Raya’s Paradise Residential Care Communities Blog

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10 Tips for Handling Sundowner’s Syndrome

Simple remedies for Sundowner's SyndromeSundowner’s Syndrome, or sundowning, is when a dementia patient becomes more fearful, agitated, or depressed around sunset. At this time of day, caregivers will notice that their loved one’s illness becomes even worse as they become more confused, anxious, and have trouble communicating. Though these episodes can be difficult to deal with, there are a number of things that you can do to lessen their effects. 1. Be calm and try not to startle your loved one. Avoid yelling or challenging them. If mom says something that doesn’t make sense at dinner, it might be a good time to let the bizarre statement go. 2. Keep the curtains drawn, so that your loved one doesn’t notice that it’s getting dark outside. Turn on the lights and try to make the inside atmosphere bright, peaceful, and cheerful. Ask others to keep the noise down. 3. Make sure that your loved one is active during the day, so that they’ll be tired in the evening. If they’re napping or sitting around, they’ll be more wakeful at night. 4. It’s a good idea to plan activities in the evening as well that can serve as a distraction. 5. Stick to a routine, as this will make your loved on less anxious. Even simple actions, like going to bed at the same time each night or watching TV together can help create a sense of familiarity. 6. Try playing soothing music, which can have a remarkable effect on creating a calm atmosphere. 7. Have locks or other safety devices installed, so that you don’t need to worry about your loved one wandering and hurting themselves. You might consider making a safe area where they can move around even when you’re not awake to keep an eye on them. 8. Ask your loved one where they would prefer to sleep. If it’s on the recliner in the living room or in a different bedroom, changing sleeping arrangements to accommodate them might help. Being comfortable will help ease their anxiety. 9. Buy nightlights to use in your loved one’s room or other areas, as lessening the darkness will make them less nervous. 10. Be reassuring. Sometimes it will help your loved one just to hear from you that everything is OK. The evening doesn’t have to be an unpleasant time for you or your loved one. The simple changes above can help the night pass more smoothly for both of you.
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Discussing Alzheimer’s with Family Members and Friends

Stigma against Alzheimer's prevents seniors from getting diagnosed.An Alzheimer’s diagnosis can be isolating, both for the person with the illness and for their caregivers. Illness can often create distance between those who were once close, and the nature of Alzheimer’s disease compounds the problem. Others are unsure if the person will remember them or if they’ll behave inappropriately. Still others may remain in the person’s life, but not acknowledge the disease at all, and thus leave a big silence about a major life event. Many people who suspect they have Alzheimer’s avoid an official diagnosis because they fear the effects on their social world and the painful feelings of rejection and loneliness that would come with it. However, it is vital that patients get a diagnosis so that they can receive proper care. If someone close to you is going through this important turning point, here’s how you can help. Listen before judging. A time like this is ripe for family conflict. Should the person get diagnosed and when? If they do have Alzheimer’s, how will the family plan for the future? It may be that the Alzheimer’s patient has disagreements with the rest of the family, or people within the family are fighting among each other. You will have your own opinion on the issues at hand, but make sure you’re hearing out the other side and giving their point of view fair and compassionate consideration. Hold back on stating your viewpoint and ask others for theirs first, to make sure they have a chance to give input. A third-party mediator may be able to help if you worry that conflict will get out of control. Be supportive. One of the best things you can do for your loved one is to help them think through all the choices they have to make at this time. This may require you to keep your own emotions in check at a time when you might be feeling a lot of fear, so it may not be easy. Keep in mind that your loved one will likely be afraid of seeming to be needy or a worry-wart. Encourage them to talk through their concerns rather than keeping them private. Stay calm. At this time it’s very important to be patient, and not all of us count this as one of our strengths. But keeping your cool can go a long way towards maintaining a positive relationship with your loved one that will keep them open to your much-needed help. Remember that pointing out that you were right or expressing negativity may not be the most productive course of action. Put a focus on keeping a good relationship. Using these skills will put you in a position not only to support your loved one, but also help you bridge the gap between them and family and friends. You can play an important role in keeping the peace.
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How to Handle Hallucinations and Delusions

