Dementia friendly activity … plus something yummy to eat!

Looking for a healthy but yummy snack?  Want something easy that you can involve your loved one in preparing?  Need a dementia friendly activity?  Need a way to encourage an appetite? Have fun making these delicious

Chocolate Peanut Butter Oatmeal

No-Bake Cookies

pnut butter choc cookies

Sugar-Free Chocolate Oat Cookies

Yield: 3 dozen

Ingredients

  • 3 cups quick-cooking oats
  • 3/4 cup honey
  • 2/3 cup natural peanut butter, optional
  • 1/2 cup coconut oil
  • 1/3 cup unsweetened cocoa powder
  • 1 1/2 teaspoon vanilla extract
  • 1/4 teaspoon salt

Directions

  1. Line 2 baking sheets with parchment paper.
  2. In a medium saucepan over medium-high heat, combine honey, peanut butter and coconut oil, stirring until everything blends together smoothly.
  3. Stir in oats, cocoa powder, vanilla and salt and mix until everything is fully incorporated and coated.
  4. Use a spoon or small ice cream scoop to drop cookies down onto parchment-lined baking sheets, then place in freezer for at least 15 minutes to set.
  5. Store in an airtight container either in the fridge or freezer (depending on how you like them) and enjoy!

Recipe adapted from 12 Tomatoes http://12tomatoes.com/2015/04/healthy-sugarfree-cookies-nobake-chocolate-oat-cookies.html

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The universal truth

What is the universal truth?

The only people who will deny this truth are the executive officers and board members of health care facilities.

For those of us working in the trenches of health care we will scream this truth at the top of our lungs.  This includes CNAs, nurses, pharmacy workers and doctors. 

Ready for it?

WE ARE MASSIVELY UNDERSTAFFED!!!

Over 90% of all US states have no staff to patient ratio legislation or rules for care facilities.   (By care facilities I am speaking of nursing homes, rehab centers and hospitals.)  The states that do have rules for staffing the numbers are woefully inadequate to provide all the care that is needed.

The CEO’s and bean counters have lost grasp on the idea that we are working to provide care for human beings.  

These people come to us for whatever length of time because they are no longer able to care for themselves.  They need whole person care.  

What do I mean by whole person care?  We as human beings need social interaction, mental stimulus and to feel like we’re part of a community.  We need to feel important, loved and wanted.  When we’re feeling lonely or afraid we need to know that someone will be there to hold our hand.

When deprived of basic human contact other than for bodily function assistance (toileting, feeding and bathing) the human beings who are entrusted into our care will withdraw.  They will become depressed.  They die sooner and in a state of isolation that I wouldn’t wish on my worst enemy.

Health care workers are told to tick off boxes of care.  Did you toilet your charges every 2 hours?  Did your charges eat?  Did they drink?  Did you get them bathed?  Did you get their vitals?  Did they get their meds?  Did you answer all your call lights?  Did you dress them?  Are they in their bed or wheelchair?  Doesn’t sound like too much, hmmm?  Well keep in mind, we aren’t doing this for just one resident.  The average CNA can be responsible for 15 – 50 residents during a shift.  

There’s no tick off box of care asking:  Did you spend 30 minutes with your charge listening to their favorite childhood memories?  Did you hold the hand of your charge who was crying because they miss their now deceased spouse?  Did you manage to calm your charge who was terrified because they don’t know where they were?  How many of your charges were you able to get to smile?  How many laughed out loud?  Did you learn anything new about the wonderful people you’re caring for?

We need changes, the system is broken.  Caps on executive/board salaries and reasonable staff to resident ratios.  

Let us always remember that we are entrusted with caring for fellow human beings.  The ‘Golden Rule’ should be at the forefront of our minds whenever working in health care.  The truth of the matter is that one day we may be the residents.  Do we want the status quo or do we want better?   

Truth, but …

“Caregivers are often the casualties, the hidden victims.  No one sees the sacrifices they make.”  – Judith L. London

 

I read the quote above and my initial reaction was ‘preach it sister’ but then I got to thinking about what that means.

I do not dispute that as a caregiver I often sacrifice of my time, comfort, and heart in the care of my loved one.  So many little things that never get acknowledged.  So many big things that may be ignored.  There are no Oscars for smiling and remaining calm when it all becomes too much and you’d like to scream.  There are no Olympic Gold Medals for physical feats you accomplish each day.  There are no Nobel Peace Prizes for getting a combative sundowning dementia patient to be calm again.  I will never gain local, national or international fame and adoration.

