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Would a Current "Life Book" Help?
5dogsGram
Posted: Saturday, January 7, 2012 9:57 AM
Joined: 1/7/2012
Posts: 3


My mom & stepdad are caring for his mother, who recently moved in with them from another state.  She has been here a few months and adjusted really well considering.  Her short-term memory is... not.  And old photographs confuse her more.

I have been wondering if it might be helpful to make a photo album or scrap book like a foster care "life book" that has recent photos of her, with her name and some basic info, her son, my mom, people she sees regularly, the house and such.  Sort of a "orienting to here and now" type book.  Mom said she loves to read, but will get confused and "remember" her memories and bits from what she's reading mixed together.  I'm thinking a book with the current reality could help... maybe?  I just don't know.

This is very confusing and frustrating for my step-grandmother, and I know it's difficult for her care givers.  I have only been around one other person with ALZ and that was a neighbor about 15 years ago.

If you have seen the movie "50 First Dates" ~ I'm thinking of a book that sort of does what the videos do in that movie.  "This is your life."  These are the people who love you.  You may not remember everything, but you are secure.  Seems it would be terrifying to wake up every day in basically a different reality.

Thanks for any input or suggestions on this!
Cheryle Gardiner
Posted: Saturday, January 7, 2012 10:34 AM
Joined: 11/30/2011
Posts: 529


Welcome to the forum. We're glad you found us, but sorry for what brings you here. Please come back often for the support and wealth of information you'll find. It's a great community.

I'm not sure if the photo album would really help your grandmother. When the short-term memory is gone, they can't really retain current information and it can be confusing to them. She may reach the point where she thinks your step-dad is her husband, and she also may not recognize you or your mom, thinking of you as much younger than you are.

She will probably eventually gain familiarity with her new home,  but she will probably - at some point - ask to go home. In this case, "home" very likely will be a childhood home or her home when she was a young woman - some place that connotes safety and well-being to her.

I'm not saying you shouldn't put the book together, just that it may also be confusing to her. Others will be along soon with their comments.
Stephanie Z
Posted: Saturday, January 7, 2012 10:50 AM
Joined: 12/15/2011
Posts: 4219


Hi  5, The type of book and other  orientation aides will help her if she is in stage 4 (Moderate decline) or less. Beyond that the better thing to do is here and now orientation, not reality orientation although there are two schools of thought on that. I have always found it better to use here and now even in the earlier stages. This means you orient the person to what is going on around them at that particular period of time. Having said that, there are times when a person's memory gets so mixed up with reality and the effects of the dementia that they hallucinate or have delusions.

Hallucinations or delusions do not need to be treated UNLESS they are dangerous or disturbing to the individual. So if step grandma misinterprets something and is not upset by it, let it go. Better to change the subject to something she does remember than constantly correct her.

I would go ahead and try your life book and see what happens. But also remind her who everyone is, and what is happening especially if she looks a little confused. Example (Grandma, I'm Ann, your grandaughter, we're going to have lunch with Sally, your stepdaughter)  May sound silly to do it all the time, but if she is forgetting or looks confused, you should do this for her.

Reminiscence is important for people with dementia because their past memories are all they have. It's OK to show her old pictures and ask if she remembers when it was taken etc. If not, put it away. If she shows some sign that she remembers, try to ask a few pertinent questions.

Hope this helps

Stephanie


5dogsGram
Posted: Saturday, January 7, 2012 10:55 AM
Joined: 1/7/2012
Posts: 3


Thanks!  Sometimes she is waiting for her Mom already ~ long since passed away ~ or a sibling.  I guess I never realized how moment-by-moment this is.  Lots to learn!
5dogsGram
Posted: Saturday, January 7, 2012 11:09 AM
Joined: 1/7/2012
Posts: 3


Stephanie Z wrote:

Hi  5, The type of book and other  orientation aides will help her if she is in stage 4 (Moderate decline) or less. Beyond that the better thing to do is here and now orientation, not reality orientation although there are two schools of thought on that. I have always found it better to use here and now even in the earlier stages. This means you orient the person to what is going on around them at that particular period of time. Having said that, there are times when a person's memory gets so mixed up with reality and the effects of the dementia that they hallucinate or have delusions.

Hallucinations or delusions do not need to be treated UNLESS they are dangerous or disturbing to the individual. So if step grandma misinterprets something and is not upset by it, let it go. Better to change the subject to something she does remember than constantly correct her.

I would go ahead and try your life book and see what happens. But also remind her who everyone is, and what is happening especially if she looks a little confused. Example (Grandma, I'm Ann, your grandaughter, we're going to have lunch with Sally, your stepdaughter)  May sound silly to do it all the time, but if she is forgetting or looks confused, you should do this for her.

Reminiscence is important for people with dementia because their past memories are all they have. It's OK to show her old pictures and ask if she remembers when it was taken etc. If not, put it away. If she shows some sign that she remembers, try to ask a few pertinent questions.

Hope this helps

Stephanie


Thank you!  This helps a lot!  And explains why the stress on close family members is so much harder.  With our neighbor, we just enjoyed him "as is" ~ and since I haven't known Miss Val without Alzheimer's, I don't have the sense of loss of her other self.  She is delightful.  She has some distress at realizing after talking a while that she doesn't remember who she's talking with, but someone without Alz. who had been through so much transition could experience the same.  (I hate that myself!)  She's aware that her memory used to be quite sharp.

