Part 3 of a four part series.

            As I have mentioned, and will keep on stressing, I am not a medical professional and will not attempt to give you any medical advice.  What I am sharing now has come straight from the caregivers, what worked for them and what did not.  You can look on the internet in several places and find other things to add here.  The things in this article come from their personal and practical experience.  I believe they might also be beneficial for visitors, or for those who offer care time while the caregiver is away running necessary errands.  These were shared by those who have been there and who want to help others with their hard-won wisdom and knowledge.

            1.  You must enter the Alzheimer's patient's world; do not expect him to understand or interact in your world any longer.  A basic tenet of education is "Start where the student is at."  The same is true of the Alzheimer's patient.  Don't try to make him do what he can no longer do.  If he wants to converse, then talk about the things he wants to talk about, but if he is no longer conversational, then you must do the talking and watch his reactions for signs of interest or lack thereof.  If he closes his eyes or turns his back, try another subject.

            2.  Address him by name ("Hello, Bob").  He may not reply but at least he knows he is not being ignored. 

            3.  Ask simple yes or no questions and give him choices whenever possible, but no more than two.  "Do you want ______ or ______ for supper?"  "Do you want to watch ________ or _________ on TV?"  Always be willing and able to live with whatever he chooses.

            4.  Don't say, "Do you remember__________?"  Instead, say, "I remember when we ______________," and allow him to say something, to nod or smile.

            5.  Find something to keep his hands busy.  Puzzles might be a good choice, but be aware that while you may have started with 1000 piece puzzles, you will gradually need to move to 500, 300, and even 100 piece puzzles as the illness progresses.  Pay attention to what is happening and his frustration level to know when to switch. 

            6.  On the occasion when something must be done (going to the doctor, getting dressed, taking a bath, taking medication), do not say, "Do you want to __________?"  Just say, "It's time to _________."  This avoids the problem of him answering your question with a "No," especially if it is something that simply must be done at a certain time.

            7.  Patiently answer the same question as many times as it takes, even if it is asked in rapid succession many times.  Use the same verbiage.  Control your frustration and answer it as if it is the first time he has asked.

            8.  Give simple three or four word instructions, helping him accomplish a task one step at a time.  Do not overburden him with too much information at once.  For instance, when he is dressing himself, you might need to tell which article of clothing to put on, one after the other and how to do it.  Another friend of mine had left her mother dressing herself for church and when she returned, found her with her slip on top of her dress.  Do not assume that the patient knows how to do anything the correct way anymore, but stand by and watch, ready to give one piece of information at a time, but only as needed.  For as long as possible, let them have their small victories.

            9.  Remember that you are the patient's anchor, especially when he begins following you around and seems nervous and clingy.  Be there for him and reassure him that you will not leave him.

            10.  And above all, remember that the patient is still a human being with feelings just like you.  They may not be able to verbalize and are limited in their abilities, but they will always remember who makes them feel good.

            The caregivers I have spoken to hope these things will help you as you travel a long, hard, and often lonely road.

And we urge you, brothers…encourage the fainthearted, help the weak, be patient with them all.  (1Thess 5:14).

Dene Ward

Number 2 in the series.

Originally, this was the only article I planned to write.  Watching my mother and hearing from my friend made me intensely aware of things I had never known before—things they had to deal with that I would have never imagined.  In a way, this might be the most important of the three articles, though I guarantee you that those two women would have thought otherwise in their attitudes of humility and service. 

            I am listing these things in no particular order, but as they have come to me, from my observation, research, and discussions with and suggestions from those involved.  I imagine the order of importance is different for each case.  It will be up to you to look for these things yourself and decide what is needed for the people you are trying to help.

            1.  Do not ask the caregiver how the spouse is doing when that spouse is standing right there, or on the phone when you know the spouse can overhear that side of the conversation.  You never know how much he will understand and how it might make him feel.

