Day to day caregiving is difficult enough. However when dealing with Alzheimer’s, the very nature of this disease and the way it affects the brain frequently have added frustrations and difficulties, which make Caregiver’s lives just that much more difficult. Our mission at www.easycaregiving.com is to make sure you have every advantage possible. Please join me at that site and sign up for a FREE newsletter and received a FREE stress management guided imagery recording.

Today, part two of our series, we are going to talk about incontinence. The primary source for the following is great booklet from my library called “Understanding Difficult Behaviors: Some Practical Suggestions for Coping with Alzheimer’s Disease and Related Illnesses”. It was written 20 years ago but has stood the test time, as one of the best resources for Alzheimer’s. It was first published by the Geriatric Education Center of Michigan.

INCONTINENCE

The first thing we should say is, it is not necessarily permanent. Except in the very late stages, it is controllable. It’s just a matter of how much time and effort you have to put into helping your loved one become autonomous when it comes to going to the bathroom. Remember there are different levels of incontinence. For example, a person may have bladder incontinence, or bowel incontinence, it could be only night time incontinence. Let’s take a look

Possible Causes are physiological, medical, and environmental.

Here’s a very long list of causes:

• Infections, such as urinary tract infection (UTI) urethritis or vaginitis, can cause loss of urine control.
• Men are especially susceptible to infections after prostate surgery.
• Prostrate problems in men can cause retention of urine
• In women, constipation or fecal impaction can block the bladder so that urine leaks past the blockage.
• In older women, weak pelvic muscles can sometimes cause “stress incontinence” or “leaking” This may happen when a person laughs, coughs, or sneezes.
• Chronic illnesses such as diabetes, Parkinson’s disease, strokes or any other condition which limits mobility and/or causes chronic pan (e.g., rheumatoid arthritis) can make it difficult to get to the bathroom.
• Vision changes can make it difficult to see the way to the bathroom or the bathroom door properly.
• Insufficient intake of fluids can cause irritation of the bladder.
• Dehydration may cause incontinence by lowering or eliminating the signal to urinate.
• The urge or signal to go to the toilet may no longer be understood or received by the brain (due to brain changes due to dementia).
• Fluids having a diuretic effect, such as coffee, tea, cocoa, beer, colas, can affect control of urine.
• Medications, especially tranquilizers, sedatives and antidepressants can affect incontinence. These are often given to facilitate sleep or calm behavior but these drugs can also affect bladder muscle function and/or reduce a person’s sensitivity to body signals. Diuretic medications such as Lasix can also increase frequency of urination.

ENVIRONMENTAL CAUSES

• Distance to the bathroom may be too far.
• Bed may be too high from the floor, making it difficult for the person to get up.
• Floor and toilet seat may be the same color, making it difficult to find the toilet.
• Improper footwear may cause person to be afraid of falling.
• Persons may have trouble undressing to go to the toilet.
• Lack of privacy, particularly in institutional settings, may inhibit the person.
• Poor lighting may make it difficult to find the bathroom or to locate the toilet inside the bathroom.
• Orientation cues (signs) may be lacking which could help the person locate the bathroom.
• In nursing homes, being in bed with rails, being restrained or lying on protective pads may give residents the message that they are expected to be incontinent.

OTHER CAUSES

• Person may not remember what to do once in the bathroom.
• The task may be too complicated.
• Person may need help undressing, sitting on the toilet, wiping or rising from the toilet.
• Person may be fearful or anxious about having to partially undress in front of an unfamiliar caregiver.
• Caregiver may not be giving simple or clear enough instructions.
• Caregiver may be rushing.
• The person may no longer be able express need to urinate.

COPING STRATEGIES

If you really want to help, observe carefully and assess the problem.

