Promote Physical

Focus point 3: People with dementia can live safely and be as independent as possible in settings that promote physical, mental/intellectual, emotional, social and spiritual wellness.

Physical: You don’t need a great memory to enjoy yourself. Each day, there are many things that provide us with purpose and pleasure. A person with dementia still needs a good quality of life, but without some assistance from families and caregivers, it is much more difficult for them to achieve purpose and pleasure. There are many ways to plan and provide appropriate activities for people with dementia.
Ideally, activities should: compensate for lost abilities, promote self-esteem, maintain residual skills and not involve new learning, provide an opportunity for enjoyment, pleasure and social contact, be sensitive to the person’s cultural background.

A person with Alzheimer’s disease gains the same kind of benefits from regular exercise as anyone else, including improved cardiovascular fitness, strength and endurance. Always talk with the person’s doctor about their exercise program or before starting on any new exercise program. Exercise can give many health benefits including:

·         improved mood

·         better sleep

·         reduced likelihood of constipation

·         maintenance of motor skills

·         reduced risk of falls because of improved strength and balance

·         reduced rate of disease-associated mental decline

·         improved memory

·         improved behavior, such as reduced rate of wandering, swearing and acting aggressively

·         better communication and social skills.

Home Safety Part 3

Step 7. Check the kitchen. 

• Dementia can dull sensitivity to temperature. Consider automatic temperature-controlled water faucets.
• Install an automatic device to turn off the stove after a set period of time if no movement is detected.

• Unplug the microwave.
• Make food easy to find and reach. Climbing on step stools, chairs or counters is risky for people with dementia.
• Store knives and electric appliances in a cabinet with a childproof lock.

Step 8. Check the den/home office.

• Wheeled swivel chairs can be a danger. 
• Make sure bookshelves are anchored to walls.

Step 9. Go outside.

• A fenced-in yard will allow your family member to go outside. Make sure gates lock.
• Look for and remove hazards.
• Light pathways and steps. 
• Keep walkways and patios clear of fallen leaves and branches, ice and snow. Corral any toys. 
• Keep the grill locked and covered when not in use.
• If you have a swimming pool, fence it in separately, and keep the gate locked.
• Consider an automatic rolling pool cover that is made to withstand the weight of people and lock in place. Use the cover whenever the pool is not monitored by someone capable of rescuing a nonswimmer — even if you’ll just be gone a few minutes.
• If you have an above-ground pool, a pull-up and locking ladder is a must. Make sure it is properly installed.
• Use a pool alarm with an electric sensor that will trip a loud, pulsating alarm — outside and in the house — when anyone enters the water. The alarm uses an on-off key.
• Handrails and stairway rails help avoid slipping on stairs and steps.

Home Safety Part 2

Step 4. Inspect each room.

People with dementia have an easier time deciphering a room when the walls are painted in a pale color that reflects light and contrasts with the floor. Also note:

• Busy wallpaper patterns can be confusing.
• Wall mirrors, especially large ones, can make the room harder to process. It’s difficult to separate what’s real from the reflection — which can cause confusion, fear and anxiety.
• Slippery throw rugs, curled edges on carpets, footstools and toys can be stumbling blocks for your loved one. Scan the floor. Put a rubber-backed rug in a single bright color in front of doors to help the person recognize that they are at the entrance.  (A dark rug can be seen as a hole in the floor.)
• Clutter is confusing. You see your collectibles as charming; people with dementia see them as a visual hodgepodge. The stuff of everyday living — stacks of papers, books, mugs, loose change, pictures, a laptop — make it hard to decipher the room. A minimalist look works best for those with dementia.
• Strong, low-glare lighting and sensor night-lights will help your family member with visual perception and physical coordination. Arrange lights to prevent or minimize shadows.

• Visual and perceptual impairments can make glass doors seem like open space. Put stickers, bright tape or removable wall decals on patio doors.

Step 5. Inspect the bathroom.

• Consider removing locks from bathroom doors to prevent your loved one from getting locked in or locking you out.
• Water can make tile or linoleum slippery. Use large nonskid bathmats.
• Install grab bars. An occupational, physical or certified aging-in-place therapist can best evaluate your loved one's needs and suggest placement of safety grab bars. (If your loved one’s doctor orders a consultation, see if health insurance will cover the cost). Many grab bars are designed to also serve as towel bars, toilet paper holders and in-shower shelves.
• Ensure that outlets in the bathroom have a ground fault circuit interrupter (GFCI) or are protected by a GFCI circuit so they will shut off if they get wet.
• Install temperature-controlled water faucets to avoid scalding.

• Put medicines in a lockbox and block access to cleaning supplies and razors. You may want to switch to a cordless electric shaver.
• Does your family member need a raised toilet seat? A shower chair?
• If you are installing a new bathroom for your family member, use a frameless walk-in shower with a sloped floor instead of a step-over threshold.

