Posts

Validation Method Restores Dignity and Respect for those with Alzheimer’s

Living or caring for a loved one with Alzheimer’s and other types of dementia can be extremely challenging – physically, mentally and emotionally. As of 2015, an estimated 5.3 million Americans¹ have Alzheimer’s-type dementia, where one’s self-awareness, cognition, memory and functional capabilities progressively deteriorate as they slip deeper into the diagnosis. The average life expectancy after an Alzheimer’s diagnosis is 8 to 10 years. In some cases, however, it can be as short as 3 years or as long as 20 years². So for many caregivers, assisting someone with Alzheimer’s can be a long arduous journey, where significant levels of frustration, burnout and depression manifest, and communication and trust can unravel.

Fortunately, both family and professional caregivers can access a number of different resources to help reduce these issues such as practicing self-care and securing additional help or alternative care or placement; equally important is disease-specific education and training. In the instance of Alzheimer’s disease, one of the most well-known and respected techniques is that of Validation Method, which reimagines the way of caring and communicating with older adults diagnosed with Alzheimer’s-type dementia.

Validation Method was developed by Naomi Feil, a well-known social worker for a number of decades, who is recognized for her breakthrough approaches in caring for the elderly. It’s an interactive method based on empathy, dignity and respect, where those with dementia can express their emotions, needs and concerns to a skilled and trusted listener. Ms. Feil realized that older adults with dementia were often trying to resolve unfinished issues during their final stages of life. Therefore, if trained caregivers could listen, acknowledge and validate their distress, they could diminish their anxiety and could attempt to help resolve those lingering issues, so they could simply be at peace.

As ALZwell Caregiver Support explains, “Validation is about the older person’s needs. Instead of ignoring or stopping what might be viewed as irrational or illogical behavior, Validation offers alternatives.” It focuses on the objective of here and now, and not on why these behaviors exist.

Key Elements of the Validation Method

  • It is based on a theory that many older adults struggle with unresolved and unrequited issues. To deal with these issues, they will express past conflicts in disguised forms or malorientation, display time confusion causing a retreat inward, rely on movements instead of words, and lastly become vegetative and potentially shut out the world.
  • To help them resolve these past issues, Validation Method practitioners listen and show empathy and respect so they feel “validated”, not judged. Therefore, if they can express painful feelings freely, these feelings will gradually diminish. But if these feelings are ignored, the pain will fester, and they will not achieve the peace they are searching for.

The Validation Method is valuable and effective for family members, professional caregivers like nurses, therapists and social workers, as well as physicians to interact with Alzheimer’s sufferers. For examples of how one might use this method or to learn more, please go to Validation.com. Furthermore, Messiah Lifeways Coaching and Volunteers of America- Pennsylvania will be hosting a Validation Method training on Wednesday, October 28 at 6 pm presented by Stephen Klotz, Certified Validation Master. If you’d like to learn more about it or would like to register, please call 717.591.7225 or go online to MessiahLifeways.org/Events.

Validation Method can help those suffering with Alzheimer’s regain that dignity the disease has stolen and, ideally, give them a greater sense of peace in their final stage of life.

¹www.alz.org/facts/
²The Facts About Alzheimer’s Life Expectancy and Long-Term Outlook- Written by Kimberly Holland | Published on December 6, 2013. Medically Reviewed by George T. Krucik, MD, MBA on December 6, 2013
Everyone is a Potential Caregiver

The Joy and Pain of Caregiving

Serving as a caregiver for an aging loved one or parent is an incredible act. According to the Alzheimer’s Association, in the U.S., there are as many as 44 million¹ unpaid caregivers performing these incredible acts every day for someone over the age of 50. That is a huge mass of people serving the needs of an ailing spouse or loved one, where you will find lots of heartwarming, courageous and selfless caregiving stories. You’ll also hear stories of burnout, frustration and despair. Anyone who’s served as a caregiver for a significant amount of time can tell you that it can be wonderful yet woeful, and joyous and painful all at once. It’s assuming a lot of responsibility, which can be unfamiliar and often uncomfortable from handling their finances to helping a parent bathe or get dressed. It’s also a time to discover your own altruism or rekindle the bond between parent and child or between a husband and wife.

I’ve connected with hundreds of caregivers throughout my career including family, friends, but mostly through experiences at work. They hold a special place in my heart. Several years ago I helped develop a workshop created to help caregivers who were stressed and overwhelmed. The goal was to help this constant cycle of individuals avoid burnout and find options and resources to make the task of caregiving for an older adult easier and more manageable.

