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.
[00:00:38] Speaker C: Disrupt care, always.
Daylight is a perfect example.
My grandchildren, who are four months older, are on a terrible bend right now with sleeping. Same thing with anyone with cognitive impairment. It's the same thing.
Redirecting behavior. These are all anecdotal things that I've heard clients to do.
If you know that the person is going to become agitated by what they see on the news, turn the news off, redirect the behavior, play some music, do something that is not going to cause that confusion or anger, usually there's a source for it.
[00:01:26] Speaker A: I have a really quick book recommendation about.
You made a really good comment about the routine. Right. It's the power of habit by Duhig. Very good book about the idea of incremental change and the vast impact they can have. But one of the case studies throughout the whole study was an individual who had Alzheimer's, and he would take a lap around the block every day, but the smallest hindrance, like a limb that had fallen across the sidewalk, that disruption in the routine, he wouldn't be able to return home. Right? Or that same individual.
His kind of routine was he would get up, make himself breakfast, and sit down in front of TV and watch something. But he would do it like eight or nine times in a day just because the routine was so ingrained. So that's a really good point. And shifting the routine, because at that point, the brain has already made those neural pathways and everything to cause that routine. So to enhance it at that point is very key. So, power of habit. Read it.
[00:02:47] Speaker D: You do not need a VA nursing home for years. Do you need to get your name on the list now?
[00:02:53] Speaker C: It's a great question. No. If you're not already experiencing symptoms. Usually I tell clients, if you believe that you might need the care within a year, probably good to go in, at least check on the waiting list, see how if the waiting list is only 60 days at that point, you probably don't want to wait a year out if you're not going to be able to take the bed if it comes available.
But if you've got somebody that's really declining and, you know, nursing home is in the near future, it's worth a call to find out. What is the waiting list? When do I need to get on it? They're usually pretty helpful as veterans administration.
[00:03:32] Speaker D: Same type of question. Does the VA have a memory care facility? They do not.
[00:03:38] Speaker E: All right.
[00:03:39] Speaker D: Next question.
Sorry. Let me get them all figured out here.
[00:03:43] Speaker C: They do accept patients in the nursing home with cognitive impairment, but they don't have a specialty care assisted living facility that's for memory care for just for veterans.
[00:03:52] Speaker D: This may be a question for all of you from different angles here. How do you know if, let's say your parents are in an assisted living facility or they're some kind of home health care or some kind of other circumstance? How do you know when your parents are ready for nursing home?
[00:04:10] Speaker A: Let's go.
[00:04:11] Speaker C: First, the assisted living is going to tell you the assisted living is going to keep them there just as long as they can. If you've got somebody who's kind of borderline that they've been in the assisted living for several years, they're going to usually work with you unless it's a really problem person and the behavior is such that assisted living can't provide them with care. But once they become not mobile, they're usually going to have to leave the assisted living facility. But normally the assisted living gives you kind of heads up that your parents really declining, and it's not going to be long before you're going to need to look at a different level of care for them. So they're usually pretty good about telling you now things can happen unexpectedly. You might have somebody who's doing great in Sistol living and they have a stroke and they just can't go back. But if they've had a medical incident, they're in the hospital. The assisted living facility will come assess them to see if it's possible for them to go back.
[00:05:14] Speaker E: There are competing values that are tough to deal with.
If you're doing everything you can to provide for them to have the assisted living treatment, then the extra thousands of dollars a month to be in skilled nursing, you're trying to figure that out. Then there is a standard by which people that are in assisted living are supposed to meet to be able to vacate the building if there's a fire or storm or some sort of thing that would require that, and probably not a storm that would require it. But if you're thinking about the long term welfare of your parent or loved one, then you see those changes, and you know that they're beyond what you're paying for. For the assisted part of the living beyond the room and board, then hopefully you can help that transition be made.
[00:06:14] Speaker D: All right, here is a very specific question. If you have an adult special needs sibling living with your aging parents, how do you legally and emotionally deal with that sibling as parents age and eventually pass away?
[00:06:32] Speaker C: I can definitely address the legal part of that, and this is not a popular answer.
When I have a couple who's well up in years who have an adult disabled child living with them, my recommendation to them is they go ahead and help their child make the transition into a different living arrangement before the parents die or before the parents end up in a nursing home. Because I've seen too many families keep their child at home.
