When Someone with Alzheimer’s Says, “I Want to Go Home”

When a loved one living with Alzheimer’s disease moves to an assisted living community, one of the toughest things for families to cope with is hearing them say the words, “Please take me home. I want to go home.” Adult children know they have made the right choice for safety reasons, but the guilt those words create can be tough to overcome.

What Someone with Alzheimer’s Means When They Say “I Want to Go Home”

Here is what your loved one might really be saying:

  • I don’t recognize anything or anyone around me.

Because Alzheimer’s disease robs people of their memory, it creates confusion. Your loved one may not understand why no one seems familiar and nothing looks like home no matter where they are. They are likely feeling lonely.

  •  “Home” may not be their most recent house.

When shorter term memories are lost, home may be the place they lived when they were a child or younger adult. They may be remembering happier times when they lived with their parents and siblings.

How to Respond When an Aging Loved One Says “I Want to Go Home”

There are a few suggestions we know other families have found worked with their loved ones:

  • Try to determine what they need.

We know this can be difficult to do when their verbal skills are impaired. The problem may be that they are hungry, tired, in pain or need to use the bathroom. Try to ask them yes or no questions to see if you can find out if something is wrong or upsetting to them.

  • Try to respond positively.

Arguing with them or telling them the assisted living community is home now probably won’t work. Instead, try acknowledging their request and agreeing to do it “later.” Using a simple phrase like, “I know you miss your garden. Maybe next week when we are at the dentist we can stop there.” It may help placate them for now and they likely won’t remember later.

  • Encourage them to talk about it if they are able.

Ask them what they miss and what they liked about home. Getting the    conversation going might give you an opportunity to determine what they are missing and see how you can help fix it. It might also provide     you with the chance to re-direct the conversation. For example, if they miss their garden or the neighbor’s dog, tell them about a new dog on your street or a problem you are having in your garden.

This issue is one of the most common struggles for families. Almost everyone who moves a loved on to a memory care program encounters it at one time or another. We hope these tips help provide you with a few ideas on how to handle it.

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Bathroom Safety: Tips to Help Michigan Caregivers

Bathroom Safety: Tips to Help Michigan Caregivers

As we grow older, our once safe home environments often begin to create safety risks. Many of us have read the frightening statistics that reinforce the importance of bathroom safety. A large number of falls that happen to senior citizens take place in their own bathroom. Falls can be more dangerous in the bathroom because floors are typically tile and not carpet that may help to cushion the impact. There are also more objects in closer proximity for older adults to hit their head on if they go down including the toilet, the side of the tub and the bathroom vanity. For the 1,361,530 Michiganders who are age 65 or older, we offer the following tips to create a safer bathroom:

  • Consider adding a panic button with a long cord to the wall of your senior loved one’s bathroom. That will allow them to call for help if they fall or otherwise run in to trouble while they are in there. If that isn’t feasible, make sure they have a waterproof medical alert pendant they can wear in the shower.
  • Take a close look at how their bathroom is set up. Are items they use most frequently within easy reach? If not, try to re-arrange the room. The goal should be to keep them from having to climb on a step ladder or reach too far over their head to retrieve an item. Either situation could cause them to lose their balance and fall.
  • Try to renovate their bathroom to create a walk-in shower that doesn’t require them to step over the side of the tub. For less than steady older adults, that can cause a fall.
  • Remove older sliding glass doors. For someone with a physical impairment or poor balance the doors often become something to grab on to for support getting in and out of the tub. Most sliding doors were not made for that kind of use and may break.
  • Raise the height of their toilet seat if necessary. A raised toilet seats is inexpensive and easy to install. You can even find them at your local pharmacy.
  • Install sturdy grab bars in place of towel bars. Another common source of bathroom falls for seniors is when they try to use the towel bar to leverage themselves with and it pulls out of the wall.
  • Be sure they have good lighting in the bathroom and nightlights that illuminate their path to it after dark.

If you are concerned that your loved one’s home needs to be evaluated for safety by a professional, talk with their primary care physician. They can probably help you find a physical therapy company in your area that offers that service.

