Important Legal Documents for Memory Loss Patients

What Makes a Great Memory Care Facility?

At Tanglewood Assisted Living, we practice the five foot rule with memory loss patients. If you wish to be understood by a memory loss patient, you should be within five feet of that person when you speak to them. Most memory loss patients simply cannot process words that are shouted at them from across the room. In order to communicate effectively you should get close, make eye contact and begin by using the person’s first name. If the patient is sitting down, you should not stand over them and talk down to them. When you stand up, you assume a dominate posture which makes people feel uncomfortable. Instead, kneel down so you are at the same eye level as the patient and you will immediately put them at ease. Touch is important to memory loss patients. While you’re speaking, hold their hand or put your hand on their arm or shoulder. Be generous with hugs and handshakes. At Tanglewood, the staff is trained repeatedly to maintain a calm and pleasant tone of voice. Memory loss patients have not lost their ability to appreciate tone of voice and if you become upset you will only make a bad situation worse. Some patients will be depressed or mad at the world. With these you should commiserate. Offer compassion, sympathy and condolences. Other patients may be mad at you. They may accuse you of all sorts of atrocities. With these folks you should simply apologize and say you’ll try to do better. You should never get mad. Always remain calm and pleasant. If you do feel yourself becoming upset, walk away. Make sure the patient is safe and walk away. Come back in ten minutes and the patient’s attitude will have changed completely. Ask only simple questions of a memory loss patient - questions which require a yes or no answer. Don’t ask “would you like lemonade or ice tea?” Even such mildly complex questions generate confusion. Ask only yes or no questions. The best chance of having a coherent conversation with a middle or late stage memory loss patient is to talk about events that happened long ago. Such very old memories usually remain intact and the memory loss patient will feel comfortable talking about them. If possible, bring photographs from the patient’s younger days and talk about the people and places in the pictures. Finally, musical memories also remain intact. A patient will remember and enjoy the lyrics and melodies of music they’ve heard throughout their lives and especially music they heard as a child. They will usually enjoy and sing along with hymns and pop music songs they heard in their youth.

Unfortunately, almost all memory loss patients will become incontinent. At first they will have an occasional accident but eventually they will forget when and how to use the bathroom and will need to wear an undergarment all the time. While nothing can prevent this from happening, there are some techniques which can delay incontinence and cut down on the number of accidents. Prompting: Accidents often occur because the memory loss patient simply waited too long before heading for the bathroom. If a caregiver will prompt the patient every two to three hours, by asking if they need to use the bathroom, the number of accidents can be reduced significantly. If the memory loss patient continually says they don’t need to use the bathroom, the caregiver should respond with “let’s give it a try” and help the patient to the bathroom. By the time you get to the bathroom, the memory loss patient may suddenly realize they have to go. An old trick which may help is to sit the patient on the toilet and run water. Bedside Commodes: Many accident happen at night. Often a sleepy resident will have trouble getting to the bathroom in time. Putting a portable commode next to the bed and keeping a night light in the room will help this situation. Washable Protective Pads: An incontinent patient can damage or destroy furniture, mattresses and carpeting. A caregiver may have to remove and wash bed linen every morning. Even the best undergarments are subject to leaks. If you have a loved one in the house who suffers with incontinence, you should cover your furniture with washable protective pads, often called “chuck” pads. Chuck pads should be used to cover furniture and mattresses. Even mattresses with waterproof mattress pads should also have an extra large chuck pad underneath. These pads are now available in a variety of colors to match the furniture. Undergarments: Some undergarments pull up and down like underwear and are useful in the early stages of incontinence when the patient still uses the bathroom by themselves and the undergarment is mainly to protect against accidents. To change this type of undergarment however, the caregiver must remove the patients shoes and pants to put on a new undergarment. This inconvenience can be avoided by using briefs which are secured on the sides with elastic bands and buttons. These can be changed without removing the patient’s pants.

Quite often a memory loss patient will say they need to “go home”, even when that patient is living in a house where they’ve spent their entire adult life. The “home” a memory loss patient seeks is probably the home where they grew up. Even though short-term memory is deteriorating, long-term memories remain intact and are very real to the memory loss patient. Because of this, memory loss patients often behave as if the places of their youth are nearby. They also believe the people who were close to them in their childhood are still alive. Frequently, memory loss patients will say they have to go because their mom or dad is waiting for them. Such powerful impulses often drive patients to leave their own home or an assisted living facility and wander away outside. Sometimes patients will wander outside even in the worst weather. Sadly, wandering is a common cause of injury and death for memory loss patients. DOOR ALARMS: Door alarms are essential for any home where a memory loss patient resides. Wireless versions are available at many hardware stores and are easy to install. Magnetic transmitters are attached next to each exit door and generate an electrical signal whenever the door is opened. The signal then triggers an alarm. During the day the device can be set to emit a one-time alarm, something like a doorbell. At night the setting can be changed so the device emits a noisy, continuous alarm, something akin to a police siren. The alarm will continue to sound until a until a switch on the side of the device is reset. The continuous alarm ensures that a sleeping caregiver will wake up if their loved one is trying to walk out at night. (The alarm has the added benefit of deterring anyone attempting to force entry into your house at night.) Although more elaborate and expensive alarm systems are available, such as ones that sound only when the memory loss patient approaches an exit door, a simple wireless system is probably sufficient. Remember, these alarms don’t work unless the door is closed each time between uses. WINDOW PROTECTION: Memory loss patients can be very determined and will occasionally climb out a window. Windows can be fitted with stop guards which only allow the window to open a few inches. Some windows have stop guards built-in and if not, after-market stop guards can be purchased inexpensively at your local hardware store. Check with your fire department before installing any device that limits the opening of a window which may be considered a fire exit. Window alarms, which function like door alarms, are also available at many hardware and home supply stores. SUPERVISED WALKS: For memory loss patients who remain physically fit and active, a long walk outside with a caregiver can reduce the patient’s desire to leave the house. In addition to reducing the desire to wander, the fresh air and the exercise can also help with the patient’s sleep habits and overall attitude. Usually, longer walks produce better results. The patient returns to the house tired, more content and less agitated. If the patient is willing, you should take walks in all seasons. Walks help the caregiver as well and provide memories of quality time spent with a loved one. IDENTIFICATION WRIST BANDS: Memory loss patients can be fitted with a bracelet which serve the same purpose as a medical alert bracelet. The bracelet identifies the person and their condition and includes phone numbers to call if anyone encounters the memory loss patient on the street. This type of identification is a good idea provided the memory loss patient will wear the bracelet. SEARCHING: If a memory loss patient does wander off, call the police immediately. Many police departments have tracking dogs trained to follow a scent. Call local television stations to broadcast pictures and information about your lost loved one. Immediately have someone visit or call everyone in your neighborhood. Often a memory loss patient will end up on the porch or in the garage of a nearby house. Have as many people as possible begin searching in cars and on foot or bicycle.