Episode 111

Essential Tips for Positive Caregiving Outcomes in Alzheimer’s and Dementia

There is no question that caring for individuals living with Alzheimer’s disease and related dementia can be extremely challenging. But what if I shared with you my 30+ years of dementia care training strategies and techniques that could make your caregiving experience a lot less stressful and much more harmonious? Wouldn’t that absolutely change your world for the better? Well, it is possible to achieve more positive outcomes for our family members and caregivers as well as the individuals living with dementia with proper guidance and having the right information at your fingertips. In today’s episode, Lisa shares more tips to help create a peaceful existence during your dementia journey.

You definitely won’t want to miss this life-altering episode!

About the Host:

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.

Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Lisa’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle so they can have a better-quality relationship with their loved ones through education and through her workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.

So many people today are heavily impacted by Alzheimer's disease and related dementia. The Alzheimer's Association and the World Health Organization have projected that the number of people who will develop Alzheimer's disease by the year 2050 worldwide will triple if a treatment or cure is not found. Society is not prepared to care for the projected increase of people who will develop this devastating disease. In her 30 years of working with family members and caregivers who suffer from dementia, Lisa has recognized how little people really understand the complexities of what living with this disease is really like. For Lisa, it starts with knowledge, education, and training.

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Transcript
Lisa Skinner:

Lisa, hello everybody. Welcome to another new episode of the truth lies and Alzheimer's. I'm your host, Lisa Skinner, and today I am going to be sharing with you tips for positive outcomes when caring for someone with Alzheimer's disease or dementia. Now this is also for family members. Good tips for family members when you are visiting or trying to maintain a healthy relationship with somebody who is in cognitive decline, in their brains just aren't working the same way they did when it was a healthy brain. So hopefully this will be helpful to you to implement on a situation by situation basis, because, as we know, there's no question about this that caring for a person with dementia is challenging, but there are several important do's that we can help make the experience more manageable and supportive for both the caregiver and the individual living with Alzheimer's disease and dementia. So here are some of the key points to consider. Establish a daily routine that's so important, and I don't think a lot of people realize the importance of this, and what that means is create a consistent daily schedule that provides structure and familiarity. Familiarity is the key here. Communicate clearly, use simple, direct language. Speak slowly and maintain eye contact and try to be patient as patient as possible. I know it's difficult, and give them time to respond. Their brains get to the point where they no longer process information at the speed and comprehension that they did when their brains were healthier. Rick, recognize that cognitive decline can lead to frustration, approach interactions with empathy, encourage their independence, allow them to do tasks they can manage, to promote a sense of accomplishment. But I just want to say that this is a fine line, because you want them to be independent, but you don't want to overburden them with tasks that are have become too difficult, because that will create anxiety and frustration, so you might have to play around with that a little bit, but eventually you will discover tasks that fit right into their current skill level, remove potential hazards and ensure the living space is comfortable and secure. Involve them in activities that they enjoy, like music, arts and crafts or gardening, offer reassurance and validation of their feelings and listen actively to their concerns and then acknowledge, oh, I really understand how you feel. Let me see if I can help try to change that or help resolve that for you, keep track of any changes in physical health and ensure regular medical checkups. This is a partnership with your loved ones, doctors and caregivers learn about dementia and its progression to better understand their needs and behavior. Caregiving can be so demanding. So please, please, please, take time for yourself and seek support when you feel you need it, encourage social interaction with friends and family to reduce their feelings of isolation. I don't know if you're aware of this, but isolation can actually speed up the decline and the progression of dementia, so keeping those social interactions on a regular basis is very important to their health and well being. Using memory aids is really helpful. Employ tools like calendars, notes and labels to assist. With their memory challenges. Use nonverbal cues such as gestures and facial expressions to enhance their understanding of what it is you're trying to communicate to them, and try to remain composed during moments of confusion or agitation and use soothing tones and gestures. Don't hesitate to reach out to your health care professionals or support groups for guidance. Tailor your approach based on the individual's preferences history and to their personalities, familiar activities and topics can evoke positive memories for them. You sense textures and sounds to engage their senses and to stimulate their senses. So a couple suggestions would be aromatherapy, tactile objects, in other words, feeling different textures and soothing music, we know is so beneficial promote gentle exercise like walking or stretching to enhance physical health and mood for those that are chair bound, wheelchair bound, bed bound, there are exercises that can still be implemented on a regular basis, so you could check into that, Praise and encourage small achievements to boost their confidence and motivation, create a calm environment with minimal noise and interruptions to help them focus and feel secure, pay attention to their body language and facial expressions, because this can provide insight into what they're feeling and what their needs may be, prepare them for changes in routine or environment. This will help reduce their anxiety and confusion, ensure they have balanced meals and stay hydrated, familiar foods may be comforting for them. Consider using apps or devices designed for dementia care, such as reminder systems, and there are communication tools available out there when they face challenges, guide them through the process, rather than immediately providing solutions to foster independence, adapt your approach based on their mood and cognitive state each day, as their needs are going to vary, build a network of family, friends and professionals who can offer assistance and share in the caregiving responsibilities. If that's not possible for you, there are respite services available out there that can come in for a few hours, or places you can take your loved one for up to a week or so, to give you a time to recharge. Have a plan in place for potential emergencies or behavioral crises, including contact information for healthcare providers. Now keep a record of any behavioral or cognitive changes to discuss with healthcare professionals for ongoing care, introduce relaxation techniques such as deep breathing or meditation to help reduce stress for both the caregiver and the person living with dementia always ensure they take their medications as prescribed, using pill organizers or reminders, if necessary, and take them on time. Help them maintain relationships by organizing visits with friends or participating in community events that are designed for seniors you want to understand and address any legal and or financial issues, including power of attorney and healthcare proxies well ahead of time, if at all possible, before they've completely lost their cognitive abilities.

