Aging and Life Enhancement
By Kathryn Kilpatrick, M.A.
One person’s caring about another represents life’s greatest value. ~Jim Rohn
As a family member, friend or caregiver of an older adult, holidays and other special occasions offer opportunities to connect or reconnect, reminisce and create new memories.
When more people, busy schedules, and constant interruptions of routines are introduced, many people can find this somewhat overwhelming.
When an older adult has physical or cognitive issues that no one was aware of or that may have become more of a challenge, holiday gatherings can trigger some unusual behaviors or concerns.
If contacts with the older adult have been infrequent prior to festivities, it can be important to share observations with others to at least find the right balance and coordinate or modify the activities and assistance offered. As in many situations, changes become more apparent over a few hours or a few days as travel, busyness and perhaps fatigue will reveal some previously unnoticed concerns.
Often, not everyone is on the same page. Perhaps they do not know the person well enough, or there is a bit of denial. Family dynamics can often be the case. As a speech-language pathologist with extensive experience with older adults and their families in their homes, my goal when seeing them prior to holidays was to offer suggestions appropriate to my client’s level of functioning. Whether it was due to cognitive issues and/or communication difficulties secondary to stroke, traumatic brain injury, Parkinson’s disease, multiple sclerosis etc., pertinent strategies could be helpful.
Empathy is the ability to step outside of your own bubble and to understand the realities. ~Oprah Winfrey
Here are the “stages” and a few possible concerns that may further your understanding of the progression of dementia:
- VERY MILD COGNITIVE DECLINE (Age Associated Memory Impairment) – Subjective complaints, misplacing items, forgetting familiar names.
- MILD COGNITIVE DECLINE (Mild Cognitive Impairment) – May get lost traveling in familiar areas, retain less when reading. Have less recall of names after introduction, misplace valuable objects, etc.
- MODERATE COGNITIVE DECLINE ( Mild Dementia) – More clear-cut deficits – decreased knowledge of current events or recall of personal history. Decreased ability to handle finances and travel. May notice denial, flattening of affect and withdrawal from challenging situations.
- MODERATELY SEVERE COGNITIVE DECLINE (Moderate Dementia) – Supervision needed on some level. Trouble recalling early biographical details, disorientation to time. No problems toileting or eating but may need help choosing clothes.
- SEVERE COGNITIVE DECLINE (Moderately Severe Dementia) – Generally unaware of recent events and experiences. Personality and emotional changes. Will need assistance with activities of daily living. May have delusional or violent behaviors.
- VERY SEVERE COGNITIVE DECLINE ( Severe Dementia – Last Stage) – Frequently no speech or unintelligible utterances. Self-care and walking need assistance.
In the situation with my mom, when visiting her in Massachusetts several times, I stayed with her in her assisted living facility for many days and nights. With my background, I started detecting subtle differences on many levels and began the journey of observing, cueing without pointing out any concerns to her until safety (driving) became a concern. Sharing with a few family members who were more open to my observations was essential since I lived in Ohio.
For anyone walking that journey, it is emotional once reality sets in. With my background, I felt blessed to support her and provide tips and resources along the way. She trusted me to have her best interests at heart, which was helpful, but she also taught me a lot.
No matter who we are, no matter how successful, no matter what our situation, compassion is something we all need to receive and give.” ~Catherine Pulsifer
In my opinion, recommendations for appropriate professional resources are key to any intervention. An important aspect should include education for the support system—staff, families, friends etc.—on how to modify their approaches and strategies for enhancing communication, activity engagement and safety for those with dementia, at any stage.
Additional blog resources: Aging & the Holidays
Holiday Travel Preparedness for the Older Adult in Your Life
