Insights into Alzheimer’s and Dementia

The capacity to deal with the expectations of life is related to the amount of energy and thought that we have available at any given moment.  Our capacity varies from individual to individual. We all become angry and despondent when our capacity is depleted through environmental and emotional inputs or “noise”.   Our capacity is recharged each night.  The cognitive ability to rationalize is diminished with Alzheimer’s and dementia.  When we are overwhelmed with input, we withdraw, become aggravated, and stress consumes us.  Everyone has had very busy, stressful days where nothing goes right.  At the end of one of these days we become antisocial with diminished ability to process.  Whether this is due to the daily accumulation of stress or just being overwhelmed with life, our ability to thrive is severely limited.

Changing our ideal state to one of bliss and contentment is hard for our production active society to do.  When we are satisfied with life and just happy to be alive or perspective changes and it is easy to be happy in the present.  Age brings wisdom and lowers our expectations.  This allows us to be contented with less and happy just being able to enjoy the moment.  Dementia/Alzheimer exacerbates the noise that surrounds us and makes the blissful state much harder to maintain.   In order for our love ones to thrive with dementia we need to see that their highest level of state is one of bliss and contentment.  Our energy and focus should be on doing everything possible to create this safe and peaceful environment for them.  The more our frontal lobe decreases in reasoning and thinking ability the more we are susceptible to environmental and emotional noise.  Working at giving the right environment to thrive for our love ones is about eliminating the noise and emotions that disrupts this environment.

Keeping a Relationship When Your Loved Ones are Suffering from Alzheimer’s

How do we create this environment?  When our love ones are in this environment they become the loving parents and mates that we remember.  If we look at anything that would interrupt a meditative state as noise then our efforts are to eliminate any noise that could disrupt the state.  Noise can take many different forms from environmental too emotional although emotional seems to be the biggest factor.

Because dementia takes away the ability to reason and rationalize they are unable to deal with emotional conflict.

“Mary was the loveliest lady that was floating through life doing her artwork and being part of our extended family.  Energetic helpful and loving.  She participated in all household activities and was a pillar of the family.  Then tragedy struck her daughter and daughter in law decided that open conflict and arguing over some detail was more important that their mother’s wellbeing.  After many open disagreements between the daughters Mary had a break down and had to be moved to a physic unit at a local hospital till enough drugs could quite her down.  After that Mary was never quite the same.  One of the tragedy’s of Alzheimer/dementia disease is that it tends to Ratchet down in steps as some event occurs that excites the disease.  Once you are transported to a lower cognitive state it is very seldom that you are able to regain the level you were at.”

When dealing emotionally with a person with Alzheimer you should keep in mind what noise you might create and minimize it.

  1. Never argue in front of them.  They cannot rationalize why you are arguing and therefor go into a high level of stress that disrupts their body chemistry.
  2. Never argue with them they cannot rationalize that they might be wrong
  3. If they forget your name do not react “mom I am you son Bill remember I am the one” mom may not be able to remember your name or face but she will always remember your being.

“They may forget your name, but they will never forget how you made them feel.” – Maya Angelou

How Environment Affects Dementia and Alzheimer’s

Do not put them in an environment with a lot of people they do not know

  1. Do not put them in an environment that is full of emotions
  2. Do put on your happy face and be in a positive mood when you meet with them.  It is better to not meet then to show up with an attitude or emotional baggage.
  3. Do make sure that everybody else understands the harm that can be done when the emotional environment becomes noisy or disruptive.

The environmental noises are easier to handle

  1. Not to warm not to cold
  2. Not to noisy (sound)
  3. Not to light not to dark
  4. Smells are pleasant (food brings them back to old found memories)
  5. Surfaces are smooth
  6. clothes are comfortable
  7. Clothes are familiar
  8. The room is simple and things are put back in the same spot

At Elite Care, we talk about the concept of a Simple Consistent Routine (SCR), . Simple consistent routines walk people into their muscle memory where competence relies on rituals, instead of thought process.

“we have all had the days when you get up in the morning and the next thing you know you’re at work sitting at your desk thinking how did I get here.”

This is float we all do it to preserve our limited cognitive abilities as our cognitive ability decrease this becomes more and more important.  What are the routines that we can establish and reinforce in a systematic way.  Them more routines they have the more our love ones will adapt to their environment and the more they will be available for relationships.

  1. Show up at the same time
  2. Have a script that you great them with so it is the same each time
  3. Use words that are simple and consistent
  4. Do the same things with them
  5. Change has to be processed try not to change anything

How to Minimize Dementia and Alzheimer’s

It is important that they maintain their autonomy and selfefficacy as much as possible.  Autonomy is not a lot of choices but the ability to predict what is coming next and the power to agree to it or not to.

Choice may be wonderful for the young and cognitive active but even to them choice can become debilitating.  When consumers are given the choice of 3 jams to buy at a farmer’s market they normally buy one when they are given 25 choices the choices overwhelm them and they normally do not buy any.

Instead of creating a lot of choices cut it down to would you like ice-cream or not.  Change and choice freezes the elders with dementia.  So the choices should be yes or no and the meetings and relationships should be consistent and simple.  The more comfortable the elder is the more they can be present and the more you can bring back the relationships that you have always had.

Understanding and Surviving Alzheimer’s and Dementia

When trying to talk to them when they are upset.  Repeat after them what they have said till they start to process.  Marry is mad “Marry is mad”  Marry is mad  “yes Mary is mad”  eventually  they will calm down and make more sense.

When trying to calm them down mimic their physical state copy how they are sitting how their hands are held.  Copy their breathing patterns this will help set them at ease

We all have our physical “personal space” that we want to be held sacred.  In most people that bubble is around 3 feet, any closer than that and you should make sure you have permission to enter.

Our elders are no difference regardless if they have dementia make sure you do not invade their personal space unless you are invited in.

When you are approaching someone with dementia make sure you are at their level.  Eyes should be at the same level this is a non-threating and allows for them to feel safe.  Talk to them I a soft slow way and repeat yourself till they understand what you are trying to say.

HI Jane I am here to help you to dinner   “hi Jane I am sally and I am here to help you to dinner”  “hi jane I am here to help you to dinner”  slowly repeat yourself till they understand what you are saying do this when you are at their level looking them in their eyes if they are hard of hearing make sure they can hear you.

When you are reaching out to hold their hand or help them walk make sure you are not using a motion that can restrict their freedom.  This is why you use the hand under hand method that is promoted by Teepa Snow.  When we are restricted in our movement and not able to process the restriction we are thrown into the fight or flight. This fight or flight response that is open by stress fills the body with chemicals that further advances dementia and Alzheimer’s.