            2.  Don't give medical advice.  Any physician would never think of impinging upon another physician's role.  How much less should someone with no medical training, or much less?  This got so often and so bad for my mother, that she finally had to say something like, "I believe I will do what the doctor says."  That might have sounded a bit rude, but she had been pressured so often that she felt harassed and judged.  Please don't put a godly and already stressed out person in that situation.

            3.  Don't say, "I know how you feel."  Knowing someone who has Alzheimer's or dementia and dealing with it 24/7 as the primary caregiver are two entirely different things with two entirely different stress levels.  Even helping on a minimal basis, like an overnight stay or afternoon substitute, is far from the same thing.  If you have not done it, you don't know.  Period.

            4.  Don't say, "You make everything look so easy."  You don't see the struggles, the extra length of time, the often frustrating explanations it took to get a spouse up and ready to go to the doctor or to worship services or any other place.  That statement minimizes the caregiver's efforts and her sometimes almost super-human patience.

            5.  If you live in the same neighborhood as a caregiver, please keep an eye out.  For example, my mother went to take a shower one evening and when she got out, two strange men were sitting in her living room.  Turned out they were vacuum cleaner salesmen rather than criminals up to no good whom my daddy had let in with no idea what was up except to be friendly, especially since they often received church visitors in the evenings.  How much better if a neighbor had told those men, "Please don't bother my next door neighbors.  The husband is very ill and the wife is caring for him and doesn't need the interruption.  They wouldn't be interested right now anyway."

            Also be aware that Alzheimer's patients tend to wander.  If you see your ill neighbor out walking the street, go out immediately and talk him into going back home.  Listen to him if he tells you where he is going or who he is looking for, and say whatever is necessary to get him to go with you.  My mother put an alarm on her door after the vacuum cleaner salesmen episode, but my daddy was a tinkerer who could figure out how anything worked, and one night as she was again taking a shower, he figured out that alarm and took off looking for "his wife."  She ended up having to call the police to get him back home.

            6.  Send cards or small gifts, and, if possible, deliver them in person.  Even the least expensive, tiniest things will brighten a caregiver's day.  Due to things like #5 above, a caregiver often has no chance for her own doctor appointments or errands like buying groceries or getting a haircut or car maintenance.  If the situation is manageable, consider offering to spend some time with the patient while the caregiver gets a few things done.  That is often preferable to you doing it for her because it gets her out of the house and in a calmer situation for an hour or so.  Talk to the caregiver about what is best in her situation.  This will change from day to day and as the disease progresses.

            7.  This may be one of the most important:  Do not judge the caregiver's choices.  No one should be telling her that she is not being a good wife if she has decided that she can no longer take care of her spouse at home and must use a Memory Care Facility.  You may not realize that the disease has reached a point where she is now in danger.  If that seriously ill mate no longer knows her and thinks a stranger has invaded his home, what might he do to her?  I know that doctors will begin asking questions about weapons in the house.  One caregiver I knew had to pack up all of her cooking knives.  Another had to give all the guns in the house to another family member.  But those are not the only weapons available when someone is frightened enough to think he needs one.

            At some point, the caregiver's own health will begin to suffer.  Most men are bigger than their wives.  How will she pick him up if he falls?  Many of these patients suffer REM disorder and sleep fitfully with dreams they try to act out.  The caregiver will often go several days without any real sleep, and this will go on for years.  Eventually reaching the point where she decides he would be best cared for 24/7 in a facility is most emphatically NOT a sign that she is a disloyal or unloving wife who has broken her vows "in sickness and in health, for better or for worse."  It is no one's decision but hers, and none of us has any right to question it.

            If you have a friend or family member in the same situation, I hope these few things that have come straight from other caregivers will help you out.  And as I mentioned in our introductory article, please feel free to share any others below.

Bear one another's burdens, and so fulfill the law of Christ. (Gal 6:2).

Dene Ward

Number 1 in a four part series.

Today begins a four part series on the difficulties of Alzheimer's and how to help those dealing with it, both patient and caregiver alike.  I believe these might also be helpful for those dealing with dementia patients as well. 

