Here are some helpful hints for increasing the food intake of persons with memory impairment:

• Finger foods are very helpful.  As your loved one is walking and pacing in the house give them chicken fingers, carrot sticks, apple slices with peanut butter. Crackers and cream cheese, and small grape tomatoes. Obviously not at the same time??
• Use a Sippy cup with juices for hydration.
• Try to get them to eat with another person who can redirect them when they forget what they are doing. Along with the memory problems comes the inability to focus on the task.
• You may add dry milk to most foods to increase calories.  Use butter, rich breads, scrambled eggs with cheeses and ,mini-burgers with extra eggs and bread crumbs.  Actually think of all the foods that we try to decrease calories and just add to them.  Chocolate milk is good.
• Routine is important and should be maintained when meal planning. Keep your meals to at least 5 each day.

Do try some of these foods and let me know if they are helpful to increase your loved ones’ appetite. Do remember to weigh weekly.

Check back for more recommendations weekly.

Simple tasks such as brushing teeth, combing hair and shaving can be overwhelming for individuals with Alzheimer’s disease and dementias.  Memory impairment makes it difficult to remember how the task is done. They may look at the objects and not know what to do with them.  These tasks also require the skill of sequencing which they can no longer do. The emotions of fear, anxiety, and resistance can sabotage their efforts of accomplishing the tasks.

There are SOLUTIONS to these troublesome tasks. The caregiver should view the task as a new event and work on providing structure and the proper setting conducive to the activity. Boosting the person’s concentration and cooperation is the first step. Making sure that the environment has good lighting, a comfortable temperature, PRIVACY, AND NO INTERRUPTIONS IS MOST IMPORTANT.

Establishing a ROUTINE to do the tasks daily and at the same time is important. Continuing past and familiar activities is comforting.  For instance if the individual is accustomed to going out to   the hairdresser etc. then try to continue that activity. Within the home environment you could have the hairdresser or barber make the visit if going out is to stressful.

Remember that memory impairment makes multi-tasking impossible. Communicating instructions should be simple, identifying one step at a time, in a quiet and friendly manner.  Smiling and using a calm voice is most desirable.

If the grooming tools begin to be difficult to manage making adjustments by using an electric razor or making the toothbrush handle easier to grip will reduce the individual’s frustration.. Keep the tools in good working condition.  Be sure to clean the razor, remove hair from brushes and rinse the toothbrush.

Encourage the individual to do the tasks that he or/ she still have the ability to accomplish.  Please don’t lose patience. For instance, you may have to do part of the task and cue the person to finish the task. You may use visual and or verbal cues to make the activity easier. Maintaining WHAT THE INDIVIDUAL CAN DO IS VERY IMPORTANT TO SUSTAINING HIS OR/HER STRENGTHS AND CONFIDENCE.

Always be realistic with what you expect the person to do.  You may find that over time he or/ she may not continue doing the activity at all. Do not be forceful but always be creative, gentle and kind.  Remember not being able to recall your past nor control your future can be quite alarming.

As performing the tasks begin to fail introduce some new activity that does not require steps nor performance. For example let the individual use cologne or perfume, paint their nails or use dry shampoo. Life and living one’s life needs to be less stressful and calmer. Emotional support sprinkled with laughter and joy goes a long way in making life enjoyable. Eating ice cream instead of sour grapes will allow the individual to feel your concern and caring. Remember life is best lived within loving relationships and not disappointments. Even though the individual cannot perform the task within your timetable he or/she  still has 24 hours in which to get his grooming done. DON’T RUSH.

Brain Aerobics: The Light at the End of the Tunnel

One piece of excellent news in the past year was that brain health seems to be improving among older Americans. A large national survey from the University of Michigan found that over a 10–year-period ending in 2002, memory loss and thinking problems were down significantly among senior aged 70 and up, from 12.2 percent to 8.7 percent.  That’s a change that translates into hundreds of thousands of men and women, though Alzheimer’s is still a top concern for millions worldwide.

Researchers aren’t sure why the decrease in cognitive impairment is occurring, but they suspect that a better educated and more affluent older generation that is less likely to smoke and more likely to eat better and get regular exercise may be helping to keep the brain young.

Here is a list of wellness approaches and prevention facts that may help set the tone for a brain healthy year.

