Thursday, May 21, 2009

Tips for Improving Sleep

If your care recipient with dementia has trouble falling asleep or staying asleep, consider these non-pharmacologic approaches for improving sleep before or in conjunction with pharmacologic approaches.

  1. Encourage the person to use the bedroom for sleeping only. Discourage the person from staying in bed while awake, watching television, or reading.
  2. Establish a comfortable, familiar, and secure sleeping environment.
    • Make sure the person’s bed and pajamas are comfortable.
    • Maintain a comfortable temperature for the elderly, who tend to be more sensitive to cold.
    • Have extra blankets available.
    • Place security objects, such as a favorite blanket or stuffed animal, within easy reach.
    • Make sure the room is quiet. Even quiet noises can be stressful to a person with dementia. 
  3. Maintain a regular time and routine for going to sleep at night and rising in the morning.  Try to make the evening hours relaxing. 
  4. Try to limit naps during the day to no more than 20-30 minutes. Discourage naps in the late afternoon and evening.
  5. Schedule regular exercise; try to time it no more than 4 hours before bedtime.
  6. A snack prior to bedtime may help reduce awakenings during the night due to hunger.
  7. Reduce or eliminate the intake of caffeine, alcohol, and nicotine, especially in the evening.  Reduce the intake of liquids just before bedtime. 
  8. Make sure the path to the bathroom is well lit and clear. Leave a nightlight on in the bathroom.  Make sure clothing is simple and easy to disrobe for using the toilet.
  9. If the person with dementia wakes up during the night, assume that s/he is disoriented and help orient and reassure her/him. Remind the person that it is time for sleeping. Find out if there is something s/he needs to help her/him go back to sleep.
  10. If the person with dementia awakens upset, offer reassurance that everything is all right and that everyone is safe. Speak softly and quietly using a relaxed tone. Consider using distraction.
  11. Bright light can help regulate the body’s biological clock (circadian rhythm). Seek sunlight exposure during the day. Bright light therapy using a light box may also help regulate the body’s biological clock. 
  12. Try to manage pain symptoms as much as safely possible prior to bedtime. 
  13. Consult a physician about any underlying health problems, pain management, and sleep problems if indicated. 

Wednesday, May 20, 2009

How to Appreciate Time Spent With Elderly Loved Ones - Especially During Holidays

  1. Step 1) Call your special elderly relative and schedule a visit. It's always best to find out what is a good time of day for the elderly, and his or her caregiver. Most elderly take naps, and medication, so visits should be scheduled around these key times in the day. Whether the special person you are visiting is living at home, or in assisted living, or a nursing home facility, it's courteous to arrange a convenient time for all of those involved.
  2. Step 2) If you are visiting an elderly woman, take a bottle of nail polish so you can give her a manicure! It only takes a few minutes, and it will encourage face-to-face attention that the elderly woman will love! Make sure the fragrance won't bother her, or those around her, first.

  3. Step 3) If you are visiting an elderly man, take shoe polish and the goods that go with it, so you can give him a shoe polish while you're there. Remember, in the 40s and 50s, a shoe polish was a grand treat for any gentleman! He'll love it! And it will give you a chance to humble your own status regardless of how successful and important you might feel in your daily work and profession. It will be a nice change of pace - a return to a simpler time.

  4. Step 4) Engage in pleasant conversation with the elderly. Tell them simple things, like: "I'm so happy to see you!" "I always feel so inspired when I spend time with you!"

  5. Step 5) Offer to go for a walk or a wheelchair tour around the area, whichever is applicable.

  6. Step 6) Offer to meet their friends in the area, especially their caregivers or other members of the nursing home staff, or assisted living team. Thank those people for being so wonderful!

  7. Step 7) Ask the elderly some questions in which they can give you their sage advice about life. For instance: "I know you were always so good at preparing dinner for your family. How did you plan your meals to make delicious meals that were affordable?" Or...."I feel like a real dolt when I talk to my wife. How did you always keep Mildred smiling all those years?" etc etc

  8. Step 8) When the elderly offer you advice, TAKE IT! Don't challenge it. After all, they have years of experience on you. Be sure to thank them for being willing to talk with you about your life.

  9. Step 9) Be sure to LISTEN to the elderly. Did you know that listening to others actually lowers your own blood pressure too? Give yourself a break from being the expert at work...let the elderly person share his or her humor, experience and advice with you, and you be so glad you did!

