Articles

2 Big Ds: Diabetes and Dementia

Diabetes is another “Big D” in the medical world, inflicting much pain and suffering. There has been some research coming out on the influence of diabetes on the risk of getting dementia. Most of the past research has focused on how Type 2 Diabetes increases the risk of dementia in older age. These studies have shown that Type 2 Diabetes increases the risk of developing dementia by only about 15-60% (depending on the study) when compared to people without diabetes. Often, the most common type of dementia people with diabetes suffer from is vascular dementia because of the damage done to blood vessels from diabetes. You’ve heard of people with diabetes having to get their foot amputated – this is because of poor blood flow. As an extension of this poor blood flow, people with diabetes can experience poor blood supply to other parts of their bodies such as their brain. When this happens, it can escalate to Vascular Dementia.

But what about the population with Type 1 Diabetes? Great question! A study was just released on February 1st in the Journal of Neuroepidemiology which focused on the effect of Type 1 Diabetes (aka insulin-dependent, or young onset) on the risk of developing dementia.

The figures are devastating. It was found that Type 1 Diabetes increases the risk of developing dementia by 1.2-3x (or by 120-300%) when compared to people without dementia. THREE TIMES!!! That is a lot!

So why do we see this stark difference in the risk of developing dementia between people with Type 1 vs Type 2 Diabetes?

One hypothesis could be that the onset of Type 1 diabetes is often much earlier than Type 2 diabetes. As a result, the detrimental effects of Type 1 diabetes have a much longer time to exert their influence on the body than in Type 2. Therefore, you may see a lot more cumulative damage in someone with Type 1 Diabetes.

What other reasons do you think Type 1 diabetes is such a greater risk factor for dementia than Type 2?

 

What to take from this? If you have Type 1 diabetes, be sure to be diligent in your self care. Make sure you’re eating well, exercising often, and taking your insulin as prescribed. Same goes for if you have Type 2 diabetes. Take care of yourself to prevent the onset of dementia. And remember, diabetes is just a RISK FACTOR for dementia. Having diabetes doesn’t mean you are going to get dementia.

 

Advertisements

“It’s a Horror Movie” – In the News

By Eleanor Pineau

Yesterday, CBC News released an article detailing the death of a man in 2013 that occurred in a nursing home. Allegations of resident-to-resident physical abuse were cited as possible contributing factors to this man’s death. After security footage was released, these allegations turned out to be true.

This case prompted further investigation into the rise of resident-to-resident physical abuse in nursing homes. In response, CBC News hired two statisticians to probe deeper. Unfortunately the outcome does no good for the population with dementia.

I was abhorred by the following statement: “They found that as antipsychotic usage went down, reports of resident-on-resident abuse went up.”

Without being able to analyze the methodology of their study, these results are absolutely useless and can lead the public down very dangerous alleyways. Anyone could conclude this outcome with very simple statistics.

This finding is not causative, meaning that the decline in antipsychotic use did NOT CAUSE an increase in resident-on-resident abuse. They could be related, but one does not cause the other. Therefore, increasing the use of antipsychotic drugs in people living with dementia will not reduce the incidents of resident-on-resident abuse.

To show you how ridiculous this finding is, here’s a famous example of a study that also had the same flaw: It was found that Switzerland has a very high breast cancer rate and they also have a very high consumption of fat. It was concluded that a high fat diet was causing this high rate of breast cancer. But this is not true. A high fat diet does not directly cause breast cancer. If it did, then many more Americans would have breast cancer than is currently present. The risk factors of breast cancer are quite numerous including age, genetics, early menstruation, low amounts of physical activity, being overweight or obese and more. With this last risk factor, consuming a diet high in fat may contribute to being overweight or obese. So in a roundabout way, a diet high in fat may increase the risk of breast cancer, but it does not cause breast cancer. More importantly, you also need other risk factors present like age and genetics to get breast cancer. A high fat diet alone is not going to cause breast cancer. This is the same conclusion we can draw about antipsychotic use and resident-on-resident abuse. A reduction in antipsychotic use has not caused an increase in resident-on-resident abuse, and there are many other factors at play contributing to the rise in abuse.

Let’s quickly look at why people living with dementia should generally not be prescribed antipsychotics.

