Friday, December 2, 2011

Alzheimer's Care, the Importance of the Early Morning Wake Up Routine


The daily routine gives a person a sense of homeostasis. A sense of stability in their life.

By Bob DeMarco
Alzheimer's Reading Room

After years of floundering around I finally concluded that the only way I was going to be able to accomplish my mission was to introduce a systematic routine to our daily activities.

The "our" in this equation is my mother, Dotty, the person living with Alzheimer's, and me, Bob, the Alzheimer's caregivers.

Prior to the installation of the "patterned" routine I had been fighting a long list of Alzheimer's wars. The list is to long to mention but did include: the early morning negativity, the poop - e war, the pee pee war, and the shower wars.

For now, lets focus on the importance of the early morning wake up routine.

Subtitle: How to get the day off to a good start.


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Years ago my mother would wake up in an immediate state of angst. As soon as she woke up she would start saying loudly, Bobby Bobby, where are you? I could clearly hear the angst and worry in her voice.

The fear, confusion, and the angst of being alone, or maybe abandoned. The sound of my mother's voice did disturb me, and it certainly filled me with a feeling of angst.

After a while I thought, I guess if I woke up and I didn't know what day, month or year it was. If I couldn't remember what I did yesterday, I would probably be confused and scared.

What I am going to describe didn't happen over night. I had to piece it together until I reached the point where I came to believe I was accomplishing my mission -- filling Dotty with a sense of safety and security.

I knew I was making real headway when Dotty started saying immediately when she woke up, YouWho I am awake you know, instead of Bobby, Bobby, Where are you?.

Dotty will continue to say You Who when she wakes up until I acknowledge her. If I don't acknowledge her quickly she will start to say negative things and the angst in her voice returns.

When Dotty sends me the first signal of the day, the YouWho, I immediately respond by letting her know I am home, and I am on my way to her.

I come up on Dotty from the right. As soon as I reach her, I put my left hand on her wrist and hold it, and I put my right hand on her elbow. I hold both gently. This is called anchoring. More or less, it brings her into the now, and gives her a sense that all is well.

Keep in mind we are also attached.

I'll ask Dotty how she is feeling or a simple morning question of that nature. I make sure I listen to the strength in her voice. Strong voice good, weak voice not so good.

I start by talking about how it is a nice day, or how we are going to have a nice day, I usually put my head on her head, if not, I rub her head or back with the right hand. I continue to hold her wrist. Attachment, tactile communication (touch), a low calm voice, and positive reinforcement are the keys. Don't go negative no matter what.

Next I move Dotty to the kitchen table. We are attached all the way until she sits down.

The first thing I do is give her her thyroid medication. This medication requires her to fast for an hour in order for the medication to work effectively. Did you get the thyroid checked by a "pro"?

Next, I pick the newspaper apart and put it in front of her so that the front section is first and the Accent section is second. The Accent section contains the recipes, comics, and crossword puzzle.

I ask Dotty to tell me the day and date. I usually have to tell her to look at the top of the paper, sometimes I have to point to the day and date.

Everyone needs to know what day it is. This includes persons living with dementia. If they can't do it on their own, you must, must help them discover the information.

Sometimes we discuss the front page, sometimes we discuss the food section, or a recipe. I always get Dotty to read to me from the newspaper. If I ask what does it say, we won't get far at this stage. I have to ask, read it to me.

By now we are fully engaged. I have Dotty attached to the world and into our normal daily routine.

Don't you have a normal daily routine?

The daily routine give a person a sense of homeostasis. A sense of stability in their life.

You can develop your own early morning routine. Don't be afraid to experiment and try and figure out what works best.

Here is the good news. Your Alzheimer's patient will feel more secure and hopefully happy.

Here is the best news. You'll feel better about yourself, you won't get all stressed out at the beginning of the day, and you will be on your way to the world, Alzheimer's World.

More Insight and Advice for Caregivers

Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,101 articles with more than 452,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room
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