Life With Dad:Laughing Through Dementia: Life With Dad: Adjustments....

Life With Dad:Laughing Through Dementia: Life With Dad: Adjustments....: This is the alarm that Dad had attached to him when he first went into the nursing home.  Since he was extremely "active" and mobile, t...

Life With Dad: Adjustments....

This is the alarm that Dad had attached to him when he first went into the nursing home.  Since he was extremely "active" and mobile, they would attach this to him so that when he would get up out of his chair, the alarm would sound and they would know that he was "on the prowl"!  Dad became wheelchair-bound after about five days in the nursing home due to over-medication.  He had physical therapy until he could get strength back in his legs. 

This would be the bag of peanut M&M's that Dad kept in his pocket!!  Proof that they WILL melt if you keep them in a warm place.  He loves sweets and would put them in his overall pockets.  He actually did eat these even though they were a little bit melted.  He carries many things in his overall pockets....flashlights, wallet, sweets, knife, and whatever he else he hasn't misplaced somewhere!

Once a loved one with dementia is admitted to a nursing home, it is a continual battle of getting medications adjusted, and also getting the loved one used their new surroundings.  With the memory problems that come with dementia, we found it easier to just agree with Dad when he would talk about things.  He still thought he was in the hospital and that the doctor would be in to tell him that he could go home.  We used that to our advantage by telling him that when the doctor said he was "okay" to go home, then he would get out.  My Mom had a hard time telling him these little "white lies" at first.  I had to remind her that he most likely would not remember what she told him anyway.  This picture shows Dad in the second room that he has occupied. They moved him closer to the nurses station so that they could keep a closer eye on him.

Notice in the picture above how his mouth on the left side turns downward?  The doctor was certain that Dad had suffered some mini-strokes, although we never got the MRI done on his brain to prove that.  They tried to sedate him due to his anxiety, but even with sedation he became too anxious to finish the MRI.  Some of the medications that he takes have a risk of causing mini-strokes, but they also help with his anxiety and agitation.

This shows Mom at the ballgame of my oldest son, Alex, on the night that Dad became so disoriented and agitated while she was gone.  It was hard for Mom to really enjoy the game because of her concern for her husband.  This was taken on Saturday, and on Monday we took him to the hospital, and on Tuesday he was admitted to the nursing  home.  Tip #1: check with your parents to see if they have purchased nursing home insurance.  Fortunately, my parents had invested in a policy when they were in their 50's, and it was a great investment.  Once my Dad went into the nursing home, Mom didn't have to pay the premium any longer.  The majority of the monthly cost is paid by this insurance.  This has been a huge relief for my Mom.  The first few months we did check through the billing from the nursing home to make sure that there weren't any unnecessary charges (and that did pay off since we did find a few mistakes).  I am not saying that they intentionally added extra charges, but just like any bill you receive, you should check it for accuracy.

This picture shows Dad playing with a strap from his wheelchair lift.  These types of things would keep him "occupied" when he could not walk around.  There were times when we went to see him and he thought that his wheelchair was his mower.  One time I had to pretend to plug in the charging cord from his electric razor into his wheelchair as the battery charger for his mower!  Anything to keep him satisfied.

Once you get a loved one put into a nursing home, it doesn't mean that you do not have to worry about them any more.  Above you see my Mom, sister Robin, and me with our gowns on when the nursing home thought that Dad had Scabies.  Scabies is a very itchy skin condition that it caused by mites, and skin-to-skin contact from someone who is already infected.  Dad was tested and after the doctor confirmed the diagnosis, he was confined to his room.  When we went in to see him, we had to wear the gowns and latex gloves.  He was not allowed to leave his room except to take a bath and then a prescription lotion was applied to his body and left on for about eight hours.  This was done twice during his isolation time.  He became extremely bored during this week, as he was used to roaming around the facility.

