According the CDC, one in three adults age 65 and older falls. In fact, falls are responsible for the most injuries and fatalities among seniors. And unfortunately, a fall can mean the end of independence . . . or worse; more than 25,000 people die each year from falls.
The good news is that falls are not a normal part of aging, and can be prevented! Since the place you are most likely to fall is in your own home, here are some simple steps to keep you safe
If you do fall, see your doctor right away, even if you are not hurt, you should find out why you fell to keep it from happening again!
For more information about preventing falls, please click here to see a comprehensive checklist.
Integrity. That word has a lot do with truth and honesty, things that can get a bit murky in dementia care, as we work to validate feelings and honor the way a person with dementia views the world. At our recent Mission Breakfast event at Ebenezer, I was asked to prepare a story that related to Integrity, one of our five core Ebenezer values. To tell the truth (ahem), I wasn’t quite sure (at first) that I could spin the story I really wanted to tell (yes, I chose the story before being assigned the value) into being the perfect fit for the value of Integrity, but I believe I’ve come around!
Integrity in dementia care has lot to do with honoring and celebrating who each person is, at their core, connecting with their passions, skills, accomplishments and dreams.
At one of our sites there was a resident named June. She was British, and I learned she had had a career as an opera singer. I was so excited to meet her and so hoping I could get her interested in the arts project I was involved in at her site -- using Shakespeare, Poetry and Music to engage residents and stimulate their memories around the theme of love. I visited with June one day in her room. She told me about her singing career, about touring overseas, performing in Prague and many other capitals of Europe, even singing with Pavarotti, I think. Lying down in her bed as we chatted, June was most cheerful, hospitable and animated. Clearly she loved reminiscing about her career. She told me she had also performed onstage in many musicals. I asked her what parts she had played. In her Northern British accent, she proudly replied: “I played Laurie in Oklahoma! But y ’know,” she continued, “My voice isn’t what it used to be, and I really don’t sing much anymore.”
I could hardly wait to see if we could get June out to attend the sessions that were part of our 6-month long project. She didn’t make it to the first couple, but the third one was all about music, and she was feeling well enough to come along. Bright-eyed and very engaged throughout the session, June was often the first person to give a response when Jeanie Brindley-Barnett of MacPhail Music Center asked the group a question. Near the end, Jeanie played the song “People will Say we’re in Love”, the famous love duet from Oklahoma. Then, Jeanie very casually invited June to sing it.
June did not hesitate. Her voice was creaky and warbling at first, but she put her heart into it and when she hit those high notes near the end of the song; her voice simply soared across the room, pure and free. Everyone in the room had an experience of the singer she once had been. Memory care residents and staff applauded heartily when the song was done. I looked over at Jeanie and saw that she, like me, had tears sliding down her face. I remember thinking in that moment that our project was already a complete success as far as I was concerned, based solely on what had just happened, because one resident had that opportunity to share her talent in front of a group again.
Unfortunately, June did not attend our other sessions. She came to just one, wasn’t feeling well, and had to leave almost immediately. Her health was deteriorating. In fact, she died before the project was completed.
A month or so after she passed away, I arranged to meet with June’s daughter. I was curious to hear more about June’s career, and thought there might be some recordings or programs in existence that might come in handy for the documentary film we were making about our project. (The day that June sang was not a day we had the film crew on site!) Her daughter let me know that June’s memory, once she got dementia, had actually….expanded…the extent of her career. In fact, June had never toured the capitals of Europe. She had not sung with Pavarotti. She had done a lot of community theater and some non-professional light opera performances! June did indeed play Laurie in Oklahoma, but she did not have the career she had described to me and many others in some detail, except in her imagination, fueled by dementia!
I admit I was a little disappointed at first, finding this out, but then I thought, wow, who wouldn’t want the kind of dementia where you remember your fondest dreams and expectations for yourself as reality?! Given the choice, I think that’s a kind I’d sign up for! There’s integrity in there for sure!
-Marysue Moses, Ebenezer Dimensions Program Coordinator
What is Godly Play?
GODLY PLAY™ is an imaginative, Montessori-based approach to religious formation developed by the Rev. Dr. Jerome W. Berryman and used by many faith groups around the world. It is a creative and playful way of bringing stories of faith to life on an experiential level. It uses two and three dimensional figures to tell the story in a vivid way and then invites – through wondering questions - engagement with the story. Traditionally, this method is used in the faith formation process of children.
In 2015 Lois Howard wrote an inspiring booklet “Using Godly Play with Alzheimer’s and Dementia Patients”. In it she outlined her experience of using this method since 2006 in Lexington, Kentucky. Her writing inspired chaplains at Ebenezer to follow in her footsteps. In March and April of 2018, our team (including chaplains in training) engaged in two days of hands-on training in Godly Play with Minneapolis Godly Play trainer Susan Mallison. Her enthusiasm and curiosity about bringing stories alive with older adults in varying stages of dementia was instrumental to our success. Another amazing supporter is Jon Lundberg, President of Ebenezer and Fairview Post-Acute Care. An avid woodworker, he created several wooden figurines that are being used in the process of telling Sacred Stories. We are also very grateful to all donors who through Ebenezer’s Foundation generously supported this project.
