Dealing With Dementia

[ramonmercado]

This will get worse as time goes on with longer life-spans. Comments at the link.

Louis Theroux - Extreme Love: Dementia is on BBC Two on Thursday 26 April at 21:00 BST
Or catch up later via iPlayer http://www.bbc.co.uk/programmes/b01gvt26

Louis Theroux on dementia: The capital of the forgetful
http://www.bbc.co.uk/news/magazine-17844315

With an ageing population, a wave of dementia is approaching. Caring for those afflicted isn't easy, writes Louis Theroux.

Nancy Vaughan is a charming and lively conversationalist, a friendly host, and at nearly 90, still has much of the sparkle and attractiveness that must have turned many heads when she was in her heyday as a model in New York.

But she also has trouble remembering her own name, or the fact that she is married (62 years and counting), or indeed, much of the time, some of the basics of the English language.

Nancy is in the advanced stages of Alzheimer's.

On a sunny late autumn day I visited Nancy and her husband, John, at their home in Phoenix, Arizona. We made friendly conversation in the kitchen and for moments I could have believed that she was mentally well.

Her smile is still engaging, she is physically fit, and she can sometimes carry on brief exchanges. When I asked if she had any problems with her memory, she said an emphatic "no".

Find out more

But when John posed the question directly "Nancy, what is your name?" she looked a bit baffled. Asked for her surname, Nancy said "Bread", a little uncertainly. I wondered whether this might be her maiden name, but was told that was Johnson.

Nancy and John's life has become surreal and stressful in many ways. John has taken to wearing a name tag with his name on it to help Nancy identify him.

He has also stuck a copy of their wedding photo up in the kitchen so that, in her confused moments, he can prove to her that they are married.

John cares for Nancy fulltime. They have no children, so there is no family help take the strain - and they are not in the financial position to have Nancy go into a care home.

Aged 88, John is the full-time carer for someone with many of the same needs as an adult-sized toddler.

John and Nancy are by no means exceptional. There is a slow-moving tsunami of dementia advancing towards us as our population ages.


Looking after those with dementia can be a full-time job

It's reckoned that one in eight Americans aged 65 and over has Alzheimer's - the most common cause of dementia. Nearly half of the over 85s has the disease. As medical science has become better and better at prolonging our lives, the mental side of things hasn't kept pace.

Nowhere is this more in evidence than in Phoenix. For years Phoenix has been a mecca for America's elderly, who are attracted by the year-round sun and dry desert heat.

Now increasingly it is a kind of capital of the forgetful and the confused.

Not coincidentally, Phoenix is also pioneering the way dementia sufferers are cared for and treated.

One of the top destinations for people in need of round-the-clock care is Beatitudes, a gated retirement complex, which has, tucked among its many buildings, a memory support annex.

Most of the residents at Beatitudes have seriously impaired memories, to the point where they can no longer look after themselves, are quite often confused, and occasionally have delusions.

It's not uncommon for a resident to imagine that they've seen a non-existent intruder, or to suppose that because they cannot find a purse or wallet, that someone has stolen it.

Partly under the influence of a Bradford University-based psychologist, Tom Kitwood, Beatitudes' carers have a policy of not contradicting - and even playing along with - the delusions of the residents, avoiding confrontations, de-escalating conflicts, and "redirecting" the attention of those in distress, using distractions and pleasurable activities.

Beatitudes staff use medication as little as possible. They try to be flexible and adapt to the quirks of the residents and the symptoms of their condition, letting them wander the corridors at night should they feel urge, letting them bathe, eat and sleep on their own schedule, and offering them snacks and chocolate at any time of the day or night.

I spent the best part of two weeks at Beatitudes, observing their practices first-hand.

One of the people I got to know was Gary Gilliam. A 69-year old, Gary had been a successful dentist in his younger years, as well as doing time in the army.

He'd been at Beatitudes several months when I met him, and though his memory came and went, he spent much of his time under the misapprehension that he was still a practising dentist, stationed at a military base.