Next up....a rash on his leg!  We never really found the culprit for this one...best anyone could decide was that the detergent irritated his skin from his socks.  So, a reminder to you all....just because they are not at home any longer does not mean that you can relax!  My Mom receives calls quite often that Dad has taken a tumble and scraped up his knees or was not actually injured, but he continues to fall periodically.  It is always a little bit frightening when you see on the caller ID that it is the nursing home.  My poor Mom....it used to be worrying about getting that late night phone call about her kids, and now it is concern about getting the call about her mom or her husband in the nursing home.  I will leave you with a video of Dad out imitating the ducks at the nursing home.  Thank you for following and supporting my family in this journey.

Life With Dad:Laughing Through Dementia: Life With Dad: Into the Nursing Home...

Life With Dad:Laughing Through Dementia: Life With Dad: Into the Nursing Home...: Trying to make the final decision as to  when to place a loved one in a nursing home can be an agonizing one for many people.  This...

Life With Dad: Into the Nursing Home...

Trying to make the final decision as to when to place a loved one in a nursing home can be an agonizing one for many people.  This one was taken out of Mom's hands when Dad had his night of confusion and delusions.  He became agitated and belligerent with my husband while Mom and I had left to go to a ballgame.  After observing him at the hospital for one night, his doctor arranged for him to be taken from the hospital to the nursing home to alleviate any more confusion for him.   Mom and I went to the facility to fill out the appropriate paperwork to get him admitted, and made arrangements for moving his lift chair into his room.  My daughter and I took the chair apart and hauled it to the nursing home, and they helped with moving it in and putting it back together.  Dad spent his first night there on September 11, 2012.  The picture above shows him on the first day he arrived.  He is with his oldest granddaughter and her two boys, plus his wife.  We gathered up some of his favorites things from home, pictures and a few other items to put around in his room so that he would feel more comfortable there. This is a very painful adjustment in one's life, and we wanted to make it as easy as we could for Dad.

This picture shows my Dad in the background asleep in his wheelchair, and my Grandma in the foreground, also asleep.  Did I forget to mention that my Mom has her mother AND her husband in the same nursing home now?  My Grandma turned 101 years old last July!  She has been in the nursing home for almost 10 years now.  My Dad didn't really comprehend that he was at the same place as his mother-in-law.  He used to go there with my Mom to visit her and would tease her all of the time.  Dad thought he was still at the hospital.  When he saw a calendar in his room and he read the name of the nursing home at the top...he looked at me and asked me where that place was.

Here he is standing at the nurse's station "checking things out".  He liked to hang out where the action was. Now...let me give you a HUGE piece of advice for getting a loved one settled into a nursing home....MAKE SURE THAT YOU CHECK THE MEDICATIONS LIST THAT THE FACILITY HAS FOR YOUR FAMILY MEMBER!!  Here is what happened to Dad: when he was admitted to the nursing home, he was walking and moving around without the aid of a walker or wheelchair.  The facility got his medication record from the local pharmacy and that is what they started administering to him.  By the fifth day or so, he became very lethargic and could not talk very well.  He also had trouble even feeding himself at meals.  Eventually my Mom thought to ask the nurse for a med list to see what he had been given, and then she discovered the problem.  My Mom was not giving him several of the medications that were listed, or she was giving him lower doses.  One medicine, Ativan, she had tried while he was still at home, but it had adverse affects for Dad.  He had not been taking that one at home, and yet the facility was giving it to him three times a day!  We did some medication adjustments and then he gained awareness back.  Then he faced the problem of weakness in his legs, due to not walking for three or four days.  They had to use a lift to get him in and out of bed or to the bathroom, and he was confined to a wheelchair until the physical therapy got the strength back in his legs.

This is a picture that shows him after he was able to move his feet again. At first he could not even lift his feet to put them on the foot rests.  Eventually he was able to move his feet to push the wheelchair around without having to be pushed, but at the beginning he had to be wheeled from place to place. It was a process that took several weeks to gain back what he had lost.  This is why I warn you to check with the facility to see what medications the pharmacy or doctor have on record!

