Sleep Issues and Sundowning

Hello Volunteers,

For July we will focus on the topic of sleep disturbances and sundowning.  Sundowning is an increase in behavioral problems that begin at dusk and last into the night.  At Seasons we often see these concerns which greatly affect the participant and their caregiver.  Hope this information is helpful.  As always we so appreciate you and your efforts at Seasons, we couldn’t do it with out you! 

What causes Sundowning?

Scientists don't completely understand why sleep disturbances occur with Alzheimer's disease and dementia. As with changes in memory and behavior, sleep changes somehow result from the impact of Alzheimer's on the brain.

Some studies indicate as many as 20 percent of persons with Alzheimer's will experience increased confusion, anxiety and agitation beginning late in the day. Others may experience changes in their sleep schedule and restlessness during the night. This disruption in the body's sleep-wake cycle can lead to more behavioral problems.

Factors that may contribute to sundowning and sleep disturbances include:

·       End-of-day exhaustion (both mental and physical)

·       An upset in the "internal body clock," causing a biological mix-up between day and night

·       Reduced lighting and increased shadows causing people with Alzheimer's to misinterpret what they see, and become confused and afraid

·       Reactions to nonverbal cues of frustration from caregivers who are exhausted from their day

·       Disorientation due to the inability to separate dreams from reality when sleeping

·       Less need for sleep, which is common among older adults

How to Help?

·        Approach him or her in a calm manner.

·        Find out if there is something he or she needs.

·        Gently remind him or her of the time.

·        Avoid arguing

·        Offer reassurance that everything is all right.

·        Don't use physical restraint. If the person needs to pace, allow this to continue under your supervision.

·        Keep the home well lit in the evening.
Adequate lighting may reduce the agitation that occurs when surroundings are dark or unfamiliar.

·        Maintain a schedule.
As much as possible, encourage the person with dementia to adhere to a regular routine of meals, waking up and going to bed. This will allow for more restful sleep at night.

·        Avoid stimulants and big dinners.

·        Plan more active days.
A person who rests most of the day is likely to be awake at night. Discourage afternoon napping and plan more challenging activities such as doctor appointments, trips and bathing in the morning or early afternoon. Encourage regular daily exercise, but no later than four hours before bedtime

·        Try to identify triggers.

·        Be mindful of your own mental and physical exhaustion.
If you are feeling stressed by the late afternoon, the person may pick up on it and become agitated or confused.

Renee Pope, CTRS

Activity Coordinator

Seasons Adult Day Health Services

(989) 633-3734

Sara's June Blog

Psalm 143:8
New International Version (NIV)
8 Let the morning bring me word of your unfailing love,
for I have put my trust in you.
Show me the way I should go,
for to you I entrust my life.

Genesis 28:15
New International Version (NIV)   
15  I am with you and will watch over you wherever you go, and I will bring you back to this land. I will not leave you until I have done what I have promised you.”

I am so sorry I have not been able to submit my blogs because I killed my computer.  My son-in-law was able to provide this one for me, but it has been a process, as this computer is an 8.0 and is much more advanced. I am slow at some of the processes like facebook, email, etc.

When I first lost my computer, I felt bad because I felt I lost my connection to people and my ability to communicate and it was frustrating, it made me angry, and tense.  But a blessing came right away because I was able to rest and not worry about keeping up with on-line communications. This is one of the hardest things with this disease, is loosing the ability to share my thoughts with others.

June has been a full month with three showers and weddings. I remain active at Seasons tending the plants, help at New Hope working with Rumi and with the Alzheimer's Association.

I assisted at a booth at the Saginaw Senior Services Center one Friday in June.  It turned out to be a great day of activities and bringing community awareness.  My part was to share about New Hope Valley, where people would be able to live a higher quality of life.

On June 20th, I was invited to attend a conference held at St. Mary's of Michigan in,  "Special Grand Rounds, Dementia and Alzheimer's Disease", featuring Dr. E. Malcolm Field and Dr. Elliott Mufson.  I enjoyed sharing with people at the buffet and made the comment, that "I am still alive, and not ready to give up my brain to science yet", and they all laughed. Later, during a question and answer period I was able to share my blog address with a few and especially one woman who was concerned for her family and friends who were showing some of the signs of Alzheimer's.  It made me feel so good to be able to give her some comfort.  Although this event was held in the evening, which is not a good time for me, I felt full of energy and revived by being able to help this one.

