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Old Age

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Elder Orphans

My dad was in a nursing home and my daughter came and fed him his dinner every single evening for three and a half years. There was another person there who had 8 children but none bothered to come and visit him. It is called karmic gardening, you take out what you put in.

My point was that I am not surprised to learn this, considering what a poor deal most elderly people get who do have family. British people have become narcissistic and selfishly motivated, and care little for the elderly, or any other group who seem to be unproductive and a drain on resources. A genuinely caring society with traditional family attitudes and values would want to help EVERYONE : their family, their friends, AND the lonely old lady two doors down.

Over the years I have seen enough in the press about elderly who suffer in various ways for lack of simple and straightforward sorts of help. This made me want to extend the Neighbourhood Watch in our area to any elderly who need errands run, etc. This is turn has led to a friendship with a very interesting lady in my area. When I hear of young people looking for volunteer ideas for the Duke of Edinburgh programme or sending letters to far-off schools I wish that someone would have the idea of matching children with pen-pals in elderly homes -- there's probably a lot of good to be done that way.

Why is it that everyone always looks to the Government to sort out issues? Doesn't everyone have a responsibility to look after themselves, if they can? I am all for looking after people who are unfortunate enough to be unable to do things for themselves but everyone knows, bar the unthinkable, that they are going to get old. So why don't they plan for it?

The answer is obvious - the state promises free cradle to grave care so nobody plans for anything and now the state has no money.

I see many examples of families sharing care for one another which is how is should be. Many of my early retired friends are helping with care of grandchildren while the parents work. That saves the younger generation a huge amount of money in childcare and is usually far more flexible than formal childcare. Some of them are also caring for their parents in their 80s who are therefore starting to need more care. Each generation cares, or receives care in different ratios as they move through the age ranges. The inter-generational contract only breaks down if families become too dispersed geographically and/or one or other of the generations declines to join in.

Dementia Care

TIL there is a secured village in the Netherlands specifically for people with dementia, where they can act out a normal life while being monitored and assisted by caretakers in disguise.

YouTube

Gizmodo pics of the village

There was a documentary on bbc radio4 about this a couple of years ago. The interviewer saw a little old lady with dementia buy 20kg of potatoes at the fake supermarket they have there and asked why she needed so much. The care assistant said it was better to let them buy what they wanted as challenging them about it confused them. Later on they would discretely remove most of them from the persons house and put it back in the fake supermarket.

Well, she ís Dutch, and if she had a small bunch of children (say 5) back in the day, 20kg would be a weeks supply.

Plus it's cheaper to buy in bulk!

That makes sense for the older people. Towards the end of the war they were cut off from food by the Germans and a lot of people starved. Not surprising that if in the grips of dementia they are worried about running out of food, might be some of their earliest memories.

I once cared for a holocaust survivor at a nursing home. She kept forgetting it wasn't still the holocaust. :-(

That's rather intriguing but sad at the same time.

"Mrs. Goldsteinberg, it's time for your shower."

A distant relative on mine in the throes of dementia kept forgetting her husband had died. Almost every day, she would find out anew. I thought that was pretty horrible (and tried to convince her kids to just tell her the husband was away on a trip), but this is worse.

Lol I'm imagining someone accidently buying a home in that village and being treated as if they has dementia.

-Back again Clarence?
-yep
-another sack of potatoes?
-yep
-what are you going to make?
-I was planning on having a baked potato assuming that BRAD DOESNT STEAL THEM AGAIN!

Step 1: Take potatoes
Step 2: Dementia
Step 3: ???

Step 3: Profit

Step 3: Take potatoes

I'm so confused...

Have you tried buying potatoes?

Some say she's still buying them to this day.

This is the best way to care for people with dementia. They become confused and even violent/combative very easily. Some of them realize that things are not quite right with them and they know they are sick but they can't really process what is wrong with them. When they are in standard closed facilities there is nothing familiar to comfort them. Many of them break out because they think they need to go shopping or do laundry or any one of a hundred routine everyday tasks. A place like this lets them do those things under supervision so they still feel like they are doing the things they need to do.
As a side story, the ER I used to work at once had an elderly male dementia patient who would attack any employees of Asian descent because he had been a POW. In his own home he was ok, but they hospital confused him, it had to be written in his chart. No doctors, nurses, lab personnel, even cleaning lady, he would become violently he saw them.