(I say ‘generally’ because there are instances where the use of antipsychotics is appropriate such as when that person has both dementia and schizophrenia. But you must consult your psycho-geriatrician to ensure that these medications don’t cause serious side effects with other medications and co-morbid conditions.)
  1. Dementia is not a psychotic disorder.
  2. The use of antipsychotics to treat things like aggression is an “off-label” use that has not been studied for efficacy or safety.
  3. When you use an antipsychotic on a person living with dementia, you are restraining them – the same way as you would restrain someone by tying them down to a bed, except this time, you are using a drug.
  4. Antipsychotics used in people without a psychotic condition increases confusion, the risk of falls, and death. They cause tremors and involuntary movements.
  5. Antipsychotics used in people without a psychotic condition cause personality changes, increased fatigue, to the point where a person who used to be full of life starts to resemble a zombie. Trust me, it’s not a very nice sight.
No to drugs
Antipsychotics are not the answer to reducing resident-on-resident abuse

Another part of this article that really upset me was the statement that one of the reasons behind increased abuse in nursing homes is the rise in the number of nursing home residents who have dementia. It is articles like these that perpetuate the “aggressive” stigma staining all people living with dementia. Without further explanation, this statement leads people to believe that people with dementia are aggressive, unpredictable people who should be restrained, whether physically or chemically.

People living with dementia get angry just like you and me. What happens when you are trying to tell someone you’re angry but they won’t listen? You might start to yell. But that doesn’t work either. Next you might throw the pillow or your phone. But that person still ignores you. Well by this time, your temper has boiled over and you might hit them…or want to. In this situation, there are a couple of differences between you and a person living with dementia:

  1. You are able to better communicate that you are upset and why. Someone living with dementia may have lost the ability to verbally communicate.
  2. When you are so angry that you want to throw or hit something/someone, you are able to restrain yourself and inhibit those desires. A person with dementia has a reduced ability to inhibit socially inappropriate behaviours. Remember, we were taught as children to use our words instead of our fists because that is what social norms dictate. But as a person loses those teachings/memories, they revert back to more natural processes – they hit.

Just like the relationship between antipsychotic use and the prevalence of resident-to-resident abuse, there are many other factors at play that are contributing to an increase in resident-to-resident abuse other than a rise in cases of dementia. Some other factors that are contributing to the rise in resident-on-resident abuse include: insufficient staffing ratios, poor dementia training of healthcare professionals, ineffective treatment of pain, overcrowding, and many more.

The humane treatment of dementia nor is dementia itself causes of increased resident-on-resident abuse. Dementia is not the problem. How we support people living with dementia is.

Please click the link to read the original article. “It’s a horror movie” – Nursing home security footage provides raw picture of resident violence problem

Please contribute to this conversation by commenting in the box below.

 

Am I Selfish?

By Eleanor Pineau

Family caregivers of someone with dementia have a tough job. These Heroes are essentially on-duty 24/7. They direct not only their own lives, but the life of the person with dementia…to an extent. They are in-charge of personal care (i.e., bathing, toileting, grooming, etc.), meals, socialization, finances, housing – anything that goes into “LIFE,” falls on the family caregiver.

Family caregivers often become overwhelmed and stressed out. And we all know what stress can do to us! Stress breakscaregiver us down from the inside out; it’s with us almost 100% of the time; it makes us eat; it makes us stop eating; it makes us sleep non-stop; it makes us stop sleeping; it makes us gain weight; it makes us get physically sick. Stress can be traced to the root of almost all physical ailments, and absolutely worsens any physical or psychological illness.

After all family caregivers do, I still get asked: “Am I selfish?”

Am I selfish if:

  • I want to take a bath?
  • I want to go to the gym?
  • I want to go on a vacation?
  • I want to see my friends?
  • I don’t want to do it anymore?

These questions, among others, are completely normal. So what’s the answer?

You. Are. Not. Selfish.

It’s completely normal to want to take a bath, go to the gym, go on vacation, see your friends, and take a step back from caregiving. It’s also completely normal and even HEALTHY to DO those things! Do th
em!

If you find fulfillment, or a sense of pride, duty or accomplishment in caregiving, then do it. But know that you also need to take care of yourself. Helping someone in their time of need is one of the greatest gifts yo
u can give that person, AND yourself. But you shouldn’t go into caregiving every day with dread or feeling dispirited. So how do you stop or prevent feeling this way?

Take. Care. Of. Yourself.

