Teepa Snow is the owner of "Positive Approach" is a Dementia Education and Skills Training Specialist. For the last four days since attending the workshop her words keep popping up in my day-to-day existence with my husband who has mixed dementia.
Teepa was careful to explain what is going on in the brain of a person with dementia as they are going into brain failure. She said that at least two parts of the brain are dying with dementia. The brain includes both grey matter (the filing cabinet) and white matter that is the wiring within the brain. She told about deterioration in the left and right frontal lobe of the care receiver. Formal speech, articulation and executive functioning are leaving sooner, while automatic speech, rhythm and expletives remain longer. When our loved one is unfamiliar with a situation or setting, they become angry and those expletives come to the fore--their filters are gone. Each day I notice that hubby's vocabulary, especially, nouns, leave him searching for words and his executive functioning (steps to do certain things) is disappearing. I have to say put this pill in your mouth and here is the water for taking that pill.
Teepa Snow in the day's presentation gave 34 examples of challenges that we caregivers face. I will cover 13 of them with this post--observations of my husband and what I observe with our friend Jake.
- Losing important things. Early on we faced loss of the cell phone and keys. Hubby no longer cares to have a cell phone. Jake has misplaced his cell and his electric razor recently.
- Getting lost in time, place or situation. Hubby asks about how we came to live in our home. His memory of the day planned is so short and he does need that daily agenda. Some times he forgets to look at that agenda.
- Unsafe task management. Jake has manhandled his lawn mower and is not allowed to mow their lawn any more. He set fire to it. My hubby is not that ambitious and Pharis now mows our lawn.
- Repeated calls and contacts. Jake must have used his cell phone to leave messages on Sally's cell phone a dozen times during Teepa's workshop.
- Making up stories, what Teepa called confabulation. I noticed this Sunday when we went to dinner with a new church visitor. To keep the conversation going hubby had his own version of events to tell.
- Swearing. Saturday we went shopping for Christmas gifts. Hubby has already forgotten what he is getting! Determined to take advantage of sales at Talbots for my gift from him we drove to a distant mall. Hubby was very angry at the traffic and at me for planning such a trip and swore like a drunken sailor in the car while I drove, wanting me to turn around and go home. Rather than play the martyr and give up, I persisted with the mission to acquire quality at a bargain. It was hard to find a parking spot, and when we finally did park, he was happy to stay in the car while I went inside to get that 50% markdown with the purchase of three items. When I returned to the car, all was well and he forgot about his upset.
- Sleep problems--too much or too little. We go to bed early and it is not unusual for hubby to sleep 10 hours. He is asleep now while I write this post.
- No initiation--can't get started.
- Paranoid or delusional thinking. Hubby has talked about how our money system is changing and can't site where he learned this "fact". He also has a story about an alligator in our back yard. Jake and hubby talk about plane trips and canoe trips they took together.
- Wandering. So glad this doesn't happen. Hubby is content to be at home watching TV with our dog Ziggy, and since he hobbles now I can't see his wandering off. Because of our volunteer caregiver, Kenny, who checks in with hubby, I can still work. However, Sally needs to be with Jake because he has this tenancy to wander and she has decided to no longer substitute teach.
- Striking out at others. Jake and DH had their argument that I wrote about last month, illustrating two behaviors that care receivers exhibit--Jake repeating himself asking where Sally was and hubby getting angry and swearing that Jake was doing this.
- Dehydration and malnourishment. Hubby needs to drink more liquid to avoid a UTI. I am very concerned about hubby's small food intake.
- Immobility. Teepa imitated the walk. Hubby has that walk now. I thought it was just a physical issue! I recently read a description of vascular dementia, however, that included mobility problems. Teepa gave examples of the correct way to move a care receiver with their walker. Hubby at times still uses his walker, although goes to the chiropractor only every two weeks now.
One of the sponsors of the free workshop, Senior Helpers of Lakeland, gave us a Teepa Snow DVD that covers more material including how to relate to care receivers at various stages. I listened to it while hubby slept early one morning and will use that tape and this workshop content to help guide me in my journey.