Sunday, April 27, 2014

Aggression in Seniors With Dementia & Alzheimer's disease.

Seniors with dementia or Alzheimer's disease may experience periods of aggression.  Aggression may be either verbal (cussing, threatening) or physical (lashing out, combative).  As a caregiver it is important to react calmly to aggressive behavior.  Avoid being harmed by the senior by taking a step back and deescalate the situation by giving the senior physical space and adopting a soothing tone.

Aggressive behavior can stem from multiple conditions.  The senior with Alzheimer's disease may be combative due to pain they cannot otherwise express.  Similarly, aggression may stem from a physical need such as toileting or hunger.  Boredom and lack of social interaction may create aggressive tendencies.  In these situations activities and engagement may decrease aggression and agitation.  Aggression may also result from environmental stimuli such as noise or too many people.  In seniors with Alzheimer's disease overstimmulation can result in combative behaviors.  Once again, modifying the environment to remove stimuli can help reduce aggression in the senior and enhance their quality of life.

Saturday, April 26, 2014

Dementia & Alzheimer Behaviors

Alzheimer's Disease Can Produce Some Unexpected Behaviors

If your loved one is in the middle to late stages of Alzheimer's disease you will begin to notice certain behaviors manifest.  Feelings of aggression, anxiety, and loneliness can become ordinary occurrences.  You may be regularly accused of theft or infidelity or become an imagined participant in other delusions.  Your loved one may begin to repeat questions or actions or wander from the premises.  All of these behaviors are associated with Alzheimer's disease and require the adoption of Alzheimer care strategies

The Behaviors

Many residents experience bouts of aggression or combativeness.  If your loved one begins to lash out at caregivers and strike staff you'll need to adopt certain precautions.  Be aware of any stimuli that prompt aggressive behavior such as loud noises or pain.  

Anxiety is another common state of mind associated with dementia and Alzheimer's disease.  When your loved one feels anxious offer words of comfort and reassurance to defeat feelings of loneliness and confusion.

Depression is another emotion associated with Alzheimer's disease.  If your loved one is feeling depressed consider celebrating small occasions and offer physical exercise and activities.  Let your loved one know that they are a part of the family and appreciated.

See our second post for more dementia and Alzheimer behaviors.

Tuesday, April 8, 2014

Why Excellent Senior Care is Expensive in Sonoma County

It's as simple as supply and demand.  There are many families looking for quality senior care facilities, yet there are few quality senior care facilities in Sonoma County.  Yes, there are over 160 licensed residential care facilities in Sonoma County, but few of those facilities carries a reputation for excellent care.  Many long term care facilities in the North Bay are board and care facilities providing a bed and minimal personal care.  In contrast, excellent senior care facilities provide 24 hour care and are managed by an Administrator with medical credentials.

The level of involvement of management in the care of every resident also separates the quality RCFE's from the average $3,500 per month assisted living facilities.  Few care homes can claim that a registered nurse is involved in the care of every resident.  In fact, Wild Rose Care Home is one of the handful of assisted living facilities in Santa Rosa that is managed by a Registered Nurse who is on-site 5 days a week.  While many large assisted living facilities may boast of low staffing ratios you need to question the role of staff in resident care.  Having a 1:5 staff-to-resident ratio is not very impressive if maintenance, kitchen, and non-care staff are included in the calculation.

In light of the lack of quality long term care facilities in Sonoma County the few that exist are fairly expensive.  Many of the better assisted living facilities charge over $8,000 per month.  With that said, some of the larger assisted living facilities that excel in marketing more so than resident care also charge high rates, so be mindful that price alone does not indicate quality of care.  In evaluating the quality of care consider the rate, number of vacant rooms, medical expertise of staff and managers, and on-site operations.  Does the facility understand Title 22 regulations?  Do the managers understand dementia care or are they only business persons.  You'll need to make your own determination before admitting your loved one, but whatever facility you choose be prepared to pay over $8,000 for a good assisted living facility.

Tuesday, January 7, 2014

Dementia Care: Don't Reorient; Validate

When a family member suffers from dementia you will be exposed to the delusions and general confusion that accompanies dementia.  Your 90 year old dad may tell you that he went fishing yesterday with his father when in fact he watched a TV episode about fishing.  When hearing these stories it can be tempting to reorient your loved one back to reality. This strategy of reorientation was a prominent school of thought in dementia care for many years.  However, Alzeheimer's is a progressive disease.  Reorienting your loved one back to reality will not reverse or stave off dementia.  In fact, reoreienting your loved one will often lead to negative emotions. Your loved one may become angry after being told that their belief is not true.  Take the instance described above.  If you told your dad that he couldn't have gone fishing with his father because his father was dead, the reorientation strategy would produce a negative emotion; your father may experience the loss as if for the first time.

Instead of reorienting a senior citizen with dementia back to reality, participate in their belief.  Ask your father what he and his father talked about while fishing.  The line of questioning can lead to happiness for your father and positive emotions.  This practice of participating in the resident's belief is a standard practice at when positive emotions can be achieved.  In essence, validation of a delusion brought about by dementia can have a positive effect whereas reorientation can have negative ones.  Therefore, don't worry about 'curing' your loved one through reorientation; you can't.  Instead focus on letting your loved one experience positive emotions which will ultimately enhance their quality of life.  Remember, dementia is a progressive condition.  Dementia is not a disease that can be cured or reversed; it is the display of various symptoms such as confusion, disorientation, and memory loss.