I know it’s easier said than done, but go take a bath, go to the gym, go on vacation, see your friends, and take a step back from caregiving.

There are many community resources that can help you along the Dementia Journey. Meal delivery services can save you time so you have more time for yourself. Respite care is great because you can be assured your loved one is safe and well-taken care of while you can go see friends, go to the gym, or go on that trip you’ve been longing for.

It is incredibly important to take care of yourself so that you can continue to care for your loved one, and so that you don’t feel your life is on hold. Your life is NOT on hold. You are growing, developing, learning, and changing every day. Though you may not feel it all the time, you are tackling and overcoming one of life’s greatest challenges. You Are Thriving. Stay strong and continue to thrive by balancing caregiving and self-care.

Because we NEED YOU.

Please share in the comments your tips and tricks for making the Dementia Journey a little easier so you can put time into self-care 🙂

What is Cognition?

By Eleanor Pineau

 

Often when I speak about my research, people ask me what cognition is. So what is it? What does it mean to have cognitive decline and how does it relate to dementia?

 

Question 1: What is cognition?

Answer: Cognition is an umbrella term used to describe all your mental processes. Cognition is made up of many factors including memory, attention, language, visuospatial abilities. Each of these factors is composed of many smaller factors. For example, memory is made up of long-term memory, short-term memory, episodic memory, semantic memory, and working memory.

Types of Memory graphic.png

What’s important for you to know is that cognition, and the processes that make it up, allow you to:

  • Experience a sensation, a perception, a notion, or have an intuition.
  • Make the decision to go to work in the morning, or pick out the clothes you are going to wear.
  • Speak and understand speech.
  • Remember where you left your keys, your mother’s name, and what your son looks like.
  • Pay attention to the road when you’re driving, or when you are having a conversation with someone.
  • Understand that a tree is a tree, and a pen is a pen.

Cognition allows you to understand and operate in the environment around you.

 

Question 2: What does it mean to have cognitive decline?

Answer: Cognitive decline means that a person has difficulties with ANY one or combination of the factors that make up cognition (i.e., memory, attention, language, visuospatial abilities).

What you need to know is that cognitive decline is a NORMAL part of aging. In fact, we cognitive decline starts in our 30s and 40s! Isn’t that crazy! But it’s ok because the declines are so minor that they don’t affect our daily lives.

 

Question 3: But isn’t cognitive decline = dementia?

Answer: Dementia is NOT forgetting where you put your keys…EVERYONE does that! It is completely normal. What dementia IS, is cognitive decline that is severe enough to impact one’s ability to complete essential daily activities such as eating, dressing, going to the bathroom, bathing, and moving around the environment.

So then what does dementia look like?

Dementia looks different in every single person that has it. Some people’s first symptoms are memory impairment. Others experience behaviour or personality changes first, while others experience problems in judgement or decisions.

Memory impairment in someone with dementia looks like this: it’s someone who forgets where they are, what they are doing, or the names and faces of their family members.

Someone else with dementia might have a personality change; so once they usually kept to themselves, and now they are more bold and interactive.

Another person with dementia might have problems with judgement and this might be expressed in giving too much money to a charity – like all their savings… eek!

As dementia progresses and affects more parts of the brain, more symptoms will appear and symptoms usually worsen. All these symptoms of dementia are due to a decline in cognition; damage to the brain.

 

Summary

Cognition is your brain – it’s all the processes that work to allow you to experience and interact with the world around you. Cognitive decline is a normal part of aging and is any decline in the ability to interact with the world. Cognitive decline may progress to Dementia. Dementia looks different in every person and all symptoms are due to a decline in cognition, damage to the brain.

 

 

6 Misconceptions about the Alzheimer Society

By Eleanor Pineau

The dementia journey is completely different for everyone. As the saying goes: “if you know one person with dementia, you know one person with dementia.” Because of the nature of the dementia journey, the services persons with dementia need, and the services their families need, vary considerably in type, amount, and timing. The most prominent provider of dementia-related services is the Alzheimer Society.

Alzheimer Society Logo

The Alzheimer Society is a non-profit organization that is driven to make the dementia journey as easy as possible for all who are affected. This article will go through all your questions about the Alzheimer Society.

