The Triple Whammy: Covid, Memory Care, and the Holidays
Like the rest of 2020, the holiday season that wraps it all up will be challenging for all of us. Even more so for those with loved ones in a memory care community … during a pandemic! Drawn from an excellent (but longer) article posted on the Alzheimer’s Association’s website, here are a few quick tips that will make this daunting triple whammy easier. Visit alz.org/help-support/resources/holidays for the entire article.
- Care for yourself: This year, that tried-and-true saying about caring for yourself so you can for others is more important than ever. You’ve made the list, right? So whether it’s candlelight baths, your favorite music, or playing with the family pet, be sure to take care of your physical, mental, and emotional well-being, because … well, you know why.
- Adjust your expectations: Be realistic about what you can, and cannot, do this season and then make a plan. Find a way (by phone, email, zoom, skype or other tech device) to have a conversation with family and friends. That way, you can inform them of your plans in advance (so they can adjust their expectations!), and tell them about your loved one’s current condition, whether they can visit or not, changes they might notice, and the importance of safety precautions.
- Celebrate while physical distancing: Remember to maintain at least 6 feet of distance between yourself and any person who is not a member of your household. You can still bake and share your favorite holiday treats; just package them and drop them off in a way that avoids contact, such as leaving them at the front desk of the community. You can also make and mail holiday cards, and encourage other family members to do the same.
- Connect through technology: Use video to capture and share special moments, such as children opening gifts. You can show them to your loved one at your next physically distanced visit. Ask a staff member to help your loved one receive a video call. If that’s not possible, a simple audio phone call can convey a lot.
- Keep current with rules: Be sure to check on the visiting policies at your memory care community; there might be new rules if the “tier color” has changed, or adjustments have been made especially for the season. Knowing what the most current policies are will help you avoid any unpleasant surprises or disappointments, and help you discover new ways to share the holiday with your loved one.
- Reach out for help: The Alzheimer’s Association has a 24/7 helpline. “No question is too big or too small” they say, so please reach out for expert help and calming advice during this time. Here’s the number: 800-272-3900.
Stay safe, stay well, and remember to pause and enjoy the season—however different it might be. # # #
DARE: Don’t Argue, Reason, or Explain
We are all navigating a very new kind of world these days, one filled with roadblocks and uncertainties. And for people with dementia, it can be even more frightening and confusing. The Alzheimer’s Association’s Central Coast Chapter recently ran an article in their newsletter with some valuable tips for those of us caring for loved ones who have dementia.
One of the best rules of the road, even in pre- or post-covid times, can best be remembered by its acronym: DARE. Don’t Argue, Reason, or Explain. Author and Memory Care Specialist Luciana Mitzkun Weston explains it this way:
“Arguing with a loved one with cognitive impairment only results in resistance to care; reasoning is frustrating and futile; and explaining takes a lot of energy and rarely increases comprehension.”
Instead, Weston suggests the following ways of dealing with the safety requirements for preventing Covid-19 while offering some reassurances.
- Say “flu” instead of Covid-19. Flu is more familiar and less scary than a global illness that is killing millions.
- Don’t take your loved one outside the safe bubble of your home (or care community) unless you know they can maintain distance and keep their mask on.
- Make the masks fun. Find masks with a theme they can identify with, such as cats, sports teams, flags, cars, or flowers.
- For those who are living in a community, window visits may be allowed. Make the most of them by bringing photos to talk about and treats to share.
- Model hand-washing and other safety measures for them. Make it part of your routine with them.
- Listen to their concerns and do your best to calm their anxieties.
- Give plenty of compliments praising their appearance and behavior (masks and distancing)
- Write uplifiting messages (post cards and letters) and stay positive. We’re all experiencing some degree of fear and uncertainty. Try to leave those at the door when visiting with your loved ones who have dementia.
A 24-hour helpline is available for anyone needing help or advice during this trying time: 800.272.3900.
Community Living in the Time of Covid-19
If you’ve been considering moving your loved one into a Memory Care community but have been putting it off due to Covid-19 concerns, here is some good advice. In a recent article written by Andrea Cooper and published on the website Next Avenue, the author explains the pros and cons. Turns out there are more pros than cons.
Even in normal times, moving a parent into Memory Care can be fraught with emotion. But in the time of Covid-19, that decision becomes even more complicated. In the best of times, “changes in routine can be disorienting and a new home is a big change, especially for a parent with dementia,” Cooper writes. And while the numbers of deaths and outbreaks in nursing homes are scary, Cooper explains there is a critical difference between nursing homes and Memory Care / Assisted Living communities.
