When you’re caring for someone who takes prescriptions, it’s important to establish good habits and medication practices. As you observe changing behaviors in your loved one, it’s easy to overlook something as simple as medication.
Consider the following suggestions for routine medication practices.
Establish a trusted doctor relationship
Regular visits to the doctor help ensure that the proper medication is being used, the correct dosages are being given and that there are no contradictions with the various prescriptions (such as two medications that counteract one another).
If you have questions or concerns about the medications that are prescribed, ask the doctor for clarification. Be sure to also understand functions, and side-effects of all prescriptions.
Storage and handling
Make sure all medication is locked away, out of reach of small children and other vulnerable people and pets. Always keep the labels on the pill bottles and double check to make sure the label matches the drug and dose that was prescribed.
It’s also important to review storage instructions as each medication could have different requirements. Be sure to read and follow instructions for refrigeration, light, moisture, etc. If medications aren’t stored properly, their effectiveness may be jeopardized.
If you’re loved one is independent, you may determine they are capable of handling their own medications. With dementia, however, they may confuse medications, or the instructions for taking them. It’s a good idea to manage the medications for your loved one and to regulate their administration.
While pill boxes may be an effective practice for some, people with dementia may confuse what day it is and fail to take their medications, or wind up taking them twice. If you are going to use weekly pill boxes, make sure you are helping to ensure proper doses are taken on appropriate days.
It’s important to always take medications as prescribed. If you don’t, you could risk their being ineffective. Or worse, improper administration could be harmful. Serve a small snack if food is recommended. Use calendars, alarms or other devises as reminders. If you own a smart phone or tablet, for instance, set an alarm to alert your loved one when it’s time to take their medication.
When reviewing instructions, it’s a good idea to also check expiration dates. If medications are outdated, or no longer in use, talk to the prescriber for proper disposal.
Old practices, may no longer be best practices. Medication should not be trashed or flushed down the toilet, but rather taken to drop-off sites. Talk to your doctor about disposal sites near you.
Always carry a list of the medications your loved one takes. In case of an emergency it’s important that first responders have this information in addition to any allergies. This will also prove to be helpful at your doctor visits. Ensure the list is always up to date and present when you are away from home. But also keep a master list at the house for anyone who helps to provide care in your absence.
Clarity is key when it comes to medication practices. Whenever there is uncertainty, don’t hesitate to question prescribers, pharmacists and other professionals so you are equipped to provide the best care.
Contributed by Leah Bigham
Contact us if you have questions about your loved one's medication management and we can refer you to sources of help or advice.
Minimizing Sleep Disruptions
People with Alzheimer’s Disease often have trouble sleeping through the night. There are some things we as caregivers can do to encourage uninterrupted rest.
Much like getting your loved one ready for the day, it’s important to develop a bedtime routine. If they fall asleep after an episode of confusion or agitation, their chance of waking before morning is likely to increase. Routines are essential to minimizing stress, agitation, confusion and disorientation. A standard bedtime routine may include the basics such as a nutritious meal, medication maintenance, a change of clothes and a trip to the restroom. You may also want to include one of the following types of activities to personalize their routine:
• Watch an episode of their favorite TV show
• Read a book
• Tend to the needs of pets or small children they care about
• Enjoy a cup of caffeine-free tea or coffee
• Start/complete a crossword puzzle
When considering what to include, reflect on their lifelong traditions. They will likely enjoy adopting the same types of activities. Try to begin their routine about the same time every night.
A lack of activity during the day, could cause restlessness in the evening. It is important to incorporate exercise and activity throughout the day, being careful not to wear them out too early. Consider a daily exercise routine, outings or hobbies like gardening. Discourage naps, or limit them if you can.
Individuals with Alzheimer’s and dementia need constant reassurance throughout the day and nighttime is no exception. While some will insist on an independent trip to their bedroom, others may desire company. To respect their privacy and independence offer your assistance.
Before you turn the lights out, assure them that you are available if they need anything and that you will see them in the morning to minimize concerns that they will be left alone.
Cultivate a safe and comfortable environment
To create a comfortable environment, remember the five senses. Ensure they don’t go to bed hungry, for instance, by offering a light snack before bedtime.