Everyone Is a Potential Caregiver

In the book “What to Do about Mama?” authors Barb Matthews and Barbara Trainin Blank exclaim, “Everyone is a potential caregiver.” So whether you have, are or will be a caregiver at some point in your life you can expect the highs and lows of this process. As you begin to read articles or books like “What to Do about Mama” you begin to see patterns and statistics that paint a very taxing picture. Over two-thirds of caregivers are women, many of whom are in the “sandwich generation,” which means they are caring for a parent or loved one while simultaneously caring for their children. Caregiver.org also states that anywhere from 40-70%² of caregivers suffer from various stages of depression. It also takes its toll on physical health, relationships, and work. Juggling all this can lead to burnout.

However, there is hope. There are a multitude of books, online resources and workshops like the one Messiah Lifeways Coaching offers to help caregivers avoid burnout. One of the most fundamental tools to elude burning out is taking care of YOU. Simply put – you cannot care for someone else if you yourself are ailing or worse. The comparison is often made to being on an airplane, and oxygen masks descend during an emergency. The rule is to place your oxygen mask on first and then assist those who need help. It’s a simple concept, but quite often forgotten.

Another important choice is seeking and accepting help from others. So often, women especially, think they can run all of mom’s errands, provide her the care she needs and drop in all hours of the day without the help of anyone else. It’s noble, but can be quite foolish as well. Ask others for help or hire help, plus take people up on their offers to help because eventually they may stop asking.

Caregiver support groups are also a very valuable asset in the effort of avoiding feeling overwhelmed, depressed or inadequate. They serve as great outlets to gain support from those who know what you’re going through. It’s a time to share, laugh and cry, to console, validate and commiserate. Jeanne McClintick RN, CHLPN from Hospice of Central Pennsylvania, runs several local caregiver support groups and shares wonderful supportive stories between members. She also states many participants continue to attend these groups even after the person they care for passes. It’s a way for them to heal and to help others new to the caregiving arena. So whether you chose to be or are thrust into the position of caregiver, do not take it lightly; however, do not fret. Remembering some of these tips along with other resources and insight can make it a better situation for all involved.

For more caregiver support and resources read “What to Do about Mama?” or visit cargiver.org or alz.org. If you’d like to attend The Caregiver Solutions Workshop on September 22, 2015 at the Carlisle Brethren in Christ Church, call 717.591.7225 or go to MessiahLifeways.org/Events.

¹Alzheimer’s Association, 2011 Alzheimer’s Disease Facts and Figures, Alzheimer’s and Dementia, Vol.7, Issue 2.] – Updated: November 2012
²Zarit, S. (2006) Assessment of Family Caregivers: A Research Perspective in Family Caregiver Alliance (Eds.), Caregiver Assessment: Voices and Views from the Field. Report from a National Consensus Development Conference (Vol. II) (pp. 12-37). San Francisco: Family Caregiver Alliance.] – Updated: November 2012

Raising Awareness: What Alzheimer’s Disease Is and Is Not

As the end of September quickly approaches, so too does World Alzheimer’s Month (WAM)®, but then National Alzheimer’s Disease and Awareness Month (NADAM) and Family Caregivers Month® kicks off in November. Organizations like the Alzheimer’s Association help raise understanding and awareness throughout the year, but have carved a special niche in the fall with the awareness months and large national fundraisers like the Walk to End Alzheimer’s (see photo below). Therefore, it’s a good time to continue the discussion and to learn more.

Though the average person generally understands that Alzheimer’s is a disease or affliction to the brain that affects things like memory, behavior, and cognition, some of the more specific details get muddled. To better understand Alzheimer’s it’s helpful to explore what it is and what it is not.

One of the most common misconceptions is that dementia and Alzheimer’s disease are one and the same, completely synonymous interchangeable terms. However, dementia is actually the broad descriptor and overall term that describes a range of symptoms linked with a decline in memory and other cognitive skills. This can also include: losing one’s ability to reason, communicate, and focus; produce aggressive or difficult behaviors; and/or reduce a person’s ability to perform everyday tasks like bathing or dressing. So if a person has dementia, it does not necessarily mean they have been diagnosed with Alzheimer’s. Alzheimer’s disease is just one of approximately 50 known causes of dementia. A few other types of dementia include: (click on each for detail)

Vascular Dementia
Dementia with Lewy Bodies
Parkinson’s Disease Dementia
Frontotemporal Dementia
Creutzfeldt-Jacob Dementia
Huntington’s Disease

But many of these other types are less common whereas according to the Alzheimer’s Association, Alzheimer’s represents approximately 60-80% of all dementia cases. Therefore it garners most of the attention and research when it comes to these types of degenerative neurological diseases.

While some forms or causes of dementia are reversible, such as thyroid problems, urinary tract infections and vitamin deficiencies, Alzheimer’s is not. It worsens over time and has no current cure and is fatal as it eventually shuts down the ability for the brain to communicate with vital organs. But treatments are available to battle the symptoms. Drugs like Namenda® and Aricept® slow the progression of memory loss, antidepressants help with mood, and anxiolytics help reduce anxiety and restlessness.

