Apathy is a Main the Road Block of Dementia Care at Home

HTML5-roadblock-ad-formatPsychological Condition..

Apathy, and anxiety are common conditions experienced by people with dementia. They are known as psychological conditions because they can affect a person’s emotional and mental health.

What is Apathy?

Apathy is a persistent loss of motivation to do things, or a lack of interest in things. It is different from depression. Many people feel short of ‘drive’ or ‘lose their ‘spark’ occasionally, but apathy is a consistent and persistent state of mind. Apathy is much more common among people with dementia than in older people without dementia. About 2–5% of older people without dementia have apathy at any one time, but
about 50–70% of people with dementia have apathy. These numbers are so significant that the relationship between dementia and apathy is unavoidable. Apathy can start at any stage of dementia but often develops early on. Many studies suggest that apathy becomes more common as dementia progresses. Once present, apathy tends to persist rather than come and go.

What are the symptoms of apathy?

A person with dementia and apathy will have less motivation, as well as
some or all of the following changes:

  • lack of effort or energy to do everyday tasks
  • lack of structuring their daily activities, and/or reliance on others to structure daily activities
  • loss of interest new things, such as meeting people and current events
  • lack of concern about their own problems or lack of planning to address these problems
  • unemotional responses to news or personal events (news or events that would have received an emotional response prior to the dementia)
  • lack of interest in friends and extended family
  • lack of interest in hobbies and activities previously enjoyed

What can be done to help?

Although numerous studies have found that brain changes as a result of dementia are the main culprits of apathy, it does not mean that a person with dementia who has apathy is not able to have fun or enjoy themselves. It means it will take more effort and creativity to accomplish this.  Creating as many opportunities as possible to socialize and reduce isolation is extremely important. Encouraging a person daily to perform activities that they used to enjoy is necessary and important. Having these activities close by and readily available is key. Creating an environment where activities are plentiful and different in scope is important. Addressing the apathy and isolation as soon as possible is key. The longer a person stays isolated the more likely that isolating lifestyle will become a habit that is harder to break.

The Importance of a Cognitive Care Community for Dementia Care

We All Age But…

There is no way to avoid the aging process. Our bodies age, we get new wrinkles in relative the same pace. The one difference is, our Brains age differently. The majority of us will encounter some level of age related decline, but some of us will experience a more pronounced level of cognitive decline and/or dementia. Although our chances of getting dementia increase with age, dementia is not a part of the natural aging process. Dementia is caused when the brain is damaged by diseases, such as Alzheimer’s disease or a series of strokes.

Many Studies have been done Comparing the Aging Population with those with a Cognitive Impairment or Dementia…

There have been numerous studies done involving those with Mild Cognitive Impairment (MCI) or Mild Dementia that looked at how that impairment changed a person’s views about themselves. These studies showed that Cognitive Impairment showed  could profoundly affect a person’s understanding of their place in the world.

Two Groups of Seniors…..

Studies looked at two groups of seniors. One group of seniors without a cognitive impairment or dementia and one group with one or both of those impairments. Both groups described experiencing common memory mistakes such as forgetting names of friends and neighbors, misplacing common items, and repeating themselves in conversation. These incidents resulted in a variety of negative emotional experiences and self-evaluations that were expressed differently by the two groups. Participants with age-normal memory changes described feeling as if they are getting forgetful but attributing that forgetfulness to normal aging that happens to everyone and laughing it off as a goof. On the other hand the group with the  MCI or dementia felt “bothered,” “upset,” and “embarrassed” by their memory mistakes. They expressed some degree of self-doubt about their abilities and a tendency to put themselves down.  Some even said that their memory mistakes made them “feel stupid.”

More Differences Between the Two Groups of Seniors…

Memory changes showed to have important consequences for everyday social interactions and relationships with others. The changes described were generally positive for older adults with age-normal memory changes and generally negative for those with a MCI or Dementia. The group with normal memory change described a sense of camaraderie with their same-age peers who experience similar types of memory changes.  In contrast to the normal memory group, individuals with Cognitive Impairment spoke about how their memory problems have led to social withdrawal and isolation . They also stated that they “don’t get out as frequently,” that they are “withdrawing more from social occasions,” and even that they have become more “introverted.” There are a variety of reasons as to why memory problems have led to social withdrawal in the group with the Cognitive Impairment. Remembering friends’ names and shared experiences is an important part of social relationships, and failure to do this can be embarrassing or frustrating. For some individuals, withdrawing from social interactions is a way to avoid embarrassment. Seniors with a Cognitive Impairment, said they have more difficulty engaging in activities because their more significant memory problems leave them feeling lost, confused, or embarrassed. They describe feeling left out or disregarded in social interactions, thus causing them to withdraw from these activities to an even greater degree. In many cases the result is a loss of confidence which leads to withdrawal from social and leisure activities, and the consequent decline in participation in these activities results in increasing difficulty in these areas, followed by further loss of confidence and feelings of inadequacy.

