Episode Transcript
[00:00:00] Speaker A: You.
[00:00:00] Speaker B: Hey, thanks so much for listening to this message. My name is Jason and I'm one of the ministers here at the Madison Church of Christ. It's our hope and prayer that the teaching you hear today will bless your life and draw you closer to God. If you're ever in the Madison area, we'd love for you to stop by and study the Bible with us on Sundays at 05:00 p.m. Or Wednesdays at 07:00 p.m. If you have questions about the Bible or want to know more about the Madison Church, you can find us online at Madison Church.
Be sure to subscribe to this podcast as well as our Sermons podcast Madison Church of Christ Sermons. Thanks again for stopping by. I hope this study is a blessing to you.
[00:00:37] Speaker C: All right, folks, we're glad to have everybody back. We're going to get started on dementia and Alzheimer's conversation.
It's hard to know how to introduce this guy because I think he's got background in like 14 things. In fact, he's got more degrees than a thermometer, but that's the best I can come up with.
But he has especially done some work in palliative care at Vanderbilt, and that's just part of what he does.
He's been a preacher. He's helped with the Sunset Institute. He's going around and helping train young men, these encouraging congregations all over the place, and we're just delighted to have him with us. We know that he's done these kind of presentations before and we are excited about that and appreciate so much you being here today. Brother Doc, thank you.
[00:01:28] Speaker A: Thank you very much. And thank you all for coming. I am so impressed with the number of people that are here and just grateful that you are thinking forwardly and you're thinking about what decisions need to be made or you're looking for some resources about people for whom you're caring. Currently, there are so many different ways to approach the topic that I've been assigned today.
And so coming down from Nashville last night, I decided I can relax a little bit if I go horseback riding, if I have an opportunity to do that before I speak. So I found a place where I could get up early this morning before coming to worship and go horseback riding. And I got on the horse and I wasn't prepared for this. It just kind of jumped before I expected it to. And so I slid out of the saddle and 1ft was caught in a stirrup and this thing was continuing to run. And I thought, what am I going to do? How am I going to explain this to the staff at the Madison Church of Christ and how am I going to apologize? But finally the little girl at Walmart came over and unplugged the horse for me, and so I felt a little better. I just had to go back to the hotel and clean up. But I am happy to have this opportunity to speak to you. I kind of feel like listening to the first two presentations when it says, this happened in your family. Has this happened to you? I kind of feel like I need to be the poster boy for the national has this happened to you foundation.
And so I hope if anybody is planning on doing the $17,000 gifts to kids, please adopt me.
But thankful to have this opportunity. I have a friend that owns the Stone Bridge Art Gallery in Nashville or Franklin at the factory, if you've ever been up to the factory at Franklin.
And I walked in a couple of weeks ago, my wife and I had a little bit of time to do that. If you could see this picture really clearly, the water is just transparent here, so you can see the rocks in the beginning. And the artist that painted this was so talented that he kind of leads you with highlights through the different places to where you end up out here. And this is in the original painting is a beautiful blue that is there. And I walked in and he had the light shining just on the right perspective. And I was about 25ft away from where it was hanging. And as I got closer, I just thought I could step into the painting and I could wait out in there and I could start swimming and just really enjoying that beautiful setting. And I would like to be able this afternoon to help you feel that way.
I would love for you to leave here and say, that was comforting, that was ReFReshIng.
But we're talking about something that is going on with Alzheimer's disease, dementia, and all the different diagnoses that are taking place. I read recently that it's something like, if you take worldwide, it's like one Person being diagnosed with this Illness every 7 seconds.
So you can tell that's really growing in what is taking place.
But I particularly want to say at the beginning that I appreciate the Madison Church of Christ doing something like this for its members, for the community, and I appreciate them doing this. I was so impressed. Just first experience worshiping here this morning and looking at all the different, just the things that were displayed for upcoming events, different aspects of ministry that this church has in this area, and I want to commend them for that. And I read in advance their values statement and the fact that they want to make sure they're bringing glory to God in all they do. They want to show people, by Exalting Jesus Christ, that you can come and get to know the Lord and Establish A relationship with him. If you don't have one, or if you do, yOu're going to be welcome here to Worship and serve here. And the fact that they are trying to build up the church.
