understanding dementia behavior, part four.

fourth tip from fca: ask simple, answerable questions. ask one question at a time; those with yes or no answers work best. refrain from asking open-ended questions or giving too many choices. for example, ask, "would you like to wear your white or blue shirt?" better yet, show him the choices- visual prompts and cues also help clarify your question and can guide his response.

my addition to this tip: when doing the above it's helpful to think "they might not remember all of my options" -- that will certainly help you to limit yourself in case you're a choice giver. choices are good. they're great. everyone LOVES choices, minus people with dementia. well, okay, i take that back. but you know what i mean. just stick to yes or no.

the majority of the above information is from one of my favorite sources: family caregiver alliance, www.caregiver.org

read my disclaimer here.

feeling filled up.

this weekend was exactly what i needed. catching up and being around the girls who've watched me change and grow since seventh grade is really fascinating. so many moments i thought about how collectively successful we are... two physical therapists, an engineer and a therapist... we all left visalia and didn't look back. we've experienced so much, alone and together. i love those girls. there is so much history.

photos to come.

side note: do not taxi from orange to huntington. ever. expensivo!

hipsters versus hip.

i offended two people this week when i was asked to describe their style. i called them hipsters. one of them has the sides of her head shaved and wears skinny jeans and screams cool while the other wears purple v-necks and rides a fixed gear bike. so i did some hipster research and i stand corrected. apparently the people i've offended are just cool. or, hip. but dear god, they are NOT hipsters (they practically cut me up with a steak knife and ate me in bite sized pieces perfect for a four year old).

here is an official definition, brought to you by urban dictionary.

understanding dementia behavior, part three.

third tip from fca: state your message clearly. use simple words and sentences. speak slowly, distinctly and in a reassuring tone. refrain from raising your voice higher or louder; instead, pitch your voice lower. if she doesn't understand the first time, use the same wording to repeat your message or question. if she still doesn't understand, wait a few minutes and rephrae the question. use the names of people and places instead of pronouns and abbreviations.

my addition to this tip: remember that they're adults, not children. it might feel like you need to talk to them the way some people do when speaking to someone who doesn't speak english (like getting louder helps someone understand better). relax. it can be totally frustrating to communicate with someone who has dementia. a lot of this work is trying to separate the way you used to communicate with them with how you need to communicate with them.

the majority of the above information is from one of my favorite sources: family caregiver alliance, www.caregiver.org

read my disclaimer here.

three nights ago.

in preparation for easter in yosemite 2009, one of the roommates purchased a new sleeping bag, which was cause for celebration in itself. what you are viewing below is a sleepover in our living room. apparently we don't sleep close enough to each other already.

if you're asking yourself, "is dan wearing a head lamp and using an electric toothbrush at the same time?" the answer is yes.

we interrupt this broadcast for some GOOD news.

the internal conversation in my head: i got a job. WHAAAAAAAAAAAT?!? yep, it's true. i will be a paid employee while accruing hours come june twentysecond. get out. are you for real? yep, for real for real.

in the mean time, i am totally looking forward to:

• the great urban race. team family double dare plans on winning.
• all things other people's weddings. ie: julie and laura.
• figuring out who my plus one will be to julie and nathan's wedding. and of course, joining in on the LGN project just for kicks.
• switching insurance carriers AGAIN. but for good reason. you see, i'm getting renter's insurance and my car insurance is cheaper if i ditch out on the lizard that i once raved about. plus, it's more amusing when your insurance friend says, "don't worry about hurting the lizard's feelings as he has thick skin."
• having a best friend reunion THIS weekend, which will include things like, but not limited to: eating, sleeping in the same bed, roller blading or bike riding to the beach, laying on the sand at the beach, riding every roller coaster at disneyland, eating, dancing, not being able to keep up with the beverage count, dancing with israeli boyfriends, taking ridiculous pictures and hearing things like, "guys, i can't find my fill in the blank" or "oooh! i don't have that color of hanky pankies!" or "don't leave me. you better not leave me!"
• easter in yosemite 2009.

how would you rate your ability to have fun...

"...poor, fair, good or excellent?"

pause.

"what do you mean 'fun'? because i like beer and sex. can you provide me with either of those?"

and then my face got really really hot.

"nope. definitely not." exhale. "awkward."

pause again. [he's demented; it was at least a fifteen second pause]

"well then i guess i would say poor. definitely poor."

