A-Z Caregiving Tips (M)

Written with love and great admiration for all those who are caring for a loved one who is facing Alzheimer’s or any other diagnosis that spells memory loss. I write from my experience of caring for my sweet mother in her later years with Alzheimer’s.

Here’s the next in a series of posts inspired by A-Z Caregiving Tips (pictured below). A diagnosis of cognitive impairment or memory loss presents caregiving challenges, each as varied as the person experiencing it. Alzheimer’s was the diagnosis that spelled memory loss for my sweet mom. You can read my previous posts for my tips on A – L. It seems I have a lot to say about “M,” so I will focus on that for this week.

Make new ways I can be of service to others

Mom was a nurse. A dedicated and amazing nurse. Even after she retired from her long career in nursing, she still practiced nursing in an unofficial way as she came alongside family and friends as they went through their physical trials in life. She was dad’s constant companion whenever he faced any of his cancers and surgeries. She served her friends as the requisite driver and responsible party when those friends faced day surgeries of various types. If someone was hospitalized, she was almost always one of the first visitors. Several of her friends had her come along to their surgeon’s or oncologist’s office when they were going to receive their scary diagnosis. Mom knew just the right questions to ask and how to help her friends through the difficult days ahead.

The time came when Mom was the patient with symptoms of short-term memory loss. I’m sure she knew something was amiss long before I started noticing memory blips. Who knows how many years she wrestled with that knowledge alone? Based upon dated notes and lists I found here and there, I would say for a few years.

Although Mom forgot many things, the experiences of her lifetime still served as a guide in her daily interactions. Even after mom moved in with me and then later into assisted living memory care, I routinely saw the nurse in mom present when she’d notice someone wasn’t feeling well and then do her best to make sure they were cared for appropriately.

She usually couldn’t remember she was my mom, but I saw the loving mother in her displayed in the way she cared for dolls.

It was like a special window into her past which allowed me the privilege of seeing what she may have been like when she mothered me as a baby. (Mom and me in this photo.)

Let me share just a few photos of her doing things which made her feel useful during her years spent living with dementia.

I’m thinking now of a resident at the assisted living memory care home where my mom lived for her last 14 months of life. June was usually the first one up every morning. She took very seriously her job of raising the window shades at the start of the day. The staff would then present her with a large basket filled with freshly laundered clothing protectors (bibs) and towels. June took great pride in folding them.

My mom would do the same thing when she was living with us for a few years. She loved to fold laundry, especially when it was warm out of the dryer. The warmth felt good on her arthritic hands. She would also dry dishes for us. Her legs were unsteady, so I would set her up with everything she needed at her place at the kitchen table. Mom had also been into gardening, so I would occasionally try to get her outdoors to help me. She especially enjoyed deadheading and cutting back spent foliage. Her specialty, however, was sweeping. She couldn’t stand to see even one leaf on the deck or porch, so we’d arm her with a broom and she’d happily sweep for quite some time.

I can’t talk about this subject without thinking of Heather, an amazing blogger I follow who cared for her sweet mother too. Heather’s mum, Margaret, had been an artist, so Heather would play to her mum’s interests and strengths by creating art therapy projects for her to work on throughout the day. They even opened an Etsy shop in order to sell some of her ‘Made by Mum’ projects, donating a portion of their profit to the Alzheimer’s Society. Heather’s amazing website Creative Carer is filled with photos and tutorials, a link to her very helpful and inspiring blog, and oodles of practical ideas for caregivers who desire to keep their loved one meaningfully engaged.

A-Z Caregiving Tips (J, K & L)

I write from my experience of caring for my sweet mother in her later years with Alzheimer’s. I hope that what I write will be an encouragement to those who are caring for someone they love.

Before you read this post, you might want read the A-Z Caregiving Tips (pictured below) which inspired me to write about my own experience related to these tips.

A diagnosis of cognitive impairment or memory loss presents caregiving challenges, each as varied as the person experiencing it. Alzheimer’s was the diagnosis that spelled memory loss for my sweet mom. I have already presented my experience with tips A – I, so let’s move right on to my take on J, K & L.

J just redirect me pleasantly if I keep repeating myself.

