May 2, 2010

Patterns and Alzheimer's Caregiving

Meanness, pee pee, poop, the way we lived our life, over time I came up with new and better ways to accomplish my mission as an Alzheimer's caregiver.....

Alzheimer's Reading Room

In the article -- Not a Ghost of A Chance -- An Alzheimer's Out of the Box Moment -- I wrote,
I continue to believe that many of the patients suffering from Alzheimer's are capable of more then most people can, or ever could, imagine.
This reminded me of something I learned and one of my first big observations.

One day I took my mother into the supermarket to buy lottery tickets. For years she had been going to the store daily to buy her Cash 3 and various other lottery tickets. After I was here for a while, I came up with what I thought was a bright idea. Instead of going daily to buy the lottery tickets, why not buy them all at once, once a week. I started doing that for my mother.

One day, I took her into the supermarket with the plastic envelop that contained the cards she had filled in and the money to buy the lottery tickets. When I handed the envelop to her and said go get the lottery tickets, she was blank. She didn't know what to do. Even when I walked her up to the counter she didn't know what to do. Completely mystified.

A few days later I told our doctor about how completely disconcerted I was, and how worried I was. He then explained to me how if I did everything for my mother it wouldn't be long before she would forget how to do things.

He didn't stop there. He went on to explain that since I was the only one that knew what my mother could or couldn't do, I should let her do everything she did normally until I determined she could no longer do it. He also told me, you might get criticized but not to let that bother or deter me.

This ranks as one of the most important pieces of advice I ever received as an Alzheimer's caregiver.


When I first started taking my mother to the gym, I enrolled her in the Silver Sneakers class. After a few monthd, I decided that it was not enough exercise. It was at this point that I started putting my mother on the treadmill.

I don't remember how many times someone "yelled' at me and told me I should put my mother on a sit down bike and not the treadmill. Here came the criticism.

I did start with the bike. But my mother wouldn't peddle. I had to stand over her and say, peddle. Over and over. The only thing I was accomplishing was making both of us upset.

She would walk on a treadmill.

I noticed that my mother would start bending over like she was going to fall down on the treadmill at the 6 minute, 27 second mark plus or minus several seconds -- every time. It appeared that she could no longer walk. For some reason, I didn't stop the treadmill when this happened.

At the 7 minute mark, my mother would stand up straight and start walking in the normal fashion. This happened time after time after time. A pattern that occurred over and over. Same way every time.

I did notice additional patterns in her walking and behavior on the treadmill. It was at this point that the light bulb in my head started to go on.

I could have thrown in the towel when Dotty bent over on the treadmill but I didn't. Instead, when I noticed that she would stand up straight and keep on going it became obvious to me that she was capable of more then I could have ever imagined.

This observation changed our future because it ultimately lead me to the many other conclusions about patterns and what could be accomplished if I took the time to help make it happen.


When we were in the gym, I also noticed that Dotty was really intrigued by the workout machines. Several times she would sit down on a machine and start trying to do the exercise. Finally, I thought what the heck, let's go for it.

It was amazing. She could pull much more weight with her arms, chest and shoulders then I could ever have imagined. I started to increase the weight a bit. Finally, I stopped increasing the weight and started increasing the repetition. Three sets on each machine, twelve reps. Dotty, my girl, had no problems doing the exercises.

As it turns out, Dotty hates the treadmill and loves the weight machines. Go figure? What would you prefer, to walk on a treadmill or lift weights?

There is an exercise that just about everyone hates. It is called a dumbbell lunge. You put a weight in each hand, then you take a big step forward, and lower your body until your knee is almost touching the ground. It is like you are being knighted or getting down on your knee to propose marriage. This exercise not only makes your quads and hamstrings stronger, it improves your balance.

Now I knew, no way Dottie can do that. The solution?

I would sit Dotty on the end of a workout bench and ask her to stand up. She couldn't do it without me holding her hands. She hates this exercise to this day. She doesn't want to do it, and she will rarely look at me as she does it.

My point. The combination of the treadmill and this exercise dramatically strengthened Dotty's legs. And, improved her balance.

Prior to these exercises Dotty was falling down all the time, and even broke her finger on a fall. After we started doing these exercises Dotty stopped falling. I think its been around 5 and half years since Dotty's last fall. When I first came to Delray Beach, Dotty was falling just about every day.


Now to my point.

It was the pattern of Dotty's behavior on the treadmill that lead me to conclude she was capable of more then I realized. It was the development of the exercise program that lead me to the conclusion that I could change things by establishing new and different patterns.

I decided to look for other patterns of behavior, define them, and then change them.

Some of the patterns took years to define. I could only try one or two things at a time. There was a lot of trial and error involved. Lots of false starts.

I cured Dotty of her mean spirited behavior through the use of Alzheimer's medications and by coming to an understanding of the pattern that caused her to get mean spirited. The triggers.

I looked at time and place, conversation, and events that caused Dotty to get mean. I was surprised when I first realized that there were clear cut patterns that caused the mean spirited episodes. I knew this pattern had to be changed. I had to replace the bad patterns with new patterns of behavior designed to make Dotty happy instead of mean. It wasn't a hard decision. If I let things remain the way there were, I would continue to suffer enormous amounts of stress, anxiety and unhappiness. And, watch Dotty go into her shell -- repeatedly.

Along the way, I had to change me and what I was doing day in and day out. Change the patterns of behavior.

I actually started drawing, kind of doodling, on these big pads of newspaper print until I could see all the variables and timing of the problem patterns.

Meanness, pee pee, poop, the way we lived our life, over time I came up with new and better ways to accomplish my mission as an Alzheimer's caregiver. Along with Dotty, we established new patterns.

Patterns designed to make life better in Alzheimer's world.

I now realize, I need to explain in more detail how I first mapped out the patterns of behavior that I wanted to rid from our life. Then, how I mapped out the new patterns of behavior that were needed to change things for the better.

How I had to learn to do things differently and systematically. Took years for me.

I intend to start writing very seriously about how I did this -- step by step.

If you are wondering why I would do this then understand this -- I am now coming to a very strong belief that you can do it too. I am getting very confident about this belief.

I now believe you can do what I did and it won't take years. It will take lots of effort.

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Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,400 articles with more than 9,000 links on the Internet. Bob resides in Delray Beach, FL.

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Original content Bob DeMarco, the Alzheimer's Reading Room