What Happens when the Two Groups Consistently Interact….

In most cases Cognitive Impairment or Dementia will not get better. It is a progressive disease that only gets worse. Currently there is no cure. It is almost impossible to teach all those Without a cognitive impairment how to interact with those With a cognitive impairment correctly. In many cases they wont even understand or know what they are doing wrong. When seniors with no cognitive impairment consistently interact with seniors with cognitive impairment, the deficits of the impaired group become more and more obvious each day. These results lead to decreased confidence and ultimately isolation for the group that is cognitively impaired.

screensavers-widescreen-field-tulips-screensaverWhat is the Answer?

Although there is no perfect answer or a solution, the best answer is a Cognitive Care Community.  A community where all the residents have a degree of cognitive impairment and are grouped by the level of their impairment. In a Cognitive Care Community, residents interact with those that are on their level cognitively. They may be enjoying a lunch where all the table mates take turns telling the same story they already told. Because all of them are doing it, no one is made to feel worse than the other. There is no one at that table that will cut off a table mate mid story and say “you already told us that story”, “stop being repetitive”. All four leave the lunch feeling good about themselves without their deficit being in the forefront.  The goal is to make those good feelings last for as long as possible…

 

Mom Needs Memory Support not Memory Care

Does mom need Memory Support or Memory Care? Good Question

I would first like to start with saying that appropriate Memory Support prolongs the need for Memory Care. In a traditional community setting, those with moderate dementia are either not thriving in Assisted Living or have to move to Memory Care too soon. In my opinion providing the right amount of memory support is the toughest area of senior care because it is not strictly defined.

Can Memory Support ever be Strictly Defined?

The answer is No. imagesqqProviding Memory Support to someone with Alzheimer’s & Dementia is like providing a step stool for someone who needs a boost to see over a ledge. The difference is there are different ledges so different step stools are needed. Providing the right amount of support will enable a person to function as independently as possible. Providing too much support will further disable a person and result in a cognitive decline, and providing too little will hinder a person’s abilities to function and thrive. Cognitive Care is another way to describe Memory Support. Memory Care is a specialized care unit/section/or building where maximum cognitive assistance is provided and independence is limited. Memory Care is also usually a small, secure section, where activities and daily interactions are done in a group setting.

Types of Memory Support

  • have duplicates for commonly lost items, and also knowing the hiding places (for this group of folks, the less space they have the better)
  • know their schedule and guide the person through the day, personally guide to appointments and events
  • anticipate needs and provide assistance without being asked
  • explain tasks by breaking them into parts, with easy to understand sentences
  • know and understand the daily routine and provide assistance in a way that does not make a person feel that they need assistance
  • do not assume a person ate if you did not see them eat.
  • while providing additional assistance, make it seem like you are providing a regular service.
  • keep an eye on someone from 10-20 feet away so they don’t feel like you are hovering over them, but you are watching for safety.

Specific Examples

Jan is 78 and has Alzheimer’s Disease. She missed her last doctor’s appointment, hair appointment, and her favorite church concert. While living at home alone, Jan did not eat for 2-4 days, passed out and found herself in the hospital suffering from malnutrition and hydration. What could have been done to avoid these scenarios?

  • Keep track of Jan’s appointments, by helping her make them at a time when transportation is available, if transportation is necessary. Remind Jan earlier that day, make sure she is ready, and personally take her to the appointment.
  • Bring Jan to breakfast, make sure she gets it in front of her.  After breakfast, tell Jan the next meal is lunch and you will get her for that meal. This will put her at ease.
  • Everyday at 2 pm come to Jan with a pretty glass of water, encourage her, and then watch her drink it. Make sure Jan has a beverage in front of her for her meals and that she is drinking. Replace the beverage with an alternative option if needed.

The Take Away……

Many people are not getting the right amount of Memory Support in their current environment. I have found that there is a large percentage of those impaired with Dementia and Alzheimer’s that need more than Assisted Living, but less than Memory Care. These folks need another option. What they need is Memory Support/Cognitive Care in Assisted Living.