When memory loss becomes apparent to family and friends, it’s the repetition of stories which oftentimes raises the warning flag that something is amiss. Mom had several stories that would frequently replay. There was one she would tell about why she loves ice cream. Other repetitious stories related to how she acquired some of the items she owned, including three blue flowerpots and a purple tablecloth. I loved each of the stories and, as I mentioned in my last post, now I wish I had recorded her telling them.

Now, there’s nothing wrong with telling family stories around the dinner table. We all do it. It’s one of the best parts of gathering around the table for a shared meal. But, when the same story keeps looping during the same meal, that’s when things get a little tricky. It’s easy to hurt our loved ones by saying, “You already told me that a hundred times, Mom!” We’re tempted to roll our eyes and inwardly groan, “Oh no! Here we go again.”

That is where the art of pleasant redirection comes into play. In the world of dementia caregiving, there are many opportunities to practice this act of gently helping a forgetful loved one refocus their attention on something else.

My granddaughter provided one of the best examples of gentle redirection that I have ever seen. My mom found my to-do list on the kitchen table. Thinking it was her own list, mom kept reading the list over and over again, worrying about getting it all done. Violet (who was probably 12 years old at the time) brought a photo album to the table and sat next to her great-grandmother. In one stealth move, Violet opened the photo album and placed it in front of her GGma as she simultaneously slid the list away from view. Then she started paging through the album and talking about the photos. My Mom’s worries melted away and she was immediately engaged in this new direction of thought.

In fact, photo albums and picture books are one of the greatest tools in the toolbox of dementia redirection.

Sometimes, mom would ask the same question repeatedly. One such question had to do with her finances–something she couldn’t handle on her own anymore, but continued to worry about. My husband handled her finances for her and greatly helped alleviate this worry by creating a single page monthly statement which listed all of her financial bottom-line numbers in one place. Mom could read this over and over to her heart’s content. [I explained more about this in Alzheimer’s and Money Worries, which may be of help to anyone going through this stage with a loved one.] If mom was having a fretful moment about money, we could hand her this statement, which we kept on a clipboard. She would sit and read (and re-read) it for a very long while and would often comment about how helpful it was to her.

K Know that closing my eyes may be me trying to find my words.

Word finding is one of the earlier struggles I noticed in my mom’s journey with Alzheimer’s. It’s a problem I am wrestling with these days too. I have noticed that when I am struggling to figure out which word I want to use during a conversation, my family and friends will often provide the word for me during my long pause. Most of the time I appreciate the help; other times it just deepens my awareness and the inkling I have that my later years of life are headed in the same direction of memory loss that my mom experienced.

In fact, photo albums and picture books are one of the greatest tools in the toolbox of dementia redirection.

I don’t remember mom closing her eyes when she was trying to think of what she was going to say–at least not in the earlier stages. I remember that she would avert her eyes upwards and away, as if she was searching the corners of her mind for what she wanted to say. I do this too. I have also noticed something in my own pause to search for the words. By the time I’m ready to add my words to table talk conversation, the direction of the conversation has moved on to something else. It’s frustrating, but it reminds me of something important when engaging in conversation with my memory-challenged friends at my workplace. Don’t be in such a rush–wait for them to answer.

L Listen with me to music and dance tunes.

Mom would rather sit quietly and read a book or magazine than dance or listen to music. It’s not that mom didn’t like music; rather, her hearing deficit made listening to music more than a little bit challenging. While this point doesn’t apply much to my mom, it does bring to mind my work place. I work as a baker in an assisted living memory care home and am sometimes surprised by the music being played in the background for our residents. Sometimes I think the music chosen reflects the preference of the caregiver on duty, rather than the tastes of the generation being served.

The other thing I’ve noticed is that the radio or television in our care home is oftentimes playing too softly. The younger folks who work as the caregivers don’t seem to take into account the need for extra volume in this older population. Nor do we pay enough attention to what is being broadcast on the television in our common spaces. It’s much better, for instance, to choose a classic movie from the era in which these folks lived, rather than a talk show featuring four women arguing their views. Better (in my opinion) to choose a nature show over a scary, blood and guts movie.

Don’t get me wrong–our care home is fantastic and is blessed with a number of great caregivers. But, there is one caregiver who I find to be absolutely delightful. She will put on music the residents love and engage in a little song and dance. She’ll even make up her own tune or sing a familiar jingle, even if she’s just passing through the room on her way to her next task. If they’re having an exercise class, she’ll join in and spread her own brand of love, laughter, song and encouragement. Marnie makes the residents smile (and me too).

The world of memory care caregivers needs more Marnies.

My Top 3 Reasons for Choosing Assisted Living Memory Care

Someone recently asked me how I decided when it was time for my mom to be cared for in a nursing home or assisted living memory care. I’ve written about that decision a time or two, but decided I should write about it again.

Before I share my personal “Top 3” list, I invite you to grab a cup of coffee (or your favorite beverage) and listen to this video by Dr. Natali Edmonds — someone who has been a virtual mentor for me as I’ve learned about being a caregiver.

Dr. Natali Edmonds

“People who place their loved ones in nursing homes are not horrible people. They don’t love their loved ones any less than people who care for their loved ones at home. In fact, sometimes placing a loved one in a nursing home is the best thing for your loved one.”

Dr. Natali Edmonds

Now, here are my Top 3 Reasons

Reason #1: Sleep

Not mom’s sleep. My sleep. I wasn’t getting enough of it and it was beginning to affect everything. Long-term sleep deprivation is brutal. Whether I wanted to admit it or not, it was creating “excessive caregiver stress” and it was showing up in all of the areas of my life that mattered the most to me. It was harming my closest relationships — my time in God’s Word, my marriage, my opportunities to spend quality time with my grandchildren, my friendships. I was a tired and distracted employee and my job performance suffered. I loved teaching Sunday School, but I knew in my heart I wasn’t able to focus on preparation for my ministry and wasn’t as creative in my teaching as I once was. Those in my circle of friends were beginning to comment about how tired I looked.

Reason #2: Personal hygiene needs

Mom’s resistance to help with personal hygiene, to put it politely; bowel incontinence, to be specific. When my mom’s brain could no longer register the “urge to go” with the need to do something about that, life got a lot messier. Literally. Between multiple clothing and bedding changes, multiple loads of laundry, and floor and bathroom cleanup, daily life was getting too hard for one or two people to handle. Mom needed more hands on care and a bathroom that was designed with disabilities in mind.

Reason #3: Safety & Mobility issues

In the later stages of dementia, mom was beginning to forget how to walk. There were days when she needed coaching to put one foot in front of the other. Her legs were growing weak, making her a greater risk for falls. Using a walker helped, but not always. Sometimes she’d forget the walker in another room. Other times, she’d drag it behind her. On a few occasions, she couldn’t figure out what it was, so stuck it outside of her room so it wouldn’t be in the way. My house wasn’t designed for using a walker or a wheelchair. All of the bedrooms and full bathrooms were inaccessible to mom since they were located on the second floor.

We made the best possible use of this half-bath space to accommodate mom’s growing needs, including taking the door off the hinges so we could have more room to maneuver and help her.

The more of a problem “Reason #2” became for us, the more I knew she needed a safer place to live.

I applaud and encourage the many who have made “at home until the end” work. You are amazing caregivers! Please understand, however, that you will still be an amazing caregiver if you make the hard choice to reach out for help in caring for your loved one. You do not cease to be a caregiver by changing the location of where that care is given or who helps you provide that care.

I’d like to leave you with a little slideshow with just a few photos depicting how happy and content my mom was in this abode where opportunities were many, friendships were sweet, and help was always on hand.

“The best place for your loved one with dementia to live and grow old depends upon several things, including: what help they receive, their willingness to receive help, their physical abilities, and the specific dementia symptoms they have. Not everybody with dementia requires the same level of care.”

Dr. Natali Edmonds

I could never forget you

It makes me a bit sad when I re-read this post and am reminded I wasn’t able to care for mom in our home until the very end of her journey on earth. But, only a tiny bit sad. I know in my heart that moving her to BeeHive Assisted Living and Memory Care in her last year on earth was the right thing to do. BeeHive was so much more than a “place for those waiting to die”. The decision to move her into memory care provided her with so much more meaningful interaction, activities, opportunities to move about, more variety in her meals, and lots of tender loving care. I am beyond grateful for the time spent with her — I know that is something I will never regret. I’m thankful for a husband whose wise investments meant that she would not “run out of money” as she had often worried. It was enough. God is good…all the time.

Barefoot Lily Lady

When you have Alzheimer’s you can’t remember that you don’t need to worry about something. So you do worry. A lot.

Mom worries about such things as whether there is food in the fridge and if she’ll be able to afford the things she needs to live. There is, and she will.

When we have guests, she worries about how they’ll get home in the dark, or where they’ll sleep for the night. She will oftentimes tell our guests that they can sleep in her bed if they need a place to sleep.  Sad, but sweet.

Her worries are usually small ones. She worries every night about whether or not she has a toothbrush. She frets about leaves and twigs out in the yard, or the water on the deck after a rain.

Other times, her worries are big. Her biggest worries are about the future. Just today, she came…

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Memories of Mom

Tuesday’s Caregiving Tip: Keep a journal of those special moments with your loved one.

To my fellow caregiving friends who are still in the hustle and bustle of caring for a loved one with dementia, be sure to take time to write down those special moments. I wish I had kept an actual chronological handwritten journal, but am so glad I blogged and took photos…and posted cute stuff on Facebook.

I moved in with mom for a period of about 9 months. It seemed long and tedious in the midst of it, but just a tiny blip on the radar of life in retrospect. I’m glad I posted this fun memory on Facebook and hope it will bring a smile to someone’s face today.

Me and my landlady

A-to-Z Caregiving Tips (F-G)

This is the third in a series of posts inspired by an article from Alzheimer’s TODAY called Tiny Gifts That Are TREMENDOUS, where Mary Kay Baum shared a helpful A-to-Z list of caregiving suggestions Thus far, I have given you my spin on A-B-C and my thoughts as a caregiver regarding D-E. Let me invite you to join me this week for F and G as I share how these excellent tips have played out in my own caregiving journey.

Thus far, I have given you my spin on A-B-C and my thoughts as a caregiver regarding D-E. Let me invite you to join me this week for F and G as I share how these excellent tips have played out in my own caregiving journey. [Click here to read the original article].

Fear not if I take a break from commotion.

We were celebrating a birthday at our house. Mom sat at her place at the table and enjoyed watching the festivity and seeing a few of her great-grandchildren. Though she didn’t contribute much to the conversation, my heart was warmed by her smile as she watched the birthday boy bask in the attention. After the candles were blown out and the cake was served, mom quietly stood up with the help of her walker and then scootched down the hall the short distance to her room. She was done with company. And that was okay.

On a previous occasion, when mom was living in a senior apartment, the residents were hosting Trick-or-Treat for the neighborhood kiddos. During our city’s Trick-or-Treat hours the residents gathered in their activity room and waited for the steady stream of costumed guests. I thought mom would enjoy seeing all of the kids and handing out candy with all of the other seniors in her building. She stayed for a few minutes, then went back to her apartment; it was just too much for her. I had invited a few kids from church to come to the event. When they arrived, I invited them to visit mom in her apartment. Mom enjoyed the smaller gathering so much more.

During this phase of her journey with Alzheimer’s it became my mission to keep her engaged by inviting people to see her. One or two people would join us for lunch; another day someone might come over to say hi and work a puzzle or engage with her by sitting with her at the table coloring. One family from church brought us pizza for supper one evening, then stayed for a bit so the girls could sort through a jar of buttons with mom.

Go with me and others on quiet nature walks.

May be an image of 1 person and smiling

Truth is, in the later stages of dementia, most days it was nearly impossible to get my mother outside of the house for a little fresh air. It was a treat when it happened.

If the weather was nice and I could coax mom outside, I’d get her seated in a wheelchair and push her to our neighborhood park.

She enjoyed watching the children play at the splash park, seeing dogs being walked along the pathways, and would occasionally engage a perfect stranger in conversation.

We didn’t stay long, as the charm of our outdoor excursion would soon be replaced by the fear of being able to find our way home. By the time I got her back in the house, she had already forgotten our little trip. Even though it was forgotten, the benefits of the fresh air and the infusion of joy would linger in her demeanor.

One day, out of the blue, mom wanted to “check the mail,” so I let her go outdoors with her walker. She enjoyed that little trek down to the curb and back.

Since she was in a good mood, dressed decently, and it was nearly dinner time, we decided to put her in the car and go for a drive to the nearest Culver’s for supper.

She thoroughly enjoyed every bit of it…especially the frozen custard.

Once my mom made the move to assisted living memory care, getting her out of the front door was even more rare. This photo shows one of those sweet occasions when her great-granddaughter Violet managed to get her outside to sit on a shaded patio.

As Alzheimer’s continued its relentless march claiming bits and pieces of my mom’s brain, it was evident that mom’s world was shrinking right along with her memory. All too soon there came a day when the world outside of Mom’s front door became too scary of a place for her to venture.

That was the day when “go with me” became “be with me.”

Alzheimer’s: When Harsh Words Fly

I work a few days each week as a baker of all things sweet at a beautiful assisted living and memory care home – the very same place where my dear mom spent her last year on earth. The people who reside here are placed for various needs, most of them needing more help than family can provide with matters related to living life with short-term memory loss. In my short time there as an employee I am getting to know and love each resident, but I do have a few favorites. One of those favorites is as sweet as she is feisty. One minute she can be doling out compliments and kisses, the next she’s telling me to stick my mixer where the sun don’t shine.

But I love her to pieces.

I think she holds a special place in my heart because she reminds me in small ways of my mom (pictured here), who also had some bad days as she wrestled with Alzheimer’s in her later years of life.

In the years before Alzheimer’s, my mom was never one to use foul language; the worst I ever heard come from her mouth when I was a kid was an under her breath, “Shhh-ugar!” Yet, in the throes of the later stages of Alzheimer’s, my mom would occasionally make me blush with her language. If she were in her right mind, she’d be truly embarrassed.

Not long ago my new friend had a really bad day — I knew from the minute I walked in the door that morning that it was going to be a doozy when she began swearing at me for just saying, “Good morning.”

When any of our residents are having a bad day, I can’t really help much, as I’m “just the baker” and not directly involved in resident care. However, there is always one thing I can do. As my hands keep busy at the work of baking desserts, I can pray for those caring for the special needs of the residents. On that morning, I prayed for everyone involved in doing what was best for her, each one doing so with compassion and grace. All the while, I fought back tears for this dear woman who was living out one of my biggest fears for my future. You see, I struggle with the fear that Alzheimer’s may one day strip the filters from my tongue and that I might use uncharacteristically foul and abusive language.

So, how should caregivers deal with the foul language issue in their loved one with dementia? To answer that question, let me share a link to a super-helpful article from Very Well Health which discusses this problem and lists many suggestions. You’ll also find some internal links to explore on related issues: Relationship Between Foul Language and Dementia

My personal go-to tactic is the one in this article called “Redirect and Distract”. Where my mom was concerned, I would say something like, “Are you hungry? Would you like me to fix you a sandwich?” My mom loved sandwiches, so I kept a little stash of halved sandwiches in the fridge.

Other times I would distract her with an activity. I’d just walk away from her angry outburst and grab her coloring books and colored pencils and begin coloring. Nine times out of ten, she’d join me in a few minutes.

Coloring cards Momma received in the mail each week from her friend (and ours) Suzy.

Another thing I did on many occasions was to grab my collection of buttons and pour them out onto a towel on the kitchen table. I’d just quietly start sorting the buttons into color groupings, or line them up in rows. Mom could not resist this little sorting activity. Before long, she’d be calm and would join me.

Sorting buttons was a favorite calm-down activity for my mom

I wrote about these two and several other activities in my post Dementia Friendly Activities. The key thing was for me to be quiet and resist the urge to argue or add defensive words. Talking during one of her outbursts would only add fuel to the war of words raging uncontrollably in her head.

My friend at work has a similar calm-down button: her sweet tooth. I can sometimes redirect her downward spiral by offering her a cookie.

Since I’m the baker, I’ll sometimes say, “I need your help. Could you taste test this for me?” My friend also likes a slice of buttered bread with a cup of milk. Paying attention to what she enjoys and asks for in her calmer moments equips me with ideas for dealing with the tense moments.