Gary was genial and playful, constantly cracking jokes, and so it took me a while to realise quite how advanced his dementia was.

He told me he'd been having some problems with his short-term memory but he had no idea he might be in any kind of care home. But rather than contradict him, the staff would gently go along with Gary's version of reality.


One technique is to avoid challenging those with memory loss
Quite often, especially in the evening, Gary would imagine that his time on "the base" was up. He'd pack his bags and start looking for the exit.

Staff would cajole him into staying another night, saying it was a little late now, it was dark out, better to leave it until morning. Or they might ask Gary to look at their teeth, at which point he would switch into dentist mode and forget his plan.

Gary also had a habit of forgetting that he was married, despite the fact that his wife of nearly 30 years, Carla, was alive and well, and a frequent visitor.

Being one of the few men on his unit, Gary's company was much in demand. He had two girlfriends, who enjoyed cuddling with Gary, though the exact extent of their intimacy wasn't clear.

I had the chance to observe this rather odd love triangle - or "love square", if you include the second girlfriend - when I accompanied Carla on a visit. To my surprise, she suggested that Gary bring one of the girlfriends with him.

Continue reading the main story
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Start Quote

The ravages of dementia can be unbelievably upsetting to see”

She said this would make the visit run more smoothly - seeming to imply that Gary might prefer the company of his new friends over hers - but I was also struck that Carla was keen for me to see and understand the pain and the strangeness of loving someone with Alzheimer's.

Perhaps the most extreme visit I observed during my time at Beatitudes took place between a young man called David Watson and his mother Gail.

Though she wasn't very old, Gail's dementia had progressed very quickly. She was on the fourth floor of the Beatitudes memory support building, home to the most advanced cases.

Gail could no longer speak at all, though she was physically well, and would wander the corridors often picking up objects and approaching people, endlessly repeating a sound that sounded like "gulla".

David tried showing old photos to his mum. He tried stopping her on her perambulations for a hug. There wasn't much sign of recognition that I could see.

David explained that his sisters no longer visited. "Because this is hard," he said. But then, a moment later, David's mother leaned in and held his face in her hands. "So that's why I come and visit," he said, visibly moved. "Because sometimes that happens, and then that's good."

Near the end of my stay in Phoenix, egged on by John, I volunteered to care for Nancy for half a day, hoping to give him some small respite but more importantly to have a small glimpse of what John goes through on a daily basis.


Selinda Border, 49, is suffering from early onset Alzheimer's
I discharged my duties as carer with mixed results. We played ball in the kitchen and broke a glass. We started a walk and then abandoned it.

Some of the time, she was baffled as to who I was and exactly what I was doing in the house. But along the way, we also managed to enjoy ourselves, listening to music, eating lunch together, looking at photos, and indeed chuckling together over the minor calamities that befell us.

When John returned and relieved me of my position, I asked him how much of Nancy he thought was left. He answered in the spirit of the engineer he'd been, with an exact number.

"Thirty per cent," he said, and then he tapped his head, and said that the rest was still preserved safely in his memory.

It was an oddly romantic moment.

The ravages of dementia can be unbelievably upsetting to see. No one would wish the confusion and forgetfulness that goes along with the disease on another person - though sadly, for demographic reasons, they are likely to be an ever-increasing part of our lives.

But my stay in Phoenix also taught me to be mindful of certain positives.

However much is taken by dementia, something always remains. There can still be a person beyond their words and their memories, a spirit, for want of a better word, and a continuity with the person they were.

Faced with the disease, and with the right support, most people can learn and adapt, finding new ways to love their parents and partners.

Alzheimer's disease

Memory and the ability to think clearly are gradually lost over time
There may also be a change in personality
Behaviour problems and communication difficulties may also occur
People with severe Alzheimer's may find it difficult to perform everyday tasks, such as dressing, washing and eating
As time passes they may not recognise people or their surroundings, so it's common for them to go for a walk and get lost
There is no cure, but drugs can slow loss of mental function for some patients

BBC Health - Alzheimer's
Is this the year of disability on TV?