• Do accidents happen only at certain times of the day or only at night?
• How often does the person urinate?
• Did the incontinence begin suddenly?
• Is the person urinating in improper places, such as in flower pots or in closets or in the kitchen sink?
• Do accidents happen on the way to the bathroom?
• Keep a diary or a log for several days noting times when accidents occur and the amount of fluid intake and output. The information will give you clues and also be helpful to the doctor.
• Have a through medical examination to discover any possible infections or medication problems that may be contributing to the incontinence.
• If a person has a fever that persists for more than 24 hours, report it to the doctor at once. Urinary tract infections are often accompanied by fevers and can be dangerous if left untreated.
• Be aware that a number of medications can be used to treat incontinence. However, these drugs may cause side effects such as dry mouth and eye problems and therefore must be carefully monitored.
• If a diuretic is being taken, it is important to carefully consider the times of day when it is given.
• Consider a continence diagnostic evaluation if the cause of the incontinence is still unknown. This would involve a series of tests that can determine how well the urinary system is functioning. These procedures are, however, uncomfortable and expensive and the benefits need to be carefully evaluated on an individual basis.
• Be sure the person is drinking adequate fluids – a minimum of 5 – 8 glasses daily. Many dementia victims forget to drink or may no longer recognize the sensation of thirst. A wide variety of substances act as fluids, e.g., jello, popsicles, ice cream. Also, try herbal teas and decaffeinated coffee; caffeine can affect continence adversely.
• Set up a regular schedule with specific times for the persons to have something to drink, e.g., with meals and three daily snacks.
• Observe toileting pattern of the person both during the day and at night. Try and toilet just before his/her expected time. This may vary from every two to four hours.
• Remember to toilet them before and after meals and immediately before going to bed.
• Make sure the person actually urinates before getting off the toilet.

VERY IMPORTANT

• Communicating with some one that has Alzheimer’s takes a conscious effort: When trying to direct someone simplify the steps involved. Do one step at a time.
• Use short words and short, simple instructions. For example: “Sit down.”
• Watch for nonverbal clues that the person with dementia has to go to the bathroom, such as reaching for a belt, tugging at a zipper or taking pants down. Also watch for restless behavior or facial expressions that may signal distress.
• Make sure that sitters, nursing home staff or other paid caregivers understand the terms or words that are familiar. Some people may use children’s words or slang like “pee” “tinkle” or “take a leak”. Make sure that the Alzheimer’s sufferer knows the words they are using.
• Listen carefully, because the person may say the wrong word. For example “I want tea” or “take a peek”
• Even severely impaired people do care when they have had an accident. Saying something like “Soon, everything will be all right” or “Don’t worry, everything will be fine” may reassure the person.

CLOTHING

• Simplify clothing. Try Velcro tape instead of zippers or buttons.
• Try elastic waistbands for trousers or wrap around skirts.
• Use underpants when possible. They can serve as a reminder to stay dry and as a stimulus to use toilet when wet.
• Change clothes when they are wet. Try not to let the person become accustomed to wet clothes.
• Select clothing that is washable and does not need ironing. Tennis shoes may be easier to keep clean if person is incontinent.

PROTECTIVE GARMENTS

• Adult briefs, are sold small, medium, large and extra large. Make sure you get the right size. A little too small an they may pinch or be uncomfortable, too large and they will not be leak proof and fall down when wet.
• Washable briefs are available with snapping plastic outer layer. Disposable briefs are bit pricey.
• Washable pants with disposable pads are and alternative for urinary incontinence only.

SKIN CARE

• Wash the skin after any accident. It is important to keep the person’s skin clean and dry to prevent rashes and sores. There are special products available which act as both soaps and skin conditioners. Look into creams for adult diaper rash.

AT NIGHT

• Consider putting a commode beside the bed, especially if the person has trouble moving around.
• Make sure there are night lights in the bathroom, hallway and bedroom.
• Make sure there is no clutter or obstacles in the pathway to the toilet. Falls often occur on the way to the bathroom at night.
• Make sure footwear is not floppy or slippery.
• Use disposable pads and rubberized flannel sheets to protect bedding.