Remember, this is what he looked like when he first went into the nursing home.  He is with my oldest daughter and her two boys.  Physically, he was doing well and had no need for assistance when it came to walking.  After the medication mix-up, he had to get his strength back up in his legs.  He also could not get in and out of bed by himself, therefore the facility had to charge more each day to use the lift to help him with bathroom time and bedtime.  It was a very frustrating and challenging time for everyone.  Once the medication was straightened out, Dad started enjoying some of the facility activities again.  For a man who didn't used to enjoy music that much, he actually seemed to enjoy going to the music programs.  He also seemed to appreciate having people around to talk to and joke with.  When he was at home, he didn't get out around people a lot, unless he went to a ballgame or to a doctor's appointment.  He liked teasing all of the workers who came in to help him...he even thought that one of them was my brother, Stub, who passed away in 2003!  This guy would go along with my Dad calling him "Stub" and would even answer him appropriately.

 This picture shows Dad in his new private room.  He started out in a semi-private room without a roommate, but his room was located at the far end of the hallway.  Eventually, the facility asked if he would like to be moved to a private room which had just opened up, that was also closer to the nurses station.  He required more assistance when he became wheelchair-bound, so it helped the nurses to have him where they could keep an eye on him easier.  My final piece of advice for this installment:  Please communicate with the primary caregiver (which is usually the spouse) and make sure that they are NOT wearing themselves out by taking care of the person with Dementia!!  My Mom did an amazing job of taking care of my Dad while he was at home....and it IS a tough decision to make.  Sometimes the caregiver will feel too guilty to make that choice, even though it may be in the best interest of both involved.  Once he was in the facility and my Mom had time to relax at home, she commented several times about how she wasn't aware of the toll it had taken on her.  She was diagnosed with Type 2 Diabetes while he was still at home.  Please make sure that you DO NOT overlook the caregiver, while you are focusing on getting the best help for the one with dementia.  Here is an article that may give you some insight:

http://www.alz.org/care/alzheimers-dementia-healthy-caregiver.asp

  

In the next installment I will talk about more challenges that Dad faced once he went into the facility, and hopefully give you some tips to make the process easier on the family.  I also want to point out that by telling you these tips and talking about our experience---I am in NO WAY blaming the facility or any of the workers there.  I feel that they are caring individuals who are trying to make this life transition easy on my Dad, but these are issues that happened to him, and most likely could happen to anyone.  I give a huge THANK YOU to all who work with and care for the elderly population!!  Have a great week everyone!

Life With Dad:Laughing Through Dementia: Life With Dad: Decisions, Decisions...

Life With Dad:Laughing Through Dementia: Life With Dad: Decisions, Decisions...: This is a picture showing my Dad on the day that we moved him into the nursing home.  He is smiling because I am taking his picture wit...

Life With Dad: Decisions, Decisions...

This is a picture showing my Dad on the day that we moved him into the nursing home.  He is smiling because I am taking his picture with his oldest granddaughter Briana, and her two boys, Tavian and Breckin. It was September 11 of this year....but let me go back to what led up to that decision, as well as give you a few tips and some background information on Dementia.

There were many decisions that needed to be made after Dad spent a week in the hospital in May after falling several times.  One decision occurred before he left the hospital.  My parents had two vehicles, a full-sized GMC truck and a compact-sized car.  The truck caused problems for Dad due to his failing vision.  Several times he ran into the side of the garage when he would be pulling it inside (and he used duct tape to hold the trim in place).  My Mom felt that the truck was too large, and that the car was too low to the ground.  What she had really been wanting was a smaller-sized truck.  We took her to the local car dealership (the same one that they had been dealing with for decades) to see what kind of a vehicle they could find her.  Lo and behold...they had a shiny red truck on the lot that fit her description! This was the first new vehicle that she had ever purchased because Dad always insisted that they buy a good USED vehicle.  It took some prodding and encouragement from a few family members...but she finally agreed to it.  I remember when we brought it home...Mom was excited, but also nervous about what Dad's reaction would be.  She made me drive it to their house. Dad came out and said, "That isn't new, is it?"   I told him that it was, and he told me that it had better be used (it did have about 13 miles on it....so technically....it was!). It was hard for Dad to adjust....especially to the idea that he was NOT going to get to drive it...which was a HUGE battle!  He kept insisting that until the doctor told him that he wasn't to drive, he was fine to drive around town.  It was a source of concern for our family. He was scary to ride with, and we tried to keep him from driving as much as we could, until the doctor did finally tell him in August that he was no longer allowed to drive.

