Minding Our Elders®

Drug free management of sundowning in people with Alzheimer's

Sundowning, sometimes called Sundown Syndrome, is the label given to late day anxiety, irritability, disorientation and general agitation in people with Alzheimer’s. Sundowning frustrates home caregivers and professional care staff alike, as they often feel completely unable to comfort the person affected.

Researchers and care staff alike are looking for answers. One nursing home in particular has made some dramatic changes in end-of-day care, resulting in a major reduction in the need to medicate residents for late day anxiety. Home caregivers can learn from their work, as well.

Read more about help for sundowning behavior in Alzheimer's: 

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol: 

 

Study shows cancer drug could reverse symptoms of Alzheimer’s disease

A skin cancer drug that has been available for nearly 13 years could be the new Alzheimer’s hero. A study using genetically engineered mice showed that bexarotene (Targretin) reversed Alzheimer’s symptoms in mice by eliminating brain-damaging proteins.

Read more about existing drug that may reverse Alzheimer's symptoms:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol: 

 

How do we address Valentine’s Day for a surviving parent?

Dear Carol: My father died a month ago and I’m worried about how to handle Valentine’s Day for my mother. My parents had a good marriage and had always made Valentine’s Day special for each other. I’ve thought about just ignoring it, and sometimes I think Mom would prefer that. However, other times I think that maybe we should do something to honor Dad’s memory and their marriage. How do people handle these times? – Jennifer

Read more about helping your elders through Valentine's Day:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol: 

 

Getting a handle on caregiver guilt

Guilt has a purpose in life. If we are mean, we should feel guilty. If we owe someone an apology, we should be big enough to do so. But guilt is a complicated emotion. We take on the expectations of our culture, our religion, our family. And then we take on the expectations of our toughest critic – ourselves. That committee that meets in our head tells us we are not doing this caregiving thing well enough. If we were "good" people, we'd just keep answering the phone endlessly until Mom found something else to do.

Read more about getting a handle on caregiver guilt:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol: 

 

 

Wife struggles to care for husband with early on-set Alzheimer’s

Dear Carol: My husband developed Alzheimer’s disease at 46. I’ve cared for him on my own for three years, while also running the business we started years ago. I can’t leave my husband at home for long so I frequently have to leave work to check on him. This is affecting my ability to do my work well. I’ve tried hiring in-home care and that helped, but I still worry if they will show up, or if someone is late in the morning, then I will be late to my business. I also don’t feel he gets much mental stimulation at home. I’m exhausted when I do get home, since I need to get up very early to take care of his needs, and when I get home he needs more care. I love my husband dearly and don’t want to feel like I’m giving up on him, but I can’t continue this way, either. What are my options?  - Emma

Read more about caring for a spouse with early on-set Alzheimer's:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

Study shows nicotine patch could help some with mild cognitive impairment (MCI)

Smoking is bad for our health. Nothing has changed that often proven fact. Also, nicotine is part of the addictive element in smoking. However, nicotine as administered through a medical patch, rather than a tobacco product, was shown in a recent study to have some benefit for nonsmokers with mild cognitive impairment (MCI). Not everyone with MCI goes on to develop Alzheimer’s disease, but many people do. Therefore, the interest in studying MCI is intense.

Read more about the nicotine patch for MCI:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

When your parent repeats "I want to go home"

A tip, here, for people who still have their elder at home, but the elder still asks to "go home." Understand what the person wants and then try the same distraction or relearning technique. Some people go as far as taking the person in the car and driving around the block, then re-entering the house. This can work for awhile, but not likely that long. No matter what you do, you will hear it again: "I want to go home." The point here is that no matter what you do or say, likely you will continue to hear the plea to "go home."

Read more about how to handle the plea "I want to go home":

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

What can caregiver do when no one comes to visit or call an elder?

Dear Carol: My mom, 93 years old, sent cash Christmas gifts to all her children, grandchildren and great-grandchildren. However, she got few thank you notes and asks why she never hears back from these people.  She also doesn’t have many friends left so there’s no one to fill the void. She has early to mid-stage dementia and gets depressed easily when she does not get visits, phone calls or notes. My siblings do call and some come to visit once or twice a month, but I wish they would do more.

Read more about how to encourage more family involvement with an elder:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

Vision and hearing checkups tough for people with dementia

You are helped into a chair and the doctor covers one of your eyes and asks what letters you see. What is a letter, you think, and why is he covering my face? You start to squirm and then push him away. You get more confused and frightened because you don't know what they want with you.

Read more about helping your loved on through vison and hearing checkups - or whether to have them done:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

Reminiscing a powerful “drug” for people with dementia

I love stories. When I was a teenager, I’d encourage grandparents to relate stories of their young years struggling to survive on the wind-swept prairie. When I grew older, I was fascinated by the stories my parents and in-laws told of their early years of growing up during the Great Depression. Little did I know at the time that peoples’ stories would become the springboard for my life’s work. Now there is mounting evidence that encouraging our elders to reminisce about their past is therapeutic as well as enjoyable.