BATHROOM AIDS:

• A raised toilet seat with grab bars makes it easier for a person to get on and off the toilet.
• Make sure the seat is fastened securely to the toilet so that it does not slip when a person sits on it.
• Padded toilet seats are more comfortable for the person who must sit for some time.
• If getting to the toilet is a problem, place a chair style commode near the bed. Make sure you leave the top off at night.
• Grab bars attached to the toilet seat are wall-mounted.

OTHER CONSIDERATIONS

• Purchase washable chair cushion covers.
• Soiled clothing hidden in a closet, under the bed or in a dresser drawer may be signs of incontinence.
• It is very important to respect the privacy and dignity of the person who may be having problems with incontinence. Losing control can be a terribly humiliating and embarrassing experience and caregivers need to be sensitive to these feelings. Every effort should be made to preserve the person’s self-esteem, for many dementia victims are quite aware of their deficits.
• Family member s and other caregivers also may feel embarrassed to awkward when assisting with toileting and should be aware that these are normal feelings Sometimes people find cleaning up to be a very difficult and unpleasant task and may gag. Try to be calm and reassuring and recognize that both of you probably feel quite uncomfortable.
• It goes without saying, put lids on waste paper baskets and other trash containers.

Wow, that is big topic. Again, like the previous topic “anger and agitated behavior”, we are only scratching the surface of possible causes and solutions. But I sincerely hope you will help me by signing up for my newsletter at www.easycaregiving.com

There is an amazing magazine called Life Extensions, and I just got a great book from them called “Disease Prevention and Treatment: Scientific Protocols that Integrate Mainstream and Alternative Medicine” Based Upon Thousands of Research Studies and Clinical Experience of Physicians Around the World.

I was amused at something I read in the Preface. Of course I paraphrased it a bit, but please enjoy and see how many of these ten points have happened to you or someone you love. Please do not be offended. Of course not all hospitals are like this, and there are some wonderful people that work in hospitals and do a great deal of good in this world.

Why Hospitals Suck
Imagine checking into a hotel and being told the following:
1. You will check in at our convenience and be placed in a room of our choosing.
2. You will be disturbed at our convenience.
3. You will be fed at our convenience with whatever food we choose to give you.
4. You will share your room and bathroom with one or more total strangers who are sick and may be dying.
5. You will be expected to go to sleep at a time of our choosing. The door to your room will be left open so that you will be exposed to noise, light, and passing medical personnel throughout the night. These distractions will intensify early in the morning, which will awaken you.
6. You will be exposed to many harmful bacteria, which could lead to an antibiotic-resistant infection that might kill you.
7. In the event you experience difficulties while staying with us, we will respond to your calls for help at our convenience.
8. We don’t know how much money we will charge you because we don’t yet know how many doctors will examine you, what tests and procedures will be performed on you, and how long you will remain in the hospital.
9. Even though you may be curious as to why we keep sticking needles in you, strapping you onto machines, putting fluids in you, giving you enemas, and inducing other discomforts. We are not obligated to inform you of our reason for these procedures.
10. You cannot check out of the hospital until we pull all the needles, catheters, and other intrusive objects out of you, give you permission to leave, and force you to sign all kinds of papers.

Now click on this link to the right —>EASY CAREGIVING and sign up for my newsletter and get a FREE stress management download.