 

[OneWingedBird]

It is such a grotesque thing... I have decided that I want to die in some dignified way before it comes to that, hopefully by being fatally poisoned by a Chechen pole dancer.

 

[poozler]

Yes, BRF, it is grotesque, and so cruel (if one can personify a disease). My mother (91 years old) has dementia, and her decline has been very rapid of late. She can't remember what a toothbrush is for, how to put food in her mouth, etc. She doesn't really know who I am. Worst of all, she no longer has language skills. She was always a great reader; I never knew her to not have a book on the go. She cannot read anymore.

She asked my sister to help her die a while ago, but it is illegal in most places; I think her occasional bits of lucidity allow her to know what is happening to her. She is now in a great care facility (state-run, in Canada) and her life has improved because of all the professional support she has received. I am so grateful to the wonderful state health care system in Canada, and to the amazingly fine people at the Salvation Army who run the care facility. My mother has a private room, beautiful gardens to walk in, good food, company and total support. The cost is 80% of her íncome, which is her old-age pension (about $800 per month).The good old Sally Ann also will not refuse anyone a place if they cannot even afford that.

I, too, wish that people had end-of-life options, like a peaceful death with dignity. Not everyone can have things as good as my mother has them.

 

[Stu73]

I've searched and searched but can't find a dedicated thread for this subject, so apologies if it needs to be merged.

I found this piece extremely interesting, and as i've always regarded Fiona Phillips as little more than a vapid autocue reader, it also reminded me that however much we may not "take to people" we're all still people.

The article (link below) is a very personal piece about putting loved ones in a home that surely has resonance up and down the country with 1'000s

http://www.bbc.co.uk/news/magazine-29644976

 

[escargot]

My mum had three children, yet none of us took her in. None of us showed her the care she'd so lovingly shown us. That is the thought that still churns over and over in my head.

Taking in a relation with dementia isn't necessarily the best thing for them. The condition is usually progressive and their behaviour and need for support can be challenging, and their health can deteriorate quite frighteningly quickly.

The stress of worrying about elderly family members can put a terrible strain on relationships too, whether or not the person is living with a couple. I have both personal and professional experience of this.

An elderly relation of ours has recently moved into a care home because she just wasn't safe living on her own and we couldn't have coped with her.

She took a few weeks to settle in but now she sits and watches TV with her new friends, who she thinks are old friends!
There are lovely meals and snacks to suit every appetite and hot and cold drinks on tap.

Best of all, we know she is safe, and she can wander around the home freely. Some people with dementia like to walk and walk, up and down corridors and in and out of lounges, and they couldn't do that safely at home.

So if you're in the position of having to deal with this, get some proper advice and ask lots of questions, and try not to stress too much.

You could also pm me if you're really desperate. I don't know everything but I might be able to help.

 

[Stu73]

I personally have no first hand experience of Dementia. However, i cared for my Mother throughout Her terminal cancer and it was ghastly.

I think that we all reach a point (those of us affected) where we admit to ourselves that we just simply cannot look after our loved ones in the way that we would wish.

At that point, what do you do? pack 'em off out of sight, out of mind? care for them yourself? Whatever you do you feel guilty as hell,

Too much aid spent abroad, not enough spent here on people who have worked their butts off for decades.

 

[escargot]

Famous people with dementia -

Timothy West reveals Prunella Scales’ “painful” battle with dementia

“When you think back over a long period and you think: this person that I’ve loved…doesn’t really exist any more, it’s another person – that’s quite painful. But you mustn’t think like that. You must just take it from day-to-day and you just notice how much she’s able to do and how much she enjoys life.”

“Her sense of humour is still there,” he continues. “And we have a lot of fun. She’s just growing old in a certain area more quickly than either of us would like.”

