Hints for care-givers

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Carers play a vital role in helping people with dementia to adjust to living an indoor life in many ways.

Carers also have to adjust to a feeling of being overwhelmed by their caring role in addition to the scope of their family, employment and/or household duties.

Regular activities at home help people with dementia to retain their life skills and learn some new ones.

Also, activities done with a carer in the home or with others in a day-care centre provide opportunities for social interaction.

By providing an occupation or an outlet for energy, activities at home may lessen anxiety or boredom and consequent behaviour such as rummaging in drawers or pacing around.

Regular tasks

It is important to make activities for the person with dementia part of the regular routine at home, so that he or she feels a sense of inclusion in the various tasks being done.

Examples of tasks at home include: Folding sheets/towels (with help, if necessary), sorting and matching socks, dusting, cleaning kitchen worktops, sweeping/mopping floor, re-organising the food cupboard, polishing brass or silver, setting/clearing the table, washing/drying dishes, tidying drawers, arranging flowers, watering plants/window box, making a shopping list, feeding pets.

These are regular activities in the home. The carer also has to ensure there are daily personal activities such as bathing/showering, shaving/face make up, and dressing. Mealtime activities include preparing food, cooking, eating and drinking, and washing/drying plates.

Sensory stimulation

Sensory stimulation given by the carer with affection and gentleness will be enjoyed even if the person cannot express this verbally or is not physically active. Some ideas include looking at family photographs, smelling flowers, eating small tasty treats, and feeling a variety of different fabrics, objects and soft toys.

The carer can extend this to personal care activities such as gentle brushing of hair, using a foot spa, and having a neck or hand massage with scented oils or lotions. These are comforting and soothing to a person with dementia.

This article is based on one of the many advice sheets which are available at www.dementiasa.org

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Long-term planning is essential for dementia

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A strong warning about the world population explosion and its effect on dementia and Alzheimer’s Disease was given at the 21st National Family Practitioners Congress held in the River Club, Mowbray, Cape Town. It was the three-day annual conference of the South African Academy of Family Physicians, and team members from DementiaSA were in attendance at the DSA exhibition stand throughout the conference.

Speaking on the importance of advanced care planning for dementia, Leon Geffen, executive director of Cape Town-based Samson Institute for Ageing Research, said there was urgent need for action now as the world population jumped from six billion in 1970 to nine billion in 2020.

Much of the increase would be in low and middle income countries, which often had inadequate medical resources.

With people living longer, extra care would be needed because of cognitive impairment, frailty, loneliness, declining functional ability, and hospitalisation.

“By the age of 85 most people will have significant loss of brain tissue and some form of dementia, and they will all need care and a focus on their rights as individuals,” said Dr Geffen, who is an honorary senior lecturer at the Institute of Ageing in Africa at the University of Cape Town, and has worked with many community-based organisations in the Western Cape.

He pointed out that the growing number of older people presents a significant challenge to health and welfare systems, which are poorly equipped to deal with the needs of older people. As a result, they often receive poor quality care, particularly at the primary care level.

He said significantly more research is needed on disease, disability and health risks in the elderly population, as well as on their mental health needs and existing care gaps.

The Samson Institute for Ageing Research was founded to address these knowledge gaps. It is a registered non-profit organisation, and in 2016 it received an initial funding grant for five years from a private charitable trust, the Samson Family Foundation.

It is working to establish linkages with local and international academic institutions in order to conduct research, share resources and develop materials for training and other purposes.

More on www.sifar.org.za

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Health, wellness and fitness

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Pump up your brain health with exercise

Prevention is better than cure, and unfortunately in the case of dementia there is at present no cure although researchers around the world are racing to find one. However, there is encouraging news when it comes to preventing it.

According to Alzheimer’s Research and Prevention Foundation in the USA, regular exercise can help to prevent dementia and may, in some cases, help to slow further deterioration.

It says exercise protects against Alzheimer’s and other types pf dementia by stimulating the brain’s ability to maintain old connections as well as make new ones.

Experts believe regular attendance at gyms and health clubs/studios is specially recommended not only because of the exercise but because of the social interaction recommended for people with dementia – another reason for attending the regular support groups organised by DementiaSA (tel 021-421-0077).