When I start thinking along these lines I become depressed and wonder why in the world did I choose to work in this field?  Am I insane for not going to work in another field where I would find less stressful conditions and certainly greater financial gain?

I choose to look at things differently.  I want to think better of what I am doing. Here’s my quote:

“Caregivers are on the front lines, the hidden heroes.  No one sees the differences they make.” –  Jen L.

I may not be the recipient of any prestigious award.  My loved one may not remember my name.  I may not have a huge income.  

What I DO have is the satisfaction of knowing that I have helped another human being.  I have stepped up and stretched my hand in love and friendship to those who are scared and confused.  I have been the one to offer comfort – for both the body and mind.

I have the satisfaction of knowing that I have made the world a better place for those who can no longer understand it.

So, I refuse to be a victim.  I like the idea of being a hero instead.

90 going on 3 …

90 going on 3 … what does that mean?

There is a fine line for caregivers to take as their loved one’s dementia progresses.  To honor and respect the person  you want to treat them as an adult, capable of making decisions for themselves.  Reality often comes to bite you when you realize their choices aren’t best decisions for their safety and welfare.  You honestly can’t allow them to go out in a snowstorm in shorts and a t-shirt, nor is eating candy for every meal a good option.

So, in reality what 90 going on 3 means is you have an adult (parent, grandparent, spouse …) who because of their disease now has the reasoning capacity of a 3 year old.

How do you continue to honor and respect your loved one, keep them safe, and allow them to have a say in their daily life?

The first thing is to give them simple choices and keep it to a minimum of 2 (maybe 3) options to choose from.  By giving them completely open options you will overwhelm them and will not get a positive outcome.

Pick out clothes that are weather appropriate – grab two tops of different colors and ask which they’d prefer.

Ask them if they’d prefer ham or turkey on their sandwich.  Or if they’d prefer green beans or peas with the meatloaf.

Would they prefer milk or tea?

Would they like to visit a park or a go listen to a concert?

Sometimes when trying to give my grandpa a choice of restaurant I would tell him “We can go to X – they have (a dish he liked at X) or we can go to Y – they have (a dish he liked at Y)”.

If we were going to a restaurant he’d never eaten at (or hadn’t been to in a long time), he would look at the huge menus and couldn’t make heads or tails of it. He would get so overwhelmed that he’d simply order whatever I ordered – even if it wasn’t something he liked.  I would usually take the menu and start by finding the drinks and ask him if he wanted something hot or cold to drink.  We would start there.  Then I would ask him if he was in the mood for fish, poultry or beef.  Then I would help him narrow down the menu to a couple of selections.  Once we got to that point he would be able to make his decision about what he wanted to eat.

Keep these to things that are immediately relevant, they won’t necessarily remember their choices hours later.  (E.g.: They won’t remember in the morning that the night before they wanted to wear a blue shirt.)

Now you are allowing your loved one some control over their daily life AND keeping them safe.  By following this technique you will usually find that there are fewer conflicts.

Words of comfort

I came into my local favorite coffee shop to work on blog posts and do some research for other projects.  I often do this as there are (actually) fewer distractions than at home.  I’m sitting near the self-serve station for sugar and creamer and getting into my writer’s brain when an older gentleman approaches to doctor his coffee.  He greets me and we exchange pleasantries.

When I speak with seniors who make negative comments about how their day is I often say “Well you’re out and about under your own steam, you must be doing pretty well.”  This often gets a smile and change of attitude.  It did for this gentleman.

He came in for some coffee while his wife was getting a massage next door.  We chatted a little more about nothing special but he started struggling for a word and got frustrated. He explained to me that his doctor had put him on a medication that has messed with his short term memory and then said if it became the real thing then he wanted to just die.  He said that he didn’t want to live when he couldn’t remember who he was.

I looked at him and explained that I care for seniors as my profession and specialize in dementia care.  I told him that while it is true you may forget about some of the people in your life that you never completely forget who you are.  It’s always there, at least some of who you are.

I told him about my dad.  Dad was bed bound and completely non-verbal, non-responsive to anything other than stimulus-response.  Still, when I walked into his room and called out his name he would grunt and move his head in the direction of the sound of my voice (the grunt was a typical guy-type grunt of acknowledgement).

I also told this gentleman that Dad had been in the Marine Corps and when I would play a CD with marching cadences Dad’s feet would tap like he was marching.  The gentleman perked up when he heard my dad had been a Marine, he too had been in the Corps.