Terry Pratchett: Those of us with dementia need a little help from our friends

For me, living with posterior cortical atrophy began when I noticed the precision of my touch-typing getting progressively worse and my spelling starting to slip. For an author, what could be worse? And so I sought help, and will always be the loud and proud type to speak my mind and admit I'm having trouble. But there are many people with dementia too worried about failing with simple tasks in public to even step out of the house. I believe this is because simple displays of kindness often elude the best of us in these manic modern days of ours.

George Melly, jazz legend and zoot suit king, dies

· 80-year-old had lung cancer and dementia
· Musician had just finished last album: Farewell Blues

...

He was a well known figure at Ronnie Scott's jazz club in London where he last performed in November. Leo Green, Ronnie Scott's artistic director, said: "No one would have known that he was ill and if he had not deteriorated we would have had him back this November."

On the other hand, poor Lynda Bellingham died yesterday of bowel cancer at the young age of 66. Who knows what's in store for us?

 

[Ulalume]

Good subject. I'm at my mother's house these days because her mind is going and she can no longer take care of things - but she's also the type who won't leave her home come hell or high water. Just getting her to the doctor is a battle! We don't really know what to expect. It's been tough so far and I'm dreading the future.

Just the other day I was searching the archives of the "this American life" radio show and found this excellent episode, called "magic words."
http://www.thisamericanlife.org/radio-a ... agic-words

The second act is an interview with a couple caring for the wife's mother who has dementia. The couple are both actors who use the techniques of improv theatre when interacting with her mother, to great success. Definitely worth a listen. (Also, the first act, "I believe I can fly" also fits perfectly on this messageboard. )

For those interested in listening to the program, I'm assuming it can be heard in other countries because it's not entirely government funded. Click on the link for "act two" for the dementia story. On the chance it won't play outside the U.S., perhaps the transcript is available.

 

[escargot]

The link works here in the UK, thank you!

In a doctor's waiting room a few years ago I heard a discussion between a middle aged couple and an elderly lady who was the mother of one of them.

The Mum was baffled about why she was there, saying she was perfectly capable of living on her own, and the wife was reminding her about all the times she's left pans to boil dry or forgotten to eat at all for days, and how she forgets to take baths or change her clothes all week...

The wife was red-faced with frustration and the husband mainly sat there gloomily, agreeing with her where necessary and obviously wishing he was not there.

Dunno whose mother it was, but the wife seemed to have been lumbered with most of the care, as often happens, and she was at the end of her tether.

That family were at the start of a hard journey. I do hope they had a good guide.

 

[Ulalume]

The link works here in the UK, thank you!

Oh, good!

In a doctor's waiting room a few years ago I heard a discussion between a middle aged couple and an elderly lady who was the mother of one of them.

The Mum was baffled about why she was there, saying she was perfectly capable of living on her own, and the wife was reminding her about all the times she's left pans to boil dry or forgotten to eat at all for days, and how she forgets to take baths or change her clothes all week...

The wife was red-faced with frustration and the husband mainly sat there gloomily, agreeing with her where necessary and obviously wishing he was not there.

Dunno whose mother it was, but the wife seemed to have been lumbered with most of the care, as often happens, and she was at the end of her tether.

That family were at the start of a hard journey. I do hope they had a good guide.

Yes, I can definitely understand that. Fears about starting fires, eating spoiled food, taking expired medicine and such are ever-present. And there are problems we never expected, like - how do you convince a stubborn 80-year old not to climb on the roof? She was always fiercely independent so it's a struggle to convince her that she does not need to be on the roof trying to do repairs - that's why we're here. But it makes her so angry, as if we're insinuating she's "weak". We're still struggling to find a way to keep everyone safe and sound without seeming like dictators.

It's a real challenge, to be sure.

