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How Does Dementia Impact Incontinence?

 

Your mother hasn’t been going out as much lately. She even declined a few outings with you recently, which is unlike her. Then you noticed a pair of soiled underwear shoved behind the toilet…and another soiled pair under the bathroom sink.

 

 

What she may be hiding is trouble with urinary continence.  She may be feeling embarrassed and is trying to hide it, or if she has dementia, she may be confused about how to cope with this new change.

 

There are many possible reasons and treatments for urinary incontinence.  Ensure your mother sees her doctor and speaks openly about what she is experiencing.  Many causes of incontinence can be addressed medically, and those should be addressed immediately.

 

You may be able to suggest some lifestyle adjustments that will help to support your mother’s bladder, rather than irritate it. Read our other blog that addresses natural ways to support the bladder. If your mother has dementia though, the source of her challenge may be related more to her functional abilities than to her bladder directly.

 

As your mother’s dementia advances, she may not be as responsive to the signals her body is sending.  By the time she realizes that her bladder needs relief, it may be too late to respond and she may not be making it to the washroom in time.

 

 

Another challenge can be complicated clothing. Buttons, snaps, zippers or belts may be proving a challenge in the washroom. The more barriers there are to quick washroom use, the more likely your mother is to be slowed down and not make it in time. Be especially aware of skirts or dresses with back closures since it may not be self-evident how to undo the zipper. Modified and accessible clothing may make it easier for your mother to be quick and self-sufficient in the washroom. Drawstring or elastic-waistbands are often the easiest to manage.

 

If your mother’s dementia is advanced, it is possible she is confused about where to find the washroom.  Washrooms are not always easy to find, especially for someone with dementia.  Often, washroom doors remain closed, even when unoccupied.  Someone with dementia may not think to open closed doors to see what is behind the door. They may not have an intuitive sense of where a bathroom is likely to be located within a home or apartment. Although she may have lived in the same home for years, or decades even, dementia can cloud her memory and obscure what was once familiar. If she cannot easily find the washroom, she will not make it in time when nature calls.

 

 

Once she is able to locate the washroom, she may be confused about what to do once she’s in there.  For some people with advanced dementia, the washroom can feel very confusing and overwhelming.  If the toilet seat lid is down, the toilet may not look familiar. A white toilet and white sink may look very similar and can be confusing.  A wastepaper basket may seem more familiar and is often mistaken for the toilet itself.

 

Sometimes people attempt to sit down facing the toilet, rather than with their back to the toilet tank, as it is typically used. Because it feels so unusual when facing backwards, there is no long-term memory to cue what to do next.  It can also be dangerous since balance is impacted and there is a risk of falling.

 

If someone needs cueing through each step of toileting, their apparent challenges with incontinence may be more related to functional abilities and less so to their bladder or bowel function. They may be able to hold their bladder or bowel and may even be aware of when they need a washroom, but the confusion sets in with how to use the washroom.  If someone is experiencing functional decline, various support measures can be implemented to promote independent washroom use.

 

 

Cue cards can be helpful for those who can read and interpret directions. If your mother is inclined to read instructions and follow the directions, a cue card in the washroom to cue each step may be helpful.  In some cases, colour coding the toilet seat vs. the sink can be helpful. Contrasting colours can make it easier to see which item is which. If cue cards and colour coding are insufficient, your mother may need a caregiver to cue her through each step of the toileting process. 

 

When functional ability is preventing someone from toileting successfully, look for which step is causing the confusion, or which component of mobility is posing the challenge

 

By solving that specific component, you can help support someone to toilet as independently as possible.  Engaging the support of a professional caregiver may also help in identifying precisely where the needs exist. For more ideas on supporting independent toileting and continence, contact us at Warm Embrace Elder Care.

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Tips to Support Your Bladder

 

Talking about your bladder may not be appropriate at a dinner party, and yet it’s an important topic! Many people experience a “leaky bladder” and struggle with a frequent and urgent need to urinate.

