How do you work with a client that has Alzheimer’s disease? She is 76 years old and is so anxious that all she does with me is walk and ride bikes.
She is in denial that she has Alzheimer’s but is very slowly slipping away from reality. I see her 3 days a week, and we are in such good shape from all this walking, but this must be the only thing she feels she has control of.
any ideas of how to redirect her during the winter months and all of the rain?
I have mentioned Sr. Centers and she thinks those are for people with wheelchairs. Looking for fall and winter activities that will not bore her. She has had ADD all her life and literally cannot sit so still. She is a precious person and I am very lucky to have her as a client. Just need some brainstorming. Her husband and two daughters are very supportive of me and I have fit right into her schedule because all of her friends had the best of intentions, but with Alzheimer’s Disease the further along it gets it is common for former friends to stop communicating with people!
Any ideas?
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* Work with family.
* Educate yourself with dementia / behaviors through Teepa Snow's website. She is one of the country's leading experts on dementia and offers free email information and webinars. I studied with her on-line webinars for two years.
* Work with social worker or any social service provider she gets that could coordinate care with you, with family.
* She may need to have meds (adjusted). This is something family could pursue IF there is a POA in place.
* If this person is a client (or even if you are a family member), and she is considered to be mentally competent, there is little you can do - without going in circles - to no avail. Never ever argue with a person with dementia. As you say she has Alz., she may need placement in a facility - as often this is too much for family or a caregiver (there on limited schedule) to manage.
* Take to medical provider, family, social worker(s) - insure that legal documentation is in place to make decisions this person cannot make on their own. If she is diagnosed with Alz., she is not competent to make legal decisions on her own behalf. Someone else needs to do - family, state.
Gena Galenski
Touch Matters
Since you say that you are " with her 3 days a week" it begs the question if you are a paid caregiver ? or another loving family member? IF you are a paid caregiver, you should be communicating these needs to your employer so that they can assess needs and appropriate follow up.
For your own protection and the primary safety of the patient, consult with the professionals caring for her and, your agency if you are indeed a paid caregiver working through an agency.
How about starting with a Geriatric Psychiatrist to help mom calm down and orchestrate her happy place: if she could do anything about changing up her life, what would she do? Where would she go? Who would she visit and request the pleasure of their visit? Would she like to adopt a pet? Hobbies? Talents? Online games. Has she ever tried the LUMOSITY site?
Can you or other family members take her on excursions to the senior events coming up around the holidays? Does she like BINGO? Is she interested in doing volunteer work? Does she paint, knit or crochet?
What music makes her happy?
Does she know how lucky she is to have YOU?
And as I mentioned medications do have or can have unintended side effects, one being that a person can become unsteady and this could be a problem for someone that wants to walk or otherwise be active all the time.
She may have been active all her life and cannot accept the
limitations of old age. Even 2020 limited us severely as far as
"outlets".
Remember activity wards off muscle atrophy / arthritis and the dulling of the mind. Accept what she is and make sure she uses common sense.
Since you are concerned, it might help if you contact her on those bad weather days.
"We" cannot presume or assume behavior based on foundational personality over decades (meds change behavior/brain chemistry as does the disease).
I don't know what M/C is however, people in memory care facilities MUST be locked in. Otherwise, obviously, their safety is in jeopardy should they wonder off premises. This is for their safety. So, it isn't necessarily 'unfortunate,' as you say. The disease itself is miserably and this is truly unfortunate, however once it is diagnosed, a person is fortunate to be in a safe place - they cannot leave unattended by a care provider.
Gena Galenski
Touch Matters
For example, I attend a free senior low-inpact in class free video activities, and the exercises are repetitive instructions for one hour 3 days weekly. I can miss a class but return at my convenience if busy. Just love it and the participants! Because I have autism, this program in Daly City, CA is perfect for me.
Walking in the winter can be safe.
Good boots if there is snow.
Proper dress for the cold and wind. This might be a time that Cross Country Skiing might be a new hobby.
The point is properly dressed a walk in the winter is possible. So if she get agitated and "needs" to walk outdoors please consider it.
Getting to the agitation. There are medications that can help BUT the medication may make her a bit unsteady so watch for any side effects and adjust daily activities as needed.
