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Old 02-04-2012, 12:51 PM   #1
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helen kominos HB User
alzheimers

Hello, Could someone explain why the person that i started taking care of is pretty nice during morning hours takes her pills, drinks her milk but refuses to eat lunch time? She also refuses to eat diner time but she does drink water.She gets very angry and and hits me. She is always trying to leave her home. She walks around andtries to open the door to go out.She says she wants to go home, but she is home. I dont know how to get her to eat. Please help me. Thankyou.

 
Old 02-04-2012, 02:27 PM   #2
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Re: alzheimers

My guess is she is at the point of not knowing hunger and not going for food.
I don't know her stage so it is my guess. You may want to check with the doctor to make sure it is not the side effect of any med.

With Alzheimer's, she would not know she needs to eat. She needs to be motivated to eat. Sometimes if you bring her to a restaurant, she may eat because of peers. Or you may want to find out what she likes. Also, if she is choking on food as a common thing for these people, you need to give her softer food or pureed food. Yogurt. If it is about how to pick up the food for now, give her finger food and cut the food for her (cut the fillet for her.) I hope she is not at the point of needing Ensure. Also she would prefer sweet food but of course you cannot give her too much sugar.

She wants to go home. This home is abstract. This means she is looking for comfort. She is not talking about her home where she is. You cannot tell her she is home. Sometimes she may need routine if she goes from the outside. Try some routine and maybe she will think she is home (say, open the door and close it; walk around the path that takes her to her favorite couch...)

These are common for the person with Alzheimer's. My FIL is in severe stage. These are common and he had all these things. Now he is on pureed food and he still likes soft desserts. Once he wanted to go home from the doctor's office. He forgot he came in. So we walked him around to the kitchen for supper and back to his couch and then he felt he was home!

Yes she is disoriented about where she is. Just make her comfortable. Also this home may be her childhood home. So don't worry about it.

Hope this helps,
Nina

Last edited by ninamarc; 02-04-2012 at 02:31 PM.

 
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Old 02-04-2012, 03:18 PM   #3
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Re: alzheimers

Helen... I assume this is your first Alzheimer's care job. All that you described is typical and normal for this disease. The Alzheimer's has taken away her short term memory. Her ability to think and reason as we do. Her ability to perceive her surroundings as we do.

She wants to leave because everything around her is confusing. She doesn't know where she is or why she is there. Going "home" is nothing more than her desire to leave the fog in her head behind and go back to a time (not a place but a time) when she was not confused. What you need to do is learn all you can about the disease.

Rule number one... do NOT argue with her. If she tells you the sky is red and the grass is purple just smile and nod. You do not have to correct her. If she wants to go out then go for a walk with her. If she doesn't want to sit in the kitchen and eat then leave finger sandwiches beside her chair in the den. She will respond better to routine along with peace and quiet. The same schedule every day is helpful. A loud TV can be very confusing since she can not follow what it is saying. If there is a horrible new story on, then she may think it is affecting her. This can be scary which can lead to agitation. Shadows can be misunderstood as well. Be sure the house is well lit and curtains used to prevent the long shadows of sunset.

For many, morning is their best time. They are rested and relaxed if they have had a good night's sleep. The day is new. As the day goes on they become exhausted and frustrated. When they don't know what you are asking or what you are doing... NO is the only answer they know to give you. She may very well have difficulty understanding what you are saying to her. To many with dementia our words sound like a foreign language. Just words with little or no meaning. She may also have difficulty expressing her emotions. Words do not come easily. This is frustrating to her as well.

When all the frustrations from 100 different angles converge on her she only knows how to do one of two things.... our basic instinct.... fight of flight. She will either fight you (hit you) or try to flee (run away and go home). What you need to do is make her life as routine, peaceful, and calm as it can be. This will help prevent that fight of flight moment. If it does come then you need to learn to distract her. Give her something she enjoys. Hand her a soft blanket to hold. Give her a pretty picture or family photo that she might recognize. Give her a big bowl of ice cream or a piece of candy.

You will not be able to force her to eat. Asking her or begging her to eat is only going to further confuse her. Many times it is in the way you present the food. She has to know that it is food. As amazing as that sounds she may not recognize what she sees as food. Find out when and where she ate before dementia. If she ate at the kitchen table then that is where she needs to eat. Make sure the plate is a different color from the food. A bright colored plate that contrast with the food is best. Give her foods she might recognize. Give her one food at a time and a fork or spoon. Too much will overwhelm her. Foods that she can pick up might help. Sometimes they do not want to be fed so give them something they can feed themselves. Sometimes you can use smell to help as well. We associate food smells with eating. If that doesn't work then leave finger foods where she will know to look for them like the kitchen cabinet or the table beside her usual chair. If necessary help her but do it in a way that is not threatening. Put the food on the fork, put it in her hand, and see if she will put it in her mouth. You can always supplement what she doesn't want to eat with a supplement such as Ensure or Boost. If they are not wild about the liquid, throw in some ice cream and make a milk shake out of it Be creative, non confrontational, and patient.

Call the local Alzheimer's Association. They have training classes for caregivers of patients with dementia. They also have literature, books, and other information

If you have any specific questions please feel free to ask And good luck with your charge!

Love, deb

 
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helen kominos (02-05-2012)
Old 02-05-2012, 08:36 AM   #4
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Re: alzheimers

Thankyou so very much for your input, you made me happy with your answers to my problem. We had a good day today except for the last hour of my shift.She said she wanted to go to the bathroom and i took her there. She started to take off her undergarment and wanted to do on the floor instead of the toilet.She than put her hand in her butt and got her hand dirty. I tried to clean her hand but she would not let me.I dont have to tell you how i felt. I took her toward her bed and called her daughter-in-law who came to help. Just before i left she was fine again.The poor thing Ive known her for years and she has a wonderful family. Her husband gets upset sometimes and cries.They have been married 60 years. I will try the things you told me and see what happens, By the way, it is the first time Im careing for someone. I guess I should mention that we are in greece in a small town in Sparta which is southwest. Thanks again, god bless you. Helen.

 
Old 02-05-2012, 04:45 PM   #5
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Re: alzheimers

Toileting can be a problem because they truly do not understand. They do not recognize the toilet, especially if it s white and the walls are white. Mom's bathroom is painted a shade of green so there is a contrast in colors. We took all other large containers out of the bathroom. There is nowhere to sit but the toilet. I help her sit on the toilet so help her feel safe. The loss of spacial perception can make sitting scary. As soon as Mom is seated I hand her something to hold. A bottle of cream works. That keeps her hands busy. If necessary I clean her up while she holds on to whatever she has. Then I let her do her wipe afterwards. It actually makes it easier. Remember to be calm and not make a big deal out of anything. If she will not let you wipe her hands then give her a wash cloth or wipe and see if she will do it herself. The more calms and self assured you are the better she will respond. The more you can figure out how to let her do herself, the better off she will be. In time you will learn how to get around her quirks. Don't attack head on... be creative and figure out ways to let her feel independent while making life easier for yourself

Hope you have a good day tomorrow as well....

Love, deb

 
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