 

There are many possible causes and treatments for urinary incontinence or frequent need to urinate. Anyone who is experiencing incontinence at any level—even minor “bladder leakage”—should discuss it with their doctor.  Sadly, only 25% of those with incontinence seek medical assistance. People often feel embarrassed or think that it’s just a part of ageing.  If you find yourself, or someone you know, feeling like you suddenly have to go and you don’t have enough warning, talk to your doctor!

 

 

In addition to seeking medical attention, there are some tricks that may help you to support your bladder rather than fight it.

 

Drink more water

 

This sounds crazy. If you’re having trouble with your bladder, the last thing you want to do is flood your bladder with more liquid. But it can help!

 

When someone is worried about making it to the bathroom on time, they often start to limit their fluid intake. They drink less because they don’t want to urinate frequently, or they’re afraid they won’t make it to the washroom in time. What they don’t realize, is that they’re actually making the issue worse. They are aggravating their bladder even more.

 

 

Concentrated urine irritates the bladder. The more concentrated the urine, the more desperately the bladder wants to dispose of the urine. Since urine is flushing toxins out of your kidneys, concentrated urine is full of toxins and your body is designed to get rid of those toxins quickly. Even a small amount of concentrated urine will irritate the bladder and signal the need to urinate.

 

 

Diluted urine, on the other hand, does not irritate the bladder.  The more liquid you put in the bladder, the more diluted the toxins from the kidneys. The bladder can hold a surprising amount of diluted urine without feeling the same strong urge to urinate.

If someone is chronically dehydrated, it will take a little while for their bladder to adjust to being suddenly flooded with a lot more liquid. But soon enough, the bladder will accept the increased volume and may not trigger the need for washroom use quite as frequently.

 

Alcohol, Caffeine & Artificial Sweeteners

 

The bladder is sensitive to other irritants as well.  Alcohol, caffeine and artificial sweeteners are all bladder irritants.  You’re probably not surprised that alcohol irritates the bladder; there is typically a long washroom line up at any bar!  And caffeine may not be surprising either. Have you ever noticed how badly you need the washroom after your morning coffee or tea?  The lingering caffeine may continue to irritate your bladder, even after you’ve been to the washroom already.

 

 

The irritant that you may find more surprising is artificial sweeteners.  From packets of sweet-n-low to processed foods labelled as ‘diet’ that contain sucralose or other artificial sweeteners, these non-sugar sweeteners can irritate the bladder and cause frequent urination.  Drinking so-called-diet soda might be adding lots of fluid, but the artificial sweetener in that soda may cause your bladder to want to release it quickly!  Aim to reduce or remove all artificial sweeteners.

 

To further support bladder health and prevent an overactive bladder, reduce caffeine intake, abstain from alcohol, and check all medications for side effects. 

 

Medication Side Effects

 

Be sure to check all medications for side effects.  Increased urination, or increased urge to urinate is a common medication side effect. If any of your medications list this side effect, talk to your doctor or pharmacist about possibly switching to a different version of medication that may not have the same side effects.

 

 

It is always worth having your pharmacist review all your medications. It is possible that the combination of numerous medications has caused a side effect that is not listed on any particular medication but taken in combination, new side effects can occur. 

 

Be sure to review ALL medications, vitamins, supplements, and over-the-counter medications that you are taking.  Natural supplements can have side effects too! Natural does not mean ‘no side effects’.  Have your pharmacist review everything that you’re taking and have them make recommendations on what you might adjust to limit the impact on your bladder.

 

Action Plan

 

If you, or someone you know, is experiencing the frequent need to urinate, start by scheduling a doctor’s appointment. Urinary incontinence can greatly impact the quality of life; it is worth seeking medical assistance to ensure every possible source of incontinence is checked.

 

 

In the meantime, go for the low-hanging fruit!  Drinking more water and reducing caffeine, alcohol, and artificial sweeteners are relatively easy treatments to implement: they don’t cost anything, and have numerous other health benefits as well.  It doesn’t hurt to try increasing water intake as a way to reduce urinary incontinence or frequent washroom use.

 

Be sure to review your medications, supplements and vitamins with your pharmacist to look for any possible side-effects or medication interactions.

