A Caregiver’s Journey

  My mother-in-law is in her 9th year of Alzheimer’s - there are now days when she doesn’t know my husband, her only child.  Very painful to watch.  I continue to try to speak to small groups, and find that there are so many caregivers who are bearing their burdens alone, and it doesn’t have to be!  There are 50 million of us in the U.S.!  Join me as we share ideas and support!!  I have found that www.alz.org and www.aarp.org are two of the best websites for information.  I have a list of several others to post this week for those who may be interested…

I just read an interesting article about predicting Alzheimer’s Disease AD).  The online version can be found at http://jgp.sageppub.com/cgi/content/abstract/18/4/192.  Check it out.  It explores such things as hormone replacement therapy, reduction of inflammation by taking aspirin (nonsteroidal anti-inflammatory drugs) and the effect of depression on increased risk of AD development.  Good article.

Did you know that one out of every 3 people age 65 and over have at least one chronic disability, i.e., hypertension, high blood pressure, diabetes, etc.  Some of these conditions can be controlled through proper diet and exercise.  Your thoughts?

Visited my mother-in-law today with AD - her disease is progressing.  She is wheeling herself around the assisted living facility and eating all of the fresh fruit set around in bowls for the residents, then leaving apple cores and orange peels in the floor.  Later, she becomes sick with what she has eaten.  They have told us that it won’t be long before they have to move her to the dementia ward.  The goal at this facility is to keep them in their rooms and out of the dementia ward as long as possible, and they have indeed tried. She didn’t know me today - her daughter-in-law of over 25 years…how terribly sad for all of us…you feel so alone in this, yet you know that you are not…

Check out the Administration on Aging’s website at www.aoa.gov.

Also, for a profile of older Americans, go to this link:  http://www.aoa.gov/AoAroot/Aging_Statistics/Profile/index.aspx

Here is a great website for you to check out.  Excellent source of information! http://www.aarp.org/family/caregiving

A visit to my mother-in-law.  She is totally different from the day before - chatty, engaging.  This disease is so incredibly strange.  For those of you who have a loved one with Alzheimer’s, be sure you go to www.alz.org - there is a lot of information there that can help you.  Also, if you need to find a facility for your mom or dad, be sure to consult the section of my book on finding an assisted living facility.  The first time I had to find one, I only knew to ask availability and rental costs.  It is amazing the things that I did not know to ask that came back to haunt me later!!!  Staff ratios, for example, are important - how many staff do they have relative to the number of residents?  Who is on the floor at night?  What is their training?  Is there a resident registered nurse on the premises or on-call during the day?  What training does the facility’s administrator have?  Is he or she licensed?  Who administers medications?  What is their training?  What records are maintained on each resident and where are they secured????   www.caregiving-elderly.com

If your elderly spouse, mom or dad exhibits signs of confusion or behavioral changes that otherwise can’t be explained, have a urinalysis ordered to find out if they have a urinary tract infection.  My mother-in-law has Alzheimer’s, but every time she exhibits a profound change in behavior, we have her checked for a urinary tract infection.  She has walked down the hall almost naked, wheeled around in her wheelchair eating all of the community fruit and throwing apple cores around the hallways of her assisted living facility.  Although this indeed is related to her Alzheimer’s, her UTI just makes her symptoms worse.  We had her checked for a UTI this past week and sure enough, the results were positive - she has a urinary infection.  Often the elderly don’t have the same symptoms of pain and burning that you and I might have.  They may exhibit strange behavior or confusion!!

As I mentioned in my last post, urinary tract infections (UTIs) among the elderly can cause mental confusion.  Often the elderly don’t experience the same symptoms that you or I might have, e.g., pain or burning.  Every single time we notice a precipitous drop in my mother-in-law’s mental state, we have her tested for a UTI, and each time, the results have been positive.  The infection is generally treated with an antibiotic such as Cipro.  So insist on a urinalysis if your elderly loved one suddently exhibits behavior that can’t be explained otherwise.  Confusion is a real tell-tale sign.  Also, older adults have less thirst sensitivity, that means that they may not realize that their bodies need water!  They have to stay hydrated!  Make sure that your loved one is drinking enough in the way of fluids, esp. water!  It’s essential.  Lack of hydration can also cause lethargy, fatigue and confusion.  Know what to look for!!!

Do you have an elderly mom or dad or significant other who has been prescribed medication, antibiotics or high blood pressure medication, for example?  Are you sure they are taking what’s been prescribed and in the dosage ordered by their physician?  Here are some tips:  If your loved one is living alone, then place the medications in a pill container that is organized by day of the week, and even time of day.  That way, you can check to make sure that the medication has been taken.  If the pills are in a bottle, and you don’t know whether or not your mom or dad has taken their dose for the day, COUNT the pills - how many are left?  This will only work if you count them on a regular basis, and keep track of the number prescribed vs. the number taken!  Also, often if they do remember, they may take Wednesday’s dosage on Monday, so check the entire pill container before you ask them to take medicine that they may have already taken.  Often the elderly get confused and do not know what day it is, so it is very plausible that they could take Wednesday’s medication on Monday, or…not at all.  Check behind them!!!  If you’re still not sure whether they took the medication or not, just wait until the next dosage time - better than taking the risk of overdosing….

My mother-in-law is mixing up her days and nights.  Last night she was extremely agitated, and the staff at her assisted living facility had to give her an Ativan to settle her down.  This morning my husband went to visit her - she was very subdued, probably still groggy from the Ativan.  I wouldn’t be at all surprised if they move her soon to the dementia, lock-down ward.  89 years old, and she doesn’t know day from night, or night from day.  Thank goodness she is in a facility where staff can tend to her.  I just do not know how families manage when trying to care for their demented loved one at home.  Not only wrestling with their confusion, but their wandering around at night, their often abusive behavior, incontinence, not knowing who you are…sometimes it is just too much to see what this disease of Alzheimer’s does to a loved one.  The phone is ringing - it is the assisted living facility - must go to see what this is all about.

Staff at the assisted living facility found my mother-in-law on the floor in her bedroom.  Of course, she has no recollection of how she got there - we can only conclude that she fell.  Thank goodness an xray of her arm revealed no fractures.  However, if I might add a word about that - often hairline, osteoporotic fractures in the elderly do NOT SHOW ON XRAY.  My mother once fractured her hip and I had an emergency room physician diagnose a urinary tract infection after her xrays were normal.  OMG - my mother couldn’t even stand up.  A trip to another physician and an MRI the next day revealed a fractured hip - a fracture that did not show on the ER’s xray.  She was in surgery immediately….So ask questions, be persistent and proactive - sometimes physicians do not know best - YOU DO….