We joked about the fact that Dad would “march” and how if you’re a Marine you’ll always be a Marine.

I brought up the fact that sometimes I would say something funny and he would giggle.  One time in particular his hospice nurse had brought more bandages for the pressure sore he had on his tailbone.  I told him that I was going to change his butt band-aid – and he giggled.

I told the gentleman that although the disease took much from him and us, it never fully robbed him of the essence of his humanity.  He knew his name, he recognized his service in the Marine Corps and he could still laugh at something funny.

He looked at me with relief on his face and just said “I’m glad I spoke with you.”

I’m glad he did too.

24/7/365

When caring for someone with dementia or any other illness that robs a person of being able to do for themselves you really sign on for a job that’s 24/7/365.

You help with bathing, dressing, grooming as needed.  You make sure meals are prepared and hope they’re well received.  You make sure doctor’s appointments are made and gotten to on time.  You make sure that doctor’s orders for treatments and medications are followed.  You keep your loved one safe from others and often themselves.  You are their protector, shoulder to lean on, and champion.  You give wholly of yourself for their welfare.  Your entire focus is on their needs.  You are their hero.

This is the life of a caregiver.  This is part of the reason I love what I do.  I get to be the hero to the caregiver.  I come along side them and offer them a chance to recharge their batteries.  I step in for a few hours to take some of the burden from their shoulders.  I look them in the eye and say, “I’ve got this, go take some time to be good to yourself.”

For a caregiver to have a few precious hours to take care of themselves is huge.  It is a chance to breathe.  It is a chance to connect with the outside world.  It is an opportunity to decompress from the stresses of life.

So, dear caregiver, here’s hoping you have someone in your life who can say “I’ve got this for a while, go take some time to be good to yourself.”

For those of you who know a caregiver, could you think about coming alongside them?  Even a few hours can make a huge impact on the caregiver’s ability to continue.

Home safety

I have spoken about home safety in the past, but I’d like to bring up a couple of specific things today.

Today more and more seniors choose to remain in their own homes for as long as possible.  There are many good reasons for this, first it can be less expensive than moving into retirement or nursing facilities.  Second, when they are in a familiar environment they are able to feel more comfortable and are less likely to become depressed.

The most important thing to remember when making the decision to age in place is whether the home is physically safe to be in.  I’m not referring to structural issues, although that is also a consideration.  I’m talking about fall risks.

Any items piled around on the floors can cause an elderly person to potentially trip and fall.  Even if they’ve always had that pile of stuff there as we age our depth perception and balance start to fade.  So the pile they’ve always stepped over will one day trip them up.

Making sure that all walk ways are free and clear of all debris and clutter is one step to making the home safer.

Another important potential trip hazard to clear away are throw rugs or area rugs.  Your elderly loved one may not be able to lift their feet properly when walking and get tripped up by the rug.

If there are tears or rips in carpeting or if the transition area between tile or laminate and carpeting isn’t secured down, these need to be repaired or the whole carpet replaced.  Once again, these are tripping points.

A large number of falls in the home happen in the bathroom.  Look into installing grab bars near the toilet and in the shower.  These should be properly mounted in order to safely take the weight of your loved one.

Transfer poles are also helpful.  These floor to ceiling poles offer support for standing.  They are helpful next to the bed and/or next to a favorite chair.

Electric lift chairs are very handy in getting a senior citizen to the point of standing.  They also recline via the electric motor.  There are many different styles both on the decor side of things and how many bells and whistles come with it, many even include heat and massage.

If there are any steps or stairs in the house it is important to make sure there are secure handrails to use.  At no point in time should anything be left on a step, they should always be clear of any clutter.

If climbing a flight of stairs is physically too taxing it may become necessary to convert a room on the main level into a bedroom or invest in one of the stair chair lifts.

In the kitchen, make sure that plates, cups, bowls and other such eating implements are within easy reach.  As we age we loose muscle tone and reaching above our head becomes more difficult.  At the same time our knees and circulatory system won’t accept bending over for more than at most a few moments.

Once everything is as safe as possible in the physical home, it may be helpful to hire a service to come to provide companionship, housekeeping help, meal preparation and assistance running errands.  Depending on the level of independence of your loved one this may only need to be once or twice a week for a couple of hours.   By starting this kind of light assistance early it may help them accept more help if they need additional help with activities of daily living (aka: ADL’s) in the future.

Another good investment of money is for a emergency call button service.  This way if your love one is alone in their home they will have a reliable method to reach out for assistance, especially if they’re unable to reach a phone.