 

Now go fill a large glass of water and ‘CHEERS!’ to a healthy bladder!

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Grieving the Loss of Your Health

 

When a loved one is diagnosed with a chronic illness or a degenerative disease, the diagnosis affects the whole family.  It is easy to overlook the ways in which other family members are also impacted by chronic illness because the focus is upon the person who is unwell. 


In the flurried rush of attempting to care for the person with the new diagnosis, families are often unaware that the emotional response they are experiencing is grief.  People sometimes assume that grief only applies if there has been a death in the family, but people experience grief from many types of losses.


Grief is our human response to a loss.  It is primarily an emotional response, but it can also have other dimensions too (physical, cognitive, social, spiritual, etc.).  When a loved one is diagnosed with a serious illness, family members may grieve.  For many family members, the grief is complicated by the fact that they are still in the throes of family caregiving, and they may be expected to remain “the strong one” for the sake of the family.

 


Grief is not a linear process that moves predictably through various stages.  While there may be stages to grief, those stages are not sequential; there is no graduation from one step to the next.  Each individual may experience various elements of grief at different times and remain with one stage for a long time, or they may move through various stages rapidly all within one day. There is no correct way to grieve, and there is no such thing as “failing at grief”.  It is an individual journey and process for each person.


There can be triggers for grief, and those triggers are as individual as the grief process.  A trigger could be something like hearing a favourite song that you once danced to with your spouse, and grieving that your spouse can no longer dance.  A trigger might also be a daily routine that has suddenly become difficult, and grieving the loss of ability or independence that changes gradually. 

 

For many families, there is grief over the loss of a role within the family.  It might be the role of primary provider if employment is reduced; it might be the role of fix-it-man around the house and no longer being able to operate tools; it might be the role of coordinating family events and family members feel scattered and disconnected. The change of roles and responsibilities can be a difficult transition and grieving those changes is a normal—even healthy and expected—response.

 

 

Grieving is an action.  It requires effort and work.  The goal of grief is not “to get over it”.  Unfortunately, many families feel that the message from friends and sometimes even health care professionals is that they should “get over it” or “get back to normal.”  When a family member is coping with a chronic illness, returning to “normal” is no longer an option. 

 

The previous version of normal doesn’t exist.  Illness has redefined what normal will be like.  The goal is to adjust to a new normal—adjusting to the illness as a new reality of life, and recognizing that this will alter many aspects of life.  Once families have begun to adjust to their new normal, they can begin to see hope for a newly defined future.


Instead of looking for a reason that the illness is present within the family, seeking meaning can be a lot more helpful.  Seeking meaning is looking for a silver lining—acknowledging that a difficult situation is the reality, but perhaps there can be some wonderful moments that are significant. 

 

 

While this may seem like a subtle shift in mentality, it can result in vastly different feelings.  Looking for reasons suggests that someone had to experience the illness in order to learn a certain lesson; looking for meaning is acknowledging that the illness has happened, and finding glimmers of hope will make the journey more meaningful.


How can you best support someone who may be grieving because of an unwell family member? 

 

The most important thing you can do is to remain connected.  Family caregivers constantly report that their closest friends and even other family members distance themselves because they don't know how to help, or they don’t want to impose. 

 

One gentleman laments that while his wife was palliative, she had so few visitors.  She felt the greatest relief from pain while a visitor was present, and her husband expressed this to friends and family, but few visitors came to the house because they did not want to impose.  Visitors weren’t seen as an imposition, but as a welcome relief. 


The greatest thing you can do is to ask how you can best be supportive, and then LISTEN!  Truly listen.

 


Allow family members to tell you what they need and what they want.  Most of all, they will appreciate a listening ear who acknowledges their challenges and validates their feelings and experiences.  Pre-judging or assuming what someone is thinking/feeling is not helpful. 

 

A woman remarked that the comment “but you look so well!” (or that her husband, for whom she cares, “looks so well”) to not be helpful.  While it is intended as a compliment, it shuts down any conversation about how she is truly feeling.  She would prefer that someone just ask her how she is feeling, and be open to a conversation.