My father was a kind man, even tempered, and polite to everyone, but in his 70s, he was temporarily out of his head following an illness and surgery, and was in a short term care home sharing a room with a Japanese man.
This was in Hawaii, and my father was terribly concerned that this man was planning to bomb the facility. He'd yell for nurses to take cover and be careful, this "Jap" was going to bomb the care home and kill Americans.
He was quite distraught, and naturally, this was disturbing to the Japanese man who shared his room, and anyone else who heard him.
The staff decided to move the Japanese man to another room, and we apologized over and over to his family during the time they shared the room and for having to move, and they were very gracious.
When it came time to move him, he walked to my father's bed and bowed, and commended my father for recognizing that he was a Japanese Spy, and that my father was a patriot and had kept the hospital safe. He then "surrendered" to the hospital staff putting his wrists out. They led him away to "jail."
My father was so relieved at having "caught" this man and making the hospital safe.
My family was moved to tears by this gesture and we thanked him and his family. He said our father needed as much rest and care as he did, and if this helped, it was a small thing.
My father healed quickly and came back to his usual self, and remembered nothing of his worries. We never discussed it in detail with him, other than to suggest he seemed to be worried about his Japanese roommate. His response was "Well whatever for? He was a fine man. No, I'm sure you're mistaken".
My father passed away a few years later, but I think of that dignified man all the time. He made my Dad feel better and heal faster, at least for a while.

I took the long way home after my discharge from the navy and stayed with my great aunt in Vermont for a week. Her husband was in the dementia wing of a state run veterans' home. They all had pictures next to their doors from their time in the service so they'd remember which room was theirs . He was a ww2 pilot and his neighbor was a retired 4 star general. The home was built for civil war veterans and is still in operation.

You'd be surprised, actually a lot of people with dementia can live very fulfilling lives. This one guy I knew was homeless and he had dementia, but he kept a full time job at the local grocery store. All he had to do was deal with customer complaints but I tell you what, he did the best job at that I ever did see. They'd come in irate one moment, the next minute they're leaving feeling like a million bucks. He had a way with words, he would help you see the brighter side of life in a way you never saw before. He'd always smoke a joint with you in the back of the store during his lunch break if you ask. They never knew he was pickpocketing them, bless their hearts. He got Employee of the Month for three months in a row.

Ive heard about a care home that has a fake bus stop outside, so the escapees go and wait for the bus until a staff member notices and leads them back inside.

Yep. Here is an article about it if anyone else is interested: Link

Some places have doors locked with a code. Above the keypad is a piece of paper that says "The code is the current year."

we'll all be ok as long as there's internet and games.
honestly, can you imagine MMOs when half the demographic playing are dementia patients? i'm only half joking. it really makes you wonder how these kinds of interactive entertainment will adapt and take on new meaning and importance in an aging population.

I think I'll be the easiest dementia patient ever. Just put me in front of my PC and I'll grind up a new RPG character every day.

Oooh just imagine replaying the start of Mass Effect 2 or Fallout 3 every day thinking it was the first time you'd ever played it. Tearing up as you stepped outside the vault in FO3 was epic.

i also wonder how social work and online communities will start to work in the future. like, will you have game companies partnering with government agencies to perform welfare checks by sending in-game messages? like, "hey, we noticed you just played the same dungeon eighteen times consecutively. are you ok? are you just grinding? what's going on?"
how will game data be used to identify at-risk players? if at all? is there an ethical responsibility to start assigning greater social importance to online communities and games?

I'm pretty sure more than half the population of most MMOs have some sort of degenerative mental disease. I'd honestly be surprised if you told me they were all normal people :)

I nursed in a care facility for several months. There was one lady who thought that we were breaking into her house every time we came in the room. Everyone hated going in that room until I pointed out that if I thought someone was breaking into my house, I would bitch and cuss and throw things also.
Found out from one of her kids that her youngest son used to break into her house and steal things for drugs. From then on, we'd just go in the room and say, "good morning, my name is _____. I'm not (name of son).
She was fine after that.

That is so awesome that you cared enough to figure that out so she could live a slightly less stressful life. I hope if I ever have dementia I have nurses like you.

It helps everyone to figure those things out. Patient is calm and happy (under the circumstances), and nursing staff doesn't get chocolate pudding tossed at them. Everyone wins!

I went on some dementia training a few months ago (it wasnt amazing training, at the end of it i got a badge declaring me a 'dementia friend') and they actually encouraged what they called 'redirection' which was essentially lying to dementia patients to make them do what you want. If they want to go shopping and are headed to the front door of the care home for example you might insist they need to go and get their car keys from the lounge, then once they're in the lounge they'll likely forget they were ever going to go shopping or you sort of lightly coerce them into watching television or something until they do forget. I wasnt sure whether or be appalled or not, i suppose there's not much else can be done.