Tips for sticking with an exercise plan at gyms and health clubs

If you have been inactive for a while, starting an exercise programme may be intimidating, but this where gyms and health clubs/studios help with advice and encouragement so that you start small and gradually build up your momentum and self-confidence

Many of them maintain records of progress made and apparatus used.. An additional aid to maintaining enthusiasm is to keep a private diary where you note increases in repetitions and weights used.

You could supplement your apparatus work with regular walks. The aim should be 150 minutes of moderate intensity exercise each week, which means at least 20 minutes a day.

It takes about 28 days for a new routine to become habit. So do your best to stick with it for a month and soon your exercise routine with feel natural, even something you miss if you skip a session.

Protect your head

Head trauma at any point in life may increase your risk of Alzheimer’s. This includes repeated hits in sports activities such as rugby, soccer and boxing, or injuries from a bicycle or skating fall or motorcycle accident.

Protect your brain by wearing properly-fitting sports helmets and trip-proofing the environment where you exercise.

Avoid activities that compete for your attention and cause you to fall, like talking on your phone while cycling or walking.

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Book review: Remembering Yesterday, Caring Today

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Remembering Yesterday, Caring Today: Reminiscence in Dementia Care – A Guide to Good Practice (Bradford Dementia Group Good Practice Guides).

P. Schweitzer and E. Bruce. 2008.
London: Jessica Kingsley.

Reviewed by Malcolm Wallis, DementiaSA

This book arises from a project initiated by the European Reminiscence Network. The project was called ‘Remembering Today, Caring Tomorrow’ (RYCT) which was based on the compelling idea that reminiscence and creative activities such as recalling proverbs or collecting memorabilia, however small in scale, can benefit persons with dementia by promoting personal wellbeing ,enriching communication and preserving lifelong relationships. There is a conventional view of nostalgia which sees it as an unfortunate way of seeing life as it prevents people from seeing the present clearly. The reminiscence approach turns this view on its head; by recollecting our past, it argues, we can better face the future. This view might not be entirely valid in South Africa. As shown by the deliberations of the Truth and Reconciliation Commission and elsewhere, for many people the past is not a happy place. This constitutes a factor to take into account when considering the possibilities of adopting such an approach in South African conditions.

This book is not just informative; it is much more than a ‘how to’ manual. It is also in places very moving as in a poem by a carer whose life was altered by her husband’s illness. It includes these lines:

“My husband’s needs must come first now
For in sickness and health I took a vow.
I will come to terms with this illness,
Even though I still don’t know how”

The book makes several points for us to take on board. To take just a few examples: the special contribution of family carers, the imperative to avoid the’ strong tendency’ to depersonalise and marginalise people with dementia, warmth (demonstrating concern and recognition), and playing to peoples’ strengths as much as possible. What is particularly impressive is the amount of practical detail provided to assist with the planning and carrying out of reminiscence based sessions. For example, based on the experience of one of the groups: ‘Fred needs one-to-one attention for activities when he’s away from Ena’ or ‘Working with the whole group, ask about the first pay packet. What did members spend their first pay on and how much was it?’

The book is definitely recommended, so long as the need to modify its advice to better suit South African conditions is taken into account.

If you would like to know more about the books, videos and any dementia related material we have available, please contact our office for more details on 021 421 0077

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Practical advice to carers

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Awareness talk by Bobby Jutzen

An inspiring talk by Bobby Jutzen, a board member of DementiaSA, left a “feel good” impression with those attending the latest meeting of the Pinelands dementia support group held at the Helen Keller Society.

He gave a graphic description of the many years he spent caring for his wife Maureen until her death, and thanked Karen Borochowitz for his introduction to DementiaSA after hearing her speak during a radio interview.

Using the word Courage as the basis for his talk, he broke it down into: C for Choice, O for Organize, U for Understand, R for Remember, A for Anger, G for Guilt, and E for Encourage.

Choice, carers have the choice of sitting in a corner and groaning or doing the best they could for affected people.

His choice was to take care of Maureen. He met Karen at a support group and DementiaSA was started in 2006. He became heavily involved in support groups.

Organize, this is essential, and carers have to have the patience to help people with dementia to wash, dress and undress. They have to make the home safe, so there are no sharp edges or knives, or slippery carpets.

