Time-tested Tips from a Caretaker
Evelyn Smith
Although the previous post cites sources, this blog page comes from a caretaker’s personal experience. Although everyone who suffers from Mild Cognitive Impairment is different, perhaps these observations will help other caregivers. Please read the earlier blog entry first since this blog entry only offers this blogger's personal experiences as a caretaker of a MCI-diagnosed patient.
Diagnosis
As soon as family members see a loved one exhibit symptomatic behavior, they should schedule an appointment with a neurologist:
- Problems with word usage, which means lots of circumlocution,
- Getting lost in familiar surroundings,
- The failure to function up to usual capacity and education level,
- A change in personality, for instance, when an introverted individual morphs into an extrovert.
If a relative is diagnosed with amnestic mild cognitive impairment, which usually affects verbal memory, then cholesterase inhibitors, like Aricept and Donepezil, can delay the onset of dementia for about a year. However, these medications lose their ability to alleviate symptoms of dementia after three years. They can also upset the stomach (as this caretaker knows from experience), so some patients may not be able to tolerate the increasing dosage schedule.
Case in point: I discovered Mother’s “problem” during a long-distance phone call in the spring of 2000. Mother told me she had gone to the “chicken place” after church, and it took me 30 minutes to find out she was talking about Long John Silver’s. After I moved back to my home town, Mother started taking Aricept in August 2000, and I was able to keep her at home until February 2008 whereupon she entered a nursing home that cares exclusively for Alzheimer’s patients because I could not lift on her.
Diet
If a relative lives alone and does not want to lose those final vestiges of independence, he or she may need some help along the way:
· Go shopping with the MCI-diagnosed individual and make sure that he or she picks out healthy foods, including fresh fruits and vegetables. Often times, individuals with MCI retain the ability to use the microwave and most probably can still make a morning cup of coffee, but they have lost the ability to coordinate a balanced meal. For instance, the diet of a MCI-diagnosed couple I knew consisted almost entirely of Lean Cuisine microwave dinners. I suspect that they had lost the ability to prepare anything else.
· Make sure the MCI-diagnosed individual dines with friends and relatives as often as possible as they include him or her in family meals. For example, before I moved in with my mom, I ate all my evening meals with her from August 2000 to January 2006; at which point, I became a live-in caretaker. This meant that even before I moved in with her, she had at least one well-balanced meal a day.
· Make sure to control for portion size. As MCI and Alzheimer’s progresses, the individual may lose his or her sense of this. In other words, when serving a MCI-diagnosed individual, make sure that he or she only takes a few cookies—not the whole plate.
Exercise
While 30 minutes of aerobic exercise daily is ideal, everyone also benefits from stretching and bending activities as well.
· Church groups often schedule exercise activities just for seniors; however, an MCI-diagnosed individual may not attend if he or she does not have a buddy to go with to these sessions. Since I worked full time, I could not do this, but in retrospect, I wonder if one of her friends might have been able to persuade her to participate in some of these sessions.
· Get a dog: While I was working, my mother would insist on walking my little Yorkie twice a day for thirty minutes, no matter how much I tried to dissuade her from doing so.
· Gardening and housecleaning mean stretching and bending, but if the MCI-diagnosed individual has any obsessive-compulsive tendencies, obsessive compulsive disorder will certainly manifest itself while doing these activities.
· Seniors with arthritis need to control it, so they can exercise. Glucosamine chondroitin worked well for Mother, although she needed to substitute a drink mix for a pill or capsule. Even though she is now in hospice care, I still provide her with a Knox glucosamine chondroitin drink mix.
Coping Skills and Instructional Activities of Daily Living
MCI-diagnosed individuals need the support of friends and family members as they try to cope with an increasingly bewildering world.
· Along the way, MCI-diagnosed individuals often lose the ability to differentiate between fraudulent get-rich schemes and efficiently managing their finances. Signs of this include a mail box filled with lottery letters that require consideration on the receiver’s part (“Just enclose $25.00, and we’ll send you the grand prize of 10 million dollars) as well as mail from all kinds of charities, while at the same time, the MCI-diagnosed person may fail to pay bills on time. In Mother’s case, this necessitated a Post Office Box as well as a trust officer and an on location relative with power of attorney handling the finances. Be forewarned, however, that while the MCI-diagnosed individual might believe everything friendly strangers say, he or she will not take too kindly to an intervening family member.
