Taking care of the memory-impaired

As one of its many services for local seniors, the Foundation for Senior Care offered a presentation on memory care on Aug. 19. The discussion, “ Journey with Alzheimer’s, and other dementias,” was led by Teddie Borges, administrator of the foundation’s Adult Day Care Center (aka The Club). Borges stressed that caregivers of loved ones with Alzheimer’s and dementia need to take care of themselves. “Reaching out for help is not a bad thing,” she told the 15 caregivers who attended the talk given at Fallbrook Library.

Borges, who has been working in adult day care for 16 years, advised the caregivers to “get a step ahead, find out what to look for” as far as symptoms go. Education is the key, she explained; “find out what is going to happen and know what you are up against.” She added, “It is okay to say you can’t do it [handle it],” reminding them that there is help available. The foundation’s care advocates can come out to people’s houses to evaluate the situation and assist caregivers in finding the right aid programs to help them.

Borges also talked about the steps to look for as dementia progresses; “It is a different journey for each individual person ...they will become incontinent, then mobility becomes an issue; short term memory goes first.” Signs also include “doing stuff out of character, being forgetful, wandering.” She recommended installing door alarms as well as alarms on beds and chairs to keep loved ones from wandering away unnoticed.

Caregivers need to make sure their loved one’s environment is safe, secure, and “baby proof” to keep a step ahead in preventing injuries. They should also be aware that common ailments in memory impaired people are dehydration, pneumonia, and urinary tract infections, in order to take steps to prevent those conditions from developing.

She explained that pain sets the memory-impaired off, making them act out, as they cannot verbalize what is wrong. For many, their brains do not tell them when they are full, so they are always hungry. Many also have compulsive/obsessive disorder and/or depression as well as an aversion to taking showers.

As each person’s condition progresses, Borges said “you march with their drummer.” She likes to see her clients as drug-free as possible. She advised keeping them hydrated, feeding them good food, stimulating them, and keeping their environment stable.

It is also important to have an advanced healthcare directive in place, as the condition of dementia and Alzheimer patients can deteriorate quickly. It is easier on the caregiver if the loved one makes their wishes known, as far as the end of life treatment they prefer, while they can decide for themselves. Having wills and trusts in order as well as a DNR (do not resuscitate) document is also necessary.

When disease takes over, people do unexpected things so caregivers need to deal with the moment as it happens she said, taking it second by second and “be on your toes every second.”

Options to help caregivers get a break include at-home care, a daycare facility like The Club, respite care, and eventually hospice which cares for the whole family. Caregivers should be prepared with the necessary paperwork as licensing requires a physical and TB tests for adults in daycare as it does with children.

The information Borges gave her listeners included two handouts, one on compassionate communication and one on medications that help with memory problems. The do’s and don’ts of communicating with the memory impaired include examples of “Do repeat exactly,” Don’t reason,” “Don’t argue,” and “Don’t take it personally.”

While she is not a fan of memory drugs, Borges did point out the last paragraph on that information sheet, a quote from dementia care consultant David Troxel who noted that “the ‘treatment’ for dementia is socialization, keeping the person active with exercise, music and creative activities.” He said, “Engaging the person in life as much as possible fights depression and keeps him or her operating at their very best.”

Caregivers can take their loved ones to The Club for four hours at a time or from 9 a.m. to 5 p.m., Monday through Friday, for social/recreational daycare. The center is not licensed for medical care but has a 1 to 4 staff to client ratio which is double what state licensing requires. Staff focus on keeping their charges hydrated and stimulated, busy and happy. Activities include baking cookies, craft projects, pet therapy, and entertainment from harmonica players, the senior ukulele group, the Fallbrook Chorale and others.

Dementia diseases are in the top 10 leading causes of death in the US, so there are a lot of caregivers dealing with people with those diseases. Susan Baglien, one of the care advocates, told the caregivers, “Give yourself permission to grieve.” Borges told them, “It is okay to give yourself permission to ask for help.”

Borges can be reached at (760) 723-0890 for advice and the cost of daycare; The Club is located at 135 S. Mission Rd. next door to the Foundation for Senior Care.

For help finding aid programs or dealing with Medi-care and Medi-cal, senior care advocates Baglien and Darlene Weber can be reached at (760) 723-7570.

Another resource is the Alzheimer’s Family Support Group which meets the third Wednesday of the month from 1:30 to 3 p.m. at Silvergate Retirement Residence, 420 Elbrook Dr.