1. Keep socially engaged. Make sure you are going out regularly and keeping up with your family either through e-mail, letters, phone calls and planned reunions. Your friends also need the same attention. Giving attention certainly helps you receive in kind.
2. Eat healthy food, fruits, vegetables, proteins. Practice good nutrition. Understand what is best for your brain. Eat plenty of fish, vegetables and avoid fatty and friend foods. Clogging those veins prevents adequate blood supply to your brain.
3. Keep your immune system healthy. Treat yourself well, get at least 8 hours of sleep daily, and recognize any depression and deal with it with your physician, eat healthy.
4. Lower your blood pressure. Work on taking your BP medicine daily, eat less salt, lose weight if necessary, and exercise regularly.
5. Do brain health and memory activities. Find word puzzles and do them frequently. Play word games such as Scrabble, puzzles, play memory word games, and matching pictures.
6. Physical activity—at least 30 minutes each day. This can be walking, cleaning house, sweeping the carpet, walking the steps, and chair exercises. These 30 minutes can be divided into 10 minute increments.
7. Treat Depression. Prolonged depression and untreated depression places a burden on your brain. It causes memory impairment.
8. Treat pain and chronic pain. Remember medications can cause forgetfulness and problems with ambulation.
9. Play card games. Fish, bridge, matching colors, solitaire and hearts. Play trivia, and how something is the same and different.
10. Establish good relationships that consist of a give and take. Allow yourself time with your friends.
11. Practice being happy and laugh frequently. Read the comics, get books that you enjoy and bring laughter into your life.
12. Stay mentally challenged. Attend adult education classes. Renew your interest in old hobbies. Learn how to do new things. All of these activities demonstrate help you prevent memory loss. Formal lowers the risk of Alzheimer’s.
13. Practice good weight management. Having a thicker middle increases the risk of developing Alzheimer’s’ disease. Belly fat in particular may be bad for the brain.
14. Work at a job which keeps your mind sharp into old age. The more complex the job, the better the memory and thinking skills held up after retirement. Retirement may not be for everyone.
15. Avoid a routine that keeps everything the same. For instance, Drive different ways to the market, friend’s houses’ and the malls.
16. Keep your Cholesterol in check. Keeps TRACK of the numbers. High numbers can create and does increase clogging of veins in the brain.
17. Pass the fish. If you like fish such as tuna, salmon and other types of oily fish may help to lower the risk of memory decline and stroke. Avoid fried fish.
18. Learn the computer. Surf the web for new information and ways of doing new games etc.This helps your brain to be involved in decision –making and complex reasoning.
19. Ask you primary physician to check vitamin levels—Vitamin D and B12, Check your Thyroid functioning.
20. Keep important phone numbers in your memory and on occasion test yourself. Change your pass codes monthly and memorize them and do always keep a cheat sheet.
21. Avoid falls and hitting your head as you age. Make sure your balance is okay and your house is safe. This includes throw rugs being picked up, having grab bars in the bathroom, good lighting and using it. Watch the steps-Highlight with red and yellow tape at the start and finish of the steps. Do not carry too much at one time.
22. Remember memory impairment is not part of normal aging. See your physician and tell him what is going on.
23. Keeping your heart healthy will keep your brain healthy. What is good for the heart is good for the brain.
24. Managing risk factors may delay or prevent cognitive problems later in life.
25. Keep your wellness program going with your physician. Make sure he checks your Vitamin D, B12, Folic Acid, and Thyroid functioning. Dysfunction in any of these areas can cause memory problems.

Nursing Homes Not The Only Option

Paul is an 86 year old man who was in a nursing home and wanted to go home.  His only living relatives were cousins who lived in the South. When Paul was able to be discharged, his cousins were referred to Ivory House by the staff of the nursing home. A geriatric care manager went to the nursing home to meet Paul and complete a needs assessment.  She felt that Ivory House would be able to care for Paul in his own home.  In preparation for discharge, the care manager made arrangements for aides to care for Paul while he was still in the nursing home. This provided a period of adjustment for Paul to begin to know the individual aides who would care for him in his home.

Paul lived in a very large home three story stone home.  Inside were various antiques he had collected through the years.  When the care manager first entered the home she noticed the paintings, some with calligraphy, which hung on all the walls. She thought some well known artist had painted them.  Paul’s cousin told her that Paul had done all the paintings and calligraphy but, due to his poor eyesight, could no longer create such detailed art.

The care manager worked closely with the cousin who was Paul’s power of attorney in getting the home cleaned and ready for Paul. A bedroom was created in the former dining room, a hospital bed was ordered along with all the other supplies that were needed. Since Paul slept during the night, the care manager arranged for a live in aide who could also sleep at night. The care manager and cousin turned the sitting room into a room for the aide.

Paul had many chronic illnesses, which included: chronic obstructive pulmonary disease, poor circulation in the legs, and osteoporosis.  His poor circulation and gait problems made walking impossible, so Paul used a wheelchair.  Prior to discharge from the nursing home, the care manager made arrangements for groceries to be delivered to Paul’s home and established a delivery system for both medications and medical supplies. Collaborating with the nursing home social worker, she arranged for physical and occupational therapy services in the home.  She also contacted a physician and podiatrist who were able to make home visits.   Through her resources at Ivory House, blood work and chest x-rays could were done at the home when needed.