“About 45% of all COVID-19 deaths in the U.S. have occurred in long-term care facilities, according to The Kaiser Family Foundation,” says Cooper. “Most of the widely reported outbreaks have been in nursing homes, which differ substantially from assisted living communities.
In nursing homes, residents require care from a licensed nurse; some may be bed-bound or have feeding tubes,” Cooper continues. “Assisted living residents, in comparison, can live somewhat independently, but need help with daily tasks such as hygiene, meal preparation, medication management, and transportation.”
Memory Care communities are dedicated buildings or wings of buildings that offer all the assisted living supports, but with added specialized services for those with dementia in a secured perimeter environment. But besides the risk of infection, there is another item to consider. Cooper writes:
“Concerns about moving into assisted living in 2020 go beyond whether residents may contract coronavirus. There’s also the issue of being able to see your parent after move-in.”
For the first few months of the U.S. pandemic outbreak, there were almost no Assisted Living communities allowing visitors. Today (in September of 2020), many are beginning to allow them, if safe guidelines are followed. At Sydney Creek Memory Care in San Luis Obispo, for example, family members can call and make an appointment to see their loved one. They meet in outside courtyards with distancing and masks, or with a plexiglass screen between them.
While your concerns about moving your parent into communal living are well founded, there are still many good reasons to place your parent in a reputable Memory Care community—even during Covid-19. Here are some things to consider as you begin the search. Here’s Cooper again:
“Before the pandemic, visiting potential assisted living communities was a smart way to help choose one. But in-person tours are rare right now, of course. So, get a virtual tour via Facetime or Zoom with the opportunity to ask the facilities’ managers questions by phone.”
Today, many places are opening back up for limited tours using safe guidelines. Sydney Creek is one of them. You can schedule a zoom tour, or a limited in-person tour. And you can get all your questions answered in a simple phone call. From Cooper’s article, here is a list of good questions to ask:
What are your protocols for testing residents and staff for coronavirus?
What safety protocols are in place to prevent COVID-19 from spreading?
What are you doing to engage residents in activities?
For more information, please call 805-543-2350.
Memory Care Communities offer Hope & Help during Covid-19
By Susan Stewart
“The most common pathology I saw [for seniors with dementia] was not heart disease or diabetes, but loneliness,” said Vivek Murthy, former U.S. Surgeon General.
As Covid-19 continues to infect Americans, the effects of the necessary distancing and social isolation have only served to increase that loneliness. However, as the senior housing industry navigates this brand new world, many memory care communities are finding new and creative ways to encourage healthy social interactions. And that makes placing loved ones in the supportive, communal environments they need much more appealing.
For example, at Sydney Creek Memory Care in San Luis Obispo, administrators and life enrichment staff are overseeing visitors in an outdoor courtyard, by appointment. “After weeks of being locked down, it’s wonderful to see our residents having conversations and taking walks with friends and family members,” said Kirk Klotthor, Administrator. Klotthor said that masks and distancing are still required.
In addition, Life Enrichment staff offer carefully orchestrated activities throughout the day that allow residents to interact with staff and each other for games, puzzles, and music. Times are staggered and the number of people who attend are limited so that distancing and safety can be maintained.
“For many families, our program provides reassurance that their loved ones are not only getting the nutrition and medication management they need, but also the social interaction, preservation of familiar routines, and other stimulation they require for optimal health,” Klotthor added. # # #
New Study Shows That Dementia Symptoms Worsen in the Spring
In an article written by Sherry Christiansen for www.alzheimers.net last year, the case is made for how the seasons affect people with dementia.
Are you a caregiver for a parent or senior loved one with dementia? Have you noticed that your loved one exhibits various disease symptoms depending on the season? Recent research has found that the seasons do, in fact, have an influence on dementia symptoms. Learn more about the recent study and how dementia symptoms can worsen in the spring.
Dementia Symptoms Worsen in Certain Seasons
Experts have known that seasons can impact the brain for some time. Medical professionals have been aware that seasonal changes can result in a type of depression called seasonal affective disorder, and other mental disorders, like schizophrenia, are more likely to begin during the winter months. Recently, researchers aimed to find if there was a seasonal component to dementia as well.
What scientists discovered was that aging adults, both with and without dementia, were found to have worse cognitive skills in the spring and winter seasons, reports the study, published in PLOS Medicine.
“We had previously discovered that the change in seasons causes large-scale alterations in the nucleus and function of brain cells in older individuals. We hypothesized that, if brain cell function was changing so much… it might also be affected by seasonal rhythms,” states the co-author of the study, Dr. Philip De Jager, professor of neurology at Columbia University.
Study Shows How Dementia Symptoms Worsen in the Spring
Researchers took a close look at the findings in other studies of aging adults in Canada, France and the United States. These studies included 3,353 participants, who researchers conducted neurological and psychological testing on.
The study findings showed that there was a strong link between cognition and seasons. They showed that:
- Cognitive function was higher in the fall and summer months when compared with spring and winter
- The chance of getting diagnosed with mild cognitive impairment (MCI), a condition that oftentimes precludes dementia, was 31% higher in the spring and winter months
- There was nearly a 5-year difference in age-related decline in the spring and winter months
In conclusion, the studies indicate that there is a significant association between cognition and season of the year in aging adults —including those with dementia. Increasing the number of clinical resources for treating dementia in the spring and winter months may lend itself to improving the overall treatment of the disease in the future.
“There may be value in increasing dementia-related clinical resources in the early spring and winter when symptoms are likely to be more pronounced,” the study authors explain.
Understanding that there is a scientific basis for the worsening of disease symptoms during the spring and winter seasons, may help caregivers to better prepare themselves for dementia symptoms and the overall needs of care recipients. # # #
First written in February of 2013 (and reprinted by huffpost.com), this article by Rita Altman has uplifting suggestions for relatives and caregivers who want to celebrate Valentine’s Day.
Valentine’s Day: The Perfect Day to Show Your Love to Someone with Alzheimer’s Disease
One of the most basic human needs is to feel loved, and Valentine’s Day presents the perfect opportunity for caregivers to meet this need for someone with Alzheimer’s disease or another form of dementia. Even though individuals with memory loss no longer have the same cognitive awareness they once did, they are still able to experience and express the full range of emotions, including love. The following are some ways that caregivers, family and friends can make Valentine’s Day extra special for someone with memory loss.
Use Music. Valentine’s Day can be a bittersweet time especially for couples that are trying to cope with the changes Alzheimer’s has made to their relationship. This holiday may bring back memories of past intimacy that no longer seems possible in the present. One way to feel this connection once again is to sing, play or dance with your loved one to their favorite love song. Research conducted by Petr Janata at the University of California, Davis, indicates that as Alzheimer’s progresses, an area in the medial pre-frontal cortex remains intact when most other areas of the brain have deteriorated. When a song elicits a memory, Janata explains, “[The] music serves as a soundtrack for a mental movie that starts playing in our head.” Playing your loved one’s favorite song from the past may help to build a bridge to communicate with them in a new or different way but be prepared as it may evoke bittersweet memories for you as well. You may want to look for local support groups where you can share your experiences and learn from others in similar situations.
Reminisce. Due to the changes in the brain caused by Alzheimer’s, it is easier for people to recall events from the past than from the present. Therefore, a good way to connect with them is to talk about some special events from the past that they can still discuss and share their feelings about. When reminiscing with your loved one, it’s good to have props such as a photo album or mementos like a wedding gown available. It’s also important to keep in mind that instead of putting them on the spot by asking “don’t you remember” you should say “tell me about the time when…” If they don’t seem to be able to recall the people or places from the past try to avoid frustrating them and just move on by asking them what they would prefer to talk about, providing them with an empathetic listening ear.
Be Creative. Engage your loved one in making a Valentine for someone they care about. By simply gathering some paper, lace doilies and markers along with your simple step-by-step directions, you can give them the opportunity to do something meaningful by giving back to others. Most importantly, you are providing them with the chance to reach out to those they still love in a very powerful way. Just think about how special it would be for a friend or relative who is not able to visit regularly to receive a Valentine from the person with memory loss and know that they are still remembered and loved by them.
Stimulate Their Senses. Research also shows that familiar scents can trigger good memories as the nerve that senses smell resides very close to the areas of our brain that are associated with emotions and memory. By giving your loved one a bottle of their favorite perfume/cologne or a bouquet of flowers, you are giving them a sense of pleasure and well-being. In addition, depending on the person’s preferences and their stage of memory loss, they might enjoy receiving a soft tactile item such as a silk pillow or a stuffed animal. And don’t forget the chocolates! There are ongoing studies that indicate that chocolate contains compounds that may bring about a feeling of happiness, alertness and even increased blood flow to brain.
