3 Steps to Help you Prepare for a Medical Visit

By Sharon A. O'Brien, SC; RN, PG; BSW, RSW; CG 
Executive Vice-President of Policy & Education 
at Senior Watch 

Medical visits can be very stressful for a person with dementia as well as for the caregiver.  I believe there are some things that can be done to lower the stress.   With limited time with the doctor and a growing list of questions needing answers, the caregiver can take specific steps to make the most of the time allotted.

1. When making the appointment try to schedule the visit for the person’s best time to be morning or early afternoon. Avoid late in the day appointments if at all possible as this is the time that confusion tends to grow. 

2. Plan the visit carefully making a list of the concerns and questions.  Are there new or changing behaviours? It is important to prioritize the concerns with the most critical ones addressed at the beginning of the visit.  It probably would be a good idea to bring along present medications so they can be reviewed as well.

3. The doctor will ask about changes in behaviour.  Try to be specific citing examples of bothersome behaviours or changes noted since the last change in medication.  What precedes a change in mood?  What activities are most enjoyed?  Is the level of hands on care needed increasing?

These three steps could make a big difference in the quality of the visit and the comfort experienced by both the caregiver and the loved one.   Does anyone have other suggestions?

To my Caregiver: “All I Have Are My Yesterdays…..”

By Sharon A. O'Brien, SC; RN, PG; BSW, RSW; CG 
Executive Vice-President of Policy & Education 
at Senior Watch 

You want me to stop talking about the past. I know by the look on your face that it bothers you, but that is all I know.

I cannot remember what I did this morning. I cannot remember how to make my tea. I don’t remember the names of my grandchildren and sometimes I don’t know who you are although you tell me you are my son. But I do remember the school I attended as a child and I still remember my grade one teacher. The pain of saying goodbye to my father at the train station when he went to war is still vivid in my mind. I was 12 years old. He never came back. You assure me when you leave me that you will return, but how can I be sure?

I remember the day our town burned. It all started from a spark from the foundry. Mama kept us safe by taking us to a big hill on the other side of the town and wrapping us in wet blankets in case a burning shingle came our way. I think I was 5 years old then. You scold me when I am afraid when you put a fire in the fireplace. How do I know it will not burn me? You don’t understand why I always go and get a wet towel to hold. I think often of the train trips Papa and I took to visit Mama when she was so sick. It took us a whole day to travel there. You correct me when I ask if we are going to see Mama when you take me for a drive. You tell me Mama died a long time ago.

You have heard the stories so many times you tell me. You turn away. You do not want to listen. Sometimes you even become angry. But these are my stories. These are my memories. They are my yesterdays. And yesterdays are all I have now. They are my present. Please understand.

Six Principles of Care

By Sharon A. O'Brien
SC; RN, PG; BSW, RSW; CG 
Executive Vice-President of Policy & Education 
Senior Watch 

The tests have been done. The tentative diagnosis has been made. Your loved one has Alzheimer Disease. You are devastated. You now must face the reality of your fears.

Each day will bring new realities and new challenges. You accept the challenge. This is the person you have known and loved for 25-40-55 years. The love is deep and the commitment goes well beyond any difficulties encountered over the years.

There are six principles of care that need to be considered as you accept the challenge to provide appropriate care. 

1. As difficult as it may be sometimes, remember how the person behaves is a direct reflection of the disease. The person has no control over behaviour. It is not a deliberate attempt to shock you nor is it “stubbornness” or “childishness”.

2. The person with Alzheimer Disease deserves the same dignity and respect as before the disease struck. As the caregiver, you must protect the person from disrespect. Remind family, visitors, and professionals of the life journey and the accomplishments of your loved one. 

3. Stress the positive. Build on abilities. The person with Alzheimer Disease needs to be encouraged to continue with favourite activities as long as possible. Included may be playing cards, golfing, curling, and family gatherings. 

4. The family is an integral part of the Circle of Care. Encourage family members to learn all they can about the disease. The Internet, the Alzheimer Society, and local education programs are available. 

5. It is important to build partnerships with other members of the care team; e.g., caregivers, the family physician, the pharmacist, the spiritual adviser, friends offering respite care, etc.

6. The sixth principle should probably be the first principle. Look after yourself. Schedule breaks. Accept support. You are one member of the care team. Allow others to help you provide appropriate care. This experience will change you. You have the opportunity to make a huge difference in the life of a vulnerable loved one.

AD Strikes Next Door!

By Sharon A. O'Brien, SC; RN, PG; BSW, RSW; CG 
Executive Vice-President of Policy & Education 
at Senior Watch 

Alzheimer Disease affects an estimated 200,000 Canadians.  Perhaps a neighbour is one of its victims.

All too often families struggle to cope on their own.  They juggle work schedules, place their own mental and physical health at risk, or become isolated.  What can you do to help?

First, you can become aware of the challenges of caring for a person with Alzheimer Disease.  Information is available from a local Alzheimer office.  Talk to the caregiver about his or her situation and together identify the specific ways you could offer support.

The next step requires courage and commitment.  Let your neighbour's family know you are serious about your offer of support.  A phone call or a visit to encourage the caregiver will mean more than you can ever imagine.  Offer to stay with the family member while the caregiver runs errands, keep appointments or have lunch with a friend.

If you are making cookies, biscuits or a meal, prepare a little extra and offer it to the caregiver.  You could offer to look after a car maintenance appointment, to pick up items needed or even to plan a special time for the caregiver away from the home.  A little creativity can go a long way!

Until you have been “the caregiver” you cannot imagine how much even the smallest gesture of support can mean.