What is the key to helping them open up? Patience and the recognition that participating is about the process, not about the product.  We don’t focus on the end result of the activity, but more on getting them to connect to any part of the process. If we try an activity one way and we don’t see engagement, we’ll try it in another way or we’ll try a completely different activity. We attempt to get participation in any way possible, no matter how small or if it doesn’t even relate to the project at all. We view success as any kind of connection that provides cognitive or physical stimulation.

Our Recreation Coordinator is so successful with the dementia population because she continuously tries different activities to see what works and what doesn’t. Ms. L. is a great example of this – she’s 86 years old, has moderate dementia and wasn’t interested in participating in most activities. Each time she attended, staff tried different types of activities to find out what might interest her.  Nothing seemed to work until one day staff gave her a newspaper. In the past she had difficulty reading, but when given the paper, she immediately started reading and going through it carefully. You could see the joy on her face. Not only was she reading the paper but she started commenting on the stories! It was amazing that staff found a totally new way to interact with her. We shared this with her family and they now get her a newspaper to read at home everyday. You never know what simple activity will spark someone’s interest, provide stimulation and improve their quality of life!

As a caregiver, if you’re trying an activity with a loved one and it doesn’t seem to be working at that moment, don’t give up hope. Let it go and try it again later. Try something else. You never know what’s going to work, but once you find something that connects and provides stimulation, your loved one will let you know!

I have also seen caregivers connect to a supportive community that enables them to provide better care for their loved ones and themselves. If you are caring for someone with Alzheimer’s, here are some steps you can take to receive the support you need:

Connect with a support group

• A local Alzheimer’s support group is a place where you can receive educational, social, and emotional support.
• Take a look at the Alzheimer’s Association website to find a group meeting near you.

Explore professional home care

• If the person you are caring for is starting to have difficulty with daily activities, such as bathing, walking, dressing, or toileting, you may consider exploring whether long-term home care is a better option.
• Our VNSNY CHOICE long-term home care team includes a registered nurse, social worker, physical therapist, home health aide, and dietitian.

Read up on resources

There is an overwhelming amount of Alzheimer’s resources on the web. Start with a few of these sites:

• The Alzheimer’s Association
• Alzheimer’s Foundation of America
• Visiting Nurse Service of New York

Have a peaceful week.

Photo by Master isolated images

If you are not familiar with Pat Summit, she is widely considered the most successful college basketball coach of all time. Her recognition is well deserved after coaching Tennessee University’s women’s basketball team to a record eight national championships and more than 1,000 wins.

Sally Jenkins of the Washington Post writes:

“Denial was followed by anger. For the first few weeks, Summitt would barely even discuss the subject. She told her doctors, ‘You don’t know me. You don’t know what I’m capable of.’ Finally, Summitt realized she would have to accept the diagnosis. ‘I can’t change it,’ she says. After a pause, she adds, ‘But I can try to do something about it.’”

Summit has made it clear that she will continue to coach despite being diagnosed with early onset Alzheimer’s. I believe Summit’s desire to continue leading her team outshines all her previous accomplishments since she is now one of the public faces of a disease that affects millions of Americans.

Dementia is a progressive disease that causes a loss of brain function, which can result in memory loss and problems with concentration and decision-making. Alzheimer’s Disease is believed to be the most common form of dementia.

Over the years, a number of my seniors who have been diagnosed with dementia have been able to lead productive lives. What is their secret? All of them have had a good support network, which included a combination of caregivers and medical staff. In my next post I’ll lay out a few helpful ways to build a support network after a Alzheimer’s diagnosis.

Are you or someone you know living with Alzheimer’s or a form of dementia? If so, I urge you to take a look at our resource page, Living With Alzheimer’s Disease, which provides helpful tips for managing the disease.

Have a peaceful week.

• Ensure that your loved one is drinking enough water and getting good nutrition.
• Try to keep to a regular schedule for bathing, dressing and eating.
• Monitor medications to ensure they’re being taken consistently.
• Watch for signs of pain – your loved one may be experiencing discomfort that they can’t express.
• Try to avoid watching stories in the media about the crisis when your loved one is present.
• If your loved one wants to talk about it, acknowledge the disaster, validate their thoughts and feelings, and redirect to a new topic.

If you or someone you know is caring for someone with dementia and needs assistance, VNSNY has many programs available to help – check out our website at http://www.vnsny.org/

In the Spring 2011 issue of care ADvantage magazine, published by the Alzheimer’s Foundation of America, there are excellent tips on how to make the dining out experience a positive one:

• Be aware of the environment — don’t pick a place that’s very busy or noisy. Too many distractions can be over stimulating and create confusion.
• Pick a time that fits with the person’s existing daily schedule. Changes in schedule can increase confusion.
• Pick a place that’s wheelchair-accessible (for getting in and out of the restaurant, and visiting the rest room), if needed.
• Pick a table where you can put your loved one’s back to the busiest part of the restaurant. This can prevent distractions and help them focus on your table.
• Pick a table near the restroom.
• Bring comfort items, such as pictures, snacks or puzzles, to help distract in an unfamiliar setting.
• Ensure your loved one has multiple forms of identification, including safe return/ identification bracelet (if needed) and ID in a jacket pocket.

Following these tips can help the senior as well as the caregiver’s comfort level. With a little preparation, going out to eat with your loved one may create many opportunities for cherished memories.

This time of year lends itself to celebrating holidays in many creative ways. We often use things like  art, music and reminiscence therapy. In our dementia program, the Activities Coordinator sends home supplies so that the seniors can make Easter bonnets and then wear them to our annual Easter Hat Parade. Every year, we’re amazed by the quality of work that goes into making the hats at home. This activity is therapeutic for the senior and the caregiver, as it allows time together to reminisce and do something fun.

Using music and culture is another way we connect with our members with dementia. We offer music therapy regularly and each session has a new focus, depending on the season, the groups’ interest and level of functioning. During a session last week, our student intern spontaneously started singing songs native to a small village in Puerto Rico. Ms. N. is from this village, and it was simply amazing to see what happened to her when she heard the songs. She’s been coming to our center for over 3 years, she doesn’t usually participate in music and we’ve never seen her sing. When the intern started singing, Ms. N. stood up, sang every word to all the songs and became tearful with joy. Her whole personality and mood was transformed the moment she heard those songs.

I was so moved by what we saw, and it really related to a meeting I had last week with Dan Cohen, Executive Director of Music & Memory. His company’s goal is to improve quality of life through the use of ipods.  A recent Newsday article called it “iPod therapy.” His program is in 11 nursing homes on Long Island and in New York City,and it involves creating personalized  iPod playlists for seniors.  I literally got chills watching a video that showed how listening to iPods completely transformed behavior in agitated and depressed seniors. This is music therapy gone high tech! If you’re interested in learning more about his program or donating old iPods or iTunes gift cards, check out http://www.musicandmemory.org/.

Ms. L. also has a prosthetic leg and never complains of physical ailments. Last week, Ms. L. was limping at the center and after much staff encouragement, she finally admitted to having pain in her thigh – the same leg as the prosthesis. She did not report it to anyone because she was scared of going to the hospital. Day Center staff immediately contacted her Nurse Consultant and her nurse made a home visit. The nurse discovered an infection and quickly sent Ms. L. to her M.D. for treatment. Ms. L. is now getting wound care at home and is on the road to recovery. The nurse also discovered that the prosthesis was damaged and she is working with Ms. L. to get it fixed.

What might have happened if Ms. L. was not attending the VNSNY CHOICE Adult Day Center? We’ll never know, but what we do know is that because she attends our center, she got the quick medical attention she needed to avoid a bad infection and possible hospitalization. Not only is Ms. L. getting the medical care she needs at home through VNSNY, but she is also keeping busy with art projects from the Day Center. Today she told staff that although she misses her “family” here at the center, she is grateful to be getting the care she needs, so she can stay at home and not go to the hospital!

At our center, we have a Wanderguard program for memory impaired seniors to help prevent wandering. The Alzheimer’s Association has a Safe Return Program (www.alz.org/safereturn) that provides identification bracelets linked to caregiver contact information in case someone gets lost in the community.

Below are a few tips to prevent wandering from the Alzheimer’s Foundation of America (www.alzfdn.org):

• Keep a current photograph of your loved one readily available.
• Tell your neighbors about the condition and give them your phone number.
• Track wandering patterns – time of day and frequency.
• Add electronic alarms at all doors so caregiver is alerted if person attempts to leave.
• Do not leave person unsupervised.

Don’t hesitate to reach out for help to the Alzheimer’s Association, the Alzheimer’s Foundation of America or the New York State Adult Day Services Association (www.nysadultday.com).

• Get information about the illness – read books, surf the web, attend seminars, etc.
• Stick to routines.  Changes in schedule or surroundings can cause confusion for your loved one and make things more difficult.
• Share caregiving tasks with others.
• Take time for respite for yourself – do something to make you feel good, even if it’s just 5 minutes a day.
• Take care of your own health.
• Join a caregiver support group, talk to a professional or discuss concerns with your family and friends.

For resources on Alzheimer’s Disease, please check out websites for the Alzheimer’s Foundation of America http://www.alzfdn.org/ and the Alzheimer’s Association http://www.alz.com/. For additional resources, Phil McCallion, Ph.D. and Lisa Ferretti, LMSW, from the Center for Excellence in Aging Services, SUNY Albany, assembled a website for Alzheimer’s Disease Resources.  The web address is:  http://www.albany.edu/aging/resources/. For you and your loved ones, please remember to take good care of yourself.

We believe and we’ve seen that the more cognitive and physical stimulation we provide, the more the participants respond and improve. One such example is Mr. M — he came to us unable to speak or read. He started coming to our center one day a week and quickly increased to three days per week. Although he was not speaking or reading, his facial expressions showed that he enjoyed his time here and he participated in activities to the best of his ability with the help of our staff. After a year of sitting in on bingo but not being able to read the numbers, an amazing thing happened — he started to recognize and identify the numbers on the card! When our Recreation Coordinator patted him on the back to support and encourage him, he started to cry and smile. From that day on, he participated in bingo and his wife told staff that he was becoming more expressive at home. We’re all about helping people do as much as they can and supporting caregivers.

Just one example of what Adult Day Services can do! For more information on Adult Day Services in New York State, please check out the New York State Adult Day Services Association website www.nysadultday.org