Memory Care in Lincoln, NE – 2018

5 THINGS TO KNOW ABOUT MEMORY LOSS

The hardest truth to accept when it comes to Alzheimer’s and dementia, and other diseases that cause a decline in memory, thinking, and reasoning skills, is that it doesn’t get easier as time goes on. Most people get defeated when they realize how overwhelming it can be, some even go into denial. That is why we’re here to tell you that it’s okay to be scared, it’s okay to not have all the answers, and it’s okay to reach out for help.

“The good truth is that you are not alone,” points out Christy Merritt with The Waterford Communities. “There are many people who are willing to lend an ear and a hand to help families impacted by Alzheimer’s and dementia. However, even though there are similarities between people with dementia, there are also vast differences. People may be at the same stage but respond very differently. There isn’t a textbook explanation for how things will unfold. As a family member, you have to be able to make tough decisions, but you also have to allow your loved one to forge their own way and come along side of them. If you understand that things are going to be constantly changing, then it will help minimize potential frustration as things progress.”

Like Christy said, there isn’t a clear step-by-step plan for dealing with memory loss in your family or friend group, but there are some main, basic things everyone should know about it. Even if it isn’t effecting a person directly, chances are it will one day. According to the Alzheimer’s Association, dementia is the sixth leading cause of death in Nebraska and in the country.

With the help of a couple local experts, we put together a list of five things we think our readers should know about identifying, addressing, treating, and living with memory loss.

1. Early Warning Signs

Dementia is a term which describes symptoms that are affecting someone’s memory, reasoning and language skills enough to which it is interfering with their daily life. There are many different types of dementia; Alzheimer’s, vascular, lewy body, mixed, and frontal lobe are most common.

Early warning signs are often difficult to identify and can often be attributed to the normal process of aging. Unfortunately, since no two presentations of dementia are the same, early detection is tricky and, therefore, people are often well into the disease before they seek help.

“The very earliest changes in the brain go undetected,” notes Beth Friesen with Oasis Senior Advisors. “Alzheimer’s and other forms of dementia can be categorized into seven stages; from the earliest stage when no outward signs are present, to the last stage when the individual is no longer able to communicate basic human needs.

The rate at which people progress through the stages is very difficult to predict and their exact symptoms will vary based on which area of the brain is most affected by the plaques that accumulate. It is important to understand that these plaques create a roadblock of sorts and the brain has no way around them. The neurological system literally stops there. It is widely held that most individuals will live five to seven years following diagnosis. Again, this depends on the individual—what stage of the disease they were in at the time of diagnosis, their unique disease progression, and any pre-existing, underlying medical conditions they may have.”

“Bridge to Better Living often recognizes signs of memory loss in their clients, sometimes even before family members recognize the symptoms,” states Robbie Nathan with Bridge to Better Living. “Memory loss carries a stigma for many and yet it is a diagnosis affecting 1 in 10 over the age of 65 and 1 in 3 over the age of 85. Symptoms of dementia or Alzheimer’s may be very subtle; misplacing possessions, forgetting appointments, not recognizing everyday objects or giving evasive answers to direct questions. Frequently families unknowingly cover for their loved ones… ‘they do really well as long as…’ or ‘we call every day to remind them of their meds or to see if they have eaten.’ Although these actions are caring they are also enabling and a clear sign the family is concerned about their loved one’s ability to remember.”

Bridge to Better Living believes in their mission of Placement with Passion when working with each client and especially those with memory loss. Every one of the Transition Consultants has had professional and personal experience with this terrifying disease. No two situations are the same. The safety and cares of these clients are a high priority. Bridge to Better Living understands the magnitude of being cared for in the right way, by the right people and in the right place, which is why they offer assistance at no cost to the client.

We’re also aware of several studies that suggest seniors with hearing loss are more likely to develop dementia and Alzheimer’s over time than those who retain their hearing. In those with hearing loss, the compensatory adaptation system significantly reduces the brain’s ability to process sound, which in turn affects a person’s ability to understand speech. Even with mild hearing loss, the hearing areas of the brain become weaker. Researchers suggest that the strain of decoding sounds over the years may overwhelm the brains of people with hearing loss, leaving them more vulnerable to dementia. They also speculate that hearing loss could lead to dementia by making individuals more socially isolated, a known risk factor for dementia and Alzheimer’s.

