“This is where I had a purpose” – Capt. Montgomery Scott

I have an honest confession for all of you.  I am a sci-fi geek.  I was raised watching the original Star Trek with my dad.  I enjoyed all the characters from the original series, but one in particular was my favorite.  The hard-working miracle worker, Chief Engineer Montgomery Scott (Scotty).  There was something special about him that made me smile.

Many years later when they started The Next Generation I saw they did an homage to the original series by bringing in some of the original cast for guest appearances.  Of those, my favorite was an episode entitled “Relics”.

The crew of the new Enterprise find a crashed Federation ship and go in to investigate.  There they discover that the transporter has been jerry-rigged as a type of life boat for the only survivor, Captain Scott, Retired.

Scotty shows his usual enthusiasm for anything related to engineering and steps in to help Lt. LaForge.  Unfortunately, 75 years have elapsed since the last time Scotty has worked on a warp engine and Scotty isn’t able to be the miracle-worker in engineering.

A dejected Scotty finds himself in the holodeck with a bottle of alien whiskey asking to be shown the bridge of the original Enterprise.

He is soon joined by Captain Picard and as they speak Scotty expresses what he’s feeling.

Scotty: “I don’t belong on your ship.  I belong on this one. (Meaning the holographic ship they’re on) This was my home.  This is where I had a purpose.  But it’s not real.  It’s just a computer generated fantasy. (sighs)  And I’m just an old man who’s trying to hide in it.  Computer, shut this bloody thing off.  It’s time I acted my age.”

He leaves with Picard looking at Scotty with compassion in his eyes.

Later Picard asks LaForge about some data that they needed to acquire from Scotty’s crashed ship.  Picard suggests that Scotty would be helpful in obtaining the information and asks LaForge to personally assist with this task as well.  Picard makes his request with this statement:

“Look, this is not an order.  It’s a request and one that you must feel perfectly free to decline.  You see, one of the most important things in a persons’ life is to feel useful.  Now, Mr. Scott is a Starfleet Officer and I would like him to feel useful again.”

I won’t post any spoilers for those who’ve not seen this but now want to. The upshot is by LaForge engaging Scotty in an area where he’s useful and taking some time to allow himself to be mentored by a more experienced engineer they both gain and grow from the experience.  In the end Scotty is able to show he still deserves the title of ‘Miracle-Worker’.

This episode of Star Trek: The Next Generation demonstrated one of the things I always appreciated about this and the original Star Trek.  The way they took on real life issues in the fantasy world of space travel.

We all need to feel useful.  We all need to feel like our lives have meaning.  We all need a purpose to give us a reason to get up in the morning.

As our loved ones get older and are no longer able to be as independent as they were it is easy for them to become depressed.  We need to acknowledge the impact they’ve made in our lives and in the world.  We need to let them know they still have a purpose in our lives and the world.  Even sharing their stories and things they’ve learned through experience will enrich the community around them.

Engage with the seniors in your family.  Encourage them in the ways they still make a difference and have a purpose.  Tell them how much their presence in your life enriches it.

Change their statement of “This is where I HAD a purpose.” to “This is where I HAVE a purpose”

As an interesting side note, James Doohan who played Scotty, died just over a decade after this episode was filmed.  He died from Alzheimer’s disease.

Advertisements

Caregiver dilemma: I’m scared of doing it wrong

Becoming a caregiver for someone you love can be a wonderful, but terrifying experience.  If you approach the experience with a deep love for your family member and the determination to make sure they are safe, loved and fulfilled as a human being should be then you will be wonderful as a caregiver!integrity

My most terrifying moment as a caregiver was the day we brought Dad back home.  He’d arrived via medical transportation and shortly afterwards I was alone with him for the first time.  I stood there scared beyond everything.

I was completely responsible for Dad’s health and well-being.  I had completed the coursework, testing and clinical experience required by my state to do this work.  I even had the little piece of paper to prove it!

But as I stood by Dad’s bedside that fateful afternoon I was nearly paralyzed with fear.  I was scared that I would do something wrong.  I was worried that I would cause him unnecessary harm with my ineptitude.

I took a deep breath.  I exhaled.  I did it a few more times – just to make sure I could.  I decided to start with the basics of caregiving.

I took Dad’s hand, told him that I was going to do my best for him and that I may have a bit of a learning curve.  I let him know that everything was going to be ok.  I spent several minutes talking to him, holding his hand and comforting him.

In comforting Dad I found that I was also comforted.  In telling him everything would be ok I felt that it would be ok.

I began to relax.  The fear that had frozen me dissipated and I was able to begin providing the personal care Dad needed.

There were times I made some mistakes, those mistakes didn’t make his condition worse.  The mistakes were a part of my learning curve and I did learn from them.  I used these lessons to provide even better care for Dad.

In the end I knew I had done everything I could to honor my father.  I had given him the care he needed.  I had ensured that his final days, weeks and months had been spent surrounded by love.  I do not regret forcing myself through my paralyzing fear – I would do it a thousand times over.

