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Why give on #GivingTuesday?

A note from a caregiver after receiving the Phyllis Watkins Family Assistance Program Grant in 2016:

” I really thought this grant was a waste of my time! Mom was so unwilling to have anyone else in the house, to the point where I could not even have dinner with family or friends at the house because she would become so upset we would have to go to the ER. I just felt like I was at the absolute end of my rope and then Mom’s caseworker suggested a grant that might help me take a break. At first, I rolled my eyes and took the application home to be recycled. But after I got home, I thought what could it hurt. I am exhausted, and I knew my daughter was planning my grand baby’s first birthday. I wanted so badly to go and attend the birthday party and just get a chance to visit with family. After I mailed the application, I had so much guilt about leaving mom even for the day. But then I got a letter back stating my grant money had been approved for respite, I just started crying. I hired a close family friend who Mom knew from church and felt comfortable with, I left so many notes and instructions I am sure the caregiver thought I was crazy. Then I drove to my daughter’s house, with so many nerves, I almost turned around twice!! But I made it to my daughter’s house well before the party started and the reaction I got from my flustered, overwhelmed daughter was one I will never forget. It was just like when she was a little girl on Christmas morning, except now I was her Christmas present.  While we were putting up party decorations and pulling out food for the party, we talked and laughed like we hadn’t lost a moment of time. Those few hours were the best with my sweet girl and it gave me a new appreciation for my own mom. My daughter and I talked about getting some additional help in for me and we agreed to meet every week to talk and make sure we don’t lose our connection. I would just like to say from the bottom of my heart, thank you so much for providing this grant for caregivers. I am so grateful for organizations like Alzheimer’s Arkansas and the Phyllis Watkins Family Assistance Program grant. Many blessings, Linda” 

All of your gifts given to Alzheimer’s Arkansas stay in Arkansas to assist caregivers and their friends and families with our free programs and services. Our free programs include nine Hope for the Future Caregiver Workshops throughout the state, 57 caregiver support groups, and family counseling. On #givingtuesday your gifts will go directly towards helping more caregivers in Arkansas with the Phyllis Watkins Family Assistance Program Grant. Alzheimer’s Arkansas also provides a 24/7 caregiver support line: 800-689-6090.

#GivingTuesday is a global day dedicated to giving back. On Tuesday, November 28, 2017, charities, families, businesses, community centers, and students around the world will come together for one common purpose: to celebrate generosity and to give. It’s a simple idea: just find a way for your family, your community, your company, or your organization to come together to give something more. Then tell everyone you can about how you are giving. Join Us and be a part of a global celebration of a new tradition of generosity. 

Give to Arkansas Caregivers on November 28th!!

 

 

If you are interested in the Phyllis Watkins Family Assistance Program grant, click here.

Only the Lonely

 

Only The Lonely

By Priscilla Pittman, MSW, MA

Mary pushed her grocery cart through the store reciting the items needed for the casserole.  She nodded and smiled at a silver headed man who greeted her with a cheerful “Good morning.” Busily cruising the aisles trying to remember the list she’d left on the table, and she passed him again.  He smiled and she asked if she could help him find something.  “No,” he replied, he was still trying to decide.  Finally, content she had done the best she could, she headed for the check-out aisle.  And here he was again; his cart remained empty.  Concerned, she touched his arm and asked if she could help him.  He lowered his head and said, “Mam, this is the only place where people will talk to me.”  A conversation followed that revealed the death of his wife following a battle with cancer, and the loneliness that consumed him.

Dr. Nancy Donovan, director of the Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital in Boston reports, “For people who have high levels of amyloid –the people truly at high risk for Alzheimer’s—they were 7.5 times more likely to be lonely than non-lonely.”