Step 6. Focus on bedrooms.

• You may want to put a lock on your bedroom door and keep your personal and potentially dangerous items out of your loved one’s reach.
• Take the lock off your loved one’s door to be certain that no one is locked in or out.
• An audio monitor between the two rooms will let you hear if your loved one is out of bed or calling for help.

Safety at Home

Focus point 3: People with dementia can live safely and be as independent as possible in settings that promote physical, mental/intellectual, emotional, social and spiritual wellness.

If your loved one has dementia, you’ll need to make the conventional home modifications an older person needs — and a great many others. People with Alzheimer’s disease or other forms of dementia literally see the world in a new, often confusing way. Everyday things can be frightening — an oil spot can be perceived as a hole, shadows may be seen as sinister beings, a “stranger" may appear in the mirror. Making a home safe and easier to navigate is a multipart process.

Step 1. Contact your local Area Agency on Aging and the Alzheimer's Association. They can give guidance and can usually recommend local aging life care experts, occupational or physical therapists, geriatric care managers or aging care experts and certified aging-in-place specialists who can come to your home and advise on safety issues.

Step 2. Take a tour of your own house, looking at it from your loved one’s compromised point of view. Dementia affects cognitive abilities, depth perception, balance, coordination, memory and strength. People with the disease have difficulty understanding instructions, accurately interpreting the world around them and making sound choices. Even if your loved one is still managing well, prepare your house for the future, ideally before moving day. People with dementia take more time to adjust and may not be able to adapt to a changed environment. Little things — like rearranging the furniture — can seem sudden and unsettling. Big changes like redecorating can be alarming. 

Step 3. Print out the AARP checklist for home safety. Start in the front yard. Make a to-do list as you go.

• Mark edges of steps with neon, glow-in-the-dark tape.
• Repair cracked pavement and uneven bricks. Steppingstones are a tripping point unless they are flush with the ground.
• Clear the walkway. Get in the habit of removing slip-and-fall hazards: leaves, snow, ice, moss, the garden hose. Relocate bikes, toys, balls, chalk, jump ropes, garden gnomes and lawn ornaments. Trade thick welcome mats for thin, rubber-backed mats with edges flush with the ground. For people with dementia, a cluttered path is like being bombarded with too much information; they are unable to weed out the unimportant bits.
• Look again after dark. Spotty lighting can create shadows, which can be perceived as deep holes or edges that must be stepped over or around. Some people with dementia see shadows as burglars, demons or dangerous animals. Well-placed, bright outdoor lighting can prevent falls, anxiety and fear.

AARP Checklist - https://assets.aarp.org/external_sites/caregiving/checklists/checklist_homeSafety.html

Wandering how to help

Tips to prevent wandering -

Wandering can happen, even if you are the most diligent of caregivers. Use the following strategies to help lower the chances:

• Carry out daily activities. Having a routine can provide structure. Learn about creating a daily plan.
• Identify the most likely times of day that wandering may occur. Plan activities at that time. Activities and exercise can reduce anxiety, agitation and restlessness.
• Reassure the person if he or she feels lost, abandoned or disoriented. If the person with dementia wants to leave to "go home" or "go to work," use communication focused on exploration and validation. Refrain from correcting the person. For example, "We are staying here tonight. We are safe and I'll be with you. We can go home in the morning after a good night's rest."
• Ensure all basic needs are met. Has the person gone to the bathroom? Is he or she thirsty or hungry?
• Avoid busy places that are confusing and can cause disorientation. This could be a shopping malls, grocery stores or other busy venues.
• Place locks out of the line of sight. Install either high or low on exterior doors, and consider placing slide bolts at the top or bottom.
• Use devices that signal when a door or window is opened. This can be as simple as a bell placed above a door or as sophisticated as an electronic home alarm.
• Provide supervision. Do not leave someone with dementia unsupervised in new or changed surroundings. Never lock a person in at home or leave him or her in a car alone.
• Keep car keys out of sight. If the person is no longer driving, remove access to car keys — a person with dementia may not just wander by foot. The person may forget that he or she can no longer drive. If the person is still able to drive, consider using a GPS device to help if they get lost.

Dementia Safety and Wandering

At our Organizing workgroup meeting we discussed focusing on 3 of the characteristics of dementia friendly communities. Previously in the blog, I have discussed focus 1 and 2. Now, point 3: People with dementia can live safely and be as independent as possible in settings that promote physical, mental/intellectual, emotional, social and spiritual wellness. I'll break this into 6 sections. Safety is a critical step in the "second stage" of dementia (using the 3 stage analysis: mild, medium, severe).