  1. As a non-profit organization, all services and products the Alzheimer Society are made possible by donations. So if they don’t have any money, they don’t have any services they can give you. Many programs often get cut due to lack of financial resources. For example, the Minds in Motion program (community exercise program) out of the Alzheimer Society of Waterloo-Wellington will be ending in the next month if additional financial resources are not secured.

 

  1. The Alzheimer Society delivers an array of services such as:
  • Individual and Family Support
  • Group Meetings
  • Education
  • Companion Programs
  • Minds in Motion
  • Walking Groups
  • Touch Quilts
  • And more…

However, the services provided by each individual Chapter are different. The Alzheimer Society is organized in the following way, and each is its own silo: Alzheimer Society of Canada à Provincial Alzheimer Society (E.g., Alzheimer Society of Ontario) à Municipal Alzheimer Society (E.g., Alzheimer Society of Waterloo-Wellington). Each Chapter responds to the needs in their community which means the programs and services available differ by Chapter. So for all you donors out there, if you want to donate to the Chapter in your region, you must specify this, or go directly to your Chapter’s website to donate.

  1. You can access services whenever, wherever. If you go to the Alzheimer Society today and receive education or support, you can come back tomorrow. You can even come back in 3 months, or a year, or 5 years! The services are there for you when you need them.

 

  1. The services offered by the Alzheimer Society are FREE!

 

  1. Your physician isn’t the only one who can refer you to CCAC. The Alzheimer Society can also refer you to CCAC which may help to get you services faster if you’re waiting on your physician.

 

  1. The Alzheimer Society also refers you to other community support services such as Meals on Wheels, exercise programs, support groups, home care, etc.

The Alzheimer Society is here to help you navigate through your dementia journey.  Through the ups and downs, the good times and the bad, people are always available to help.

For more information on the Alzheimer Society, click here: http://www.alzheimer.ca/en

Steps to Remember your Daughter

By Eleanor Pineau

We all know: Exercise is good for you. Go for a run. Take the Stairs. Lift some weights. Walk or bike, don’t drive.

But how important is exercise really? And how important is exercise to someone that has dementia?

If there was a magical pill for all of our aches and pains, it would be exercise. The number of things exercise prevents AND treats is, well, EVERYTHING. High blood pressure? Go exercise. Depressed? Go exercise. In pain? Go exercise. Afraid of getting dementia? Go. Exercise. Name a condition or symptom, and exercise is bound to have a positive impact on it.

A group of elderly people exercising together on balance balls

Exercise in older populations is incredibly important to maintain independence, dignity, and quality of life. It is also the most important intervention to prevent falls. This is extremely important as falls is a predictor of loss of independence and death. These factors remain applicable to persons with dementia.

People often think that once someone is diagnosed with dementia, that all is lost, and exercise is not needed. Because, well, “they’re not all there anymore.” Right?

Wrong.

Persons with dementia need to exercise. Oftentimes, these people are also quite capable of physical activity. They need to exercise in order to prevent falling, control other comorbidities/diseases like heart failure, osteoporosis, arthritis, high cholesterol levels, and so forth. They also need exercise in order to prevent depression, delirium, and to help them reduce any pain.

Another thing exercise helps with is drugs. Unfortunately, many people with a cognitive impairment like dementia, take multiple drugs. Taking too many drugs is very dangerous, especially in someone with dementia. Side effects or interactions between drugs are very likely, and these can cause heart attacks, accelerated cognitive decline, and even death. Exercise helps to fix the reason they are on a drug. For example, exercise helps with cholesterol levels so now they don’t need to be on that cholesterol medication.

Many people with dementia are put on anti-psychotics because they have sedative properties. These sedatives are used to sedate the person with dementia so that they no longer yell, wander, or show physical aggression – these are “problem/responsive behaviours” aka “personal expressions.” These drugs actually cause greater cognitive decline, and physical decline – so independence is reduced. In lieu to these drugs, we should be prescribing an exercise regime. Oftentimes, the reason why someone with dementia is yelling, wandering, or being physically aggressive, is because they are in pain, they’re agitated, they’re bored, or they need some physical stimulation. Well you guessed it, exercise cures these!

Exercise!