“Hearing loss is a slow process and often ignored,” Leslie Frank MS, CCC-A with Nebraska Hearing Center says. “It is important to have your hearing tested annually, like any other checkup. The ability to communicate with the help of hearing aids can help enhance quality of life for individuals with Alzheimer’s and their caregiver. We are lucky to live in such an exciting time where technology is constantly improving. Hearing devices today are small and the clarity is amazing. We have devices that sync to your cell phone where you can stream music and phone calls right to the aids.”

2. First Steps To Take

Sometimes, the person who is actually experiencing memory loss deals with the idea of dementia better than the family members. It’s not easy for loved ones to face the reality of what these signs mean. The family doesn’t want to admit that there is a problem, especially if the dementia hits at an earlier age, such as in a person’s sixties. Denial is very common and, like a death, there are many stages of grief in recognizing, dealing with, and finally accepting the outcome.

On the other end, it is the individual experiencing these symptoms who has the hardest time accepting them. Imagine how frustrating it would be to have difficulty doing things that once came easy for you, such as balancing a checkbook and solving simple math problems. Not only is it scary, it’s embarrassing.

“It is not uncommon for someone struggling with memory issues to have a lot of mood swings or depression in the early stages,” addresses Gayleen Bradley with Care Consultants for the Aging. “There is a lot of shame associated with memory loss. Your loved one might become combative when you point out the warning signs you’ve noticed. These are things they don’t want to see in themselves. When addressing memory deficiencies and concerns, do it in a very calm, loving, and reassuring way, and be very intentional about getting help. Talking about an issue doesn’t do much good without an action to follow.

This can be the hardest first step—getting the individual to agree to see a doctor in order to get an official diagnosis. Comfort your loved one by acknowledging that there could be a host of different issues going on which could be cleared up by seeing a doctor. It could be there is a medication interaction, excessive alcohol use, an infection, a metabolic disorder such as diabetes, even untreated depression can be very taxing on the brain. No one is asking anyone to assume the worst.

If there is a diagnosis of dementia, educate yourself. Join a support group, if possible. Letting other family members be a part of the process can be very beneficial, as well, especially if you are the main care partner. The journey will become very overwhelming alone. The more people and resources you utilize, the less stressful it will be for everyone. People who don’t reach out and get help tend to become ill themselves from the stress they are under and then end up in a crisis. Decisions that are made in a crisis aren’t always the ones you would make otherwise.

My father has dementia and lives with one of my sisters in Colorado. The stress this journey has put on her has caused her to be in the hospital four times, and she is in her 50’s and was always in good health.”

When your loved one is diagnosed with Alzheimer’s or another form of dementia, start making plans for the future right away. Seek out legal expertise to ensure all affairs are in order while the patient can still make decisions. Have discussions about what they want and don’t want in terms of their future care.

“These are tough, tough discussions to make,” affirms Beth Friesen, “but ever so important. Without them, the family is left guessing what they would want. It is never too soon to consult the assistance of a senior living advisor, especially one who is specifically trained to work with dementia and has been personally impacted by it in their own life.”

Beth shared with us that she has walked this heartbreaking path with her own mother. Seeing her mother suffer from dementia gave Beth a whole new outlook and motivated her to help others who are affected by this disease. As a RN at Oasis Senior Advisors, awaiting her Certified Dementia Practitioner Certificate, Beth will help connect you with community, legal, and medical resources to help you every step of the way.

“Start with a conversation, whether a diagnosis has been made or not,” remarks Barb Tyler with The Woodlands. “When you and certain family members or friends start noticing signs of forgetfulness with other friends or family members, start talking about what each of you would want if this happened to yourself. This includes legal and financial decisions. By asking them for their input, they’ll feel valued and they’ll gain a sense of control in the midst of an unruly position.”

Like Gayleen, Barb agrees that seeking an actual diagnosis is the most beneficial thing you can do. “This will tell the family members the type of dementia, or the combinations of more than eight types of dementia, that may be present,” Barb continues. “A diagnosis will also determine the next steps to take in terms of health care. For instance, some insurance companies will not cover a person who drives if a diagnosis is made. Be truthful in how you deal with the diagnosis or different behaviors; don’t sugar coat the symptoms.”

Financial and legal issues may not be the first thing people think about when faced with a diagnosis of Alzheimer’s disease or another form of dementia. However, as we previously touched on, these are important considerations that shouldn’t be overlooked.

“There are several legal documents that a person diagnosed with dementia needs to sign before his or her decision-making abilities diminish in the later stages of the illness,” states Christine Vanderford with Vanderford Law. “Final wishes, such as preferred living situation, long-term care plans, care for a pet, and even funeral arrangements, need to be made ahead of time.

There are also some important legal documents designed to protect the finances, health, and rights of an individual with dementia that should be signed as soon as possible after the diagnosis is given. These documents include:

• Power of Attorney—Who will be making decisions if/when the patient is unable to make informed, sound-minded decisions themselves?
• Living Trust—How will finances and property be managed when the patient is unable to manage them?
• Living Will—What are the patient’s wishes regarding complicated medical or treatment decisions?
• Will—How will the patient’s remaining assets and belongings be handled once he or she is deceased?

When people with dementia no longer have the mental capacity to understand the severity of their condition, it is more difficult to set up legal arrangements to make decisions for them. Don’t put yourself in a situation where your loved needs help but they are refusing it because they can’t comprehend what is going on.”

3. The Truth About Dementia

The truth about dementia and Alzheimer’s is that it’s fatal. No matter what the media says or what studies might “suggest,” at the end of the day, there is still no cure. This is a harsh truth, but it’s better to accept it than fight it and be disappointed. You have to treat your loved ones where they’re at in the disease process.

The emotional toll of “the long goodbye” is enormous. First, you lose the person mentally, and then you lose them physically. It’s important that caregivers seek out their own support throughout this process. Alzheimer’s not only affects the person diagnosed with the disease, but the entire family and social network.

“Dementia can be a long and unforgiving journey for all who are involved,” confirms Megan Herter with Sumner Place Skilled Nursing & Rehabilitation. “It is impossible to truly understand the fear, confusion and emotions that those who suffer from dementia struggle with on a daily basis.

Dementia does not just affect memory loss, but also the ability to communicate and understand what is going on in the world around them. At Sumner Place we educate our team members on effective communication skills so each resident can be successful in their daily lives. Sumner Place uses Buddies Forever, which is a comprehensive dementia program. These techniques and skills such as, getting down below eye level, using simple statements, and endorphin boosts to name a few, create a foundation for person-centered care. It is also very important to remember that we as caregivers are now living in their world, they are not living in ours.

Sumner Place also focuses on the strengths of each resident by using their historical personal interests as a method of minimizing the difficulties associated with dementia. This could be something as simple as giving a former painter a paint brush.

Sumner Place is certified in Music & Memory which taps into the long-term memory, an area of the brain unharmed by dementia. Selecting the appropriate music for each resident triggers pleasurable emotions from their past. We work closely with their families to figure out not just the genre of music they listened to during their peak years (16-26 years old) but the specific songs. The purpose is to give those who suffer from cognitive and physical challenges a more meaningful connection. Researchers have observed team members and family participants report observations of participants having elevated mood, higher levels of engagement, and note positive environmental and facility culture changes.

Sumner Place will be hosting a Family Memory Support group on Tuesday, November 13 at 6:00 p.m. Contact me at (402) 475-6791 or mherter@vhsmail.com if you are interested in attending.”

4. What You Can Do

Perhaps the best thing you can do, as the caregiver of a person who has been diagnosed with dementia, is to come from a place of understanding. It’s hard to understand dementia if it’s not something you’re going through yourself, but as Michele Carlson with Legacy Retirement Communities reminds us, we live in the age of virtual reality.

“Memory loss can bring on a whole onslaught of feelings for the individual and their caregiver,” Michele comments. “Feelings of confusion, frustration, anger, irritation… the list goes on. As the caregiver, put yourself in your loved one’s proverbial shoes. At Legacy Arbors, our memory care location, our caregivers do just that. We train our staff using a virtual dementia kit, in which the user can discover firsthand what dementia feels like by wearing certain items to mimic the feeling of common ailments you would experience with aging and memory loss. After taking the “tour”, many users say the experience is eye-opening. This allows for the caregiver to gain a deeper sense of empathy, understand the disease through a different perspective, and ultimately provide the highest quality of care.

We always encourage families to become educated on the disease. This can be done through several avenues such as caregiver support groups, books, and researching online. Knowledge is power; when you feel educated and confident in your care giving abilities, you’re able to make better decisions for your loved one.”

The person with dementia loses their sense of purpose while they are on this journey. So, take time to give them back their sense of purpose. Find tasks they are still able to help with, share a meal with them, sit and pet an animal, take a drive, listen to music they like, and don’t forget to give lots of hugs! Embrace the moments, no matter how small. Remember, this can be a long journey. The better you take care of yourself, the better you’ll be able to care for your loved one.

