A Practical Post

I recently received an email from a dear lady who deals with her Alzheimer mom's incontinence. "Do you have to deal with incontinence issues with your mom?" she asked.

Well, yes I do.

My primary ways of offering comfort to fellow caregivers are in the emotional and spiritual realms; this is my assignment from the Lord. "Nuts and bolts" advice is not so difficult to find, but the provision of heart-solace to caregivers is an oft-neglected area of ministry.  However, it occurs to me that those who read this blog regularly might appreciate knowing how we manage the day-to-day caregiving issues that so many have to face. This is not meant to be advice for anyone else; please clear all caregiving procedures with a health care professional who knows your loved one well. 

Bathing--Back in 2007 (where does time go?) I wrote a post entitled Bath Day that you can find here. About the only change we've made in the ensuing years is that I now have Mom wear her Crocs right into the shower and don't remove them until she is seated. After she has bathed she puts them back on so that she never has to walk barefoot on slick surfaces, which, even when she is leaning heavily on me, makes her feel insecure.

Incontinence--Mom wears adult diapers 24/7. I recently found that brands are important; Depends don't work for us, or at least the mid-absorbent pack I recently brought home definitely did not!  We use Sam's Club and/or Wal-mart's store brand. We are so blessed that she has healthy skin that doesn't chafe or get diaper rash easily, but when she does we use Boudreaux Paste, a product whose full name annoys me but is the best I've found!

Medication--Mom takes two Alzheimer's drugs (work out a plan with your doctor), an anti-depressant (I think this is so important for Alzheimer patients), an antihistamine for her severe allergies (most antihistamines are contraindicated for dementia patients, again, check with your doctor), and a cholesterol lowering medication that was prescribed off label for her irritable bowel symptoms (Colestipol/colestid). People who have had Cholecystectomy (gall bladder removal) as Mom has often need a medication such as this, but I've always thought it might also be useful for those who have lost bowel control or have irritable bowel symptoms as well. Let's repeat my litany: check with your doctor! 

Mealtime--Mom very much prefers to be served meals in her recliner.  When she moved in with us I very much felt she should sit at the table with us at mealtime. This became a "choose your battles" issue which I finally allowed Mom to win, and she is much happier.  We have a wooden lapboard that fits across the arms of her chair and a side table to hold her drinks. The chair is leather and has a cloth cover that has to be laundered regularly. But, the key words are she is much happier.

Entertainment--Music from Mom's own C.D. collection plays constantly on the "repeat" setting. It was difficult to find a CD player for her--everyone now uses their MP3 players--but I found a 5 CD changer at Amazon and hooked my iPod speakers to it (WHY didn't the CD player come with speakers?).  Music is vital for Mom's contentment level, and the familiarity of traditional hymns is the most powerful mood enhancer for her. Films that have very little dialogue are best; Mom can no longer follow rapid fire dialogue that characterizes most movies. Bambi is a favorite, and Mom loves the That's Entertainment films. 

Reading material--sometimes people are surprised that Alzheimer patients may continue to read. Mom's short term memory is indeed shot, but in the moment she is in she is still able to comprehend a sentence or two of meaning. She loves the My First Little House books, and is not offended when I offer her beautiful children's picture books, but she also very much enjoys devotionals such as Richard Carlson's Don't Sweat the Small Stuff  and Max Lucado's writings.  She also peers intently for long periods at a daily newspaper, so I guess she retains some meaning or at least a feeling of being a part of the world from that. And, of course, I have her read a daily selection from the devotional I wrote just for her, Beautiful in Each Season.  The selection of music and reading materials depends entirely on the individual preferences of your patient. What did he/she enjoy pre-Alzheimer's? Find straightforward or simplified versions of what was enjoyed in the past. 

Schedule--I've printed her daily schedule on a piece of posterboard and placed it within her line of vision, along with her clock and whiteboard that has the day's date written in large letters. These things help her very much. Further and more detailed information is available in the post entitled How We've Managed Thus Far,

Phone--Mom loves her one touch phone. She can call me any time by lifting the receiver and pressing the key printed with my name. She is still able to read so instead of photos I printed names of family members on each key and programmed the phone with their numbers so that she is always able to reach someone.  When she calls several times in an hour I put a sign on the phone: "Linda is taking a nap, call if there is an emergency." This has worked so far. 

How I cope with "Why has this happened to us?"--A real change in my perspective occurred with the experience I describe in this post entitled Farther Along...

 Further information of the practical sort is available in the post entitled How We've Managed Thus Far. 

I'm praying now for every caregiver who reads these words, and also for your precious care recipients.  My heart goes out to you.  Let's pray for one another as we walk this caregiving path together.