Proverbs 31 Woman

While I dread the thought of ever having Alzheimer’s, I do trust the Lord with my future knowing that He will provide what I need should this be in His plan for me. It is my prayer that the Lord will keep my tongue sweet and gracious, and that the “law of kindness” will always be on my tongue. (Proverbs 31:26)

Palliative Care Praises

My friend and I talked recently about palliative care and how it differed from hospice care. I recalled writing a little blog post about this subject, so decided to reblog it today. I hope that it helps my friend and anyone else who is approaching this stage in the care of their loved one. I praise God for leading me to Agrace and for the wonderful palliative and (later) hospice care my dear mom received.

Barefoot Lily Lady

As this mid-stage of Alzheimer’s drags on, Mom is sleeping quite a bit more, not only at night (which I appreciate), but during the day as well – sometimes skippinga meal in lieu of sleep. Unfortunately, her nighttime sleep doesn’t appear to be very restful, as she gets in and out of bed various times throughout the night – sometimes to use the restroom, other times to explore the contents of her purse or her dresser drawer, or watch the real or imaginary happenings going on inside our house or outside of her window.

We have also noticed she has been less content during her awake hours and is more easily agitated. She paces back and forth between her bed and her chair at the kitchen table, never quite settled in either place; never quite sure if she’s going to bed or getting up.

Long ago, when my mother was…

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In Search of Billy

Once upon a time, not so very long ago, I arrived at BeeHive to sit with mom during lunch. Momma was able to stay focused on eating if someone was nearby to remind and coach her. As her Alzheimer’s progressed, she had begun missing meals – sometimes only eating one meal a day – so I tried to be there during that time whenever possible. On this particular day, I was running a bit late and most of the residents were eating their dessert.

Not Momma. She had already toodled away from the table in her wheelchair and was calling out, “Billy! Billy! Where are you, Billy?” Now, I didn’t know anyone there by the name of Billy (not even one of her dolls had that name), and had never heard her call out for someone in this unconsolable way. Mom seemed almost frantic to find Billy.

I put my things down near her place at the table, then approached her and asked if I could help. “No! I want Billy!” insisted Momma. “Well, let me help you find him,” I replied. “Can you tell me what he is like?”

Momma seemed glad to have someone help her find Billy. The staff was nearby beginning the cleanup process after lunch, so I asked if any of them knew who Billy was. No one did.

Then, with tears in her eyes, Momma brought me back to the situation at hand and plead, “Please, help me find Billy. He’s my friend and he’s so kind. He helps me.”

That description was all I needed to give me a strong hunch as to the mystery of Billy’s identity. Going with my hunch, I asked one of the gals if Momma had been hanging out with Andy that morning. Why, yes! Andy had paid quite a lot of attention to Momma earlier that morning, strolling with her around the building and helping her with daily cares.

Photo credit: Kathleen Zelinski, BeeHive of Oregon’s Activity Director

Andy is one of the owners of BeeHive of Oregon. Like the other co-owners, Josh and Gina, Andy has more than just money in the business. He puts his caregiving heart in there too.

Andy showed his interest by taking the time to notice the photos I had placed in mom’s room. As he looked them over, he would ask questions about them so he could learn more about my mother’s past – important because Momma was living in the distant past in her mind. Knowing more about a someone’s past is helpful in caring for those with any number of conditions which cause short-term memory loss.

Andy often told me how much he adored my mom. He wanted to know about her and took a genuine interest in hearing stories from her past so he could better understand what made her tick. Though Momma probably didn’t say so, she trusted him and I think she sensed how much Andy loved her.

And Momma loved her ‘Billy’ too.

Taking Mini-Breaks for Creativity

I have all sorts of excuses for why I’ve been a little hit-or-miss in the blogging department. The best reason I can proffer is that I’ve been taking little breaks for a bit of creativity of a different sort.

First up, a very special sewing project. My son sent me a text one night asking if I would make a Christmas stocking for a teen who is staying with them. I had made a stocking for each of my grandchildren prior to their first Christmas and he was hoping Danni could have a similar stocking too. I was so very glad he asked because I had it in my heart to do something for her, but wasn’t sure what she would enjoy. This would be fun!

Continue reading “Taking Mini-Breaks for Creativity”
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