Lisa Skinner:

This is always recommended. I've run support groups before they can be really, really helpful to caregivers and to family members by joining caregiver. Support groups, because it enables you to share experiences, gain insights from other people's experiences, and find the well needed emotional support. Avoid introducing unfamiliar technology without proper guidance, as this can lead to confusion and frustration, and try to pay attention to their life experiences and their stories. They really love to share their stories so acknowledge their past and use it as a way to connect with them and for them to connect with you and to their life. Avoid presuming what they want or need. Always ask and involve them in decision making as much as possible, but don't make it complicated. What you want to do is give them one or two choices or yes or no, because, again, they're not able to process information the way they were when their brains were healthy. So keep it simple. You uh, avoid environments that are too loud or busy, because this can be overwhelming for people living with dementia. You want to keep their spaces calm and soothing. Avoid talking about them if as if they weren't sitting right there in front of you. They know what's going on, even though it might not be obvious to you. There is a person inside there that hears what you're saying, that can feel what you're feeling, and you know they even though they're they may not be showing it or responding most of the time, they still are well aware of what's going on around them. So you want to include them in conversations, even if they struggle to respond getting a smile out of them. You know that you made them feel good at that moment, and that feeling will last for a while. Avoid overlooking their physical health, such as nutritional needs, hydration needs and exercise. A lot of times, people living with Alzheimer's disease and dementia don't recognize when they're thirsty, but for older adults, it's imperative that they take in as much water or hydrating liquids as you can provide so offer. As often as you think about it, they may accept it or they may not, but keep it top of mind, because they're not going to be able to tell you a lot of times that they are thirsty. Avoid sticking to rigid routines that may not suit their current feelings or abilities. You gotta be flexible. You gotta be adaptable. Avoid ignoring their body language or facial expressions. These cues can convey important feelings of discomfort or some other issue that may be bothering them, they're trying to let you know, but don't know how to tell it to you or say it to you. Avoid withdrawing from social support or resources for caregivers. Seek help and connect with others. For support, avoid being overly focused on challenges, acknowledge and celebrate small achievements to boost their morale. I've said this before. It doesn't matter how well an art project turns out, because you're the one that's assessing it. They're not so just make a big deal out of it. Even if it's kind of wonky to you, it's not to them. Every little achievement is a huge success for people with dementia, avoid thinking they cannot adapt or learn new skills, encourage cognitive engagement through simple activities and games that are at their skill level, avoid making abrupt changes to establish routines without preparation, because this can cause confusion and anxiety and. Avoid neglecting to assess the environment for safety hazards. Ensure that their living space is secure and free of risks. Avoid responding with frustration or anger to emotional outbursts. This is not an easy thing to do for caregivers or for family members, but it's a must, because staying calm and offering comfort will diffuse a situation and keep it from escalating into what is called a catastrophic reaction on their part, which is synonymous with a huge meltdown, avoid withholding information about their care or changes in their routine. Keeping them informed can reduce anxiety, so walk them through what you're planning to do at that moment. An example would be, it's dinner time, and this is what you are preparing. You know, make a little story out of it. Now avoid not using appropriate physical contact when comforting them as gentle touch can be very reassuring, avoid ignoring their hobbies or interests, engage them activities they enjoy and maintain that will help them maintain joy and meaning and fulfillment. People who live with Alzheimer's disease and dementia, as most of us are aware, do repeat questions, they repeat statements, they repeat stories in the same conversation, and that can drive us crazy, but remember, they're not doing this to drive us crazy. They're not remembering that they just asked that question 20 times. So try to think of that and respond patiently and help them feel heard. They're not they will hold on to that thought, that statement, that question, that story, until they feel that they have been heard and that you're paying attention to them and acknowledging them. That's what really what they're looking for, and then you can try to distract them to become interested in something else. Oh. Always respect their dignity and personal boundaries and avoid true intruding on their personal space or privacy. Avoid thinking they're comfortable without checking in regularly ask them about their comfort levels, regarding temperature, seating and overall well being a few more. Avoid letting them stay inactive for long periods of time. Encourage gentle physical activity or stimulating mental exercises. Avoidant neglecting their spiritual beliefs or practices. You can help them engage in activities that align with their spiritual values. If they express interest, avoid trivializing their complaints about discomfort or pain. Take their concerns seriously and address them appropriately. They may be telling you something when it's actually something else, because they don't they can't differentiate between what it is they're telling you and the something else. But if they're expressing concerns about something, pay attention because they are trying to communicate something to you. Now, this is really important. Don't assume that they understand or comprehend all conversations around them. Be mindful of what you say in their presence, avoid overlooking daily activities like grooming or meal prep, because these things can foster a sense of normalcy and independence for them. Avoid using phrases that imply frustration or negativity, such as you never remember anything, because that hurts them.