 

To best support someone else, be a listening ear and don’t distance yourself.  Remember that the person with the illness as well as the whole family is adjusting to a new sense of normal. 

 

Be wary of judgmental statements such as “things happen for a reason”, and instead help others to see some of the meaningful moments that have touched you and might also touch them.

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How is someone with dementia impacted by COVID-19?

 

I think it’s safe to say that COVID-19 has thrown everyone a curveball. In a matter of a few short weeks, our society as we know it has been completely altered. And while it may only have been a few short weeks, it somehow feels like it’s been much longer. Routines are completely upended, we’re all glued to the news and social media updates, and we’re attempting to keep up with the constantly changing guidelines and recommendations.  For you and I, it can feel exhausting and tiresome.

 

How does it feel for someone who has dementia?

 

Depending upon which stage of dementia someone is in, their ability to fully comprehend the pandemic will be impacted. For someone in the very early stages of dementia, they may be managing to live independently but may require notes posted on every door reminding them to remain at home.

 

 

For someone who is much more progressed in their dementia journey, such notes would not be effective.  Attempting to comprehend a world-wide pandemic would be quite difficult, if not impossible. You and I may have difficulty fully comprehending the scope and impact of COVID-19, and we have the benefit of our brain still providing executive functioning with insight and reasoning and processing. For someone whose dementia has impaired their brain functions, it is not fair to ask their brain to process information that requires interconnected executive functions.

 

For someone with advanced dementia, comprehending the pandemic is further complicated by the fact that there is no context for a global pandemic that is easily relatable. They do not have life experience that is easily understood.  The closest comparison would have been the Spanish Influenza, but even that was before their lifetime, or certainly before their own lived experience and memory. While they may have heard stories from their parents, it is unlikely that the long-term memory would be vivid enough to remain without lived experience to coalesce the memory.

 

 

So, for those with advanced dementia, trying to understand a global pandemic is very challenging. But that does not mean that they are unaffected by the information of the pandemic, as we all are.

 

While the facts of the pandemic might be difficult to comprehend, people with dementia are often highly attuned to emotions.  The content of a conversation or a news story may be difficult to follow, but the underlying emotions are abundantly evident.  So, while a person with dementia may not be able to recite the number of local cases or even recognize that people are sick in the hospital, what they can feel is the anxiety, nervousness, sense of helplessness and fear of the unknown.

 

These emotions are evident on newscasts and probably seep through your own interactions more than you realize.  If you’re discussing the pandemic with someone else, your brain is distracted by the content of the conversation—the number of cases, which protocol has been updated, what to do next. You may be subliminally processing some level of emotion, but the content of the conversation has your brain focused on facts more than emotion.

 

 

Someone with dementia who is observing that conversation is experiencing it quite differently.  Their brain is not able to process the facts; they are left strictly observing and absorbing the emotions. They are reading the uncertainty and fear; they can hear the anxiety and stress. They recognize and may begin to reflect these emotions, but do not recognize the source of the emotions and cannot connect it to the pandemic.

 

Just because someone does not remember the details around the pandemic does not mean that they are failing to process the situation. They are processing all the emotions that you are; they are just missing the context for the cause of the emotions…which makes the emotions even more upsetting.

 

It is important to recognize that the emotional experience is always valid—whether someone has dementia or not.  The emotions are always real, even if the source of the emotion is not fully understood.  Even though your loved one does not know the latest update about COVID-19, they are likely still processing many complex emotions and need your reassurance now more than ever.

 

 

Families require professionals who are trained and equipped to assist those with dementia during difficult times like these.  Caregivers to the elderly are an essential service and can continue to provide professional dementia support.  For more information on how to support a loved one through this crisis, please contact us at 519 954 2480.

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It's Okay to Ask for Help

 

When self-isolating at home, have you found yourself scrolling through random online updates more often than you want to admit?  If so, you’ve probably seen articles and posts about parents who are going crazy being cooped up with their children for weeks on end. Both the parents and the children are feeling the strain.

 

It isn’t just the parents of young children who are feeling the parent-child relationship strain. It can be felt at all ages but is showing up particularly strongly for those who have been thrust into a caregiving role that is more extensive than they anticipated.

