Stephanie Z's link list

Stephanie D Zeman MSN RN
This is an updated list of links about information care givers will need. Most helpful will be "Understanding the dementia experience" which will give you an idea of what your LO is going through; and "Communication skills" Which will help you to communicate in ways which will avoid or decrease her negative behaviors.

It is also important for you to use the 800 number at the National Alz. Assoc. if you run into problems we can't help with. The 24/7 Helpline is: 1.800.272.3900

Here are some very helpful links on dementia care:

Guide to diagnosing and treating dementia

https://www.caregiver.org/diagnosing-dementia

Anosognosia explains why dementia patients are unaware that they are ill:

http://alzonline.phhp.ufl.edu/en/reading/Anosognosia.pdf

Understanding the dementia experience

http://www.smashwords.com/books/view/210580

Communication Skills:

http://www.alzconnected.org/discussion.aspx?g=posts&t=2147511283

Selecting a home health caregiver:

http://www.alz.org/care/alzheimers-dementia-screening-providers.asp

Elder abuse and neglect:

http://www.alzconnected.org/discussion.aspx?g=posts&t=2147495517

Bathing and Showering

http://www.alzconnected.org/discussion.aspx?g=posts&t=2147491802

Help with dental care (PDF fine from Aust. Alz. Ass.)

http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=1782

How to determine if your LO has pain. Use the Pain Scale:

http://prc.coh.org/PainNOA/Abbey_Tool.pdf

Picking at skin/scabs

http://www.alzcompend.info/?p=233

Sexual Consent Guidelines Weinberg Center and Hebrew Home

http://www.businessweek.com/pdf/hebrew_house_policy/sexualconsentguidelines.pdf

Finding a Memory Care Unit:

When you start to look at nursing homes or ALFs, begin with a call to your local AD chapter and get a list in your area.

You can also go to: Guide to retirement living

http://www.retirement-living.com/ where you will get free information on nursing homes in your area.

Then go to the government site called Nursing Home Compare and get the results of their last surveys so you can get some idea of the quality of their care.

http://www.medicare.gov/nursinghomecompare/search.html

Also, when you select some, Google them along with the word lawsuit to see if there are or were any significant problems that crop up.

Do select at least 3 to look at. DO NOT expect them to look like an ALF. The decor will be less attractive, but in a good nursing home with a dementia unit, the care will be much better.

Once you have picked one, you will want to visit at least 3 times. Once during meals to see what the residents are eating (see if you can eat there as well), once on the evening shift, and once during activities to see how many people attend or have other things of interest available to do.

OTHER HELPFUL SITES

Twenty Common Nursing Home Problems and How to Solve Them.

http://www.nsclc.org/wp-content/uploads/2011/02/20-Common-Problems-Nov-2010-Final.pdf

Urinary infections in people with dementia

http://www.disabled-world.com/health/aging/uti.php

Eating problems

http://www.alzconnected.org/discussion.aspx?g=posts&t=2147489263

Caregiver kitchen

http://caregiver.com/kitchen/index.htm

Australian Site: Nutrition Matters – Finger Foods:

http://dietitiancentre.com.au/wp-content/uploads/2011/11/Nutrition-Matters-Aged-Care-September-2010-Final.pdf

Hope this helps Stephanie Z

Delirium or Dementia - Do you know the difference?

From   http://www.alz.org/norcal/in_my_community_17590.asp from Northern California and Northern Nevada Chapter Home > Delirium or Dementia - Do you know the difference?

What do we mean by delirium?

Also called the acute confusional state, delirium is a medical condition that results in confusion and other disruptions in thinking and behavior,
including changes in perception, attention, mood and activity level.

Individuals living with dementia are highly susceptible to delirium. Unfortunately, it can easily go unrecognized even by healthcare professionals
because many symptoms are shared by delirium and dementia. Sudden changes in behavior, such as increased agitation or confusion in the late evening, may be labeled as “sundowning” and dismissed as the unfortunate natural
progression of one’s dementia.

When is a change in behavior delirium and not part of dementia?

In dementia, changes in memory and intellect are slowly evident over months or years. Delirium is a more abrupt confusion, emerging over days or weeks,
and represents a sudden change from the person’s previous course of dementia.

** Unlike the subtle decline of Alzheimer’s disease, the confusion of delirium fluctuates over the day, at times dramatically. Thinking becomes more
disorganized, and maintaining a coherent conversation may not be possible. Alertness may vary from a “hyperalert” or easily startled state to drowsiness and lethargy. The hallmark separating delirium from underlying dementia
is inattention. The individual simply cannot focus on one idea or task.

What if you suspect delirium?

..... Secondly, create a safe and soothing environment to help improve the course of delirium: keep the room softly lit at night, turn off the television
and remove other sources of excess noise and stimulation. The reassuring presence of a family member, friend, or a professional often prevents the need to medicate.

And lastly, tread lightly with medications. Sedatives, sleeping medications and other minor tranquilizers play a very limited role in delirium management
unless a patient is experiencing drug withdrawals.

Prevention of Delirium

  Avoid illness through smoking cessation, a balanced diet, regular exercise, adequate hydration and vaccinations to prevent influenza and pneumonia.