  10. Step 10) Always avoid asking about an elderly person's health care situation, becasue this topic gets old and can lead to depression. Keep in mind the caregiver is already on top of this. Go ahead and show concern about the elderly person's health status by saying general, encouraging comments, such as "I hope you're doing well," or "I hope you're feeling better." But in all cases, DO NOT give medical advice!

  11. Step 11) When it's time to go, thank the elderly person for his or her time. Give a gentle hug or kiss, and offer to get anything he or she might need, such as a blanket, magazine, eyeglasses case, etc. Make a plan for the next visit and write it on the elderly person's calendar, so he or she can look forward to it, and then make sure you follow up and show up when you promised!

  12. Step 12) Please remember that someday, if you're fortunate, you too will be elderly...and imagine how nice it will be to feel valued by someone who invests their time in meeting with you. 

    The elderly are indeed treasures for the community. Show them respect at all times.

    By RA Cologna


The Story of The First Alzheimer's Patient

In November 1901, German psychiatist Alois Alzheimer encountered a woman named Auguste Deter (Auguste D, as she came to be known) who had been brought to Alzheimer's Frankfurt clinic by her husband.

According to the husband, the couple had been harmoniously married since 1873, but he had recently noticed a gradual decline in his wife that went beyond short- and long-term memory loss. At the relatively young age of 51, she had become disturbingly absent-minded, making obvious mistakes in food preparation, neglecting her housework, stashing objects in nooks and crannies around their apartment, wandering aimlessly from room to room, and suffering from intense bouts of jealousy and paranoia.

As the months went by, thoughts of Auguste D. stayed with Dr. Alzheimer. He recognized that Auguste D.'s case could prove to be of great scientific importance because of her young age. At fifty-one, she was exhibiting the behavioral symptoms that one might expect to observe in a dementia patient in their seventh, eighth, or ninth decade.

The dilemma for Alzheimer and his colleagues was the same as it is today: Did Auguste D. (and others like her) have a specific disease separate from normal aging? Or were their brains simply moving quicker along the continuum of aging and experiencing the symptoms of senility a bit more rapidly than others? This quandary puzzled Dr. Alzheimer for years to come.

In 1906, Auguste D. passed away. Dr. Alzheimer performed an autopsy, finding a high volume of senile plaques and neurofibrillary tangles in the tissue of her brain. In November of that year, Dr. Alzheimer delivered a now famous lecture to the Assembly of Southwest German Psychologists in Tübingen. Alzheimer stood before nearly ninety of his colleagues in this lecture theatre and reported on the case of Auguste D, interspersing his lecture with wonderfully-drawn slides of the plaques and tangles found in and on Auguste D's brain in post mortem investigation.

Until the day he died, Alzheimer was reluctant to label the condition he observed in Auguste D. as a specific disease. Nevertheless, his boss, Emil Kraepelin, the authority on psychiatry in Europe, published an account of Alzheimer's disease on in the 8th Edition of his definitive Psychiatry textbook. And so, in 100 years we've gone from having one Alzheimer's disease patient, Auguste D., to having more than 25 million worldwide.

Honda's Walking-Assisted-Device to help Elderly walk

Honda has developed a gadget that they say could make walking easier for the elderly and others with weak leg muscles. The aptly named Walking Assist Device is a 6 lb. motorized belt with hip sensors that gauge how much help the wearer will need. The motor then gives the wearer an appropriate boost, lengthening his or her stride enough to make walking easier on the legs.
Honda began research of a walking assist device in 1999 with a goal to provide more people with the joy of mobility. Currently, the device has entered into the feasibility stage.
The research of this device is being conducted by the Fundamental Technology Research Center of Honda R&D Co., Ltd. in Wako, Saitama.

Friday, May 15, 2009

Evolution of Assistive technology

Evolution of Assistive technology


Civil war: Wood and leather limb prostheses with pelvic attachment bands were replaced by suction socket attachments. A socket developed by Parmelee in 1863 featured the first suction attachment of lower limb prosthesis (Murphy, Cook, and Harvey, 1982). Current prostheses use composite metal and plastic, whereas Parmelee’s device was made of wood and leather. Hearing aids were invented, but were bulky and had much lower fidelity than today’s hearing aids (Cook & Hussey, 2001). 

Twentieth century: Evolution in health care and technology saves lives (battle line hospitals, emergency medical transportation, intensive care units, advanced treatment, antibiotics and other medications), but also leaves large numbers of people to live their lives with a disability or chronic illness. Creativity by individuals (some of whom have disabilities themselves) and the evolution of electronics (computer chips of reduced size, reduced cost, and increased capabilities resulting in synthesized speech, robotic aids, graphics) result in the development of assistive technology devices.