Minnesota Care Givers Ask What To Do With A Person With Alzheimer’s

Creative Collages–A Bit of This and a Bit of That

Many who care for loved ones with memory loss have a difficult time filling the hours of the day. As cognitive ability decreases, there seem to be fewer and fewer possibilities. Here’s one activity that not only fills the time, but helps fulfill both care recipient and care giver, and additionally, serves a few other purposes.

Making a collage is an enjoyable way to spend an afternoon. All you need is a large sheet of colored construction paper, some old magazines, glue, scissors and a felt tip pen. The idea is to make a collage with your client using pictures that are meaningful to him or her. The goal of the process is to facilitate self-expression, communication and social interaction.

To begin, just look at old magazines together. The care giver cuts out pictures that seem appealing to the care receiver. He/she tells (or points to) where he or she wants the picture pasted on the sheet. If the person is verbal and able to give you a title or caption for the picture, you write it under the picture. If not, suggest one and watch for a “yes” or “no” response (it could be a nod or a smile. Instead of writing with a felt tip pen, you could also cut out the words you need from the magazines to make captions. (They look rather like a ransom note!)

This pleasurable activity has been successfully used in skilled facilities even with patients who were barely able to communicate, who wandered, avoided eye contact, and who did not appear to recognize family members. In one instance, a wife (Mary) found that when she sat down with her husband James and began to page through a magazine in search of items to use in the collage; her husband surprisingly seemed interested. Mary would point out pictures and talk about them, and though James would often turn away, he remained seated and actually listened. Eventually he bagan touching pictures he seemed attracted to. His selections seemed to reflect elements the couple shared in their life together, and Mary would talk to him about the memories they triggered. James would sometimes remain engaged for more than an hour.

One day, Mary began to sob as she showed staff their collage. It depicted a car, a tractor, basketball players and the words, “I’m OK, I’m Alive” that seemed to leap off the top of the page. Mary tearfully explained that James kept touching these words even though she had been reluctant to cut them out for him. It was the message that helped her realize that she hadn’t lost him completely.

Besides encouraging communication and social interaction, the collage process also increases self-esteem and enables the individual with dementia to express thoughts and feelings. This often improves speech and cognitive ability, which can help reduce depression and difficult behavior.

The process is beneficial to the professional caregiver because it helps pinpoint an individual’s interests, making it easier to create discussion by finding common experiences. We are social beings and our emotional and often physical well-being depends upon our ability to interact and communicate with others. Collage communication is a simple tool that enables access to both.

–From an article in Care Advantage by Katya Luisa, Cost Rica and Los Alamos, NM., who developed the program. An exerpt from this article was included in one of the monthly newsletters sent to all Seniors’ Choice employees. For information about Senior Care in the Twin Cities of Minnesota, call 763-546-1599, or check out our website at http://www.seniorschoicemn.com

Dementia Care: Making a Difference in Minnesota Continued

Even in the Mid and Late Stages of Alzheimer’s and Related Dementia, Professional and Family Caregivers Can Still Make a Difference

Sadly, Alzheimer’s disease is a progressive disease.  There may be some noticeable ups and down, but over time, it will worsen.  As the loss of cognitive ability worsens, there comes a time when it is nolonger useful to try to help someone remember.  It only reinforces their fears and anxiety.  Many people will respond either with anger (they may feel you are putting them on the spot,) or they will pull in because they feel embarrassed about not be able to respond appropriately.

*  Keep learning as much as possible about the disease and its progression, so you can recognize changes in the person’s behavior and understand that it is the disease, not the person.

*  Validate feelings.  Persons with Alzheimer’s disease continue to have the same feelings we all do right through to death.  The difference is, they lose the ability to communicate their feelings.  Fear is a common emotion, because people whose brain cells are being destroyed don’t understand what’s happening to them.  They become frustrated and sometimes act out when those who care for them seem unable to understand them.  When they exhibit combative or other unwanted behaviors, there is almost always some need, feeling or fear that they have be unable to communicate.  Caregivers need to become detectives in order to discover the need behind the behavior.

*  “Does this really matter?” becomes a question the caregivers should ask them selves on a regular basis.  This is another version of “pick your battles.”  If the patient doesn’t want to do what you ask, in most cases it really won’t matter to just let it go and try again later.  No one ever died of not bathing eating or sleeping on a specific schedule.  Give some latitude where a delay is not a dangerous thing.

*  Don’t ask questions that put people on the spot.  Instead of asking do you remember the names of your grandchildren, say, ” Let’s talk about the little ones.”  Showing some pictures may help.  Don’t ask a person what they had for lunch or breakfast, instead, gives some clues to make it easier.  “Let’s see, we had eggs for breakfast, let’s have some chicken soup for lunch.”

*  Be aware that before dementia, the person had a daily routine.  Trying to continue that as much as possible with some adaptation toward simplifying can be helpful and give a feeling of security and success.  People with Alzheimer’s disease tend to tire easily (my theory is that they need to work very hard to just understand what’s going on in their day,) so alternate activities during the day with active (mild exercise, going for walks, help with simple household tasks) and more restful (naps, listening to music, reading short pieces to the person) tasks.

The bottom line is as the disease progresses, simplify, simplify, simplify.  If music, especially singing is enjoyable, just singing one verse and repeating the same verse a couple times is probably better than trying to get through all 4 verses of a favorite hymn.