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Manor on The Hill updates & insights

They say “It takes a village to raise a child”; Knowledge, wisdom, and unconditional love by seniors have a lasting effect on children. Children can also bring happiness and smiles to seniors. We can reminisce about the past when extended families lived close together on the same street or in the same town and interacted frequently. Manor on the Hill (pre-pandemic) had a “Adopt a Grandparent Program” where preschool children came every month to do activities with the residents. This was the most popular activity for both generations. Meaningful activities between seniors and children can be fun and educational. Here are examples of things that the seniors can talk about bringing back nostalgic memories and educating the children at the same time: Tin of Spam: Most children will have no idea what it is however seniors will have memories of tinned meat that could be transported and stored without refrigeration. Rotary phone: Dialing numbers one-by-one, one mistake or busy line and had to start all over again Payphones and a dime in their penny-loafers to call home. Many may have used their dime for a treat at the corner store. Printed references like the phone book, TV Guide and an Encyclopedia set Gramophone records; Side A & B with a handful of songs Silent movies & news reals Rationing during the wars Games they played

Sundowning is a neurological phenomenon associated with increased confusion and restlessness most commonly associated with Alzheimer’s disease, but also found in those with other forms of dementia. The term “sundowning” was coined due to the timing of the patient’s confusion as it typically occurs late in the day or early evening as the sun is setting. The symptoms may include increased confusion, anxiety, aggression, agitation and ignoring directions. Sundowning seems to occur more frequently during the middle stages of Alzheimer’s disease and mixed dementia and subsides with the progression of a patient’s dementia. Here are some useful tips to deal with sundowning behavior: Close blinds and drapes so that the decreasing light outdoors is not easily seen. Brighten the interior environment with increased lighting being careful to keep the room free from shadows. Dementia sufferers may mistake a shadow for a hole to avoid increasing the risk of falls as they move away to avoid what they believe is a danger. Create a calm environment. Turn off the TV and put soothing music on. Be sure the music is era appropriate; Sinatra not Madonna. Limit day time napping. While the cause of sundowning is not completely understood, it is known to be a disturbance of the internal clock. Keeping to a set sleep schedule with limited napping is known to help. Be patient and distract with an enjoyable activity. View a favorite photo album, brush hair, water indoor plants. Find a calm, soothing activity the senior enjoys and be patient sharing the activity with them. Here at Manor on the Hill, we incorporate these tips into our evenings to help our Residents who suffer from sundowning helping them get to their bedtime routine and sleep.

Risk factors have been identified to assess your risk of developing Alzheimer’s. Some are uncontrollable, such as age, while others can be influenced by your choices. Uncontrollable Factors: Age – is the greatest known factor for Alzheimer’s. One out of three people who are 85 or older have the disease. Family History – is another strong risk factor. Those who have a parent or sibling with the disease is at a higher risk of contracting Alzheimer’s. Genetics – Science has identified several risk genes and deterministic genes that influence the odds of developing Alzheimer’s. Risk genes increase the likelihood of developing the disease but do not guarantee that the person with the risk gene will indeed develop the disease. The gene with the strongest link to the disease is apolipoprotein E-e4 (APOE-e4); those who have this gene have a one in four chance of developing Alzheimer’s. A deterministic gene is a gene that directly causes the disease. Those who have a deterministic gene will develop Alzheimer’s. Science has so far found three deterministic genes that lead to Alzheimer’s – amyloid precursor protein (APP), presenilin-1 (PS-1) and presenilin-2 (PS-2). Controllable Factors: Recent research has found links of risk factors we can control through our general lifestyle and wellness choices. Head Trauma – research has shown a strong link between serious head injuries and further risk of Alzheimer’s. Healthy Heart – there is growing evidence of a link between heart health and brain health. Those who suffer from high blood pressure, heart disease, diabetes and high cholesterol have a higher risk of developing Alzheimer’s. Ethnicity – because Latinos and African Americans have higher rates of vascular disease (see above), they may also be at a higher risk for Alzheimer’s. Healthy Aging – overall healthy aging may also keep your brain fit. Keep your weight within recommended guidelines, avoid tobacco and excessive alcohol use, be socially involved and exercise your brain and your body.