· Before a MCI-diagnosed individual shows signs of dementia, he or she needs to make out a will, a living will, and give a trusted relative power of attorney as well as perhaps arrange with a family member’s help to have the trust department at a local bank handle finances. Unfortunately, however, that MCI-diagnosis makes it a little too late to buy long-term care insurance.
If I might cite a personal example: Fortunately, Mother had three years of LTC coverage through my dad’s employer, which cut her nursing home expenses for these years in a nursing home almost in half. The best age to buy LTC insurance is in the early 50’s before its gets prohibitively expensive.
· MCI-diagnosed individuals and patients with early Alzheimer’s are very embarrassed by their failing memory and growing inability to function. Accordingly, they may want to do everything themselves. This might include getting up and down without the aid of a cane. This caused Mother much embarrassment on several memorable occasions.
· Taking the car away from a parent is perhaps the hardest task a caretaker ever has to do. With Mother, this was done in stages since for a couple of years she drove to church on Sunday while I sat on the passenger side of the front seat. (Needless to say, I did not look forward to Sundays.) She lost this privilege, however, when she backed into the garage door. I kept the keys on my person at all times.
Mother, incidentally, was a latch-key parent for over a year; at which time, a Visiting Angel came from 10 a.m. to 2 p. m. Later a second paid caretaker also came from 2 to 5 p. m. (I had about 30 minutes from the time I got off work, teaching school, before the last caretaker left at five. This meant a mad dash to the post office or the bank on the way home since I was Mother’s caretaker during the evening hours).
· I cannot emphasize enough the support of the friends of MCI-diagnosed individuals and Alzheimer’s patients. Unfortunately, however, all too often, their former peers as well as some of their family members neglect them. Just sending a card on Mother’s Day card or noting in passing that he or she is on the prayer list should not do.
Cognitive Activities
Remember that except in certain instances MCI-diagnosed individuals lack the attention span they earlier had. Nevertheless, they can continue to enjoy some of the activities that have previously given their life meaning.
· While using a computer to surf the Web boosts cognitive activity, do not assume that providing a MCI-diagnosed individual with a computer means he or she will use it. For example, my brother bought Mother a computer, so they could e-mail each other. She attempted twice to take a continuing-education class in computer use at a local community college, but otherwise found the computer useless except for playing solitaire. For example, I had to retrieve any e-mails sent to her. All of which was a little surprising since she earlier had taught business subjects and typing both at the high school level and at a local community college.
· If your relative displays a particular talent, he or she should focus on it. For instance, my mother played the piano beautifully, so she spent countless hours a day practicing after her diagnosis with MCI because she had read that challenging activities could delay dementia. Indeed, she was able to sight read and play really difficult classical pieces after she lost her ability to speak and after she was forced to enter an Alzheimer’s care center perhaps because she had trained as a concert pianist in her youth.
· Attending religious services is one activity MCI-diagnosed individuals and Alzheimer’s patients can enjoy. I took Mother to church, or rather she insisted upon going, until a forced stay in the hospital eventually sent her to a nursing home. Please also remember that regularly scheduled activities sometimes require an enabler who can carry the conversation. For instance, Mother drafted me into attending retired faculty meetings and faculty wives teas at the local university as well as meetings for her study club, even though I took off work to do so.
· Eventually, television probably is not something that these individuals will particularly enjoy beyond watching the news and weather. When I moved in with Mother, I soon discovered that I could not watch a complete 30-minute or hour program because inevitably she would need something just as the plot reached its climax.
· One activity that many senior women really look forward to is their weekly trip to the beauty shop. If a loved one enters a nursing home, make sure that beautician/barber services are available.
I hope that these thoughts help other caregivers and their MCI-diagnosed loved ones. Please feel free to add your own tips.
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The tips furnished on this Web page
represent the opinion of the author, so they complement—not substitute—for
a physician’s advice.
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