The winter holidays are here! Thanksgiving with turkey and the trimmings, conversation, football on TV, and family games. Kwanza, Christmas and Chanukah are next. What warm memories of these celebrations many of us have and how much we would like to participate in all our usual traditions.
But . . .
We are caring for a loved one who has a dementia. Everyone is adjusting to new ways of living our daily lives. We don’t have energy for all our usual preparations. And some of the old traditions aren’t appropriate for a person who has a dementia.
How can we have our special holidays? Here are a few quick tips.
- Adjust your celebrations.
- Modify and simplify your traditions, keeping some of the special memories.
- Involve your loved one in holiday activities that are comfortable and safe for him or her.
- Communicate with family and friends.
- Talk about your loved one’s strengths and changes.
- Plan new traditions together.
- Take care of yourself.
- Ask for help with holiday tasks and caring for your loved one.
- Arrange for respite time . . . quiet time, pampering, exercise . . . for you.
Holidays can still be special for you, your family and friends.
Enjoy the possible. Enjoy the moment. Enjoy new traditions.
For more about holiday celebrations, read the National Institute on Aging article, “Holiday Hints for Alzheimer’s Caregivers” at https://www.nia.nih.gov/health/holiday-hints-alzheimers-caregivers.
Celebrating in new ways:
As we approach Mother’s Day, many of us think about how different the celebration is, now, if Mom is in the middle or late stage of Alzheimer’s Disease or another dementia. We feel sadness, but we also try to honor our mothers in ways that they will understand.
Tips abound on the Internet and in publications, and the tips are wise:
- Simplify the celebrations.
- Adapt your expectations about what Mom will understand and enjoy.
- Give gifts that are meaningful today: soft items to hold, fragrant flowers, a bird feeder that Mom can watch from the living room or porch.
- Listen to Mom’s stories about the past, if she can tell them, and tell the stories to Mom if that meets her needs better.
Still, there are important statistics that suggest there is more to do.
The majority of caregivers for older adults. . . about 2 out of 3 . . . are women; about a third of the caregivers are daughters of the older adult.
As we know, caregiving is time consuming and stressful. It causes the caregiver to put aside her needs, relaxation, hobbies and interests. While the caregiver is providing love and support, she may not have time to “receive” love and support in return.
So, on Mother’s Day this year, let’s celebrate with Mom, but let’s also celebrate the caring and generous hearts of the daughters and daughters-in-law who are by Mom’s side.
- Provide respite for caregivers . . . time away from responsibilities.
- Give gifts that show appreciation and provide the pampering that relieves stress: a gift certificate for a massage, tickets to an art exhibit or popular movie, a quiet meal on the patio.
- Listen to the caregiver’s stories. She may well need to share the delights and the stresses of her caregiving days.
For ideas about celebrating Mother’s Day, read an article posted by the New York City Chapter of the Alzheimer’s Association at Honoring Mother’s Day When Mom Has Alzheimer’s.
For “2018 Alzheimer’s Facts and Figures” (and caregiving statistics), go to https://www.alz.org/facts/.
Recently, “Grandma to Be” sent a letter to advice columnist (and Wait, Wait Don’t Tell Me panelist – yeah!) Amy Dickinson.
Grandma to Be wrote with pleasure that her daughter was expecting her first child. However, she also wrote that she had an 8-year-old step grandchild. She didn’t publicly acknowledge this youngster because she didn’t want her friends to think she was old enough to have been a grandparent for almost a decade.
Dickinson answered, essentially, that life happens when it happens. Embrace the reality.
And I would go even further. Embrace new paths. Embrace change. Embrace the possibilities! New paths can be exciting and joyous.
Becoming a grandparent is one new path that we may come to as we get older. What are other paths you are considering for your life?
- A new job
- Playing with your grandchild
- Caring for an older relative
- Moving to your dream home
- Moving to a senior community
- Taking up a new sport
- Traveling across the United States
To read Grandma to Be and Amy Dickinson’s letters, go to Too Young to Be a Grandmom.
For help thinking about and planning your new paths, contact Dr. Cheryl Greenberg at TheAgeCoach@gmail.com. She will be happy to meet with you, at no cost for a sample session, to see if coaching is a good fit for you.
The legendary cellist Pablo Casals asked why he continued to practice at age 90.
“Because I think I’m making progress,” he replied.
How brilliant! How positive! How engaged in life!
The Myth of the Rocking Chair
The myth about getting older is that seniors can’t work, play or learn, at least not well. When folks believe the myth, they think they must polish up the rocking chair and isolate themselves. They feel useless to others and bored with themselves.
But that is a myth.
Pablo Casals composed his last composition in 1971, at age 94. He traveled to Israel to conduct the Jerusalem Symphony Orchestra at age 96.
Astronaut and Senator John Glenn went into space at age 77.
Everyone remembers that Grandma Moses took up painting when she was 76.
And it isn’t only famous people who have accomplished great things as seniors. In June 2014, Charlotte, N.C. resident Harriette Thompson completed her 15th marathon . . . and broke a record for women in her age group.
Teiichi Igarashi, a former lumberjack, climbed Mt. Fuji when he was 100 years old!
The Reality of New Accomplishments
There is only one secret to accomplishing great things as a senior: refusing the rocking chair and engaging in life.
What new skill would you like to develop? What new adventure is on your horizon? What passion would you like to pursue? How will you complete the sentence, “I did ____________ at age ____________?
Hear an interview with Harriette Thompson at 91 Year Old Breaks Record.
Does she have a dementia?
Every day, we all take part in activities that we do routinely, often without much thought or planning. We complete work tasks, take part in hobbies and social events, cook and clean, and care for ourselves.
When an individual is not able to independently and reliability complete “activities of daily living” (ADLs) he or she may be showing signs of Alzheimer’s Disease or another dementia (cognitive impairment).
Having temporary trouble with an activity of daily living may not be alarming, but when an individual has persistent difficulties with one or more ADL, it is recommended that they consult with a physician for a thorough examination.
What are “Activities of Daily Living”?
Activities of Daily Living (ADLs) are tasks that we carry out routinely every day. They include
- Hygiene: bathing, washing, brushing teeth, and grooming)
- Dressing: selecting and putting on clothing
- Using the toilet and maintaining continence
- Movement: walking and getting into and out of bed and chairs
There are also Instrumental Activities of Daily Living (IADLs), which are more complex tasks that have an impact on whether an individual can function independently. For example,
- Communication: using phone, email or other tools to communicate as needed
- Transportation: driving or using appropriate public/private transportation
- Shopping: buying food, clothing, medications, and other necessities
- Food preparation: making appropriate food choices, preparing and storing foods safely, and following recipes
- Medications: organizing and taking medications appropriately
- Home maintenance: completing tasks related to safety, cleanliness, and proper functioning of the home and appliances
- Finances: making sound financial decisions, keeping accurate financial records, and understanding one’s financial resources
The American Elder Care Research Organization provides its definitions of ADLs and IADLs, along with a checklist for informal use, at ADLs & IADLs.
Another article, by social worker Esther Heerema for VeryWell.com, provides information about the reasons for changes in ADLs and some tips for caregivers at ADLs – Causes and Tips.
When Did He Get Alzheimer’s Disease? A Continuous Journey
We probably all know that we can’t date the start of Alzheimer’s Disease. Instead, we notice changes over time.
- Hal’s memory is not working well. He is asking the same question several times in a row or he drives to the neighborhood supermarket, but doesn’t remember what he went there to buy.
- Susana, a sweet and passive woman for most of her life, seems grumpy and snaps at her family members.
- Bella has bruises on her body, but doesn’t remember falling.
Alzheimer’s Disease develops gradually. In fact, it may begin to develop long before the symptoms are noticed by the patient or people around him.
We won’t know when the disease started, but it is helpful to know how the disease develops over time.
Most descriptions of Alzheimer’s Disease include three stages, starting with noticeable symptoms. The following list includes two additional stages . . . stages before symptoms interfere with daily living.
Before noticeable symptoms:
- Prior to Symptoms: The brain may undergo changes for many years, but there are no noticeable, significant symptoms of the disease.
- Mild Cognitive Impairment (MCI): People who have MCI experience some memory and thinking changes but are capable of independently carrying out daily activities. About 38% of people with MCI go on to develop Alzheimer’s Disease.