Day to day caregiving is difficult enough. However when dealing with Alzheimer’s, the very nature of this disease and the way it affects the brain frequently have added frustrations and difficulties, which make Caregiver’s lives just that much more difficult.
I start a series today that I hope will help caregivers with ‘Difficult Behaviors’. Difficult behaviors are fairly common conditions that we (Alzheimer’s professionals) see frequently and cause added difficulty for caregivers. For example: Angry, agitated behavior, Incontinence problems, and problems with dressing, bathing, eating and sleeping. There are also problems with Paranoia, wandering, repetitive actions, and ever frequent “wanting to go home”, and in the very late stages screaming and verbal noise.
With each of these problems, no matter how random they seem there is a cause. Therefore, the solution will be found in thinking about possible causes and addressing it. They might be physical, mental, medical, environmental, or circumstantial. When you notice a reoccurring problem in a loved one first start by trying to figure out the cause, for example:
Lets start with Anger and Agitation.
Physical, Mental, Environmental and Medical Causes:
Fatigue at time of request, activity or event.
Disruption of sleep pattern (day and night reversal) causing sleep deprivation.
Physical discomfort, such as pain, fever, illness, constipation, fecal impaction, bladder infection, expressed as anger.
Loss of control over behaviors due to physical changes in the brain.
Adverse side effects of medication such as psychotropics, sedatives or tranquilizers.
Impaired vision or hearing causing person to misinterpret sights and sounds.
Hallucinations.
Sensory overload – too much noise, activity, or clutter, or too many people in immediate environment.
Unfamiliar people, place or sounds.
Sudden movements, startling noises.
Feeling lost, insecure, forgotten. When familiar person is out of sight, impaired person may feel abandoned.
Difficulty adjusting to darkness from well lighted area and vice versa.
Being asked to respond to several questions or statements at once.
Responding to arguments between other people.
Response to caregiver’s impatience, stress, irritability,
Person scolded, confronted, contradicted.
Surprised by unexpected physical contact.
Inability to perform what was once a simple task, e.g., buttoning clothes.
Instructions unclear or too complicated.
Change in schedule or routine.
Attention span too short for task.
Task not broken down into manageable steps.
Activity perceived as too childlike, insulting.
How to Cope
Begin with a medical evaluation to rule out physical and/or medication problems, always ask about bladder infection as a possible cause. You would be surprised at how often it’s the case.
Discuss possible adverse side effects of current medications with their doctor.
Have vision and hearing checked.
Alternate quiet times with more active periods.
Plan outings, activities when person is rested.
Make sure person is comfortable – clothes are not too tight, perons is not too hot or too cold.
Simplify environment by reducing noise, number of people, and clutter.
Keep daily routine as consistent as possible. Avoid changes and surprises. For some people with dementia, the slightest change may lead ot confusion and disorientation. Try scheduling meal, bathing, and walks, at the same time every day.
Keep furniture and objects in the same place at all times.
Make sure the person is protected from hurting him/herself. Remove sharp utensils, tools, and objects from environment.
Remove the person from stressful situation, persons, or place. Gently guided the person from environment while speaking in a calm and reassuring voice.
Distract the person with a favorite food or activity. This may reduce agitated feelings. Distraction and avoidance are often the most useful approaches to handling agitated or angry behaviors.
Rules of Thumb
Try these communication techniques:
Avoid asking questions that rely on memory
Try not to reason with the person as they no longer have the ability to think logically.
Reasoning or rationalizing with the person frequently leads to frustration and anger.
Try not to express your anger or impatience verbally or with physical movements, like wagging your finger at the person.
Speak slowly and clearly, and use short sentences.
Allow adequate time for persons to respond and/or process information.
Limit choices. For example, never say “what do you want to eat” rather say “do want the chicken or the fish”.
That’s a pretty long list, for now. However, if you have ideas that you find work well, please add your comments here so we can share it with some other caregivers. I have found over the years that there is nothing better than someone giving advice based on their actual experience.

Please sign up for my newsletter – go to www.easycaregiving.com you will get on the mailing list AND get a free stress management recording.

Are you using the internet to its fullest potential? Almost every time I log on, I find something truly amazing. Here’s my latest discovery:

The Mayo Clinic, now has a health manager site that is absolutely free! Imagine having all of your medical information at your fingertips. Or if you are a caregiver, having your loved one’s total medical records available at any time of day or night. Imagine you have to take your parent or spouse with dementia to the ER on a Sunday morning. Now with a click and password you can give the hospital access to their medical records, prescriptions, etc.

But this site doesn’t just consolidate medical records from a half a dozen sources. You can also get medical advice or look up symptoms or problems from top doctors. Based on the person information you provide, the site automatically recommends important health screenings and tests that are suggested for your age and condition.

It stores your emergency information, your doctors, your health insurance information and even your pharmacy. It will even keep track of your appointments and send you appointment reminders,  and even remind you about perscription refills.