 

 

Adult children of ageing parents who have dementia or other high-care needs may suddenly find many of their regular support systems removed. The Adult Day Program that your mother attended a few days weekly is now closed; her regular social groups at the church have shut down; even the PSW who usually comes to bathe her has not been coming. Your mother’s schedule is in upheaval and you have become the primary—and only—caregiver.

 

It can be pretty overwhelming to suddenly find yourself in the full-time position of caring for someone with dementia. While you’re happy to help sometimes on some days, being the only support person day after day is wearing you out and you’re starting to feel the strain.

 

 

It is okay to admit that, just like your mother, you’ve experienced a massive upheaval in your schedule and routine, with newly added responsibilities.  And though you may be tempted to think “I’m not working at the moment so I should be fully available to care for mom,” providing 24/7 dementia support is more than one full-time job.

 

Providing care to a loved one with dementia is more than just physically taxing. It can be emotionally exhausting as well. There are certainly very meaningful moments with laughter and joy, but when it is your parent or your spouse whom you’ve known for decades, it will undoubtedly be emotionally exhausting as well.

 

 

Just because you are home at the moment and may not be working does not mean that you are equipped to provide 24/7 dementia care. It is okay to acknowledge that sometimes, a professional is required and someone who is not related to your mother may be better able to provide the assistance she needs right now.

 

Fortunately, caregivers to the elderly are essential and permitted to continue caring for seniors. Here at Warm Embrace, we continue to serve our longstanding clients and we are also equipped to help families who are now finding themselves in need of more care.

 

As an essential service provider, we’re here to help your family through this difficult time. Contact us for more information.

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Thank You to All Our Incredible Caregivers!

 

From the bottom of our hearts, we want to thank all of our incredible caregivers who are front-line heroes during this COVID-19 crisis.  Every day, our caregivers continue to serve the clients who need them most. 

 

 

Our caregivers are absolutely essential. Without their help, some of our elderly clients would not be able to get out of bed, or use the washroom, or cook a meal. It is our caregivers who help these clients to maintain their daily routine and ensure their most critical needs are met.

 

One of our clients, whom we’ll call Viola, is 99 years old and lives in her own home. She needs daily assistance and desperately wants to remain living at home instead of moving into a group setting at a time like this.  Viola is lucky enough to have her son living nearby, and he usually visits her daily to ensure she has her medications and a proper meal. However, Viola’s son is a senior himself and he has an immune disorder. He cannot visit his mother at all right now as he is strictly self-isolating.

 

 

Fortunately, our wonderful caregivers are filling the need by taking care of Viola on a daily basis, helping with everything her son once did. Viola is thriving with daily visits and her son has peace-of-mind knowing that his mother’s medications are on track and she is eating well, even in his absence. Viola’s son called to tell us how relieved he is feeling, and the emotion was palpable even over the phone!

 

Our services are truly essential to so many elderly individuals in this community. We serve some individuals 24/7 and provide necessary assistance like bathing, dressing and help getting in and out of bed. Our amazing caregivers are the ones that can make that happen!

 

 

Thank you to our caregivers: you are more than essential; you are front-line heroes who continue to make a difference in our community, each and every day. Thank you for all that you are doing to support seniors; we appreciate your sacrifices and your diligent care to the seniors we serve. We appreciate you and everything you’re doing! 

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Being Factually Correct is Not the Point

 

When you break down the format of everyday conversation, you might be surprised how much it tends to be an exchange of facts.  We’re often using the old-fashioned newspaper reporter method of the W’s: who, what, where and when. Sometimes we also include the “why” and “how”, but often it’s just the first four W’s.

 

 

Conversation tends to report on who did what with whom, where they went and when.  We depend on each other to convey those “facts” in an accurate way, and we equate that with telling the “truth”.  Since we tend to consider “truth” as a value, we place a lot of importance on conveying facts accurately.

