Sunday, May 24, 2020

Routines for those affected by Alzheimer’s and Dementia

We all have routines, without them, our lives will be chaos and would cause extreme anxiety. It is very important to establish a routine when one becomes retired. I believe that it is the key to avoid depression. Although if you have been clinically diagnosed with Depression, then that is another situation altogether. When older adults retire, some of them find themselves with a huge void in their lives. suddenly they don't have to get up in the morning and run out of the house.
It would be ideal if we could retire gradually. I used to work with two nurses that when I joined the team they were a few years from retiring. Which meant they worked part-time. That time off helped them find another way to occupy their day. They volunteered, which let me tell you I love older volunteers because usually, they don't require a lot of micromanaging. One of them loved cooking, she started a small catering business with her close friends and family. The other nurse loved gardening, fruits, and vegetables took over her day. That would be ideal to retire gradually. Well only a few fortunate ones have that choice. But for the rest of us, we have to find ways to occupy our days. Establishing a routine early on does not guarantee you that you won’t get depressed, often the people diagnosed with Alzheimer’s disease or Dementia, have a second diagnosis of depression. Keeping occupied will help you ward off depression, we as productive human beings we have a need to keep busy. Learn new things, some colleges offer an Emeritus program with a wide range of subjects, how about adult learning classes?. Volunteer, there are several organizations that would love to have experienced adults help out. I know the title of this blog is “Routines for those affected by Alzheimer’s and Dementia.” keep in mind that you will get older and it would be nice if you keep these suggestions in mind.


Moving forward to the suggestions:

Mornings can be tricky for a person with AD/Dementia. Yes, give them a schedule always listen to their own clock. What do I mean by that? Don’t wake them up from deep slumber! They don’t need to be up at 6:00 a.m.? do they? Let’s contemplate 8:00 a.m.  Always approach them with a positive attitude, a warm smile, a cheerful greeting. Prepare their clothing ahead of time, for those that are in the first stage of the disease always respect their individuality and offer them choices on everything. From clothing to options on what to do, what to eat, drink dessert. For those that are in the second stage present to them with a very positive attitude the items that they will be wearing for the day. It’s all about the sale! You are radiating with that huge contagious smile! If the first thing they see is a big smile, a cheerful attitude that is telling them that they are safe with you. Start telling them about how you prepared a wonderful breakfast and after breakfast we are going to be working out in the garden, or taking a walk, a drive, or to the park. Sell it baby! It’s about making the morning successful. You are preparing for the morning to go as smoothly as possible. Yes, I say the morning because we all know that things might change in a nanosecond and boom, meltdown. I want to share something with you, you will hear me, or read me :) saying this, and trust me it is the hardest thing to learn “NEVER, EVER TAKE THINGS PERSONALLY” remember its the DISEASE! Yes, that is a complicated one to digest! WE know as, my sisters, I and my kids are learning to make this our mantra, it is work in progress.

Morning routine: Breakfast - Clean up - Shores (sweeping is a good exercise) -gardening -going for a walk - putting a puzzle together - music, always put music on, not the one you like! The type that they identify with. Find a time slot in the morning to have a bit of exercise, go for a walk, watch a video on YouTube on fitness for seniors there is a large variety to choose from. Exercising three times a day gives them the opportunity to burn off the extra energy that they have accumulated. As we all know is a fantastic release of stress. Unless they are bedridden everyone needs to get active.

Lunch is the same thing present the options with a lot of enthusiasm, this is when tea time enters the picture for me. I start offering them soothing, calming tea. They don’t care for hot tea that’s okay, a delicious iced brewed tea has the same effect. Don’t’ care for tea at all, that is ok.
Get creative and mix it with their favorite juice, coffee even their favorite soda. I like to use calming teas throughout the day.  Keep offering liquids throughout the day, a preventing UTI should be on your to-do list along with everything else that is important for the care of the patient. What is UTI? Urinary tract infection is very common among women but men are also
Susceptible to this. It usually occurs in the bladder, kidneys, or urethra. This is a whole other subject which I will cover in the future. Let’s refocus on the subject at hand, Lunch!
 We have to be careful here, I usually start limiting liquids around 4 p.m. why? Because we are getting closer to bedtime, and the last thing you want is to find a soaking bed in the morning or even worst, getting up in the middle of the night and finding that they have fallen, because they needed to go to the bathroom. Going back to our lunch subject, I know I keep getting sidetracked. If possible keep them involved in the process of preparing lunch. Simple tasks as setting the table, afterward they can clean and help put the dishes away. By keeping them involved you are giving them a sense of purpose, productivity and leaves them with a sense of accomplishment.

Lunch routine: Again keeping them involved in the process of preparing the food items. Or setting the table. After eating offer some sort of physical activity. Usually a visit to the bathroom at this time is needed. At this time of the day, it is important to keep them engaged in a project.
For the ladies it can be a variety of things, such as folding clothes, knitting. for the men anything having to do with gardening, polishing, arranging. Always be mindful of the stage of the disease that they are in, be very aware of their abilities to accomplish the projects at hand. You would not want to set yourself up for a major meltdown, because the project was just too daunting for them. At this time of the day, you have to keep in mind that if they take behavioral medications,
They should be given half an hour before they are prescribed to be given. You don’t want to be trying to medicate in the middle of a full sundowning episode! That is just a mission impossible.
Always aim to give the medication for pain and for behaviors half an hour before its needed, that is the time frame that it takes for it to start being effective. I learned that from the nurses that I worked with, now mind you it wasn’t effective all of the time, I would say 80 percent to the time.


Dinner time: following the same pattern already established for the morning and the afternoon.
Keeping them engaged, positive attitude, and exercise. You have to find out what works for the person you care for, Pay attention to what they like, to how they respond to things and situations
That is key, pay attention to their physical, emotional cues, and body language, read their body language. Some people are embarrassed to ask to go to the bathroom, when they need to go they start to fidget, don’t wait for a messy cleanup. It’s all about prevention! Establish a routine for bathroom visits. Again at this time of the day be mindful of the timing of the medications, half an hour before they are prescribed, let’s remember it takes half an hour for our bodies to absorb it and get the benefits from the medications. At this time of the day you have limited the liquid intake. I’m not saying don’t give them anything to drink, just limit the ounces given.

Having a routine for a person with Alzheimer’s or dementia is vital for successful quality of life.
Progression of the disease is inevitable, keeping that in mind all of the activities should be presented to the individual keeping their abilities in mind. Having in place a good support system, between family, Caregiver, Primary Physician, and neurologist you will have built a good foundation for the proper care of the individual. If you add to this foundation an array of activities that promote, social, emotional, and physical engagement and you will create a good environment that will provide the individual with excellent opportunities to feel supported, loved, and productive. Did you notice how I changed my wording to “Individual”?  When we care for a person, it doesn’t matter their diagnosis we have to focus on the individual needs of that person.
We are all unique, different needs, different likes, and dislikes. Take the time to figure out the behavioral triggers for the individual not just what upsets them, so you can avoid those pitfalls, but what makes them smile or puts them in a good mood. put on your detective hat and try to figure them out. When you have gained that insight you will be empowered to provide the best care possible for them. It's not an easy road, it's full of bumps along the way. We will travel it together.


Don’t forget to breathe, hit a cardboard box, cry if you must, don’t keep it inside as it will make you resentful and will zap the light out of you.

I send you lots of positive virtual energy.
As always please send me your feedback.


With gratitude-
A,