We All Have a Reason to Care

Heritage Group meeting of February 18, 2016

by Guy Dugas

The Heritage Group was pleased to welcome Wendy Schettler, Chief Executive Officer of the Alzheimer Society of Manitoba. Her presentation helped illuminate an otherwise dark topic for any retiree, dementia. It’s a spectre whose visit many of us fear as we get older.

But Wendy’s was a positive message of hope, perspective, and humour, often drawn from her own personal experiences with her dad and grandmother.

What is Dementia

Wendy pointed out that dementia is an “umbrella term” for a set of symptoms that are caused by disorders affecting the brain. Symptoms may include memory loss and difficulties with thinking, problem-solving or language, severe enough to reduce a person’s ability to perform everyday activities. A person with dementia may also experience changes in mood or behaviour.

Changes in the brain of a person with Alzheimer’s

Many diseases can cause dementia. We hear a lot about Alzheimer’s disease because it is the most common, accounting for about 55% of those suffering with dementia.

Alzheimer’s disease is NOT a normal part of aging.

A progressive disease of the brain that results in damage and death of brain cells, Alzheimer’s commonly presents itself through memory loss. Changes include having difficulty making decisions and performing everyday activities. The changes can also affect the way a person feels and acts.

The Numbers

The statistics for those living with dementia (including Alzheimer’s disease) are sobering:

• Today, 747,000 Canadians, 22,000 Manitobans (15% of those 65 and older)
• By 2031, 1.4 million Canadians
• 43% of Manitobans have a family member or close friend living with dementia
• Hits 1 in 3 people over 85

Early Warning

Currently, there is no single test that can determine if a person has Alzheimer’s disease. Because of this, many individuals often go for years thinking their memory issues are simply age-related. Even friend and family members will dismiss the person’s confusion as just a normal part of getting older. However, being able to recognize the 10 early warning signs of Alzheimer’s disease can allow an early medical assessment that can lead to an early diagnosis.

The good news is that people with Alzheimer’s disease can live meaningful and productive lives for many years after an early diagnosis. Dementia diagnosed early helps both the person and family members to learn about the disease, set realistic expectations and plan for their future together. Early diagnosis means that you can get support and information, treatments that may slow the progression of the disease, and you have time to make key financial and care decisions for your future. If you see any of these warning signs in yourself or someone you care about, please encourage that person to discuss what they are experiencing with their family doctor.

There is also no cure yet, but medications may help minimize some symptoms.

Risk Factors

The cause of Alzheimer’s disease is still unknown. But its risk factors are about equally split three ways: 1/3 age, 1/3 genetics & family history, 1/3 other (e.g. cardiovascular diseases & diabetes, head injury). As Wendy pointed out, though we can’t control aging and genetics, our lifestyle choices can have a significant impact on that “other” risk factor.

Challenge yourself to:

• Be socially active
• Make healthy food choices
• Be physically active
• Reduce stress
• Protect your head

Wisdom for Caregivers

People with Alzheimer’s exhibit short term memory loss.  As the disease progresses the person’s memory loss becomes greater and they begin to live deeper in their past. What they say of the past will reflect their memories and perceptions, which may be different than those (family members) who provide care. Their memories may be warm and wonderful or difficult and disturbing.

Care-giving may not be an easy journey. Learn about dementia and its effects upon the person, and don’t take things personally. Try to separate the dementia from the person, and treat the person first, dementia second.  Think about their behaviour as communicating unmet needs or emotions. This might help you to take the person’s behaviour less personally.

And often your body language is more important than what you say. No matter the words spoken, your facial expression and tone can convey disapproval, annoyance, frustration, and impatience. It is discouraging enough for someone with dementia to not remember how to do a simple task without also feeling dismissed or burdensome. Every now and then we need to simply stop, smile, and reassure. For example, Wendy shared that there were times she wasn’t sure her father even knew who she was. But taking his face in her hands, looking him in the eye, and saying, “I love you”, was enough to calm and comfort him. Sometimes he’d even say, “I love you”, back.

Important message: think of the positive moments.

Life History and Care

Learning the life story of a person with dementia may help you to explain why a person fears water and therefore avoids bathing, or why care providers with certain physical attributes may cause fear.  Life history information is also very instrumental in assisting a person with reactive behaviour.

When a care provider knows a person’s life story, it may help to engage in reminiscence activities. Reminiscence is “a visit to the destination of the mind”.  Care providers are encouraged to go with the person to the place they are re-experiencing, rather than trying to bring the person into the present tense. Reminiscence may be stimulated with tactile objects or by the care provider picking up on themes in conversation.

Activity and Care

People who have lead active and productive lives want to continue to lead active and productive lives. As leisure was only a small part of the person’s life when healthful, it should not become their whole life in their current situation.

Keeping people with Alzheimer’s engaged is more than creating busy work, it is assisting them to retain skills. Do not use activity as a “test” of the person’s ability. Engaging the person in activity is more important than the end product of the activity; the relational time spent during an activity is more important the actual activity engaged in.

People with Alzheimer’s are more able to take part in an activity when cued.  This may include helping them to start the activity, demonstrating the next step of the activity or providing an example of the completed activity so that they can recall the relevance and value of what they are doing. A person who is engaged in meaningful activity will not be bored, or feel helpless, rather they will gain self esteem from what they do.

Finally, if Dementia Impacts You

• Think Self Care
• Look after your physical health
• Talk about your feelings, both positive and negative
• Use coping strategies for stress, anxiety, and frustration
• Remind yourself of the good things in your life
• Laugh a lot
• Take time for rest and relaxation
• Keep friends and family close
• Pay attention to your spiritual needs

The Alzheimer Society of Manitoba is a community-based volunteer organization, whose mission is to alleviate the individual, family and social consequences of Alzheimer’s disease and related disorders while supporting the search for a cure.

Their Website is at www.alzheimer.mb.ca. Phone 204-943-6622 or 1-800-378-6699.

You can open and view Wendy’s entire PowerPoint presentation by clicking here.