And I can just want to say that I really appreciate that emphasis and the clarity of their values and what they're trying to do here to bring honor and glory to God and to expand the work of the kingdom. And so I just want to say thank you to the staff and elders, whoever else involved in this, in allowing me to come and be a part.
There are times in life where life just doesn't make sense.
And I know that people tend to think about the Book of Job and think about the unexpected suffering and the way Job's life was turned upside down, his wife's life was turned upside down, and how everything changed in his.
You know, if you read that book closely, it's not just a book about suffering.
It's a book that in the very first chapter raises the question, will a man serve God?
Because it's know what Satan told GOd and how Bold of him to walk into the presence of God. But what Satan told, you know, you put a hedge around this man and everything he does prospers.
And so God allowed Satan to go to work on Job because he had confidence in his servant.
But if you read the book closely, his friends thought they had it all figured out, and they're going to him and telling him where he's got it all wrong. And he's saying, no, let me tell you what you're not seeing.
And the first instance of his being attacked by Satan, it says, in all these things, job did not sin. In the Second instance, it says, in all these things, job did not sin with his lips.
And when you start reading the book, you see that Job is Wrestling with things in his mind, and he's wanting to take God into the courtroom of his mind and show God where he doesn't have it all.
Eventually, you know the Book, toward the end, God says, job, let me ask you a few questions.
And he lets Job know that he doesn't have it all figured out either.
So situations are going to arise in our lives where we aren't going to have it all figured out. We don't know what's going to happen today. We certainly don't know what's going to happen by the end of tomorrow or how many more tomorrows there'll be?
So there are a variety of types of dementia, Alzheimer's. Depending on what you read, I'll just give a general statistic. It's probably more than 50%.
Some Books say 60, 50 to 60, 50% to 70% of the diagnosed cases of dementia is AlzHeimer's dementia. But there are a variety of other types of dementia. Most of the ones that we hear about that Concern us are the Ones that are irreversible, and so we don't have medicines to cure it. There are some that if they're based on low thyroid output and different illnesses that can be treated, things can be Delayed or addressed. But for most of these types of dementia, it's just untReatable. So just a good UmbReLlA term for this and definition is that dementia is the loss of Memory and Other thinking Abilities Severe enough to interfere with daily life. So all the things that Julie put up there about activities of daily living and instrumental activities of daily living, that's one of the ways that you can watch a person to see how they're changing.
And you can think, oh, I wonder what's happening here with mom or Dad or with your husband or your wife, or some cases where someone has early onset dementia. Maybe it's one of your adult children that you're watching.
And so there are fewer people familiar with Alzheimer's and dementia's chronic illness than they are with things like COPD or diabetes or different types of chronic illnesses. But dementia is prevalent, and it's on the rise, and it not only impacts the person that has the illness. And I've tried hard not just to say patient all the time, but the person, but it also affects the person's family.
That happens. So my wife and I have lost all of our parents.
Father in law died in the Broadway Theater in New York City. Massive heart attack. Five cardiologists there trying to save his life. 45 minutes for an ambulance, get through Times Square to get to him, and by that time, he's basically gone. And he eventually deceased that evening.
My mom died at 58 with breast cancer that had been metastasized to her brain eventually, and she died at a young age. My father in law was 61. My dad lived to 80.
And just turned around, got a container of orange juice out, put it on the counter. He had a small little kitchen, poured him a glass of juice. When he turned around to put it in his two bones, his lower legs just broke completely in half, just from torquing it the wrong way. And we found out he had severe osteoporosis and a condition. They weren't going to be able to do anything but just slow it down a little bit. He had, because of a caring physician who did not get paid a dime for having the conversation with him back then.
In the fall of 2001, he'd had a stroke. And the neurosurgeon came in, and her neurologist said, are these your children? My older brother and my little sister and I were there. And he said, yes. And she said, all of them? He said yes. And she pulled up a chair and just sat and looked him right in the eye and took him through an advanced care plan.
So all of us heard what my daddy's wishes were, and after he had this diagnosis, and they told him for the rest of his life, if he bumped into a door frame or if he tripped and fell, he was going to have multiple breaks and fractures, and they couldn't do anything to stop it. Dad looked at us and said, put my care plan in place.
And within less than two weeks, he was gone.
