Three women, all three 90 year’s old, similar symptoms, different diagnosis.

Known as the three Ds, depression, delirium, and dementia can be confused and it is essential that we know the differences so that we can approach care and treatment in the best and most appropriate manner possible.

The first of these three was diagnosed with dementia. She stopped bathing, slept in her recliner chair and stopped eating anything more than toast and coffee. The curtains were pulled all day to keep the light out and visitors away. She had memory problems including being unable to name the child that had drawn a picture for her, once considered important enough that it is framed and hangs on the wall in the living room. Suspicious of others, she refuses care and believes she is doing just fine.

For this woman careful scrutiny by her doctor and interviews with family members’ revealed severe depression that had likely been going on for years and her diagnosis “pseudo-dementia” related to depression became a diagnosis of hope. Hope because depression is often something that can be treated with medication and from which she may recover. And she did. The shades were opened and she began to venture outside from time to time. Showers were acceptable and conversation began to flow.

Another woman tells me her dead husband is in the basement talking. She knows he died a year ago but also is certain he is talking in the basement. She is also certain that she swallowed her mother. Although she can pay her bills she is convinced her money is being stolen. She is awake at night fighting with someone she sees but no one else can see. There are loud parties in her driveway and she is convinced the police need to be called. She sees dead people. Sometimes her speech is gibberish. Her hallucinations and delirium are disturbing to her and to her caregivers. They come on rapidly and resolve, sometimes in hours, sometimes in days. They leave her weak and exhausted as she battles people and things all night.

Her delirium appears related to a reaction to medications but also to infection and constipation though there is not a clear and consistent correlation, making it more difficult to teat. . Though sometimes mistaken for progression of dementia, we know this is delirium as her symptoms come on rapidly and she can be reoriented. Early recognition is key and delirium can be treated and reversible. Unlike dementia, reorientation is important. This means we discuss the fact that her husband died and it seems unlikely that she could swallow her mother.

Finally, another 90 year old who doesn’t know her son but knows he is the nice man who helps her. She resists bathing, certain she already has, says “no thank you” to breakfast, lunch and dinner, not hungry and certain she has already eaten. She sleeps in her clothes because she can no longer plan and process how to change them and it doesn’t matter to her because she cannot clearly see the stains. Sometimes she wanders away from the place she has lived for 65 years to find her home, likely recalling the home of her childhood. She is incontinent at times. Usually happy and easily redirected, she is also afraid at times, confused and having trouble making sense of a world she no longer remembers.

She has dementia, specifically Alzheimer’s Disease. This is the most common form of dementia and it means that the changes in her brain are permanent and fatal. Like the two woman above her struggles are daily and impact every aspect of life. In her case however, things will get worse. Dementia will progress over a period of 8-20 years and although progression can be slowed in some cases, it cannot be reversed. The approach for the caregiver is not reorientation but to maintain and enhance the skills that remain.

Depression, delirium, and dementia. There are many similarities between the “3 Ds” but it is essential for an optimal outcome that a correct diagnosis is made. As caregivers we need to provide the caring and compassion that each individual deserves while understanding the challenges they face.

Judy Loubier told us about the “miraculous turn” for the better her father took recently during a hospital stay. The fog is clearing. Her personal experience has given Loubier of Caring for Seniors NH a very unique perspective on folks suffering from dementia, or Alzheimer’s. Loubier reminded us that September is Alzheimer’s Awareness Month and gave us the details on this weekend’s Annual Walk to End Alzheimer’s. Judy also discussed the tricky business of diagnosing and treating the disease.

Link to register in Manchester, NH September 27, 2014

Link to register in Portsmouth, NH September 28, 2014

There is not a moment that I have spent at our summer home in Belgrade Lakes, Maine that I have not thought how lucky we are to have this place. A somewhat remote camp on Long Pond (pond is loosely used in New England as this pond is 2714 acres in size),I have come here to vacation all of my life. We still do not have electricity but have moved up from the classic red manual pump to bring water into the house to a generator run pump and a large holding tank in the shed. We have kept the outhouse but now have 2 indoor toilets. You could say we now have 4 toilets as the outhouse has 2 seats but as far as I know only one is used at a time.

Very little kerosene is used these days and lights are via propane, as are the refrigerator and stove. A wood stove heats the house and a fire is made on 80% of the mornings we are here, sometimes to truly take the chill off as it is Maine, and sometimes for ambiance. Most of the family also realizes that once you pass 80 years of age you are frequently cold and therefore it is now a family joke that the house is cold if dad has not yet gotten the thermostat up to 82.

But it is always easy to cool down in the lake, where 74 is a standard, 78 a luxury. My sisters and I grew up with a couple of cousins playing house on the rocks in the woods, making huts, playing Barbie Dolls down by the water, reading comic books on rainy days and during a mandatory rest time every afternoon (what ever happened to mandatory rest times)? And when we were teenagers we spent time sunning, waterskiing, and thinking about the boys back home or the boys next door.

This camp is a legacy in our family. My grandfather bought the land in 1940 after having been on the lake for many years fishing. The 225’ of waterfront were bought from the neighbor with whom my grandfather fished about a quarter mile down the lake. That camp was built in 1898 and housed the boys next door 2 generations later.