Mall Walking is a possibility if there is a nice safe mall near by. (sad thing around me is many Malls have closed or remodeled and are now "outdoor" malls with no inside area to walk.)
Check the local Park District many have indoor areas with walking tracks.
The local Y might also be an option and you would have to option for other activities as well. (some insurance plans cover the Y and a few other fitness places)
The place I took my Husband for Day Care had a woman that walked the hall non stop all day. Maybe she stopped for lunch but I never saw that. I just had to be careful that when I brought my Husband there or picked him up she was headed away from the door so that she could not "escape" when entered the code and opened the door.
I had a dementia client a while back who walked all the time. She was very physically for and very spry. She had dementia though. I took her walking outside and to the mall in the winter.
One time we were at the mall and she decided to start running and I ended up having to have mall security find her. She had made it all the way out to the parking lot. She was trying get on a bus. After that I started putting her in a security belt with a leash attached to it. Like what is used for children when you're taking them into a crowd. She threw a tantrum about it at first but got used to it because it meant we went walking.
We'd get some looks at the mall of course because an old person on a leash being taken for a walk is not something you see every day. It was a safety precaution. We walked right up until three weeks before she died at the age of 96.
I see senior walking clubs at the mall near me all the time. A lot of them go with their home/health aides because they need supervision. From what I've seen these people have a good time. They walk the whole place then stop off at the food court for refreshments and to sit for a while.
Call the senior center in your area and talk to them. They might have a mall-walkers club that you can bring your client to.
IMO, you are not going to be able to teach her anything new. Her short-term memory does not allow it.
"colouring in, easy jigsaw puzzles." I have a couple of the wood puzzles that Fisher Price made from 45 yrs ago. A friend was suggested this kind of Puzzle for her husband suffering from ALZ. I loaned her mine. Coloring should probably be the same way. Maybe a coloring book for grade school ages. Personnally, I so hope if I have Dementia, that they don't have me color. Haven't liked to do it since 2nd or 3rd grade when it was "color all the even #s blue and all the odd #s red".😁
I like idea of walking a Mall. Can window shop, eat lunch, have a snack. Maybe an aerobics class.
You can take her to an indoor mall to walk in the winter months or when the weather doesn't cooperate to be outdoors. She could also go to an Adult Day Care center up to 5 days a week, as they keep the folks there pretty active and as busy as they want to be.
The YMCA could also be a good choice as they offer "Silver Sneaker" classes along with other classes appropriate for the elderly.
Keeping her active will certainly benefit her(and you)in the long run, so just keep her moving best you can.
I would recommend Teepa Snow's approach for care. Plenty of info via Google search & many really interesting videos & talks.
Thr 'emerald' stage in particular describes people who are on the go. Can be on the go go go physically or in a repetitive verbal loop unable to stop. There is a really good video showing how to distract & realign the person to another activity or take a much needed rest. The lack of insight prevents them from recognising when they need to stop or slow down themself, or even other essential self-care requirements eg eat & drink.
ADD (or ADHD) may add another layer of behaviour that is tricky to manage, but not impossible.
Maybe once the lady seems physically tired of walking/riding/using her big muscles - an activity could be introduced to use smaller muscles eg fidget spinners, colouring in, easy jigsaw puzzles.
Is there a Physio or OT on her care team? I think an OT could really help with activities. The Doctor may be able to prescribe medication to lesson the agitation (if appropriate) too.
While some may say, well let her walk all day if she wants.. and I get that.. as a support worker you have some duty of care to protect her from known risks eg over exercion in hot weather & dehydration.
It would be reversed if we had nice summers and brutal winters.
Studies have shown learning (or trying to learn) something new can help stave off the effects of dementia. Perhaps finding an interest for her and working on that part of the time can help her be less anxious. You know, like learning a new language, anything to help her focus.
Get her to check out the senior center with you. She'll quickly see it's not all wheelchairs.
How about cleaning her apartment? Can walk malls or even Target or the grocery store.
Join a gym? Planet Fitness, where I was a member for years, has cheap memberships and she could get the one where she can bring a guest (you!).
Good luck.