A lot of people look for a cure or for something that will slow the progression of dementia. And you guessed it again. So far, the only thing that holds promise to prevent or slow the progression of dementia is exercise! Exercising increases blood flow to the brain which increases nourishment and waste removal. It also enhances neurogenesis, or neuron growth! (So in dementia, neurons are constantly being destroyed, and this is why we see memory loss, poor judgement, poor communication, etc. But exercise stimulates the growth of neurons, and keeps neurons healthy which prevents their destruction!) So in essence, exercise slows the rate of dementia, which keeps the person happy and healthy for longer! They can remember more things throughout the day, they have better judgement, and they can find the words they’re looking for!

Exercise!

But where to start? You have a couple of options:

  1. Exercise at home on your own
  2. Attend a fitness class in the community
  3. Access personal training

 

  1. Exercising at home on your own

If you and your loved one prefer to exercise at home without any expert advice, you need to take into consideration a couple of key things. First, make sure that your loved one with dementia is wearing comfortable, proper-fitting shoes. This will reduce the risk of falling. Second, make sure your workout space is clear of debris and you’re in a well-lit room. Again, these will reduce the risk of falling. Third, make sure you use proper equipment and safety measures. For example, you should consult a personal trainer or physiotherapist to ensure that you aren’t doing any movements that are contraindicated by a medical condition. If you have osteoporosis, you should not be doing any twisting motions with your back. Consulting a personal trainer or physiotherapist will undoubtedly ensure your safety. Lastly, the most important thing is to have fun! So turn up your favourite music and get your body pumping!

  1. Attending a fitness class in the community

There are lots of exercise classes in the community. You can find them at gyms, churches, or senior centres. Unfortunately, most are not tailored to people with dementia. There is however one program – Minds in Motion – that is delivered by the Alzheimer Society. This exercise program is catered to persons with dementia. It runs once a week for 8 weeks in a community recreation centre. Participants engage in 45-60mins of physical activity, and 45-60mins of mentally stimulation activities.

To find out more, follow this link: http://www.alzheimer.ca/en/on/We-can-help/Minds-In-Motion

  1. Using a Personal Trainer

If you are looking for more one-on-one training, you can access a personal trainer who specializes in dementia. This is a great way to get specially tailored exercise programs that are perfect for you! Because these programs are tailored to you, the time spent exercising will give you the most bang for your buck. You will maintain your independence for longer, be able to get up off the toilet easily, walk to the grocery store, and so much more. Personal training can be offered in a facility or in the home, whatever is preferable to you. Looking for a personal trainer who specializes in dementia in the Waterloo-Wellington Region? Contact MemoryFit at 905-299-1206.

 

So take that magic pill, no matter which way you do it, so you can live independently, maintain your memory, language skills, judgement capabilities, and have fun with your family!

 

 

 

 

 

 

Dementia – They Don’t Tell You These Things…

Amazing story told by a daughter caring for her mother with Lew Body Dementia:

 

My mother has had Lewy Body dementia for the past three years. I recently read an article in a newspaper giving advice about how to care for a loved one with dementia. The gist of it was that you h…

Source: Dementia – They Don’t Tell You These Things…

Are Social Work Therapy Services Covered?

Angela G. Gentile, MSW, RSW

contract-reimburse1-266x300ato-tax-refund

“Are your services covered?”

I get this question asked many times. If you are in Manitoba and would like to claim the expenses for my Social Work services, please take note of the following options:

There are two ways to claim services offered by a registered social worker:

1. Manitoba Blue Cross Health Spending Account

If you have a Health Spending Account through Manitoba Blue Cross, it states that

“In general, expenses are considered eligible if they qualify as a medical expense tax credit under the Income Tax Act of Canada and have not been 100 per cent reimbursed by another benefit plan.”

2. Medical Expenses on Income Tax Through Canadian Revenue Agency (CRA)

You may be able to claim the therapy on the CRA Income Tax Form, Line 330 – Medical Expenses for Self, Spouse or Common-Law Partner, and your Dependent Children.  Social workers are on their list of approved…

View original post 214 more words

Who’s Caring for Mom? – Part 2

By Eleanor Pineau

Last week I wrote about an incredible PSW who truly takes pride in her work and shares her love with all she meets. Our interview covered topics such as: (1) how she came to be a PSW; (2) what the general work day of a PSW consists of; and (3) specific topics relating to dementia. In this part 2 of the article, we will discuss the topics relating to dementia.


 

And so the interview continues:

Tell me about the experiences you have with families who have a loved one with dementia.