 

[poozler]

My mum developed dementia several years ago. When the deterioration started, she was very fearful. She had always been a very independant and active person, but suddenly had to rely on others all the time. My eldest sister lived with her for a while and ensured that she kept her eye on her all the time. Mum was doing things like putting her nylon socks to dry on the toaster or in the oven; washing her hands with toothpaste; not remembering what a toothbrush was for; forgetting to eat. My sister cared for her for as long as she could, but Mum got to the point where a district nurse came to the house and basically told my sister that it was no longer a question of whether my sister should care for Mum. The nurse would not allow it, and arranged for my mother to be put in a care facility for dementia patients. Mum was sad at first, because she still sort of knew who we all were, but soon she forgot everything and everybody. Nothing is sadder than calling your mother and saying 'Hi Mummy! It's X' and having her reply 'Who?' Mum is no longer 'my mum'; she is now just a sweet old lady who repeats herself a lot and whose life centres around eating soft food and Simulac. Where she is is the best place for her.

I tell this story so that anyone who reads this and feels horrible guilt about putting a demented parent into a hospital or care home will feel assured that it is the right thing to do. Do not feel guilty or ashamed. You will be doing the right thing. Your mum or dad will be better off, and you will too because you can continue to live your own life.

 

[escargot]

Thank you for your wise words, Poozler.

Had the same thing in my own family, and dealt with it for years at work.

Families can find it hard to let go and allow skilled professionals to take over, and as you say they can feel guilty or ashamed for not being able to cope.

It's the right thing though. If the person with dementia could see themselves they'd accept that they need to be safe and have dignity, which is hard for well-meaning relations to provide on their own.

Also, people with dementia benefit from being around others rather than alone.

Even when they don't recognise their families any more they can enjoy activities like a singalong with people of their own age.

I worked in homes where singing was a regular feature of the day. Most of the old folks knew all the songs from the 40s, 50s and 60s onwards, and I learned quite a few off-colour versions! :shock:

A singer specialising in George Formby impressions tours homes round here and the residents love him. He does a funny act, full of Formby's original innuendo. I learned the songs especially to join in.
The residents know it's not really him, or perhaps some don't, but they have a great time singing and laughing.

Here's a Fortean angle to dementia: some years ago, when my Nana was well into the mind-wandering, she used to nod off in her chair a lot. Sometimes she'd appear distressed when she woke up.

We put this down to her having nightmares, until my brother reported that he'd apparently encountered her in a Ouija board sesion! :shock:

He and his student housemates were playing the Ouija board, nothing much happening, until sudenly it began spelling out 'WHERE AM I? WHO ARE YOU? WHY AM I HERE?'

The lads asked a few questions and found that the spirit was called Nancy (Nana's name) and she was wandering around in the dark, scared and alone, and didn't know what to do...

My bro was convinced that his Nana had died. She hadn't, and was at that exact time asleep in her armchair. He is still convinced that he met her having an OOBE.

Nana would hallucinate too. She'd 'see' children playing around her chair and tell them off for being noisy.

Sometimes she'd chat with people we couldn't see. When asked who she was talking too, she'd say 'Uncle Fred! Who d'you THINK I'm talking to? He's standing right there!'

Uncle Fred being long-dead, of course. :shock:

Marvellous. :lol:

 

[GNC]

My great aunt used to hear children crying in the house next door. There were no children in the house next door. She was fairly sharp, it was just these little details would creep into her day to confuse her. She probably died before it got really bad, which was a blessing of sorts.

 

[poozler]

Thank you for your wise words, Poozler.

And thank you! If more people who have personal experience of coping with dementia in loved ones speak up about it, the more people will be reassured and do all they can to help. I think it is so important to reassure the relatives of dementia patients that 'putting mum in a home' is not as horrible as they think (although the first psychological moments can be devastating, I admit).

On a lighter note, we also found that my mother, although she could not remember us -- her own children -- still remembered the songs of her youth. My musical neice still takes her guitar along on visits to her grandmother. My mum, who cannot remember what she did two minutes ago, still knows all the music and lyrics to the old songs! It makes her very happy, too, which is what really counts.

 

[escargot]

How kind of your niece to sing for her gran.