My friend Terr is here helping me write this and you must realize that neither of us are familiar with the 8.0 but are learning and laughing together.

Today my husband Butch and I are having lunch with his daughter Garlynn and her daughters Jessica and Cali.

This weekend we have our last wedding and then on Monday I will be going with mom to the Retired Nurses Luncheon in Bay City and I have a meeting that evening.  I am hoping I can keep on going with this. 

A good reminder for all of us is, "WE DO NEED TO HAVE REST".  

 Suspicion, Delusions and Alzheimer's

 This month’s Volunteer Training Tip will focus on suspicion and delusions that can be experienced with people with Alzheimer’s and Dementia.  It is important to know not all people with Alzheimer’s will experience these symptoms but it can be common.  Remember, our coin phrase at Seasons is “If you have seen one person with Alzheimer’s disease, you have seen only one person with Alzheimer’s Disease.”  No two people are identical nor will their disease progress the same way!

A person with Alzheimer's may become suspicious of those around them, even accusing others of theft, infidelity or other improper behavior. While accusations can be hurtful, remember that the disease is causing these behaviors and try not to take offense.

How to respond

·       Listen to what is troubling the person, and try to understand that reality. Then be reassuring, and let the person know you care.

·       Don't argue.

·       Don’t try to convince or reason.

·       Allow the individual to express ideas. Acknowledge his or her opinions.

·       Offer a simple answer.

·       Share your thoughts with the individual, but keep it simple. Don't overwhelm the person with lengthy explanations or reasons.

·       Switch the focus to another activity.

·       Engage the individual in an activity, or ask for help with a chore.

·       Duplicate any lost items.

·       If the person is often searching for a specific item, have several available. For example, if the individual is always looking for his or her wallet, purchase two of the same kind.

·       Share your experience with others.

·       Don't take it personally  J

Thank you for all that you do!

Renee Pope, CTRS

Activity Coordinator

Seasons Adult Day Health Services

(989) 633-3734

My Days of the Month in March

Psalm 23

The Lord the Shepherd of His People

23 The Lord is my shepherd;
I shall not want.
² He makes me to lie down in green pastures;
He leads me beside the still waters.
³ He restores my soul;
He leads me in the paths of righteousness
For His name’s sake.

⁴ Yea, though I walk through the valley of the shadow of death,
I will fear no evil;
For You are with me;
Your rod and Your staff, they comfort me.

⁵ You prepare a table before me in the presence of my enemies;
You anoint my head with oil;
My cup runs over.
⁶ Surely goodness and mercy shall follow me
All the days of my life;
And I will dwell^[a] in the house of the Lord
Forever.

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1.  Went to eye Dr. and found I have cataracts that will need to be rechecked in 6 months and then decide if they need to be removed.

3.   Penny had to take mom to the hospital and I was there, after she had some tests they gave her medication and sent her home.

4.   The next day she took a turn for the worse and we had to call 911. She came home after 4 days and her health improved slowly. My sister Penny stayed with mom for a week and half and we continue to check up on her. We are grateful she is getting better and better and can get out again.

5.   Visited Meadows Manor in Saginaw, MI. I met with the support staff and family caregivers to share what it is like to have Alzheimer’s Disease. 

8.   Met with Jeanne Schaller a very good friend who lives in Midland.  She is very focused on peacemaking and justice. Jeanne was in Saginaw caring for her grandchild and then at 4:00 Jeanne met me at New Hope together.

9.   Met with our family at Olive Garden.  We went at 4:00 pm and waited one hour to get a table. The food was great though.

12. Laura Ruhle asked me to share at an Alzheimer’s Support Group at Meadows Manor in Saginaw. This is a beautiful facility.

13. I took my mother to Senior Services in Midland for a pedicure.

15. The day after our Anniversary-we took our Anniversary road trip!  Butch and I believed that our Marriage was on March 16, 1984 because Butch picked up the Marriage Certificate that day.           Butch’s daughter, Garlynn and my sister Penny told us we were off by a day and I had to later step up and say, “you were right” (we were married on March 15, the Ides of March).

