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How Person-Centered Care can Alleviate Sundowning in People with Dementia

If you have a loved one with dementia, you may have seen or dealt with the issue of sundowning—problems sleeping or increases in behavioral problems that start at dusk (sundown) and can last into the night. Sundowning usually peaks in the middle stages of Alzheimer’s and other dementias and eventually diminishes as the disease progresses. However, while sundowning is an active condition in the person with dementia, it can present challenges for caregivers and the patient.

Symptoms of sundowning are agitation, anxiety, and increased confusion, changes in sleep patterns, and nighttime restlessness. Because the sleep-wake cycle is often disrupted, this can lead to more behavioral problems.

Although the causes of sundowning are not totally clear, contributing factors may be:

  • Physical and/or mental exhaustion
  • Less need for sleep (common in older adults)
  • Reactions to nonverbal cues from tired caregivers
  • Misinterpretations of surroundings due to lower lighting or shadows
  • Disorientation stemming from the inability to distinguish dreams from reality during sleep
  • Disrupted circadian rhythms (one’s internal body clock), leading to a mix-up of day and night

Managing sundowning
There are some easy steps caregivers can take to reduce the symptoms of sundowning for persons with dementia. If disorientation caused by the dark is a problem, keeping the lights on in the evening can help. The sleep environment should be kept at a comfortable temperature and the overall environment should be calming. Having an active day helps anyone sleep better at night, as does avoiding stimulants such as caffeine, nicotine, alcohol, and watching TV during periods of nighttime wakefulness.

Physical factors that are disrupting sleep (such as sleep apnea or issues related to incontinence) can often be addressed medically after an examination by a physician. However, there’s another way to manage or even reduce sundowning: person-centered dementia care. In fact, this type of individualized care has been shown to greatly reduce—even eliminate—sundowning in residents in the Memory Care Suite at Lester Senior Living.

Person-centered care
The caregivers in our Memory Care Suite are all trained in the Comfort Matters™ approach, an internationally recognized dementia care program that emphasizes person-centered care. In fact, the Weston Assisted Living Residence, where the Memory Care Suite is located, recently received accreditation as a Comfort Matters provider.

This level of personalized care places the emphasis on the individual’s comfort at all times, catering to each resident’s preferences and needs in the moment. Because our memory care residents may eat or sleep when they want to, select the activities they wish to enjoy, and have the attention of a caring team in a soothing environment, they are happier, calmer, and less likely to experience the upset or disorientation associated with sundowning.

If you have a loved one suffering with a memory disorder, and would like to find out more about Memory Care at Lester, contact David Rozen at (973) 929-2725 or davidr@richardc95.sg-host.com.

Tips for Helping Your Older Loved Ones Navigate Memory Loss

How many times has this happened to you?

You’re watching your favorite TV show when you suddenly remember you’ve left something in the bedroom and run upstairs during the commercial, only to forget why you went there. Sound familiar?

Everyone experiences a brain freeze or a “senior moment” on occasion, forgetting why you came into a room, where you left your keys, or familiar words or someone’s name. That’s normal and can stem from a multitude of reasons: you’re tired, stressed, or on medication among them.

However if you are noticing more serious memory loss or perhaps the early signs of dementia in loved ones, it can be frightening for everyone. If you see your parents or other seniors struggling with failing memory, here are some ways to support them as you all deal with issues of their cognitive health.

Help them to:

1. Socialize on a regular basis. Socializing wards off depression, loneliness and stress, all of which contribute to memory loss. Make sure those you care about get together with others, and for your own well-being, you be sure you do it, too.

Crossword Puzzles to Help Against Memory Loss2. Stay mentally active. Crossword puzzles and bridge are useful, but studies show that learning new activities, such as learning to play an instrument or learning a new language, stimulates new areas of the brain.

3. Get organized. A cluttered home, with everything in disarray, makes it that much more difficult to think clearly. Clear out their house. Write things down. Keep a special notebook, calendar, or a list on the refrigerator, and check off items as they are completed. Keep wallets, keys, purses, and other items in one special place. Keep activities organized, too; trying to do too much at one time is much too distracting for anyone.

4. Use “brain boosters.” Connect certain memories together in order to remember them, break long numbers down into small chunks and link together the small pieces, or encourage your loved one to close her eyes for a few seconds to allow a memory to return. Repetition of memories in the mind will help ingrain them and strengthen neural connections. For those who lack focus, offer them a doodle pad and pencils.

5. Eat well. A well-rounded, healthy diet is as good for your brain as it is for your heart. Include avocado, green leafy vegetables, fish, nuts and seeds, berries and whole grains. Cut back on alcohol, which contributes to memory loss and confusion even under the best of circumstances (and, it may adversely interact with medication).

6. Exercise. Even a 30-minute walk each day reaps benefits for your body and mind. If your loved ones are still relatively fit, go with them on a bike ride or take them bowling. Get them to play with the grandkids or the dog. Encourage them to do some gardening. Exercise improves blood flow and oxygen intake, and studies have shown that exercise changes brain chemistry for the better. Physical activity also triggers the release of a protein called BDNF that promotes healthy nerve cells in the brain. So, get going!

7. Get enough sleep. Make getting enough sleep a priority. It helps to consolidate memories, and gives the brain, which remains active while we sleep, the necessary time to process what it must at night to promote a better day ahead. Be aware that dementia often causes various types of sleep disturbances, so maintaining a routine (active) schedule and reducing nighttime distractions can help.

8. Manage chronic conditions. Follow doctor’s orders, and use medications as instructed. Depression, high blood pressure, high cholesterol, diabetes, kidney or thyroid problems, as well as other medical problems are common in later years, and the related medications can affect memory.

You are not alone if you have a parent or loved one with memory loss; millions of people face this every day.

At the Lester Senior Housing Community, seniors in our Memory Care Suite keep both their minds and bodies active amid beautiful surroundings. They listen to music, enjoy pet therapist visits, can attend presentations on many topics, and participate in discussion groups. Most importantly, they are part of a dynamic community that offers person-centered care.

Our caregivers understand that each person is an individual and is treated as such, with compassion and understanding in an intimate, comforting environment where their needs always come first.

Here’s another tip to support your loved ones with memory loss: Come tour our Memory Care Suite at our open house event on Sunday, June 24 from 12-4 pm. Contact David Rozen if you’d like to attend or for more information: DavidR@richardc95.sg-host.com or (973) 929-2725.

Creating Memories with Seniors in The Face of Memory Loss

The effects of dementia on family members and friends can be difficult to deal with as older loved ones suffer with memory loss. Grown children and grandchildren may yearn to maintain connections with the seniors in their lives who are having trouble remembering shared experiences, milestone occasions, or even names.

However, there are many wonderful ways that families can create new memories for themselves and reawaken the joy of past people, places and things for seniors with dementia.

Memory boxes. Memory boxes, like scrapbooks, help seniors recall events and people from the past. The memory boxes and the memories they hold—literally and figuratively—can stimulate the person with dementia and prompt conversation. Memory boxes can be about one specific event, person or time in one’s life and they link the senior to his or her identity. Making and looking through a memory box can also lift spirits and spur creativity.

Items to include can be family photos, newspaper clippings, recipes, artwork by the grandchildren, and personal keepsakes; think of items that bring back memories of the loved one’s youth, special achievements, a beloved family pet or favorite vacation place. The box can be a shoe box or plastic bin—something easy to decorate, lift and open, and that can store items of different shapes and sizes. If your loved ones needs some prompts, you can label the items with stickers or tags to spur a memory and get your loved one to talk about the objects and events they are associated with.

Playing favorite music. Just as photos bring back memories for seniors with dementia, so can listening to music—especially music of their youth. Upon hearing music, many older adults with memory impairment become more alert; many will sing along, clap their hands and tap their feet. In our Memory Care Suite, residents enjoy weekly music therapy programs and iPods are available with music for them to listen to and bring back those happy memories. Because music crosses generations, visiting grandchildren can sing along and create a beautiful memory in the moment for everyone.

Bake or cook something together. The sensory stimulation of aroma can bring back memories—and doing the activity together can be fun. We have a baking club that meets every week in our kitchen to make something together and share memories of favorite foods (and some goodies).

Make a video. Provide some gentle prompts that help your loved one to share some family history, a funny story or personal events; or record family visits to play back for your loved one. Get the kids involved and on camera, too during the “interviews.” This is a beautiful way to strengthen family bonds and create a keepsake for the next generation. You can also have your family pre-record video messages to play for your loved one to brighten his or her day, remind them of their family connections and create a feeling of familiarity if they are no longer living at home. If you have old home movies, consider transferring them to DVD and watch them together—and enjoy a nice trip down memory lane.