Is it too loud in the next room? Its it too quiet? Consider turning down your television set and hush small children at play. Or if they prefer noise, offer soothing music to help them relax.
Are the blankets on the bed too heavy? Is it warm enough? Are their pajamas too confining? Observe your loved one’s reactions to their environment and try correcting the things that pose frustrations.
Make sure hallways and rooms are equipped with night lights to help navigate through the darkness. Complete darkness could increase the chances of falls or injuries, but it may also spark fear and confusion if they can’t see their surroundings.
Investing in a monitor will allow you to observe your loved one’s activities in the middle of the night. These devices can help to minimize the number of times you intervene and increase their chances of getting back to sleep. If you need to intervene, gently remind them that it’s not time to get up and help them back to bed. Again, confirm that they’re comfortable and reassure them that you will be there when they wake in the morning.
Medication & Doctor’s Visits
Though you may want to delay medication as long as possible, sometimes there are underlying issues that need temporary attention. An early visit to the doctor could reveal unforeseen issues that your loved one may not be able to communicate.
Disruptions in sleep patterns can be a result of a urinary tract infection, for instance. Medical attention could minimize, if not eliminate multiple sleep disruptions. A lack of sleep could also indicate necessary changes to current medications he/she may be taking. Involve the professionals in these decisions to encourage uninterrupted sleep.
Remember, there is no guarantee to get them to sleep through the night. But you will rest better, knowing you’ve done what you can by keeping these suggestions in mind. And once you find something that works, be flexible, knowing their preferences can change as the disease progresses.
Contributed by Leah Bigham
It’s not uncommon for caregivers to get caught up in the task of taking care of their loved one and altogether forget about their own needs. The problem with this is layered, but at its core, caregivers can’t properly care for someone if their needs aren’t being met first.
It may sound selfish on the surface, but taking time out for yourself is the best thing you can do for your loved one. Without self-care, you risk over-exerting yourself, which is common for caregivers. And they often do so without even realizing it. It’s imperative to replenish the energies that are depleted in the caregiving process. Without this important respite, caregivers have little left to offer and their caregiving efforts fall short at the expense of their loved one.
Some of the indicators that you aren’t getting the care you need will show in the form of stress, depression, feelings of being overwhelmed, anxiety, fatigue and burnout. If you have reached this point in caregiving, you may come off as short, detached, stressed, and even annoyed to your loved one.
People who suffer from dementia are already prone to these types of symptoms. When you become subject to them, too, it can easily intensify their stress and agitation.
Taking the time to meet your own needs—be it down time, entertainment, a break from the mundane, ordering food in, or simply taking a bath—could alleviate these types of tensions for you both.
Here are a few ideas to take time for yourself as they relate to caregiving:
- Spa day
- Going out to dinner or order in
- Regular maintenance (haircuts, grocery shopping, washing your car etc.)
- Get together with friends and family
- Weekend getaways or day trips
- Watch your favorite television show
- Skip chores that can be put off for a time
- Attend church and other social functions
In addition to meeting your personal needs, it’s important that you are constantly learning new insights to the task at hand. Connect with your community resources to see what is available in the way of education. Take advantage of these resources and carve out the time you need to participate in them.
Connect with Assured Senior Living Solutions to learn about these types of resources:
- Support groups
- Workshops and educational classes
- Day Centers
- Respite care
In addition to the community resources, don’t be afraid to lean on your own family and friends for relief. If they make themselves available and you are in need of a break, don’t hesitate to take them up on the offer.
It has been observed that caregivers’ health will suffer in the shadow of their dedication to caring for their loved one, if they neglect taking care of themselves. For your own well-being and that of your loved one, take advantage of the resources available. Give yourself the care you need and see to it that you develop some sort of regularity.
Whether it’s a couple hours a week, a bimonthly getaway or daily relief so you can maintain a full-time job, connect with the resources that will ensure your loved one is cared for, without you having to give up your life, your health or your peace of mind.
Contributed by Leah Bigham
Many people affected by Alzheimer’s Disease have a tendency to wander. Though it is common behavior, it can cause high levels of stress and fear for caregivers. Wandering isn’t always harmful, but it can be if your loved one is prone to leave. Here are some tips to help ease your fears and minimize the dangers of wandering.
