What do I do when my words seem to fail me?
Humans have the amazing capacity to intuitively process, comprehend, and respond to nonverbal cues in their environment. In fact, when engaging in a conversation with another person, your nonverbal language often speaks much louder than your words.
Beyond our vocabulary, which at time feels inadequate or restricting when we are attempting to express deep emotion, we can share our feelings with others through our posture, facial expressions, tone, and movements. Individuals with Alzheimer’s disease are no exception. While they may suffer from an impaired ability to communicate verbally, they often seem to retain their ability to respond to the nonverbal cues around them. A person with Alzheimer’s can still understand their environment- they know if they are being excluded, looked down upon, or otherwise mistreated.
However, as you might imagine, nonverbal communication is a two way street. We must also learn to interpret the cues of those around us. In patients with Alzheimer’s, attention to body language can often reveal the presence of pain or discomfort. Does your loved one seem unable to get comfortable? Do they suddenly get up and pace around the room? Do you ever notice a grimace on their face? If yes, then invite them to talk to you about these things.
Strong nonverbal communication can also be helpful in managing aggression, agitation, or confusion. At times, a simple touch can do much more than a thousand words could ever hope to do. A hug or a gentle touch on the shoulder says “I’m here for you” in the most powerful way imaginable. Be aware of the power of this sort of communication. Even if you feel as though you are not the “touchy feely” type, you will be surprised to see how those around you will open up once you step outside of your comfort zone.
For more information on Alzheimer’s, or any of your other Colorado 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 Denver elder law attorneys.
What can I do to gain a better understanding of my loved one’s agitation?
While frequent or intense agitation threatens to place a substantial strain on the relationship between an individual with dementia and their caregiver, many professionals working in geriatrics would urge us to think of that agitation, not as an irrational impediment, but as a behavior that is rooted in legitimate emotions. Thus it may be helpful for caregivers to place a greater emphasis on empathy as they strive to comprehend their loved one’s agitation.
As one might imagine, a common source of agitation in those with dementia comes from the feeling that they have not been heard or properly understood. Despite the presence of a disease, those with dementia maintain a fundamentally human desire to connect with those around them. Consider times when you yourself have felt agitated or frustrated. In our own interpersonal relationships agitation often comes from a failure to effectively communicate. We have all felt as though our words, as well as the raw emotions behind them, have been misunderstood or ignored altogether. In a circumstance such as this, it is not a disagreement itself that is most hurtful- it is the failure of others to validate our own emotions and experiences.
Suppose you have, over the last twenty years of your life, compiled an extensive collection of teacups. If, one day, you were to return home from work and find one of those cups in pieces on the floor, you would, more than likely, experience an emotional response. You might cry, scream, or cast blame on yourself or others. However, as you recount this event to your friends, you can sense a very real difference between the person who thinks teacups are silly trinkets and thus assumes a dismissive tone, and the person who, without necessarily understanding the significance of that particular teacup, accepts your emotions for what they are and attempts to work through them with you. Which of these friends would you like to have? Which of these friends would you like to be?
The same idea applies to the individual with dementia. Just as we all want to feel validated in our emotions and in our thoughts, so too does the person with Alzheimer’s. We must remember that, while an event may seem trivial to us, the same perception may not be shared by the person experiencing it. When a person has Alzheimer’s, the day to day activities that we often take for granted become frustrating and threatening. What is simple for us may be a source of great anxiety for another. Be sensitive to these differences. Work to become an unwavering source of comfort, understanding, and support. Practice conveying these principles in your actions and in your speech.
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.
How can I better care for A loved one who has both Alzheimer’s disease and Down’s syndrome? How should I respond to their behavioral changes?
