2008-08-22 / Columnists

Spotlight On Elderlaw

Living And Coping With Dementia
Commentary By Nancy J. Brady, RN, Esq. And Linda Faith Marshak, Esq.

As attorneys with many clients who are elderly, we frequently encounter couples and families who live with someone with dementia. This month we decided to write about some of the things we have learned from them.

Learn to accept the disease. Loved ones with dementia often do or say things that can make others anxious or embarrassed. Don't keep the disease a secret - there should be no shame involved. If your loved one offends anyone, simply smile and explain, "He's got dementia." Learn to identify situations that trigger outbursts, and avoid them if possible. If you can't manage to avoid an outburst, try your best to distract your loved one. Sometimes it's best just to validate his or her feelings rather than try to rationalize with him or her, which may be frustrating to both of you, and allow the outburst to escalate.

The most important consideration is the safety of the loved one. People with Alzheimer's disease, or dementia, often take shuffling steps, and therefore trip and fall. Remove all throw rugs and electrical cords, and make sure good footwear is worn at all times. Have railings and grab bars installed, especially in bathrooms and on stairways. Increase lighting throughout the home, including night lights if the loved one wanders during the night. Block exits and stairways only if other family members are present to remove the blocks if there is an emergency. Place all medications, insecticides and cleaning products out of reach and secure them away at all times.

Many of our clients use day care programs - and love them. The day programs serve two purposes - activities and socialization for the individual with dementia, as well as a break for the caregiver. Our clients that use day programs attend them for three to five days a week. Once they started using the programs, they say, they don't know how they managed without them. The time apart is good for the self esteem of the loved one with dementia, as well as a "battery charger" for the caregiver.

Try to keep the loved one with dementia involved in as many daily activities and routines as possible. One client told us he wants his wife, who has Alzheimer's disease, to believe that she is taking care of him. He does his best each day to allow her to do as many chores as she can without his help, but he is always nearby to remind her when she forgets certain parts of the tasks. Another client's husband walks to a friend's home each day by himself, and they go to the gym together - she calls ahead when her husband leaves the house, and the friend calls when he arrives. They plan to continue this routine as long as it is safe.

For those with mildly impaired memories, measures should be taken to minimize the fear and frustration of memory loss. Keep a list of important numbers near the telephone. Place a hook or basket near the door so that keys and glasses can be placed in the same place each day, and not misplaced. Hang a large calendar near the phone, and fill in important occasions and appointments on it. Encourage your loved ones to read the newspaper and watch the news to keep current with events.

Arrange frequent visits with younger family members, and grandchildren to avoid isolation and maintain socialization. Offer your assistance at regular intervals. Your loved one may be too embarrassed to ask for your help, but may accept it gratefully if offered.

Many families we see fear that their loved one with dementia will be offended if they ask to help with finances, bill paying or other chores, but are pleasantly surprised when the loved one with memory loss seems relieved to have the assistance.

Finally, make sure to have the appropriate documents in place before your loved one is incapable of comprehending and executing them.

The Power of Attorney and Health Care Proxy are two forms that may serve to avoid Guardianship proceedings should the memory impairment progress to a point where the individual is incapable of managing his or her own affairs.

Ms. Brady and Ms. Marshak can be reached at 718-945- 7777 or 516-829-8265.

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