Day Care Provides Relief for Family Caregivers

In most caregiving, there is a delicate balance between caring for the patient and caring for the caregiver. Caregivers often neglect their own needs, including meals, rest and exercise. They believe they are strong enough to handle everything because they don't "have the disease." In reality, AD caregivers are impacted as dramatically as their patients.

This reminds me of the instructions parents on an airplane receive before takeoff. If there is an emergency, the parent must put on their own oxygen mask BEFORE tending to their child. If they don't, their child can't count on them for help when they need it most. It's the same when caring for an AD patient. You must be sure you're healthy, so you can keep your patient safe, too. This post focuses on adult day care as an excellent way to care for caregivers and patients.

Long before full-time care is needed for an Alzheimer's patient, adult day care can provide social interaction and practical support to the patient and the caregiver.

Art classes are fun for attendees.
During early and middle stages of Alzheimer's, adult day care can be the best option for a caregiver and patient. Most day care facilities have flexible hours. You decide how much or how little you use them. They serve breakfast and lunch, plus snacks. Gentle activities like walking and stretching are combined with mental "remember when" exercises. Music, arts and crafts are included, too.

Some places offer visiting podiatrists, health monitoring, and free manicures by local beauty school students. The schedule may include pet therapy, picnics in a local park or visits to the zoo.

Structured activities and a routine which frees the caregiver for work or respite, provides an entertaining, safe way for the person with Alzheimer's to spend their day. Attendees enjoy socializing in a place where the stress of trying to understand a complicated world is removed. The companionship of new friendships cannot be overrated.

Exercise can be a social event, too.
Added physical and mental stimulation may result in better nighttime sleep patterns for the person with Alzheimer's.

Caregivers benefit by meeting and talking to other families in the same situation. Most facilities offer support groups that comfort and educate caregivers. Nurses and social workers employed by the day care are valuable resources for information, too.

Look for a clean, Alzheimer's-friendly environment with open spaces, bright lighting and room to roam. Visit at different times of the day and observe the clients. Do they look happy? Are they supervised? I visit at meal times to watch the staff. Meals are always a test of ingenuity and patience.

Check for walking paths that are secure. Many AD patients like to pace and wander. You'll want to be sure your person can't wander away from day care. Ask about staff credentials. Is there an RN on staff in addition to CNA's? Make sure the program is licensed by the state.

Consider a trial run for a day or a week. Finding the right place is a process, and you may not be happy with the first place you try. It's a combination of the right people and services, and how comfortable your person feels there.

Taking a break will make you a better caregiver.
Costs vary depending on location and services. Most adult day care range from a few dollars to $50 a day. Some offer discounts on weekly and monthly rates, others have flexible plans for 4, 8 or 12 hour visits. Many social service agencies provide help with the cost of day care. Check with your local Area Agency on Aging, the Alzheimer's Association and government agencies.

Day Care is not a permanent solution. However, it's an excellent choice because it prolongs the time a patient can live at home by providing necessary care for the patient, and respite for the caregiver.

by Karen Favo Walsh | 

Alzheimer's Communication Tips

There are tricks to improve communications.
You already know caring for someone with Alzheimer's requires tremendous patience and understanding.

You also know even in ideal situations, people misunderstand each other every day.

So, how are you going to communicate when Alzheimer's makes conversations difficult or confusing?

As the disease progresses, the person with Alzheimer's:
-may have trouble finding the word they want
-may repeat familiar words
-may invent new words
-may lose a train of thought in mid-sentence
-may put words into an illogical order
-may use curse words more often
-may speak less
-may use nonverbal gestures more than words

It's important to remember, medications and physical conditions can further complicate the situation.

How to Improve Communication

Below are a some ideas for improved communication with AD patients.

-Identify yourself, or others, before you begin a conversation to orient the patient.
"I'm your daughter, Karen" or "This is Bob, our neighbor."
-Use simple, familiar words.
-Maintain eye contact.
-Short sentences are easier to understand.
-Weed out slang and cliches. Use simple language.
-Keep to the point.
-Break instructions into bite-size pieces; talk about one step at a time.
-Speak clearly.
-Speak slowly.
-Don't ask more than one question.
-Wait for responses. It takes an AD patient longer to process information.
-Provide answers, instead of questions when possible.
"Here's your lunch" rather than, "Are you hungry?"
-Be specific. "Let's put on your shoes" is clearer than, "Let's put these on."
-Visual clues are important. Point, touch, or display your subject.
-Provide simple explanations.
"It's fun this way." "It's safer." "It's your favorite."
-Use a positive tone of voice, especially for difficult tasks.
-Stay calm and your patient will stay calm.
-Smiles and happy expressions will reassure your patient and you, too.
-Eliminate distractions such as TV or radio, and find a quiet place to talk, or sit together.
-Smile, touch, hold hands, nod and maintain eye contact to show you are paying attention.

As a caregiver, I discovered if I sounded agreeable, my mother-in-law responded agreeably. My tone of voice always meant more than my words.

Try to read nonverbal cues, too. Pacing, fast breathing, facial expressions, body language and behaviors all offer clues.

Another suggestion is to talk to your patient in the same way you would talk to someone just learning the language. Identify objects and use gestures to clarify the meaning of words.

Other Ways to Communicate

Sometimes words disappear or cease to make sense. You'll have to find new ways to talk as memory and cognitive skills decline. You can communicate through shared experiences, such as art, music, nature walks, or looking at old photos together.

Watercolors, drawing, coloring with crayons, and working with clay can be satisfying ways to spend time together. Some pottery studios are certified to work with people with physical or developmental challenges. Therapeutic art is successful in rehabilitation centers and assisted living facilities. Whether you go out, or stay at the kitchen table, art can be a fun, shared activity.

Or, choose music from your patient's youth, and play it. Your person may enjoy listening, or perhaps dancing about the living room to favorite songs.

The Bottom Line

If something you say doesn't work the first time you communicate it, whether it's eating, bathing,
or getting into the car, wait a few minutes, and try again as if for the first time. Try some of the
tips above for better communication. You may be pleasantly surprised.

by Karen Favo Walsh |