executive capacity is affected at a very early stage. These impairments make it difficult to think out, plan and execute an action, often causing complications with activities of daily living. Sometimes, these problems will show up even before memory difficulties.

It should be noted that since dementia is typically a progressive condition, difficulties with executive function usually worsen over time.

Examples of executive function in dementia

Activities that require several different steps, no matter how routine, can become difficult for those living with dementia. Your loved one may become confused while trying to complete a previously-familiar task, lose track of where they were in the process, or just lose interest altogether and walk away.

Here are some signs of impaired executive function that you should be aware of:

  • The person has trouble preparing meals (even those they used to make on a routine basis)
  • He or she often stops in the middle of projects, failing to complete them
  • The individual is less engaged in a hobby that once absorbed them (gardening, scrapbooking, crosswords)
  • They have lost interest in a talent that they were once proud of (music, painting, quilting)

How to handle impaired executive capacity

With the support of those around them, individuals with dementia can still manage a wide range of activities despite their difficulties. Keep calm, remain patient, and remember the following tips:

  • Even though your loved one may have difficulties with simple tasks, they likely don’t want you to take over, just help
  • Allow as much independence as possible
  • Never scold or make comments about mistakes
  • Give verbal directions one step at a time. For example, “get dressed” may be too vague and overwhelming, while “put on your undershirt” may be just right.
  • Even better? Lead by demonstrating. Try laying out your elderly loved one’s clothes in order (with underpants on top) or show them how you put on your own sock and shoes.
  • Practice the activity using the same exact routine every day
  • Allow extra time to decrease stress
  • Use humor appropriately

Bottom line? It’s ok for your loved on to take a break and try again later if they need to. It’s even ok to completely give up and allow someone else to help! The key is to be supportive and kind, don’t push them into anything they don’t want to (or really can’t) do, and allow mistakes to happen.

Posted in: Aging, Dementia

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Common reasons seniors refuse to bathe and how to help

Monday , January 14 , 2019

Common reasons seniors refuse to bathe and how to help

With advancing age, many seniors become reluctant to bathe. The reasons why can vary greatly from person to person. Though illness and disease are often to blame, for others it may be a case of embarrassment or depression.

Below, we’ll discuss those and other reasons your senior may be avoiding bath time.

Weaker Senses
With age, the senses of sight and smell decrease. Body odors and stains may be obvious to you, but your loved one may not even notice the most unpleasant smells. This is especially the case when it comes to their own odor, as people become “nose blind” to smells after only a few minutes of exposure.

Depression can make simple tasks seem like impossible feats–and while personal hygiene is important, those who are feeling down often cannot muster up the energy to do something as simple as brush their teeth.

If you notice that your senior is reluctant to bathe, it’s wise to rule out depression as the cause right up front. Keep an eye out for these other common warning signs and consider a trip to see their doctor.

Fear and pain

For many seniors, the bathroom can be a downright scary place–especially at bath time. Wet, slick floors are a recipe for disaster, and every bath or shower offers a new opportunity to slip and fall (perhaps breaking a hip, or worse). In addition, the bath itself can be uncomfortable for the elderly. Many seniors become cold easily, and joint pain can make it difficult to find a comfortable seated position.

For dementia patients, these issues are often amplified. Your loved one may not understand why there is water running on them and become afraid or hallucinate. They often don’t understand what you’re trying to do and think you want to hurt them.

Lack of control
As people age, they lose more and more control over their own lives. From driving a car to something as simple as opening a jar by themselves, lost abilities are a part of everyday life. The one thing elders often cling to longest is their own personal hygiene, and they can be very reluctant to give that up. For many, it can seem like a final step towards death and they fight it as long as they can.

Tips for helping a senior bathe
There are many different approaches once you’ve figured out why your senior is reluctant to shower or bathe. It can take some trial and error, and often involves compromise, but you can find a solution.

Here are some of our best tips:

Keep the environment safe
If your loved one is avoiding bath time out of fear, there are several things you can do to ease their mind.

