9 Sep 2007
Dear Readers,
I hope this brings a smile to your face. I was recently conducting a caregiver workshop and made the point that in order to manage behaviors caregivers must change their behaviors - because dementia-affected people cannot change. I also said that lessons we learn from experience attest to this philosophy. The group agreed and one woman volunteered to share her experience. She explained that her husband, who has Alzheimer’s disease, likes to help with household chores. One day she was doing laundry and noticed that all the whites were missing and a garbage bag was sitting in their place. It turned out that her husband set the laundry out at the curb and put the garbage in the laundry room. She said the lesson she learned was “never do laundry on garbage day.”
Dear Mary,
My sister's husband who is 57 has Multiple Sclerosis. He is no longer able to work and they live on his social security disability checks. He has many physical problems and my sister is his sole caregiver. Is there some assistance she can receive for her role as caregiver? Any help would be much appreciated.
Dear Reader,
Like so many people, your sister is caught between a rock and a hard place because of her husband’s age: he is too young for National Family Caregiver Support Program funds that are designated for caregivers of loved ones over age 60, and too old for children’s services. However, there are resources such as the Department of Human Resources Attendant Care Program (410-767-6025) which uses a sliding scale reimbursement system for money spent on caregiving. As most public and non-profit programs, there are specific needs and financial criteria. The National MS Society is a resource for advocacy and support. I contacted them and was told they have respite funds available that can be applied for four times a year. Call the local chapter at 443-641-1200 and ask for Brandy Dorr.
But, the best advice I can give is to have your sister call the Department of Aging and Disabilities (410-222-4464) and request an Adult Evaluation and Review Service (AERS) assessment. A nurse or social worker will visit in the home and direct her to every resource that can meet her and her husband’s needs.
Dear Mary,
I have a question about my mother’s peculiar behavior. She has advanced Alzheimer’s disease and now when I put a plate of food in front of her she plays with it or walks away. It also seems she can’t use a fork or spoon anymore. Is this normal?
Dear Reader,
Your mother’s behavior is common with advanced Alzheimer’s disease. Agnosia and apraxia are the clinical terms used to describe her disabilities. Agnosia renders her incapable of recognizing things, including food, and apraxia makes her unable to use objects appropriately, like eating utensils. She now requires help to eat in order to prevent malnutrition and dehydration. Placing a fork or spoon in her hand and guiding it to the food then to her mouth can trigger the response to eat. She may also be able to mimic your actions while watching you eat. Finger foods are easiest for her to handle and small frequent meals throughout the day instead of three large ones are best. Encourage her to drink with each meal and in between. If these tips do not work, you will need to feed her manually. Be watchful for “pocketing” of food between her gum and cheek. This is a sign that she is not able to swallow well and is at risk for choking. The Alzheimer’s Association provides valuable information about the progression of the disease and how to plan for future needs. The Greater Maryland Chapter can be reached at 1-800-443-2273. Please call them today.
Mary C. Fridley RN, BC
| 