Promising New Therapeutic Approach

Keeping up with new research on Alzheimer's Disease is nearly impossible unless you don't have anything else to do.  How on earth are caregivers supposed to keep up, much less care for their loved ones.  I know the Alzheimer's Association does a good job of trying to keep reputable news updates on it's website.  I am thankful that I am able to get concise updated information because of my job.  This week I got a long term care publication in the mail that talked about a promising new approach for individuals with dementia.  It is called the SAIDO approach.  So far in the US, there is only one certified program, the Eliza Jennings Center in Ohio.  This organization sent staff members to Japan to train with professionals there who have been using this approach for several years now.  According to the Japanese data, it has proven to have a significant improvement in functioning ability for the individuals who participate.  I would recommend googling to find precise description of the program.

My understanding is the program encourages engagement of the prefrontal cortex of the brain using various verbal and math activities.  A major component of the approach is the use of staff members as coaches and cheerleaders, providing encouragement and positive feedback.  Although certainly not scientific, there are elements of this approach that resonate with me based on conversations with my mother.  She is disturbed that people no longer talk to her, but everything is directed at my Dad.  Congratulations to the psychiatrist who did her testing whose comment "You used to be smart" is one memory that has been well retained by my mother.  I understand that people know if the information is going to be retained, it has to be delivered to my Dad, but at the same time, this marginalizes my mother as a person.  Psychology and mental health has always been an interest for me and I have to wonder how much of the success of this program is due to the intense involvement of the staff members.  I can see how just from a quality of life standpoint the positive encouragement must be a significant part of this approach.

Since I am involved in practical application, not scientific research, I don't really care about how it works or whether it is statistically significant.  Sure if I thought our company were going to invest significant dollars to become certified or develop this approach as part of our care program, I would want to be sure it was not just another one of those fad approaches.  If we were a facility that was going to include this approach in marketing materials, you would want to have concrete data.  But it seems to me to be a ray of hope for those every day caregivers.  Finding verbal and math activities to give to individuals, especially since there are really no "right" answers, seems to be something that could be done by regular people.  Refocusing your attention on "cheering" or encouraging your loved one is something else that with practice and focus regular people could also implement.  What a great opportunity for intergenerational interaction.  Whether it is statistically significant or not, when I look at the faces of residents when they are interacting with children and young people, I know that in terms of quality of life, intergenerational is a good thing.

So Kudos to the company that has invested in this new approach.  I wish them well not only in the care they provide in their own facilities but in their commitment to train others in this approach.  And I hope elements of this approach can be used by regular caregivers to give them another tool and a hope, if not for actual improved functioning, but at least opportunities for moments of joy during each day.

Work with a Purpose

This week I had a call from another former family member.  This resident moved out to another facility that was closer to his family member.  Even though he has not been a resident in my facility for about 6 months now, I still get phone calls from his family member from time to time.  I am so thankful for so many things related to these phone calls.  I am thankful that our facility is only 16 beds so that I have the time to spend talking to previous family members.  I'm also thankful that with 16 beds, it allows me to develop true relationships with family members.  I am thankful that family members feel I have help worth sharing and they still call me from time to time.

My oldest son has finally realized he will need to go back and get his college degree in order to get a good job.  Right now, he is trying to decide what he wants for his major.  As so often happens, we have examples of various possible scenarios for him to help make his decision right in our family.  I have one brother that has a job that does well to pay his bills.  However, it is not really something he enjoys, it really is a "job" for him.  My other brother has a job he loves and he feels he is really helping others, but he is not going to get rich.  I am pretty much in the same boat with that brother.  I get paid a good salary and I am thankful for the owners of our facilities that I can work for a family who does things for the right reasons.  I am very thankful that at the end of the week anyway, maybe not every day, I know I am able to do small things that make my little corner of the world a better place.

I tell people all the time I am learning about wisdom.  You can have lots of knowledge, but with age comes wisdom, realizing what is really important.  I hope my son can find a job that he loves as much as I love my job.  Knowing I'm able to help people has always been important to me.  There are some days that I think helping other families distracts me from thinking too much about my own family and the road we are traveling.  At the same time, my experience with others, I hope, will help our family make the best of a very difficult situation.  To look back at the end of a day, a week, a resident's funeral and know I have made a difference, there is nothing more important and nothing more fulfilling.  I thank God for giving me the skills and abilities I have and the opportunity to serve others.

Getting Too Far Ahead of Myself

Yesterday, the family of my resident that recently had to move to a specialty care assisted living stopped by to thank us for the care we provided and tell us how she is doing in her new home.  By the time she left us, she was the lowest functioning resident and that fact really stood out.  Her family talked about how at the specialty care facility, all the residents have similar needs and function at a similar level.   "They are all like babies", was the description.  I could see the loss in their eyes and it reminded me of what I have to face in the future.

I have always been terrible about rushing through, trying to get to the end of the journey.  During school, I wanted to hurry up and graduate and get a job.  When my children were little, I wanted them to grow up.  I realized when the youngest graduated, how I had wasted their youth being in a hurry.  I still have regret that I did not slow down and enjoy the journey with them more.  Now I find myself in a similar situation.  I know better than anyone else in my family what is coming.  I have watched the progression of the illness in strangers for 30 years.  I could easily become overwhelmed with loss at this point.  Like with my children, I could become so focused on the end of the journey that I miss out on what is still available.

I believe God places events and situations in our lives to allow us to grow step by step.  I am still trying to forgive myself for wasting my children's youth, being in a hurry.  Yet I hope that experience can be a lesson and reminder to me in this situation.  Let me take advantage of what abilities and the relationship that is still here.  The time will come soon enough to face the losses, but let me not get so far ahead in the future that I miss the present.  What a blessing it is to be human and to be able to learn from our mistakes so as not to repeat them.  Thank God for His guidance and teaching.

More on the "Sandwich Generation"

I've spent this week sharing an agonizing review with a family member, "did I do the right thing?"  It is so easy for people on the outside to point fingers and say the children are just trying to get the money.  I know that is a reality in some cases.  Fortunately in assisted living, I don't run into those families very often at all.  Those families aren't interested in spending mama's money on her care.  They are more likely to try to put in minimal supports to keep mama at home and keep the main asset, the house, intact.

If "those people" would only stop and think for a moment about what the family actually chooses to take on with trying to make sure their parent has their needs met, whether at home or in a facility.  Fact of life, it is usually the daughter that takes on the main caregiving responsibility.  And by virtue of life span factors, the daughter is middle aged.  In today's world, that person is usually working, may still have her own children at home, may have grandchildren, may be fortunate enough to have a marriage or other significant relationship themselves.  If you think just in terms of personal energy available, the selfish person would say "forget it".  It would be far easier to live in denial and let mom or dad stay home by themselves like they usually want.  Who wants to take on the additional tasks of being responsible for yet another life?

And it is to common for us as women to always feel guilty.  We wonder if we do enough for our children.  We second guess making tough decisions for our parents well being.  Those people who say the kids are in it for the money have never really thought through what you take on when you are caregiving for your parent as well as your own family.  I don't know if I was any help at all for this family member.  I know I believe strongly one of the most important things I can do is to encourage family members.  And I hope I am still professional when I acknowledge from experience that it is really, really difficult.  As happens so often these days in our society, the minority of people who are doing the wrong thing, lead others to expect that worst from the majority that are trying to do the right thing.  It is a rough journey and we all need to be kinder and more supportive of each other along the way.