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Bathroom Safety: Tips to Help Michigan Caregivers

Walk for Life: Advice to Get Michigan Seniors Moving

Now that the snow is finally behind us for another year, it’s a great time to head outdoors and get moving again. Older adults often see the numbers on the scale creep up during winter months. It’s often because they avoid going outdoors during a Michigan winter for fear of falling on the ice and snow. A less active lifestyle often results in weight gain. Walking has both physical and mental health benefits, as well as the added benefit of helping you safely drop those extra pounds.

Here are a few tips on how to get started with your own walking program.

Tips for Older Adults Beginning a Walking Program

  1. As with any form of exercise, check with your family physician before starting. Ask for their approval and any advice they can share. They will likely encourage you to begin slowly and build up your endurance.
  2. Invest in a good pair of walking shoes that support the structure of your foot. Everyone’s foot is shaped a little differently. If you are flat-footed or have a high arch, for example, make sure the shoe is designed to support that. It may be worth a trip to sports store at your local mall to have your foot measured and fitted.
  3. Set manageable goals for yourself. Unless your physician has indicated otherwise, you might want to start out with a daily 10-minute walk. Add 5 minutes at a time until you are up to about 20 to 30 minutes most days of the week.
  4. Be sure to stretch and warm up your muscles before you head out. This video offers some good pointers on how to warm up before and after walking.
  5. A pedometer or sports watch that measures heart rate and distance can help you track your progress.
  6. As your physician may have shared with you, the rule of thumb on how fast to walk is referred to as a “walking pace.” That means you have elevated breathing but can carry on a conversation.
  7. Watch your posture as you walk. Keep your head up and your shoulders back and relaxed. Your arms should hang comfortably at your sides.
  8. Find a buddy or two to walk with you. It is safer and more fun!
  9. If you are walking alone, be sure to bring your cell phone and a photo ID with you and to avoid walking in isolated areas.

After you’ve been walking for a few months, you can reevaluate your success and talk with your physician about increasing the distance or pace of your walking if you feel like you need more of a challenge.

 

Bathroom Safety: Tips to Help Michigan Caregivers

What Causes Wandering in Adults with Alzheimer’s Disease?

For Michigan caregivers of an aging parent or loved one with Alzheimer’s disease, one of the most frightening behaviors is an unfortunately common one. Wandering is generally believed to be a means of attempting to communicate after language skills are largely gone.

A person living with more advanced Alzheimer’s disease may not recognize their surroundings any longer. They may be trying to find their way “home” where home is a place they lived as a child or young adult. It might be that they are hungry or thirsty or need to use the restroom and don’t know where or how to find help. Whatever the reason, wandering causes stress and concern for caregivers trying to keep them safe.

5 Tips to help Michigan caregivers decrease a loved one’s wandering

What can you do to try to decrease the odds that your aging loved one will wander? Here are a few recommendations to try:

  1. Keep a clear path for your loved one to safely pace indoors. That means packing up throw rugs and eliminating clutter.
  2. Store potential “leaving cues” out of plain sight. Items like car keys, coats, mittens, and umbrellas should be kept in a closet or cupboard. It isn’t always as convenient, but it may prevent their mind from being triggered to the fact that an exterior door is nearby.
  3. Installing an additional lock at the top of all exterior doors might also help. As Alzheimer’s disease progresses, a person’s gaze often becomes directed down toward their feet. A lock that is located higher on the door will be out of their line of vision.
  4. Paint the interior side of exit doors the same color as the walls. That will make them harder to distinguish and less likely to attract attention if your loved one is seeking an exit.
  5. Another common strategy used in senior living communities is one that is very easy to implement at home. Consider placing STOP or DO NOT ENTER signs on the inside of exterior doors. These universal signs and symbols are recognizable to even those with advanced Alzheimer’s disease.

Prepare Ahead in Case a Senior Loved One Wanders

If the unthinkable happens and your loved one does wander away, having an emergency plan in place can minimize the time it takes to find them. Some preventative measures you can take care in case a crisis happens include:

  1. Always have a recent photo of them available. A digital photo that can be quickly emailed to media is even better.
  2. As much as you don’t want to hurt the dignity of your loved one, consider labeling their clothing with tags containing their name and your phone number.
  3. Don’t hesitate to call 911 as soon as you realize your loved one is missing. Every minute counts in helping them make a safe return home.
  4. The Alzheimer’s Association offers several GPS tracking programs you can use called, ComfortZone and Comfort Check-In. They use cellular technology to help you monitor your loved one’s location.