Please notice:  I will not be approaching these as a professional on any level, but simply as someone who has seen it up close and who also has friends dealing with it.  I will not be giving medical advice beyond what the doctors have told me and my family and friends.  This is strictly practical information from those who have dealt with it firsthand, information that I hope will be a true service in helping and encouraging others. I also hope it will help us all to avoid saying and doing something hurtful, even with the best intentions.

            My father developed dementia gradually over the last twelve years of his life.  It was hard to watch a highly intelligent and competent man become as dependent as a child, and especially to see him forget who his wife of sixty-four years was, even as she patiently waited on him day after day.  I have a close friend whose husband is now traveling down the road of Alzheimer's.  I see the disease taking more of him every time I read one of her letters, and watch as she bravely faces the unknown every day.  These two, and others I have known, are my inspirations, and the primary source of the things I will write in this series.

            Please, if you are facing, or have faced, similar challenges yourself and have more to add, feel free to comment on the bottom of every article so that others can learn from you as well. It is better to put it on the article than on the Facebook link because it will eventually reach more people, especially as others discover it in the future from an internet search. As many problems as it might cause, one real benefit of the internet is reaching more people.  Please help me do that. 

Too many times I have stood frozen in my tracks, not knowing what to do and totally unable to think as something happened to someone close to my heart or simply standing nearby, and then wished for days afterward I had known how to act and what to do, mentally flailing myself for being so clueless.  Let's see if we can help one another avoid that. 

            This is merely an introductory article.  The remaining three articles will run the next three days.

We who are strong have an obligation to bear with the failings of the weak, and not to please ourselves.  (Rom 15:1).

Dene Ward

Psalms 74 and 79, along with the books of Lamentations and Habakkuk, which are also national psalms of lament over the destruction of Jerusalem, will make you cringe in their horrific detail of destruction.  Women and young girls raped, leaders hung up for all to see, the Temple in ruins, dead bodies lying everywhere, far too many for the few left alive to bury. 

              Psalm 74 lists sacrilege after sacrilege:  God’s enemies standing in the meeting place; the intricate and artistic carvings of the Temple chopped to pieces by heathen axes, the sanctuary on fire, the dwelling place of God razed to the ground.  Psalm 79 uses opposites to the same effect:  the holy defiled; Jerusalem in rubble; God’s servants as carrion; and blood flowing like water in the streets.  Imagine seeing all this one horrible morning and then speaking to God in these words:  Help us, O God of our salvation, 79:9.

              God of our salvation?  How could the psalmist possibly use that description?  Where in all this nightmare does he see salvation?

              The poet understood this basic truth:  even in this dreadful event, God is still seeking the salvation of His people.  He could still see a Father’s love behind the most severe discipline.

              Again in Psalm 74, the psalmist says, Yet God is my King of Old, working salvation in the midst of the earth.  Not just in the midst of the earth, but in the middle of all this horror, he can still see the true nature of God.

              Habakkuk in his lament ends with the same thoughts:  For though the fig-tree shall not flourish, Neither shall fruit be in the vines; The labor of the olive shall fail, And the fields shall yield no food; The flock shall be cut off from the fold, And there shall be no herd in the stalls: Yet I will rejoice in Jehovah, I will joy in the God of my salvation. Hab 3:17-18.

              What do we see when evil befalls us?  If all we feel is the pain, if all we see is the sorrow, Satan already has a foothold.  We must learn to use what happens in our lives as a steppingstone to Heaven, a lift to a higher plane of spirituality. 

              Surely it isn’t always punishment from God as it was for those people, but then it becomes even more important to see events in the correct way.  We are in a world that is temporary, that is tainted with sin.  Of course we will have problems.  Are we so naïve as to think that something Satan has poisoned will ever be good?  Jeremiah tells us in his lament, that if it weren’t for God there wouldn’t be anything good left in this world at all, Lam 3:22, and we have no right to expect it to be any different. 

