caregiver

Hi, This is My Grandmother!

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Spoiler alert: this post has nothing to do with my grandma. It’s not a sappy account of how I consider my residents to be my stand-in nonnas, either (though that is obviously the case). It is, however, in reference to a “role” I guess I could say I’ve happily assumed: One of my favorite residents constantly introduces me as her grandmother. I’ll get the occasional “daughter” or “neighbor,” but a solid 97% of the time I’m her grandma.

I joke about my laugh lines and how I have an old lady bedtime, but I can confidently say I don’t look like my 80-year-old love’s grandmother. Regardless of her reality orientation, there’s no way she would visually mistake me for her, as even if she believes herself to be ten years old, her grandma would not be pushing 30. Why does she call me that, then? Though demented, this seemingly offensive (wrinkle cream regimen starts TONIGHT) introduction has nothing to do with her memory; she has aphasia.

Aphasia refers to the inability to understand and formulate language due to impairments in specific neurological regions. In other words, it’s an f’ing nightmare. They say there are four communication modalities: auditory comprehension, verbal expression, reading & writing, and functional communication. Aphasia significantly impairs at least one at a time, and its symptoms range from the occasional difficulty finding words to losing the ability to speak, read, or write. However, it has zero impact on intelligence or episodic memory. Semantic memories, on the other hand, are compromised; while an aphasic individual will retain their experiences and remember life events, their comprehension of words, pictures, objects, and environmental stimuli is destroyed. This means that as the disease progresses, they lose not only the ability to name things, but also the meaning or conceptual knowledge of those things they’re trying to recall.

As if the above wasn’t scary enough, it’s important to understand that aphasia doesn’t always go hand-in-hand with dementia. Sadly, it’s way more common than one might imagine: according to Robin Straus of the Adler Aphasia Center, 1 in 250 people experience the disease. That’s more than Parkinson’s, Cerebral Palsy, and Muscular Dystrophy. It’s most often the result of a stroke, but any damage to the left hemisphere of the brain can cause aphasia – think brain tumors, traumatic brain injuries, and progressive neurological disorders like dementia itself. Oh, and there’s no age limit.

But if it’s not my laugh line wrinkle, how am I a grandma to my aphasic love?! If they can’t think of the correct name, nonnas with the disease may substitute a word with a related meaning, such as saying “wedding” for “ring” or “music thing” for “piano.” Her grandmother was an important person in her life – a source of comfort, joy, and love. Her brain can’t remember what to call me, but it knows we share a unique bond (cue my cliché tears..) and that I make her feel at ease. That’s evident not necessarily in the words I speak, for they’re not understood; it’s in the laughs, the playful shrieks, the overly affectionate hugs, and the kisses every morning. That her mind remembers, her heart won’t let her forget.

While she talks a mile a minute, my love –to be completely blunt– makes no sense at all. It’s extremely difficult for her to communicate her thoughts and to understand those of others that are relayed to her. Repeating something to her, even slowly and with clear enunciation, will make no difference; the issue does not lie in whether or not she hears you, but rather deep within the wiring of her brain. As Dr. Taylor so frankly put it:

“Their current dilemma continues to be to figure out just why I am not complying with their requests. Is it because it hasn’t registered in my brain? Is it because I can’t figure it out? Is it because I forgot it? Is it because I don’t believe them? Is it because I don’t want to do it?

Old strategies that worked for years – say it again and say it louder – just don’t work any more. I’m glad I’m not a caregiver who has to figure me out every day.”

– Dr. Taylor

Instead of asking the same question twice, try rephrasing it. Use short words and simple sentences, avoiding multipart requests. Do speak slowly and be patient when awaiting a response; the act of processing and replying to a demand may take much longer than what is natural to us. Use other signals besides spoken words: point, touch, write, etc. Most importantly, be empathetic and have patience. Don’t take things personally and expect the unexpected: even if your nonno’s never muttered a curse word in his life, you may be compelled to wash his mouth out with soap. Unfortunately, increased cursing just seems to be a quirk of language skill diseases. Don’t feel embarrassed or, worse, embarrass him; laugh about it! Just last week, my beloved “granddaughter” called me a skinny b*tch. Naturally, I took it as a compliment ;), as I most certainly do her usual nickname for me. I’ll gladly be her grandma any day. ❤

 

*note* This post was written prior to the extremely unfortunate passing of the love I mention above. It is dedicated to her and aphasia awareness. Please don’t hesitate to email me or comment below for more detailed information or additional resources. Our lives will be sadder and our days duller without you, D.

