What Do I Need To Know About “Sundowning?”
The term “sundowning” relates to the tendency of those with Alzheimer’s to experience increasing levels of confusion as the day progresses. While the physiological cause of this phenomenon is not yet understood, there are some external cues that are believed to elicit the symptoms of “sundowning.” These cues involve fatigue, low lighting, and the resulting change in shadows throughout the home as the day progresses. As these environmental changes take place throughout the course of the day, the individual with Alzheimer’s experiences an increasing level of confusion. Sundowning is a rather predictable phenomenon in that it tends to surface around the same time every day. It is because of this predictability that both the individual with the disease and their caregiver can take proactive steps to counteract “sundowning.”
To address the most manageable component of sundowning, consider combating fatigue by encouraging short naps in the afternoon or creating a “quiet time” that can be used for relaxation. This can be a valuable time for both the loved one and the caregiver to step back from the morning’s events and recuperate. Consider ambient elements that might promote relaxation. Your loved one will need to be in a comfortable place, like a bed or a favorite recliner. You might play soothing music, create a source of white noise by turning on a fan or a water fountain, light a candle with a mild fragrance, and dim the lights for your loved one. (It may also be wise to alert your loved one to the impending changes in their environment so they do not become alarmed when they notice the dimmed lights.) In this spa-like environment, you might also take the opportunity to give your loved one a soothing hand massage with warm lotion. If you are currently receiving assistance from a volunteer or a secondary care giver, this might be the ideal time to enlist their help so that you can also take advantage of this period of relaxation.
After quiet time is over, make sure that your home environment remains brightly lit for the rest of the day. The goal is to minimize dark shadows that contribute to your loved ones confusion. If your loved one is visiting an unfamiliar place, like a hospital or a relative’s home, pack things that are familiar to them. Bring their nightlights, their favorite pillow or quilt, their radio, or another comfort item that they will be able to identify with.
If sundowning begins despite these measures, try to keep your loved one occupied with another task. If your loved one is actively engaged in a meaningful activity, such as a hobby, this can help to distract them from the setting of the sun.
For more information on Alzheimer’s, or any of your other Denver elder law questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Colorado estate planning attorneys.
Is It Common For A Person Who Is Experiencing The Early Stages Of Alzheimer’s Disease To Begin Losing Their Ability to Verbally Communicate?
In order to answer this question, we must again remind ourselves that the stages and symptoms of Alzheimer’s are unique to the individual experiencing them. Different people with the disease will progress at different rates and experience different symptoms. While symptoms such as memory loss and feelings of frustration, fear, and uncertainty are relatively common, other symptoms are more variable.
While this is not a universal symptom of Alzheimer’s, individuals who do lose their ability to verbally communicate often do so during the middle to late stages of the disease. As Alzheimer’s progresses and the individual’s brain begins to deteriorate, certain bodily functions become impaired. One such bodily function may pertain to the individual’s ability to communicate with others. Early on, this symptom can be detected in an individual’s inability to complete a sentence or find a word that they are looking for. However, as time progresses, speech can deteriorate to the point that it is all together unrecognizable. A person may form complex sentences in which the words have no relative meaning, or they may lose the physical ability to speak overall.
In dementia, as in many neurological diseases, there is always the frightening possibility of miniature strokes. People who are diagnosed with Alzheimer’s disease often experience miniature strokes. Conversely, there are also a number of people who first experience these strokes and then, consequently, develop dementia. In both of these scenarios, a stroke can be responsible for an individual’s loss of speech. In such a situation, speech therapists may be able to work with these individuals and help them regain or improve their ability to speak.
If your loved one experiences a loss of speech early in the course of the disease, you may need to consult your physician. If you are not comfortable with your doctor or the information he provides you with, seek a second opinion. You may also want to get in touch with a specialist. Since miniature strokes can be difficult to detect, even with the help of an MRI, it is important to seek out an experienced neurologist who will also take observable symptoms and family reports into consideration when formulating a diagnosis.
As always, for more information on Alzheimer’s, or any of your other Denver estate planning questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Colorado elder law attorneys.
Is Wandering a Common Concern?
While wandering is not a universal symptom of Alzheimer’s, for many, it can indeed be a major concern. Each person who experiences dementia experiences different symptoms and progresses through their journey at a different rate. Yet, unfortunately, it is difficult to predict whether or not your loved one will wander until he or she has already done so for the first time.
After being diagnosed with Alzheimer’s disease, your loved one can be registered in the “Safe Return” program through the Alzheimer’s Association. When you join the “Safe Return” program, you will be offered a variety of jewelry that your loved one can wear with a special identification number on the back. Many people choose the bracelet because it can be worn like, or alongside, a watch. Typically, individuals who did not frequently wear jewelry in the past will agree to wear a simple bracelet. To reduce the potential of arousing your loved one’s suspicions, and consequent resistance to wearing the jewelry, it may be helpful to order two bracelets - one for you to wear and one for your loved one. Many caregivers have found this tactic to be very helpful in the past.
As soon as there is any sign of wandering, it is important to take immediate action. You may want to put a baby monitor in your loved one’s bedroom so that you can hear them getting up in the middle of the night. You can also have safety devices installed in your house. Let your neighbors know about your loved one’s tendency to wander. Speak with your doctor to see if they can suggest a form of treatment that might help to alleviate this particular symptom.
Should you find that your loved one has wandered away from home, call 911 immediately. Many police officers have been educated about Alzheimer’s and have been trained to safely and effectively deal with situations like wandering.
For more information on Alzheimer’s, or any of your other Colorado elder law questions, click here to view our Wills and Trusts 101 seminar or call or call 303-758-0680 to get in touch with one of our Denver elder law attorneys.
Is There A Way For Me to Better Understand How My Loved One With Alzheimer’s is feeling or What They are Going Through?
It is difficult for anyone to fully wrap their head around any situation that they have not experienced firsthand. However, for those who are interested in trying to gain the fullest understanding possible of the disease and its impact on the individual, it may be beneficial to read the published work of men and women who have themselves struggled with Alzheimer’s disease.
The books listed below offer a firsthand account of the writer’s experiences with Alzheimer’s. These books can be heart-wrenching, but they are also good resources for a person who is attempting to better understand how the disease impacts an individual person.
Living In The Labyrinth: A Personal Journey Through the Maze of Alzheimer’s
by Diana Friel McGowin
Show Me The Way To Go Home
By Larry Rose
These books are widely available through local bookstores, online resources, and your nearest Alzheimer’s Association.
As always, for more information on Alzheimer’s, or any of your other Denver elder law questions, click here to view our Wills and Trusts 101 seminar or call or call 303-758-0680 to get in touch with one of our Colorado probate attorneys.
Does My Loved One Need to be Evaluated? If so, Where Should I Turn for Help?
The answer to this question is yes. When your loved one begins to display the early indicators of dementia (a noticeably elevated level of forgetfulness or confusion), a comprehensive work-up and evaluation by a doctor is necessary. The physician’s examination will help to determine if your loved one’s symptoms could be attributed to other issues such as poor nutrition, depression, drug or alcohol abuse, or organ dysfunction. If the person you are concerned about has not been evaluated in the past, you should first contact a geriatrician or a neurologist. Individuals who have already been diagnosed with Alzheimer’s disease should stay in contact with a geriatric psychiatrist for assistance with behavioral or emotional issues such as anxiety, agitation, and depression.
A list of Colorado physicians specializing in this area can be accessed through physician referral services. Yet, the majority of caregivers get information and recommendations through support groups. For many, it is reassuring to see a doctor that has already provided other caregivers you know with excellent service.
Since everyone is unique, it is important to find the right physician that best fits your needs. If you are not comfortable with one doctor, begin searching for another one. Having a comfortable relationship with your physician is profoundly important in that it will better enable you to ask those difficult questions and gain the information you need.
Diagnosing dementia early can help to influence treatment and work to slow the disease’s progression by pairing the individual with the most effective medications for their case. If, after receiving a comprehensive work-up, your loved one is diagnosed with Alzheimer’s disease, you should notify their primary doctor. They will continue to meet with their primary care doctor for their regular checkups while a geriatrician, psychiatrist, or a neurologist will work with them on issues directly linked to their dementia.
However, in the course of treating your loved one, it is also important to look after the caregiver. Alzheimer’s disease is a family illness, and often takes a toll on the stress level of the caregiver. By offering support to the caregiver, as well as the patient, a physician can also work to better facilitate effective caregiving within the family unit and the home.
For more information on Alzheimer’s, or any of your other Denver elder law questions, click here to view our Wills and Trusts 101 seminar or call or call 303-758-0680 to get in touch with one of our Denver estate planning attorneys.
How Long Can A Person With Alzheimer’s disease Survive?