All of this – For Free – no strings attached. You don’t even have to wade through obligatory advertisements like you might on other supposedly free websties.

The list of services on this one site could go on and on, like tracking your alergies, surgeries and procedures, and family histories. But go see for youself: www.healthmanager.mayoclinic.com

But before you go there, quickly jump over to www.easycaregiving.com to sign up for my newsletter, I am sending out the latest edition within a day or so, and it will have tons of invaluable information just like this!

Prevent Burnout by using Adult Day Care
If you are caregiver you may be struggling with exhaustion, frustration, and depression. You may be feeling that you have little support from friends and family and feeling that people do not understand the difficulty of what you do. Let’s face it; most people would not unless they walked in your shoes for a week. If you are a typical caregiver you are alone and it’s not easy. Given that, you need every break you can get. Fortunately, Adult Day Care Centers can be one of the best weapons in your arsenal. There are very few opportunities for you to get a break, so you should never pass up a chance to take one.

There are two general types. One is based on a medical model and the other on a social model. The medical model provides comprehensive medical, therapeutic, and rehabilitation day treatment. The social model offers supervised activities, peer support, companionship, and recreation. Both models assist older adults and those with chronic conditions to remain as independent as possible, for as long as possible.

Adult day care is a planned program of activities designed to promote well-being though social and health related services. Almost exclusively adult day cares are only open during the week, typically between 8am and 3 or 4pm, and they provide snacks in addition to a midday meal.

Adult day care offers a win/win situation for everyone in the family-not only for the member who attends the program, but also for the family member who has primary responsibility as caregiver. Adult day care provides a much-needed respite for the caregiver, affording a break from the physical demands and stress of providing “round-the-clock care.”

For the participant, adult day care’s benefits can be extensive:
* A safe, secure environment in which to spend the day
* Enjoyable and educational activities
* Improvement in mental and physical health
* Enhanced or maintained level of independence
* Socialization and peer support
* Nutritious meals and snacks

For the caregiver, adult day care’s benefits are equally important:
* Time for routine chores like shopping and banking
* Make time for ones own medical and dental needs
* Time for personal rest and recreations: exercise or naps
* Opportunity for household tasks and cleaning

A well-run adult day care center’s goals will focus on enriching the participants’ lives, building upon their skills, knowledge, and unique abilities and strengths. Below are some of the activities that may be available:
* Arts and crafts
* Musical entertainment and sing-a-longs
* Mental stimulation games such as BINGO
* Stretching or other gentle exercise
* Discussion groups (books, films, current events)
* Holiday and birthday celebrations
* Local Outings

Besides recreational activities, some adult day care centers provide transportation to and from the center, social services including counseling and support groups for caregivers, and health support services such as blood pressure monitoring and vision screening.

Finding the right one for you

The National Adult Day Services Association (NADSA) recommends you start by asking yourself what specific services both elder adult and caregiver most need. For the day care participant, are social activities primary? Assistance with walking, eating or medications? Mental stimulation? Exercise? As a caregiver, is support what you need most? Some free time? Answering these questions will help you determine which type of adult day care center can best serve you: social or health-focused.
In addition to the many references and resources to help locate adult day care centers in your area, you can also try:

* Your family doctor
* Local social services or health department
* Mental health centers
* Local senior centers
* Area Agency on Aging (Call 1-800-677-1116 for the Area Agency in your area)
* Yellow pages listings under Adult Day Care, Aging Services, and similar categories.
When you phone the center(s) that you are considering, NADSA suggests asking the following questions:
* Who owns or sponsors the agency?
* How long has it been operating?
* Is it licensed or certified? (if required in your State)
* What are the days and hours of operation?
* Is transportation to and from the center provided?
* Which conditions are accepted (memory loss, wheelchairs, incontinence)?
* What are the staff credentials, and what is the ratio of the staff to participants?
* What activities are offered? Are there a variety of individual and group programs?
* Are meals and snacks included? Are special diets accommodated?