In cases of disturbed sleep, there has to be an arrangement for the affected person to sleep in another room with a light on, as it was essential to obtain sufficient rest.

Understand, family members have to take time to understand the various changes in the home and in the family member affected.

If difficulties or tensions arose, it is often effective to take the person for a walk in the garden or around the block.

Remember, he said it was essential to understand that each person was an individual and his or her brain had different memories. “Try to think of a common memory, such as when you laughed together.”

Bobby pointed out that memory slips could be embarrassing and particularly when shopping, as the person with dementia could slip away while the carer was choosing goods.

Anger, he said God was the first object of anger. “You ask yourself – Why has this happened? My wife is a good person. Instead of blame, you must ask God to give you strength and peace, so that you can direct your anger into love for your wife and children.”

Talking on Guilt and Encouragement, he said carers must at all times persevere with doing the right thing for the affected person. “Sit in front of them, look them in the face and keep your tone of voice, body language and words under control.”

All family members had to be trained to demonstrate encouragement.

Also essential was choosing the right care centre to suit one’s pocket, with suitably-trained staff and activities such as crossword puzzles, word games, indoor ball games and sing-alongs with other residents.

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A trouble shared…

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An old saying “A trouble shared is a trouble halved” may not be applicable in all cases, but it certainly helps when it comes to dementia problems.

DementiaSA has been successful in tackling the problems in several ways: (1) Establishing support groups for those caring for people with dementia; (2) Arousing awareness of dementia through talks given by DermentiaSA social workers; and (3) Training people to become carers

Support Groups

DementiaSA now has support groups throughout the Western Cape and is busy setting up others outside it. It has nearly 20 support groups in the Western Cape, spreading from central Cape Town to Pinelands, Milnerton and Plumstead and from Bellville to Gordons Bay, Hermanus, Kleinmond, Kuils River, Langebaan, Strand and Somerset West.

There are regular surveys to establish the impact the support groups have in caring for a loved one with dementia. Examples of the written replies are: “Enlightening” and “I most definitely would recommend the support group experience to others.”

Other replies are more detailed: “The minute I walked in we were embraced like family because everybody’s stories were different, some sad, some happy, some funny, but we all had a similar experience that I could relate to. Just being in the support group uplifts my spirit and I come home feeling more renewed.”

Another example: “I was feeling alone, not knowing what to do or how to cope with my mom’s dementia, with the way she was dressing herself. It looked like she never cared.” Later the writer is much more optimistic after attending the support group: “ “It has made me more relaxed. I’m talking to her and she doesn’t get upset with me. I’m really going with the flow. It is awe-inspiring. You learn a new thing every month, and how to go back in their time because our time doesn’t exist any more.”

Awareness Talks and Training Meetings

The DementiaSA social workers are well known for giving encouraging and stimulating talks at the support group and training meetings.

Also, readers are encouraged to contact DementiaSA about getting a social worker to talk at other social events, such as church meetings. In this way the dementia message is being continually spread, helped by the advice leaflets which are distributed at the meetings.

The social workers are well-respected, highly trained and experienced, with the older persons speaking English, Afrikaans and isi-Xhosa.

They are equipped to assist with complex dementia cases where expert interventions are required. They can also help to investigate reports of elder abuse.

The social workers are also invaluable in helping to train people as dementia carers. They encourage people who have family members living with dementia to do the training to get a better understanding of how to care for them.

Anyone is allowed to do the training, and this has encouraged an increasing number of people to come forward, so that well over 300 carers are now active in the field in 2018.

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Coffee with Roffey

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By Fred Roffey

Dementia and Alzheimer’s disease attack regardless of age, sex  and financial status.

Dementia and Alzheimer’s don’t just target one group of people. Many of the affected people had everything to live for in the material sense, but what was the use of their money if they had to endure a slow but inevitable deterioration in their memory? At present, there is no cure.

Affected people range from film stars to sports personalities, musicians to artists, politicians to activists, and authors to physicians. Here is a list of just a few of the well-known people who died from dementia and Alzheimer’s Disease.

