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Friday, April 18, 2014
Dealing with the Progression of Dementia
Your reponse about Grannie was more sensitive and practical than any of her doctors have given us. Today a visit to the GI specialist resulted in "there is nothing we can do but treat the symptoms...nothing seriously wrong with her...progressive problems due to illness". So we listen to her belching, etc., see her in discomfort with reflux, see her tiring, and see her appetite deminish (has lost 6 pounds in last month - great if it wasn`t due to not feeling well). Called before leaving work this afternoon to let her know i was on my way home. I asked if she had already eaten supper- I keep meals in divided plates in refrigerator. Response was "I don`t know what to eat and I don`t know which medicines to take - I`m confused." When I got home I stood by and watched as she sorted through her medicines and put them back in their right places (had been in bag to take to doctor`s office). Prepared dinner and she ate a small amount. Asked her before we went to doctor if she wanted to stop and get more crossword puzzle books (monthly routine)- response was "no, I have a drawer full..can`t work but one or two a day...can`t see well and can`t remember words." She is speaking 2 or 3 words at a time and will hesitate and continue with another few words. This is especially so in public - better when here at home. What are your thoughts on this? What is a good way for us to help with her medication when she has her own system right now? Should we wait until she asks us to help. Presently there is no way for us to be sure that she is taking meds correctly. Should we strongly encourage getting out and about even when she resists? Thank you for giving me some insight on caring for her.
As the disease progresses, you will notice a decline in Grannie and she may not understand the timing of meals and the taking of her medication, so she will need a lot of coaching. Some techniques to use for her reflux include: continue to limit her food intake to small amounts and instruct her not to lie down for at least 30minutes after she eats. Some foods to avoid that may aggravate her reflux are those that are acidic, spicy, fatty or contain caffeine. Instruct her to chew her food thoroughly using as much lo fat as you can to decrease the gastric volume that contributes to reflux. You may want to try an antacid 1 hour after meals, but be sure to check with her primary care physician that the antacid will not interfere with any of her routine medications. Unfortunately, as the disease progresses Grannie will have more difficulty in remembering if she ate or took her pills so she may need increased supervision. Have you thought about a daycare program where she would have more supervision? This would also give you more peace of mind as you will know that she is being watched. Her limited communication is probably part of the disease process and if she is aware of her decline, she may have more difficulty communicating in public due to embarrassment of making a mistake. I do not think she will ask you for any help as her judgement will decline with the disease process also. Her lack of inititiative is also an indication that the disease is most likely progressing. It sounds like you are doing a great job in addressing her needs and I hope this message gives you some techniques as Grannie declines.
For additional help/suggestions: After consulting a few doctors here at University Alzheimer Center and staff at the Alzheimer`s Association, Doreen Kearney thought it would be beneficial to you and your family to have a Family Care Plan. By contacting either your local Alzheimer`s Association or by emailing Doreen, they will help you find ways to cope with your Grannie`s behaviors and to help you learn more about the disease and the course it`s taking.
You can contact Doreen by emailing her at: firstname.lastname@example.org
Also, if you want to find the Alzheimer`s Association chapter that is closest to you, follow the link below.
If we can be of anymore assistance to you, please don`t hesitate to contact us.
Thank you and good luck!
Jon Stuckey, PhD
Case Western Reserve University