Sensory gifts

During the late stages of Alzheimer's disease my mother enjoyed listening to music and holding sensory objects. She particularly enjoyed objects that vibrated or were heavy, cuddly or made sounds. Here are suggestions for objects that might make nice gifts:

1. The baby water mat shown at the bottom of this blog. My mother enjoyed the feel of this on her lap.
2. A massaging/vibrating pillow, snake or massager that fits inside the hand.
3. Holiday cards that played music when opened up.
4. Beanie Babies
5. Koosh balls
6. Fidget toys like a chain of Links
7. Stuffed animals that made sounds when squeezed
8. Soft pieces of fabric tied together to fidget with
9. Socks filled with sand or pennies, packing peanuts, marbles. Sew the ends closed.
10. Plastic plants
    

Pilates Training

Here's a nice article:
Pilate Exercises

Strength Training

I started using the weight room at my YMCA after the doctor said I am beginning to have early signs of osteoporosis. From talking to friends this seems to be a common concern after menopause. Although I already roller skate, hike, bike and swim I decided that I needed weight bearing exercises. So after 3 months- I am definitely stronger but have aches and pains I didn't know were waiting to be discovered. I just finished reading the book Strength Training for Seniors- looking for some tips on how to do things better. My goal is not to change my appearance but to have stronger bones. This book would make a nice gift for an older friend or relative who is not used to exercising and/or has some medical issues such as obesity, arthritis or high blood pressure. The author does a nice job of explaining why strength training is important, the relationship between good nutrition and strength, principles of strength training such as how to keep it safe, frequency, intensity, duration, how to select an exercise and pace of progression. The specific exercises look fairly easy for a beginner with exercises done while seated, using the wall, a bench or ball. I personally like the ball the best for home exercises and if I feel lazy just lie on it to stretch and relax.

I purchased my ball at Target a while back and think it was less than 20 dollars. It is not super strong but I don't really abuse it much so it has lasted several years. There are much stronger balls sold in therapy catalogs and websites but they can be quite expensive.


I recently began taking a yoga class to become more flexible and hopefully get rid of the aches and pains just mentioned. I was very surprised that I was able to lie on my back and slowly lower my legs to the floor-a demonstration that my abdominals had strengthened from time in the gym. Aside from that, the yoga class was a lot of fun.
BarbaraSmithOccupationalTherapist.com

Environmental Adaptations

There are many books (including my own) that describe in detail ways to adapt the environment to make a person with Alzheimer's disease more independent and less agitated. Here are 10 simple tips:

1. Use visual cues to guide where the person needs to go. For example, leave the bathroom door slightly open with a big bright picture and printed word "Toilet" on the door. Keep the path clear and easy to walk to with a night light on.
   
2. Do the opposite to discourage going places- such as keeping the door to the basement a color that blends in with the walls. Consider blocking it with furniture
   
3. Provide simple labels or signs such as "Use soap" near the soap dish and label dresser draws with "shirts" or " underwear".
4. Remove remote controls and most technology that is just confusing and frustrating.
5. Use a large number, simple phone and set number 1 to call a helper. Add a sign next to the phone that says "Press number one to call ________"
6. Set the television to the person's favorite station. Cover the button that changes stations with brown tape. Highlight the button that turns the TV on and off with bright orange nail polish.
   
7. Disconnect the stove and microwave if the person cannot safely use them and fill the refrigerator with prepared cut up vegetables and fruits, cheeses, sandwiches and other finger foods.
   
8. Provide a digital clock with date, day of week and time. Some people obsess over this information and then you can just tell them to check the clock.
   
9. Remove clutter
10. Avoid glare that may contribute to faulty visual perceptions. Use curtains that let in some light, but not enough to cause glare or blinds that can be adjusted according to the outdoor lighting. Position the television so that light does not shine on it. Special low vision lamps are designed to decrease glare. Add lots of good overhead and table lighting.

Visit my Vision Resources page

I'm Still Here Amazon Book Review

I finished reading I'm Still Here by John Zeisel. I heard of this book and the Alzheimer's and Arts program he runs after attending a conference last month. I have mixed reactions because I don't agree with a lot of what he says in terms of people with Alzheimer's being more receptive to art because of their brain changes. Many people are not even interested in art. My mother in law couldn't have cared less but would have enjoyed stimulation related to farming and gardening. In fact, when we visited her we always put on a show watering plants and picking flowers to show her. Every individual responds to stimuli that is meaningful to them. A former tennis star may love batting a balloon around. My mother enjoyed our trips to the North Shore Music Theater until taking her to the bathroom was too difficult for me. Then we spent our time together singing and eventually me singing, her smiling.
I do think that Zeisel did a good job explaining how to set up the environment and behavioral techniques designed to prevent or reduce agitation.
Amazon Book Review
Here is the book. I'm happy to hear other opinions.