              If I cannot see the salvation of God even in the midst of trials as Jeremiah did, I am blind to who He is.  He is there, helping us prepare for a world where those things will be no more.  If I rail against Him when the trials come, I do not know Him.  Illness and death are the tools of Satan to lure us away, but with faith and the proper perspective--seeing the God of our salvation instead of the God of our pain--we can use Satan’s own tools against him as a road to triumph. 

              It is better to depart and be with the Lord, Paul said, Phil 1:23.  To die is gain for a Christian, v 21.  “O death where is thy victory, O death where is thy sting?  The sting of death is sin and the power of sin is the Law, but thanks be to God who gives us the victory through our Lord Jesus Christ” 1 Cor 15:55-57)  If I see death as the victor, I am giving myself away—showing that my perspective is indeed unspiritual, immature, and faithless.  

              Is it easy to have this perspective, especially in the middle of a traumatic life event?  No, because we are still in this flesh.  But while in this flesh the Lord Himself conquered all these things and expects us to follow His example, as difficult as it may be.  And He gives us the means to do it. 

              He is and always will be the God of our salvation.
 
But as for me, I will look unto Jehovah; I will wait for the God of my salvation; my God will hear me, Mic 7:7.
 
Dene Ward

I learned as a child in the Florida school system that Juan Ponce de Leon was the first Spanish explorer to land here.  He had heard stories about a magical spring that could cure diseases and make you young again, so he began the search.  The land he finally set foot on somewhere near St. Augustine was so beautiful he called it Florida, "full of flowers".  Spring in Florida is beautiful.  I understand why he was impressed.  If he had landed in July, we would have had a much different name.  (What’s the Spanish word for “steam bath?”)
            We do have a lot of natural springs in Florida—probably more than half a dozen within 30 miles of where I sit—but none with the magical powers he looked for.  I can find a Fountain of Youth quite easily, though.  I have it laid out right next to me as I type.  The eternal life promised to the faithful may be the most obvious application of that concept, but I can think of yet another.
            As I watch my grandsons play I find myself remembering my own childhood, realizing as an adult how unfettered it was by worry, pain, and sorrow.  I never for a moment wondered where my next meal was coming from.  I never worried about storms, not even hurricanes.  I never worried about bad people doing bad things to me.  I had a Daddy I trusted implicitly.  He would take care of me.  That’s what Daddies do.
            Once when I was still in early grade school, I had a bad dream.  My Daddy came in and sat on the bed next to me, asking me about the dream and then carefully undoing every worry it had evoked in me.  When he finished I could go back to sleep because of his reassurances.  That’s what Daddies do.
            One morning in first grade I was upset about something—I don’t even remember what now.  But my Daddy noticed that I had tears in my eyes when I got out of the car at school.  As I stood in front of my classroom, waiting for the bell to ring, I looked up and there he was, striding down the sidewalk.  He had parked the car and come looking for me to make sure I was all right.  That’s what Daddies do.
            Daddies provide.  They protect.  They comfort.  Do you want a Fountain of Youth?  Stop worrying about things you cannot fix.  Stop being afraid of things you cannot handle alone.  Stop wondering how you will manage.  Cast your cares on a Father who loves you.  Once again become a little child who has a Daddy who will always be there, always watching out for your needs and taking care of your problems.  If you don’t have that, it’s only because you insist on ignoring His outstretched hand.  You insist on trying to control everything yourself—as if you were the Daddy. 
            Do you begin your prayers, “Father in Heaven?”  Then act like He is your Father.  Trust Him.  Begin this day with a new exuberance, one born because you have surrendered your cares to Him and finally found the Fountain of Youth.
 
For all who are led by the Spirit of God are sons of God. For you did not receive the spirit of slavery to fall back into fear, but you have received the Spirit of adoption as sons, by whom we cry, "Abba! Father!" The Spirit himself bears witness with our spirit that we are children of God, Romans 8:14-16.
 
Dene Ward