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Dementia Challenges Continue

 REGINA D. Posvar LPN,RNA
REGINA D. Posvar LPN,RNA

Q: Dear Ms.Posvar, my husband is not doing well. He has had Alzheimer’s and has been falling a lot lately. I try to keep him sitting down but he doesn’t stay seated. I do not know what to do to keep him safe. I can’t sit with him 24/7. Is there something I can do to keep him from getting up so he does not fall?

A: I understand your concern. I am sure you understand that he cannot stay seated as he does not remember that he falls or that he has a balance issue. Falling can be part of the decline and has been a challenging part of care for families. There are a few things I would consider that may help with decreasing some of the falls: make sure a medical check-up has been done to ensure no illness (like heart problems) or deficiencies are present; make sure his environment is safe; check all medications to be sure no side effects that contribute to balance problems; track when, where, why the falls; after tracking assess for solutions.

While you are working on the things above and waiting for results, you may want to invest in a walker for him. He may not remember to use the walker on his own but if you and others who help or live in the home remember for him by putting the walker in front of him every time he gets up this will train his automatic response that is still present. If he is using the wall, table or anything around to help him balance himself, a walker is a good tool for him. Get an assessment for the right kind of walker for him. Sometimes something simple like a walker will help with his independence and you will not have to keep him confined to sitting. If he has broken a leg and it is recommended he stay seated to heal, you will need extra help with keeping him busy with things that he can enjoy and be engaged in.

Remember if he feels confined he will want to get up and leave. Understand that it will be challenging to avoid all falls 100% even if you had someone with him 24/7 to walk around with him. However it does decrease the risk significantly.

Q: Hi Ms Posvar, my mom has Alzheimer’s and her caregiver says that she is aggressive and she cannot get her to eat, change clothes or shower. It pains me to see my mom so unkempt but I do not want the caregiver to get hurt either. The caregiver has been with us for many years. I am not sure what to tell the caregiver. Do you have any ideas?

A: Your mom’s dignity with her hygiene is a legitimate concern. I would have the caregiver give you details on her approach towards your mom and how your mom responds. For example what time of the day does she try to dress or shower her (when did your mom normally take her showers?); Is the caregiver trying to help physically too much or not enough; what words are being used to communicate with your mom, too much or not enough words? I am sure she is doing the best she can but it has been proven that the majority of the time aggression with dementia can be avoided by our approach and really putting yourself in “Alzheimer’s World.”

If this is a sudden change for your mom, make sure she has seen a doctor to rule out urinary tract infection (UTI) or other illness. If no infection, illness or medication interaction, then it may be time to change your approach on how you communicate to her. The caregiver may need some dementia training to help her with your mom. The two of you can get some training that is inexpensive or free at http://internationalcaregiversassociation.com/. Keeping a good record on daily tasks and what your mom and caregiver are experiencing will help you better understand your mom’s needs and you can become creative with her care. Make sure your caregiver and you have good relations and are helpful to each other. Check that she is not burnt out with caring for your mom… Her fatigue can trigger negative responses from your mom. And do not forget to care for yourself with plenty of rest.

Silly~ A gentleman told the nurse during the day that the nurse at night was making beer at the foot of his bed… The night nurse was emptying the Foley catheter. 

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