16. My sister called me this morning to tell me that ABC news does weird things with some follow-up posts. Anyway, if you saw my post from yesterday about my TV interview, take a look at the same link because they've expanded the interview to include a conversation with me and my experience with Alzheimer's Disease. Penny said I did a great job. The actual interview was shown later on the news. They remarked that I was 67 years old(ha ha). I am actually 69, shhhhhhhh.

http://www.abc12.com/story/21724414/1-in-3-seniors-dies-with-alzheimers-or-another-dementia

18. This was my first evening FA meeting this winter which I could attend since there was enough light of day. It was snowing harder and harder by the time I got there and I chose to leave early to go back home.

20. Went to the Health Fair at SVSU and talked with people.  I shared at the Alzheimer’s booth and then s

kipped over to the New Hope Valley booth and shared with them.

23. Planned to meet my sister Claire in Whittemore to celebrate her birthday at lunch but she got sick the night before.  But we decided to pick up my mother’s best friend Verlyn  who lives in an assisted living facility known as Stonecrest in Freeland. We took her to lunch at Harvey’s in Saginaw and had so much laughter.

25. Went to my evening FA meeting and was able to stay the entire meeting, because there was enough light.

26. Terri came to my home to work on the blog and then we left to go out for lunch.  Mmm!

27. Plan to go to my regular FA morning meeting.  I sat down and stayed.  It was great!

28.  Planning to go the Maundy Thursday services at my church, the Community of Christ in Midland at 6:00 pm.

29.  Penny and Mom the Good Friday services at my church  1:00pm. 

30.  My Sister Claire was sick last week and now she is felling good.  Now with Mon, Penny and I,will go to lunch and connect  in Standish  with Claire and Shawn “son”.   We had good time. 

31.  Easter Sunday.  This morning I opened my car, got in, turned on the key, started the car ,backed out oft

he garage, got on the road and I am going to my Mom and Penny’s Church.  Mom didn’t know I was 

coming and when she saw me, her face was smiling.                  

For God so loved the world that He gave His only begotten Son, that whosoever believeth in Him shall not 

perish but have everlasting life.  John 3:16.  

                                               

Coming in to April……….one year ago this month, I first received an email from Rumi,  I  remembered that New Hope Valley came out of ground and now you need to see the inside of the building and meet the people working and living here.     Many things have happened since April 2012—2013! 

Using Validation to Manage Difficult Behaviors

Hello Seasons Volunteers,

It’s time for the monthly volunteer training tip! This month, I will be discussing validation therapy, a popular form of conversation among persons with Alzheimer’s disease and related dementias. The idea behind validation therapy is to “validate” or accept the values and beliefs of the individual with dementia. The key is to “agree” with what the individual wants by using conversation and redirection. 

Often times, direct confrontation among individuals with Alzheimer’s disease and related dementias can cause increased anxiety or agitation. Validation therapy has a high success rate because it is using a non-confrontational approach.

Take a look at the example below…

                                                

Chuck: "I have to find my car keys."

Me: "Your car keys..."

(Don’t tell him he doesn't have a car and he hasn't driven for years)

Chuck: "Yes, I need to get home - lots of work to do, you know!"

Me: "You are busy today?"

(Don’t tell him he is at an adult day center and isn't going home for hours)

Chuck: "Heck, yes. I'm busy every day, girlee."

Me: "You like being busy?"

(Try to find a topic of conversation that he might accept discussing)

Chuck: "What planet do you live on? I didn't say I LIKED it. I just have to work - like most of the rest of the world, ya know?"

(He's getting a little frustrated, but seems to have forgotten the keys.)

Me: "I know about work, Chuck. I do some of that myself. In fact, I'm getting ready to fix some lunch for us. Care to join me?"

Chuck: "Lunch, huh? What are we having?"

Renee Pope, CTRS

Activity Coordinator

Seasons Adult Day Health Services

(989) 633-3734

My Time in February

Your word is a lamp for my feet, a light on my path. Psalm 119:105

Jesus answered, “If I want him to remain alive until I return, what is that to you? You must follow me.” John 21:22.

New International Version (NIV)

In my daily devotional, “Jesus Calling” written by Sarah Vaughn, for the day February 29^th (although we don’t have a Feb.29^th this year), this meditation was meant for me to read. Excerpts remind me, I’m on the right path, to listen more to Jesus, and less to my doubts, that He is leading me along the way He designed for me; it will be lonely humanly speaking. But it goes on to remind, that He goes before me as well as alongside me and that I am never alone. It further reminds me that God is revealing my path of life day by day and moment to moment.  Jesus says to me, “Follow Me”.