More research is needed, but Wolf-Klein asks, “If you were able to impact on this loneliness by creating interventions where people were taken out of their loneliness and engaged in social events, would you have less likelihood of progression toward dementia?” (1)

The grocery store experience could also include an Alzheimer’s caregiver.  When caring for a spouse, the couple may still be married, but the change in the relationship is dramatic.  Despite hugs and smiles, the social, emotional and physical aspect of their marriage has been dissolved by the disease, and the term, married but widowed is often heard.  (2)

In addition, William Thomas, M.D. designed the Eden Alternative version of long-term care to deal with the plague of loneliness, helplessness and boredom he observed in the traditional system.  (3)  These three terms are also problematic for any elderly person living alone or in long-term care.  Too often caregivers bring a parent to their home believing they are rescuing them from long-term care.  But if the caregiver is employed full time, the parent is abandoned during work hours leaving them without another social base.

How can we treat loneliness?  An organization called Little Brothers, Friends of the Elderly in San Francisco is striving to alleviate the problem by providing visits from volunteers.  Older clients served by the agency say they found the stairs once climbed easily are now a roadblock; the illnesses that occur also keep them at home. (4)

 

In the UK, a volunteer staffed agency called the Silver Line receives phone calls from lonely, older people.  They hear from about 10,000 people each week, and they are the only communication resource for 53% of their callers.  The Helpline shares: area resources, helps them get in touch with a service that provides visits, and helps protect those being harmed from continued abuse. (5)

 

 

 

Building social connections is good medicine.  No More Throw Away People or Time Dollars describes a method of creating social connections.  This theme would make an excellent model for religious or community organizations.  A person could accrue points by cleaning, mowing, cooking, transporting, etc. someone in need.  The points could then be used by their family or the individual when needed.  Some people would be less likely to refuse assistance if they, their friend or family member had earned the hours of aid they needed. (6)

“Loneliness is a huge issue we don’t talk enough about,” said Dr Charlotte Yeh, chief medical officer of AARP Services.  “There is a huge stigma.” (4)

  1. http://www.cbsnews.com/news/could-loneliness-be-an-early-sign-of-alzheimers/
  2. AFA Care Quarterly, Spring 2015
  3. What are Old People For?, Dave Thomas, M.D.
  4.   AARP, http://www.npr.org/sections/health-shots/2017/01/01/506724900/easing-old-peoples-loneliness-can-help-keep-them=healthy
  5.   https://www.thesilverline.org.uk/who-we-are/
  6.  No More Throw-Away People,  Time Dollars,  Edgar Cahn

Metabolism & Swallowing

By Priscilla Pittman, MSW, MA

Alzheimer’s Arkansas Programs and Services

 

METABOLISM

  • Slower processing of meds and alcohol
  • Slower reflexes might impair driving
  • After age of 30, metabolism slows about 2% each decade due to loss of muscle mass if we are not working on our muscle strength.   The average American loses as much of 50% of their muscle mass b/w ages of 50-70 (www.johnhopkinshealthalerts.com/reports/nutrition_weight_control/1811-1)
  • A good way to offset the changes in metabolism and loss of muscle mass is to reduce the calories consumed and increase physical activity.
  • Exercise and weight training can help maintain muscle mass & it is also important to eat breakfast, lean protein, get sufficient sleep and move around more!!

 

SWALLOWING

  • There are a number of medical conditions that affect the nervous system and may cause swallowing problems (dysphagia), but it is a common problem experienced with aging.
  • The Swallowing Disorder Foundation suggests that about 20% of people reaching 50 and most of those 80 years old will encounter swallowing problems.
  • Some changes we need to be aware of are:
  • As we age our vocal cords may reduce in volume and not be able to protect our airway.  This may allow what we swallow to enter our lungs.  (aspiration) If you often cough or experience a voice change after a swallow you might want to check with your doctor.
  • The muscles in our tongue and throat are responsible for moving foods and liquids from our mouth to our esophagus, but if this movement is not completed food may remain in the throat
  • The sphincter is a round muscle that sits atop the esophagus that opens and closes to allow products to enter.  But, when we age the muscle may decrease in size and pills, food, etc may become stuck or swallowing may be more difficult.
  • As we age the throat is longer and more dilated resulting in a longer swallow time and the need for more protection from the sphincter and vocal cords to compensate for additional swallow time. (increase of 20%)

Some medications may contribute to swallowing problems, but alerting your physician to problems you recognize could result in a swallow study and assistance that could protect your life.

Swallowing Exercises!

  • Gather saliva under tongue, hold tip of tongue between teeth & swallow
  • Blow a kiss
  • Lick a Popsicle
  • Try to touch your tongue to your nose

Bravery by Priscilla Pittman, MSW, MA

Think about your favorite movie. Chances are the main character, the hero in that movie, probably faced a challenge that seemed insurmountable.

What makes a hero is facing that insurmountable challenge and finding a way to do something, anything to meet it.

Heroes are brave.

People diagnosed with dementia and their caregivers are brave. There is so much more than the neurological diagnosis for families to address. It includes learning to take a personal tragedy and then by adapting their lives and working together or alone they create a life far different from former expectations.

It involves pushing aside negativity frequently, accepting the losses, learning about dementia, caregiving and care-receiving. Education is a must, but there is no silver bullet that solves all communication and caring issues…it is more like silver buck-shot. Support groups are one of the best learning tools. We learn from one another about what worked and what flopped in our efforts to improve quality of life for our loved ones. We learn that “normal” is only a setting on the clothes washer, and that each person will continue to be unique and no two will progress or experience the same symptoms in dementia world. But our beliefs and experiences will color our world and assist others in their journey.

Arthur Klineman speaks knowingly when he writes: “We have each of us gone through feelings of loss, anger and frustration. We have been marked by a special kind of pain. But we have also experienced a deepening sense of responsibility, gratitude for all that we had lived through together, love, solidarity, and a shared sensibility that we have resisted what is beyond our control and are, individually and collectively, more for it.”

Klineman defines care giving as ”…a defining moral practice. It is a practice of empathic imagination, responsibility, witnessing and solidarity with those in great need. It is a moral practice that makes caregivers, and at times the care-receivers, more present and fully human.”

The task is not easy. The disease saps energy, and makes the possible seem impossible. Words and actions create oceans of tears, mountains of guilt and quakes that divide families as caregivers struggle to manage the difficult decisions, the financial problems and attempt to understand those who turn their head and will not care. But, according to Kleinman, “…out of the billions of ordinary acts of care giving comes much of that which… sustains the world.”

Need more info?

Email or call us at elise.stuart@alzark.org or 501-224-0021

Swallowing Problems: Tips for Patients and Families

by Priscilla Pittman, MSW, MA
Alzheimer’s Arkansas Programs and Services


Swallowing is a complex motor function and, therefore, may be affected by some chronic illnesses. The process begins unconsciously as the amount of saliva increases in the mouth when we see food. Then, the food is taken into the mouth where it is chewed and moved from side to side for chewing, tasting and shaping by the tongue.  When the tongue pushes the food to the back of the mouth, the food touches the tonsil region and a swallow is initiated setting into motion the movement of the food through the throat and into the esophagus.  The Mayo Clinic advises us that the swallow requires approximately 50 sets of muscles and nerves.

When swallowing problems occur it is important to seek medical assistance.  Often a swallowing study is ordered in order to determine the cause and treatment needed.  Some swallowing occurs when food sticks or seems to be lodged in the throat (esophageal dysphagia).  There may be problems with the nerves and muscles in the throat that make it difficult to perform the normal swallowing action (oropharyngeal dysphagia).

Depending on the chronic condition, swallowing can become uncoordinated and result in choking or aspiration (food going into the lungs).  Persons with a dementia diagnosis may eat slowly, have too much or too little saliva, or forget to swallow and store or pocket food.

Suggestions to aid swallowing:

  • Body position is important. A speech therapist recommended the person sit upright at a 90-degree angle for 10 minutes before, during, and for 30 minutes after eating.
  • Incline the head slightly forward for easiest swallowing. Sometimes positioning can be aided with a U shaped pillow behind the neck in a high-backed chair.  If a person is helping, they can place their hands gently on top of the head, but not on the back of the neck.
  • Best results are obtained when all of the person’s senses are engaged. Dentures that are properly fitted and placed, plus hearing aids and/or glasses at meals will provide optimum sensory input.
  • Sensory overload can be distracting. Turn off TV, use soft, relaxing music, and if possible limit traffic. Food placed in small colored bowls or plates may decrease the overload experienced when food is piled on a single plate.
  • Color is important; some research has shown people eat more when food is served on a red plate.
  • Some swallowing problems can be eliminated when caregivers limit servings of milk products and other foods that increase mucous levels or sticky foods that are difficult to swallow.(white bread, mashed potatoes, pasta)