Before discussing Safety, I need to define "wandering". Wandering, in people with dementia, is a common behavior that can cause great risk for the person and is often the major priority (and concern) for caregivers. It is estimated to be the most common form of disruption from people with dementia. Even in the early stages of dementia, a person can become disoriented or confused for a period of time. Warning signs someone with dementia is wandering include  

• Returns from a regular walk or drive later than usual
• Forgets how to get to familiar places.
• Talks about fulfilling former obligations, such as going to work
• Tries or wants to "go home," even when at home
• Is restless, paces or makes repetitive movements
• Has difficulty locating familiar places like the bathroom, bedroom or dining room
• Asks the whereabouts of past friends and family
• Acts as if doing a hobby or chore, but nothing gets done (e.g., moves around pots and dirt without actually planting anything)
• Acts nervous or anxious in crowded areas, such as shopping malls or restaurants.

Getting Your Affairs in Order

National Institute on Aging: For Caregivers You may have some extra time at home due to social distancing. Use it to get your important papers in order. The specific list of documents will vary from family to family, but here are some examples of personal and financial records to put together: Personal Records Full legal name, Social Security number, and date and place of birth Location of birth and death certificates and certificates of marriage, divorce, citizenship, or adoption Names and phone numbers of close friends, relatives, doctors, lawyers, and financial advisors Current medications  (be sure to update this regularly) Location of living will and other legal documents Financial Records Sources of income and assets (pension from your employer, IRAs, 401(k)s, interest, etc.) Social Security and Medicare/Medicaid information Insurance information (life, health, long-term care, home, car) with policy numbers and agents' names and phone numbers Names of your banks, account numbers (checking, savings, credit union), and safety deposit box information Investment income (stocks, bonds, property) and stockbrokers' names and phone numbers Copy of most recent income tax return Liabilities, including property tax, mortgages, and other debts— what is owed, to whom, and when payments are due     What kinds of papers should you collect while getting your affairs in order? The National Institute on Aging has a place to start! Check out these lists of personal and financial documents to pull together: https://www.nia.nih.gov/health/getting-your-affairs-order#important-papers

Community Resources

COMMUNITY RESOURCES RESEARCHED DURING COVID-19

Updated Friday, 03/20/2020

2-1-1 - Texas Social Services Hotline For COVID-19 Information and Referrals

Texas Health and Human Services encourages all Texans in need of COVID-19 information and referrals to community resources to call the 2-1-1 Texas hotline 24 hours a day, 7 days a week.

Texans, no matter where they live, can dial 2-1-1 or (877) 541-7905 and select option 6 to get information and referrals to COVID-19 social services, including testing, community clinics, unemployment benefits and more.

For general health-related information and precautions on COVID-19, visit the DSHS website and the CDC page.

Stay up-to-date on the latest news and updates impacting HHS services and regulated providers by visiting the HHS COVID-19 page.

For more information on the state hotline, visit 211texas.org.

 

 

H-E-B - Beginning on Friday, March 20, seniors across Texas, age 60 and older call

Senior Support Line,  1-833-397-0080- -from 9 a.m. to 1 p.m., seven days a week. same-day service -seniors will be able to place orders with Favor using a curated list of products available from H-E-B  in partnership with Favor Delivery,  simple, low-cost solution that gives seniors access to their very own personal shopper by phone, allowing them to get essential food and supplies delivered to them, while remaining in the comfort and safety of their home. “To further promote social distancing, Runners will leave all orders placed through the Senior Support Line at the customer’s doorstep, eliminating close personal interaction.”               

All delivery and service fees are waived for the first 30 days of the program. Further helping Texans, orders will include a $10 tip, which goes entirely to the Favor Runner, who will personally shop and deliver items.

H-E-B and Favor will staff its Senior Support phone line with volunteers from both companies to accept and process orders over the phone . Built by the Favor engineering team, this system allows our company volunteers to process orders remotely from across the state. Seniors can also place their orders on Favor’s website, or by downloading the Favor app and searching for “H-E-B”.

To start, the Senior Shopping Support Line will be available from more than 240 H-E-B locations where Favor operates, with plans to quickly expand this service.                              To find out more about the program, visit favordelivery.com/senior.

VETERAN SERVICES- RE: Food Items for Homebound Veterans                                                                    J.J. De La Cerda

Sgt., USMC

Director of Veterans Services / Veterans Service Officer

602 N. Staples, Suite 180

Corpus Christi, Texas 78401

Phone: (361) 888-0820

Fax: (361) 888-0818

Juan.DeLaCerda@nuecesco.com

If you have a homebound veteran in your organization that needs help with food, kindly send me their Name, Address, and Phone number. I will compile a list and submit it to the food bank to get them help ASAP. At this time, this is only for Homebound Coastal Bend veterans. The faster I get this information, the faster we can get the food to the veteran.

 

This was put together by Sylvia Alvarado AAA/ADRC Options Counselor