10 Famous people who have died from Dementia

  1. Ronald Reagan, former USA President
  2. Harold Wilson, former British Prime Minister
  3. Sugar Ray Robinson, American boxer
  4. Otto Preminger, prominent film director
  5. Charlton Heston, American actor
  6. Rita Hayworth, glamorous film actress
  7. Charles Bronson, USA film actor
  8. Dana Andrews, USA actor
  9. Perry Como, American singer
  10. Terry Pratchett, writer noted for fantasy novels

The countdown

Statistics show that about 10% of people develop the disease at some point in their life, and the figure is increasing with earlier and better diagnosis.

About 3% of people between the ages of 65-74 have dementia, 19% between 75 and 84, and about half of those over 85 years of age in the Western World. It is the 8th leading cause of death for the elderly in the USA.

Every three seconds, someone in the world develops dementia, which is rapidly becoming a trillion-dollar-a-year industry. Developed countries are budgeting for a big increase in spending on retirement centres and health clinics with dementia-treatment facilities. For example, Britain has stated it wants to become a leading global centre for the treatment of dementia.

A little wine a day

If you are feeling despondent after reading the above, don’t reach for a bottle of the hard stuff. Just reach for a small glass of wine a day.

Middle-aged people who drink the equivalent of 175ml of wine a day are half as likely to develop dementia as those who abstain from alcohol, according to a study in the British Medical Journal.

And it was a serious study. Researchers tracked more than 9 000 British civil servants over 23 years, and the amount they drank was closely monitored.

This is not an excuse to fill your glass to the full, as research in France shows that a small amount of red wine daily is good for your heart, whereas an excessive amount is definitely harmful.

Congratulations to Helen Keller

The Helen Keller Society in Pinelands, Cape Town, is celebrating 60 years of care. It must be one of the oldest continuous-service retirement centres in South Africa. It provides accommodation and care primarily for people who are blind, visually impaired and hard of hearing.

American author, political activist and lecturer, Helen Keller, was the first deaf-blind person to earn a Bachelor of Arts degree and when she visited South Africa in 1951 she appealed for building funds for a hostel for blind working women in Cape Town.

The present Helen Keller Society site was acquired from the City Council, and the Society has grown to such an extent that it offers independent living in its cottages, assisted living in its home, and full nursing care in the care centre, complete with entertainment programmes, film shows and occupational therapy classes.

A series of special events at the Society marks its 60 years of outstanding care.

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Woolworths staff visits DementiaSA on Mandela Day

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A celebration in progress after the handing over of a R5000 donation, from Woolworths staff members at the DementiaSA offices in the Gardens, Cape Town. Natalie Marrow (right), lead import merchandiser at Woolworths head office in Cape Town, is seen with her team involved in importing lingerie. The team arrived at DementiaSA as part of their commitment to expressing solidarity with the ideals of the Nelson Mandela 100th birthday celebrations.  Karen Borochowitz (standing), executive director of DementiaSA, spoke on her personal involvement in dementia caring over many years, and showed short video clips.

Woolworths announced at their 85th anniversary that they would be partnering with the MySchool MyVillage MyPlanet fundraising programme to provide 50 educational bursaries of R20 000 each, totalling R1 million.

DementiaSA is honoured to be a part of this fundraising programme and would like to encourage you to sign up for a free MySchool card in store or online at www.dementiasa.org/ and choose DementiaSA as your beneficiary; you can have up to four beneficiaries.

The MySchool MyVillage MyPlanet fundraising programme is one of South Africa’s biggest community programmes. Who raises funds for schools, charities and environmental organisations through a card system that allows supporters to raise funds for their beneficiary (school or charity) every time they shop at a partner stores. Partners make a contribution, on behalf of the supporter/cardholder, towards the beneficiary they have selected.

Nominate DementiaSA as your MySchool MyVillage MyPlanet beneficiary here.

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Making Memories Matter

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Every three seconds a new case of dementia is diagnosed worldwide. Alzheimer’s and stroke is 2 of the main reasons for dementia development. It is crucial to detect dementia early on in its progression, to help the person with dementia, who could be you, or your family and friends, optimally.

Film credit: Michelle Pretorius

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Communicating with people with dementia

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Coping with behavior that challenges.

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Ukumelana nesimo esihluphayo

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Vroee waarskuwing tekens van demensie

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Early warning signs of Dementia

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