Recently we learned a bit in class about what causes Dementia and Alzheimer’s Disease (AD) and also how to interact with these patients. Although we really just touched on the complexity of this disease, it was enough to make me realize that I had it all wrong, and I’m probably not the only one. AD seems to defy logic in the way that it takes the most recent events of life and virtually erases them, then replaces that space with false recollections or worse yet, simply nothing. Then to add to the mystery, old memories suddenly become crystal clear and confuse the sufferer as they try to deal with current reality. As if that wasn’t bad enough AD also affects the ability to think clearly, and changes the normal behavior of that person.
I’ve had the great disappointment to experience AD first-hand with my own mother. Looking through the common progression of symptoms, I relive the slow deterioration that I have watched my mother suffer throughout her years. I don’t think my siblings and I wanted to believe it was anything more than aging - her forgetfulness, her difficulty with words, her odd behaviors. We were quick to dismiss her limitations and simply do things for her, finish her sentence or shrug off her actions. But time told the truth as she became worse and worse and we couldn’t dismiss or ignore her symptoms anymore. As a family we didn’t know how to handle what was happening to her. What we wanted for her - to be safe, happy and content in her later years, was no longer something any or all of us could give her. It was with heavy hearts that we helped her choose her assisted living home so that she could get proper care.
Our frequent visits and phone calls are now quickly forgotten each day, like a computer memory wiped clean at the end of each shift. We mistakenly reminded her, insisting on disagreeing with her as she tells us that no one came or called. It was too hard to agree with her, as if we were allowing her to believe we didn’t care anymore. We wanted, needed to her to remember that we were there, that we cared. But each day is now for her, an empty, lonely day of old memories and confusion. I’ve lost count of how many times she has asked me to take her back home. I’m so sorry now that I told her that she was home already. That place is not home in her memory, only a strange place where she awakens every morning to staff that reintroduce themselves to her daily. There is a link in my title that tells you what you should say and do in situations like this.
There are no words to explain the sadness I feel when I call her and her silence tells me that she really doesn’t know who I am anymore. I talk to the shell of my mother, but I have said goodbye to her spirit a long time ago. Now we both just wait for God to take her home so that she can be happy again...
Thursday, June 23, 2011
Home Sweet Home
I have been at a SNF this summer working with a wonderful lady. She is working hard to be able to go to her home that she shares with her adult son. There are many cliches about home, such as: There's no place like home. Home is where the heart is. Home is where you hang your hat. A man's home is his castle. Until the cows come home. You can never go home again. You can always go home. It's nothing to write home about.
Home is where I want to be. When I am on vacation having a great time, I look forward to go home when the vacation is over. When I turn into the driveway, I get a feeling of peace. After I have been in school all week, I don't want to go anywhere on the weekend because I have not been home all week. I love being home.
Of course, I am sure all the residents in a SNF would like to be healthy enough to live at home. That is why I try to treat them the way I would want to be treated and the way I want someone to treat my parents. If at all possible, I want to care of my parents myself so they will not have to leave their home. Like I have said before, this is the reason I want to become a COTA.
Since I love being home, I cannot imagine being in a SNF, or any other facility, and know that I may never get to go home. I want to age in place. I attached a link containing 10 FAQ's about aging in place. It explains what this is and where to find resources that can help you age in place.
I have already instructed my husband to never put me in a SNF or anywhere else. I want to live out my life at home (being able to take care of myself) until God calls me to my eternal home in heaven! I hope every one of my classmates will be fortunate enough to live healthy, long lives!
Home is where I want to be. When I am on vacation having a great time, I look forward to go home when the vacation is over. When I turn into the driveway, I get a feeling of peace. After I have been in school all week, I don't want to go anywhere on the weekend because I have not been home all week. I love being home.
Of course, I am sure all the residents in a SNF would like to be healthy enough to live at home. That is why I try to treat them the way I would want to be treated and the way I want someone to treat my parents. If at all possible, I want to care of my parents myself so they will not have to leave their home. Like I have said before, this is the reason I want to become a COTA.
Since I love being home, I cannot imagine being in a SNF, or any other facility, and know that I may never get to go home. I want to age in place. I attached a link containing 10 FAQ's about aging in place. It explains what this is and where to find resources that can help you age in place.
I have already instructed my husband to never put me in a SNF or anywhere else. I want to live out my life at home (being able to take care of myself) until God calls me to my eternal home in heaven! I hope every one of my classmates will be fortunate enough to live healthy, long lives!
"Grandpa"
I recently met a wonderful, 88 year old man, who asked to be called "Grandpa". He came down to NC to visit his daughter and her family and never left. He was born and raised in Iowa, and worked on the family farm all of his life. He retired a number of years ago from farming daily, but never walked completely away from it. He built a huge garden at his daughter's house, and spends most of his time tending to it. He enjoys hanging out with his grandchildren, and "pretends" to need their help with his hobby!