Additional tips:

  • It is a good idea for the caregiver to encourage their care-recipient to use the restroom before the meal begins because when they begin eating a gastrocolonic reflex may occur stimulating elimination.
  • Have a mealtime routine-set a time and try to stick to it. Relax; they are not in a hurry.
  • Finger foods may be easier to manage if the person has difficulty using eating utensils. Delicious soup could be sip ped through a straw if properly blended; potato is one of my favorites.
  • Food temperature-the desire for warm or chilled foods may change, gut very hot foods or plates can be dangerous.
  • Watching a fish swim can be calming and some research credits this activity with a 27% increase of appetite. When mentioned at a support group meeting one participant later reported his autistic son’s appetite improved using this tactic.

It is important to not be overly concerned about a balanced diet if your care partner is losing much needed weight. The loss of smell can increase the difficulty caregivers’ face; therefore it is good to experiment with ways to add taste and calories.  Try adding sour cream, or other dipping sauces for bite-sized meat or vegetable products.

Nibble foods are good; place these where the person can see them and sample regularly.  Tailor these to meet your care recipient’s likes and dietary needs.  Fruit or cookies are possible examples to try.

Swallowing exercises are important also.  A swallowing study can provide excellent information and improve quality of life!  Check with your doctor.


For more information please call or email us!

501-224-0021 or elise.stuart@alzark.org

 

It is Easier to Give Than it is to Receive

by Priscilla Pittman, MSW, MA
Alzheimer’s Arkansas Programs and Services


 

Do we participate in a community group or attend a particular church or temple and enjoy doing for others?  Providing time and effort for others whether or not we know them is a rewarding experience.

But we really don’t like to have needs or have others provide for us do we?

Before moving to Arkansas, hospice was my focus.  During a hospice training in the 90’s, the leader told us our session would include a foot washing, but quickly urged us to erase the Biblical references that sprang to mind.  Instead, she instructed us to see receiving care from the eyes of the patient.  Most were in line to pick up the supplies needed to wash feet, no one wanted to have their feet washed.  But soon friends opted to take care of one another, until our leader announced we could only participate with a total stranger.  Some donned a good natured attitude and slipped off their shoes, or gathered washing utensils, but the person assigned to me was an angry, young woman who resented the assignment since she couldn’t wash her friend’s feet.  Quickly she dunked my feet in a pan of tepid water, soaped, rinsed and partially dried my feet before she scurried away.  She did not say a word.

I was seated next to a woman who sighed when her feet were immersed in the warm water provided.  Her “washer” looked at her, spoke to her, and slowly soaped, rinsed and dried carefully between her toes.  She even applied lotion and massaged her lower legs.  I watched with moisture still evident between my toes.

This was a prime example of doing a job with love and care versus doing a job to “get it done”.  As one who received “un-care”, I felt slighted in one regard, but honored to have seen the proper care given to another and to have learned a valuable life lesson as well.

Families often have similar scenarios with children or siblings providing the same type of care. Others would be grateful for even the smallest contribution because they are carrying the entire load.  But despite the long, arduous hours the overall picture is one of gratefulness.  Some have overcome past issues to reclaim personal health, forgive, and find a new relationship with a family member.  Caregivers have wonderful stories; each support group meeting inspires and confirms my belief that out of adversity springs solutions!

One caregiver reported seeing something on HBO some time ago that examined the benefits of hugs and affection.  She was now the caregiver for her mother, and was increasingly frustrated by the personality changes and behaviors contrary to conduct she had known. Recalling the television production she hesitated, but although they had never been an affectionate family she decided she had nothing to lose.  When preparing her mother for bed she asked if she could give her a good night hug. It was a nice long hug (7 seconds is recommended), and she believed the results were soon evident.  Her mother was less angry and more compliant and our caregiver also smiled more. Every night they hugged, and when she forgot one evening her mother reminded her.  The results benefited her as well; she was now enjoying her new role as caregiver and daughter.

