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2023 MAY Family Caregivers Blog

Family Caregivers' Blog is available to share helpful information to support families caring for those with dementia.

Outbursts in the Evening!?

Mr. A's husband lives in a care facility and has recently begun uttering violent threats like "I'll hit you" towards staff and family members. These outbursts occur particularly frequently in the evening. Previously, he had been very calm, so why the sudden change? This question led to discussions about experiences in caregiving among participants.

It seems that when something disrupts the routine, such as a doctor's appointment or an outing, he becomes irritated. Additionally, stepping out of his comfort zone triggers anxiety and irritability. Since he may not be able to express physical discomfort or pain, it sometimes manifests as verbal outbursts or frustration. These insights emerged from the experiences shared by participants.

Another symptom associated with dementia is called "sundowning." As dementia progresses, individuals may experience sudden mood swings, aggression, restlessness, or increased confusion, especially around evening time. This phenomenon is referred to as sundowning. While distraction techniques and calming strategies can help manage these symptoms to some extent, medication may also be necessary. In fact, Mr. A's husband is on medication for this reason.

Timing is crucial when it comes to medication. It's best for Mr. A's husband, like many others, to take his medication before he becomes irritable. It seems that the medication starts to take effect after some time, just when he would typically become agitated. After all, once he's already irritated, he may not be willing to take the medication.

"Wouldn't it be Nice to Have Some Help?"

We discussed how it would be beneficial for elderly individuals living alone to have some assistance, regardless of whether they have dementia or not. According to Mr. B, in Toronto, there is assistance available for "snow shoveling," provided by the city free of charge. It would be great to have a similar "snow shoveling" service near Vancouver, where we occasionally get snow. Another helpful task could be changing lightbulbs. In Japan, some community services, such as the bus drivers for day care transportation, also provide assistance with tasks like changing lightbulbs. Unfortunately, we don't have such services here, which can be inconvenient. Fortunately, our neighbor Kumi-san is looking into whether such services are available somewhere. Stay tuned for updates!

"Taking Care of Your Feet: Importance Matters!"

One symptom that arises with dementia is neglecting personal care tasks such as bathing, brushing teeth, and trimming nails. A common concern among participants is that caregiving family members or those offering assistance may be resistant to providing or receiving personal care. What we casually do as personal care actually requires advanced cognitive abilities. Tasks like filling the bath with water, preparing soap and shampoo, undressing, and getting towels ready all require complex cognitive skills. With dementia, these abilities are lost, leading to neglect of personal care. The same applies to brushing teeth and trimming nails. While caregivers may notice and attend to fingernails, toenails are often forgotten since they're out of sight. However, participants unanimously agree that trimming toenails can be challenging. Ingrown toenails are a common occurrence and can cause pain, leading to difficulty walking. Since avoiding walking is undesirable, it's crucial to prevent this. Sometimes individuals may not communicate their pain effectively. Mrs. B's mother regularly has her toenails trimmed by a footcare nurse. Footcare nurses are specialists in foot care and can also address issues like corns. For individuals with diabetes, especially, having a footcare nurse handle toenail care provides peace of mind!

"Thank You, Volunteers! Collaboration with Family and Facilities is Key to Support"

Mrs. B's mother relies on volunteers at the facility for assistance. These volunteers speak Japanese and engage her in familiar activities, becoming an integral part of her important routines. The volunteers work diligently, playing a crucial role in supporting her daily life. However, while Mrs. B is grateful, she also finds them somewhat of a headache. This is because sometimes the volunteers take her mother away for activities during her important bi-weekly bath time, causing her to miss the bath or other care routines. Mrs. B has been trying to coordinate with the volunteer organization, but it's proving challenging.

The care provided by the facility, the activities organized by volunteers, and the care provided by family members are all essential for her mother's well-being. During such times, coordination among everyone becomes crucial, as agreed upon by the support group participants. Collaboration is key to maximizing the effectiveness of each form of care. Mrs. B continues to strive for collaboration with the volunteer organization and the facility. Even after entering the facility, the struggles of family caregivers seem to persist.

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