Grandpa is a lively and animated story teller, so much laughter was shared as he told stories from his past, and much to the dismay of some in attendance, from the present as well. Grandpa claims that while his mind is still "sharp as a tack", he feels a "twinge of Art" in his hands. He calls on the grand kids to help out when he fakes his "excruciating pain". They are always willing to help out, as they have yet to find out about his exaggerations.
I was struck by a number of things as we listened to the stories, but the most beautiful thing was watching the family dynamics at work here among three generations. Clearly this family has had their fare share of ups-and-downs, struggles along the way, as well as hardships, but the love and support is clearly evident and working well. There is a deep-rooted respect and kindness among the members of this extended family, and all appear to be reaping the benefits of this.
I left our visit with a sense of wonder. I never knew either of my grandfather's, as they both passed away before I was born. I wonder if they would have been like Grandpa. He welcomed us into their home that night and talked and laughed with us, just as easily as could be. He gave me some of the most delicious tomatoes I have ever had, and the cucumbers were out of this world. He said he does something to the soil to grow them that good, but could not give up the recipe!!!!
As we continue on our FW this summer, I am reminded that the geriatric population has so much to share. Their lives tell tales that I hope we all get to hear about. I realize that while Grandpa is fortunate to still be active and feeling well, we do not often see this side of the folks at our FW site. We, as OTA students, have the opportunity to sit and talk with most of our patients. While we can provide dignities and activities to work on engagement, function, and meaning, I feel that we are on the receiving end of something even a bit bigger. We have the opportunity to listen and learn from a population that has a wealth of info. to share. We have the capacity to impact those we serve, and they have the ability to impact us as students for a very long time. The geriatric population has lived, loved, and survived much!
I am looking forward to another visit with Grandpa soon. I can't wait to hear more about his antics and to get another basket of garden goodies!!!
I have included a link which talks about the positive impact grandparents have on their granchildren. I think it is worth the read!
Grandpa is a lively and animated story teller, so much laughter was shared as he told stories from his past, and much to the dismay of some in attendance, from the present as well. Grandpa claims that while his mind is still "sharp as a tack", he feels a "twinge of Art" in his hands. He calls on the grand kids to help out when he fakes his "excruciating pain". They are always willing to help out, as they have yet to find out about his exaggerations.
I was struck by a number of things as we listened to the stories, but the most beautiful thing was watching the family dynamics at work here among three generations. Clearly this family has had their fare share of ups-and-downs, struggles along the way, as well as hardships, but the love and support is clearly evident and working well. There is a deep-rooted respect and kindness among the members of this extended family, and all appear to be reaping the benefits of this.
I left our visit with a sense of wonder. I never knew either of my grandfather's, as they both passed away before I was born. I wonder if they would have been like Grandpa. He welcomed us into their home that night and talked and laughed with us, just as easily as could be. He gave me some of the most delicious tomatoes I have ever had, and the cucumbers were out of this world. He said he does something to the soil to grow them that good, but could not give up the recipe!!!!
As we continue on our FW this summer, I am reminded that the geriatric population has so much to share. Their lives tell tales that I hope we all get to hear about. I realize that while Grandpa is fortunate to still be active and feeling well, we do not often see this side of the folks at our FW site. We, as OTA students, have the opportunity to sit and talk with most of our patients. While we can provide dignities and activities to work on engagement, function, and meaning, I feel that we are on the receiving end of something even a bit bigger. We have the opportunity to listen and learn from a population that has a wealth of info. to share. We have the capacity to impact those we serve, and they have the ability to impact us as students for a very long time. The geriatric population has lived, loved, and survived much!
I am looking forward to another visit with Grandpa soon. I can't wait to hear more about his antics and to get another basket of garden goodies!!!
I have included a link which talks about the positive impact grandparents have on their granchildren. I think it is worth the read!
Sunday, June 19, 2011
Senior Center
I visited the Robert & Pearl Seymour Senior Center a few weeks ago & was very impressed by the layout & how friendly & warm it was there. We went early in the morning & only about 15 people were there - playing table tennis & taekwondo. When we left 1 1/2 hrs later, there were about 50 people there.
They provide so many activities & programs (too many to name them all) - ie fitness, crafts, weekly movies, support groups, interests groups, aging transition support, foot care, even day trips & getaways. There's even an 11 day trip to France! Wow, I want to go!!! I've enclosed a link in the title for the senior centers website. Click on the Senior Times link, and it provides more information, along with all the programs & classes available.
Therapy room
FW's therapy room really frustrates me. There are two rooms that PT, OT, and Speech share and when we all have patients in there, we are tripping over each other. I'm surprised that there has not been a collision of patients! We have equipment, kitchen stuff, mats, balls and parallel bars, and just the other week they added a television and a Wii! Talk about whole lot of stuff in a little space! How are we going to play with the Wii? Is this type of setup really effective and fair to the patients? It feels like everyone is invading your personal space. Even the therapists do not have their own space, even to write notes. The therapy room definitely does not promote health and wellness. The area needs feng shui. Some examples of how to feng shui your treatment area is at this link http://www.feng-shui-vibes.com/feng-shui-health.html
I know that nothing is perfect and we cannot get everything or in this case space that we want. Who knows, maybe the facility has grown so much that therapy has outgrown their space. I was told that the company is renovating, and that speech will be getting their own therapy room. I am not sure if I have the answers about space but as therapists we do the best that we can with the space that we have and the amount of people that we have to share it with.