Specialized Memory Care for those with Alzheimer’s & Dementia

What is Memory Care?

When you ask this question you get a range of answers. You hear Memory Care is a specialized unit for Alzheimer’s & Dementia. You also hear it is a lock down unit that is separate from the rest of the community. You hear it is a unit for wanderers. You hear Memory Care is somewhere where specialized care is provided.

What is the Answer?

Depends who is answering. Technically a Memory Care Community or a Memory Care Section is where care is provided to those who exhibit symptoms and/or behaviors related to Alzheimer’s or one of the many Dementia Types. The thing is these symptoms and behaviors are vast and vary to different degrees, effect people in different combinations.

The One Size Does Not Fit All phrase I hear everywhere?000 one size

Every community claims that their memory care offers care based on each person’s ability. How is it possible to offer this type of individualized care in a unit where you have residents that are very active physically, residents who are wheelchair bound and have lost their ability to speak, residents that are prone to outbursts or inappropriate behavior?

The Answer?

You can’t. Unless you have a private caretaker or an activity coordinator for each group of individuals you are not able to provide individualized care and engagement because the abilities of the residents with Alzheimer’s or Dementia vary to such a large degree.

The Real Answer?

A Community has to be able to offer 3-4 levels (sections) of secure care for memory support. One of the sections should include the high functioning resident that is prone to wondering, and has an extroverted type of personality. One section should include high functioning residents that need memory support that are not prone to wondering and also have introverted personalities. Another section should be for those residents in the severe stage of Dementia, who have lost most of their language abilities, as well as independent movement. These residents will also likely need specialized diets, and nutrition therapy. The abilities of these residents are the most diminished of the 3 groups and their care and activities are set up accordingly.

The Take Away….

Although there may be a desire to provide individual care and engagement, that desire is not enough if the environment is not conducive to make that happen. Because the symptoms and behaviors of Alzheimer’s Disease and Dementia vary so greatly, it is imperative to separate residents within the community into smaller groups based on their cognitive and physical abilities. Once this is accomplished, a community is able to create the environment, the care structure, and an engagement plan to meet the need of the residents in each section or group.

Delicious Puree Recipes for Assisted Living & Memory Care

One of my favorite puree recipes are Mango Moose Cups. They are easy to make, and  most importantly very delicious.

    Ingredients you will need
  • 1 tsp gelatin powder
  • 2 tbsp water
  • 5 oz mango puree
  • 2 tbsp granulated white sugar (or more to taste)
  • 5 oz heavy whipping cream

Dissolve gelatin into 1 tbsp of water. Heat remaining 1 tbsp water until it is hot/almost boiling and add to gelatin, stirring until gelatin is fully dissolved. Add gelatin and puree into blender and mix on high speed until fully blended. In a stand mixer, add 2 tbsp sugar and heavy cream and whip on high speed until stiff peaks form. Slowly add puree into the whipped cream, folding it into the cream until completely mixed and uniform in color. Pour into individual portion cups and refrigerate to set.

It is very important to use pretty glassware that is the right size for the right person. One person may require a 4 oz glass and one a 12 oz glass. It is important to note that personal preferences are very important in all food preparation.  Here is an example of a pretty glass.

68d62aeb13c9fe7b24924c8bef61ca5a--dusty-rose-pretty-in-pinkIf we follow this wonderful, easy to make recipes you will get:

mango-mousse-cups-22                                                                                                                    Mango Mouse Cups

(please note that the garnishment on top of the mouse is for decoration designed to make the cup look appetizing. Decoration should be removed prior to consumption for those that are on a pure diet)

Conversations with Dementia Consultant-Navigating the Transition

Alzheimer’s and related dementia’s have a profound impact on family members and the experiences of loved ones living with dementia. As neurodegenerative medical conditions progress they often demand increased attention to needs and environmental transitions can be imminent, but helpful.  The stress and duress of change requires decision making, a lot of detail, and typically a period of adjustment for everyone involved.

Orchard Senior Living recognizes change for some families can be emotionally and physically overwhelming or challenging.  We want to help by offering you the provision of a Transitional Counselor who will support your transition beginning to end.

When living with dementia, we face transitions that are accompanied by a desire and longing to find our way to “well-being.”  We want to feel in control, confident, comfortable with ourselves, and valued by those who are important to us. Talking to someone who understands, creates courage and elicits new ideas when managing change or challenges.