So today, in looking back over February and remembering what God told me three days after my diagnosis, He said, “You are alive, you have things to do, and Let’s go. So, I will follow Him.

4^th      Nursing Breakfast

We met to discuss the Benefit Pension Plan under scrutiny that I mentioned in January. We discussed at great length, but I am trusting God for the best outcome. The breakfast was great, visiting and sharing our stories was fun. Laughter,laughter, laughter in spite of the problems.

5^th      Lunch with Garlynn (my step daughter) and when we sat down, then the words did not stop.  She told me about Cali, my granddaughter, a 16 yr old Junior who is Awesome.

The International Brain Bee is a neuroscience competition for secondary students. Students compete locally, feeding into national and then international competition. Cali placed first in the regional competition and is heading to Baltimore, MD, in March, to compete in the National Competition.   When she goes to Baltimore she wants to look around the Johns Hopkins University. Today, they go to Baltimore and she needs a lot of prayers, but also has other upcoming competitions and exams coming up that I’ll share with you next month.

                    

6^th     Because I am a food addict, I go to a weekly meeting. Normally I have meetings on Wed at 10:00-11:30 and so I go to Harvey’s and have lunch with a friend afterward and then on to New Hope Valley. I like to connect with the residents there and I meet the new people and sometimes walk with them and listen to their stories.

Also on this day, was the first meeting of the month for the Alzheimer’s Support Group that I went to afterward in Freeland.  My mother and sister came also and we had a great day.  It was a full, wonderful and exciting day, but after I got home, I needed to rest.

13^th    We had an Advisory Council meeting at New Hope Valley. It focused on how we could better share information with residents, for instance using Skype to communicate with families, including bringing that technology to all resident’s rooms including those who are bedridden.

15^th  I went to Senior Services to take care of the plants.  Butch and I went to New Hope to pick up Alzheimers  information and then to lunch at Harvey’s. We then went to find were I will be speaking at

20^th   I was at a Saginaw for Meeting 10:00-11:30, which was a new Training Day at  New Hope Valley, for new  Employees and the those who are working now. I never know what awaits me when I go and its wonderful.

23^rd    This day involved my friend Fernanda of Brazil.  To raise funds to get her a ticket to come to the U.S, we had a Spaghetti supper in Caro, with Josie and her husband. Josie attends the Caro church and started the effort.  It was held Saturday at 5:00; then at 6:30, three of us shared our experiences of our recent trip to Brazil.

25^th   On this day, I spoke at Meadow View Manor in Saginaw about:  Speaking Out, Not Giving Up, and Living the Rest of our Lives.  I also spoke to the caregivers, teaching,  “We have Alzheimer’s disease, but it is not who we are”. 

28^th I met with Jeanne Schaller and Marge Darger who are the two who started a program, that I cannot remember right now, but I do remember it was about a 10 year program re: Peace and Justice the love, the caring, and the children of our future. I suggested putting together an essay contest for kids interested in Peace and Justice which we’ll pursue.

We are in a leap year, so we’ll be seeing you in March.

I am so glad to be here and love all of you so much.

  Let Us Remember God Is With Us,  All The Time

John 14:1-2

New International Version (NIV)
Jesus Comforts His Disciples
“Do not let your hearts be troubled. You believe in God believe also in me. My Father’s house has many rooms; if that were not so, would I have told you that I am going there to prepare a place for you?
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Hi, to you!  I

 love you all.  Please forgive me for not calling , talking, remembering, even the church!  My family, my friends, and everyone that reads my Blog, I thank you.  Alzheimer’s is slowing me down.  I will keep sharing what I can, driving (not at night), walk, talk, the best is Laughter.  Butch has been helping me with letters, here and there, now I am slowing down.  I often have to call out to him, “ Butch, how do I spell the word laughter and I know lauter is not right and he tells me where to put the letters, and I need to remember to say, thank you Butch.

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6th     Through the month have had many ups and down.   Of course, people are dealing with Flu and other illnesses, meetings, eating out, dancing, sports, working and being with our families and friends.

And my Mom was sick, Penny called at 6 am to tell me that mom has to go to the hospital. Mom is on the 5^th floor, thankfully having an elevator because Penny had to hold on to mom to help her walk.   When they got downstairs, Penny called for 911 and they got there fast.

Now, I was out of bed, clothes on, Penny called she was on the way and wanted to meet at the hospital.  When I got there mom was on the bed.  They took her up to the 5^th floor.  (Shhh, don’t tell anyone that I turned the wrong way going to see mom.) So I got a little lost, but I found her and we all laughed.