 

The reality is that any of us is only ever conveying our perspective, our experience of the world, our interpretation of events.  You know the old saying….” if there are 10 eyewitnesses, there are 10 different accounts”. I might even argue that you’d get 11 or 12 different accounts with 10 eyewitnesses!  We each have our own understanding of events or recollection of past events.

 

Oftentimes, a conversation that includes sharing past memories becomes an exercise of correcting each other’s recollections of the “facts” or telling the “truth”.  When different narratives emerge, a lot of effort is spent trying to reconcile those different narratives, assuming only one can be correct; or that details of each need to be merged and one variation decided upon.

 

The focus on “facts” and telling the “truth” makes conversation very difficult for those with dementia. 

 

Recalling the first 4 W’s is tough: who, what, where and when.  When someone’s brain has been impacted by dementia, their ability to recall precise details is impaired.  Short term memory no longer encodes details into long term memory.  When someone attempts to retrieve the details a few hours or days later, the information is no longer there since it was not encoded into long term memory.

 

 

Long term memory that was established decades ago may remain as the strongest memory.  Eventually, even long term memories are impacted by the progression of dementia. When those memories are affected, it will be the details and the “facts” of the memory that are first at risk.  Someone will continue to remember the feeling associated with a memory, but they can’t necessarily recall who was present, or when it occurred, or where exactly it was. They’re more likely to remember the “why” or the “how” of the event because those elements are typically more connected with the feelings of an event.

 

When trying to recall a memory, and someone with dementia or Alzheimer’s has an impression of the “why” or “how” of an event, their brain may fill in the gaps on some of the missing “facts” of the story to help it make sense. Their brain may provide a missing “who” or supply the “when” of the story—and those details do not line up with your recollection of the event. 

 

In fact, those supplied details may not line up with the version of the story that the person told yesterday. Each time they retell the story, their brain may have to supply a different missing detail.

 

Instead of focusing on the “facts” of the story, focus on the feelings.

  • Don’t worry about correcting the details that may have different from the last telling of the story. 
  • Don’t contradict the details or get worried about the “accuracy” of the story. 
  • Do listen to the “why” and the “how” of the story that starts to emerge.

Let your loved one explore their memory and remember that they are trying to put words to an emotional experience. The emotion of the memory may remain strong, but finding the words to express it can be difficult. If the details they supply keep being corrected by someone else, they may stop trying to articulate what they’re feeling.

 

 

Stop and consider: what is the purpose of this conversation? 

 

If it is a nice conversation between you and a parent, then enjoy it for all it is worth! Savour the clear moments, find the emotion underneath the words, and use it as an opportunity to connect.  Correcting “facts” will only inhibit the purpose of this conversation—which is to create a connection and convey love and caring.

 

If it is a conversation with your loved one’s family doctor, then the purpose of the conversation is different. Suddenly, the facts of a particular symptom are critical. In this case, having correct “facts” truly is the purpose of the conversation and being focused on precision is important.

 

When you consider the purpose of a conversation, you can remain focused on what matters most.  If exchanging factually correct information isn’t the point of the conversation, then don’t worry about correcting facts! 

 

If the purpose is to create enjoyment for your loved one, you can achieve that by supporting their feelings and their recollections.  Focus on the feelings, not the facts and you’ll find conversations far more enjoyable!

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What is Doll Therapy?

 

When someone has advanced dementia, their ability to complete tasks may become impaired, but their desire to have an important role and care for others often remains strong. While they may require quite a bit of assistance themselves, they are keen to offer assistance in return.

 

 

Caring for others is a deeply rooted desire for many people that persists throughout the journey with dementia. Simply trying to tell someone “you’re retired and you don’t have to worry about anything!” often produces more agitation. Instead, figure out how to tap into that desire to help for even better results.

 

One option is to provide doll therapy. 

 

Doll therapy allows someone with dementia to care for a doll as though it were a baby.  For some people, this can be highly effective and meaningful since it connects with identify—someone’s identity as a parent or a caregiver.

 

In some cases, a regular doll is sufficient. In other cases, a true therapy doll is more effective. A therapy doll is designed to be as life-like as possible. The doll is weighted so it feels similar to holding an actual baby.  Most are designed to look like a peacefully sleeping infant.