It seems higher stress levels exacerbate her pain, as well as cause more walking about, aggravating her back... so I'm fishing for ways to lessen her distress.  This is all really hard for those "in the fray" day to day.  Thanks again!

Kate
cathyjm
Posted: Sunday, January 8, 2012 3:32 PM
Joined: 12/2/2011
Posts: 160


At stage 5, probably edging into 6, my partner still enjoyed looking at notebooks. We made one together of cards she got for her 90th birthday, for example. I had the laptop hooked to the cabin printer, ready to print out a description for each card -- who sent it, and how my partner knew them. 

I used a VERY large font -- something I've found to be very important for helping someone with AD. My partner picked out the color of background paper she wanted for that specific card, I wrote and printed the description, and together we used clear photo mounts to mount the card on the background. We did it so that if she ever wanted to slip the card out of the page protectors and read the inside, she could.

There were several looseleaf binders, well labeled, that my partner used for several years this way: photos of friends, one page each -- again with explanations in HUGE type; photos of family members -- when they died and where buried, living family members and where they are, how they're related, etc.

We did browse through old photo albums and scrapbook folders too, as well as look at photos on the computer. 

And one of the best things I did, early on, was to make her a looseleaf address book out of 4x6 index cards, with one name and address (and explanation) on each card, with alphabet dividers. If she wondered if anyone knew her any more, I could say "Well, you do have over 80 people in your address book right here." "Really?" "Sure, here they are. Take a look." She'd pick out some, usually, to write to.

It also helped, early on, to just write out (in a huge font) some highlights of her life: where she was born, then what happened....

As long as things like this are fun and don't come across as a memory test of some sort, I think they're great. You do have to be careful not to do overkill and make a "life book" that tells things that are so easily remembered that the book becomes insulting. (Been there, done that.) Be ready to put away anything that doesn't work.

In my experience with my partner, short term and long term memory fluctuated. Sometimes something she couldn't remember at all became familiar and easy to remember after practice. I don't mean I coached her -- just answered whatever she wanted to know whenever she wanted to know it. You can also use a more structured approach called "spaced retrieval training" and I guess we played that as a kind of game a few times, but I never really took the time to do that in earnest.

A doctor can order a home health consultation from a speech therapist who specialized in cognitive rehab, if you have questions about how to work with your loved one's issues with memory and thinking. Ours just basically said "love the address book, make sure she looks at that or an album every day, keep doing what you're doing."

One thing I'd tell my partner if she worried about getting confused about old photos or confused about what happened when, was just along the lines of "At 90, all those memories are still in there, but it's like having huge piles of paper on your desk. Sometimes they get out of order and it's hard to find the one you want." A veteran "paper piler," she liked that image. (An engineer would probably prefer the image of a brief short circuit in the brain wiring.)

Just follow the loved one's lead about what they want to know, and their own goals for improving their lives. They are wiser than we might guess at first.



DZ
Posted: Sunday, January 8, 2012 3:53 PM
Joined: 12/7/2011
Posts: 1736


FWIW, put the book together for you and your  family.

 

 

--


EARchat
Posted: Sunday, January 8, 2012 4:35 PM
Joined: 12/17/2011
Posts: 108


When I first started taking care of my MIL, I wanted to FIX everything and correct her ALWAYS ... and I'm still learning ...

 

I put together some small size photo albums of clear, close pictures of people and put 3x5 cards between them printing in big letters who the people were.

 

Sometimes she would go through the albums and enjoy them, still very confused about who the people were .. other times, the books would make her angry and frustrated that she SHOULD know these people but did not ...

 

As time has gone on, she gets them out once in a while .. or a caregiver gets them out ... and they go through them.  The pictures trigger stories she can tell.  Mostly now the albums are of interest to her ... although still very confusing.

 

Here is what I wanted to get to .... after a hospitalization last fall, she had a speech therapist come for about 6 weeks.  That therapist suggested we put together a book about her life ... somewhat like you were describing, I think.  I thought it would NEVER work ... but actually, it has!  There are NO pictures in the book ... we made categories .. (1) Important addresses (2) My family (3) my children (4) my grandchildren (5) my friends (6) my school days (7) Where I taught school ( My parents (9) my husband (10) Important dates ... a page for each month listing birthdays and holidays (11) Hospitalizations and (12) My goals.  I think that is most of the categories.

 

This book is where we send her when she is wanting to remember something.  It helps her to know she can go to that book and figure something out ... although we have to help her through it ... but she feels like SHE is figuring it out.

 

We are also finding that it helps the caregivers immensely!  They can use the book to help her figure out HOW someone is related to her.  They can use it to help her write letters to people, etc.

 

When she remembers a bit or piece of a story, we write it into the book and when there are enough things, I retype that page.

 

It is actually a 1/2 size 3-ring binder, so I just cut 8 1/2 x 11 paper in half and 3-hold punch it ... I have all the pages stored on my computer so it make adding information easier ...

 

I say .. give it a try ... we have found it extremely helpful!   ... Betty