The worst time came at the hospital when Mom took a nap before her dinner came:  The food came and I said to mom, “ your food is here”, she did not respond.  I kept speaking and Penny called to tell the nurse what was happening.  She did not wake up for about an hour.  Penny and I were scared. Mom went home on the 4^th day!

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7^th.   What a great day at New Hope Valley in Saginaw, Michigan. New Hope is a new assisted living facility on Center Road that had its grand opening ribbon cutting ceremony. There were so many people. Rumi Shahzad, managing director at New Hope Partners LLC was welcomed by the Saginaw Chamber of Commerce, supporters and partners at this ceremony.  The 45 bed, 27,000 square feet facility is beautiful and is now open and accepting residents. I was blessed to be a part of this ribbon cutting event along with Saginaw’s chamber president, Bob Van Deventer, commerce ambassador chair, Amy Buben and Timothy Brawn, Saginaw Township supervisor. There was food, music, tours, laughter, joy, love, excitement and appreciation.

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11th    Subject:  Memory Care training for New Hope Assisted Living Facility employing the Montessori Method. Tom and Karen Brenner led this training for memory care needs.  I am forwarding a link to their website that provides more color on their approach.
http://www.brennerpathways.org/about/

We had a phenomenal response for jobs with over 1,000 applicants.  Our first 17 employees are on board and now we are structuring various training programs for them to equip them with the right tools to support the residents. I was really glad to be a part of this training.  There was much to learn, but I listened.  In April they will return and bring additional information to help us to take care of the residents.
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Alzheimer’s Disease” by the Field Neurosciences Institute and the Alzheimer’s Association about 17^th- I attended a conference, “New Insights from Research on the Causes and Potential Treatments of research being done in Saginaw and Mt. Pleasant conducted at the FNI labs, CMU and SVSU together with St. Mary’s of Michigan. The presenters were almost all doctors and many people there wanted to know how the research would help them. I am so happy that somebody invited me and it was a great night.  There were many people there and lots of questions and answers.

28^th   On a News  Channel  11,

Monday morning, McClaren Bay Region retirees, of which I am and was apart of, came together to find out why they were overpaid on their pensions, and would have to pay back the money.
70 employees were underpaid on their pensions, while 213 were overpaid a total of about $832,000.
see their monthly pension checks reduced. Katherine Lattimore of Saginaw has to pay back $11,000.

These sentences were quoted by me in the newspaper, “Sara Parkin says her monthly pension check will be cut in half."Actually, it's what it is, we're going to have to do it, we're going to have to do it," she said.  As far as I know, this was an honest mistake and we are told McClaren is working with the IRS which may take at least 12-18 months to forgive the interest on the money we would have to pay back. McClaren may pick up the interest so the people do not have to pay it according to the IRS.
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28^th-Rumi emailed and asked for a bio and picture from me that I will share here too.

Sara Parkin is an activist who campaigns on behalf of those who have been diagnosed with Alzheimer’s  Disease.  She encourages people to e proactive in all aspects of their health, and especially advocates early awareness and diagnosis of all forms of dementia.  She is a Regional Council member of the Alzheimer’s Association Greater Michigan Chapter Central Michigan Region.  As a volunteer of the Alzheimer’s Association, she is a frequent guest speaker at events throughout the region and promotes fundraising for Alzheimer’s research.  Sara views her own diagnosis of Early Stage Alzheimer’s as a blessing because she feels empowered to live her life and focus on helping others with this disease learn how to find the support they need to live with such a diagnosis, too.

31st    I am so happy to share this to you!  The first residents have been coming in, here they are: 9th Fred, 12^th   James,  22nd  Earl and  25^thLorrine.   When you come in to see New Hope Valley say Hi and I know you will be smiling, I will be smiling.

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Proverbs 3:5-6
New International Version (NIV)
Trust in the LORD with all your heart
and lean not on your own understanding;
in all your ways submit to him,
and he will make your paths straight January 1-2013

God is right. I need to stay on the right path, sometimes I get off, but I know He will always be there with me, All the Time, All the Time. God is Good, ALL THE TIME.

I know that most of you know that I receive help with my writings from my friend, Terri.  Terri is a awesome person that I love and care about her.  She will help those in need, she will be there!  Thank you so much!