Next, If you are a meticulous person, spend a day at the center that sounds best to you, so that you can get a “feel” for the people and environment. Be sure to bring a site checklist with you (see references and resources below). You may wish to go back a few times to see whether your experience on different days confirms your initial impressions.

To find out more about the specific adult day care centers where you live, you will want to contact your local aging information and assistance provider or area agency on aging. The Eldercare Locator, a public service of the Administration on Aging (at 1-800-677-1116)or www.eldercare.gov can help connect you to these agencies.
The National Adult Day Services Association is a good source for general information about adult day care centers and programs. They can help you link to a state adult day care association. It can be reached by calling the toll-free telephone number 1-866-890-7357 or by going to their website which you can find with a simple web search.

Some area agencies on aging have programs or link to services that assist older people obtain low-cost assistive technology. You can call the Eldercare Locator at 1-800-677-1116 to locate your local triple A. In addition local civic groups, religious and veterans’ organizations, and senior centers may be able to refer you to assistive technology resources.

I hope this helps enough to get you started. This article is just a synopsis of a much longer eBook which will be included for subscribers of the CaregiverRelief newsletter. Find out more by checking out easycaregiving.com When you get there, take a look in the upper left-hand corner and sign up for the free stress management CD, and are automatically enrolled for the next newsletter and ton of other free stuff.
If this is your first time here and you want to read some of my published articles please go to How to Avoid ending up in Nursing Home and Caregiving is a Thankless task These are just longer versions of what has already been posted here.

Finally I want to shamelessly promote an amazing product called Resveratrol and refer you to the manufacturers of the most powerful compound I have found so far: Longevity RezV who graciously offer a free sample for those that find them through my link. It worth looking at the site if just to see the 60 minutes segment that they use on their home page.

thanks, Donahue

Sitting here on a Thanksgiving weekend, I am roused to concern as I am watching Dr. Oz on television. Today’s episode is on over-the-counter medication, and the most common dangers of mixing your prescriptions with over-the-counter medications.

For example if you are on blood thinners like coumadin you should be aware than many supplements, as well as over-the-counter meds, are also blood thinners. Garlic, ginger, ginko biloba are all blood thinners. As are aspirin and some other OTC pain pills. Some people are on several of these things at the same time!

What to do? Be sure to tell your doctor if you are taking these supplements. Dr. Oz used the example of someone bleeding internally potentially bleeding out due to overly thinned blood and an abnormal reduction in platelets (our natural blood clotters).

Another danger is over-the-counter decongestants. These are very bad for diabetics and people with high blood pressure, as they raise your blood pressure and can be very dangerous for someone who is hypertensive.

Dr. Oz had several experts on the show and used various experts to support his warnings. But none of this means you shouldn’t take supplements or vitamins, or that you should not use OTC meds. It only means that you should do at least one of two thing: One, thoroughly research what you take before you take it. Which means look it up on the internet or take the time to read the accompanying literature. You can go to a health food store and ask them about what you are taking, or pick up a good book on the subject. Two, make a note of all your supplements and vitamins, and everything in your medicine cabinet (whether you are currently using them or not), and take it with you to your next doctors visit.
Free 30 Day Sample of Resveratrol

I am testing some marketing items…and the only way is to see it in a blog. So feel free to ignore what follows, but if you like, go check it out. They have really cool personalized Christmas ornaments.

1
<a href="http://www.cpaclicks.com/secure.asp?e=drkbhmckrkrx&d=0&l=0&o=&p=0&subID1=&subID2=&subID3=&subID4=&subID5= Personalized Ornaments
2
Beautiful Personalized Ornaments
3
Awesome Holiday Ornaments
4
<a href="Christmas Ornaments
5
Look At This

7

8
http://www.cpaclicks.com/secure.asp?e=drkbhmckrkrx&d=0&l=0&o=&p=0&subID1=&subID2=&subID3=&subID4=&subID5= Click Here

Very interesting video from “The Economist” of all places. It is a short, less than 5 minute video with little factoids about the future of the internet. It’s mind boggling (and there is nothing for sale) just watch

cool huh?