But my wife's mother had dementia, and she died in July of 2022. And we watched this unfold over a number of years.
And for those of you who are dealing with this or are anticipating where this might go, someone you love, it's hard, and that's an understatement.
My wife is. They keep talking about engineers. I'm assuming there are a few people in this town that work as engineers.
My son in law is an engineer. Two weeks ago, I was in Sweden for a week. Right now, he's in Japan for about two weeks. And so my wife's down with our daughter in Knoxville, helping with the twins and just enjoying our kids and just having a good time, hopefully. But she's not here. But I promise you, if she was here and I looked out and started making this presentation, that I would just lose it emotionally.
So it's probably a good thing that she's not here, because I watched what she did as a daughter to a woman with dementia over a number of years and how she loved her. And I've told her many times, you'll never forget doing that.
Often asked, is dementia just part of the natural aging process? And, no, it's not.
There are real differences between what happens in normal aging process and what happens when a person has dementia. And then we've talked about how hard it is to give up your independence when you finally get to the point that dementia, if it's allowed to progress to its end stage if you don't die of some other illness first.
And most people, when they die, they have dementia, but they have other chronic or comorbidities that eventually take them. But you go to a point where you're fully dependent on someone else. And one of the first people as an adult that I ever visited in hospital setting with going in, knowing they had dementia was a man whom I think had been in this state for maybe more than a decade, was in a VA hospital. He was in a fetal position on his side. He couldn't communicate, didn't express normal emotions. He just progressed so far in his illness. And that's one of the most vivid pictures I have in my mind when I think about where dementia can go.
And so what we see, I can remember going in and first starting seeing the sticky notes on the door frame or on the refrigerator, and my mother in law writing herself notes. And then we'd say afterwards, well, how did that doctor's appointment go? Or did you enjoy having lunch with so and so? And she would have completely forgotten, even though she had the sticky notes up. So you see these types of things. Memory changes that disrupt life, challenges in planning or solving problems, difficulty completing familiar tasks.
Just always been kind of second hand thoughts, confusion with time or place, trouble understanding visual images, spatial relationships, new problems with words and speaking and writing, misspelling items and losing the ability to retrace their steps, decreased or poor judgment, withdrawal from work or social activities, and changes in mood and personality. You see those things and you think, what's going on with my husband? What's going on with my wife or one of my parents? As you watch all that begin to unfold. But what you don't see is what's happening in the brain.
And so this is kind of a blurry picture, but this is what a normal side of a brain would look like as it's progressing towards severe Alzheimer's disease. This is what it looks like. So you have these changes where the brain is shrinking and the ventricles are getting larger and that type of thing. So it's dramatic what's taking place that we don't see. And Basically, if they do an autopsy after a person is deceased, that's when they can really visualize the extent of the illness and what's been going on for years.
But if you suspect that someone might have that, and if you broach the subject and if they're willing to go have a neurological evaluation, then a doctor is going to do some sort of memory test, probably and he's going to do some sort of mental status exam, and he's going to talk to you about symptoms. And if one of your family members is there with you, they may be adding things. I have patients that have called me in the past and said, dad doesn't need to be driving anymore. And so they'll come in, they want me to tell him he can't drive, and they'll be standing behind him, and I'll just ask a few general questions, and he'll say, oh, no, I don't have any problem. Yes, I can do this. And they're all standing behind him going like this.
So then they can do lab work and check whether or not you have vitamin B, twelve deficiency, or if your thyroid stimulating hormones out the top. And then if those things are happening, there are things medicinally they can do to try to keep you from progressing into further demented state. But other types of dementia that are occurring, it's just irreversible over time. But they can do MRIs and CTS and PET scans and look and get an idea of some changes in the brain, the way it's working. But you don't see know. You just see that know going through things. I got called down to Vanderbilt Hospital not long ago, and a lady had been hit broadsided. She was in the passenger seat, and her husband had missed a turn. And she said, you missed a turn? He tried to take the next turn, pulled right in front of a car and broadsided. And I went in, and she was just bleeding out, and she was so severely injured. And it wasn't long until she was gone.
Their sons were shocked when the dad was saying, well, where's mom and where's so and so and that type of thing. And they got to listening and thinking. She had been covering for his dementia for years, and they had not picked up on it.
And so it's just hard to watch that happen because people want to cover each other. Normal aging, you maybe forget part of an experience as you're getting older. Leave out a detail. Forget a person's name and a story that you love to tell. But with dementia, you forget the experience totally.
You may remember later who that person was. Or my mother in law used to tell a story about a man that when he took a shoe off, you need to pay attention to it if you were there at night visiting, because when the second shoe hit the floor, that meant you got to go, you know? And that was his signal, it's time for you to leave. But the name changed in the retelling of that story.
And then soon she couldn't remember what elements she was forgetting.
Understanding directions.
Mom, we're going to meet you here. We're going to run, do this, and we'll be right back here in 20 minutes. And then you get back and Mom's not there, then they can use reminder notes. Like I mentioned already, they can provide self care, but they slowly lose the ability to provide that self care.
And so there are so many behavioral changes that happen. They lose the ability to understand what's said. They respond differently to situations than you've always known them. How they respond, sometimes they show very strong emotions, and it's because they're picking up some way, or maybe feelings. You're communicating without intending to communicate that, and they know something's wrong, even though they don't know and understand all the details of what's happening. Behaviors may occur to where they harm themselves or people around them if they feel some need is not being met in their lives.
And so I've been, as a health care provider, I've been spit upon. I've been hit. I've been bitten by just going in. One little lady, I could go in one morning, and she was in an assisted care facility, and I could go in. Lovely to see you. It is so nice to see you today. And could I listen to your heart? Oh, sure. Next tiMe. I'd barely get my head in the door and she'd be screaming, get out of here. I don't want to see you. What are you doing here?
And so you never know exactly. But if you learn how to communicate in a way to where you can remove those triggers and adapt the environment, then maybe you can have more pleasant interactions. But there's so much of this that you can't really control.
So you have to start thinking about retraining yourself. You've talked to a person that has a master's degree from one of the most respected universities in the country and a bright person, a teacher, and been involved in mission work around the world, literally. And all of a sudden you have to speak in simple short sentences.
You have to change your vocabulary as you communicate, maybe have to. If you're with them and they're in a memory care facility, you've got to maybe provide some directional cues, or you maybe have to give the person time to understand what you said and not get impatient. Give them time to think about it, process what they can, and then you try just to listen to pick up on what they're one of my first experiences talking with a young man whose mother was in a situation with dementia. He'd say, every time I go and I sit down by her bed, she'll look at me and she'll call me by name and she'll say, I sold the cattle today.
And he said, you did? And he said, yeah. And he said, what kind of payment you get? And she said, oh, I got $30,000.
And he looked at me and said, she doesn't have any cattle.
But I would just smile at her and say, yes, ma'am, I hear what you're saying.
He didn't try to argue with her, didn't try to say, mom, you don't have cattle. He just listened and tried to limit the irritation that would have come following that. And you'll hear me repeat this, but if we see something different lead than someone else, sometimes, if we know them well, we'll talk about that. My dad was from West Virginia, and he was one of those they called a yellow dog know. And I went to speak in Dothan, Alabama a few years aGo, and there's a little girl that stood up on the pew and she was pulling on her mother's sleeve, on her blouse. And after service was over, her mother came to me and said, my daughter pulled on my blouse. The whole time you were speaking in some way about the way my noses, my nostrils flare. She thought I was George Bush.
And she was asking her mother during worship, why is the president here, Mommy? Why is the president?
So I called my yellow dog Democrat dad when I got on the interstate to go back to Nashville, I said, dad, I said, you're never going to believe it. And turned out that little girl was a member of the church where I was baptized when I was 13 years old. And she was just a tiny little girl. Now she's the mom. They came up and told me that. She told me your maiden name.
And I said, bob Tullis's daughter was at service this morning and said her daughter thought I was George Bush. And my dad just went silent.
And he said, not a compliment, son, not a compliment.