Create art. Art give seniors with dementia a creative outlet, promotes relaxation and improves mood. Doing art together as a family also enables everyone to enjoy a fun activity together, even when verbal communication is difficult for the senior. Whether it’s drawing, painting, or flower arranging, a keepsake is also created that the person can keep in his or her room … and remember a happy moment with family or friends. At the Lester Senior Housing Community, our eclectic creative arts program is popular with residents in our independent living and assisted living buildings, including residents in our Memory Care Suite.

As you’ll see on our calendars, we offer our memory care residents a full range of activities that both stimulate and soothe: poetry and conversation circles, floral arts, music therapy and baking, aromatherapy and pet therapy among them. If you have a loved one with memory loss, we invite you to take a tour of our Memory Care Suite and learn more about our personalized approach to caring for seniors with dementia. Contact David Rozen at DavidR@richardc95.sg-host.com or 973-929-2725.

The Importance of Good Nutrition for Dementia Sufferers

So many of the things we take for granted in life become difficult for those with dementia, not the least of which is eating healthy and nutritious meals. Poor nutrition can increase a dementia patient’s behavioral symptoms. It can also cause weight loss that could make a person’s condition deteriorate more rapidly. To prevent these issues for seniors with memory disorders, caregivers need to make sure that those in their care are getting nutritious meals that help them maintain their physical and cognitive health.

It sounds simple, right? However, for a variety of reasons, people with dementia, especially older adults, don’t always want to eat. Some reasons for this include:

  • Not recognizing food. The person may no longer be familiar with the foods that they may have eaten in the past.
  • Ill-fitting dentures. Eating may hurt because of dentures that don’t fit correctly.
  • Medications. Any additions to or changes in medications may change the patient’s appetite.
  • Not enough exercise. Not exercising will decrease a person’s appetite.
  • Decreased sense of smell and taste. This may cause the food to be less appetizing as it once was.

Despite all of these issues, a healthy eating plan is important for seniors with dementia. They don’t need to have any special diet, unless they have other issues that call for certain food restrictions. If not, they should eat a well-balanced, varied and nutritious diet which will help them maintain optimal health.

Here are some ways you can help someone with dementia to keep up good eating habits for as long as possible:

  • Limit distractions. Serve meals in a quiet place. Avoid television or other distractions so the person can concentrate on eating.
  • Keep the table setting simple. Don’t put items on the table such as centerpieces or plastic fruit that might distract or confuse the person. That goes for extra utensils as well; only put utensils on the table that the person needs.
  • Distinguish food from the plate. Someone with dementia may have a hard time distinguishing food from the plate or the plate from the table because of impaired visual abilities. Try to use white plates or bowls with a contrasting color placemat. Avoid anything with patterns.
  • Check the food temperature. A person with dementia might not be able to tell if something is too hot to eat or drink and may burn themselves. Test food and drink temperature before serving.
  • Serve only one or two foods at a time. Too many foods at once may be confusing to the patient. Try serving one food at a time, for example, mashed potatoes followed by meat.
  • Be flexible to food preferences. Dementia patients may not remember liking certain foods, or may suddenly like something that they didn’t care for previously. Keep that in mind when preparing food. This is one of the ways our individualized comfort care comes into play in our Memory Care Suite; it’s about providing what the individual prefers.
  • Give the person plenty of time to eat. This helps avoid the risk of choking and creates a calm atmosphere, so important for emotional well-being.
  • Eat together. Make meals a social event so residents look forward to the mealtime. Research suggests that people eat better when they are in the company of others.
  • Keep in mind that people with dementia may not remember when or if they ate. If the person asks over and over about eating breakfast, consider serving several breakfasts—maybe eggs, then toast, then a pancake, then juice.

At the Lester Senior Housing Community’s Memory Care Suite, we understand the importance of good nutrition and caring for healthy bodies as well as minds and spirits. Healthful and enjoyable meal experiences for our residents are just one component of the holistic, person-centered care our caregivers provide. If you have a loved one with a memory disorder who would benefit from Memory Care at Lester, contact David Rozen at (973) 929-2725 or davidr@richardc95.sg-host.com.

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