Lisa Skinner:

Avoid hesitating to seek help from health care professionals when needed. Expert Advice can enhance care strategies. Avoid neglecting their personal hygiene. Pain this can affect their self esteem and overall well being. And as I've shown you before, if they're really becoming combative and just digging their heels into the floor and refusing to take a shower, there are products available out there that you can use, like a dry shampoo or wipes to accomplish the same thing, avoid disregarding the therapeutic potential of music and art, because we have seen case study after case study after case study that engaging in these activities can evoke positive emotions and memories. Now try to keep a record of changes in behavior, mood or health. This information can end up being valuable to you to know what tools and strategies you can use if those same behaviors, moods or health situations come up again, avoid assuming they're not interested in family activities or gatherings. Invite them to participate at their comfort level, avoid making care decisions without consulting them when possible. Their preferences matter and should be considered now under the circumstances, they're not always going to be able to tell you to respond. Cohesively to a care decision. So these are things that should be done proactively before they progress too far into the dementia and find out what their care preferences are. Then you'll know and you won't have to second guess. Avoid using humor that relies on wordplay or sarcasm, because that can be very confusing, and avoid a one size fits all approach recognize that their needs and preferences may change from day to day. Avoid keeping them from outdoor activities or nature fresh air is just that it's fresh air and nature uplifts people's moods, including theirs. Avoid downplaying the challenges that they face. Recognizing and validating their experience is crucial, and avoid sticking to just one communication method. Try adapting your style based on their responses and moods, and you do this enough times, and you really get to know the your your loved one, and the way that they're currently responding to to a variety of things, or you're their caregiver, this will eventually become second nature. And then one of the things that I recommend is try not to dwell on distressing topics if they become upset, gently redirect the conversation to a more positive subject, and then finally, try to avoid thinking that your person does not no longer requires emotional support, regular check ins and conversations can provide reassurance and connection. So there's quite a few tips to produce positive outcomes when you're caring for people living with Alzheimer's and dementia. There's a lot of suggestions there. You may want to replay this episode several times and write them down and just try different things with your loved one, but these are all proven techniques to help promote positive outcomes and to help prevent escalating situations into catastrophic ones. So thanks for being here with me today, and I'll be back next week with another brand new episode of the truth lies and Alzheimer's show. I'm Lisa Skinner, your host, and I'm hoping everybody out there has a happy. And healthy rest of your week till next time. Bye. For now, bye.

About the Podcast

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Truth, Lies & Alzheimer's

About your host

Profile picture for Lisa Skinner, CDP, CDT

Lisa Skinner, CDP, CDT

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.
Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Skinner’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle they can have a better-quality relationship with their loved ones through education and offering workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.