I Care: A Handbook for Care Partners of People with Dementia

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No book review in over a year ≠ no books read in over a year. However, none have truly moved me enough to write about them… until I Care: A Handbook for Care Partners of People with Dementia. Though well over 100 pages, I Care is a quick, easy, engaging read that I honestly couldn’t put down. Its co-authors are well known in the field and offer not only insight and guidance, but also real-life stories of caregivers navigating the world of dementia.

One of my favorite things about I Care is the way the authors explain dementia and exactly how it can affect various parts of the brain. They’ve written in a manner that is both informative and easily understood. An awesome analogy, for example:

“[the brain] is a communication network, with neurons being the computers and phones, and the axons and dendrites being the wires and radio signals that allow them to share information.”

Why didn’t our bio professors explain it this way?! Find I Care on Amazon here.

Kiss Me Like You Mean It

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Full disclosure: I am not a PDA kind of girl. The above title is actually a direct (and frequently used) quote from a college boyfriend who was contrarily very into public displays of affection. He was super huggy and kissy regardless of where we were or who was around, and the fact that I wasn’t drove him nuts; a quick peck to appease him was clearly insufficient, hence the “kiss me like you mean it.” Don’t get me wrong, behind closed doors is a completely different story – I am beyond affectionate, playful, and even huggy-kissy. There are only two instances in which you’ll witness that side of me in public, however: with dogs (surprise, surprise 😉 ) and with my loves.

I am a huge advocate for touch. Numerous studies have proven that it’s not only essential for our development, it is also necessary for us to grow, learn, and literally survive and thrive. From infancy, touch is used to both communicate and to heal; a loving caress releases oxytocin and instantaneously boosts one’s mood, strengthens the immune system, and reduces stress. It’s not one-sided, either: there is evidence that the person doing the touching gets just as much benefit as he or she being touched. Incorporating even the simplest pats with other forms of communication increases connectedness, improves attitudes, and calms nerves. We are biologically wired to the need to connect with others on a basic physical level, and it’s something we don’t grow out of.

I’m not alone in being anti-PDA; we are a seriously touch-phobic society. The resultant touch deprivation in the elderly is alarming, especially for those who are frail or demented. Such deficiency leads to feelings of isolation, anxiety, poor trust in caregivers, a greater decrease in sensory awareness, and insecurity – the last thing they f’ing need. As if dementia didn’t leave one feeling frightened and alone enough, our lack of intimacy just kicks a nonna while she’s down, as to deny it is to deprive her of one of life’s greatest joys and deepest comforts.

It’s not just our nonnos we’re depriving, either: a study from the 1960s looked at café conversations all over the world. In France, friends touched each other 110 times per hour. Puerto Ricans beat them by 70 – a whopping 180 touches were recorded in the span of 60 minutes. In the US? Twice. In “bursts of enthusiasm,” we touched each other twice. 😐

Touch is the universal language of compassion. When words are no longer understood, there is no better substitute than a gentle hug or holding hands. In old age especially, the need for physical affection is more powerful than ever, for it is one of the only sensuous experience that remains. It is one of the few persisting methods of communicating with a nonna of limited cognitive function, and its effects are both physically and emotionally favorable. In a study that examined the impact of touch on appetite in picky elderly eaters, all participants had a significant increase in caloric intake when given a gentle touch and spoken to during mealtime. Additionally, a study on dementia patients proved that touch is calming; all residents who received hand massages presented significantly less agitated than those who did not.

Sources of proof are endless; there is no question that affection is insanely beneficial to seniors (and to the rest of us!). How we choose to implement it in our daily practice is subjective. In my own experiences, I have found that while being huggy-kissy with boys makes my eyes roll, doing so with my loves is invaluable. I greet nearly every resident with a kiss.. I don’t care if they’ve got half their lunch on their lap or if they’ve had a cold for days, I’m wrapping my arms around them and kissing their cheeks (don’t worry Dad, I wash my hands). If a nonno’s in a wheelchair, I crouch beside him and rest my hand on his knee. I’ll walk arm-in-arm with nonnas and cozy up on the edge of their recliner when we rest. I’ll sit right on that hospital bed, my fingers locked with theirs, regardless of cognizance or how tightly they grasp back. If there are tears (God, I hate when there are tears), I softly wipe them dry. I kiss them like I mean it, and honestly, the impact is immeasurable.