“All families are different and unique.” Maryanne gave examples of the different types of families. Some families are always present, making sure their loved one ate, are dressed, engaged in activities, and so on. Some families even request staff to show the resident their photo when they go away. I think that this is interesting for 2 reasons. Why do they Familywant their loved one shown a photo of them? Is it because they don’t want them to forget who they are? Or is it because they want their loved one to know that they care and love them and will be back? Or maybe both.

There are also the families who complain. But Maryanne believes that most of the time, these families just have a different way or a difficult time expressing their love for someone. She does however admit that there are the complainers and whiners.

And then there are the families who do not come at all.

The emotions families experience when a loved one falls ill with dementia are numerous and often conflicting. But what’s interesting is that so many different emotions can cause the same reaction. For example, a family member might visit their loved one because they truly love the person; they may visit them due to a sense of duty; they may visit due to culture; they may visit them because they feel guilty; etc. Although these emotions differ, the person still visits. However, you may be able to imagine that the atmosphere of the visit might change depending on the driving emotion.

I then asked Maryanne more specifically about families and their understanding of dementia.

“Most families understand what’s going on with their loved one with dementia but they don’t accept it! They know it’s dementia, and that they’re losing this and that, but they come to you and ask ‘why is my mom doing this, or doing that?’”

So if families understand what’s going on, but aren’t willing to accept it, how can we help them?

“I think they need support in order to accept it. Unfortunately the PSWs don’t have the time to help the families.” Having access to quality information and support at every stage of the dementia journey is essential to the emotional, physical, psychological, and social health of family members and family caregivers. Families should know that “your mother is at this stage and she will progress to this level, and then that level; her functions will be this, and the care will be that. They just bring them there, with no education or support. They need someone with the expert knowledge and someone with the experience to help them through it”

So where do families access this information and support? Do they have to do everything on their own in such a stressful and overwhelming time? Are the services adequate? You tell me in the comments below.

My next question asked whether she had some tips for people who are caring for someone displaying a behavioural problem.

Immediately, Maryanne replied with:

“Trust your instincts, use unconventional ways of caring for the person, and use an open mind.”

Maryanne told me a story about a man who had a very dirty mouth and would ask for sex every time a female PSW would walk into the room.

“So I walk into his room to get him up and ready for the day and he asked me for sex. I said ‘we will have sex after we go to the bathroom.’ He said ‘really?!’ And I said ‘yes, I promise.’ He got right up and went to the bathroom. For everyone else, he would fight them and wouldn’t go to the bathroom. They would have to do everything for him in there. As soon as I promised him what he wanted, he did it all, and I didn’t even have to help him. It was great. After, he forgot about the sex.”

What is absolutely incredible about this story is the feedback from the daughter. She told Maryanne, with tears in her eyes, that this is the first time that a PSW has not complained about her dad.

So you can see, that when caring for someone who may not be acting in the most socially appropriate way, that it is crucial to trust your instincts, use unconventional ways of caring, and have an open mind. After all, it’s not about you. It’s about making sure the person you are caring for is safe, happy, and has the best quality of life possible.

Another story Maryanne shared with me was about a man and wife living in the same suite, but in different bedrooms. The man would always wander at night and this made the staff very anxious about his safety and wellbeing, as well as the safety and wellbeing of the other residents. Maryanne analyzed the situation. What were the usual arrangements for this man and woman before they came to the home? And then the most obvious solution came to her head, that oddly enough, couldn’t be seen by any of the other staff. They rearranged the suite, put both beds in the same room, and now they shared a room at night. He never wandered again. You see, what was happening, was the man would wake up in the night, see that his wife was not beside him, so he would get up and go searching for her because he wanted to make sure she was ok. Now when he wakes up, he sees that she is right there in the bed beside him.

Again, in people with dementia, you need to look at what’s normal?! What were their routines before the disease? The solutions then come very easy.

To conclude our interview, I asked Maryanne if there was anything else she’d like to tell me. She left me with one striking statement:

“We care for animals, but we don’t care about the elderly. What does that say about us?”

 

 

Who’s Caring for Mom? – Part 1

By Eleanor Pineau

I recently had the absolute pleasure of interviewing a personal support worker (PSW for short) who has worked in home care, in assisted living, and in nursing homes. The kindness, love, and passion that emanated from her, was something so moving that it gave me hope and joy for the profession, and for older adults residing in nursing homes. Maryanne is a different kind of person and PSW. She is someone that sees the good in everyone, and even when residents spit, curse, or throw things at her, she remains devoted, loving, and compassionate. I am astounded and overjoyed by the love Maryanne exudes.