We decided that our goal was not to help participants remember the stories but to facilitate a way for each person to connect with the Sacred while also being in community with each other. Our context in larger long term and senior care settings in Minnesota is one of growing cultural and religious diversity. We wanted to create a welcoming and inclusive atmosphere for everyone while drawing on different sacred stories. We called it “Sacred Story.” What we discovered continues to amaze us.
Initially we anticipated 4-6 people would come and listen to the story and engage with it. To our surprise, at one of our communities we regularly have between 15-20 participants, at another 6-10. Not everyone knows or remembers the others’ names all the time. We introduced name tags so that residents could see and hear each other’s names frequently. Calling each group member by name is a crucial aspect of this model, to create community and to be known by each other (and the Sacred) by name. Interestingly, one of the residents whose Alzheimer’s disease had progressed significantly was so delighted to see her name in writing. For her, to be in that circle of friends, to be known and to recognize her own name was the most meaningful part of this day’s Sacred Story time. As we sing together and then hear, see, and feel a Sacred Story, we open up new and different ways to experience the Divine. Wondering questions invite each participant to connect with the Sacred in their very own way. Residents may recall memories that resonated with the stories being told, such as reconciling with a sibling, welcoming back a child into one’s family, or helping a stranger in need.
The stories we tell include the parable of the Great Pearl (which touches on what may be the most important thing in one’s life, and what it feels like to give everything away), the Ten Best Ways to live by (traditionally known as the Ten Commandments) and the story of the Exodus (a story about suffering, liberation, freedom, divine intervention and joyful celebration).
Recently when I told this last story, using our “desert bag” filled with sand, I was deeply touched by the reaction of one resident who kept saying: “This is my story, these are my people.” We then spent time together speaking about the resident’s childhood and family. The smile and warmth reflected on the resident’s face as we talked was enlivening.
When we conclude our Sacred Story time, we go around in the circle and offer silence, thoughts or prayer, deepening on each resident’s desire. Those who voice prayers out loud frequently pray for their families. I hope that many families know that despite their sad experience of no longer being recognized as son, daughter, spouse or friend, their family member may well be reaching out in an unseen way, and praying for them.
Paranoia is one of the many possible challenges of dementia. It’s a blaming belief or suspicion that a person with dementia holds onto, despite explanations or lack of proof of this belief.
Sometimes people with dementia will accuse others in the household of stealing something that they themselves have misplaced. It is very tempting to try to convince the person otherwise when they believe that something has been stolen. But arguing doesn’t get us very far when a person has dementia. It usually causes stress, frustration and upset for all concerned! It is more productive to “cross to their side of the street” in order to see things compassionately, from the person’s point of view. Sandra McGurran, social worker with Fairview Home Care and Hospice Senior Services, recently shared with me the idea that “Compassion = Empathy + Action” This concept can be applied here.
Here are some DO’S and DON’TS to guide you in giving a compassionate response in these sorts of situations.
DO NOT TAKE OFFENSE on behalf of the accused person.
DO LISTEN to what is bothering the person with dementia, and VALIDATE their feeling, i.e., “That’s not a very nice feeling, to think someone would just take something from you.”
DO RESIST THE URGE to get into an argument with the person.
DO ACKNOWLEDGE the upset. “I can see why you’re upset. I would be too, if that happened to me.”
DO NOT offer a lengthy opinion or a list of reasons why they shouldn’t be upset.
DO OFFER A SIMPLE IDEA. “I wonder if your blouse is in the wash.” Or… “Maybe your wallet was left in a pocket?”
DO BE HELPFUL and action-oriented. “I will go check the laundry room. Or, "Let’s check your pockets”.
DO ASK QUESTIONS. “Let me get this right. What color was that shirt?"
DO BE REASSURING. “Don’t you worry. We will get to the bottom of it. I’m sure we’ll find it” Or, “I’m good at finding things.”
DO SHIFT THE FOCUS. “Let’s have a cup of coffee; coffee always helps me think more clearly!” Be sure to offer something you know the person will be interested in!
DO DUPLICATE items that are repeatedly misplaced. For example, if a person often loses their wallet, obtain several of the same kind to keep on hand. Make copies of cards that are in the original, so you can stuff the replacement wallets with those.
But what if YOU are the person being accused directly? This can certainly be tricky. It’s hard not to feel hurt by such an accusation. What can you do?
DO LET THAT ROLL OFF YOUR BACK in favor of remembering that your family member is functioning with a brain that is doing the absolute best it can possibly do under the circumstances of dementia.
DO TRY IGNORING THE ACCUSATION. Instead, simply validate the person’s feelings, i.e., “Oh no! Your favorite blouse is missing? Of course you’re upset. That’s a beautiful blouse!”