The symptoms and progression of Alzheimer’s disease are incredibly variable from person to person. Each individual case of Alzheimer’s develops at a unique rate, and not all people will experience every symptom or phase. Some people will experience a prolonged state of stasis with little or no change in their condition, while other people’s symptoms will move forward quite rapidly.
Alzheimer’s disease itself does not result in death. Yet, Alzheimer’s advances to the point that crucial organs are inhibited and, if the individual becomes sick or incapacitated, they may develop illnesses, like pneumonia, that they are unable to recover from.
According to various accounts, an individual with Alzheimer’s disease might live anywhere from three to twenty years after the symptoms are first recognized. However, on average, most people with Alzheimer’s survive for roughly eight years after their symptoms begin.
For more information on Alzheimer’s, or any of your other Colorado elder law questions, click here to view our Wills and Trusts 101 seminar or call or call 303-758-0680 to get in touch with one of our Denver elder law attorneys.
Colorado Alzheimer’s Care: How Important is Routine for Your Loved One?
Routine is extremely important for a person with Alzheimer’s Disease. As the disease progresses and the individual begins to lose more and more memory, a routine is both comforting and familiar. If your loved one is still living at home, you can make everything you do within a day part of the routine or schedule. If the person attends an adult day care center or is in a nursing home, the schedule is set.
At home, you need to develop a routine for both of you. Rituals are also very important (a bedtime ritual, for example). If your loved one always checked the doors to make sure they were locked before going to bed, continue this ritual. If he ate a bowl of ice cream before bed, continue this. You want him to feel at home, and these routines and rituals help with that. If he is restless before bed or having a difficult time falling asleep, let him get up and do the ritual.
The routine for the day can consist of eating at certain times, taking medication at a certain time, going to check the mail at the same time every day, bathing on certain days, going to the hairdresser or barber on certain days, and anything else you want to add to your routine or schedule. Even drinking water at scheduled times each day is advisable. This adds to the routine while encouraging hydration at the same time. Making time in your schedule to sit down and relax is also important. You both need to do this so you can regroup.
Other examples of activities that can be included in your daily schedule are going for a walk, feeding the dog, folding towels, taking out the trash, reading the newspaper, drinking coffee, going tor a drive, getting ice cream.
Try to have fun with this, but avoid becoming rigid. Remain flexible so if the activity you had planned isn’t working for your loved one, don’t argue. Just go with the flow and move on to the next thing. If the previous activity needs to be completed, such as dressing, go back later and try again.
Colorado Alzheimer’s Care: What to Do When Books Are No Longer an Option
Q: My mom used to love to read, and now that is going. Any suggestions on what she can do if books are no longer an option?
A: If books have become too long, and she is losing interest, try giving her short stories. You can purchase all sorts of reading material at thrift stores or used book stores. Ask her to read recipes to you when you are in the kitchen. She’s not only reading, but she is helping you. Comprehension really isn’t an issue because she isn’t actually doing the cooking.
You can go to your local library and check out books on tape. There are all types of books, magazines, and newspapers on audio cassettes and CDs. In some areas, you can also check out a tape player and keep it at your home for as long as it continues to benefit your mother. The tape player is designed to be user-friendly for individuals who are blind or have other disabilities. Headsets are also available so she can listen anywhere and any time without disturbing others. Check out books that are upbeat, inspirational, or funny. If you check out the newspaper, she could internalize the information and become more confused, anxious, or agitated. Pay attention to the volume. If it is too loud, it can cause your mother to become overstimulated, which can lead to anxiety, agitation, or even wandering.
Many libraries have reading programs. She could ride the bus or have a friend or family member take her to listen to the programs. Senior centers also have similar programs.
She could attend an adult day care center and join in the activities there. If she can still read but doesn’t comprehend, she could read to the other clients and feel she is helping them. This would help her self-worth. Many times, centers have reading times so she could listen to a live person read.
You could also find a volunteer organization such as a neighborhood girl or boy, a neighbor, church member, civic organization, or family member to come over and read to her. This would be a great service project for a student. Many people are willing to be help; they just need to be approached.
Reading together can be quality time you could spend with your mother. But, if you are unable to do this, do not feel guilty. Find someone to do it for her. But if you are looking for something to do with and for your mother that would be beneficial for both of you, read to her. Even if she doesn’t completely comprehend what is being read, she is experiencing an activity she has always enjoyed, and that feels good to her.