Yup, music is the way forward. Oldies know all the words and they enjoy the lovely memories. Although I expect there must be sad ones too.

Also... a few years ago I was singing a song from one of the old musicals, I forget which, while helping with meals, and one lady had quite a dangerous fit of the giggles.

It seems that she and her young man saw the show in question in London on their brief but apparently very enjoyable honeymoon.

 

[Ronnor]

Quite frankly if it happens to me, the day after I'm diagnosed with dementia will be the day I top myself. Having seen one of my grandparents succumb to it I wouldn't wish it on my worst enemy. A truly horrific condition.

 

[poozler]

My thoughts, too. But on the lighter side of dementia ... when my mum first realised how bad things were getting, she asked my sister to help her to die. My sister was horrified at the thought but tried to find ways of fulfilling Mum's wishes, but luckily Mum forgot all about the whole thing very soon afterwards! (Please don't think that this is a callous or heartless attitude. It's not. But you do have to see the humour in order to survive.)

 

[escargot]

My sister married one of two brothers. Her mother in law hated Sis but loved the brother's wife. Sis wasn't good enough, y'know, and MiL spent several decades reminding Sis of this fact.

However… MiL eventually began showing signs of dementia and switched her affection to Sis, abandoning Sis in Law and even starting to hate her.

She'd ring the police and accuse Sis in Law of stealing her pension book, purse, new coat, cat, whatever, and they'd pop round for a chat, by which time MiL had forgotten all about the call.

Sis was highly embarrassed by the whole thing, as she and her SiL had heretofore been good friends and they'd both tried to look after the MiL as well as possible. SiL had certainly done nothing to deserve such opprobrium.

Mothers in law, eh. :lol:

 

[GNC]

Mention of the positive power of music reminds me of the Pulp song Help the Aged, which was inspired by Jarvis Cocker musing over his generation ending up in care homes in decades to come singing "I like to move it, move it!"

 

[escargot]

I (selfishly) count my blessings that there is no history of dementia in either of my parents' families, so I'm not likely to get it myself.

There're many types of dementia and it doesn't follow that because someone's parents escaped it, they will too.

From the Alzheimer's Research UK site-:

Dementia is a word used to describe a group of symptoms including memory loss, confusion, mood changes and difficulty with day-to-day tasks. There are many causes of dementia, with Alzheimer's the most common.

...

Common Causes of Dementia:

Alzheimer’s disease
Vascular dementia
Dementia with Lewy bodies
Frontotemporal dementia

So one may or may not be lucky.

 

[escargot]

I have looked after so many hundreds of people with various diagnoses of dementia that I'm more or less resigned to getting some form of it myself, in much the same way as undertakers don't like their teenagers to drink/skateboard/drive home late because they buried someone who died of that only last week.

In preparation, I have compiled a very detailed list of preferences for when I'm no longer able to look after myself, viz.

1. Stick me in a home.
2. Leave me there.

 

[Naughty_Felid]

Just a few pointers in picking a nursing home should anyone have to make the decision.

You can always tell a good home from a bad one and sorry to be crude about it but by the smell.

When you have 20 odd residents living together where almost everyone has incontinence at some level a place will smell no matter what happens.

A good nursing home, you'll notice a slight smell but it's not overpowering, a bad one the smell will hit you when you walk in.

Also talk to whoever is the manager and ask about what sort of training do they offer to the Nursing assistants/Health care assistants. This is vital. Nursing homes don't pay good wages so they need to engage their staff and better trained staff are able to spot deterioration in physical and mental health. A good HCA should know about, incontinence, wound care, diagnosis, hydration. You should not expect a level of understanding of a professional but they should have a decent, basic understanding of what to look for and what to monitor. This includes sponsored NVQ training for staff. Post qualification training for Registered Nurses.Training also stops burn out and abusive practices.

Look at the Registered Nurse/HCA ratio. You should have more than one RN working if you have more than 8 residents. The more RN's employed the less mistakes you get as they are not working in isolation. Also the greater the severity of dementia, the more staff should be provided.