The most important thing is your loved one’s safety. While it may sound obvious, caregivers should never leave someone affected by the disease alone. You may think that your loved one is independent enough to care for themselves for a few minutes while you make a “quick trip” to the store. Despite their capabilities, though, your absence could spark an episode of agitation.
Confusion, frustration and boredom are known to prompt wandering behaviors. In your absence, your loved one could become confused and may even fear for your safety. They could get frustrated for being left alone, or simply get bored.
It is not burdensome to depend on your closest friends and family for help when you need to leave. If you don’t have friends or family available for this type of help, familiarize yourself with the community day programs and services that are available to help.
Remove trip hazards and install night lights so as to avoid any falls in the night. Keep dangerous items out of the reach of your loved one and consider childproofing doors and cabinets in your home.
Wandering can often be a sign of an unmet basic need such as hunger, body temperature or the need to use the restroom. Keeping your loved one occupied and content is one of the best ways to keep them from wandering. If you observe excessive fidgeting or agitation, consider what basic need must be met.
If, on the other hand, they become bored, confused, or frustrated, you will have to be more creative in finding something to appease them. Knowing what keeps your loved one content can reduce their instinct to elope. Knowing their dislikes will be imperative for avoiding escalation.
Capitalize on their likes by offering to do things they enjoy, such as turning on a sports program or their favorite music. The activity may distract your loved one from whatever agitated them in the first place.
If they have a common escape route, try strategically placing points of interest that can be used as deterrents along the way. Old pictures, for instance, may serve as a distraction. Pointing out these points of interest may engage your loved one in such a way that they forget why they were trying to leave in the first place. Food, books, and other attachment items may also prove to be simple but effective strategies.
If your loved one does elope, it may be your first instinct to tell them they need to return home. Under stress, your tone may even be on the demanding side. They are likely to resist any such requests. You can honor their independence by simply diverting their attention to conversation. “What a great idea to go on a walk today, mom! The weather is perfect, isn’t it?” Simply walk and engage in conversation. As you talk, gently and casually redirect the “walk” back to the house. Consider taking an abnormal route back inside, such as through the back door.
Making your home as wander-friendly as possible could prevent your loved one from ever leaving. Its not necessary to discourage their need to wander, but rather to maintain their safety as they do.
Contributed by Leah Bigham.
As you already know, the challenges that accompany the caregiving role are plenty, not the least of which is maintaining adequate hygiene. Getting ready for the day can be exhausting. While there are some proven methods that help, there is no one-size-fits-all formula. Consider these suggestions as you see to it that your loved one is properly cared for.
1. Be patient with yourself
It is not uncommon to experience complaints, resistance, or even combatant behavior. These are indicative of the disease and not a result of something you are doing wrong. Resist the urge to look for a cause or cast blame upon yourself. Don’t take their frustrations personally.
2. Develop and stick to a routine
Disrupting your loved one’s routine induces anxiety, confusion and frustration. If they feel disoriented, they will be more apt to be resistant or even combative. Come up with a simple morning and evening routine that works well and stick to it as much as possible. Be concise and only include what is necessary. You don’t want to wear your loved one out before they are ready for the day.
3. Encourage independence
Honoring your loved one’s independence, may require more time and direction. Be patient and avoid rushing them. Offer succinct directions so as not to overwhelm them. Give them a task that they are capable of, such as brushing their hair, while you tend to something more difficult like cleaning their dentures. It will boosts their self-esteem, and distract them from the fact that they actually are dependent.
4. Limit correcting
It may be instinctive for you to correct your loved one, especially if you have raised children. But the care we provide for our elderly is contrary to that which we give our children. It is imperative that we, as caregivers, are willing to adapt. Our loved ones aren’t learning to do daily activities, they are forgetting how to do them. The objective here, isn’t to teach them. It is to support them.So when they don’t do something “right” or the way they once did, like parting their hair on the right side instead of the left, resist the temptation to fix it. If it’s not going to put them in harm’s way, let it be. But if it poses a danger, be subtle as you redirect.