Life may present a circuitous road with ample potholes and more detours than we like to find.  But we all know those who prevail and complete their journey with gratitude; and although they lack material wealth consider themselves wealthy beyond measure.


 To learn more about Alzheimer’s Arkansas please call or email us at 501-224-0021 or elise.stuart@alzark.org


 

Awfulizing

By Priscilla Pittman, MSW, MA


 

Opinionator…Wow! The computer doesn’t like that word. But we all have opinions don’t we.  This time of year we only seem to hear political opinions and unless we have the time to do a fact check we may turn a deaf ear to those as well.

A number of caregivers confess a family member focuses on criticizing everything they do, and inevitably they are the only family member providing care.  Being a caregiver is a difficult task and then adding additional negativity makes it twice as difficult.

Sometimes it is the care-recipient providing the negativity. It is best to take this criticism and convert it into a distraction or a positive remark.  With a little practice, some caregivers have become pretty good at returning the verbal jabs.

Being positive in the face of constant verbal adversity is good self-care, but this type of resilience takes practice.  We often are critical of ourselves and it seems we continue to replay the same negative remarks and often in advance of a situation and predicting our failure.

Zig Ziglar cautions us, “The most influential person who will talk to you all day is you, so you should be very careful about what you say to you.”

What we say to ourselves will determine our success at what we attempt, every day.  Unfortunately, more than 75% of what we say is negative programming that works against us.

Our brain does not care where the programming comes from or how it arrives, and it will continue to accept information fed to it by you and others including the pictures, feelings, thoughts and judgments we make about ourselves and others.

You may have had someone you considered an authority figure tell you, you are stupid, you are useless, etc. You may even be replaying programming from your childhood.

Your wonderful brain is a powerful computer system, and will do all in its power to help you live out the programs saved in your subconscious mind.

If we pay attention to the things we think and say, we can reprogram our brain by replacing the negative thoughts and words with those that are positive.

It pays to be more aware of the things we tell ourselves.  In fact, Ben Martin with psychcentral.com, believes we need to question some of our mental activity and, replace some reflections with more reasonable thoughts.

He suggests:

  1. Reality testing to examine the evidence for and against our thinking
  2. Alternative ways to look at a situation
  3. Examining the situation and our perspective; is it as bad as I believe it to be?
  4. Utilizing goal-directed thinking and learning from each situation a better way to do it next time

Challenge negative self talk with him at: http://psychcentral.com/lib/challenging-negative-self-talk/0003196

A closing thought: When negativity comes into our mind it brings a folding chair.  If we pay attention it might buy a recliner.


 

For more Information please contact us at elise.stuart@alzark.org or call us at 501-224-0021.


 

Anger: A powerful emotion that can produce positive or negative results

By Priscilla Pittman, MSW, MA


 

Anger is a warning sign that something is wrong and resolution is needed.  When the warning signs are ignored others may not know what has bothered us and we are likely to respond with self-destructive behaviors such as over-eating, spending, etc.

Stuffing anger can also be destructive and can lead to stress and stress related illnesses.  Why?  When we are angry the adrenal glands flood the body with stress hormones that include adrenaline and cortisol.   Anger initiates the “flight or fight” syndrome by limiting the blood flow to the gut and using this blood to prepare the leg and arm muscles to run or take a fighter’s stance.  Additional preparation accelerates the breath, heart rate, blood pressure, and body temperature.

When the anger or stress response is infrequent the body recovers and levels return to normal.  But a constant demand on the body’s defense mechanisms can result in health problems such as:

  • Headache
  • Digestive problems, abdominal pain
  • Insomnia
  • Increased anxiety
  • Depression
  • High blood pressure
  • Eczema or other skin problems
  • Heart attack or stroke

According to Ronald Potter-Efron, PhD, an anger management specialist in Wisconsin, the neurological process that triggers anger lasts less than two seconds.  Extending an anger response beyond that brief jolt takes a commitment.

Commitment, so it is our responsibility.  What do we need to learn?