Read more about how reminscing can perk up the mood and brain for our aging loved ones:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

When we can no longer carry the caregiving responsibilities alone

...outside care eventually becomes a necessity for many. When we are talking about elder care, often people jump immediately to the "nursing home" solution, since in days past, that was pretty much the only choice people had once someone couldn't stay at home, or with family. Things have changed now, but that doesn't mean it is easy.

Read more about when the time comes for outside help:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

 

How to prepare when a parent or grandparent comes to live with you

These days, having grandma move in with the family is still an option for some families, but it has become more complicated. First of all, there are fewer families with a stay-at-home adult in the home. This is where a great deal depends on Grandma's health. I know of one family where the dad is single. He has custody of his two young sons most of the time, and his mother has moved in. For the most part, Grandma is actually a help with the boys. Yes, she has her issues, and there has been some adjusting on all sides. But with Dad's odd hours and Grandma still fairly capable, it's a situation that works well for all.

Read more about preparing for a live-in parent:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

Handling the pain when your loved one no longer recognizes you

I recall asking one of the nurses at the nursing home if my mother-in-law knew who I was. I was aware she couldn't have told anyone my name or my exact purpose in her life. That much was evident. However, I wondered if she knew that I was there to see her. The nurse assured me that my mother-in-law's seeing me step off the elevator as she sat in the common room was a highlight of her day. I was glad of that. I felt my visiting her was important no matter what she "knew," but it was nice to hear those words from the nurse just the same.

Read more about when a loved one no longer recognizes you:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

Time management for caregivers

For me, the need to be prepared for anything is mandatory. During my heaviest caregiving years, I cared for two children, one with multiple health problems, plus multiple elders. During their last years, several of my elders lived in a nearby nursing home, while I worked full time, so that care was a blessing. I could visit daily, but still know they were cared for while I worked at my "real world" job.

Read more about managing time when caring for aging parents:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

Sundowning with Alzheimer’s common and difficult behavior

Dear Carol: My husband has Alzheimer’s. We get by fairly well for most of the day, but he gets agitated late in the afternoon and acts as if he’s searching for something or someone. The doctor said he’s “sundowning.” He says it’s common with AD, but he hasn’t helped much other than label it. I’d like to know if there’s anything I can do.  - Betty

Dear Betty: "Sundowning" refers to an increased state of anxiety and confusion at the end of the day that often occurs in people with Alzheimer's. There have been many theories about the behavior. Some professionals think the person is used to a normal work day, therefore as the day ends, he or she is trying to go home from work or accomplish something that is related to wrapping up the day. Other’s think

Read more about sundowning and coping with the behavior:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

Why distance siblings are often in denial about parents' health

What the distance sibling doesn't see is the intense decline of the parent once the visit is over. The elder sinks back into reality. Often, they've forgotten the visitor even came. That happened after my brother and his wife visited us when our mom was getting very ill. She had looked forward to the visit for weeks.

Read about sibling denial and problems with relating real issues to distance siblings:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

Alzheimer’s Foundation of America stands up against antipsychotic use for people with Alzheimer’s

We’ve addressed the inappropriate use of antipsychotic drugs for dementia patients a number of times on these pages. In one article, I wrote about my dad’s terrifying experience after he was given one of those antipsychotic drugs after failed brain surgery, and my fight to get him off the drug.

Read more about standing before Congress to fight against non-essential use of antipsychotics:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

10 thoughts caregivers aren't proud of

Caregivers often run from person to person, job to care receiver, home to nursing home, never really having time to do something that they want to do – just for themselves.  If this describes your life,

Read about those thoughts most caregivers have even if they don't tell people:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

Improving elder health care transitions

Fortunately for me and my family, I was able to make myself available to help each of my elders after their many hospitalizations. Typically, however, many families simply don’t have anyone in a position to help, and elders go home only to return quickly to the hospital setting because they didn’t have the community support needed for recovering.

Billions of dollars are spent annually by elders returning home from hospital stays. According to the US Administration on Aging, almost one out of every five Medicare patients ends up back in the hospital within 30 days. Most of these readmissions are due to poor transitions due to poor communication and medical mismanagement. The Centers for Medicare and Medicaid Services (CMS) have been trying to address this problem.

Read more about getting the information download from CMS on reducing hospitalization of elders:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol:

When a parent with dementia lies about you

Imagine someone with dementia who has diminished short-term memory capacity. The person places an object somewhere, and then wanders off to do something. Later, this person can't find what he or she is looking for. Anxiety, frustration and a sense of loss accompany most dementias. Add paranoia to the list, and you've got a scenario where the elder feels taken advantage of, and sometimes that leans toward thinking people are stealing things.

Read more about when parents with dementia or Alzheimer's lie about you:

Find care agencies to help you care for your loved ones:

Support a caregiver or jump start discussion in support groups with real stories - for bulk orders e-mail Carol: