Tag Archives: caregivers

Senior Care Professionals

Responding to Agitation and Aggression in persons living with Dementia

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Agitation and Aggression- Individuals with dementia frequently become restless, anxious, or upset you may see a resident pacing, moving furniture or objects, talking to themselves, yelling or swearing. These behaviors can escalate to aggressive behaviors like, threatening or causing harm to another by pushing or hitting, cornering another resident or staff, or even throwing objects or food. And unfortunately, aggression among people with dementia can happen suddenly and seemingly without warning.

I am here to let you know if you pay attention you may be able to diffuse the situation or even prevent it.

Things to try to decrease agitation and aggression:  First thing to do is remind yourself to stay calm, it can be very very difficult but by reassuring your resident you are offering them security and creating a safe environment.

Our job is to figure out What they are trying to tell us?? remember all behaviors stem from something. So, we are going to listen to our resident as they verbally and maybe physically express their frustrations. They may not make much sense to you but sometimes a good detective can figure it out and ease the person agitation.

Possible triggers:

So, what are possible triggers:  Pain, discomfort, like being too hot, too cold, hungry, needing to use the bathroom, etc.). Perhaps they may be frustrated or overstimulated.

Environmental triggers: turn down the tv/radio, decrease noises that are loud and startling, move the resident to a smaller dimmer area, play soft music, hold their hand if they will let you and continue to reassure them you want to help.

Do Not: scold them or tell them things like “you know better”  “stop that” “ don’t touch that” that’s not yours” “ this is not acceptable. Because it is not going to help, in fact, it may make things worse.  Get yourself into their reality they are only trying to meet their needs.

Your Behaviors: It is also very important to reflect on your behavior in response to the person. If you are not already doing so, reassure the person that you are there to provide assistance and comfort. If it seems like the person needs something to do, try redirection to an enjoyable activity. Refer to a social history if there isn’t one accessible talk to your manager.

Behavior charting:  when charting on a behavioral incident or when filling out a behavior flow sheet, it is helpful to use specific, concrete words that clearly describe what a resident is doing so you can truly track whether the interventions/changes the environment work to decrease the behavior

Remember: no person is the same so not every intervention will be successful and what works for one may not work for the other. When you do find something that works, share it with your coworkers and manager.

Emmy Kaczmarksi, RN is a Master Trainer for AGE-u-cate® Training Institute, Dementia Educator, Behavioral Specialist and lives in Hudson, WI. 

http://www.AGEucate.com

Dementia Live, Faith Community, Family Caregiver, Senior Care Professionals, The Family Caregiver

The Important Role that Money plays in Caregiving Decisions

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It’s no secret that families tend to shy away from the topics of money and death more often than not.  The fact, however, is that caregiving decisions often revolve around money, as care options will vary greatly depending on one’s assets.  So money plays a very important role in the choices that are made and discussions that take place between family members.

Understanding generational differences with respect to money can help today’s caregivers.  Like my own parents who were raised during the Depression,  money for our oldest generation was to be saved.  Before the era of mass production of goods, this generation did not waste, valued “things” in terms of their quality and how long they would last.   Older generations did not accumulate debt but rather watched their nest egg grow through hard work and perseverance.  One of their goals is the ability to leave an inheritance for their children.   In turn, adult children have expected this nest egg, rightfully or not.  And this is when conflict arises when families are faced with decisions on parent’s long-term care.

Too often, parents are reluctant to talk with their children about their financial situation.  My advice was always to give their children the gift of talking about it BEFORE  needs arose for decisions to be made that may conflict with theirs.  So plan A is always for families to approach this difficult topic earlier than later.

Try to start the conversation with a what-if scenario.  “Mom, we want to make sure that decisions regarding care are ones that you had envisioned.   We never know what to expect, but what if you fell and broke your hip and this required you to have ongoing care.  Can we talk about what this might entail and what you would want as next steps?”

Or another conversation starter might look like this:  “Dad, you have always been such a wonderful provider and keep such great care of your finances;  I know everything is fine now, but what if something happened to you?  Can we talk about how you would like help with paying bills?”

Children and other family members need to be respectful of the money issue, understanding that when one gives up oversight of their finances, even if it’s perceived as such, it’s a huge step in losing independence.  Tread these waters gently, approach with a sincere heart and understand that an initial response from others may be to pull back.  If that’s the case, then give it time, and reapproach maybe at a different time and with another family member present.

Put yourselves in the place of that person before approaching, and ask how you would like to hear the words of the person talking about the difficult money topic.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  

http://www.AGEucate.com

Faith Community, Family Caregiver, Senior Care Professionals

How Counseling Can Help Caregivers Cope with Emotions

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Caring for a close family member friend can be emotionally overwhelming.  While many caregivers find fulfillment in helping another person, along with this comes feelings of loss, anger,  grief, and guilt.  Caregivers struggle with depression and anxiety at a much higher rate than the general population.  Counseling can be very beneficial for helping people with what is called caregiver burnout.

Learning to cope with the myriad of emotions that accompany caring for persons with dementia is critically important.  Unfortunately too often caregivers don’t realize they are spiraling downward until it’s too late.  The importance of self-care goes well beyond eating right and exercising when it comes to caregiving.   Counseling can be beneficial in allowing caregivers to express their emotions, while also benefiting from non-judgemental guidance that counselors can provide.

There is sound evidence that counseling and support groups can reduce stress in caregivers of people with dementia. This evidence is strongest for face-to-face or telephone assistance that is targeted at caregivers with depression and tailored to the individual and their circumstances. If caregivers can learn how to respond to persons with dementia, and understand the signs of depression and anxiety in themselves, they are much better prepared for day-to-day changes that are inevitable.

Caregiver burnout is a state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude – from positive, and caring to negative and unconcerned.  Burnout can occur when caregivers don’t get the help they need, or they try to do more than they are able, either physically or financially.

Symptoms may include fatigue, stress, anxiety, depression, withdrawal from family and friends, loss of interest in hobbies or activities, feeling irritable, hopeless and helpless, change in appetite, weight or both, changes in sleep patterns, getting sick more often, excessive use of alcohol or medications, and even feelings of wanting to hurt yourself or the person you are caring for.

Factors that lead to caregiver burnout include role confusion, unrealistic expectations of yourself or others, lack of control, unreasonable demands and lack of caregiver education.

If you or a loved one has signs of caregiver burnout, please seek a support group or counselor as soon as possible.  The snowball or domino effect of burnout can have many detrimental effects on care partners and their families.

If you would like a list of Symptoms of Caregiver Burnout, please contact us and we will send you this list, which we suggest you tape on your bathroom mirror to remind yourself of what to watch for.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  

http://www.AGEucate.com

For 24/7 hotline contact ww.alz.org

Faith Community, Family Caregiver, Senior Care Professionals

How Caregivers can Deal with Anticipatory Grief

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Anticipatory grief refers to a grief reaction that occurs before an impending loss. Typically, the impending loss is a death of someone close due to illness but it can also be experienced by dying individuals themselves.

I dealt with anticipatory grief with both of my parents, and this often happens with long illnesses.  I’ve coached many caregivers through the years on recognizing and responding to this grief, especially for those caring for someone with chronic illness, or neurological illness such as dementia, Parkinson’s Disease, MS, Huntington’s Disease and others.  It’s very important that caregivers understand this grief and have tools to cope.

Although we most often think of grief as something that happens after a death, it often begins long before death arrives.  Many times this grief carries similar symptoms of regular grief (after a person passed).  These symptoms often include sadness, anger, isolation, forgetfulness, and depression.  What complicates anticipatory grief is the fact that it is often coupled with caregiver’s stress and exhaustion.   This can bring on overwhelming anxiety, fear and quickly snowball into physical, emotional and spiritual challenges for caregivers and families.

Anticipatory grief encompasses the loss of a person’s abilities and independence, loss of cognition, hope, future dreams,  and loss of identity for both care partners.   Anticipatory grief can last a long time, as with chronic illness of a loved one, thus the reason caregivers often become overwhelmed and simply exhausted from the lingering feelings mentioned above.

Here are a few tips on how I dealt with anticipatory grief and coached others along their journey as well:

  1. Feelings attached to anticipatory grief are normal  Like normal grief, you must allow yourself to experience the different emotions that come with it so that you can move on to acceptance.
  2. Remember you are not alone!  Reach out to others who are walking your path.  Support groups often provide vital links for people to share with others openly and honestly.
  3. Accept your loss. Although it’s not easy and you may need to spend time talking with others, reading, journaling or other means where you can express yourself, ultimately as caregivers we must face and accept that no matter how much you would like to change a situation, it is what it is.  You will give yourself a gift by going through this process of acceptance.
  4. Remember that death is a part of life and that because you are grieving does not mean special moments and memory-making is gone.  Quite the contrary… you may find that by reframing your thoughts and accepting that every moment is even more precious, you will gain so much more in return by truly living in the moment with your loved one.
  5. Everyone grieves differently and accept that your grief will be different than other family members and friends.  Accept that the journey of grief is everyone’s own walk and we should be as accepting of others and our own.  In other words, this is a time to walk with grace.
  6. Be intentional about caring for yourself.  This might mean extra time allotted to meditation, prayer, exercise, journal-writing, reading of whatever it is that feeds your soul.
  7. Reach out to others, even when it’s the last thing you want to do.  Maintaining your relationships and connections is the healthiest antidote to cycling into isolation.
  8. Be mindful that when your loved one dies, feelings of relief are normal, but this does not mean that you will also not experience grief again.  It will be different grief but certainly will come with many of the emotions felt during anticipatory grief.
  9. Your best gift may be to reach out to others who are experiencing anticipatory grief.  Giving when you feel you have none more to give is often the best medicine.
  10. Practice the art of gratitude for the ups and downs, joys and challenges.  Illness and death certainly bring soul-pain, but can also open up avenues for deep personal growth and strength.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who serve them.  A long-time caregiver herself, Pam has inspired thousands of caregivers with education, support, and wisdom.

http://www.AGEucate.com