Reply to Mikey

Hi Mikey, Reading some of your responses as you suggested. I’m a nurse with over 20 years working with people who have dementia. I also have a masters degree in geriatric long term care. You make a point I agree with. There is so much to learn and our patients keep teaching us. We never learn it all.
I believe in what I call common sense dementia care. The story you read about Elizabeth is just one of many in my book. The idea of her story was that we can change the mood of people with dementia by doing something for them that they enjoy. If someone is being negative, do something positive. We all do this for ourselves every now and then. For some people it is a chocolate kiss, for others a cup of tea or a cigar. Hot bath? Massage?, Petting your dog? If we can discover what they like, it’s easier to work with people who have dementia and adds a little happiness to their day.
My guidelines for common sense care are simple. Here are 4 of the 15.
! Put yourself in the place of the person with dementia to find a solution to their problems
2. Communication is key. Approach the person with dementia from the front, communicate at eye level (standing above them is threatening) Speak slowly and distinctly in simple terms and short sentences and monitor your body language. You can be saying wonderful things, but if there is a frown or stress on your face, that is what a person picks up.
3. Validate the feelings of people with dementia.
4. Consider the whole person, not just the dementia.
Sounds like you are already moving in this direction. It is rare to find someone with your compassion. I’ve delt with many nursing assistants for whom it was just a job. I’d rather hire people like you.

I worked in a specialized dementia care facility for nine months

invisiblemikey wrote:

I worked in a specialized dementia care facility for nine months as both a caregiver
and medication aide (nurse delegate).  We had 25-32 residents with not only
Alzheimer's but also vascular, Lewy bodies, you name it.  Ages 50s to 100+.  I am
near retirement age, so I could not continue, as it was too physically risky for me.
 The young ones bounced back from injury with two weeks of PT.  The ones over 55
ended up with joint replacement surgery.  I loved the job, but I'm needed to help
care for my wife, whose own career was ended by injury.  
In addition to six ambulatory patients, each caregiver had responsibility for four
adults who were semi-or completely immobile, though they still communicated even if
just by eye contact.  By comparison to the physical risks of caregivers being
injured (back strain, knee injuries, shoulder problems), the creative management of
resident behavior was a breeze.  We did band together fluidly in pairs or even trios
for lifts, feeding and toileting, but most residents still had at least one incident
of combative behavior, and we couldn't always see it coming.
I did enjoy Elizabeth's story, and we had some easy, pleasurable residents like her
too, but most of ours had diabetes or other restricted diets because of non-dementia
conditions unrelated to their mental state.  We couldn't have used food-induced
reinforcement.
In case you might enjoy my own stories, here are some of the posts I wrote about it:
http://invisiblemikey.wordpress.com/2010/04/30/make-me-a-saint-already/
http://invisiblemikey.wordpress.com/2010/05/02/endless-rewards/
http://invisiblemikey.wordpress.com/2010/05/24/destination-unknown/
http://invisiblemikey.wordpress.com/2010/05/27/from-here-to-there/
http://invisiblemikey.wordpress.com/2010/06/13/sweet-little-lies/
http://invisiblemikey.wordpress.com/2010/10/01/the-grid/
http://invisiblemikey.wordpress.com/2011/02/08/deep-river/
This is as close as I got to providing a place for people to respond with their own
stories of Alzheimer's and caregiving.  Perhaps seeing the responses I got will help
you.  Good luck!

Friends and memories of the professional kind

I met with Jane P a nurse I’ve worked with and a friend for many years. We were discussing patients with dementia we had on a unit we developed together some of which are in my book. When I gave her the chapter on “Ben” to read, she remembered the odd way she had to put him to bed at night. Ben was a man with advanced Alzheimer’s disease and multi infarct dementia. He hated to be touched and his combativeness was a problem at times. Jane spent a long time teaching the staff to read his body language and avoid him when he showed signs of agitation.

One of Ben’s problem behaviors included refusing to stay in his room at night and wandering in and out of other resident’s rooms. When he became agitated it was hard to get him back to his room at night and it was becoming a major problem. Not wanting to ask the physician for medications to help this problem, we searched around for other ways to control him.

One evening Jane was playing with her cat at home, getting it to follow a laser light around the room. She decided to try the same thing with Ben. It worked! She would shine it on a wall at eye level until Ben saw it. Then she gradually lowered the light beam to the floor and down the hall. Ben followed it to his room. However, Ben frequently just turned around and came back out again. He often was awake until 2 or 3 AM with the staff doing all they could to keep him out of other resident’s rooms.

Jane liked the idea of using light to control Ben and she found an article about research involving dementia patients and colored lights. The research indicated that people with dementia are attracted to blue lights. We tried putting a blue light bulb in the lamp in Ben’s room. We were amazed by his response. Not only could we lead him back to his room with the laser, but as long as the blue light was on, Ben was happy to stay in his room and usually fell asleep on our first try.

Just wanted to share this memory in case someone else is having the same type of problem. It’s worth a try.

Stephanie

Welcome

This is a new blog created to discuss Alzheimer’s and dementia care. I am Stephanie Zeman a nurse with a master’s degree in geriatric long term care. I have worked with people who had dementia and their families for over 20 years. Recently retired, I have written a book about the approach I used when working with this fragile population. It’s called Kisses for Elizabeth and is based on the 15 guidelines I created for common sense dementia care. Each guideline has a number of true stories attached to them to illustrate how they were used. To read Elizabeth’s story, please log on to Kissesforelizabeth.com

Hello world!

     This is my book. Kisses for Elizabeth is a book about common sense dementia care. There are 40 true stories about people who have dementia in the book. I have developed 15 guidelines for common sense care and each true story illustrates a way one or more of the guidelines was put to use.

Elizabeth was the first dementia patient I took care of in a long term care setting. She taught me two things: I had to try to put myself in her place to figure out what she might need (Guideline 1) and I could change the mood of a person with dementia by giving them something that they enjoyed. Simple common sense.

Please visit my website: kissesforelizabeth.com to read Elizabeth’s story. The book will be available in January and can be ordered from the website at a discount or from Amazon.com.

Please let me know what you think about Elizabeth’s story. I’d also like to hear from you about your caregiving concerns or ways you have solved caregiving problems.

Stephanie

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