Time Flies

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I cannot believe the post entitled “Conversational in Italian, Fluent in Pavarotti” was written over a year ago. As we wrapped up one of our awesome parties at Il Sogno last night (this one featured a belly dancer :-O), I can’t help but reflect on the truly remarkable effects music has on people. I just had to repost (while listening to Pavarotti, of course)!

Since I recently left the kennel ( </3 ), I’ve decided to update my resume to be sure it’s reflective of where I’m at now. I have a “Skills” section at the bottom where I mention that I’m “Conversational in Italian,” and I’m impatiently waiting for the day that I can confidently change it to “Fluent.” I probably have a solid 10 years before I’m close, so Conversational is staying for now. I am, however, tempted to include “Fluent in Pavarotti” below my subpar Italian skills, and I have my loves and this trip to thank for that.

According to Paula Spencer Scott:

“The arts have an amazing power to reach people with dementia. When rational language begins to erode, symbolic emotional communication remains. That is what art is, symbolic emotional communication – sharing a vision of the world through gestures, words, sounds, images. Shared communication of any kind can bring people suffering from loneliness and isolation into community.”

She goes on to specify that “lyrics can stay in the brain even after language skills are lost; music can be a real source of joy.” How nuts, right?! We’ve all of course experienced this to some degree – an old favorite pops up on shuffle and we’re able to excitedly recite every word. Songs often evoke memories, too. I always make playlists for my trips so that when I’m home, I can be reminded of that vacation and how it made me feel.

If it hasn’t been apparent already, I truly value and appreciate what Dr. Taylor writes in his essays (being that he is battling Alzheimer’s himself):

“Singing something, anything, from children’s songs to hymns, from the Hallelujah Chorus from Handel’s Messiah (I can still recall the first note for tenors) to any and all Beatles songs, helps me feel that I am feeling okay and, in fact, good.”

It’s no secret that music is an incredible therapeutic tool. My only dilemma initially was that I am not, in fact, a ninety-something year old nonna; I didn’t grow up here, I understand next to nothing when I hear different dialects, and the closest thing I’m familiar with to an old Italian song is “Dominick the Donkey.” While my site doesn’t offer formal music therapy, a few patients are avid (and loud) singers. I began to decipher as much of what they were belting out as I could, then searched Google for the rest of the lyrics and to find the title. The clouds parted and God presented Luciano Pavarotti, one of the most successful operatic tenors of all time. Thankfully for me, he’s covered almost every top hit amongst my audience.

Our day to day has changed. While not a music therapist, I am a self-proclaimed Pavarotti cover artist and enthusiast. My laptop speakers blare songs with all their might, and w e g o n u t s; we f’ing scream those lyrics, thanks in part to the advice of Dr. Taylor:

“It is best to sing out loud and loudly. Thinking about singing is like thinking about sex. It is much, much more satisfying if done with all of your body instead of just between your ears. It is much, much more satisfying if others can and do join in.”

What has this incorporation of music done besides wake our neighbors? It’s allowed us to let loose, have fun, and simply enjoy each other. A loud singer is a lot less aggravating to others if they themselves have joined in too. It has also, and most importantly, facilitated communication and elevated mood. There are nonnas who I actually believed to be unable to speak that have since blossomed into some of the most caring, outgoing, and affectionate patients that I have the pleasure of loving every day. One in particular hadn’t smiled or spoken once in the weeks that I’d known her; I had ignorantly assumed her to be either shy or too far cognitively impaired to converse. She is one of my most passionate (and vocal!) back-up singers today, and she does not stop hugging, kissing, or smiling.

I cannot forget my nonnos, some of whom can often be particularly cranky (am I the only person who adores cranky old men?!). One of my favorites enjoys sharing stories about his hometown (my Roma ❤ ) but becomes more forgetful and likely disinterested when in an unfavorable mood. Though not a singer himself, after our concerts he is without fail more cheerful and able to recall that which he had difficulty remembering only hours before. It is truly remarkable what music can do. Grazie Pavarotti ❤

*note: our fav https://www.youtube.com/watch?v=UNmT7UswM7E

Rainbows & Tornadoes

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Last week, I had a nightmare so vivid that it woke me from my sleep. On a normal afternoon, an eerily calm friend warned me of a fast-approaching tornado. When he brought me to the window and I saw it for myself, I knew time was of the essence: this monster storm, equipped with lightning bolts and roofless homes, was tearing through the streets. As quickly as I could, I grabbed every nonno and nonna in sight and hurried to the elevator. Once safely in the basement, I slid into the crawlspace and peaked out its tiny opening. When the twister hit our building, it was so loud I panicked IRL. How horrifying is that?