The other day as I was walking through our Memory Care Lane, the memory care wing at our Assisted Living Community in Leominster, MA, I was able to observe the quality care and compassion one of our CNAs was providing one of the seniors living with us. The Resident, whom I will call Nancy (not her real name due to HIPPA) was being attended to by one of our long-tenured aides (whom will refer to as Lisa) who had specialized training in Alzheimer’s Care. Lisa’s approach to Nancy demonstrated several key practices in communicating with a senior citizen with Alzheimer’s or Dementia which I thought would be useful to share. Lisa had approached Nancy from the front, introducing herself, probably for the thousandth time. As Nancy was seated, Lisa got down on her level maintaining eye contact the entire time. Lisa placed a hand on Nancy’s forearm to give her physical comfort. Keep in mind that if the senior is irritated by touch, to avoid this, but be sure to practice the other approach keys – approach from the front, introduce yourself by name, be on the same level and maintain eye contact. Lisa called Nancy by name to help orient her and to gain her attention and focus. Lisa used a lower pitch as it is more calming. She spoke slowly asking Nancy one question at a time in short sentences with simple words so as not to overwhelm Nancy. When Nancy didn’t respond immediately, she patiently waited as Alzheimer suffers often need more time to process. When Nancy didn’t respond, Lisa repeated the question using the same words rather than changing words which can lead to more confusion and agitation. Rather than asking Lisa questions, she turned the question into an answer, providing a solution. As it was close to lunch time, rather than saying “Are you hungry?”, Lisa said “The Dining Room is around the corner. Let me take you there.” To get Nancy ready for the walk to the Dining Room, Lisa placed Nancy’s hand on her walker, providing a visual cue on what Lisa would like her to do. Nancy understood this cue and stood up, allowing Lisa to escort her to her meal. During this entire encounter, Lisa avoided quizzing her, peppering her with questions or asking her questions such as, “Do you remember what you wanted?”. Asking a person with dementia to remember only adds to their frustration. Throughout Lisa presented an easygoing manner with a gentle, kind tone of voice supported by friendly facial expressions. Most importantly, Lisa treated Nancy with dignity and respect. I was so proud of Lisa that I gave her a Manor Moment, a program of recognition for these numerous special moments at Manor on the Hill. Please look for more useful information each week. Thanks for reading.

We often have family visit us here at Manor on the Hill and can see immediately in their eyes the stress of caring for an elderly parent. Moving Mom or Dad from their long-time home can be unsettling, however, making that move is often in their best interest. 30 days after moving in, we see Residents gaining weight since they are being served three nutritious meals a day and their mood improves as they socialize with others in their new home. Other than the stress caring for a senior presents, what are some other signs it may be time to consider Assisted Living? Housework is being neglected The senior doesn’t bathe regularly, often as they worried about safety in the tub or shower Laundry isn’t being done and the same clothes are being worn day-after-day Bills aren’t being paid timely Medical care is needed more frequently, often with hospitalization Your loved one feels isolated and bored, often leading to depression Difficulty managing their medication Increased falls and other accidents Memory loss and forgotten appointments Increased aggressive behavior The generation your Mom and Dad belongs too often views an Assisted Living Community with their image of a Nursing Home from the 60s or 70s. This isn’t accurate as Nursing Homes are very different from that image and Assisted Living Communities are a relatively new concept. Assisted Living should be thought of as being comprised of three parts – real estate, hospitality and care. The real estate is the apartment they rent, as well as the enjoyment of the communal living spaces such as the dining room, library, activity room, community kitchen and grounds. The hospitality consists of dining, activities, entertainment and trips to area stores, restaurants and cultural attractions. And the care component is assistance with the six Activities of Daily Living (ADLs) – bathing, grooming, dressing, toileting, mobility and eating. After a family makes the decision to move Mom or Dad to Manor on the Hill, we often hear within the first month, “I wish I had done this sooner”. Call for a visit to see how we can help you and your senior parent.