Also ask about Snoelzelen therapies and reminiscence therapies. A nursing home should actively be using them or at least know where these therapies can be accessed.

Talk the HCA's, see if they appear happy, watch how they interact with residents, (respect and touch being important). look at the Nursing home, the equipment, the sluice room etc. Does it look clean and modern?

If I think of anything else I'll post, I've got to go and cook now!

 

[escargot]

On the smell issue, I've known good and bad. The best was in a unit for residents with severe dementia, most of whom were mobile, which means in practice that people are wandering around occasionally peeing on the floor.

It didn't smell at all though, partly because of good continence practices and partly through maintenance.
Bedrooms were not carpeted but had tough laminate flooring which was mopped every day and all carpeted areas were constantly processed with a special push-along deep cleaner. Must all cost a fortune but it works as the place smells lovely!

The worst was a large rural home, where the smell made you gag.

What I've learned about care homes is that as most staff are female, and the pay is poor, a rural home will have fewer potential staff to choose from.
They'll need transport at unsocial times, for a start, and may not be able to afford cars. So the home will have to put up with what it can get, staff-wise, and may not get rid of poorer carers.
On the other hand, a home in a town or city will have better public transport links and a larger pool of applicants. Quality of staff is likely to be better just for those reasons.

When choosing a care home, there're easy pointers to look for. You can soon weigh a place up just by observation.

Can you see any hoists (little cranes for lifting people) in corners, possibly plugged in and charging up? Are they used at least a couple of times during your visit?
Finding a hoist bearing down on you and being expected to scatter is a good sign! As opposed to a place where staff are loth to use a hoist for fear of disturbing visitors, y'know. Residents' needs come first.

Do the elderly people look cared-for? Men should be shaved, women's hair should be neat, and all should be in clean and tidy clothing. If clothing has become stained with food it should be changed right away so look out for that.
(I'd look discreetly for bras too. If staff don't bother to put bras on their charges, that's a clear sign of neglect. Most elderly women are fussy about bras.)

Look at the environment. Is it clean and tidy? Are the walls and skirting boards knocked and chipped? Have dirty cups and plates been tidied away?

Is the atmosphere pleasant? I'd be looking for nice pictures on the walls and maybe pot plants and ornaments. There should be music playing too, and access to TV for people who want it.

You might walk in on an entertainment event, such as a singer visting, or just a game of bingo or a sing-song. That's a good sign.

In fact, I'd be happier to see care staff spontaneously organising a keep-the-balloons-up game or just putting on a CD and encouraging people to sing, rather than finding that they leave all the entertainment to professionals!

There will also be a notice board with details of future events and excursions. If you can't find one, that's a bad sign. I like to see photos of the residents on a notice board, taken on days out or just sitting in the garden, showing that they don't just lozzock in chairs all day.

You have to remember that staff can put on good behaviour if necessary to impress visitors, whereas the feel of the place can't be faked.

These are things you can find out just by looking around, before you start your serious interrogations!

 

[rynner2]

And there are problems we never expected, like - how do you convince a stubborn 80-year old not to climb on the roof?

I only discovered this thread today, but just yesterday I came across a story of a fire brigade having to rescue a man in his 80s from a roof. There was no fire, but the story gave no reason for the man being on the roof. (And today I can't find the story. :? )

 

[escargot]

My sister told me yesterday that when a colleague's bungalow caught fire, she ended up on the roof clutching her pet cat. Her husband, a firefighter, arrived with a crew to rescue her and carried the cat to safety first! :lol:

The whole place burned down and they were homeless. They still had the cat though...

 

[Recycled1]

That would be me! :lol: (One under each arm)

 

[ramonmercado]

My father doesn't quite have dementia but he does ramble on a bit. Doesn't want to get out of bed much.

He had another fall while I was home last week. I had gone out to get the papers but my mother, the community health nurse and a physio-therapist were present when he fell. I arrived home to find 3 para-medics (1 in training) plus nurse & physio attending to him.