Dementia patients may experience hallucinations.One of the more unnerving side effects of dementia are the delusions and hallucinations these patients sometimes suffer. They can leave the patient very troubled and scared, yet they’re difficult for loved ones to address because they know these illusions aren’t real. Around 25% to 40% of dementia patients experience these episodes. They will often respond with agitation, aggression, or even violence. This behavior may be more threatening and troubling as the disease advances, as patients are more likely to respond to what’s going on in their minds. Your initial instinct might be to try to reassure your loved one that what they’re seeing isn’t real. But this is often a mistake. The patient can easily get the perception that you don’t take them and what they’re seeing and feeling seriously. Rather than being comforted, they may feel isolated and hurt. Instead, what you’ll want to do is offer some acceptance to their reality. No, you don’t have to believe that mom’s long-dead sister is in the room with you, but you should understand that the experience is real for your mother. If you do this, you’ll bring stability to the situation much more quickly than if you tried to fight them on what they’re perceiving. Be reassuring: “You must feel frightened. I would be frightened too. But I will stay here with you to make sure you’re safe.” It may also help to offer some form of physical comfort, such as a touch on the arm. No only does this reinforce that you are there for them, but also helps draw their attention towards you and away from what’s bothering them. You can also help make the problem vanish by getting your loved one to a different environment like another room or outside for a little fresh air. Some hallucinations might be comforting. Dad may be imagining that he hears birds pleasantly tweeting. If he seems to be happy about this, you may not want to disrupt this at all. You only really need to worry if what your loved one is perceiving puts them or others in some kind of danger. Unfortunately, you won’t always be so lucky and there isn’t much you can do to prevent these incidents. Medication may help, but it may have side effects that bring new problems. Understand that feeling distressed and overwhelmed in these situations is normal. By learning all you can about this effect of dementia, you can help yourself to cope with it more effectively.
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The Process of Alzheimer’s Memory Loss

Alzheimer's memory lossHow memory loss in Alzheimer’s patients works may at first seem mysterious to those whose loved one’s are suffering from the disease. The senior can tell stories about their childhood, but doesn’t remember that they had lunch just a half hour ago. It just doesn’t seem to make sense. First, it may be helpful to learn a little bit about the nature of memory. When a person who does not have Alzheimer’s undergoes an experience or learns a piece of information, a part of the brain called the hippocampus plays a role in taking in that new tidbit. However, in Alzheimer’s patients the hippocampus is one part that suffers first, thus preventing new memories from registering properly. Also, memories that have an emotional component to them are stored separately from other memories. This may explain why dad can’t remember what he did with his glasses, but can talk about his service during the Korean War. As the disease advances, even older memories stored elsewhere in the brain begin to disintegrate. Also, plaque builds up in the nerve cells in the brain, which may lead to disorganized thinking or confusion. Unfortunately, there is nothing we can do yet to stop this process. However, you can help a loved one with Alzheimer’s by sticking to a routine. The regular schedule will help them be more comfortable and feel less confused. Also try to reduce the amount of extra stimulation, such as noise, that the patient is subjected to. All the additional activity can contribute to disorientation. It can be very stressful for caregivers to watch their loved one lose their memories, especially their most-cherished ones. During this time, be sure to take care of yourself. Seek out friends and family who can give you support. Caregivers can too easily feel alone and shut themselves in their own worlds. Don’t let this happen to you. You might find it helpful to learn as much about Alzheimer’s as you can, so that you know what to expect. Never take your loved one’s forgetfulness personally: it is the disease that is causing your dear Aunt Judy to forget your name, not any lack of love on her part. And finally, choose to make light of the situation as much as you possibly can. Yes, the pain will still be there, but if you can laugh about the effects of the disease, you can manage to ease the negativity you may be feeling.
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Alzheimer’s 101

Alzheimer's introductionIf you or a loved one has recently been diagnosed with Alzheimer’s disease, you probably have a lot of questions. This article is intended to address some of the most basic facts and get you started in the learning process. Alzheimer’s disease, which is the most common form of dementia, is a problem with the brain and affects a patient’s behavior, thought processes, and memory. The symptoms are fairly minor to start, and then gradually get worse to the point where they drastically affect the individual’s everyday life and they need other people to help them complete even basic functions. There are several million people in the US who have Alzheimer’s disease. It usually starts sometime after 65 years of age, and becomes more likely the older a person gets. Among those people older than 85, some estimate that half have Alzheimer’s. One of the first signs of Alzheimer’s disease is problems with thinking skills, especially memory, and behavior alterations. The person may be moody, restless, or confused. They may display uncharacteristically poor judgment or have trouble processing visual information. They may also experience difficulties communicating and using language. Alzheimer’s can be difficult to diagnose because its symptoms can easily seem like the normal effects of aging. The disease is frequently ignored in the early stages. How can you know the difference? When you see the doctor for a diagnosis, he or she will run a variety of tests designed to measure cognitive functioning and behavior. The only way anyone can know for sure that a person has Alzheimer’s, though, is to see if there is plaque in their brain tissue. This usually isn’t possible until after the patient has passed away and an autopsy is performed. The disease may take anywhere from around 5 to 20 years to run its course. Because it damages the brain, it can cause a person to have trouble with basic physical functions such as swallowing, which can in turn lead to death. Alzheimer’s patients are also more likely to get an infection. As of yet, no cure has been found for Alzheimer’s disease, but there are treatments available that can lessen some of the negative effects of the disease on patients and caregivers, as well as slow its progression. To learn more about this disease, see the articles below: How to Choose a Memory Care Facility When Your Parent Forgets Who You Are Three Big Questions to Consider After an Alzheimer’s Diagnosis
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Addressing Agitation in Someone Who Has Dementia

Old woman's hands tucked between her legs

Used under Creative Commons by Horia Varlan.