After noticeable symptoms:
- Early (or Mild) Stage Alzheimer’s Disease: People with an Alzheimer’s Disease diagnosis experience changes in memory, language and personality that make some tasks difficult for them. The changes are noticeable and interfere to some extent with carrying out activities of daily living.
- Middle (or Moderate) Stage Alzheimer’s Disease: In this stage, the person with a diagnosis needs significant amounts of help with activities of daily living, but can communicate some and carry out some activities without help.
- Late (or Severe) Stage Alzheimer’s Disease: Typically, in this stage, the person with a diagnosis needs help with all activities of daily living. Communication and memory are severely restricted.
Alzheimer’s Disease is a progressive disease. It is often described as a “continuum,” which reminds us of a smooth, steady progression of changes. However, this is not always the case.
- The changes caused by Alzheimer’s Disease and the timing of those changes vary from person to person.
- The disease does not always progress in a continuous, smooth path. There are times when some changes seem to be noticed “suddenly” or “acutely.”
- A person’s ability to remember, communicate, and engage in activities may be stronger some days than other days.
For more about the progress of Alzheimer’s Disease, you might see the Alzheimer’s Association’s Stages of Alzheimer’s.
What is a Dementia? Are there many types of dementias? Are they treatable?
As we get older, we wonder and sometimes worry about “having dementia.” What is it and what are the chances?
Dementia is a general term – and umbrella term – for many diseases that affect the brain, or “cognition.”
Cognition involves memory, thinking, problem solving, decision making, communication and/or personality.
Dementias are diseases that affect cognition and, as a result, affect an individual’s ability care for himself or herself, work, do hobbies, and socialize.
It is not unusual for people to become disoriented and forgetful as a result of a medical condition When diagnosed and treated promptly, the dementia may be reversible. Examples of conditions that may be reversible are
- Nutrients insufficiency
- New medication or interaction of medications
- Alcohol consumption
- Thyroid disorders
Dementias that are progressive or chronic, and for which there are no known treatments at this time, are associated with diseases such as
- Alzheimer’s Disease (about 60% of all dementia cases)
- Vascular Dementia
- Dementia with Lewy Bodies
- Frontotemporal Dementia
- Creutzfeldt-Jakob Disease
- Alcohol-related brain damage, including Korsakoff’s Syndrome)
- HIV-associated neurocognitive disorder
For a brief description of chronic dementias, see the Alzheimer’s Society website at Chronic Dementias. A list and brief overview of reversible dementias can be found at Reversible Dementias.
How Can I Make My Memory Better?
We have all heard about ways to maintain a good memory, but what are the best ways?
Take a quick quiz: Look at the list below and number them from 1 (very important), 2 (somewhat important), to 3 (not important at all).
- Do the crossword puzzle in the local newspaper every day.
- Play a musical instrument.
- Meet with friends for coffee and conversation.
- Continue to work as long as possible.
- Exercise thirty minutes five days a week.
- Meditate when you feel stressed.
Was this quiz a trick? Well, maybe. All these activities can be helpful in maintaining a “strong” memory if you challenge yourself when you do them.
Challenging the brain helps build more connections between brain cells, and these connections are the support system for a strong memory.
- Doing a crossword puzzle is a great way to stay sharp, if you don’t choose a puzzle that is very easy for you. Step it up. Go to the next level. Make sure you have to put some effort into completing the puzzle.
- The same is true for playing an instrument. When you learn new music, practice it and think about what you are doing, you build connections in your brain that are good for a “strong” memory.
- Talking with friends? Just going over the same old gossip? Enjoying being with your friends is good for your brain. However, when you tackle new ideas, talk about books you have read, or even argue about politics, you add a challenge that is good for your memory and thinking.
- Just putting in time at the office? There is benefit to staying active by continuing to work, but as with talking with friends, taking on new tasks and challenges causes our brains to build connections.
- Reducing stress and increasing exercise improve the biochemistry of the brain. Stress hormones have a negative effect on the brain. Exercise helps to keep a good flow of blood and oxygen to the blood…and reduces stress. Great ideas for a healthy brain!
For some more about maintaining a good memory, you might look at Ideas for Maintaining a Good Memory.