Make an Activity Book for Loved ones with Alzheimers

My continuing education course at Salem State College was canceled due to low enrollment. I was looking forward to sharing activity ideas with caregivers. The best activity I made for my mother was an activity book because during the early stages of the disease, when she could still read she loved flipping through the pages of a book all about her life. It included:

• The Story of Sarah Smith made with scanned pictures from her early life and more digital pictures put together to tell the simple highlights of her life.
• Large print songs to sing over and over again
• Simple pictures with captions or brief description
• Nursery rhymes
• Ben Franklyn Adages
• Descriptions of her favorite recipes and foods
• Yiddish words

Creating an individualized, meaningful book such as this for a loved one may be the most appreciated holiday gift for a loved one with memory impairment.

ArtistsFor Alzheimers

There was a presentation at the recent Alzheimer's Partnership Conference I went to in Peabody, Mass-by Artists for Alzheimers - an organization that promotes art, music and theater to help victims of Alzheimer's. The concept is fascinating although I don't understand how anybody can say that abilities to enjoy the arts does not diminish. My mother absolutely lost the ability to understand what she was seeing and spent more and more time with her eyes closed. The circus would have terrified her as did the costumed door man at the Magic Show. However, music remained powerful and much appreciated up until the end.
John Zeisel the president of Hearthstone Alzheimer Care developed the Artists for Alzheimer’s™ program, which involves guided museum tours for people with the disease. Check out his blog with a video demonstration of how a troupe of actors interact and stimulate the residents: I'm Still Here
I think that it is wonderful that the residents are receiving this great stimulation but does it really take professional actors, trained museum guides, etc.? I have found that people in institutions simply crave attention, interaction, the human touch and often times looking at family photos, hearing familiar songs from their youth and being amongst lively people is all that they need to come alive. However, I ordered Dr. Zeisel's book to check out.

Barbara

The Driving Dilemma

I enjoyed the Alzheimer's Partnership conference yesterday. Elizabeth Dugan, author of The Driving Dilemma shared some very scary photographs of accidents caused by elders and discussed the types of assessments available to determine driver safety. Testing assesses the person's vision, cognitive and mobility abilities needed to quickly respond to driving demands. States greatly vary in regulations related to who is responsible to report a dangerous driver.
My own mother's doctor reported her early stage Alzheimers to the Dept. of Motor Vehicles. They suspended her license but that didn't stop her from driving. I called the police near her home in Connecticut and they wouldn't do anything unless she was caught in the act of driving. The transition between respecting the person's rights and taking them away is the most emotionally wrenching stage of the disease. Fortunately, after my husband disabled her car, she forgot about the whole issue and my sister moved it to her own back yard. Technically- did my sister steal? Good material for an ethics class.


Resources:
The Driving Dilemma
Caring and Driving
SeniorDrivers.org
ITN America(transportation alternatives)
thehartford.com/alzheimers/
Driver Rehabilitation Specialists

Multi-Sensory Rooms

I used to bring clients with developmental disabilities into a multi-sensory room such as this when I worked at Hogan Regional Center in Danvers, Massachusetts. I think they can also be helpful for patients in the later stages of dementia who get agitated and need to relax. However, therapists need to think about whether the patients may or may not benefit more from social and movement activities that are familiar, feel purposeful and expend energy. Also, sitting in this room may just put patients to sleep, something they already get plenty of in an institutional setting.

93 year old mom helps little old lady cross the road

I love this "mom" story-
http://otinpublicschools.blogspot.com/2009/02/its-still-christmas-at-my-house.html

Barbara
BarbaraSmithOccupationalTherapist.com

Activities for a Healthy Brain

Will keeping this blog keep my brain healthy? Watch this video about activities to keep your brain young.

Northshore Alzheimer's Partnership Conference

I hope to attend this conference given by Norshore Alzheimer's Partnership in Peabody, Massachusetts on November 7, 2009. I think the lecture about driving and the elderly sounds very interesting. I will be sharing what I learn.....
BarbaraSmithOccupationalTherapist.com