A dementia patient’s agitation is one aspect of the disease that can be distressing to family members. They may fuss and fidget or repeat certain phrases. They may scream out or ask the same question over and over again. For some family members, this is the aspect of the disease that inspires the most dread. This behavior may have a variety of causes. It may be that something in the person’s environment is bothering them. Or they may be trying to complete a task that is too complex for them. Or the behavior could simply be due to changes in brain chemistry. There are ways that families can address agitation and help the dementia patient become calmer. First, determine the root cause of the agitation. If it is something specific, such as a runny nose or a room that is too cold, you may want to simply address the problem if all it requires is a sweater or a tissue. Another technique to try is to remind your loved one of an activity they used to enjoy. For example, if your mother stayed at home to raise four children, you could give her a baby doll and get her to tell you stories about when you and your siblings were growing up. Or if your father used to pride himself on his garden, take him outside to look at the flowers or maybe even do a little pruning. He may no longer be capable of carrying out more advanced tasks he used to be able to do, but it’s likely he’ll take pleasure in re-learning simpler ones. Re-directing the patient’s attention on something they enjoy can have surprisingly powerful effects. Some professional caregivers have even found that this technique reduces the need for medication. Whatever you do, avoid confrontation and try to remain calm. The tone of your voice matters more than you think, so try not to let your frustration or annoyance show. Try to distract your loved one from whatever might be irritating them. Don’t try to rush your loved one along; let them move at their own pace. When deciding how to address a loved one’s agitation, be flexible and consider a variety of solutions, depending on the cause. There is no one magic way to address this behavior. Instead, try to find different solutions that work at different times, and consider them part of your toolbox of ways to respond to the disease.
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How Music Can Help Alzheimer’s Patients

Music has many benefits for Alzheimer's patients.We all respond to music on a very deep level, especially the music we remember from our childhood and teenage years. Some pieces cause an automatic, powerful flood of memories. It’s not hard to understand that music can be beneficial to Alzheimer’s patients. But what you may not know is just how pervasive these benefits are. Music can alleviate pain, improve sleep, ease anxiety, and boost one’s mood. Indeed, it can sometimes do more to stimulate healing than conventional medicine. Music has been demonstrated to release the feel-good chemical serotonin and decrease cortisol, which is associated with stress. How does this work for Alzheimer’s patients specifically? Seniors who are new to assisted living are in an unfamiliar place, and this change can result in negative psychological effects like aggression or aggitation. But a meaningful song takes them back to the familiar, and as a result they become more comfortable in the new environment and easier for caregivers to work with. The senior may be smiling, tapping their feet, or even swaying in place: their joy is palpable. Some experimenting with music and seniors have found that this technique can lessen or even eliminate the need for drugs that treat depression and anxiety – at a much lower price than the cost of these expensive treatments! Consider getting your loved one some sort of music player as a gift, so that they can listen to songs of their choice whenever they want to. Some have found dramatic effects when giving seniors iPods or other digital music players, but even a less cutting-edge CD player will do if it’s easier for your loved one to handle. Use upbeat music stimulate: to help motivate mom to move towards her bath, for example. Songs with slower tempos can be used to help your loved one calm down or fall asleep. Encourage movement and singing along to help increase the benefits. Before you know what songs they’ll enjoy, watch their reactions carefully. A song that is beautiful to one person may evoke feelings of sadness in another, for example. Stay away from music that has commercials, such as that played over the radio or by a streaming service such as Pandora. These interruptions can confuse Alzheimer’s patients. Also make sure that there aren’t too many other distracting noises in the room, and don’t turn the volume up too loud. Bringing music into your loved one’s world may seem like a small change, but it’s likely to make their life dramatically better.
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Accusations and Dementia

Dementia patients often make accusations.One of the most difficult dementia behaviors for caregivers to cope with is false accusations. We’ve all had the experience of losing track of something, thinking someone must have taken it, and then later finding the object and discovering we were mistaken. Dementia patients, with their short-term memory problems and tendency towards paranoia, are all the more prone to these kind of misunderstandings. Because so much of their world no longer makes sense, they have a need to explain things and are unable to accept that the strange occurrence may be due to their own actions or perceptions. Is mom’s favorite sweater missing? Horrifying as it may sound, to her the most likely explanation may be that you stole it! They are also grappling with the insecurity that comes with old age, so the “lie” may be an unconscious attempt to preserve their dignity. Dad can avoid the embarrassment of misplacing his watch if he believes the aide stole it. Mistreatment and abuse of elders certainly does happen. But perhaps more often, the wrong exists only in the senior’s mind. What’s tragic is that these accusations are often leveled at loved ones and caregivers who are trying hard to make sure the senior is safe and comfortable. How can you cope with this difficult situation? Here are some suggestions. Bring in someone to help you. Find a third person to help you explain yourself. It may be a friend of your loved one’s, a staff member at the assisted living facility, or another family member. Seeing that someone else will back you up may help your loved one realize that they’re placing blame where it doesn’t belong. Seek advice from a senior care counselor. An expert in senior care can teach you good ways to respond to your loved one. You may want to start with the Alzheimer’s Association’s 24/7 Helpline at (800) 272-3900. Keep good financial records. Accusations often have to do with money. Being able to show documentation that proves what’s going on with a senior’s finances can help straighten things out. Bring a family mediator on board. Sometimes within families there can be confusion about what to believe. A mediator can help everyone sort through the issue as calmly as possible. Consult an elder care lawyer. This is only for extreme situations, but especially with accusations of abuse or major financial wrongdoing you may need to take serious measures to protect yourself. Before you take any major action to address the problem, remember that your loved one may forget about it the next day and display no ill will towards you. In the strange world of dementia, sometimes what seems like a serious problem will simply evaporate. And always remember that such behaviors are caused by the disease, and often mean nothing about how caring or devoted you’ve been.
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New eBook: How to Choose a Memory Care Facility

Free memory care ebookAre you searching for a memory care facility for your loved one, but aren’t sure where to start? Our new complimentary ebook, How to Choose a Memory Care Facility for Your Loved One, is a thorough resource that tells you everything you need to consider when making this important decision. Alzheimer’s disease and dementia are challenging conditions, both for patients and for their families. There comes a point when the care mom or dad needs goes beyond what adult children can provide on their own. It’s at this stage that families begin to seek out a place where their loved one can not only have their care needs met, but hopefully thrive as well. This guide covers the following:
  • What to look for regarding a facility’s environment, safety, staffing, quality of care, and policies.
  • A checklist of important details that can help you distinguish high-quality care homes from the rest.
  • How to identify signs that a facility has serious underlying problems.
  • Types of facilities that have dedicated staff and highly personalized care.
  • Important considerations when evaluating the cost of memory care.
This ebook is a free resource provided courtesy of Raya’s Paradise. We encourage you to share it with anyone you know who is looking for a memory care facility for a loved one. Click here to access the book in PDF format. For the best quality, we recommend that you download the file to your computer, rather than reading it in your browser.  
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Exercises for the Later Stages of Dementia

Simple movements are all it takes for late dementia paitents to get exercise.Those in the later stages of dementia may have lost much of their former mobility, but that doesn’t mean that they can no longer exercise, or that it isn’t beneficial to do so. As discussed in an earlier post, dementia patients can slow the progress of the disease by working some activity into their daily routine. We’re not talking jogging and playing volleyball, but rather simply moving and experiencing some physical challenge. Here are a few exercises that those in the later stages of dementia should be able to complete:
  • Encourage your loved one to stand up and move around as much as possible. This will maintain strength in the legs and help with balance.
  • Have your loved one lie flat on the bed for up to a half hour. This will give the neck a break and help him or her stretch out.
  • Help your loved one sit without support. They should not try this out when they’re alone, as there’s a chance they may fall. This will aid the muscles in the stomach and the back that support posture.
  • Your loved one can also stand and balance. If they need to hold onto something for support, they’ll still get some benefit. They can even try this any time they have to stand for a few minutes, such as in the shower.
  • Have your loved one sit on one end of the bed, and then scoot to the other end while sitting. This exercise is good practice for getting up from a chair.
In general, encourage as much movement as possible. The key is to push oneself just a bit to help slow decline. Of course, pushing too far will result in your loved one getting hurt, but not moving at all and always staying comfortable isn’t great either. Be sure to observe your loved one carefully for signs that they’re over-exerting themsevles. When starting an exercise routine like this with your loved one, go slow. Try to just add one thing each day, rather than dramatically changing their routine. Just like younger exercisers, trying too much at once will just lead to an injury or dropping the whole thing. The most sustainable change is gradual, and this is all the more true for dementia patients, who get anxious with change. Also remember that completing exercises perfectly is not the goal: simply moving is. Be encouraging even if your loved one is having trouble. It may be that what they can’t do today, they’ll be able to do tomorrow. As always, speak to your loved one’s doctor about how much movement they can handle.
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