p.s. if you have another 2 minutes, take a look at www.easycaregiving.com and sign up for the newsletter. thanks, Donahue

If you are caregiver you may be struggling with exhaustion, frustration, and depression. You may be feeling that you have little support from friends and family and feeling that people do not understand the difficulty of what you do. Let’s face it; most people would not unless they walked in your shoes for a week. If you are a typical caregiver you are alone and it’s not easy. Given that, you need every break you can get. Fortunately, Adult Day Care Centers can be one of the best weapons in your arsenal. There are very few opportunities for you to get a break, so you should never pass up a chance to take one.

There are two general types. One is based on a medical model and the other on a social model. The medical model provides comprehensive medical, therapeutic, and rehabilitation day treatment. The social model offers supervised activities, peer support, companionship, and recreation. Both models assist older adults and those with chronic conditions to remain as independent as possible, for as long as possible.

Adult day care is a planned program of activities designed to promote well-being though social and health related services. Almost exclusively adult day cares are only open during the week, typically between 8am and 3 or 4pm, and they provide snacks in addition to a midday meal.

Adult day care offers a win/win situation for everyone in the family-not only for the member who attends the program, but also for the family member who has primary responsibility as caregiver. Adult day care provides a much-needed respite for the caregiver, affording a break from the physical demands and stress of providing “round-the-clock care.”

For the participant, adult day care’s benefits can be extensive:

* A safe, secure environment in which to spend the day

* Enjoyable and educational activities

* Improvement in mental and physical health

* Enhanced or maintained level of independence

* Socialization and peer support

* Nutritious meals and snacks

For the caregiver, adult day care’s benefits are equally important:

* Time for routine chores like shopping and banking

* Make time for ones own medical and dental needs

* Time for personal rest and recreations: exercise or naps

* Opportunity for household tasks and cleaning

A well-run adult day care center’s goals will focus on enriching the participants’ lives, building upon their skills, knowledge, and unique abilities and strengths. Below are some of the activities that may be available:

* Arts and crafts

* Musical entertainment and sing-a-longs

* Mental stimulation games such as BINGO

* Stretching or other gentle exercise

* Discussion groups (books, films, current events)

* Holiday and birthday celebrations

* Local Outings

Besides recreational activities, some adult day care centers provide transportation to and from the center, social services including counseling and support groups for caregivers, and health support services such as blood pressure monitoring and vision screening.

Finding the right one for you

The National Adult Day Services Association (NADSA) recommends you start by asking yourself what specific services both elder adult and caregiver most need. For the day care participant, are social activities primary? Assistance with walking, eating or medications? Mental stimulation? Exercise? As a caregiver, is support what you need most? Some free time? Answering these questions will help you determine which type of adult day care center can best serve you: social or health-focused.

In addition to the many references and resources to help locate adult day care centers in your area, you can also try:

* Your family doctor

* Local social services or health department

* Mental health centers

* Local senior centers

* Area Agency on Aging (Call 1-800-677-1116 for the Area Agency in your area)

* Yellow pages listings under Adult Day Care, Aging Services, and similar categories.

When you phone the center(s) that you are considering, NADSA suggests asking the following questions:

* Who owns or sponsors the agency?

* How long has it been operating?

* Is it licensed or certified? (if required in your State)

* What are the days and hours of operation?

* Is transportation to and from the center provided?

* Which conditions are accepted (memory loss, wheelchairs, incontinence)?

* What are the staff credentials, and what is the ratio of the staff to participants?

* What activities are offered? Are there a variety of individual and group programs?

* Are meals and snacks included? Are special diets accommodated?

Next, If you are a meticulous person, spend a day at the center that sounds best to you, so that you can get a “feel” for the people and environment. Be sure to bring a site checklist with you (see references and resources below). You may wish to go back a few times to see whether your experience on different days confirms your initial impressions.

