Stroke Victim Care Starts with Rehabilitation

Today I would like to discuss caring for someone who has suffered from a stroke, or Cerebral Vascular Accident (CVA). A lot of what I have written thus far has been pertaining to the care of people with memory loss but there are many other illness that can affect older adults that will leave them with a need to be cared for.  When a loved one has suffered from a stroke, it can affect them in many different ways.  It can leave them with paralysis of one side of their body, difficulty with speech, difficulty with swallowing, changes in personality, memory loss or any combination of these things.  Caring for your loved one can be complex.
It is very important to be extremely involved in their rehabilitation program that should have begun while they are still in the hospital setting.  After their discharge, this program should continue into the home to help ensure that you are able to adequately manage their care.  Do not be afraid to ask questions of these therapists.  This rehabilitation time is very valuable to you and your loved one; it will not last forever and it will then be up to both of you to continue it when they are done.  Typically, initially after a CVA the effects can be significant but with good therapy some of the lost functions can be regained.

 

Physical Therapy (PT) offers the opportunity to increase your loved one's strength, regain their ability to walk, increase their balance and improve their overall movement.  This is important for any stroke victim no matter what losses that they may have.  A stroke, in general, exhausts your entire body and it needs to be built back up again.  PT is especially important if you have suffered paralysis as a result.  Physical therapists will work extensively at regaining your ability to walk.  They have valuable knowledge in devices such as specialized mobility devices that may be needed.  They will also work with their hands, elbows, knees and feet to prevent contractions from developing in their joints by using braces and stretching exercises to maintain their mobility.  It is vital that you learn these techniques so that you continue their treatment when the therapy ends.

Occupational Therapy (OT) focuses on their activities of daily living such as bathing, dressing, using the bathroom, and other basic self-functioning skills.  These are especially important when you are ready to go home.  They will come to your home and help you set up your living area so that you can more easily and safely provide care.  Occupational therapists come with a wealth of knowledge of adaptive equipment that can be placed in your home to make the care of your loved one physically easier on you.  Do not hesitate to bring concerns you have to their attention.  Once again, the more involved you are in this rehabilitation program, the more success you and your loved one will have when you are on your own.

Speech Therapy helps your loved one relearn to speak more clearly or to take nourishment safely if their speech or swallowing has been affected as a result of the stroke.  In my experiences with these losses, many patients do regain a lot of what was initially lost.  Speech therapists will do pronunciation drills and oral exercises to improve their tongue and throat muscles.  They will explain what foods and drinks are safe for them to eat.   It is essential that you clearly understand any restrictions that they may have; you don't want to end up back in the hospital with pneumonia because they are silently aspirating food or drink.

This is just an overview of what I have seen in my work.  In my experiences with stroke victims, the families that are the most involved see the best results in the care of their loved one.  It can be managed at home if you are up for the challenge.  Most CVA victims still are very alert and oriented.  Being involved from the beginning with the rehabilitation process increases your chances for success at home.  It will increase their chances of Aging with Ease!

Caregiver Help for Alzheimer's Patients

Many people that either have Alzheimer's Disease themselves or are caring for someone with the disease will face many difficulties adapting to the changes that are coming or are already happening.  You will be looking for help in learning more about what to expect, how you will manage financially, what legal matters should be handled and where can you turn for help.  If you have not located the Alzheimer's Association web site, you need to check it out.  It provides an endless amount of knowledge and guidance through the process.  I discovered and explored this web site after participating in the Alzheimer's Walk in September 2011.

I encourage you to click the above image to visit this site; the link will take you to their CareFinder page where it can help you find assistance in your area.  Explore the site and let me know what you think...

Remember to have a Good Time!

As a caregiver for someone with dementia you can become consumed by the daily chores that need to be completed.  You can forget that you need to find some fun in each day for you and your loved one.  This is important to help maintain your sanity through this process.  Laughter, as they say, is the best medicine for what ails you.

So how do you find that fun?  To find the answer, you need to remember some things you used to enjoy with your loved one but are no longer doing.  Maybe it is going for walks, visiting museums, going out for dinner.  Whatever it may be, you can find a way to still participate in these activities.

If you enjoyed going out to eat or visiting museums, you can easily still do these activities but I would suggest that you go to these places at non-peak times to avoid large crowds.  Too much stimulation can be upsetting to a person with dementia.  If there is too much activity going on around them, they cannot focus and feel overwhelmed.  They may even begin to become scared or paranoid by all the activity because they cannot take in everything around them.  To increase your chances of a fun time at these places, it is best to go to smaller venues with smaller crowds and less noise.

The same concept applies if you enjoy going for walks.  Find parks or developments that are quiet and not overpopulated to walk in.  People with dementia are usually still very capable of participating in physical activity.

Each day, I am sure, something unexpected happens, especially when caring for someone with dementia.  Try to find the humor in these unexpected events.  Say your loved one walks out with his shirt on backwards - instead of pointing out their error, maybe say "Are we having backward shirt day? Looks like fun!"  You will both be able to laugh about it happening instead of making them feel that they have made a mistake.  If they lost their glasses again, make it a game to find them instead of expressing frustration about their continually declining memory.

You will find if you use some respectful humor in these situations, it will make you and your loved one less frustrated with their decline.  As dementia progresses, it is important as a caregiver to live in the moment.  Do not expect your loved one to remember that one hour ago you went out to eat when they are now digging in the refrigerator looking for something to eat or that a half hour after returning from a walk he is looking at you for something to do.  They simply do not remember.  If you learn to appreciate that for that moment you are having a good time together and laughing, you will not be as disappointed when they don't remember.

If you have an activity that you and your loved one used to do together and are having trouble figuring out how you can still do this activity, send me a comment and we can try to figure it out.
Having a good time will increase your chances of Aging with Ease!