When it was time for Paul to be discharged from the nursing home, he was determined to be incompetent.  His care manager arranged for an elder-law attorney to assist Paul in setting up a Power of Attorney to manage his financial and healthcare decisions.  Once discharged, Paul was very happy to be home. He immediately began listening to the radio and to his record collection. He loved classical music and would talk with his care manager about what was happening in the world.  After several months in his own environment, Paul’s health and mental state improved so much that his physician felt he was competent to manage his own affairs.

The care manager visited Paul weekly to assess his medications, medical supply needs and medical condition.  She reviewed Paul’s plan of care with him and the nursing aide.

Plumbing and heating problems with Paul’s home were handled by the care manager. Due to cost of heating the home, taxes and utilities it was decided that it would be more cost efficient for Paul to move to an apartment.  He agreed with this move and the care manager visited various apartments.  She found a lovely two bedroom apartment for Paul, which overlooked a rose garden. The care manager made all the arrangements for the move which included: deciding with the client what furniture and paintings he wanted to take to the apartment, cleaning the oriental rugs he was taking, arranging for the placement of his furniture and making arrangements for his paintings to be hung in the apartment. She assisted Paul’s power of attorney in the sale of his antiques, the cleaning of his home and getting it ready for the move.

During the years Ivory House cared for Paul he was never hospitalized. After several years, his power of attorney felt it was necessary to move Paul to an assisted living facility. The staff from Ivory House visited Paul often after his move.  They sent him cards and celebrated his 94^th birthday with a cake and gifts.  Approximately six months after his admission to the assisted living facility, Paul died.  Paul had a great life once he came home from the nursing home and he enjoyed being home with his belongings, both in his home and his apartment.

Activities for Seniors

Listed below are ideas for activities to do with Senior Citizens or encourage them to do on their own or in a group settings.  Engaging in activities such as these helps keep individuals active and social.  This goes a long way in keeping Seniors happy, healthy and enjoying life.

Sittercise – Encourage gross motor functions.  Sittercise includes having seniors while sitting  kicking legs, lifting legs, lifting hands above head and making circles with hands.  May adapt the hokey pokey to sittercise.

Devotional time – May read a passage from the Bible and sing  hymns.  Must be non-denominational.

Reminiscing Group – Seniors through reminiscenceing recalling memories review them and recapture the moments that went with them.  Seniors enjoy talking about the old days as it gives them a feeling of well-being and raises self-esteem.  Use Reminiscing Book and Magazine

Games - May be gross motor games where resident is moving arms/legs, i.e., basketball, cards, bingo, dominoes and checkers.

Baking Group – Seniors may assist in mixing ingredients, putting dough on cookie sheets, cake in cake pan, icing and decorating cookies, and icing and decorating cakes.  The purpose is not to have the cookies and cake perfect, but have seniors socialize, participate and enjoy the end product.

Reading Club – Consists of reading a short article and discussing it.  May also be looking through magazines and discussing what is in the magazine.  Try to help seniors apply, if appropriate what they read to their lives, i.e. Music boxes relate this to seniors like music boxes; cooking what did the seniors like to cook?  The newspaper can be used.

Current Events – Take an article from the newspaper, current magazine or news from television.  Encourage seniors to talk about the information.  If material is from newspaper or current magazine, may read highlights from article, then discuss.

All movies – Make comments throughout film as to what is happening as well as which stars are in movies.  Try to get residents to talk about what they liked about the films.

Documentary – May be on countries, sports, special events.

Oldies But Goodies – Maybe I love Lucy comedies, Jack Benny, ect…

Sing-A-Long- Play musical tape and help seniors to sing. You may want to repeat a song that that particularly enjoyed.

Creative Arts Group- This group involves the art project that are “free lance art” i.e.. clay, finger painting, paper mache and watercolors. Collages may be made from outdoor gathering and cloth ect…

Letter writing – Encourage seniors to write letters, notes to family members.  You may need to assist them in formulation of thoughts and what to write to family member. Suggest to senior that they tell the family member what they have been doing. ie. cartoonist came and did the presidents; we made cookies today and they were good; or arts and craft project.

Arts and crafts – This may be theme oriented based on what is happening during the month: St. Patrick’s Day, Easter, and July 4^th. May start art and craft one day and finish the next.

Nature Group- This may be a walk, painting flowers or vegetables. May also be a film on nature or watching the Discovery Channel.

Musical Tapes- Have senior listen to quiet music. Let senior select the tape talk a little about the performer before or after the song or tape.

Word Puzzles / Number Games- Do encourage seniors to do word puzzle and number games.

Call Ivory House Health Services if you need assistance
Phone: 410-823-3153
Toll Free: 1-800-704-3536
www.ivoryhouse.net