Karla Frese with Home Care Partners of Nebraska reminds us that November is National Family Caregivers Month! It is a time to recognize and honor all caregivers. Being a caregiver can be hard, but it can also be rewarding.

“It is wonderful to hear stories from caregivers of meaningful activities they engage in with someone suffering from dementia. Recently, one of our caregivers at Home Care Partners took a client to the Lincoln Zoo and was able to share that joy with the family when they got home,” shares Karla. “As a result of these kind of stimulating activities, our team sees an increase in cognitive function and an overall improvement in quality of life, positively affecting happiness/mood.”

Karla shared a few other stimulating activities for all caregivers to try:

• Bake/cook simple recipes together
• Easy cleaning tasks around the house
• Arts and crafts such as knitting and painting
• Look at books the person used to enjoy
• Organize household or office items
• Read the newspaper
• Tend to the garden or visit a botanical garden
• Watch family videos
• Work on puzzles

The one-on-one environment with family members and/or professional caregivers will encourage these positive interactions and provides a feeling of safety. Karla advised considering the following when planning activities for a loved one with dementia: their skill/ability level, interests, physical limitations, and energy level at a given time of the day. It’s important to focus on enjoyment, not achievement.

“One of the ways our caregivers at Home Care Partners are trained to support our clients with dementia is through different types of reminiscence therapy,” adds Karla. “This therapy incorporates a mix of past activities, events, and experiences with another person or group of people. Different types of media are used such as photographs, household, and other familiar items from the past, music, and sound/audio recordings that enable them to hold onto cherished memories. Some families have a photo album with audio recordings from children and grandchildren. You can imagine the smile on someone’s face when they hear a familiar voice say, ‘I love you, Grandpa!’

These moments involve sharing thoughts and feelings of experiences to recall and reflect upon important events within their life. The ability to recall and reflect serves different functions, including boredom reduction, strengthen cognitive memory components, peace at the end of life, and maintain sense of identity.”

Regardless of whether you educate yourself and install these recommended activities into your routine, your loved one with dementia will come to a point where professional help will be needed. There are many things you can do as a family member, but you simply can’t do it all alone. Due to the fact that dementia and Alzheimer’s are terminal diseases, you may consider hospice or in-home health care.

“One of the commonly overlooked aspects of memory care is the individual’s daily basic health needs,” addresses Grace Kats RN/BSN-CH with Graceful In Home Healthcare. “If you are monitoring an individual with memory issues, you should know that dehydration, malnutrition, urinary tract infections, and/or irregular sodium or potassium levels can result to an increase in confusion, falls, and agitated behavior. These are areas that can be challenging to monitor as someone who is caring for a family member with dementia. Most people have jobs and families of their own to also care for. Not to mention that most people lack the medical background to identify these types of health concerns. That is why Graceful In Home Healthcare exists. Our caregivers can provide that extra set of eyes when it comes to those basic health needs, so that you can focus on your loved one’s well-being.”

To emphasize Grace’s point, an individual with advanced dementia cannot report their symptoms. As a result, these symptoms are often left untreated, leaving them vulnerable to pain, difficulty breathing, and various other conditions. This is where hospice can help!

5. Choosing The Best Care

There are many different options available for care when it comes to treating memory loss. The most important thing for readers to know is the vast and varied resources available to assist with dementia and Alzheimer’s care. It is important to access the most appropriate services at the most appropriate time, while anticipating future needs. There are services designed for in-home care, assisted living services, and skilled care. There are also a plethora of resources available to answer questions or provide individualized information for the family members. Like we previously touched on, respite breaks can often make all the difference to a loved one who is also a full time caregiver.

“Respite, short-term stays are a valuable way to trial residence away from home to help decide if this might be a viable option in the future,” notes Amy Fish with Lancaster Rehabilitation Center. “On too many occasions we’ve needed to provide care to the caregiver as they find themselves exhausted from the 24-hour care they are attempting to provide. The dedicated memory support neighborhood at Lancaster Rehabilitation Center is equipped with passionate team members who are truly devoted to caring for each individual, along with providing the safety and security expected.”

Caring for a person with a form of dementia often involves a team of people. Whether you help provide the daily care (assisting with meals and bathing), participate in the decision making (care arrangements and legal/financial plans), or you simply care about a person with the disease, there’s much to do and plenty to know—but finding the resources and support you need doesn’t have to be a burden.