CLICK HERE to read about one couples journey through Alzheimer's and how they still are able to have a good time!

Maintain the dignity!

How do we maintain dignity as we Age with Ease?  This can be answered in two ways: from the point of view of the aging adult or from the point of view of the caregiver of that aging adult.  I am going to speak on the point of view of the caregiver.  In my years of caring for older adults, I have seen all different kinds of approaches on this matter.  Some work, some clearly do not.  I think the best way to answer this question is fairly simple: How would you want to be treated?  It can be hard to put yourself in the role of the other person and know how what you are saying or doing is affecting them.  By simply asking yourself how would I want to be treated if it was happening to me, you can better provide assistance.  This will, in the end, make caring for someone easier because they will feel respected.
As I write about this topic there are certain caregivers that come to mind.  They so easily and naturally provide this respect and dignity with very little effort.  They are spouses or children that are providing care.  They are dealing with different types of conditions: dementia, Parkinson's, ALS or a stroke, just to name a few.   In observing them, the main thing I notice they all do is continue to keep their loved ones involved in their lives and the things they always enjoyed doing.   They don't stop living because of the illness.   This can take some creativity.
Some examples of what I am talking about:
1.  Let's say your husband has dementia. Chances are, that is his main health problem and he's probably still pretty physically able.  So when winter comes around, can he still shovel snow? Yes!  When fall comes around, can he still rake leaves? Yes!  When spring comes around, can he still help mulch the flower beds?  Yes!  When summer comes around, can he still help with yard work? Yes!
While these activites may need you to supervise him discretely, he is still physically able to participate in your life.  It will make him feel useful and satisfied that he can still participate.
2.  Let's say your wife has been diagnosed with Parkinson's.  You are noticing that she is having trouble getting dressed and with her medication management but you feel uncertain about how to discuss this topic with her.   These situations can be delicate because you want to be sure to present the problems you are observing just as that, observations.  You don't want to make her self-conscious about her abilities.  So what do you do?  Be upfront and just talk with her about it calmly; communicate with her as you would about anything else. Ask her what she needs to make her life easier.  Decide together how to proceed, offering suggestions.  Solutions that make her day easier could be very simple at first.  Maybe laying her clothes out for her or rearranging the set up of your bedroom or bathroom.  Preparing her medications with her for the day of the week in pill boxes.   Whatever you do, don't let her continue to struggle and pretend that you don't notice.  It never feels good to fail day after day doing simple tasks or to feel alone in the process.   You need to remember that she can still participate in the decision-making process in your lives even if she has Parkinson's.
3.  Let's say your father has suffered a stroke and has come to live with you and your family in your home.  This is a huge adjustment for everyone!  As a result of his stroke, one of the problems is that your father has difficulty with his speech - he is hard to understand but yet is still very alert and oriented.  Speech difficulties can be especially frustrating for stroke victims and their families.   You notice that he seems depressed and has withdrawn from the activities that he used to enjoy.   It is important to break that cycle and to break it as soon as possible.  He needs to be reminded that he is still able to participate in life.   Look for useful things that he can do around the house to make him part of the household.  Find a chore or two that he can successfully do and is responsible to complete.  If he was a people person before and now sits at home all day, consider an Adult Day Center or Senior Center.  Try to involve him is your lives as much as possible.  People need to feel useful and have a purpose. Most importantly, you need to discuss this with him and decide together how to proceed.  If he feels like you are making decisions for him, he will most likely resist and then have trouble trusting you if the future.
These are just some examples.  Any solutions, of course, are going to be unique to your family.  If you are struggling with finding a solution for your unique problem, feel free to send me a message.
Aging with Ease cannot be done without maintaining dignity!

HELP! Caregivers Need To Reach Out.

When is it time to ask for help?  In my work, I am asked this question so many times, you would not believe it!   Whether it is Dementia, Parkinson's disease, ALS, just plain getting old or any other ailment affecting your family the question eventually always comes...  When should I look for outside help?
As a primary caregiver of someone you love, this can be a very difficult question to ask yourself, let alone someone else.  As a caregiver you may feel guilty about not being able to handle it all, or that in someway you have failed by admitting that you need help.  Here are a few things that you, as a primary caregiver should ask yourself:

1. Am I physically exhausted and overwhelmed by the situation?
2. Do I feel like I never have time to myself to just relax, read a book or do anything that is just for me?
3. Do I dread each day and what it may bring?
4. Do I view my loved one as a dependent and have trouble enjoying time with him/her?
5. Is my health suffering because of the needs of my loved one?

If you answered "Yes" to any of these questions you should begin to look for information and services that are available in your area.  I would also encourage you to be honest with the people closest to you about the true reality of your situation.  Many times caregivers try very hard to make things look as though everything is fine, when their reality is very different.  It is a way of coping for the caregiver to try to keep things the same for as long as possible.  I don't know anyone who does not try to avoid an unpleasant decision for as long as possible before facing it head on, especially when dealing with a progressive disease or condition with no cure.
In most situations the people close to you want to help and are just waiting for you to open up to them.  That is the best place you can start to reach out.  Making these decisions alone can be overwhelming and when you are already trying to deal with the everyday chores of being a caregiver that can feel like one more thing to do when in fact finding help can actually allow you to become the spouse, daughter, son, friend, or sibling again.
I started this blog to try to help families and caregiver find what it is the right path for them.  There are no right or wrong decisions about the path you choose except to do nothing.  If you have never dealt with anything like this before, how could you possibly know about what health services available- they certainly do not make them easy to find sometimes!  I will be posting more blogs about each of the services available out there and trying to give you some direction.
If you have specific questions about a need you may be having; feel free to write me and I will try my best to steer you in the right direction
The goal of course is Aging with Ease!