My nightmare does not go with the compassionate, encouraging, optimistic theme of this blog. It is neither comforting nor hopeful. It is, however, an indisputable metaphor for an unfortunate reality: despite its infinite rewards, caring and advocating for the elderly can burnnnn youuuu outttt.

Is this burnout inevitable, or is it felt only by the weak? I was fortunate enough to meet Dr. Charles Dodgen, author of Simple Lessons for a Better Life, this month. Dr. D has posed a similar question:

“Is the capacity for love, compassion, and caring for others finite? … Do the burdens of human service necessarily result in exhaustion of caretakers so that they either have limited careers or become emotionally debilitated?”

Respite and self-care, I’m learning, are a lot like trekking sticks: no matter what we’ve got to offer or how in shape we think we are, we all need them:

“There is no limit to the depths of these reserves or the number of people one can love or care about. However, there are certain basic conditions that I believe must exist in order to maintain the supply of compassion.”

Dr. Charles Dodgen

To care for someone you love, particularly someone older, frail, and vulnerable, is both an honor and a duty. Advocating on their behalf will be equal parts rewarding and disheartening.. hopeful and discouraging.. empowering and humbling. It is simultaneously one of the most fulfilling and draining things you’ll ever have the strength and courage to accomplish.

The ultimate loving act, however – the ultimate selfless act is to first love yourself enough to care for you:

“Think of it as an investment that will allow you to love and support the person who’s sick. When I felt my reserves were depleting, I’d remind myself to stop achieving and start receiving.”

Paula Spencer Scott

As Dr. D reiterates, “Another major factor that affects a caretaker’s ability to give positive, loving care to residents is the general condition of his own life.” We must secure our oxygen masks before attending to a child, and blow up our life vest before assisting a companion (sorry not sorry for the flight references 😉 ). The point is, if we do not take care of ourselves first, we will not be in a position to love and care for others. Get your nonna to the basement, but make sure the crawlspace is vacant.

Lonely or Alone?

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Have you ever heard the saying, “Being alone doesn’t mean you’re lonely, and being lonely doesn’t mean you’re alone”? The psych grad in me is cringing – I can’t find its source to cite it anywhere! Though it’s only been a month, working at Il Sogno has already taught me an incredible amount of information, much of which relates to the aforementioned quote.

It’s no secret that the value of personal connections is immeasurable. In fact, it has been found that social engagement is a more potent predictor of health and longevity than is our age, chronic disease, or even risk factors like smoking cigarettes. In its absence, studies confirm there is an increase in depression, blood pressure, cholesterol, heart problems, cognitive decline, and even Alzheimer’s disease. Loneliness, then, is not only depressing; it’s unhealthy.

Luckily, we have just under 90 nonnos and nonnas residing at our community. Between the caregivers, dining staff, managers, and nurses, I couldn’t guess how many employees there are; one thing we’re not is desolate. But is that enough? As my mystery saying alludes, warm bodies don’t fill voids; loneliness is not necessarily defined as the state of being alone, but rather as a lack of intimacy. There is no significant relationship between solitude and sociability.

Truthfully, our census is irrelevant. There are 45 million seniors in the US alone, yet nearly half of them feel lonesome. Each nonna at Il Sogno requires two types of assistance: emotional support and hands-on care. The latter tends to physical needs and is necessary (but not sufficient) for survival. Emotional support, however, enhances confidence, upholds respect, and nurtures value. That’s where our hearts come in.

“Emotional intimacy depends primarily on trust, as well as the nature of one’s relationship. It frequently involves individuals discussing their feelings and emotions with each other in order to gain understanding and offer mutual support. It is necessary for human beings to have this form of intimacy on a regular basis for them to develop and maintain good mental health.”

There is no health without mental health. Warm bodies heal the wounds, but it’s love that lifts the spirits.

“Actually, what I need is to feel that I am still taking care of something. Something that returns love, that gives itself away without expecting anything back. Something that never, ever judges me but just accepts me for who and what I am at that particular moment. Something that is not hung-up about who I was, or who I am, or who I will be. … Something that is happy to be with me no matter where I live, or am forced to live (for my own good, of course). Something that remembers little or nothing of yesterday, but does its best to make today the best day of its life and, quite unintentionally, the best day of my life.”

– my favorite, Dr. Taylor

Passionate, successful care partners exude empathy and perseverance. We focus on the present, brighten days, and practice patience. We celebrate accomplishments, seek out guidance, and give thanks. We offer more than helping hands; we fill hearts and we feed souls. With love and positivity, we partner and enrich. Grazie a Dio, we’re neither lonely nor alone.