“We recognize that no two people have the exact same care needs,” states Natalie Leon with Visiting Angels. “In order to address the wide range of health and wellness concerns facing older adults, we provide personalized assistance, especially when it comes to memory care. We begin the process of arranging home care by meeting with clients and their loved ones for a free care consultation in order to gain a better understanding of the client’s needs. Then, we take the time to match each care recipient with a caregiver who is uniquely qualified to handle their specific care requirements. At Visiting Angels, we have a personalized approach to our home care services, treating each client’s needs as unique and specific so that their care plans are always comprehensive.

Visiting Angels’ non-medical home care services allow your loved one to maintain the independence of their daily routines and familiar surroundings. We can help your loved one avoid the emotional trauma of leaving their cherished home while helping cope with dementia and providing the respite care that is so crucial for the family.”

While memory care is expensive, it is an investment that allows your loved one to really enjoy their life as much as possible. Being in assisted living community with memory care allows families to navigate down the line when the added care is needed.

“We help families find the safest and best memory care communities based on the individuals needs, wants, finances and overall situation,” explains Theron Ahlman with CarePatrol of Nebraska. “Our services are always 100% free to those we help, which is great as it makes it a no-brainer to utilize our service and knowledge when working through this challenging time.

We find a lot of families who are struggling at home and the caregiver ends up not being in good health themselves. Nothing is worse than getting a call where the caregiver had to go to the hospital and now we’re in an emergency situation, trying to find a community to care for the individual with dementia. We can help families in those emergency situations, but much prefer to help families walk through the process without a rush so they can really make sure they find the best fit.

At CarePatrol, we really recommend families going through the struggle of a loved one with memory issues to join a support group and get the extra help they need to help make life as easy as it possibly can be for them. We also have many different educational cards that we are glad to send out to families for free and are always willing to sit down and visit with a family to go over the various options they have. CarePatrol can help make this challenging time be a little easier.”

MaryLynne Bolden with Fallbrook Assisted Living also shared advice on choosing a memory care community. “There are new options in care services available,” notes MaryLynne. “These memory care communities are different from nursing homes or traditional assisted living centers in some very important ways, including:

Staffing—The staff in a memory care community are specially trained in caring for those living with dementia. Activities and rehabilitative therapies keep residents as independent for as long as possible. The experience and attitude of the staff members is critical when considering a memory care community for your loved one.

Consistency and Stability—Consistency for the person with dementia is very important. They are much more comfortable with people and places familiar to them. The memory care community should have consistent staffing. Make sure to ask about their turnover ratio.

Staffing Ratio—How many staff do they have on site each shift to care for their residents? Your loved one needs personalized care and attention. It’s vital to have enough workers on staff to provide quality care for your loved one.

Communication—Residents who have dementia often say and do things that may not technically be correct for OUR world. If they perceive it, they believe it. Continue on with their story even if it isn’t accurate. The staff must understand the person’s perception is their reality.

Atmosphere—A secure and comfortable setting. The environment should be highly controlled and specially designed for the person with dementia, and very calm.

Support—Quality memory care communities have support services for residents and families. Support services may include support groups for you to communicate with others who are experiencing some of the same feelings and emotions you are. It may also include additional education for you to learn more about the disease. All of these are meant to be a support to you in having a more meaningful experience with your loved one as they progress through this disease.”

Kayla Jerkovich with CountryHouse Lincoln Communities emphasized the importance of programming as well: “At CountryHouse, we believe programming is one of the most important aspects in dementia care. We’re all about experiences. Our days are filled with joyful moments to ensure our residents have opportunities to lead enriching lives, filled with the happiness simple pleasures can bring. Walk into any CountryHouse community and you will see residents engaging with one another, whether that be playing miniature golf on our putting green, enjoying s’mores around the campfire, or baking a treat for our afternoon snack. Our experiences extend outside the walls of our houses. Our residents go on bus trips in the community almost every single day.

One of my favorite examples of helping our residents use their talents is our employee softball team. We have a resident who was a former women’s college softball coach. If you come to the ballpark, you’ll see “coach” on the back of her shirt while she’s yelling and shaking her head at our terrible softball skills from the third baseline. You’ll see the rest of our residents in the bleachers having snacks and cheering us on. We’re all about experiences. Do more. Engage more. Live more.”