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Thursday, March 31, 2011


Looking Beyond Dementia to Personal Preferences

Every person with dementia is still an individual who has certain tastes, needs, and desires and who will act and react in a different way from others. None of them were raised the same way or had the same life experiences, so they will all respond to any given circumstance based on their own personal history. One common example of this is "Frank," who always arose early every morning of his adult life to tend to farm chores. His internal alarm clock may still be working, and he still awakens every morning around 5 a.m. You should arrange your work schedule so that you can easily accommodate Frank’s desire to get up early. On the other hand, "George" likes to sleep in until at least 7:30 a.m. If you continually attempt to get George up and into the dining room by 7 a.m., you will probably have a very unhappy resident on your hands, and it will affect whether or not he eats his breakfast. Again, can you arrange your schedule so George is the very last person you get out of bed before breakfast? One area in which individuality is often most apparent is during activities. Not everyone likes to play Bingo, so you should not attempt to convince them to join in that activity if they tell you they don’t care to play Bingo. You should know your residents’ likes and dislikes, and modify their favorite activities so they can still enjoy them in the facility. If Annie loved to sew, there are many modified ways she can still do that, or at the very least, can she sort a jar of buttons for you? The dining room is another place where individual preferences must be honored. If June can’t stand meatloaf and mashed potatoes, then ask her if she would like a sandwich instead. A refusal to eat a meal because a resident doesn’t care for that type of food should always be taken seriously and a replacement should be offered. You cannot tell yourself that you’re “spoiling” them by allowing them to refuse certain foods because they will probably not recall this conversation by the next mealtime. All they know is that they don’t care for the food offered, and some really nice person is asking them if they would like a sandwich instead. Remember, they cannot necessarily tell you they don’t like a particular food and would prefer something else — that’s why you should always make an alternative suggestion when they refuse a particular food. The goal is to get them to eat and not lose weight, so your goal would be accomplished by honoring their wishes. Remember too, that when presented with too many choices, a person with dementia will be unable to decide. A great example of that is in the dining room. If your food arrives in the dining room on carts and trays, and you put down an entire tray full of food in front of most people with dementia, the sheer number of choices will render them incapable of deciding, and thus, not eating anything. That is why you should present them with only one food item at a time. “Do you want cake or pie?” is an appropriate choice but only if they are able to answer you. If their dementia has progressed to the point where they really cannot make even that simple decision, then there is no need to ask. In the early stages of the disease, different types of dementia will present with different behaviors and symptoms. As the dementia progresses, the behaviors will begin to be pretty much the same. To learn more about customizing care to meet the specific ramifications of the type of dementia, consider the Master Key for Dementia Training, Love, Laughter & Mayhem in Eldercare Facilities.

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Tuesday, March 08, 2011



An article in Medical News Today seems hopeful to me that we may some day in the near future have a vaccine that will not only protect against stroke damage in the brain, but also against the cognitive damage in Alzheimer's disease. Researchers at Tel Aviv University's Department of Neurobiology at the George S. Wise Faculty of Life Sciences are currently testing this nasally delivered vaccine on mice with no signs of toxicity. Apparently the drug in the vaccine stimulates the immune system to gear up to fight against vascular damage in the brain by activating large numbers of macrophages, which are a natural mechanism to clean up any damage (in this case, the amyloid proteins in the brain) detected. Promising results in these animal models has shown that this action by the macrophages can help prevent further damage in the brain.
As I always caution, it's a HUGE step from mice to men in the testing for new drugs, but I still think this is very hopeful news.
Dr. Dan Frenkel is the lead researcher, along with students Veronica Lifshitz, Ronen Weiss and Tali Benromano. They also worked with MRI specialist Prof. Yaniv Assaf and his student Tamar Blumenfeld-Katzir of Tel Aviv University's Dept. of Neurobiology. The article URL is found at http://www.medicalnewstoday.com/articles/217776.php


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Cindy Keith, RN, BS,
Certified Dementia Practitioner

Nationally Known Speaker
On Dementia and Alzheimer's Care

Phone 814-235-0691

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