 

During our time, I asked Maryanne a couple of things:

Can you tell me in general, what you do for a living?

Maryanne is a PSW, and is currently working night shifts (11pm-7am) in a nursing home. Since it is night time, residents should be sleeping which leaves the PSWs time to do

senior woman with home caregiver

laundry and make sure all supplies are in order such as towels, and personal hygiene products. Every 30 minutes, Maryanne will check on her 25 residents. She ensures everyone is safe, where they should be, and if they are incontinent (which means they do not have control over their bladder, and sometimes bowels), she will change and wash them. Just like when you care for a baby, you cannot leave them wet or they will get skin sores. All care is done using a “Gentle Care” approach which means taking your time with the resident, not rushing, communicating with the resident what you are doing, and most of all, giving the resident choice – empowering them – with what they want to do, how they want to do it, or what clothes they want to wear.

I then asked Maryanne,

How did you start on this career path or what made you choose to go into this industry?

“I always loved the elderly. Back home, when my grandmother got sick, I gave up my job to be with her.”

Maryanne says that caring for older adults is such a rewarding experiencing and that she gains personal gratification every day. She makes it her goal, to go into the nursing home, and make people happy. She jokes, plays, and talks with the residents whenever she can squeeze in some time in her busy schedule.

She also learns something every single day. Maybe not textbook knowledge, but real-life, applicable knowledge! Imagine that! Learning something from someone so old? (*sarcasm*)

Maryanne told me a couple of stories where she learned something from a resident:

“One lady said when you take the bus, always have something in your hands (like a book), so you keep busy and don’t get into trouble. Keep your hands busy! When you’re busy, you don’t think of sad thoughts, or pay attention to others. I also learned how to knit.”

The most opportune place to learn life lessons is in a facility that houses older adults. After all, they are the ones that have lived through war, famine, and a depression.

The next question went like this:

Tell me about your work with people who have dementia?

“When you’re working in a locked unit, which is the dementia unit, there’s no such thing as ‘routine’! They’re walking around, going through someone else’s room, and taking things from other residents, so you constantly must be manning the unit. All closets are locked too so people can’t get into other peoples’ things. They lie down on someone else’s bed, and we allow them to lie down there because some are tired from walking around the whole day and they don’t recognize it’s not their own bed. If you can redirect them to their own room, then of course we do that. But if it’s an aggressive person, then we let them lie down for a bit and come back later to redirect them.”

I think it is important to highlight that working with someone who has dementia can never be a routine. And this applies to all settings – in the home, in assisted living, in retirement homes, and in nursing homes. It is of utmost importance to be with the person, in that moment, when caring for someone with dementia. If they say someone is standing there (even though no one is), you agree and play along…as long as it’s not hurting them or someone else, and they’re not in danger. This is called Validation Therapy. It literally just means that you live in the moment, in their moment, all the time.

Maryanne also noted that everything needs to be individualized for each person with dementia. For example,

“One [resident] has a doll that she believes is her baby and that she is a new mother. When sitting in the living room, she gets agitated and starts rocking back and forth. But as soon as you give her the doll, she calms down. She really takes care of it. The doll, I think, gives her a sense of purpose and security.”

Caring for someone with dementia means you get to be a kid again. You get to experience their experiences, when they were 60, 43, 22, and even 6 years old. It is a privilege and an incredible experience to live someone else’s life and to learn, so intimately, about that person. When someone with dementia re-lives their teenage years, and you are using validation therapy, you get to be a teenager again too. Full of whit, life, joy, and without a care in the world. Remaining positive and upbeat when caring for someone with dementia makes the adventure of caring so much more fun and rewarding.


From this point of the interview, we can see what excellent care looks like. We can see that someone who is caring for an older person, with or without dementia, needs to show compassion, needs to be patient, needs to be understanding, and most of all, needs to love – regardless of profession. Maryanne is the best example I could have found for going above and beyond caring for older adults. She truly sets the best example for all PSWs, nurses, physicians, family caregivers, and all healthcare professionals, on how to care for someone.


 

Part 2 of “Who’s Caring for Mom” will be released shortly.

Photo from: http://www.nahb.ca/blog/tag/psw-courses