Are you caring for a loved one who wanders? Have we missed anything you’ve found to be of help?

 

 

 

Bathroom Safety: Tips to Help Michigan Caregivers

Question from a Michigan Caregiver: What is the Medicare Wellness Visit?

The Medicare Wellness visit is one of the many benefits the Affordable Care Act (ACA) brought to seniors. Despite being launched in January of 2011, however, many primary care physicians and their patients are still not utilizing the benefit. For physicians, the visit provides them with an opportunity to develop a preventative plan for each patient on an individual basis. There is financial incentive for physicians to be sure their Medicare patients schedule the wellness visit – it pays nearly three times the rate of a typical Medicare patient visit.

So why are many seniors still not taking advantage of the benefit? Most are simply unaware of it and what it entails.

The Medicare Wellness Visit

The once-a-year benefit is a wellness visit provided at no cost to seniors. The focus of it is to develop or update prevention plans and evaluate chronic health conditions, such as diabetes or asthma. The physician will talk with the patient about their health, lifestyle and overall fitness regime. In addition, the physician will likely:

  • Measure height, weight, and body mass index
  • Check blood pressure
  • Perform a simple vision test
  • Evaluate cognitive function
  • Assess the patient for their risk of depression
  • Other routine testing based on patient and family medical history
  • Refer patient for further testing or evaluation by specialists if necessary

Based on their discussion with the patient and the results of the physical examination, the primary care physician will develop a personalized preventative care plan that includes timelines for health screenings. They will also make recommendations for any lifestyle improvements they believe will contribute to the patient’s overall health and wellness. It might be nutrition counseling, a smoking cessation program or suggested physical activities.

Medicare Welcome Visit versus Wellness Visit

There is some confusion among patients because Medicare also allows a one-time Medicare Welcome Visit. This appointment is for new Medicare recipients. It must take place within the first year of receiving Medicare Part B benefits.

Medicare Part B Wellness Visit Costs

Because one of the goals of the Affordable Care Act is to reduce health care expenses by focusing more on prevention, there is no cost to Medicare Part B recipients. Patients are entitled to one wellness visit every 11 months. One important thing to note is that while the visit is at no cost to patients, any recommendation testing or follow-up may not be.

If you are the caregiver for an older adult in Michigan, be sure to speak with their physician about scheduling an appointment to take advantage of this benefit.

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Bathroom Safety: Tips to Help Michigan Caregivers

Helping a Senior Loved One Avoid the Hospital

Dear Donna:

My mother has been in and out of the hospital over the past 9 months for a variety of injuries and illnesses ranging from the flu to a badly broken wrist. She usually only spends one or two nights, but she is just worn out from it. Before this started, she was always on the move! She played in several card groups, enjoyed working in her yard during warmer months, and was a real social butterfly. Do you have any advice that can help us? We are trying to figure out a way to stop this cycle and get her back on her feet again.

Barb in Holland, Michigan

Dear Barb:

I’m so sorry to hear about all your mother has been through lately! But you are right in thinking of it as a cycle. Unfortunately, a serious illness or injury can take a toll on our senior loved ones. They are at greater risk for a variety of reasons ranging from mobility problems to impairments caused by a chronic illness.

To help your mother get back on her feet and avoid another trip to the emergency department, here are a few suggestions I can offer:

  • Consider employing in-home care to help support her daily activities. Private duty aides can help her with grocery shopping, meal preparation, personal care and more. That may help her rest and regain her strength while giving you peace of mind that she is getting well-balanced meals and support around the house.
  • Assisted living communities offer short-term stays for situations like your mothers. She could stay for just a week or two up to one month. She will receive all of the benefits a long-term resident does including meals, personal care, housekeeping, life enrichment activities to join, and more. An advantage in selecting this option is that it would help her test the waters and see if she might enjoy life in a senior living community!
  • You could also talk with her physician to see if she would also qualify for skilled home health care during this time. That would allow physical therapists and skilled nurses to visit her at home or at an assisted living community to work with her on a recovery program. If she qualifies, these services would be covered by her Medicare benefit.

I hope these suggestions help you develop a plan that will keep your mother healthy and safe and out of the hospital! Please let us know if you have any more questions or would like to consider a short-term stay for your mother at a Heritage Senior Community near you.

Donna

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