5. Prepare for bath time
Bathing can be one of the most difficult challenges. While it is important to communicate to your loved one that you will be giving them a bath, delay doing so. Explaining too soon (before breakfast, for instance) may prompt premature anxiety and they may get fixated on the bath, which will interfere with other activities. It can also make the trip to the bathroom more difficult.
Have everything prepared and ready so they can return to their normal routine as quick as possible. However, be aware that quick and rushed movements may feel aggressive and perhaps even scary. Acknowledge their fears and don’t chastise them for their resistance. Reassure them as you tend to the task.
6. Less is more when it comes to wardrobe
Simplify the dressing process for your loved one by limiting their options of what is available. Remove confusing and restricting articles like pullovers and lace-ups and replace them with zip-ups and slip-ons.If your loved one has an attachment to a certain piece of clothing, it may help to add articles that give them the same tactile and sensory experience.
At the end of the day, remember that your goal is to make sure your loved one is well taken care of. Consider that you may have to set aside some of your own standards. Try to keep your focus on the simple and crucial elements of care.
Contributed by Leah Bingham
Moving a parent or a loved one into assisted living is one of the more difficult milestones in any adult’s life. It represents a loss of independence for the parent and is stressful for everyone involved. Planning ahead for the challenges to come will make the experience easier for everyone.
First, put yourself in your elderly parent’s place. They might be leaving a home they’ve lived in for 50 years. They are certainly having to face new restrictions on their independence. They might be moving away from friends or neighbors they’ve known for years. If they are difficult or uncooperative, be compassionate about the massive change that this represents for them.
Second, acknowledge that you and any siblings and spouses probably are feeling guilty no matter how clearly mom or dad need the help. Look at the quality of life they are currently experiencing and if they would receive more and better care in an assisted living facility.
You may even feel like you should be taking care of them personally but you need to consider the rest of your family and your nursing or senior care skills. Families sometimes search for a fancy senior living facility based on easing their guilt. Instead, focus on what’s best for your loved one and the level of care that they will receive.
Third, try to recruit help from the family members who are going to be the most level-headed. You may find that distant siblings may feel left out and that might translate into unhappy, emotional responses directed at you. Remember that when they offer opinions they are most likely just trying to be helpful rather than criticize. They may be feeling guilty for not being closer.
Listen to their advice – they may have helpful insights – and acknowledge them for caring. You can also help yourself and the rest of the family by reaching out to everyone early in the process to recognize their feelings. Ask those who are not going to be hands-on in the process to help with support in the form of a kind word, a smile, or a hug.
Fourth, be honest with the assisted living facility staff. They need to have accurate information about any care needs your mom or dad may have. Sometimes a family will not disclose everything because they want to improve their chances of being accepted. This is not only dishonest, but it can be dangerous to your loved one’s health. You need to be transparent and provide as much information as possible so the staff can care for all of their needs.
Fifth, setup your loved one’s new rooms to be as comfortable as possible for him or her and for visiting family. It will be difficult to pare down a lifetime of belongings so again, be compassionate in the weeding out process. Remember, too, though that a cluttered, cramped space won’t be comfortable either.
You might also invite each family member to choose something for the new space that they loved to see at mom or dad’s. Maybe your sister loves the painting that’s been over the couch, or your grandson always liked to see the “old timey” photos. Work with the facility staff to get room dimensions and to find out what’s already there.
Finally, realize that you need to be an active care partner for your loved one. You’ll want to get to know the staff. Make sure you know who to contact with questions or concerns. The assisted living staff will need to know who they should contact for any care decisions. Remember that you’ve had a lifetime to get to know mom or dad. But realize too, that the staff members are professionals trained to care for seniors. They understand their health and daily living needs. Be actively present but don’t “helicopter parent” them or your loved one.
This will be an emotional and physical challenge for you and your family, but if you use these strategies to help you plan and prepare, it can be a less stressful experience with a more positive result for everyone.
David Reed is the David Reed, Founder and Executive Director of Assured Senior Living Solutions, a free senior care referral service in Fresno and Clovis. Contact him at (559) 283-2566 or www.assuredseniorlivingsolutionsfresno.com for more advice or recommendations.