To find out more about the specific adult day care centers where you live, you will want to contact your local aging information and assistance provider or area agency on aging. The Eldercare Locator, a public service of the Administration on Aging (at 1-800-677-1116)or www.eldercare.gov can help connect you to these agencies.

The National Adult Day Services Association is a good source for general information about adult day care centers and programs. They can help you link to a state adult day care association. It can be reached by calling the toll-free telephone number 1-866-890-7357 or by going to their website which you can find with a simple web search.

Some area agencies on aging have programs or link to services that assist older people obtain low-cost assistive technology. You can call the Eldercare Locator at 1-800-677-1116 to locate your local triple A. In addition local civic groups, religious and veterans’ organizations, and senior centers may be able to refer you to assistive technology resources.

I hope this helps enough to get you started. This article is just a synopsis of a much longer eBook which will be included for subscribers of the CaregiverRelief newsletter. Find out more by checking out easycaregiving.com When you get there, take a look in the upper left-hand corner and sign up for the free stress management CD, and are automatically enrolled for the next newsletter and ton of other free stuff.

If this is your first time here and you want to read some of my published articles please go to How to Avoid ending up in Nursing Home and Caregiving is a Thankless task These are just longer versions of what has already been posted here.

Finally I want to shamelessly promote an amazing product called Resveratrol and refer you to the manufacturers of the most powerful compound I have found so far: Longevity RezV who graciously offer a free sample for those that find them through my link. It worth looking at the site if just to see the 60 minutes segment that they use on their home page.

thanks, Donahue

I’m on the speakers bureau of the Alzheimer’s Association and this weekend I am giving a talk on “Partnering with Your Doctor”  In the materials that the Alzheimer’s Association provided me for the talk was a short little quiz.  I was impressed with this short 12 question survey, and thought you would like to see it too.

In my experience, caregivers often lose focus when they take their loved one to a doctor.  Maybe you do too?  Do you feel rushed when the doctor finally comes into the examination room?  Do you sometimes leave the office and remember something important you wanted to discuss with the doctor?  Or do you start running at the mouth frittering away your time with the doctor talking about the minutiae of your loved one’s behavior or symptoms and get side tracked from the important changes that you should have covered.

Here’s the quiz, lets see how you do.  And remember afterwards to go over to either www.easycaregiving.com or www.caregiverrelief.com and sign up for the newsletter.

One more thing: I noticed that the quiz seems to be written to you and about your own doctors visits.  If you are a caregiver for a memory impaired person please mentally re-word the questions so they fit your circumstances.

(Keep track of your answers so you can determine your score afterward.)

Do you usually:

1. Make a list of questions, symptoms and concerns before your doctor visits? (Yes or No)
2. Bring a friend or family member with you to the doctor’s office? (Yes or No)
3. See the doctor right away when you feel like something is wrong? (Yes or No)
4. Ask your doctor questions about your symptoms and concerns? (Yes or No)
5. Bring a list of your medications and medicine bottles with you to your doctor visits? (Yes or No)
6. Ask your doctor what you need to do next about your illness? (Yes or No)
7. Make decisions about your care together wit the doctor? (Yes or No)
8. Ask your doctor what results and side effects you can expect from your medications and treatments? (Yes or No)
9. Take notes during doctor visits? (Yes or No)
10. Leave the doctor’s office with all your questions answered? (Yes or No)
11. Ask your doctor for written information about your medical condition? (Yes or No)
12. Ask the doctor for a diagnosis so you know exactly what the problem is? (Yes or No)

Count the number if times you circled “yes”   (score: _________)

0 – 4 = I am not a very active health care partner

9 or more = I am a very active healthcare partner

So how did you do?  Is there room for improvement? Not to worry – you are on the right track, you will be fine.

Remember you have two websites that can help you with all your caregiving questions. Start with www.caregiverrelief.com and stay updated with www.easycaregiving.com and don’t forget to sign up for the FREE newsletter at either site.

Please help me keep this blog active and at least visit my sponsors website. (Not to mention that its an amazing product that I use faithfully) “>CLICK HERE for the ResV site and you can get a FREE sample by using this link!