Then dad dies, mom goes to the nursing home, and all of a sudden, this child has lost both parents and their home within a matter of two weeks.
And it's just a horrible experience.
So I have some dear friends that are getting on up in years, and they've had their childhood down with them their whole life, and they just made the transition to him. Going into a residential home facility with people with his needs, it's been terribly difficult for them, but now they can breathe a sigh of relief that if both of them die tomorrow, that he's already settled in a home where he's made that transition, with their help, into a different living facility. They've also set up a special needs trust for him, which is another legal component. And one of his siblings has applied to be his guardian so that if something happened to mom and Dad, there's already a medical decision maker in place to make his decisions.
So you're not doing your child a service by keeping them at home with you till the very end, generally, and that's not always a popular answer for my clients, but it's a realistic one.
[00:08:34] Speaker D: Okay, real quickly, if a will was written in one state, does anything need to be adjusted if the parent moves to another state?
[00:08:41] Speaker C: Probably not. If your will is legally done in any other state in the United States, it's going to be recognized by every other state in the United States. Now, if you move to another state, it's a perfect time for somebody to look at your document to make sure they don't need updating, just generally. And every state has little weird nuances in the law, so it's a good time just to check.
I'm a big fan of legal checkups. Every five or six years, do a legal checkup. I wish you do it every year, but I know you won't come see me every year.
I'll be happy.
It's just a good time. It's a major life change when you move to another state just to have it look at. But generally it's going to be valid. It's valid here. It's going to be valid Tennessee or Michigan or wherever you move to.
[00:09:28] Speaker D: Okay, this question, this may wrap us up. We'll see here.
What do you recommend for dealing with several questions regarding their anger upset? When someone has dementia and they have certain patterns or behaviors that they've always done that have been very comfortable for them, that they're becoming unsafe or hostile when they're told not to do certain things, what is a recommendation for how to go about handling those situations?
[00:09:58] Speaker E: One of the things we're trying to find out is what their needs are that maybe even though they can't communicate well or understand simple words are not being met.
And it's just really hard when you have a loved one that's refusing to be assisted with bathing or when they're wanting to wear the same clothes every day, or they hop up in the morning and you come in to see them and they've got on yesterday's clothing and they tell you, and though they've been a solid Christian person all their lives, well, yes, I had a shower. I've already had that. When they haven't and they don't understand. And there are things like that, that depending on what is the trigger for that patient or that person, that can set them off like that. And so if you can pick up the cues and really pay attention and know what those triggers are and try to avoid that, you can argue with someone that's progressed in dementia all day long, and they're not going to understand your argument. They're not going to change, and they're going to become more and more frustrated. They're going to become angry or they may reach out to try to hit you.
You have to figure those out and learn by experience sometimes.
And when someone comes and talks to me and says, my mother hit me or she really pinched me and it hurt not just physically but emotionally, then you have to try and say, okay, what am I doing that could have contributed to that. It's hard to think that when you're.
[00:11:38] Speaker C: Hurt.
[00:11:42] Speaker E: It'S a real process, and it just breaks your heart to see people go through that. But they're loving and caring for their mate or their parent or someone in their family, and they're trying to do their best.
But we can't control all that. Medication can be used, not in a way that the same thing as tying them in a chair or something. Not that type of approach to it. But if their agitation is growing and you evaluate what they're given, if there's a permissible bump in that just to kind of control the agitation, not to control the person or try to do something that would just be unethical, I.
[00:12:30] Speaker A: Think it's also important, and you did a really good job of kind of those phrases to avoid and like, oh, remember I told you this yesterday, and those type items to where you're just going to be hit with hostility every time that you have those sort of conversations, right? Like you're setting yourself up for failure rather than coming from a place of, hey, I'm caring for you. Let's find a solution. And again, rather than continue to hit that brick wall, find ways around the brick wall. And just be careful in your speech more than anything.
[00:13:09] Speaker C: Again, mine is anecdotally from clients, but peach your battles. That bathing thing, they don't have to bathe every day.
That's be clean. But they don't have to bathe every day, so pick your battles. And this is for my engineers in the audience. It can't reason with them.