• Check the water temperature beforehand to make sure it’s not too hot or cold
• Use a hand-held showerhead to avoid water on the face
• Make sure there is a rubber bath mat and safety bars in the tub
• Start by washing the least sensitive parts of the body first, such as feet & hands
• Keep toiletries and other supplies within easy reach
• Use a sturdy shower chair to help a senior who has trouble standing
• Keep the bathroom floor clean and dry to help avoid falls post-bath
• And, most importantly, NEVER leave your loved one alone

Ease embarrassment

For many seniors, getting help with bathing is embarrassing. It’s vital to do what you can to help them feel comfortable.

• Use a large towel or shower curtain to cover your senior while they undress
• Keep a towel over their private areas while bathing and use a sponge or washcloth to clean underneath
• Give them a washcloth to hold and allow them to do as much as possible on their own
• Distract them with conversation if they become upset
• Note that sometimes it is less embarrassing for a senior to be bathed by a stranger, so bringing in a third party may help

Make hygiene fun
If you find yourself in a power struggle with an elder who simply will not bathe, try making it into a game. Bribery may seem silly, but sometimes the promise of something fun to look forward to can do the trick.

• Turn bath time into a “spa day” by using scented products and your loved one’s favorite lotions
• Get “spruced up” to go out to lunch or to a favorite park
• Reach out to an old friend and set up a special dinner date for bath day
• Put on some happy music and sing your way through bath time
• Don’t forget to say how wonderful they look and smell after their bath

If all else fails, compromise
Above all else, maintaining a loving, trusting relationship is key. When it comes to hygiene, sometimes you have to lower your standards and meet in the middle. Do not expect or insist on a bath or shower to happen every time it’s on the schedule: sometimes it’s just not going to work out.

Final thoughts
If personal hygiene has become too overwhelming for you or your loved one, we can help. At ComForCare, we not only have the professional experience to ease your troubles, but we’ve been through it ourselves.

One of our favorite parts of the job is educating you and your family about senior health and caregiving. The more you know about the prognosis, care, and treatment of your family member’s condition, the more in control you can feel.

Posted in: Aging, Caregivers, Home Care

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Tuesday , April 21 , 2015

Seeing the Whole Elephant

Remember the ancient Indian parable of the blind men and the elephant? In the story, six blind men are brought before an elephant. Their task is to figure out what it is they are dealing with. But each man’s experience of the elephant is limited to the part right in front of him. Touching the elephant’s trunk gives a completely different experience than touching the ear or leg, so they come to very different conclusions about what the elephant is.

So often our experience of being a patient in the health care system can feel like being that elephant. Every specialist we see understands a part of us, but no one is looking at the big picture, or seems to have responsibility for making all the parts work harmoniously.

That’s certainly what I felt after my mother had surgery to remove a hematoma in the brain resulting from a fall on her back porch. There was a neurologist, a cardiologist and a pulmonologist to track down and get updates from. But you could never get them in the same room at the same time. And no one pulled all the data together to present to me. No one spoke for the whole person that was my mother.

Even worse, at moments, I could see her through their eyes and realized they were seeing a passive, diminished person. She looked somehow shrunken sitting in a chair in her hospital room. And, face it, no one looks powerful in a hospital gown.

But she was only 78, and I knew that just a week before the surgery, despite some health problems, she was a dynamic, vital woman who was looking forward to starting another season of teaching her piano students. She had been teaching piano and music pedagogy for over 50 years. She was a recent past president of the Music Teachers National Association.  In many ways, she was just as smart and just as on top of her game as the doctors were. It was painful that they didn’t see it.

That experience informs the way I want to interact with our home care clients. No matter their age or health status, these are human beings with goals, values, abilities and desires that matter. Our job is to give them support for their health and well-being with as little compromise as possible to their independence and personal integrity.

To succeed in this we need to gain an understanding of the whole person. That means considering not only a client’s health needs, but her personality, physical environment, social support network and her preferences. Everything from the client’s medication schedule to the fact that he prefers his coffee in the blue cup can be important to providing high quality, respectful care.

We are fortunate in home care that we can take the time to talk to the families and clients we serve and get to see them as individuals. Our initial RN assessments and interviews are extensive. Our nurse always asks the client what his or her goals are, and we judge our success by how close we can come to achieving them.

And with my mother’s experience in the health care system in mind, we spend a lot of time communicating with other care providers and encouraging them to share important information with the clients, their families and each other.

Looking at the whole person helps us do a better job for our clients, and it makes our days a lot more fun and interesting.

Posted in: Aging

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