And so person may understand the words, but they sense the expressions and the mood. They may not understand the verbiage, but they sense the expressions and the mood. And so it's such a tricky illness to try to figure out why it's happening, and they haven't figured that out completely, why they are on one day, off the next, or maybe on that morning, off the afternoon, and to try to navigate that, it's just very challenging. So this was just actually, I printed it just so you could read it. But it was a little poster type thing that I found on the Internet a number of weeks ago. But it said, trying to correct yourself. As you communicate with other people that have dementia, you can agree with them, acknowledge what they've said, but it doesn't go very far trying to argue with them. You can divert them from something they're doing that maybe embarrasses you, and things just come out at times. It may be something to do with another person's weight that's at the table right by you at the restaurant, or their ethnicity that comes out and yoU're just wilting as that's being said. But it happens. So you distract, know, you divert their attention. You don't shame them for that, because you have to remember they're not the person they've always been cause this illness. You reassure them, you don't lecture them. And when Julie, I think, said this about reminiscing with know, do you ever have someone walk up to you and say, you know who I am?
I walked into a church in Marion, Ohio, to speak, and this lady, a few people standing around the foyer, she came up and just bear hugged me. And so when I was coming up for air, she looked at me and she said, you don't remember me?
And I had to look at her and say, no, ma'am, I don't. And then with all these people standing around, she said, I practically raised you.
And then I just thought quickly then, and I said, well, where did you live? And she told me, and I said, ma'am, I have never lived there before in my life.
And turns out there's another guy named Gary Dodd up in the Ohio area that's a well known song leader who must be of similar stature. And she thought I was that, you know, you have to reminisce. Don't say remember, because that can really throw them because they're already struggling with that.
Repeat stories. Let them tell you stories over and over again. Or don't say to them, I told you that last week, do what they can do, but never say, let them do what they can do, but never say, you can't ask, never demand, encourage, never condescend and reinforce, but never force.
And so those are some good practical things to remember in trying to communicate, and this is really hard.
You can make a simple change in a person's environment that has dementia, and it completely throw them and change them.
You can limit stimulation to what the person finds enjoyable. They may have always liked to watch old black and white movies with you on Turner Television.
But now that noise, they can't hear as well and they don't understand as well. They can't follow the storyline and it just frustrates them. It's no longer enjoyable.
Use validation and distraction as strategies. If someone starts to get irritated, you can turn their attention in another way to something they like.
It's just a strategy for communication.
And then you have to adjust the environment as the illness progresses and you have to change things. You doing things sometimes just for fall.
So, you know, Julie was good about pointing out resources, and you can find a variety of sources in your community that can help you identify the types of situations that arise and that need to be done.
So one of the things I wanted to talk to you about here, if I can go back here for a know, identify things in advance that you can do. Aspire Healthcare Aspire was started by Senator Bill Frisk and a few young men in Nashville, Tennessee a number of years ago. And within five years, it had grown. Less than five years, it had grown into 27 different states in the United States. This company had, and they sold it at that time, and it was bought out by a major insurance company. But what they were doing was they were doing palliative care in the home setting.
So it's something like 83% of people that say that if I can control the way my end of life goes, I want to be at home.
And it's about 83% of the people that end up in an ICU with tubes in them and all the bells and whistles attached to them.
And so palliative care is upstream from hospice. When you think about hospice people, some people hear the word palliative care and they think hospice. But if you look in the medical textbook, it says hospice is palliative care, but all of palliative care is not hospice. So palliative care is addressing the symptoms that come along with chronic illnesses.
Used to be if you had a diagnosis of Alzheimer's disease, you could get accepted by hospice, but that's not the case now.
But if you have dementia, then there have to be these scales that are met, and then it's typically having comorbid illnesses along with that for you to be able to qualify as hospice eligible. But you can have palliative care way upstream. Ideally, if you were 48 years old and diagnosed with a particular type of cancer and you knew there are going to be symptoms that are going to come along, either as a result of the illness or the treatment of the illness, that's when you should be introduced to a palliative care doctor or caregiver. And at first, you may not even need to be seen by them that regularly. But then as the illness starts to change your life and the side effects of treatments come into play, well, then that's when you need to be seen more often. And so what Senator Frisk company did was he showed that in the last nine months of life, where instead of being put in the ICU 3.2 times, that was reduced down to about 0.8 to 1.2 times. And it was saving the family a lot of heartache, saving the family financially. It was saving the insurance companies a lot of money. And so it was just a win win for everybody. So now, a lot of places that offer palliative care, if you have a particular type of insurance, you don't pay a dime extra above your premiums. You can have that type of service in your home. And when you think about the changes that happen with dementia, what a valuable service to have someone come into your home, on average, two and a half times a month, checking on mom or dad or husband or wife, and being able to tell you how things are going, being able to educate you on what you might see next. I mean, wonderful program. But then this last thing here, the last white sentence or phrase, I don't know how many of you have completed advanced directives, and you have to sit down and think about it. The neurologist that I mentioned and did that for my father when it came time, about eight years later, seven years later, and dad wanted his plan put in place. All three of us had heard it. We knew exactly what my dad's desires were for treatment at the end of life.