I used to work in a long term care facility. Unfortunately this is the way to take care of those with dementia and Alzheimer's. You need to keep them safe and that's the only way to do it. I lied to many residents because they had dementia. I would trick them, play in their world, and just lie. They were happier sometimes that way, and we, as well as the families, knew they were safe.

Going along with them just seems the obvious way to deal with it. It's probably upsetting and confusing to those with dementia if the people around them are always contradicting them or trying to make them do things they don't understand or don't want to do. These people do have an illness that effects their ability to think normally, but I still think it's important to respect their perception of reality even if it is skewed. I realize that it can be difficult for families to do that though, Alzheimer's and dementia are very painful to watch, but honestly, I think just playing along in their world is easier and makes the person a lot happier than trying to force them to live in yours.

I'm a physical therapist, not exactly an expert in Validation Techniques (the broader term for what you were taught), but I've learned a bit during my days working in an acute care hospital.
It's normal to be conflicted because we value honesty. We think that lies hurt people. Generally speaking that's true, but you have to see the anxiety, confusion, and agitation first-hand to really appreciate the harm a "reality-check" can cause in a person who is, to be quite frank, no longer living in the real world.
I'll be hyperbolic for a moment, but this is still a real example. A lady is wandering around looking for her husband. Her husband is dead. You might think: "Better let her know, so she can grieve and move on with her life. It'll destroy her, but she can't go on looking for him forever. It'll only be worse the longer this goes on." You tell her the truth, her world is destroyed. Two minutes later she is still emotional but not sure why, she is looking for her husband to comfort her...
Once they reach a certain point in the disease progression, there is no bringing them back to 100% reality. It is extremely variable but everyone will at some point believe something with all their heart that isn't true. It's just not worth breaking their heart or screwing with their mind.

My grandmother stopped smoking because at this stage in her dementia, she never could find her cigarettes and Mom never would find them either, and so eventually she just forgot she smoked.

You'd understand more if you worked in a dementia ward for a few months.
People with this disease very often get their minds really set on things like this (eg: "I've got to go get my car keys! ... I've got to go pick up my wife!") Meanwhile, there is no car and there is no wife.... The kindest way to resolve the problem is to say something along the lines of, "yes, its okay, your wife is on her way with the keys".
That makes the difference between a patient who might be able to relax, and actually spend some time being content and happy vs. a patient who is anxious, combative, and scared. It's a difficult thing to wrap your mind around sometimes, but just how the nature of the disease is, you have to be able to keep people calm. When you see them day after day, you begin to realize that successful redirection can make the difference between someone spending every day in anxiety and fear vs. spending their days experiencing more calm and content. Tough things to think about, but that is the nature of dementia.

This is pretty much the only way to help them. I know it feels horrible to lie to a patient, but in reality, you're not hurting them at all. You have to get into their reality, because to them, they actually think they have to go shopping/meet their family/get the bus to leave. It's much worse for them to be told that they're wrong and can't leave. Redirection works because eventually, the patient forgets about what was bothering them in the first place.
I volunteer at a nursing home that specializes in dementia, and I had a patient wandering around, nervous that she needs to call her husband to pick her up. I told her that I just spoke with her husband and that he's on his way; he's just a little late. I asked her if she wanted to sit down and talk with me while she waited, and she calmed down and eventually forgot about what was bothering her a little while before. Yes, it felt bad lying because I knew her husband wasn't going to show up, but in the end she was fine and that's all that mattered.

My grandmother has dementia, and occasionally will speak very candidly about how she recognizes that her memory is failing, etc., and that she knows that being in an assisted care facility is best for her.
Other times, she can barely string two thoughts together, but she'll still get very anxious and upset if she feels like she's being 'interfered with'. This kind of approach actually works very well for her -- pretend everything is normal unless she brings it up.

Many memory care units in the US do this. At Sunrise senior Living they have activity areas in their memory care units that mimic occupations or hobbies. For example, in one I've worked at, there would be a woodworking station(with toy tools), a desk with a typewriter and lots of paper, a baby area with dolls and a changing station(many residents are very calmed at holding a baby, even a doll), and even a dressing area with mirrors and hats, boas, scarves, etc...

Me: wait....so..I'm actually 90?
Nurse: Yes.
Me: So....what year is it?
Nurse: 2070
Me: Huh.....so..did Tom Cruise ever come out of the closet?

But ma'am....you WERE Tom Cruise....









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