Last Days

Recently a former caregiver client I coached years ago, presented me with a book she and her dad wrote about the last year with her mom who had Alzheimer's and the first year of his being without her. I am anxious to find the time to read this story. It is called Her Final Year; a Care-Giving Memoir and His First Year; A Journey of Recovery. The authors are James Downey and John Bourke with Martha John and Kathi Bourke. Kathi was my coaching client. In the section How to Use This Book, the authors write,"...some of it is more than a little embarrassing. We have decided to share it, and show it as it was, because we deeply believe that it is extremely important that anyone entering into a care-giving relationship understand the reality of what they will likely experience. You will make mistakes. You will think you are going to go crazy. You will sometimes feel crushed by the isolation and stress. You will sometimes resent, or even hate, the person for whom you are caring. You will get into arguments with family and friends and say and do things you might later regret. These things are all completely normal human reactions to the situation you will be is."
This gives me courage again to write my second book; my journey with me mother in law Bette over 14 years until her death at 99 1/2 years of age in 2009. Thanks Kathi for reminding me to expose true feelings both good, bad and ugly at times, to help others who are going through the caregiving experience. It also is 2 books; the first exploring changes in attitudes and treatment of dementia and the second, a personal story. Perhaps because it has been almost 3 years I'm ready to finish it.

New Blog on Mental Health

Please note my new blog focusing on understanding mental health and illness. It is a slight but important deviation from my educating about dementia. The new blog is www.coach-nurse.blogspot.com Visit it and post a comment. I'm going to try to post something each week. Now with my inpatient experience renewed, I have plenty to say.

Hospitalized Elders with Dementia

I have recently taken a position as one of the nurse educators in psychiatry at a Boston hospital. I'm glad to be back in the thick of it and notice once again what a therapeutic milieu is for people with dementia. Research shows that it isn't really the ratio of staff to patients but the number of contacts the patient has with staff on any given day. This cements the practice of frequent connection with a confused and frightened elder reduces the likelihood of agitation and/or aggression. We've seen that aggression is most often the result of not understanding what is going on around them or misperceiving the intent of the caregiver. Smiling, connecting by calling him or her by their name, asking, "how are you today?'(the only open ended questions that is OK),making a positive comment about the person all go towards creating a therapeutic milieu (environment). Therapeutic communication is the practice of being clear, keeping eye contact, speaking slowly, simply and concretely. One patient who recently returned to the hospital after an outburst at the assisted living residence he had been discharged to,recognized staff's faces and voices but thought he had been on a cruise last time he was hospitalized. Sometimes delusions can be helpful I guess. Happily with the right dose of medication he was able to be returned to his new home at the residence.