But it's a huge percentage of people that don't do that in advance.
And so if you do that, what a gift that is to your children, adult children.
So Then know, and you tell them, this is what I want. This is what I don't want. And if you have those types of discussions with people, you really need to take time to be educated on CPR.
You watch a 30 Minutes television show and the man has a heart attack at the beginning. And by the end of 20 minutes or 22 minutes, however much is actually Showtime.
They're out playing tennis at the end of the program.
And so that's not the way it happens.
A lot of people, when they have CPR, if they were functioning at this level, then after they've had CPR, they end up more functioning at this level.
There's a lot that you need to know about whether or not you do liquid nutrition and what that means and what kind of side effects there can be from tube feeding, and can it lead to aspiration pneumonia, where some way you end up swallowing some of that liquid feeding down into your lungs, and then you have to deal with being treated for pneumonia. And people have to decide, do you put them in the hospital for treatment or you keep them out? I mean, there are all kinds of things to really consider, but if you'll take the time to get educated and get good answers to those questions, and you do it, it'd be great. And I told one lady one time in the home setting, I said, they need to put this in a place where if you ever call 911, they'll know where to find it. She hung it by the front door on the wall like it was a picture.
And that's not exactly what I was saying, but it's so helpful. I was on call one night, and I got a call, and I said, you only live about a mile and a half from me. I said, I'm coming to your house.
And I said, do you know where your husband's advanced directives are? And she says, I do. I said, well, if you wouldn't mind finding them while I'm on the way. And so I went outside and I met the EMTs when they got there, and I said, these are his advanced directives.
She knows what I've already told her about where he is, and I'm not hearing his heart, I'm not seeing respirations. But she just wants to be reassured. Can you just come and hook things up and let her see the monitor so she knows?
But that kept them from coming in and breaking his ribs, doing CPR and everything, and putting him through all of that, because he had those advanced directives.
And I would really encourage you to think about that and things that the attorney will talk to you about here in a minute. Maybe the healthcare POAs and everything to where you can actually do that. If you're the one that's been designated palliative care. This is a few examples of what can be done. I'm going to fly through these real quickly, but if you're in the Green Zone, if you can just envision a traffic light, green means go.
So you're in the Green Zone and these symptoms aren't showing. It looks like it's going to be a pretty typical day. You just keep doing what you're doing. If you're not sensing changes in urination to where you're thinking, oh, no, mom has Utis. She's heading toward being delirious. If there's no coughing or choking to where she's not aspirating things, she can still swallow and function normally, which is something that can change with dementia.
She's eating a normal diet and drinking as usual.
If those things are in place, no fever, no chills, then you kind of got a green light for that particular time of the day and maybe that day.
But if you wake up night and you hear worsening cough or wheezing or they have increased shortness of breath with just normal activity trying to go from the chair to the bathroom, or if they have fever greater than 100 degrees, or they've become constipated for more than two days, if you are sensing those changes in urination, where you're afraid they might be moving toward a UTI, or if you have, as the caregiver, an increased level of stress or anxiety.
That's why it's so good to have an on call service through palliative care, because you can call and talk and be listened to, reassured, or given directions about what should be taking place next.
If those type of changes are happening, then you want to make sure you're giving them the right medicine on a regular basis for their heart failure, kidney failure, whatever it is that you're addressing.
If they've left you a box of supplies that are kind of rescue medications, if they're becoming extremely agitated or restless, they can tell you what to give them for that.
And if the symptoms increase or are worsening, you may want to call your palliative care provider so that they can know what's going on and give you a further example. So the red zone is when there's direct, immediate action that needs to be taking place.