Hes in hospital now, nothing seems broken. We'll have to get him to go to a day centre, but hes stubborn. My mother is 81 next month so shes finding it hard to cope (hes 88).

How do we persuade him to go to a day centre? Threaten to put him in the workhouse?

Any suggestions from experience?

 

[rynner2]

Change in sense of humour 'a sign of impending dementia'
By Michelle Roberts Health editor, BBC News online

An increasingly warped sense of humour could be an early warning sign of impending dementia, say UK experts.
The University College London study involved patients with frontotemporal dementia, with the results appearing in the Journal of Alzheimer's Disease.
Questionnaires from the friends and family of the 48 patients revealed many had noticed a change in humour years before the dementia had been diagnosed.
This included laughing inappropriately at tragic events.
Experts say more studies are now needed to understand how and when changes in humour could act as a red flag for dementia.

There are many different types of dementia and frontotemporal dementia is one of the rarer ones.
The area of the brain it affects is involved with personality and behaviour, and people who develop this form of dementia can lose their inhibition, become more impulsive and struggle with social situations.

Dr Camilla Clark and colleagues recruited 48 patients from their dementia clinic at University College London.
And they asked the friends or relatives of the patients to rate their loved one's liking for different kinds of comedy - slapstick comedy such as Mr Bean, satirical comedy such as Yes, Minister or absurdist comedy such as Monty Python - as well as any examples of inappropriate humour.
Nearly all of the respondents said, with hindsight, that they had noticed a shift in the nine years before the dementia had been diagnosed.

Many of the patients had developed a dark sense of humour - for example, laughing at tragic events in the news or in their personal lives. The dementia patients also tended to prefer slapstick to satirical humour, when compared with 21 healthy people of a similar age.
Dr Clark said: "These were marked changes - completely inappropriate humour well beyond the realms of even distasteful humour. For example, one man laughed when his wife badly scalded herself."

etc...

http://www.bbc.co.uk/news/health-34766361

 

[rynner2]

Dementia game 'shows lifelong navigational decline'
By James Gallagher Health and science reporter, BBC News website

The world's largest dementia research experiment, which takes the form of a video game, has indicated the ability to navigate declines throughout life.
The findings, presented at the Neuroscience 2016 conference, harnessed data from 2.4 million people who downloaded the game.

Getting lost is one of the first symptoms of Alzheimer's disease.
And the researchers at University College London believe the results could help make a dementia test.

Sea Hero Quest is a nautical adventure to save an old sailor's lost memories.
With the touch of a smartphone screen, players sail a boat round desert islands and icy oceans.
The game anonymously records the player's sense of direction and navigational ability as they work their way through the levels.

Some require them to weave through waterways and fire a flare back home, while others challenge them to memorise a sequence of buoys and then sail round them.
Data harnessed from the flare levels is the first to have been analysed, by scientists at University College London.
And it suggests the sense of direction declines consistently after the teenage years.
Players aged 19 were 74% accurate at firing the flare back home, but accuracy fell year by year until it reached 46% at age 75.
Dr Hugo Spiers told the BBC: "What we're able to announce to the world is it does decline across the lifespan, the ability to shoot the flare back to the target - that sense of direction."

The data also suggests men have a slight better sense of direction than women and that the Nordic nations outperform the rest in the world, although it is not yet clear why.

Ideas include:

• people in better health, common in Nordic countries, retain their navigational abilities longer
• coastal nations create better navigators
• a genetic "Viking blood" boost to navigational skills

The point of the research is to develop a way of diagnosing dementia in its earliest stages - something not yet possible.
Becoming completely disorientated is normally rare, but is more common in people with Alzheimer's disease.
Having a record of the normal decline in the internal compass could help doctors spot patients developing Alzheimer's.

etc...

http://www.bbc.co.uk/news/health-37988197

 

[Frideswide]

good find Ryn!