June 15, 2005

The newsletter for all elder caregivers. Sent twice a month, and only by request. You are welcome to pass on Elder CareTips™ to anyone you think might be interested. You'll find information about how to get your personal subscription below.

This Sounds Interesting

Athena Research Marketing has been hired to conduct a survey of caregivers or people with multiple sclerosis, traumatic brain injury, stroke, Alzheimer's disease or another form of dementia who find themselves uncontrollably crying or laughing, very easily or for no reason at all.

You will receive a $50 American Express gift certificate in exchange for qualifying and completing this survey.

If you feel that you are eligible to participate in this survey, call (800) 322.4499 anytime from 10:00 AM to 8:00 PM (EDT) Monday through Thursday, or 10:00 AM to 5:00 PM (EDT) Friday. Identify yourself as part of the "COVANCE SURVEY" and you will be connected directly to a study representative who will verify your eligibility for the survey.

At no time will your name be shared with any third party. All information provided will be maintained in the strictest confidence.

If you'd like to participate, call as soon as possible before July 20, as participation in this survey will be limited.

Please, Please, Take Me Home

A lot of older folks with confusion go through a stage of "wanting to go home." No matter how often they're told they are at home, they don't seem to recognize it as home. No matter how poor their memory, the desire to "go home" crops up over and over, and there's no diverting it.

No one can really get inside the thoughts and emotions of someone with medium to later stages of a dementing illness. The experts are probably getting fairly close to the truth when they say the present is becoming more and more strange, unfamiliar and frightening.

The desire to go home is probably the same desire you or I would have if we found ourselves in a strange and unreasonable place. We would want to go back to the home we remember as safe, secure, and predictable. For the dementia patient this home is most often the home of their childhood, where they were surrounded by their parents and other loved ones. These are the people they remember most clearly, as their more recent memories are slowly eaten away.

The "home" they are usually looking for isn't any particular house. Many would not recognize the house if you took them there. It's the lost feelings of warmth, security, strength and optimism of childhood and youth that they seem to yearn for.

So what do you do when the person you care for is obsessed with wanting to go home?

First, try not to argue about whether your loved one is "home." If he or she doesn't recognize it as "home" at that moment, then for that moment it isn't home.

Then, try diversion. Sometimes it actually works. Try going out for a short walk, or a drive. There's a real chance that, on coming back in the door, it may look like home again. For a while.

Other diversions might be the chores that have to be finished before doing anything else. Try to engage your loved one in drying dishes, folding towels, dusting, making a sandwich or tearing coupons from the paper. Often the engaged person will forget about going home for a time.

Keep a photograph album handy for a diverting conversation. Sometimes looking at pictures from their childhood and being given the chance to reminisce will ease a feeling of anxiety. Avoid asking questions about the picture or the past. Try to make comments: "That looks like Uncle Harold. Grandmother told me about the time he...."

A reassuring hug while you're doing these things can't hurt. A neck rub or a back massage can be relaxing, reassuring and diverting. We almost all like to be touched in these ways.

Put those things that are reminders about going home out of sight. Hats, coats and purses can trigger the idea of going home.

Sometimes the sight of the family car can trigger the need to leave. If this is the case, try parking it out of sight. If you must park on the street, ask the neighbor a few houses down if you can park there.

If your elder is constantly bound and determined to go home, one of the first things you must do is take precautions against him or her wandering outside alone when you aren't looking. Door alarms or deadbolts placed high on the frame can reduce the chance of wandering. Even if your elder has never wandered, and you don't think it's a danger, secure your doors if he or she is ambulatory. The first time could be the last deadly time.

Keep a log. You might find that certain times of the day are worse than others. What is the common denominator about these times? Is it near mealtimes (a snack might help). Is it during times when the environment is noisier than usual? Is it later in the day when shadows are creeping in? If you see a pattern, you can take steps to lessen or avoid some of the triggers.

Routine is your friend. As much as possible try to do the same thing at the same time of day, every day. The person with dementia doesn't manage "spontaneous" very well, as that usually demands a flexibility they no longer have. The need for the safety of routine is why you will see the same thing, at the same time, every single day on the activity chart in an Alzheimer's residence. Sameness and predictability are reassuring.

Wanting to go home is one of the most frustrating behaviors for caregivers. It will eventually pass. In the meantime, if all else fails, and as a last resort, ask the doctor about medications for reducing anxiety. They can help immensely.

Letters To God

Dear God,
I read the bible.
What does beget mean?

Nobody will tell me.

Love, Alison

Elder CareTip

Some pills can be really hard to swallow, so ask your doctor or pharmacist if it would be safe to grind it up and combine it with food. If they say this would *not* be a good idea, try using a fruit nectar instead of water. The thicker liquid is easier to swallow. Or put the pill in a spoonful of applesauce, pudding or honey.

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If you've got a Reader Tip you'd like to share, please send it to molly@eldercareteam.com with the subject line "care tip."

Let me know if I can use your name. Or if you'd rather have me leave your name off, that's OK, too.

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Start living now. Stop saving the good china for that special occasion. Stop withholding your love until that special personmaterializes. Every day you are alive is a special occasion.

Mary Manin Morrissey

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The air conditioner went out on Saturday. Now, unless you live in Texas or another of the hotter 'n hot states this might not sound like anything to whine about. Let me tell you, I felt personally entitled to a whole lot of whining. Of course, the silly thing croaked it's last at 10:00 on a Saturday morning. You probably know exactly how much luck we had finding someone to come fix it over the weekend.

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Even the poor cat was comatose.

And why do I think my uncomfortable weekend is worthy of your attention? Because if I had been your elder my life might really have been threatened, instead of just miserable. Older folks' bodies don't regulate extreme temperatures well. Older folks don't always know when they should be drinking more water.

This is the time of year when we're going to start to see news stories about older people who died during a heat wave.

Please make sure that your elder has working fans in the house, as well as a recently-serviced air conditioner. Be sure that there is extra bottled water in the house, just in case. Check on your older neighbors, too, if you haven't seen them and the temperatures get excessive.

And if you can, please buy a fan on your next trip to the store. Donate it to one of the local organizations that distributes fans to the elderly. It will cost you very little, and you may literally save someone's life.

'Till next time,

Don't keep us a secret. If you know other people who should be reading this too, then do them and us a favor by telling them about Elder CareTips™. Just send them this link: http://eldercareteam.com/resources/newsletter.htm

© 2005 Molly Shomer, All rights reserved. You are free to use material from Elder CareTips: Mastering The Eldercare Maze™ as long as you include complete attribution, including live web site link and email link. I would appreciate it if you would let me know where the material will appear.

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