This is him holding their dog, Punky, during his first ride in the new truck.  Don't be deceived by the smile...as soon as I took the picture he began grumbling about the new vehicle and not getting to drive it....just once!  He also kept insisting that they needed a second vehicle....what would happen if she had trouble with the truck and he needed to come and get her??  No matter how hard we tried to explain what OnStar was in a vehicle...his mind just couldn't wrap around that one (not surprised given that he didn't understand how automatic headlights worked either!). He kept telling my Mom (and anyone who would listen) that he was going to call the car dealership and have them start looking for a used car for him.  [Tip #1:  make phone calls to places that your loved one called frequently and explain to them what the situation is.  I had to call the car dealership and the implement dealer that Dad had purchased his mower from.]  This gave us some peace of mind to know that at least even if he DID call them....they knew to agree with him or distract him.  Living in a small town helped out in this area, but if he had lived in a larger city, the same tip would apply.  [Tip #2: visit with your neighbors and explain the situation as well. They can keep an eye out in case the loved one takes a fall outside, or they see them doing something unusual.]

After Dad came home from the hospital in May, he continued to stay at home for about three-and-a-half months.  Mom would take care of him to the best of her ability, while continuing her daily activities.  [Tip #3: when the primary caregiver has to start giving up their daily activities, it may be time to find another option.  The  primary caregiver can become exhausted and wear themselves out, causing health problems of their own.]  My Mom was diagnosed with Type 2 Diabetes during the time that she was taking care of Dad.  Stress had taken a toll on her.  I have also heard of the caregiver spouse having heart problems or other health issues made worse because of taking care of the loved one with Dementia. 

The summer passed without too many mishaps with Dad.  His short-term memory continued to be a problem throughout the summer.  When school started, we took him to a couple of football games to watch his grandson play.  He sat in the vehicle to watch the games.  The turning point came on a Saturday night while Mom and I had gone to watch the older grandson's college football game.  My husband, Terry, stayed behind to stay with Dad so that we could enjoy the game.  Without Mom there, he became very disoriented and wanted to get his jacket on to go and help his parents.  His parents have been gone for decades now.  Dad became agitated with my husband for not letting him leave.  Terry called me and had my Mom call home to explain to Dad that he was at his home and to just go to bed.  When the phone rang, Dad confused the TV remote as the telephone and missed the call.  Mom left a message on their answering machine, and when Dad heard her voice in the kitchen, he went out there.  When my husband explained that it was the answering machine, Dad insisted that he had talked "face to face" with his wife.  Mom did call back and speak to Dad and told him that he was at his own house and he needed to go to bed.  He went into his bedroom, but then got confused and couldn't find the door to get back out.  Then he went around the house turning on all of the water faucets so that the pipes wouldn't freeze (it was September).  Finally, he then went and turned on the shower and when my husband asked him what he was doing, he responded that he was "releasing the water pressure".  Dad worked at the power plant for many years,and apparently thought he was back at work. He finally did settle down, but he had worn out my husband by that time!  The next decision was whether to take him to the hospital that night, or wait until the next day, which would be a Sunday.  My Mom worked at the hospital for many years so she knew the routine there.  She decided that we should wait until Monday and call his regular doctor's office instead of take the chance of getting the "on call" doctor.  When I called on Monday, the nurse said to take my Dad to the ER.  The doctor admitted him to the Observation Unit for the night. [Tip #4: always keep a CURRENT and ACCURATE list of ALL medications and/or supplements that your loved one takes.]  They watched Dad all night on the medications that he normally takes.  While he was there, he saw the TV cord unroll and roll back up on the wall, and many other hallucinations.  The next morning, the doctor advised that he would arrange for Dad to get into the nursing home. Mom and Dad had purchased nursing home insurance several years ago, and it would prove to come in very handy.  The doctor diagnosed Dad with Vascular Dementia. A question that I have been asked many times since Dad's diagnosis is: What is the difference between Alzheimer's and Dementia?  Alzheimer's is actually a type of Dementia.  And Vascular Dementia is caused by Strokes, or a series of mini-strokes.  Rather than try to explain what this is to you, I have included this excerpt from a website: 