  • Sidestep the temptation to vent until time has allowed us to evaluate our anger.
  • Was this a response to danger?  Was someone’s welfare threatened? Hesitancy is not warranted here.  This situation requires a swift response.
  • Was this an effort to have a problem recognized, diagnosed and solved? Are your questions or concerns going unanswered?  Anger that is properly expressed may fuel a response.
  • Did anger occur because of a rule or law violation? Is the problem due to our expectations? Unclear rules? Or has the rule or law not been dealt with consistently.  Is this a violation of a social code such as “It is rude to continue personal cell phone conversations on speaker phone in a public place.”  Frequently, people have not met our expectations. They may not have knowledge of a legal ordinance or may have different perceptions of proper and improper.
  • Were we angry because of our misperceptions? Are we a one-person mafia making our “truth” heard?  Self examination is important.  We may have personal rules we believe are spiritual and moral imperatives.  This may be well and good for us, but we cannot demand the same of others.
  • Be aware, anger may be used as a coping device to protect us from the truth.  We may be unaware of why we respond in anger and it may take a large shovel to unearth the “truth.”
  • We may have learned our anger management skills from our parents.  Pay attention to what causes anger and recognize the response
  • What can we do?  Reacting appropriately to anger is a learned behavior designed to keep from hurting yourself or others with words or actions that may have long-term implications.   Fortunately, we can learn new responses and with practice can manage to produce healthier, happier relationships.  Continue to remind yourself that anger is not bad it does have a purpose; the problem with anger is our response.

What are your coping mechanisms?  Walking? It depends on where you are; you can’t go for a walk when attending a meeting or at work.  Try these coping tools:

  • Count to 10 slowly
  • Take a prayer or meditation break
  • Use Dr Weil’s breathing exercise. Inhale through the nostrils, deeply into the diaphragm for the count of four, hold it for the count of seven and release slowly by exhaling through your mouth for the count of eight.  Do this three times
  • Go to a quiet spot. Close your eyes and visualize yourself in a calm and peaceful place
  • Listen to music
  • Later journal the event and record your feelings. It is interesting to read these later, but the biggest reward is the peace obtained when you write about it.

Does anger continue to delete healthy expressions?  Make an appointment with your physician or therapist. 


 

Want More Information? Email us at elise.stuart@alzark.org or call us at (501) 224-0021


 

The 8 R’s in Alzheimer Care

  1. ROUTINE will help someone with AD anticipate what to do next and what is expected of them. It sets boundaries that feel secure.
  2. RITUALS or lifelong habits should be maintained. Don’t try to break old habits. For example, if the individual never enjoyed crafts, don’t expect to involve him/her in crafts now.
  3. REASSESS physical health if there is a sudden behavior change. A person with AD will become more confused, agitated or hostile when a physical complaint develops. Consider constipation or a urinary tract infection, etc. as the cause of the behavior disturbance.
  4. REDIRECT or distract the person with AD. This can be accomplished by suggesting that it is snack time. When the person with AD asks to go home, say “in a little while, but first how about of tea and a cookie?” You will be surprised that the person will forget about leaving, at least for a little while.
  5. REAL questions may be difficult to figure out if the person with AD has difficulty communicating. If the individual becomes agitated, perhaps they are telling you that they need to use the bathroom. Learn to read their body language.
  6. RECONSIDER the behavior. Is it truly a problem? Does it present a danger for the person with AD? Or is it upsetting you? Is talking to his/her reflection in a mirror, just like it was another person, a problem? Should the mirror be covered up? Only if the person appears to be upset or frigtened by the reflection.
  7. RESPECT is always the appropriate attitude when caring for a person with AD. Laugh with them, not at them. Never talk about them to another person in front of them as if they are not there. And remember, a person with AD will know how you feel by your body language and tone of voice.
  8. REASSURE the person with AD often that you love them and will care for them. A gentle pat, stroking their hair, and holding hands all say “I care for you.” Think about how much reassurance of love you would need if you were suffering from dementia.

Distributed by:
Alzheimer’s Arkansas Programs and Services
201 Markham Center Drive
Little Rock, AR 72205

http://www.alzark.org
501-224-0021 or 800-689-6090


 

For more information please contact us @ elise.stuart@alzark.org