Many individuals who have been diagnosed with Down’s syndrome are living longer and fuller lives than would have been imaginable in past decades. However, as those with Down’s syndrome are living longer, a rise in the number Alzheimer’s cases among these individuals has also been recorded. Regardless of your loved ones level of functioning prior to being diagnosed with Alzheimer’s, the impending threat of further mental deterioration from Alzheimer’s disease can be exceptionally difficult to deal with. Due to the fact that individuals with Down’s syndrome often live with their families throughout their adult lives, family units often become accustomed to the individual’s capabilities. However, with the onset of Dementia, those capabilities, along with behaviors and mannerisms, begin to change. Part of this change involves impaired memory and increased difficulties with simple daily actives like getting dressed or helping out with chores. Individuals in this situation often being to isolate themselves from others and tend to resist leaving their home because of intense feelings of anxiety or fear that may arise from an unfamiliar environment.
In this situation, establishing a routine can be vital tool for maintaining their comfort level and self-esteem. Inviting your loved one to contribute to various family tasks at an appropriate level can provide a much need boost for their sense of self-worth. Work to maintain an environment that evokes as little anxiety as possible - this includes limiting the potential for disappointment or failure in activities. Bearing in mind that their level of functioning will change over time, maintain a sense of flexibility and invite other family members to contribute in ways that will help “fill in the gaps.”
As someone who cares for this individual, it is important that you allow yourself to fully experience your grief. You have, in a very real sense, lost a person that you once knew. Work through your feelings of anger, shock, denial, fear, and depression. Keeping a journal or talking with a support group might be helpful for dealing with these emotions. Work towards a state of acceptance, both for your own sake and for the sake of your loved one.
It is important to allow your loved one to function at their own level. If necessary, lower your expectations. If you have not properly dealt with your own grief, and have become stuck in a state of anger or denial, you risk pushing your loved one into situations they are not capable of managing on their own. This will only result in frustration and hurt-feelings for everyone involved. The importance of acceptance cannot be overstated. Continue to engage your loved one in the activities they are capable of handling and do not force them to participate in the ones that they cannot. Sometimes you only need to modify the way in which the person participates in an activity. While they may have once been responsible for setting the dinner table and pouring drinks, they might now be in charge of making sure that a plate and a drink has already been placed at every seat.
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 303-758-0680 to get in touch with one of our Colorado estate planning attorneys.
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 Natural For Me To Experience Anger At The Fact That My Loved One Has Alzheimer’s Disease?
As you negotiate your way through this situation, it is important to bear in mind that you are involved in a grieving process. One stage of this process is anger, and it is quite normal for people to experience most, if not all, of the stages of grief in some form. However, it is necessary for caregivers, relatives, and friends to seek help in dealing with their anger if it begins to affect their physical or mental wellbeing.
While involved in the grieving process, you may pass through different emotional stages that color the way in which you respond to the world around you. The grieving process is unique to everyone who is experiencing it. Some will move through the phases rapidly, some will become “stuck” on a certain phase for a very long time, and others will skip some phases all together. The best advice that can be given to a person who is grieving is this: be patient and don’t resist your feelings of grief. Working through your grief is an essential part of the healing process.
The typical stages of grief are as follows:
-Shock: In this phase, it is common for people to experience a sense of disbelief and it is difficult for them to fully comprehend what it means for their loved one to have been diagnosed with Alzheimer’s.
-Denial: In this phase, people often have thoughts such as, “It’s not really Alzheimer’s, my loved one is just becoming older and more forgetful. It’s a phase and they will snap out of it.”
-Depression: People at this stage in the grieving process primarily experience overwhelming feelings of sorrow, isolation, and loneliness.
-Physical Distress: In this stage, people will experience a physiological response to their grief. They may become ill, experience tension headaches or irritable stomachs, or they may feel very weak and tired.
-Anxiety: People involved in this stage of grieving experience an elevated sense of worry about future events.
-Anger: The grieving person may feel anger towards the loved one themselves, the illness, a doctor, a caretaker, or at God for their apparent “failures.”
-Guilt: people will often direct their anger inwards, and begin blaming themselves for things they think they shouldn’t have done, like berating or criticizing a person.
-Reluctance to Maintain Normality: People are often hesitant to participate in normal activities due to the fear that people will thereat themselves and their loved one differently.
-Memories: Memories that were once painful to recall become an integral part of the healing process. Over time, they become a source of happiness rather than pain.
-Acceptance: Acceptance is the final stage of the grieving process, and it is marked by the point at which a person is able to accept the fact that their loved one has a disease. At this point, people cease worrying about the future as much, and begin to enjoy the time they have left with their loved one.
However, this is not to say that you are immune to further grief once you have reached the acceptance phase. As a loved one’s illness progresses to new stages, people often experience the reemergence of some feelings of grief. This is also very normal.
At any point in the grieving process, the most important thing you can do is commit to your feelings. Do not try and internalize them or run from them. Feelings of grief are a necessary step in the healing process.
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.
Are Delusions and Hallucinations a Part of Alzheimer’s, or Could They be Caused by a Medication?
A hallucination is a sensory experience that is not shared by other people. While a hallucination might involve any of the five senses, people most often experience auditory and visual hallucinations. Delusions are not necessarily sensory in nature; rather, they are rigidly held belief structures that remain fixed despite the presence of conflicting evidence. The presence of both hallucinations and delusions can be the result of the disease’s progression or the side effects of certain drugs.
If you believe that a loved one’s medication may be inducing hallucinations or delusions, speak with their doctor. Information on hallucinations or delusions can also be found through your pharmacist or by visiting the website for the medication in question. Even if you believe that a medication is causing hallucinations or delusions, you should always speak to a doctor before discontinuing usage because it is often dangerous to abruptly disrupt any medicinal regiment. Physicians will often suggest that you gradually reduce usage over time until it is safe to stop.
However, the presence of hallucinations and delusions may not be related to drug use - they could simply be symptoms of a progressing case of dementia. Yet, since each individual’s experience with the disease and its progression is unique, it is difficult to predict who will and who will not experience hallucinations and delusions as a natural part of dementia.
As a general rule of thumb, if a hallucination or a delusion is a “friendly” one (meaning it does not cause distress to the individual or those around them), the caregiver should not disrupt the hallucination or delusion. It may be best to “go with the flow.”
When dealing with hallucinations, validation is essential. If your loved one believes they see and/or hear someone who is not actually there, you could ask, “Who is your friend?” “What is their name?” and “Are they friendly?”
However, should the hallucinations or delusions be of a more distressing nature, the situation becomes increasingly difficult. Commonly experienced delusions that are of a more distressing nature include belief structures such as: “A person is trying to break into my house and rob me,” or, “Someone is trying to kill me.” In this situation, validation may also be somewhat helpful. It may be necessary for the caregiver to use “therapeutic fibs” (meaning you are telling a half-truth for the good of the loved one). For example, if your loved one is afraid that there is an armed robber in the house, you might say that you are also afraid, but you called the police and the authorities have arrested the stranger. While this may temporarily alleviate your loved one’s anxieties, the hallucinations and delusions may persist over time. If this is the case, you should consult your doctor.
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.
Colorado Estate Planning - Will You Disinherit Your Grandchildren by Mistake?
Most parents leave their estates outright to their children. They have language in their wills giving the share of a deceased child to the children of that deceased child if the child dies before the parents. But what happens when the parents die, giving the inheritance to the children, and then the children die later. In most cases, even if the children are well meaning, their inheritances will pass to their spouses. This is where problems begin. Even if you love your son-in-law or daughter-in-law, they may marry again or become ill or use all of the money. They may get manipulated into leaving money to other people at death, leaving your grandchildren out in the cold holding an empty bag.
This problem is easy to solve with a Bulletproof Trust. With proper trust planning, the funds left to a surviving child will remain in trust with all of the money available to your grandchildren when a child dies. All of the money goes to the children of that deceased child, (your grandchildren), and no one else. The ability of the Bulletproof Trust to keep family assets in the family blood line makes these types of trust extremely popular with our clients blessed with grandchildren. The use of a Colorado Living Trust with special Bulletproof Trust provisions is the answer.