There is no single test to diagnose Alzheimer’s. While physicians can usually determine if someone has dementia, it may be harder to determine the exact cause. Diagnosing Alzheimer’s involves mental status testing, a comprehensive review of their medical history, neurological exams, plus blood work and diagnostic brain scans to help rule out other causes.

There is so much to learn about dementia, and websites like alz.org provide a great resource to gain knowledge and understanding of Alzheimer’s as well as other forms of dementia. But it also serves as a great place to turn for those dealing with issues like early onset dementia, caregiver burnout and other care issues. It also provides helpful facts and figures, 10 signs to look for, an overview of the stages, risk factors, treatments, and even covers myths about the disease, plus much more.

Additionally, other resources like the Alzheimer’s Foundation of America will be offering National Memory Screening Day on Tuesday, November 19 at various locations throughout the state at no cost. Click here for a full list of sites across the country.

“Dirty Words” the Series: You Called a Resident What!?

This week we continue with the third and final installment of the controversial blog series, “Dirty Words.” Hopefully by now we’ve learned the more courteous terms for referring to elders and the locales they may call home. However, if you still refer to an aging neighbor as the “old frail guy” next door or continue to call Messiah Village an “old folk’s home,” there may not be any hope for you. Either way we march on. This week we will be tackling a mish mosh of “dirty words.”

Long ago in our humble beginnings in the late 1800s, the Messiah Rescue and Benevolent Home referred to its residents as inmates! Insert joke here. Thank goodness for change. Could you imagine if we still called residents that? Eventually inmates gave way to guests. That’s a little better, I guess. Nowadays patient is the overused generalization. Like the term facility from last week’s blog, patient is not highly offensive; it’s just not very accurate. The people who live at Messiah Village and Mount Joy Country Homes reside in their homes, therefore should be referred to as residents, whether that home happens to be a cottage, an apartment or a single room. Patient should be reserved for a hospital or medical setting.

Here are a few more terms we need to pay attention to:

Adult diapers – as they say “incontinency happens,” but using terms like brief or pad or even call it by the brand name i.e. “Depends” or “Attends” offers a person a little more dignity.

Alzheimer’s disease – pronounced [ahlts-hahy-merz] it is often overused to describe a broad spectrum of dementia. Rather the word dementia is the broad term and Alzheimer’s disease happens to one form. Go to the Alzheimer’s Association website to learn more about the differences.

Bibs (for those unable or that struggle to feed themselves at mealtime) – we are caring for loved ones, parents, former teachers, scientists, pastors and politicians. They are not babies; they don’t wear bibs. Consider using the term napkin or clothing protector.

Tray or tray line (referring to meals or meal service in nursing care) – this isn’t high school. Let’s try meal, mealtime, dinner, lunch, etc.

Other names to be aware of are unit and wing. These refer to the different areas or sections within nursing or personal care home settings. Other communities may still use these terms, but we do not. Unit and wing are a bit old school and conjure up a more institutional feel or vision. Residents socialize, stay active and journey around the campus; therefore we like our descriptor of neighborhood. It evokes a more pleasant and communal setting. While not the prototypical neighborhood, ours has residents (neighbors) living side by side in condensed sections of our campus (community) with distinctive characteristics and personalities. While some may read this and say it sounds like a spin on reality, I’d say you’re not entirely wrong. Undoubtedly being called a resident of a Continuing Care Retirement Community may not be as appealing as being a resident of your own home, or you may also find it a stretch calling the section of nursing your father lives in a neighborhood. However, it’s about perception, appreciating the hand that is dealt, and believing these concepts to be true. Therefore those who have made the move to a place like Messiah Village- when you, your loved ones and staff embrace these ideas; it begins the process of culture change. When you call it home or call it a neighborhood, it inspires people to make it and believe in it as such. Families tell us stories of their parents wanting to return “home” to Messiah Village while they’re off campus during the holidays or a long weekend. That says a lot.

Lastly, I have a suspicion that if you have read this blog series, I’m probably preaching to the choir. You’re likely not the type of people to use these politically incorrect or derogatory terms we’ve covered. If you have, maybe you simply weren’t aware that certain terms like facility or senior citizen are falling out of favor. I must admit, I falter at times. I use facility or refer to someone as old on occasion. We’re all human, and we have to help each other when we slip. Times change, values and views change, so together we must recognize these “dirty words”, embrace the contemporary terms and change the conversation about aging.

If you have an idea or story for our blog, please contact me at coach@messiahlifeways.org. And don’t forget to subscribe to the Messiah Lifeways blog (hint: look to your right).