‘Elephant Feet’…An Idea to Reduce Falls

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I learnt something new the other day from an Occupational Therapist at Alzheimers Australia recently. Firstly I discovered what an OT does and secondly I found out about ‘elephant feet’.

They are special height raising supports for chairs and beds. There are several brands available and often come in two heights eg 90mm and 150mm approx. they can carry a load of 200-250kg. They are not suitable for chairs or beds with castors and recliner chairs.

I am looking into these for Bob as he has had at least 10 falls in the last month and they are happening whenever he tries to sit in a chair or on his bed.

My point is that falls can be avoided by adjusting the environment to the person at a particular point in their decline. The problem with Bob now is ‘spatial awareness’ and the result of a bad fall is potentially another trip to hospital which is worse case scenario for our family.

We need to advise care staff to be alert whenever Bob goes to sit down and support him where possible. These are the moments you need to report the changes and take proactive steps to reduce fall risk.

Dad has had several incidents where he has accidentally hurt other residents by misjudging chairs and sitting on another smaller resident. This is dementia….

Shaving the Aged Care Cuts…A ‘Rough Cut’ Indeed

 

I am addressing a subject today that may not have been brought up before, but after hearing stories from family members from several different nursing homes it is a conversation that needs to be had. Shaving (and personal grooming) is a big part of caring for an elderly resident, and I would imagine the objective is to continue the routines and standards that were in place when the resident was at home.

It has been said that some nursing homes are ‘penny pinching’ by using the cheapest and nastiest razors. This is false economy in my opinion. If a ‘rough shave’ is given to a resident it will potentially cause agitation to the resident, and frustrate carers and make their role even more difficult. It will cause a painful experience for the resident, but also add more time to complete ADL’s (activities of daily living). I have even heard some carers are buying better quality razors for residents (with their own money) and storing them in their cars. I believe this is a situation that should not occur in modern times but it certainly highlights how carers feel (when they are already on low wages) yet have the decency to selflessly do this kind act for their residents. Bravo I say!

Bob uses his own electric shaver so I am not sure who bears the costs in these situations, but I assume razors are a cost that is incurred by the nursing home, unless the family wishes to provide their own? Can anybody clarify this for me?….What if the person has no family or has fallen out with their family? What are the protocols here?….I am also told that some aged care homes have towel and flannel limits per resident (eg one of each per shower). Surely in the name of hygiene and human decency extra towels can be obtained by carers if required?

We need to treat our elderly community with respect and dignity at every opportunity.

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Guest Blogger #1 – Ngaire Hobbins (Tasmania)

Let’s face it, eating is something that brings pleasure and social connection. That is no different merely because of a diagnosis of dementia. In fact, food continues to hold the power to help get the most out of life, supporting brain and body, while always continuing to add joy to life.

It might not always seem to be that way if dementia has messed up connections in the brain that link hunger with all the quite complex steps needed to be completed to shop for, prepare, serve and then manage to get food into the mouth and swallowed. If any of these are impacted and strategies not put in place to help get around such issues, there is a big risk someone living with dementia will go hungry.

I don’t know about you, but if I was hungry and wasn’t able to carry out whatever steps I needed to deal with that in the way I had always easily been able to do in the past, I think I’d find it depressing and might even lash out in frustration. Those of us who care about someone living with dementia can do so much to help maintain not only the pleasure in eating, but to head off malnutrition by being aware that just because someone is not eating the food put on the table or what is sitting in the fridge, it doesn’t necessarily mean they are not hungry. In fact, I believe they often are.

Unfortunately, the importance of eating, and the disastrous consequences of the malnutrition that is all too common in dementia, is frequently ignored by health professionals too. I released a book in 2014, Eat To Cheat Ageing that among many things, highlighted the damage weight loss does in later age, providing strategies for avoiding it and minimising it’s impact. This is no less important when it comes to brain health and dementia, as was recognised in 2014 in the report on Nutrition and Dementia by Alzheimer’s Disease International, which states that close to half of those diagnosed with dementia had lost weight in the previous year, the consequences of which include increased frailty, falls and death.

My new book, Eat To Cheat Dementia looks more closely at the impact of eating on brain health and cognition, and how these then in turn affect the ability of someone living with dementia to. It’s not a book that claims to be able to cure, or that guarantees a way to avoid dementia – we all know that’s just not possible yet. But what it does do is provide evidence-based advice on what you can do to give your brain the best chance possible to head off dementia if you are not living with that diagnosis. And for those who are, provides sensible, practical advice and strategies to enrich life as well as maximise health and independence.

For those who do not live with a diagnosis of dementia, food assists in three main ways: by helping maintain the smooth running of your vascular system (blood vessels), by providing vital substances to minimise the harmful effects wrought by inflammation and oxidative stress on brain cells, and by providing protection and support for brain function.