All of these suggestions are great ways to celebrate Valentine’s Day, however, remember that your care and support is still the best gift you can give to a loved one with memory loss. Even if he or she may not be able to speak or express their love for you, know that on some level they may still be able to sense that you are there for them. It’s important to know that your presence, gentle touch and soothing voice helps them know on this special holiday, and every other day, that they are still loved.
From an article by Markus MacGill on the website Medical News Today
Dementia: Symptoms, stages, and types
Dementia is a collective term used to describe various symptoms of cognitive decline, such as forgetfulness. It is a symptom of several underlying diseases and brain disorders.
Dementia is not a single disease in itself, but a general term to describe symptoms of impairment in memory, communication, and thinking.
While the likelihood of having dementia increases with age, it is not a normal part of aging.
An analysis of the most recent census estimates that 4.7 million people aged 65 years or older in the United States were living with Alzheimer’s disease in 2010. The Alzheimer’s Association estimates that:
- just over a tenth of people aged 65 years or more have Alzheimer’s disease
- this proportion rises to about a third of people aged 85 and older
- Alzheimer’s accounts for 60-80 percent of all cases of dementia
This article discusses the potential causes of dementia, the various types, and any available treatments.
Fast facts on dementia
- there are an estimated 47.5 million dementia sufferers worldwide
- one new case of dementia is diagnosed every 4 seconds
- dementia mostly affects older people but is not a normal part of aging
Dementia symptoms include memory loss, disorientation, and mood changes.
A person with dementia may show any of the symptoms listed below, mostly due to memory loss.
Some symptoms they may notice themselves, others may only be noticed by caregivers or healthcare workers.
The signs used to compile this list are published by the American Academy of Family Physicians (AAFP) in the journal American Family Physician.
Possible symptoms of dementia:
- Recent memory loss – a sign of this might be asking the same question repeatedly.
- Difficulty completing familiar tasks – for example, making a drink or cooking a meal.
- Problems communicating – difficulty with language; forgetting simple words or using the wrong ones.
- Disorientation – getting lost on a previously familiar street, for example.
- Problems with abstract thinking – for instance, dealing with money.
- Misplacing things – forgetting the location of everyday items such as keys, or wallets, for example.
- Mood changes – sudden and unexplained changes in outlook or disposition.
- Personality changes – perhaps becoming irritable, suspicious or fearful.
- Loss of initiative – showing less interest in starting something or going somewhere.
As the patient ages, late-stage dementia symptoms tend to worsen.
Sometimes, dementia is roughly split into four stages:
Mild cognitive impairment: characterized by general forgetfulness. This affects many people as they age but it only progresses to dementia for some.
Mild dementia: people with mild dementia will experience cognitive impairments that occasionally impact their daily life. Symptoms include memory loss, confusion, personality changes, getting lost, and difficulty in planning and carrying out tasks.
Moderate dementia: daily life becomes more challenging, and the individual may need more help. Symptoms are similar to mild dementia but increased. Individuals may need help getting dressed and combing their hair. They may also show significant changes in personality; for instance, becoming suspicious or agitated for no reason. There are also likely to be sleep disturbances.
Severe dementia: at this stage, symptoms have worsened considerably. There may be a loss of ability to communicate, and the individual might need full-time care. Simple tasks, such as sitting and holding one’s head up become impossible. Bladder control may be lost.
There are several types of dementia, including:
- Alzheimer’s disease is characterized by “plaques” between the dying cells in the brain and “tangles” within the cells (both are due to protein abnormalities). The brain tissue in a person with Alzheimer’s has progressively fewer nerve cells and connections, and the total brain size shrinks.
- Dementia with Lewy bodies is a neurodegenerative condition linked to abnormal structures in the brain. The brain changes involve a protein called alpha-synuclein.
- Mixed dementia refers to a diagnosis of two or three types occurring together. For instance, a person may show both Alzheimer’s disease and vascular dementia at the same time.
- Parkinson’s disease is also marked by the presence of Lewy bodies. Although Parkinson’s is often considered a disorder of movement, it can also lead to dementia symptoms.
- Huntington’s disease is characterized by specific types of uncontrolled movements but also includes dementia.
Other disorders leading to symptoms of dementia include:
- Frontotemporal dementia also known as Pick’s disease.
- Normal pressure hydrocephalus when excess cerebrospinal fluid accumulates in the brain.
- Posterior cortical atrophy resembles changes seen in Alzheimer’s disease but in a different part of the brain.
- Down syndrome increases the likelihood of young-onset Alzheimer’s.