  Avoid alcohol in any amount.

  Exercise caution with medication, especially sleep aids, and periodically ask the physician for a “medication review.”

  Eliminate or reduce the use of the following medications:

  Antihistamines (e.g., diphenhydramine)

  Bladder relaxants

  Intestinal antispasmodic

  Centrally-acting blood pressure medicines (e.g., clonidine, methyldopa)

  Muscle relaxants

  Anticholinergics (drugs with atropine-like effects)

  Opioids (e.g., codeine, hydrocodone, morphine)

  Anti-nausea medication

  Benzodiazepine type sedatives

The following interventions appear to reduce the risk of delirium during hospitalization:

  Early mobilization after surgery

  (e.g., walking, getting up in a chair)

  Assisting the individual with eating

  Round-the-clock acetaminophen for surgical pain (may lessen the need for stronger drugs)

  Minimizing bladder catheter use

  Avoiding physical restraints

  Avoiding multiple new medications

  Hydration – encourage and assist with fluids

  Normalizing the environment (e.g., pictures from home, familiar objects, cognitively stimulating activities and reminders, visits from family
members)

  Providing sensory devices if needed

  (glasses, hearing and visual aides from home)

---

Overview of Delirium and Dementia

by Juebin Huang, MD, PhD

Delirium (sometimes called acute confusional state) and dementia are the most common causes of cognitive impairment, although affective disorders (eg,
depression) can also disrupt cognition.

Delirium and dementia are separate disorders but are sometimes difficult to distinguish. In both, cognition is disordered; however,

dementia affects mainly memory, and

delirium affects mainly attention

--------------------------
 Matching the environment to patients with delirium: lessons learned from the delirium room, a restraint-free environment for older hospitalized adults with delirium.
Flaherty JH1, Little MO.

Abstract

Delirium is associated with several negative outcomes and is not always preventable. Current practices for the management of older hospitalized adults with delirium, such as one-on-one sitters, antipsychotic medications, and physical restraints, have limited effectiveness or potential health risks. 

{snipped} The authors have found that a restraint-free environment can be achieved; "tolerate, anticipate, and don't agitate" (the T-A-DA method) are the core principles of the nonpharmacological approach that go beyond the traditional strategies of management (such as reorientation); based on observational data,

Alzheimer's and Dementia Care Must read books

 Kisses for Elizabeth: A Common Sense Approach To Alzheimer's and Dementia Care (Volume 1) by Stephanie -Large Print Paperback
also available as  Kindle Purchase

 Creating Moments of Joy: A Journal for Caregivers, Fourth Edition (NEW COVER) by Jolene Brackey (Sep 1, 2008) Paperback
also available as Kindle Edition

The 36-Hour Day, fourth edition: The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease, Other Dementias, and Memory Loss in Later Life, 4th Edition

Day Trips for Caregivers - Visiting Nurse Service of New York

Day Trips for Caregivers - Visiting Nurse Service of New York: Day Trips for Caregivers
Nature Getaways within 2 Hours of NYC

People who spend time outdoors, particularly around trees and in gardens, have better physical and mental health, and the benefits can be immediate. One recent study at Stanford University found that volunteers who walked in a park-like section of the university’s campus were less anxious, less likely to dwell on negative things, and performed better on short-term memory tests than those who walked near a highway.

Arrange for a day of respite care and plan your escape! Here are day trips in the Hudson Valley, on Long Island, and in New Jersey that can help caregivers recharge. If you can only steal a few hours, we’ve also included ideas for NYC.

Over-Night Care: Night programs serving individuals with Alzheimer's

Over-Night Care: Night programs serving individuals with Alzheimer's: Over-Night Care: Night programs serving individuals with Alzheimer's

Carers often experience chronic sleep deprivation. At the onset of nighttime. The demons of anxiety, anger, fear, hallucinations and paranoia come out. Night time can be unpredictable, up and down cycles.We need All-Night Care all night respite programs. 

Hospice is likely to be the most important health care decision we make. by Joy Loverde

Hospice: I had no idea | Eldercare Blog: Families have a choice in hospice programs.
Hospice is likely to be the most important health care decision we make. For a long time, we could assume that every hospice provided high-quality care. That assumption is no longer safe. Families must shop around. To start the process, request a home visit for patient assessment and a customized Q & A. How receptive a hospice is to the following questions is an indicator of the quality of their program:

What do others say about your organization? Get references.
How long has the hospice been in operation?
Is the hospice Medicare-certified?
What is the expectation regarding the family’s role in caregiving?
Is there anything currently being done for the patient that you would not do?
(Make a list of specific family needs.) How will you address these needs?
What extra services are offered?
Is your availability 24/7?
How rapid is crisis response?
Do patients ever get transferred to inpatient care? Under what circumstances? And where do they go?
Is family respite care available? What kind? Under what circumstances?
Are your MDs/RNs certified in palliative care?
How are family complaints handled?
What kind of emotional support do you provide – now and after?

This is just brilliant! It can help so many people..

This is just brilliant! It can help so many people....Please SHARE, let's make this available for everybody! :)

Posted by Motivational and Inspirational Quotes on Thursday, August 20, 2015