This September 2020 marks my fourth anniversary of caring for one of my Alzheimer’s clients. She turns 94 in November. In the four years that I have been with her, I have only experienced three baseline confusion episodes, and each one lasted about six hours.
We (all caregivers) log everything. We read each other’s log entries from shift to shift to understand where our Alzheimer’s patient’s activities and experiences have journeyed from week to week or from day to day. My experience with her is very positive. I have been with her for four years. Because I am a full-time student, I work twelve hours per week with her during school and fifty hours per week during summer, spring, and winter breaks. The first year with her, I worked a forty-hour week before I started school. I learned triggers that made her uncomfortable and triggers that made her happy, content, satisfied, and joyful. Of course, I avoided the triggers that upset her and concentrated on triggers to satisfy her and make her life experiences pleasant.
Her baseline confusion and triggers have changed and evolved through the four years as her vascular dementia and Alzheimer’s has progressed. But she is still the wonderful lady I first met and have come to love as a dear friend. Allow me to demonstrate a current example. A positive trigger is the watching of old Engelbert Humperdinck music concerts. When she listens and watches any of the performances, she will make comments as to his age. If he is young, she will reference him as her lover; if he is middle-aged, he is her brother-in-law; if he is old, he is her father-in-law. She talks to the TV monitor and believes that the image she sees is an actual person. Sometimes she will get up off her chair, walk over to the TV monitor, and ask the image on the screen to come down and come and sit with her. (It is a wall-mounted ex-large screen TV monitor.) When the image does not respond to her invitation to join her in the family room, she may become agitated. Usually, when this happens or even before it happens, we, the caregivers, have learned to change the channel and present music with a static or moving nature scene without people. This calms her, and she is soon content again.
I constantly conversate with her, dance around her chair with the music, or give her an activity. She was a seamstress in a New York sweatshop when she arrived from Italy in the 1940s, so she has a very high work ethic. The other day she was picking lint off of her sweaters and asked for a pair of scissors. I had a pair in my bag and gave them to her. I oversaw her and asked her if she was going to cut her sweater. She said no. She explained that she needed work to do. My eyes lighted upon a basket of rags on the counter used to clean the doorknobs and light switches each shift. I gave her the basket of rags, and with the scissors, she neatly trimmed each rag, folded it, and proceeded to organize the rags by size and color. When she was finished, she neatly sorted and organized the rags to fit perfectly in the basket. When she was finished, she gave the scissors back to me. She then went on to tell me a story of how she worked as a seamstress in New York and how important it was to be neat and organized. She felt accomplished; I praised her for a job well done. She then contended, we returned to listening to music with full concentration.
She and her husband use to dance together and perform as part of a senior dance team; she loves it when I dance in the family room as we listen to musical concerts of Dean Martin, Frank Sinatra, Elvis Presley, and even Michel Jackson. Often time she will get up and start dancing with me.
I am with her when she wakes up. I have learned to perform positive triggering, such as brushing her hair and helping her to don her apron immediately upon awakening. As soon as she is standing, I put the music on. Music therapy is one of the best positive triggers for her. It gives her mind and emotions a steady beat/rhythm to connect to and aids in memory connections that make for a less confused and happy person who happens to have vascular dementia and Alzheimer’s.
April Cares 