Aug 11, 2010

Alzheimer’s Caregivers Who Get It!

One of the most frustrating things I encounter daily is the vast array of home health aides that, although trained to provide clinical and household help to their elderly clients just aren’t trained well enough in Alzheimer’s Related Disorders.

By Olga Brunner

The Alzheimer’s Association offers the required Alzheimer’s I and Alzheimer’s II level courses required for continuing education credit, but when confronted by the Alzheimer’s client who dismisses the aide because there is “nothing wrong with them”, all that training goes out the window and the first thing some caregivers do is call their agency within earshot of the client, blowing the prospects of having a really good opportunity to bond with the client.

Rarely, do you get a person with that innate ability to simply redirect the individual, or use common sense. On the other hand, I have seen other aides who very comfortably care for a person with an Alzheimer’s related disorder avoiding rejection issues.

They don’t react negatively on hearing the lament,
“But there’s nothing wrong with me - I don’t need you”
and use simple techniques leading to lasting relations with their clients.

I recently worked with a frugal client who received a telephone bill which should have gone to the POA but was inadvertently sent to her address. Needless to say, this began the mantra to the horror of her caregiver,
“All of my money is going out the window and I won’t have any money left”.
Ordinarily, this would have ruined the day’s plans to purchase hurricane supplies and get groceries for the week. The savvy caregiver asked her to see the bill, redirected her to a new thought, and soon my client never remembered the bill again.

That is actually one of the blessings of having this disease, you can lovingly redirect and it goes out of the short term memory window.

Another incident was reported by an out of town daughter when she found her mother with MCI just would not warm up to a caregiver. It seems the caregiver would tell the client,
I am here to help you!
Well a statement like that just doesn’t work with Alzheimer’s. When asked, the client said, “there’s nothing wrong with me” immediately rejecting the stranger’s help.

What does work is telling the cognitively impaired individual, “I seem to have put on some weight recently, why don’t we go out for a walk.” Or “You really eat healthy food, why don’t you show me that recipe for ......” These situations require a new way of thinking.

This past April I visited a model assisted living facility in New Mexico for residents with moderate cognitive impairment that trains their staff to employ these techniques. Their mission statement reads:
New residents are not expected to acclimate to the staff; the staff is required to acclimate to the incoming resident.
It may take training and retraining, but they’ve had great success substantially decreasing their resident’s antipsychotic medications.

When in doubt, redirect, change your willingness to help by asking clients or family members for their help. Always use a loving, gentle approach, and when in doubt, always validate them.

Olga Brunner is a Certified Geriatric Care Manager with over 20 years in health administration. Olga cared for her mother who had Alzheimer's disease, followed by a management role in a nursing home that led to her role of advocacy. Ms Brunner is President of A Good Daughter Geriatric Care Management in Boca Raton, Florida.

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Original content Olga Brunner, the Alzheimer's Reading Room