We Need to Talk…

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Last week, I got a call at work from a concerned nonna inquiring about our services. She explained that her husband is in the earlier stages of Alzheimer’s, but that it’s difficult for her to talk to her friends about his condition; not only can they not relate, they’re skeptical about what she describes. Though he’s been getting lost, taking four days’ worth of meds in one pop, and hiding keys in the freezer, in social situations, this same nonno shines. He’s able to chat with acquaintances and is the life of the party.

This may sound surprising but it’s actually not uncommon at all. We often hear only of the losses associated with Alzheimer’s disease and are therefore unfamiliar with what’s preserved. Early on especially, the right side of the brain is left relatively untouched; while one’s reality orientation, impulse control, and eyesight are diminishing, their ability to engage in social chitchat is intact. In addition, they hold on to rhythm and music and (uh oh!) curse words, which is why your angel of a nonna may come out with things that would have otherwise appalled her.

Pretty interesting, vero? When I lived and volunteered at il Rifugio three years ago, one of my loves used to always say things like, “Look at you. I remember when you were a tiny baby! How’s your mother? Everybody good at home?” She’d even call other nonnas over to revel in how big I’d gotten. I’d obviously never seen this lady before, but I was more than happy to laugh with her about my chunky high school years and how protective my crazy brothers are.

I had countless conversations like this in Treviso, too, and also since I’ve been home with my new loves at Senior Helpers – one is even convinced that my boss is my dad :-O . Could I correct them and specify that we’ve just met? Or skip the small talk and get down to business? I guess, but why the f would I want to do that? Recently, I visited an Italian-speaking nonna who we care for five days a week. I was obviously ecstatic to meet her. After sitting at her kitchen table for a little while, she asked me why I had come by. When I responded with, “Perche no? Just to see you and spend time together,” she actually cried she was so happy.

Cary Henderson, a former history professor who suffered from Alzheimer’s disease and recorded his thoughts, has said:

“And another really crazy thing about Alzheimer’s, nobody really wants to talk to you any longer. They’re maybe afraid of us. I don’t know if that’s the trouble or not. I assume it is, but we can assure everybody that we know Alzheimer’s is not catching.”

I beg you, chat with your love. Talk about anything. Shoot the breeze with the nonno who lives down the street. Call the nonna who shops at your job and who you know is alone. Chat even if they’re mistaken, and especially if they’ve lost the ability to answer you back. These social interactions, while seemingly trivial, can mean the world to someone, even after their mind has deteriorated and their memory is erased.

Do We Ever Grow Out of Being Afraid?

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Soo I reluctantly had a birthday recently and am officially a late twenty-something 😐 At 27, I’m already a solid three years into a full blown quarter-life crisis. I’ve spent too much time thinking about who I am, where I’m going, and what I want. I have set goals and chased dreams. I’ve taken chances, saved all my money, spent all my money, and learned big lessons. Despite some questionable decisions and bumps in the road, I’m proud of and ecstatic for present and future endeavors. I still, however, can’t silence all of my twenty-something anxieties; though older, I’m still afraid.

As much as I like to argue otherwise, 27 fortunately isn’t that old. My fears are justified, perhaps, but they’re trivial; I worry about wrinkles and paying rent. I’m afraid of Ferris wheels and spiders and being late to work. I’m scared to go to a bar and not be asked for ID. Otherwise, I am for the most part blissfully naïve and pretentiously invincible.

I joke around, but not all my fears are narcissistic; after all, I work and immerse myself in a field that treats the demented. I see firsthand the impact that Alzheimer’s has on both its victims and their caregivers, and it’s terrifying. It’s no surprise that the disease was recently found to be the scariest disabling condition in later life. According to those 3,000+ surveyed, it’s more frightening than cancer, heart disease, stroke, and diabetes combined.

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It’s not uncommon for those experiencing symptoms of dementia to attempt to deny and conceal them, and understandably so. Who the f would want to admit to people that they have the most feared disease out there?! Imagine the humiliating stigma that accompanies a brain disorder. If sharing a diagnosis resulted in being treated like an incompetent child, I’d keep quiet too. Similarly, those caring for a loved one displaying signs are often quick to conceal as well.. if I can’t bring myself to face or accept that my mom is slipping, how am I supposed to speak of her condition aloud?