"alright. i think we'll pick up here next time."

must i remind you that my clients, including this one, ARE OVER SEVENTY YEARS OLD. awesome.

sixtythree hours in chicago.

amazing food, a sweet hotel, an architectural boat ride, three museums (THE CHICAGO ART INSTITUTE WAS INCREDIBLE), sears tower, the oprah show, shopping, navy pier, and a cool theater performance.

so fun to go jet setting with my hilarious mother.
(who made us take this photo)

o is for oprah.

i've previously thought about the life of a talk show host. how hard it would be to be "on" all the time when in front of a camera. for some reason that translated to being "on" all the time in life. and WOW did she prove me wrong. she was her great and happy self when the camera was rolling, exactly how we see her on tv. but when the cameras were off... well, not so exciting. not so friendly. not so happy. BUT THAT DIDN'T RAIN ON MY PARADE. kelly clarkson was adorable, ali wentworth was hilarious and jenny mccarthy was just down right honest (fake boobs, botox, life with jim carey, etc.)

the only other surprise besides oprah's boring-ness... not walking away with kelly clarkson's new cd. what's up with that?

what to wear?

i leave tonight for chicago and apparently kelly clarkson will be entertaining me. something about oprah fridays live with kelly clarkson and jenny mccarthy. WHAAAAAAAAAAAT? no favorites show?! damn. oh well, beggars can't be choosers.

hey there brother.

hey there sister.

you know what's scary?

what?

when your mom and your aunt ask to be your friend on facebook.

NO WAY. SHUT UP. wait? aunt molly?

no stupid! aunt sarah!

oh. ok. good.

so get this. sarah called me the other day to tell me about a friend from pre-school who asked her to be friends on facebook.

yah, that's pretty normal.

but sarah rejected her because she's now a porn star.

GET OUT.

yep. pre-schooler friend turned porn star. so. when are you going to get facebook?

i'm not. i don't want to know who the porn stars are. duh.

----

on a musical side note: check out the antlers-- they just released hospice. it's a little bit of bon iver and sigur ros with some radiohead lovin'.

anti-strength.

i see it like this... when there's a loss we don't understand we try to make sense of it. so we pray for things like strength. in the last week i have realized that praying for strength might just be the exact opposite someone who is grieving needs. in the work with my clients who are experiencing extreme loss and now with my friend's family, my sense is that they need the space to feel exactly what they're feeling: deep sadness, anger, frustration, loss. they don't need strength. they need you and me to be strong and to walk with them. they need us to say "you must be tired. let me help you." they need us to have empathy not just today, but in two months and in two years.

out of sequence death is the worst type of grief. this is awful.

understanding dementia behavior, part two.

second tip from fca: get the person's attention. limit distractions and noise- turn off the radio or tv, close the curtains or shut the door, or move to quieter surroundings. before speaking, make sure you have her attention; address her by name, identify yourself by name and relation, and use nonverbal cues and touch to help keep her focused. if she is seated, get down to her level and maintain eye contact.

my addition to this tip: when getting the person's attention and limiting distractions, try not to think of the person as defective; it's really easy to feel like you are talking to a six year old in an eightysix year old body. but they have stories to tell- though they might not relate or be connected, listen to them. chances are, the further they get into their dementia, the less people are listening to them and acknowledging their HUMAN existence. they need you to get their attention and listen to them.

the majority of the above information is from one of my favorite sources: family caregiver alliance, www.caregiver.org

read my disclaimer here.

almost no-knead bread.

i bake when i'm stressed and when i'm bored. and when i'm happy. and when i'm hungry. and when i'm sad. and and and.

anyway, i made bread for the first time. i kneaded and baked it in the oven like a champ.

i feel like a mom sending her five-year-old off to kindergarden. so proud of them (hence the photo) but so sad to see them go (ie: when it gets eaten!). ehh, bad analogy.

a big heart ache.

there's a jack johnson song titled "if i could" that says, "new life makes losing life easier to understand." i believe that's true, usually. i guess i say usually because it makes sense when a new baby is born and an older person dies. but this weekend, the reality of those words didn't comfort me like they have in the past.

i started balling in church today as i found out that my friend's sister lost her babies. we were hanging onto hope and praying that the last four would make it but they didn't. and just yesterday i got an email from a different friend: "eliana was born at 1:14... and is a precious gift." there was a photo included; she is beautiful.

two different families. celebration and mourning. life and death.

joy for one family and devastation for another. i hate this dichotomy.

the rat on the cat on the dog.

i just learned about this man who has a pet rat, cat and dog. not too abnormal, right? WRONG. he has trained his rat to sit on his cat to sit on his dog. and they walk around san francisco like that and make money. i saw them all eating so i took an iphone photo:

and then i googled him to see if there was a better photo. turns out there's a youtube video and it was made in santa barbara:

understanding dementia behavior, part one.

we certainly aren't born with knowing how to communicate with someone who has dementia. but the good news is that we can learn. let me give you some tips.

first tip from fca: set a positive mood for interaction. your attitude and your body language communicate you feelings and thoughts stronger than your words. set a positive mood by speaking to your loved one in a pleasant and respectful manner. use facial expressions, tone of voice and physical touch to help convey your message and show your feelings of affection.

my addition to this tip: do not treat the patient with dementia like they are a five year old. turn off your cutesy voice and turn on your adult voice. if you've never been rainbows and butterflies don't all of a sudden start. be yourself. but check your stuff at the door. don't bring in your angry feelings and your bad day to your demented grandpa. not only does he not care, he doesn't need your added stress. and just because someone has dementia, it does NOT mean they are stupid. try not to talk to them like they are.

the majority of the above information is from one of my favorite sources: family caregiver alliance, www.caregiver.org

read my disclaimer here.

am i at risk for dementia?

uhh..i don't know. you tell me.

let me tell you the risk factors:

age.

genetics, family history.

smoking and alcohol use.

atherosclerosis.

cholesterol.

plasma homocysteine.

diabetes.

mild cognitive impairment.

downs syndrome.

working women while mothering young kids will cause divorce, most of the time.

WRONG. let's find out the truth! the following questions and answers on the topic of working women was researched by my friend, annie, for one of our class projects. as a soon-to-be-mft, it's important to be up to date and know what research is saying. and it's fun to share with you, of course.

annie wrote:

Many women wonder what kind of impact working outside the home has on their marriages. New research has some of the answers...

Does women’s employment increase the risk of divorce? No. Research shows that women’s employment does not increase the risk of divorce, but unhappiness in the marriage does. Women’s employment has no impact on happy marriages and does not destabilize marriages unless the marriage is unhappy to begin with.

Why does some research show that dual income marriages have higher rates of divorce? Women who work outside the home are more likely to divorce if unhappily married than those who don’t work. Working and making money enables women to leave unhappy marriages.

What impact does it have on marriages if the wife is more successful than the husband? It’s unclear. There doesn’t seem to be increased rates of divorce in marriages where the wife makes more money than the husband. However, divorce rates increase dramatically in marriages where the husband is unemployed.

Is it better to live with your partner before you get married? It depends. Contrary to popular thought, couples who live together before marriage have no greater risk of divorce than those who do not, if they are happy living together. If you are happy living with your partner you’ll probably be happy in your marriage. However if you are unhappy living with your partner, DO NOT get married. [duh]

What’s the best age to get married? Research shows that women who marry after the age of 25 have less risk of divorce.

What impact does your childhood have on whether you’ll be happily married? Women who grew up in intact homes have less risk of divorce. Additionally, women who had a poor relationship with their father growing up have a greater risk of divorce. If you grew up in a broken or dysfunctional home, it’s probably best to get some therapy before you get married :)

source: Astone, Nan Marie, Kim, Young J., Rothert, Kendra, Schoen, Robert, Standish, Nicola J., (2002), Women’s Employment, Marital Happiness, and Divorce, Social Forces, 81(20: 643-662)

and here's my addition: no matter what research says, everyone has a different story to tell. [THANK GOD]

what if we all stopped saying it?

it = "you're so strong; how do you do it?"

and instead we said: "you are so strong. i imagine you need a break though. what can i do for you? or how can i help you?"

i asked my client what would happen if someone said that to her. she stopped and thought for a good ten seconds and said, "no one has ever said that to me. everyone just thinks of me as being able to handle anything and everything."

i wonder. how different our lives would be.

i blame my brothers.

because i am completely aggressive on the soccer field. and i blame them for teaching me how to fight. for teaching me how to wrestle with boys. for teaching me how to put my fists up. for teaching me the hold-your-shoulders-down-poke-you-multiple-times-really-fast-between-the-clavicle move. and especially for teaching me that i can fight, even when i shouldn't.

got to play soccer yesterday; probably shouldn't play anymore. yikes.

medicine for melancholy.

opens tonight in san francisco. heard about it on kqed/npr and can't wait. set in san francisco with a garden state feel and more complex racial issues relating to the city i live in. seeing it tonight.

upcoming events.

one. DAYLIGHT SAVINGS IS THIS SATURDAY NIGHT. what?! seems early to me.

two. the price of stamps is GOING UP AGAIN as of may eleventh. fortyfour cents!

the depth of a belly button.

well, mine is deep. like i can almost stick a whole bobby pin in it, deep. WEIRD, i know. and i'm not alone because julie can stick half her finger in there, and she has LONG fingers. this is probably something i shouldn't be disclosing to the internet world, but i figure if anything ever happens to me and you can't recognize me, just check out my belly button and you'll know it's me.

the only thing that was deduced as good from the depth of our belly buttons is that if we ever get pregnant, we have a high chance of continuing to have in INNY instead of being forced to move to the dark side of an OUTTY.

innies for life. [are we alone in this?]

a little bit about alzheimer's.

there are three stages-
early: memory impairment, lapses of judgment, subtle personality changes
middle: memory and language problems worsen, difficulty performing activities of daily living (remembering to take medications, balancing checkbook, etc), visuospatial problems (difficulty navigating an unfamiliar route), disoriented about places and times, delusions (like someone is stealing from them or their spouse is cheating on them), and may become short tempered and hostile
late: lose the ability to control motor functions, may have difficulty swallowing and lose bowel and bladder control, eventually lose the ability to recognize family members and to speak

important to note is that this path is not linear. for example, i have a client who knows my name and recognizes me, has major lapses of judgment, but has some serious delusions. a little bit from the early and middle stages. there is no one route for alzheimer's.

lesley, i promise i'm getting to your question!

read my disclaimer here.

i think i just went to hummus heaven.

have you tried this? seriously. changed my life.

gtd like it ain't no thing.

working on an initial evaluation all day and catching up on school work. so much for a lazy sunday.

today's therapeutic thought from patty's class last week: the degree to which you are angry can be a significant indication of how much you care. try that on for size.

*gtd = getting things done. have you read it? you should.