Maybe this will distract the focus from YOUR culpability, or maybe not. Depending on the level of the person’s upset and suspiciousness, you might need to step away and if someone else is available to assist. In that case, try, “I can see you’re upset with me. I’ll go see if Ann will help you look.”
DO THINK AHEAD. For things that are frequently misplaced, it could be helpful to establish and clearly label a home base in the room where a purse can hang or a wallet can sit. You might initiate a routine of checking that spot every night together.
Finally, it can really help in any sort of frustrating situation with a person with dementia to MAINTAIN A SENSE OF HUMOR AND GOOD WILL towards the person. Is there a way you can turn that uncomfortable situation around and actually give the person a compliment? Maybe you can remind them of advice they once gave you! “You know, Mom, I remember you telling me when I lost stuff that I would forget my head if it wasn’t attached. You were so right! You also said that lost things usually turn up if we are teensy bit patient! That was always so helpful!”
For more info on coping with paranoia as well as other challenges that can arise with dementia, see Coping with Behavior Change in Dementia: A Family Caregiver’s Guide, by Beth Spencer and Laurie White.
--Marysue Moses, Ebenezer Dimensions Program Coordinator
Many older adults want to stay in their home as long as possible. There is an assumption that staying in your home means you are independent, but the reality is it can often lead to loneliness and isolation. The health effects of long-term isolation are measureable and include chronic health conditions, depression, anxiety, dementia and even premature death. One study reported the negative health effects of long-term isolation are equal to smoking 15 cigarettes a day.
Loneliness is on the rise overall, but those most affected are those 80 and older according to a 2016 study.
Older adults who are most at risk are often:
The best remedy for loneliness is staying connected. Staying connected, interacting with others, and staying socially engaged with friends and your community can help keep fight loneliness and the health risks that are associated with it.
How can a move to Senior Living help fight loneliness?
When people move into a senior living community, the older adults often tell us, “I wish I would have moved sooner.” And their family members tell us, “We’ve seen our loved one blossom in the last few months!”
We invite you to visit Vintage Hills. Talk with our residents to hear how their health and their lives have changed for the better after moving to senior living.
For more information about loneliness and isolation, the AARP Foundation offers its online resource Connect2Affect. There you can find a self-assessment to determine your risk factors and tips on how to stay connected. Click here to take your self-assessment. Resources that informed this article include Government’s Role in Fighting Loneliness by Emily Holland, as published in the Wall Street Journal, and the Blue Zones Power 9 ® by Dan Buettner.
Many older adults think about moving to a senior living community, or have had talks with their family members about moving, but often have the feeling that they are ‘not ready.’ At Ebenezer, we hear you. (We also hear “I don’t know why I waited!” but that’s another article.)
Just because you’re not ready now, doesn’t mean you can’t work on getting things in order when or if you move. And even when you’ve taken care of the things below, it still doesn’t mean you have to make a move. It’s always best to be prepared. So if you want to or have to make a move, you’ll have the important pieces all ready to go!
Visit Your Doctor
Hopefully, you are getting your regular check-ups with your primary physician, but if not, make an appointment. Have the doctor review your medication list to make sure the list is up to date and appropriate. Let him or her know that you are considering a move to senior living. If you end up needing to move to an assisted living setting, your doctor will have to sign off on orders. This can happen more quickly (and more smoothly) if you have recently seen your doctor and have had these discussions in person.
You have 2 assignments here.
Depending on where you want to be, what type of apartment you want, and what service level you need (senior living, assisted living, memory care or enhanced care) you may encounter long waiting lists. When you do your research and shop around, ask about waiting lists and get on a few of them. There’s no guarantee something will be available for you when you are ready, but this gives you a little more priority and increases your odds of getting the apartment you want when you want or need it.
When you move to a senior living community and it comes time to sign a lease, you will likely need to identify a Power of Attorney and Health Care representative, and you may need to provide copies of the forms. Make sure you have quick access to your notarized Power of Attorney form and your Health Care Directive.
That’s it! You may have noticed there is no ‘to-do’ item for the house. Even though getting the house ready, or needing to downsize, is a reason many people feel they’re not ready for a move, a lot of times, when people make a transition, it’s not because they’ve finished downsizing and their house is in perfect condition to sell. When you decide you’re ready, you’ll figure out quickly what to do with your house and your stuff. There are realtors and move managers who specialize in working with seniors who can make your move and the sale of your home a breeze!
When persons with dementia move into a memory care community, it can take from several weeks up to three months or more for the person to adjust and feel comfortable with the new environment and routine. From my personal experience working with memory care residents at one assisted living for over a decade, I would say the average amount of time before the person settled in was no longer than a month. Your loved one may be angry for a while, and may seem more confused than before. This is a perfectly normal phase. Rest assured, things will improve in time. Here are ten tips to help ease the transition: