As much fun as the holidays can be, they can also be just as stressful. Planning parties, decorating the house, shopping for gifts, the extra expenses...these can all take their tolls and leave one feeling exhausted and/or frustrated. This can be especially true for someone who has the added responsibility of caring for a loved one with Alzheimer's disease.
     A very common symptom of Alzheimer's is a rise in anxiety.  Even the simplest of changes from their daily routine may confuse, disorient or anger them.  Holiday gatherings and parties can easily become overwhelming for the person with Alzheimer's.  Even the preparation of the event can cause anxieties.  If you are caring for someone at home, there are many things to consider. Undoubtedly, there will be changes that have to be made that may interrupt "traditions".  For most families, these traditions have come to symbolize their holiday season. 
A common example would be:  Grandma has always held Thanksgiving dinner at her house and, like my grandma, insisted on cooking everything herself. However, this year, she is also caring for grandpa who was diagnosed with Alzheimer's earlier in the year.  He is easily agitated around large groups of people and tires quickly. Some changes will need to be made, but often times meet resistance from other family members or even the care givers them self.  It could be that grandma may not want to give up her "role" as the hostess or she does realize that she won't have time, but feelings of guilt prohibit her from asking for help or canceling altogether.  Other family members may be unsure of how to approach grandma with offers of help and, sadly, there may be some who don't understand the process and the level of commitment and time it takes for caring for someone with Alzheimer's.  They focus on the "changes" that are occurring and can even be resentful. As these changes in tradition occur, it is common for family dynamics to change as well.
     Keeping all of this in mind, Carrie Hill, Ph.D., has offered several tips to help family care givers to not only cope, but to enjoy the holidays as well.

Prepare your family for the holiday gathering. (Contact invitees and describe in plain terms how
     their relative has changed since their last visit.  If necessary, send articles and source
     material describing Alzheimer's and it's effects.)
 Give yourself permission to ask for help. (If you've always been in charge of the holiday
     gathering, consider letting someone else host, or others help out with preparing, cooking and
     clean up.)
Get feedback from your family AFTER the holidays. (Family members may be tempted to give advice
     and/or criticisms about the care you are providing.  Set a date after the holidays to discuss
     concerns and address issues.  Best to state this to the guests beforehand.  Make it clear that
     the focus is to be on the gathering.)
Lean on people who understand. (If for various reasons, family members fail to understand or are
     unsympathetic towards your caregiving situation, reach out to support groups or others who
     have experiences similar to yours.)

Dr. Hill goes on to stress the importance of the care giver to take care of themselves as well. Getting plenty of rest, eating well and taking time out for yourself is all necessary to being a good care giver.  You obviously can't take care of another  very well if you yourself are sick, tired or become resentful.  The holidays should be enjoyed, even if it means breaking rations. Look for ways to start new rations in your family, that incorporate the needs of those with Alzheimer's as well as those who care for them.

If you have any comments or stories you would like to share about the holidays and caring for someone with Alzheimer's please share it here.  Your experiences could greatly benefit someone who may be dealing with similar issues or just recently became a caregiver themselves. 
                   

WISHING EVERYONE A WONDERFUL & HEALTHY HOLIDAY SEASON

     Maintaining and providing independence is as much a top priority for caregivers as it is for the senior individual.  Aging in general can cause the decrease or loss of certain functions and abilities, which in turn can lead to depression.  Depression itself, as shown in studies, can lead to the increase in physical deterioration and even dementia and Alzheimer's, thus completing a vicious circle. 

      It is a natural response for people to want to gain and maintain their independence or "freedom".  From early childhood, we develop that need to "do it myself".  This continues throughout our lives in every stage, but is most evident, when as teenagers, we learn to drive.  Especially in America, where the car is king, the ability to get into a car and drive anywhere is considered a right.  As mentioned above, the decrease in certain abilities will undoubtedly affect driving.  Some individuals will realize this on their own and cease driving due to fear of a getting into an accident.  Others, however, may be deny their capabilities and continue to drive.  Family members, friends or caregivers may need to intervene and determine if, in fact, the senior in question should cease driving. Todays' Caregiver Magazine (www.caregiver.com) has provided a list of questions to ask or signs to look for:

•     When exiting a highway or interstate, does the driver seemed confused?
•     Does the driver seem nervous or agitated when driving?
•     Does the driver fail to stop at red lights or stop signs?
•     Is there confusion over the gas pedal and brake pedal?
•     Are there unexplained dents in the car? Mailbox, garage, trash cans, etc...at home?
•     Can the driver read and/or understand traffic signs?
•     Does the driver stop for no apparent reason?
•     How do other drivers on the road react to the senior driver?
•     Are turns, especially left turns, difficult for the driver to navigate?
•      Is the driver aware of potentially dangerous situations/activities on the side of the road?