 

The ways that people interact with their own personal therapy doll can vary significantly.  We served two different clients, Mildred and Betty who each resided in long term care and had a therapy doll, but their forms of interaction with their dolls differed.  In each case, we let the client initiate the interaction with the doll and we matched their interaction.

 

 

Mildred treated her therapy doll as though it were a real child. She held the baby properly and laid it down to nap peacefully.  In this case, we mimicked Mildred’s interactions and also treated the doll as though it were real.  Often, Mildred wanted to put the baby’s needs above her own—she would decline to go to the dining room for dinner since the baby was sleeping and she didn’t want to disturb a sleeping baby. In this case, we offered to hold the baby during dinner so Mildred could eat.  We went together with Mildred to the dining room and sat by her table, holding the doll where she could keep an eye on her baby during mealtime.

 

Betty had quite a different interaction with her doll. Betty always wanted to have her doll nearby, but she didn’t always hold it the way one would hold a child. Sometimes she’d pick the doll up by its head, or carry the doll around in a plastic grocery bag.  She was comforted by having the doll nearby, but she didn’t interact with it as though it were real.  Out of respect for Betty, we handled the doll carefully, but rocking the doll throughout dinner wasn’t necessary for Betty’s peace of mind.

 

When interacting with someone who is soothed by doll therapy, always ensure that you act as though the doll is a real baby.  Offer to hold the baby, and hold it correctly as you would a real child.  If someone is upset their therapy doll is not within sight, provide an explanation that would make sense if it were a real baby.

 

 

Saying “it doesn’t matter where the baby is—it’s just a doll!” can be quite upsetting. Instead, saying “oh, your baby is having a nap and the nurses are keeping an eye on her. Best to let the sleeping baby sleep.”  Your reassurance with an explanation that fits the scenario will provide more peace of mind.

 

Therapy dolls can meet someone’s need to nurture and care for others. It isn’t only women who have a need to nurture. Many elderly men with dementia do very well with a therapy doll as well.  One gentleman we met, Dyck, was rather despondent. He wasn’t interested in joining any of the activities in the long term care home he had just moved into. He was even trying to avoid some mealtimes. 

 

The introduction of a therapy doll completely changed his demeanour. He was proud of his new role and was keen to show off his baby to others. When staff and visitors would say: “Good morning Dyck, how is your baby today?” he would proudly respond “she slept through the night again!”  The tactile comfort of carrying the baby, joined with the sense of purpose and newfound caregiving role helped Dyck with his transition into long term care.

 

 

Doll therapy does not have universal appeal. Many people are not at all interested in carrying a doll; others are very well aware it is a doll and not a real baby; others still become so preoccupied with the doll that it can become problematic. Some people become concerned that the baby is sleeping all the time and they’re concerned when they cannot wake the doll. The inverse can happen too if the doll is designed to look like it’s awake—a concern that the doll never sleeps.  If someone is distressed in any way by the details, then doll therapy may not be ideal for them.

 

The next time you’re in a long term care home and you see someone carrying a baby doll, remember that it could be a therapy doll and you should treat it as though it’s a real child.  Ask the person holding the doll about their baby—you will likely see them perk right up and be very proud to tell you more.  While doll therapy certainly isn’t for everyone, it can be a great comfort and benefit to those seeing a nurturing role.

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Our Mission During COVID-19

 

What a turbulent week it has been!  Undoubtedly, you’ve been following the news more than usual as things have been changing by the day, sometimes by the hour. It is easy to get swept up in the wave of uncertainty. Here at Warm Embrace, we are remaining grounded by our mission of:

 

Empowering the elderly

To experience fulfillment daily

Through dignified care

 

Our clients need us just as much today as they did last week, last month, and last year. In some ways, they probably need us even more than before!  We remain committed to doing more than just meeting basic needs. We aim to go above and beyond each day to help our clients have the best day possible.

 

Right now, meeting basic needs includes practical measures such as doing the grocery shopping so that elderly clients and their loved ones are not out in stores. It also means sanitizing the home more thoroughly and frequently than usual. It means cooking homemade meals to ensure quality nutrition.  It means serving clients whose family members may be in self-isolation and are unable to visit.