I know that nothing is perfect and we cannot get everything or in this case space that we want. Who knows, maybe the facility has grown so much that therapy has outgrown their space. I was told that the company is renovating, and that speech will be getting their own therapy room. I am not sure if I have the answers about space but as therapists we do the best that we can with the space that we have and the amount of people that we have to share it with.
The thin line
My patient for this semester's fieldwork is in the locked portion of the nursing home. He was exposed to agent orange and now has cognitive impairments and progressive dementia. I have worked with him for a couple of weeks now and getting to know him I have discovered that his cognitive level is higher than what I imagined. He understands what I say and responds but it is difficult to understand what he is saying because of his stuttering and aphasia. It was really difficult for me last week when after my therapy session with him, I took him back to his lounge in his unit and left him watching TV. A few minutes later as I was filling out paper work he came wondering out into the courtyard and tried to get into both doors that led into the unlocked portion of the nursing home. I took him back to his room but once again a few minutes later he came wondering back out again. I went out to him again and asked him why he didn't want to stay in his unit and he told me because he was bored. I can't imagine being in a locked unit all day with nothing really to do except wonder the halls and go into a small courtyard. It must be really hard for him because he is just over that cognitive threshold were he understands what is going on but is getting progressively worse in his condition. So I wonder, is this the right kind of environment for him? Is it challenging him cognitively? Or is it just putting him at a level that everyone around him is at a level that is lower than him and that is the only direction he can head? Who is there to talk to him or do activities with him when he is bored?
I have attached a link in the title on how to choose an appropriate facility for someone with dementia: what to look for, if they have special accommodations, special adaptations for them.
I have attached a link in the title on how to choose an appropriate facility for someone with dementia: what to look for, if they have special accommodations, special adaptations for them.
Fieldwork ... the good, the bad and the ugh!
I am, generally speaking, a "learn by doing" kind of girl. To me, learning something from a book whether it is OT or fixing a car, is challenging. I'm just not built that way.
Last semester on fieldwork, I got to "try out" a lot of the things that we had read about or been lectured on. It was great. I had a nice OT with which I worked great. She was very detail oriented and let me know why she was doing things, but still let me try whatever I felt comfortable with (under her close supervision, of course). I was comfortable. I saw a steady core of 4 or 5 patients with a few one-time patients sprinkled in.
This semester, I thought would be a gradual "up grade". I would have basically the same patient each week and be working on a skill that would either gradually improve or wouldn't. At any rate, I would know basically what skills to work on from week to week. Ugh! I've only a total of 3 patients in my 4 weeks. I saw the first patient 2 times, but have been getting new patients each week since then. For me, this "unknown factor" has made fieldwork very stressful. Not only do I not know the patient, but at what level they are performing. For example, 2 weeks ago, I was supposed to see J. I had gathered the information from her chart from when she was admitted, but didn't get to see her that week, so when I met with her this past week, all of the STG they had listed had been met. When I went to start the treatment session, I found out that she had also met all of her LTG and was getting ready to be d/c from OT. I felt like my session was pretty much blown all to pieces, though she was a lovely lady and I thoroughly enjoyed chatting with her about fishing spots that we had in common. I ended up working on ue strength, even though she was very strong.
This week, I am due my 4th new patient in 5 weeks. I know that this will be commonplace in the real world, but I am finding it frustrating when my Tx session plans are due 4 days in advance.
Last semester on fieldwork, I got to "try out" a lot of the things that we had read about or been lectured on. It was great. I had a nice OT with which I worked great. She was very detail oriented and let me know why she was doing things, but still let me try whatever I felt comfortable with (under her close supervision, of course). I was comfortable. I saw a steady core of 4 or 5 patients with a few one-time patients sprinkled in.
This semester, I thought would be a gradual "up grade". I would have basically the same patient each week and be working on a skill that would either gradually improve or wouldn't. At any rate, I would know basically what skills to work on from week to week. Ugh! I've only a total of 3 patients in my 4 weeks. I saw the first patient 2 times, but have been getting new patients each week since then. For me, this "unknown factor" has made fieldwork very stressful. Not only do I not know the patient, but at what level they are performing. For example, 2 weeks ago, I was supposed to see J. I had gathered the information from her chart from when she was admitted, but didn't get to see her that week, so when I met with her this past week, all of the STG they had listed had been met. When I went to start the treatment session, I found out that she had also met all of her LTG and was getting ready to be d/c from OT. I felt like my session was pretty much blown all to pieces, though she was a lovely lady and I thoroughly enjoyed chatting with her about fishing spots that we had in common. I ended up working on ue strength, even though she was very strong.
This week, I am due my 4th new patient in 5 weeks. I know that this will be commonplace in the real world, but I am finding it frustrating when my Tx session plans are due 4 days in advance.
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