Those continue to apply for people who have received a dementia diagnosis, but what overrides all else at this time is the vital importance of avoiding weight loss wherever possible. There are some people with dementia who will gain weight, but for the vast majority, advancing frailty including weight loss is a problem. That means focussing on food that provides plenty of kilojoules along with protein and other nutrients as much as possible. Adding cream, butter or oil to recipes, sprinkling grated cheese on hot vegetables and extra parmesan on pasta, adding milk powder (or commercial high protein supplements) to drinks and dairy dishes and using treat foods to entice appetite are all useful strategies. Don’t fuss about avoiding sugar or salt – the important thing is getting food in, and if that means an extra spoonful or 4 of sugar, or adding salt to meals, that’s what needs to be done. There is so much more that is outside the scope of this blog, and that you will find in my books, but before I go I want to leave you with one other thought: If an individual’s memory is looking into the more distant than recent past, work with that – offer foods and meals that were enjoyed years, even decades previously. It might just be that the latest food trend is not even recognised as food if memories are mostly being recalled from a younger life 50 years ago. Embrace the meat and 3 veg, the custard, scones with cream and jam, steak and kidney – it might just add both joy and good nutrition.

Ngaire Hobbins APD is a dietitian specialising in ageing and brain health. Her books are available through all bookstores and the usual online outlets. In South Australia and Tasmania Eat To Cheat Dementia is also available through Alzheimer’s Australia (where a donation from the sale of each book goes to AlzAust)

www.eattocheatageing.com
www.facebook.com/eattocheatageing

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New Feature – ‘The Guest Blogger’

A new feature of the ‘Dementia Downunder’ Online Support Group is the ‘Guest Blogger Post’.

I will be asking dementia specialists, trainers, authors, doctors,healthcare & aged care professionals, service providers, celebrities plus more to contribute a special blog to our group.

The blogs will come from different areas of dementia care and will be posted at random times and will engage, educate and entertain.

Stay tuned for our first blogger who will be talking about ………?????

I Rode the Emotional Rollercoaster Today

I presented to a fabulous caring audience today that were mainly from the aged care sector and they totally inspired me. I went through so many emotions and almost ‘lost it’ and so did they (many told me afterwards, they were a bit teary ) but you could feel the ‘need for change’ in dementia care within the room.

I was totally cooked afterwards and almost choked on my pitta bread lunch, but was so worth it. Dad having multiple falls at the nursing home lately and me being tired certainly tested me today, but I now look forward to a rest in Melbourne with son Max for our boy’s weekend.

Thank you to the ‘Dementia Whisperers’ and DBMAS/Alzheimer’s Australia for allowing me to to tell our family story to try and make a difference. Keep on caring!

‘Dementia Downunder ‘ – Inaugural Afternoon Tea

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What a fabulous afternoon!

It was a thrill to have a lineup at the door waiting to get in. The reason?… Bob (Dad) made a rare public appearance out of his nursing home and of course arrived ‘fashionably late’ at the venue just after 2pm in a black convertible BMW.

It was a last minute decision to bring Dad but it was so worth it. A massive effort was required by the nursing home staff to have his meds done, get him ready, (placing him in the car took 20 mins), then we cruised the streets of Adelaide like a couple of rockstars. Bob kept trying to open his door on the way (while the car was moving) but eventually relaxed and laughed as we had the wind in our hair (well… Dad’s hair) before arriving at Kent Town and shuffling him into the room to an audience. You would swear Elvis had just entered the building:-).

As I am in Melbourne next weekend with my son, this DD event was my early Father’s Day and I loved it. To share Dad with such an understanding and caring group of people was very special to me .

Whilst it may have looked like I was under pressure and pre-occupied with Dad, this is just how you spend quality time with someone with dementia. (With one eye always on them)

I must say a special ‘thank you’ to Liz and Kate for all the delicious rocky road, scones and sandwiches. They were also instrumental in rotating ‘looking after’ Dad with Jane Doolette, allowing me to mix with everyone. Thank you very much ladies for this and also a big thanks to the ‘always happy’ Paris who helped handing out food plus a variety of other tasks.

We had a great mix of carers, trainers, family members, people with dementia and it was a very patient and sincere group indeed. It was so nice to not have to worry about Dad and who he might chat with, or what he might get up to, and touch.

The conversations flowed with ease and everyone stayed an extra hour to catch up on all things dementia. New friendships were made, information and stories were shared and food was devoured.The group bonded really well and laughed, especially when Dad without warning lifted up Nicki’s leg up in front of everyone.This is dementia….

A big thank you to everyone for attending and for all the preparation and clean up efforts to make this day possible.

Bring on the next event!

thank you
Brett.