Dementia’s Impact on Fall Risks

The National Council on Aging has many resources to help adults build a foundation for longevity and prevent falls.  Currently, 1 in 3 adults 65+ falls each year.  Fall risks are usually the product of a combination between physical condition and environment; however, individuals with dementia are actually 4-5 times more likely to experience falls than older people without the disease.  There are many different types of brain disease that cause a wide range of physical and mental complications.  Here are a few common ways that dementia increases the risk of a  fall and what to watch for in a loved one with dementia:

Disorientation:  A large part of our stability involves awareness of surroundings, judging distances, knowing where we are and what we can expect from our environment.  When individuals with dementia become disoriented not only can they lose their ability to judge an environment properly, their increase anxiety puts them at greater risk.

Changes in gait and mobility:  As parts of the brain that coordinate our fine and gross motor skills are impacted by dementia, the way we walk and move changes dramatically.  Some types of dementia such as Parkinson’s can have a greater impact on ambulation and coordinating movement.  These changes may occur slowly over time and often a fall will alert family to the extent of the changes.

Changes in vision, hearing, and balance:  Our senses naturally decline with age; however for those with a dementia, the parts of the brain that coordinate our hearing, vision, and balance can be greatly impacted very quickly.  Any one of these senses contributes to our stability as we make our way through our homes and communities.

No memory of present condition/ mobility limits:  The different types of dementia are often associated with a range of difficult behaviors.  These may include yelling, unfiltered speech, repeating questions, refusal of care, etc.  Wandering is quite common in those with dementia as well as a desire to return home for those in a memory care facility.  This behavior uniquely impacts the risk of a fall as individuals can be so focused on getting where they are going that they are not able to take precautions in moving safely.  Increased agitation can compound this situation as well.

Dehydration:  As we age, we naturally feel less thirsty.  This can put seniors at risk for dehydration and range of other complications such as urinary tract infections.  For those with dementia who are not able to remember their needs, this is particularly an issue.  Dizziness or lightheadedness and headache from dehydration can greatly increase the risk of a fall in addition to these other complications.

Difficulty problem solving and adapting to new environments:  Many times families will rely on professional facilities to provide nursing and day-to-day care for a loved one with dementia, especially during the mid to end stages of the disease.  Adapting to these new environments would be difficult for anyone, but especially for those with dementia.  Confusion and an inability to problem solve can increase the risk of a fall as individuals with dementia lose their sense of what is safe or not safe to do in a particular environment.

Hallucinations/ delusions:  Some types of dementia can cause individuals to have hallucinations or delusions.  These types of experiences can erroneously heighten their sense of danger and cause them to behave rashly.   The increased anxiety and false sense of reality can increase the risk of a fall.

Lack of judgement/ inhibition:  The frontal lobe of the brain is the command center, filter and brake pedal for our actions.  It is the rational voice that says, you probably shouldn’t say that or do that action.  When dementia impacts this part of the brain, those filters and brake pedals deteriorate and no longer inhibit individuals with the disease.  This changed judgement and fading access to memory can greatly increase the risk of a fall as the individual may no longer be able to appropriately judge the limits of their environment and body.

If you are a caregiver providing or coordinating care for a loved one with dementia, we understand how complex and emotionally challenging the responsibility can be.  Our well-being has many components.  In fact, our lives are surrounded by a complex web of needs and desires.  When a loved one is diagnosed with a type of dementia, it is common for a spouse or adult children to become the hub of care, managing several categories of needs.  Professional Care Managers are pivotal in assisting families at the hub to simplify, coordinate, and proactively guide the care of a love one.

Side note from the blogger:  This is an article I found from a publication put out for seniors in my community.  The publication is produced by our sheriff’s office and is called S.A.L.T. (Seniors and Law Enforcement Together) Times.  The only notation as to it’s original source is Sound Options.  I would like to give proper credit to the original writer of this article, if anyone can help me find the author I will make sure they’re given credit where credit is due.

 

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.

If your days on Earth were numbered, what would you want to do most?

This question is sometimes talked about, but when push comes to shove what would you really like to do as your time comes to an end?

For most of us it would involve an activity we enjoyed, perhaps where we felt the most peaceful within ourselves and with the world.

This Vietnam vet requested to do just that … he wanted to go fishing one last time.   I’m sure it took some inventive thinking and extra effort on the part of this man’s family, friends and caregivers but they made sure it happened for him.

Why?  Why do this?  Simply for this reason: make every moment count.  Take every day you have whether 1 or 100,000 or 1 million and find joy in the living of that day.

Gone Fishin’

Big Pharma Vs Patient needs

We’ve seen this over and over again, patients being prescribed medications because the doctors are being encouraged by the pharmaceutical companies to prescribe.  Right now it’s some of our most vulnerable who are being prescribed medications that may or may not be safe for them.  PBA (pseudobulbar affect) is a real condition, but is rare and usually affects those with MS or ALS (Lou Gehrig’s disease) but a surprisingly large number of dementia patients in nursing care facilities are being prescribed this medication often without the knowledge of their medical power of attorney.

It is being used as a behavior modification medication.  There hasn’t been sufficient studies to determine if this medication is; a) safe for use in dementia patients, b) actually works across the board as an effective treatment for behavioral outbursts or c) drug interactions with other medications typically prescribed for dementia.

This article goes into quite a bit of detail about the disturbing practices of the drug’s manufacturer, prescribing physicians receiving kickbacks for prescribing it and the fact that a medication designed to treat a rare condition specifically related to completely different diseases there are a large number of patients (especially in nursing facilities) being dosed with it.  Read here.