What we don’t realize, however, is the damage this denial does. Alzheimer’s is progressive and as of now it can’t be cured, but at least its symptoms can be kept at bay or its progression slowed. Early diagnosis allows for planning and for treatment, both of which nonnos and nonnas should be involved in themselves. With this disease, time is undoubtedly of the essence and unfortunately not on your side.

To add some perspective, those experiencing Alzheimer’s symptoms who are worried about stigma remain undiagnosed for 3½ years. That’s 42 months! 42 months that could have been spent delaying advancement, deferring effects, and planning for the future. Especially frightening is the fact that when we as caregivers are concerned of stigma, the delay is even more severe: a nonno remains undiagnosed for an average of 6 years.. 72 f’ing months.

These are serious and unnecessary setbacks. I understand this disease is scary; I witness it every single day. It can be not only confusing, but absolutely heartbreaking and discouraging. It requires the biggest adjustment you’ll likely ever have to make in your lifetime. I beg you, though, be honest. Be open about what you’re seeing or experiencing. Be accepting and empathetic, not shameful. Show compassion and truly mean it. The disease itself is daunting enough – seeking support shouldn’t be.

Approaching Relationships

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It’s been way too long since I’ve posted here! I’ve been debating about whether or not to keep going, as I’m back home and unfortunately no longer with my loves. However, there’s so much more that was learned that I didn’t have time to share, so I decided to keep it up! That and I’m hoping to get a job in the field here, so I will ideally have plenty more to write about in the near future 😉

When I first started working with patients back in 2012, I remember having mixed feelings regarding visitors. Some family members would come to il Rifugio every single day, others occasionally, and some I had never met at all. The same held true this past trip.

I understand that it’s difficult; the illness’s impact on relatives and caregivers can be crippling. Of course, then, the thought alone of the possibility that a loved one may be showing signs of it is terrifying. In fact, a recent survey revealed that people fear being responsible for someone with Alzheimer’s more than they fear actually having the disease themselves. :-O No wonder some have a hard time visiting!

I’ve learned from observing their interactions, though, that the relationships family members have with their ill loved ones can be some of the most beautiful and heartwarming ones to witness; I promise that it doesn’t have to be frightening. What determines where these relationships fall on the scary scale is simple: the approach.

Though we as caregivers may be painfully aware of the change in our nonna or nonno’s condition, they are not. Lucky for them, patients themselves lack this kind of insight; anosognosia is a condition that accompanies dementia and refers to reduced awareness of symptoms. Even in earlier stages, when one may recognize that something isn’t right, they aren’t entirely sure of what’s actually wrong. More important to keep in mind is the fact that they likely don’t care. Anosodiaphoria is also present with dementia, and it refers to a lack of concern about the consequences of these cloudy symptoms. As Dr. Taylor writes in the midst of his own battle with Alzheimer’s:

“Caregivers have pointed out to me a number of incidents during which I was unaware of what I was doing. Even more amazing to me, when told what I did, I didn’t seem to care! And, as a matter of act, I really don’t feel like I should care right now… It is simply amazing to be aware of what you don’t want to do, and when you do it, not to care one way or the other… I have wandered away and didn’t care, and I don’t care, although it sure upset a lot of other people. I didn’t get upset about it. I was not and am still not afraid. Others are upset and afraid for me.”

While we understand facets of our loved ones’ conditions, it’s important that we recognize that they do not and that we treat them accordingly. When your nonna asks you for the fourth time that day if you’ll be eating lunch together, try to keep your patience; don’t allow aggravation to overcome your emotions. Instead of answering frustratingly and asserting that she knows you always eat together, keep in mind that unfortunately she may not. Not anymore, at least. When your nonno insists on wearing a button down and nice slacks every day, refrain from trying to convince him it’s unnecessary; allow him to be comfortable. Compliment him. Ask for his opinion of your own outfit. Whatever you do, respect his harmless decision and thank him for passing his sense of style down to you. Above all, for your own health and sanity, try to remember that the difficulties you’re facing are part of the disease process, not part of the person. Per favore, approach your interactions accordingly.

A Dignified Life

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I am too in love with this book! A Dignified Life: The Best Friends Approach to Alzheimer’s Care is absolutely incredible. I must admit that I am biased, though, as its suggestions nearly mirror my own therapeutic approach to geriatric caregiving. The authors describe a refreshing, respectful, mutually beneficial caregiver/patient relationship that fosters trust and relieves anxieties. Aside from being extremely well-written, its combination of anecdotes and recommendations offer hope and strengthen optimisim.