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Dementia Downunder Afternoon Tea – The Dementia Whisperers Are Coming!

Great News! South Australia’s most knowledgeable dementia trainers will be attending the  inaugural ‘Dementia Downunder’ Afternoon Tea tomorrow.

Bring your tricky questions, and challenge Sue-ellen & Jane ( from DBMAS) to help find you a dementia related strategy. These ladies are the best in the business and we are really lucky to have both ladies attending at the same time.

The venue has been prepared. Look forward to seeing you there.

Saturday 27 August, 2016

2pm – 3.30pm

22 King William St, Kent Town.

Please rsvp via the ‘Meetup Event’

regards
Brett

Carer Burnout…”Are You Burning The Candle At Both Ends?”

When you are a caregiver for someone with dementia people often tell you to look after yourself, and you are priority #1.

If you are like me you will probably think to yourself “I’m fine….I am dealing with this and am doing ok”. (and you probably don’t like being told this as well very much either).

Early on I made a silent pact with Dad that I will care for him 24/7 and do whatever it takes to get the job done. The result?…..You end up providing a standard of care similar to me in the picture below…. with my eyes closed.🙂

The problem with this is Dad could then walk off and get outside and potentially get run over.

I now realize it is important to pace yourself and give yourself a break. You also don’t have to spend endless hours with the person to avoid feeling guilty. Sometimes a short burst of ‘quality caring’ can have just as much impact as sitting with someone for hours.If I personally ensure dad is not in pain, not uncomfortable and not unhappy I am content leaving him with the paid care staff to do their role. So why do I not let them do it all?…Because I can pick up subtle changes in dad’s decline and act upon them quickly eg involve doctors, adjust meds etc. I also love being around Dad as much as possible because we are close and have a great time together.

As Dad is constantly declining and his care needs are increasing (ahhhh),the way I approach things now is to ‘share the load’ and manage the time better with the paid carers in the nursing home and take different care shifts to my Mum. (eg I do mornings, and she does evenings and then switch after a while). This keeps you constantly learning and understanding the condition so much better. The care requirements at different times of the day can differ greatly and it gives you a better overall understanding of the impact of dementia.

So in a nutshell…….give yourself a break from time to time….don’t feel guilty…..and give yourself a small pat on the back occasionally.

Keep on Caring!

PS – Nicki Peaston from the Carer Wellness Centre you are the inspiration for this post. 🙂 (thank you!)

Is This The No#1 Problem in Dementia Care?

After 5 years of being surrounded by people with dementia, aged care facilities and hospitals I have come to a conclusion. Noise seems to be at the bottom of many behavioural issues when it comes to people with dementia and we need to do something about it.

Noise ….It is EVERYWHERE! and we are not putting enough emphasis on it when we search for answers why people with dementia act the way they do. They often cannot express their feelings or thoughts, and maybe we are chasing the wrong things?

I have some video of Dad in hospital and when I played it back I was shocked to hear the noise and it was not only ‘too loud’, the ever repeating beeping alarms on the machines combined with the bed alarms and the constant din of people in the hallways was like a cruel form of ‘water torture’. Can you imagine what it is like to be stuck in a bed all day listening to the same machines beeping over, and over, and over again?…It is no wonder most of the people with dementia in hospital are in the hallways, heading for the locked door trying to get out!

In hospital Dad was manically walking the hallways for 10-12 hours per day across 5 weeks and I believe it was the noise driving this. How do I know this?…because I was walking with him and witnessed a miraculous change in his behaviour that was mind blowing! We transferred him to another hospital which has a ward that specializes in treating people with dementia and surprise,surprise it has no stimulus, no noise, no bright lights and no beeping…just silence. To watch Dad on his first day walk over to a couch and sit down and rest, and be at peace was ‘game changing’. His medications were the same, and the environment was the only thing that was different….conclusion?…enemy no#1…noise!

It is no different in the aged care facilities and some have construction going on for extended periods and the sound of concrete saws, nail guns and jack hammers over breakfast is surely not the best way to start your day? We need to allow people with dementia to enjoy their mealtimes at least, and there should be a no construction noise policy across meal times.

The clanging of the cutlery and crockery on the meal carts needs to be a focus, and the vacuum cleaner is blaring nearly every morning when residents wake up. Is 7am – 9am the best time to be creating that kind of noise?

Nurses and care staff are often carrying phones which have alarms that go off constantly as residents trip their movement sensors in their room alerting them to a resident on the move. This is a great system that protects residents, but in some facilities every single bed alarm is triggered through the same phone and not just a designated area. The result?…the mobile phones on staff are constantly ringing and beeping as they try to attend their residents and invariably setting off unwanted behaviours.

In a nutshell….reduce the noise and reduce the problems. ….Hopefully this blog does not fall on deaf ears.