If it is determined that it is not safe for the person to drive, it will be necessary to have a conversation with them.  State driving requirements may automatically lead to the termination of driving rights, but since driving laws are different from state to state, the individual may have years before they legally have to be tested again. Therefore it may be a good idea to get the individual's physician involved.  By having them explain the situation and the reasons behind it, will not only provide a third party, but an authoritative one as well.
The family member or caregiver should also come up with options of alternative transportation before suggesting that the individual stop driving.  That can help alleviate a lot of the stress that may come from surrendering their license. Todays Caregiver Magazine also provides some suggestions:

Selling the driver's vehicle and setting aside those funds to pay for public or private transportation.
Rotating a schedule with family and/or friends to provide ongoing transportation.
Qualifying for special transportation in their community based on medical need; especially for medical appointments. (Visit www.211.org to see if the driver qualifies)
Look into para-transit options for public transportation. (Call your local public transit authority for details).
Joining an existing neighborhood carpool service.
Senior centers may provide transportation directly to and from programs on a regular basis.

There will be other options available, depending on the community in which the driver resides. Talking with senior centers, church leaders and even health care providers can usually lead you to several options.  By helping a loved one through this transition will ease the stress over safety for the loved one and still allow the freedom and independence that we all want.
Have you had to speak with a loved one about this issue? Do you have more questions regarding this topic?  Please feel free to let me know.  I look forward to your comments and questions.
 

     It can be very hard to find time in today's busy world to dedicate to exerecise and overall fitness.  For those with disabilities, be they physical or mental, it can be even more challenging.  Depending on their level of independence, some may require the aid of a caregiver to assist in any kind of fitness program or daily exercises.  This can be especially true for older persons who may find that they don't move like they used to, whether it be due to arthritis or some other chronic illness.  They can easily cease all activity due to the constant pain.  This of course will lead to further physical deterioration and even a mental decline.  One group, The National Therapeutic Society, has established a week to promote awareness of the importance of physical fitness to the body and mind.  Each year, since 1984, the second week in July is dedicated to creating and promoting recreational activities for those people with disabilities.

    This year, National Therapeutic Recreation week is being observed July 12th-18th.  Throughout the nation, workshops, health fairs, athletic events and seminars are being held to offer information and showcase the importance of physical recreation to all disabled persons, regardless of age.  The NRPA (National Recreation and Park Association) offers 15 simple ways to get involved and help promote therapeutic recreation in your community.  This includes everything from sending a press release to your local media to organizing a team-based tournament for those with disabilities.  For those who work in senior living communities, it is the perfect time to discover new programs and activites that you can adjust to fit the needs and interests of your residents.  Just recently, at The Pointe at Kilpatrick, several belly dancers came to perform a show.  At the end of program, they encouraged the residents in attendance to join them in a lesson.  A surprising number of the women AND men, eagerly joined the dancers.  What started out as simple entertainment, quickly became a physical and social exercise.  The group clapped along to the music and danced together. 

     There are so many ways to get seniors with disabilities invloved in physical recreation.  Everything from bean bag tosses to a Wii gaming system can get those residents that may have become withdrawn involved in their community again.  Obviously, each individual's physical capabilities must be taken into consideration, but many activities can be adapted to fit each one.  Most of the Wii games, for example, require nothing more than a slight movement of the arms. This can easily be done from a wheel chair or walker.  It is also a great way to connect the generations.  Entire families can play the games at the same level, from young children to their grandparents.  If you are disabled, find a recreation you enjoy and figure out how it can work for you. (Consult your doctor or physical therapist for ideas and resources). If you know someone who is disabled and having troubles adjsuting physically, help them find something of interest that you can both participate in.  Group activities tend to be more motivating and will help to build a routine.