So you need to focus on those things. And so when you see the worsting of those things that we just talked about, a lot of people are on blood thinners.
If they've fallen, they've taken a hard hit to the head or you're concerned about internal bleeding, that'd be a reason you'd want to call and say, hey, this is what's happened. If you're concerned about broken bones, that'd be a reason for calling about that.
And with palliative care, you can do in home X rays and things like that, and it reduces your limp. You're getting care in the home, and that's a good thing.
You need to know what a person's advanced directives are. I found a family member. I was called and asked to go check on them and found that person in the floor with three fractures in their left lower leg.
Very independently minded person, not just not wanting to give up her independence, but she didn't want you in the middle of her things.
And so I had to tell her. I said, I've called the ambulance. I've got to know where your advanced directives are. I've got to know what your medications are so that we can do this correctly when we get to the hospital.
And so if you're not going to go because you know the advanced directives and you're not going to take her, then you need to call your healthcare provider and let them know this is what's going on. And so caregiver role, you're going to be affected, and that's a gross understatement by what the family is doing.
You may struggle individually with spending time with your family at holidays or going to a kid's birthday party or a grandchild's ball game, something like that, because you don't want to leave the person for whom you're caring. And other people just may not understand what you're doing. So you have to develop thick skin.
Caregivers need to remind themselves of things that are outside of their control.
And you can rely on your neighbors that love you, care about you, to help you with things at times.
So you end up feeling like you're on an emotional roller coaster. But what I'm telling you is feelings are facts. When you're caring for someone with dementia, your feelings are very complex.
In a family environment, those feelings are going to vary from person to person.
It's uncomfortable to have those feelings, and your feelings can affect your judgment. So you need to be able to deal with people in a way so that can help you, but most of all, help the patient. I think one of the toughest things is the fact that you're watching a person with dementia. You're watching them lose their past, their present, and if they had the ability to understand what was happening, they'd be quite despondent about losing their future.
As the caregiver, you're going to have anticipatory grief. When someone dies, you're going to go through the regular form of grief and relive those anticipatory grief feelings, and then you're going to have this conflict.
People say, well, good, they're not suffering anymore. And you're thinking, no, but I've lost my mom.
And they're thinking, you're relieved. And then you're thinking, no, I'm still grieving because I love my mom and I'm not rejoicing that she's just gone. I didn't want to suffer like that. But it's just such a mixture of feelings and so there are signs and symptoms you have to pick up on. I love this.
Do not try to be a superhero. They tell a story about Muhammad Ali being on an airplane.
Flight attendant gave the instructions. She didn't think Mr. Ali was paying that much attention. And she walked back and lookEd. Seatbelt was unfastened. Said, Mr. Ali, you need to fasten your seatbelt. And he said, superman, don't need no seatbelt. And she looked at him and said, superman, don't need no airplane. Put on your.
So you need to inspect what you expect as a know because you're not going to reach all the goals that you have for yourself. And things are just so much is out of your control. And you understand compassion. Fatigue is real and this is the way one person defined it. It said a tiredness that you can't describe.
And some of you are going through that. You know that and understand that.
And so life's a journey, but you don't have to make it alone.
Adam and Eve had fallen and sinned in the Garden of Eden.
But God in his grace and mercy came walking to them in the cool of the afternoon.
Abram and Sarah were so brokenhearted. They weren't going to have a child. They weren't going to have an heir. They weren't going to have a family. And God came to them in the form of three men and gave them the message.
It's through your seed that people are going to be blessed. I love Hosea. Eleven. God called Israel and he said, I took your hand and I taught you how to walk.
God walks with us.
And he's the same today as he was yesterday and what it'll be tomorrow. And he's not going to leave us alone, even though at times we feel alone in what we're.
And so I put this picture up the beginning because aw Tozer in one of his writings, said, faith is the gaze of a soul upon a saving God.
And in the times where you feel the most alone, you don't know if you can go on. You're waking up in the middle of the night. You don't know if you want to wake up in the morning. You don't know. You don't want to begin another day. And going through the unknown and all the feelings that you have.
Know that there's a loving, merciful God that loves you and is going to provide assistance for you. And he's going to care for you if you turn to him. So thank you for letting me have this opportunity. I've been given the sign, and I've probably gone over a minute, too.