I’m Robin Andrews, a solution focused communications consultant specializing in transition for families living with dementia.  I have a master’s degree in marriage and family therapy and have worked in behavioral healthcare and aging services for 15 years. My collaborative counseling model is based on personal competency and solution-building rather than problem solving. Minimizing emphasis on past failings and problems, I instead focus on a persons’ strengths, abilities and successes.  I would be honored to assist you in a journey toward hope, healing, and self-discovery.skydd

Atlanta assisted living

Do Seniors Need A Living Will?

What is a living will?

Talking about end-of-life and critical-care issues are never an easy subject and can often get pushed aside because family members aren’t ready to confront this stage, but planning ahead can avert confusion and unnecessary distress during times of concern and grief.

Knowing a loved one’s wishes in advance before an illness or accident ensures that family members won’t have to make tough calls on their behalf during a crisis.

Livings Wills Are Legal Instructions

Also called advance directives or healthcare directives, living wills are written, legal instructions detailing a person’s preferences for medical care if they are unable to make decisions. Advance directives manage healthcare choices for medical professionals and caregivers if a person is terminally ill, critically injured, in a coma, in the late stages of dementia or near the end of life.

Living Wills and Power of Attorney

A living will typically work together with a medical power of attorney (POA). Some states combine the two into one document. The medical POA enables a person to select a person (a spouse, family member, or a friend) to make medical decisions on their behalf.

This isn’t just for older adults either, unexpected critical care and end-of-life situations can occur at any age, it’s crucial for all adults to prepare these documents. For more helpful information for seniors, read more articles on our blog here. To contact the Orchard for assisted living click here to speak to a representative.

Orchard Senior Living for the 2016 Tucker Small Business Excellence Award in the Retirement Homes

Orchard Senior Living selected for 2016 Tucker Small Business Excellence Award

Tucker,GA – January 05, 2017 — Orchard Senior Living has been selected for the 2016 Tucker Small Business Excellence Award in the Retirement Homes classification by the Tucker Small Business Excellence Award Program.

Various sources of information were gathered and analyzed to choose the winners in each category. The 2016 Tucker Small Business Excellence Award Program focuses on quality, not quantity. Winners are determined based on the information gathered both internally by the Tucker Small Business Excellence Award Program and data provided by third parties.

About the Tucker Small Business Excellence Awards Program

The Tucker Small Business Excellence Awards recognizes outstanding small businesses that serve the Tucker area. Each year, our selection committee identifies businesses that we believe have achieved outstanding marketing success in their local community and business classification.

Recognition is given to those companies that have shown the ability to use their best practices and implemented programs to generate competitive advantages and long-term value. These are small businesses that enhance the positive image of small business through service to their customers and our community. These exceptional companies help make the Tucker area a vibrant and vital place to live.

The Tucker Small Business Excellence Awards was established to reward the best of small businesses in Tucker. Our organization works exclusively with local business owners, trade groups, professional associations and other business advertising and marketing groups. Our mission is to award the small business community’s contributions to the U.S. economy.

SOURCE: Tucker Small Business Excellence Award Program

 

New Year’s Resolutions for Seniors

Start on January 1

Making a New Year’s resolution to eat better, exercise, watch your weight, and see your healthcare provider regularly, can help you get healthier and feel better for many more years to come. Here are our top New Year’s resolutions for seniors.

Eat healthier
When it comes to eating, make sure you have plenty of veggies on your plate. Choose foods with deep colors like spinach, oranges, and carrots. Start a fiber-rich diet and switch fatty meats with heart-healthy fish like tuna or salmon.

Stay active
Physical activity can always be helpful despite any constraining situations like heart disease, diabetes, or arthritis. In fact, physical activity is known to improve all of these conditions. Exercises like water aerobics, walking and stretching can help improve your bones and balance.

See your provider regularly
Schedule an annual appointment with your doctor to discuss health screenings that can check your vision, hearing, and other conditions such as cancers or osteoporosis. After each visit talk about medications you’re taking and whether you still need to take them.

You may feel like you hear these same resolutions every year, but it’s only because these are the easiest to slip away from us! People can quickly fall into bad habits, getting on the right track can make all the differences. We are located in the Tucker, Georgia near Atlanta to find out how our community of care is working together with your loved one to meet these New Year’s resolutions through assisted living and memory care, contact us here or call 770-938-5600.