[Vascular dementia is the second most common form of dementia, according to the Alzheimer's Association. Like other forms of dementia, vascular dementia affects the elderly, particularly people between the ages of 60 and 75. The National Institute of Neurological Disorders and Stroke (NINDS) notes that men have vascular dementia more often than women. The patient has a decline in cognitive functions as a result of a disrupted blood flow in the brain. Helpguide.org notes that a series of small strokes causes the most common type of vascular dementia, multi-infarct dementia. The inadequate blood flow damages the brain cells.

Cognitive Symptoms

A patient with vascular dementia may have memory problems, which affects his ability to recall stored memories, form new memories or both. The Alzheimer's Association notes that the severity and type of memory loss depend on the location of the damage in the brain. For example, damage to the hippocampus, the part of the brain that converts short-term memories into long-term memories, prevents the patient from storing new memories. A doctor can detect the area of the brain damaged by using a brain scan, such as an MRI or CT scan. The patient may also have concentration problems and difficulty following directions. Confusion may also occur, which worsens at night, according to the Alzheimer's Association. Other cognitive problems with vascular dementia include difficulty planning and language problems.Movement Problems

Vascular dementia also affects the patient's ability to move. For example, the patient may experience sudden weakness. The weakness can occur in the patient's arm or leg. Helpguide.org notes that when the patient moves, he may walk with rapid, shuffling steps. The patient may also slur his speech when he talks. The Alzheimer's Association adds that the movement problems, combined with the cognitive decline, cause the patient to have problems taking care of herself.

Other Symptoms

Helpguide.org states that vascular dementia causes abnormal behavior in the patient. For example, the patient may cry or laugh at inappropriate times. The patient may also wander or get lost easily, even in places he knows well. Other symptoms of vascular dementia include a loss of bowel or bladder control, dizziness and difficulty managing money. The NINDS adds that the problems managing money affects the patient's ability to complete monetary transactions appropriately: she might, for instance, overpay for an item.

Read more: http://www.livestrong.com/article/109921-symptoms-vascular-dementia/#ixzz2EJjaRysv]

 According to medical evidence, dementia--symptoms of cognitive and behavioral impairment--can be brought on by some medications, health conditions such as lung disease, and diseases. (Dad has had difficulties with his lungs due to years of smoking and then working in his workshop and inhaling wood dust.)  The Merck Manual notes that the most common cause is Alzheimer's disease, which accounts for 75 percent of dementia cases.  Other than Stroke (Vascular), Lewy Bodies, Huntington's Disease, Parkinson's Disease (my Dad's mother passed away from this), and Creutzfeldt-Jakob Disease can cause dementia in people. There is also Mixed Dementia, which has abnormalities from more than one type of dementia occurring, most commonly from Alzheimer's and Vascular Dementia. I believe that Dad has Mixed Dementia.  Here is a link that tells you 10 signs to watch for Alzheimer's:
10 Signs to Watch to Alzheimer's

Dad in his lift chair on his first day  in the nursing home.  Physically, he was in fairly good shape, just very confused.  Next time I will  talk about the process of getting someone admitted into a nursing home, and tips to keep in mind.  I wish everyone a very Merry Christmas!

Life With Dad:Laughing Through Dementia: Life With Dad: The First Signs...

Life With Dad:Laughing Through Dementia: Life With Dad: The First Signs...: Let's go back to the time before the Dementia began to affect my Dad.  This is a rare photo for our family....one where Dad is in it wi...