 

 

Going above and beyond to ensure our clients experience fulfillment each day means meeting clients’ social and emotional needs.  For those with dementia who may not understand all that is happening, we are maintaining a routine.  People with advanced dementia may have a difficult time following the facts of a news story, but they are very aware of the emotions conveyed by the coverage. They can feel the anxiety and stress of those around them without understanding the source of anxiety. For our clients, we are a reassuring presence, the calm in the storm.  Instead of focusing on what’s happening out in the world, we remain present, in the moment, with the person at hand to help them feel at ease.

 

We’re here for those who continue to need support caring for loved ones. Family members who live at a distance are now unable to travel; we will provide the help needed for local elderly relatives. For those who typically attend adult day programs, we can provide one-on-one support instead of the usual group setting.

 

 

As always, we prioritize the health and wellness of our clients and our caregivers. We continue to monitor and follow the recommended guidelines of the CDC and public health. We have equipped caregivers with specific COVID-19 training and essential supplies such as personal-sized hand sanitizers that they can carry at all times.

 

Of course, the situation continues to remain fluid and is ever-changing and we will adapt to keep up with the changing times. Through it all, we’re here for you and we’re here to serve the elderly who need us most. If we can be of assistance in any way, please reach out to us; we look forward to hearing from you.

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Why Bed rest isn't always a good thing

 

Avoid bed rest at all costs!

 

No one gets excited at the idea of being on bed rest. We can all agree it’s not something we would necessarily want to experience. What we may not realize is just how risky bedrest can be, especially for the elderly.

 

Bed rest most commonly occurs within the hospital, but can definitely happen at home as well.  When an elderly person is admitted to the hospital, they typically remain in bed. While they may not have been “put on bedrest” by doctor’s orders, the outcome is that they tend to remain in bed. Our hospital system is set up in such a way that those who are admitted to the hospital largely remain in bed all day long.

 

 

The problem is that remaining in bed all day long is one of the worst ways to recover from almost anything!

 

Bed rest limits someone’s physical activity to little more than a few steps to and from the washroom, a few times daily. That is not enough physical activity to maintain muscle mass.

 

The data proves that with an alarming statistic:

 

For every day of bed rest, the frail elderly lose 5% of their mobility.

 

Consider how long an elderly person tends to be in a hospital. Once admitted, most elderly patients are hospitalized for at least a number of days, but upwards of a week or ten days wouldn’t be uncommon. After a week of bed rest, 35% of mobility is lost! If someone is unfortunate enough to be in the hospital for two weeks—which is all too common—on average they would lose 70% of their mobility. 

 

That's a very high risk!

 

 

That could mean that prior to hospitalization, someone was living independently and walking without any aides. After two weeks in the hospital, that same person now requires a walker and struggles to get out of bed or out of a chair.  That’s a drastic change in their ability level and independence. It will significantly impact the quality of daily life.

 

With such a high risk of losing mobility on each day of bed rest, you can see why it is critical to keep people up and moving as much as possible (unless expressly prohibited by doctor’s orders).  Seniors should be encouraged to sit up and get out of bed and into a chair, stand up and sit down numerous times to keep leg muscles strong and do exercises either seated in a chair or passive exercises in the bed.

 

Even just sitting up straight in a chair is beneficial since it is typically easier for people to breathe deeply or cough and expel when they’re upright versus lying down.  Many elderly patients are at high risk of developing pneumonia while in hospital, and failing to sit up, breathe deeply, cough and expel can increase that risk. Developing pneumonia will lengthen a hospital stay, which increases the likely number of days on bedrest—meaning more days of losing 5% mobility each day!

 

 

Unless a medical condition or injury specifically requires immobilized bed rest, remaining active in any possible way is absolutely essential to recovery and long-term maintenance of mobility and muscle mass.

 

Next time you’re visiting a senior in the hospital, have them sit up or get out of bed and into the chair.

 

You just might be helping to save their mobility and prevent the 5% daily loss!

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