You engineers know what I'm talking about.
Yeah, I have clients who are engineers.
Dementia is the most frustrating disease for my engineer clients because they just. I've had a guy tell me, her house is filthy. Why can't she not see her house is filthy? I can bring a housekeeper in and clean it, and it'll just be filthy again. Why doesn't she see that?
It's so reasonable to him, but he's dealing with a person who's beyond being able to reason. There's brain damage. They can't reason anymore. So pick your battles.
Redirect.
Don't use those loaded phrases. I told you that yesterday. Don't you remember? Of course they don't remember. If they remembered, they wouldn't be arguing with you.
Don't make them feel crazy. Because when clients come to see me and they have dementia or they have some sort of cognitive impairment, and I'll ask them a question, and I'll say, I don't know. And I'll Say, that's okay. Well, I know you think I'm crazy.
They're afraid.
A lot of these behaviors stem from fear. They know that the world is slipping away different. They don't know what's causing it. They don't know why. And they know. They don't understand sometimes, and they're afraid. And just remember how frightening that must feel.
And I know it's hard when you're a caregiver because you just want to just get to the point where I just want to sweep the floor. I just want to change the sheets on the bed. I don't want to have the argument about it.
[00:15:09] Speaker D: I want to thank you guys for answering a lot of the questions that we had on the front side in your presentation. Three of you have done an amazing job. Julie Smith did an amazing job setting the tone for the day. We've had a great day. So here's our final question, and then we'll wrap up because we've got to get upstairs. People can't be late for church tonight.
All right, so the last question is this or really just. I'll throw this out to you guys. What are some resources or some books? You've already mentioned one, Marshall, but are there other books or resources, or are there other local services that help the caretaker, someone who is providing the care for their loved one that might be just really insightful or helpful with some of the things that they're going through?
[00:15:56] Speaker E: Someone had the website up for the Alzheimer's organization, alz.org. And if you go there as a caregiver, there are a variety of resources there.
Some that are educational for you as a caregiver, some that will point out additional resources that are available in the community. One book, if I was going to recommend any one book, I would recommend, it's in paper back now, about that thick, so not a lot of air in it, but it's worth reading. It's called the 36 hours day.
The 36 hours day. And when they don't have a concept of time and that type of thing, they reverse nighttime, daytime, and they're wondering and doing all these things that they do. It gives you some perspectives on not only what's happening with them, but on how to take care and intervene with them as well.
[00:16:51] Speaker A: Yeah, as far as resources go, vector. We do a lot of work with the Community foundation of Huntsville, Madison county, and there are a number of nonprofits in the area that helps with elder care. The Alzheimer's association is one of those really just wonderful, wonderful resources. There. Could not speak more highly of them. I know I mentioned the power of habit. And then the other one is atomic habits. James Clear, I believe, is the author. But it's both of those understanding what causes those habits and atomic habits. Meaning that on the smallest level, on the lowest level, why are those certain things happening on a regular basis, on a routine basis. And so understanding how those habits are formed can then turn around and help you be both a counsel and advise them, kind of moving forward. There.
[00:17:54] Speaker C: Those are all excellent. And I second all of those. I would encourage. This is not really formal resource, but more an informal resource. I would encourage each of you who is a caregiver to not isolate yourself.
You need a community around you. It might be a community of five people. It might be a big performal support group.
But you have to have your safe place.
You have to take care of yourself emotionally, physically, spiritually.
You have to. If you're on an airplane and the oxygen masks drop, you put yours on first. Before you take care of your child or anyone with you, you must put on your mask first.
You cannot be a caregiver when you are emotionally, physically, spiritually spent.
If you hear nothing else I said today, please hear that, because it is so critical for you to take care of yourself. Give yourself a break.
Give yourself some mercy and grace, because you have to have it. You are doing the hardest job in the world, and you've got to have a place where you can vent and take care of yourself.
[00:19:18] Speaker D: Thank you guys so much. Let's thank our presenters for.
[00:19:27] Speaker E: May I say thank you to you all for being here. You've given a large portion of your time to allow us to be part of this, and. And I thank you for doing that. It's an honor to speak to folks that make a choice to come to something like this.
[00:19:44] Speaker C: Thank you.