My father and his brothers built our camp in 1960 and in 1962 we arrived for our first summer, my sister and I just under a year old. 52 years later my children and my sisters’ children have spent many days playing, swimming, and laughing at this camp. We are so very fortunate to have been given this legacy but it strikes me that a legacy can be anything you wish it to be. By definition a legacy is “something received from an ancestor or predecessor or from the past” (Webster). It also means how someone is remembered, and what contributions they made while they were alive.
If we were wise enough to live life thinking forward we would begin to consider our legacy early. Maybe as we are new parents peeking in the crib to make sure our first born is really ok we would think “how do I want this child to remember me when I am 90?”

To that end the following documents might be helpful. We should think about our legacy sooner rather than later but invariably it is as we reach the end of our life that it becomes front of mind. I believe that if we are mindful of what we may leave behind for our family and community we would make choices that reflect our true nature and the heart of who we are.

It can be a family tradition of baking cookies together at Christmas, a recipe passed down through the generations. Or a day trip to the beach or local fair. Maybe it is a donation of time working at the soup kitchen together or collecting jackets before the cold weather arrives. A legacy of giving from the heart is sure to have a greater impact on how you leave your family than any money.

Check out the forms below and consider them. They were developed for a younger generation and in hopes of turning the decisions that generation makes in a positive direction. Surely the sooner we think about the legacy we will leave the better our legacy reflects our true heart.

http://www.caph.gmu.edu/Legacy/1legacy.html
A Personal Reflection (pdf)
A Wellness Perspective (pdf)
Perspectives Based on Audience (pdf)
Reflections Based on Time (pdf)
Reflections Based on End of Life (pdf)
A Letter to Yourself (pdf)
A Letter to You from Others: Today and Tomorrow (pdf)

The more I gave thought to writing about hospice and dying, the more I found that I resisted writing.

It was that death used to be part of life, an expected event that almost always arrived quickly, death has now become an event that we are able to influence and for a moment on some occasions, even seem to be beat. Many have beaten cancer, survived unimaginable trauma, overcome heart disease with innovative surgeries. In fact, I know a woman who wears her heart on her back, literally. While she waits for a heart transplant she and about 1,000 others are now able to wear a heart pump in a backpack. Weighing about 13 pounds, it will help to oxygenate blood and pump it throughout the body, essentially replacing the heart that is no longer working effectively. http://www.syncardia.com/2014-press-releases/itemid-1658.html

Talk about beating death.

We live in an age where our medical advances have permitted us to extend life. At 16 with a failing heart I don’t know anyone who wouldn’t take the opportunity, the gift of another day, another month, another year.

There is no denying, however that we will all reach the point at which life can no longer be prolonged. For the oldest of the old, those over 85, bodies have worn out, transplants are not an option, and the next phase must be stared at squarely in the eye and, for good reason, accepted. Because it is inevitable. One day we will die.

Sometime in the 20^th century we became what many call a death denying generation. In the cockiness of medical advances we no longer found accepting death acceptable. We became a society that valued youth, productivity and independence, and we began devaluing age, family and interdependent caring. http://endoflife.northwestern.edu/introduction/what.cfm

Prior to the incredible medical advances seen after World War II, most people in the USA died quickly, and in the 1800 and early 1900s death often occurred at home with family nearby as there was little time to respond to a grave illness. By 1949 50% of all deaths occurred in institutions and by 1992 only 20% of deaths occurred at home. This despite the fact that 90% of those asked state they want to die at home. http://endoflife.northwestern.edu/introduction/what.cfm

Where is the disconnect? How can our end of life wishes be fulfilled?

First and foremost is education. We need to become educated about what our loved ones want, to accept that it is likely to die at home, and then to become educated as to how we can support that desire to the best of our ability. As you learned in part 1 of this series, I learned that the hospital is not where I want to be if I am given the gift of approaching death slowly and with the ability to make choices.

These are difficult discussions and for that reason, the primary block to having our family members’ wishes about dying understood. Often I hear an elderly person say that their family will not let them talk about their death. As if not talking about it will mean it will not happen.

Take the first step and ask your loved one what they hope for at the end of their life. Remember that your loved one was likely there for you when you wanted to talk about graduation, falling in love, raising children, your hopes, dreams, and desires for life. Do the same for them in death. Ask. Listen. Take notes. Let them know it is out of love that you want to respect them to the end.

If you were not fortunate enough to have the loving support of family throughout your life, give this gift as the first step in changing a trend. The way we treat our loved ones will be witnessed. It is the only way our children will learn how to care for us at the end of our lives.

Think about it, write about it. Talk about it. Perhaps use this article to initiate.

Today I was asked a good question; a question in which the answer takes thought, careful consideration and for which the answer could divide families. The question? “How can hospice care be about quality of life when you are deciding not to treat someone anymore but to accept that they are dying? Isn’t this giving up?”

If you have not yet faced the diminished quality of life that goes with a hospital stay for an elderly person, or with a chronic untreatable condition, this could seem like a tough one. Let me describe poor quality of life first, through an example of my own, and then we can get to the hospice discussion on common ground.

My beautiful and wonderful mother, Priscilla had a 2 week hospital stay last fall. The hospital was excellent and I truly cannot say enough about the nurses and doctors. But here is what a hospital stay in even the best of circumstances can do for someone with dementia or for an elderly person: it can increase suffering while attempting to improve health.

This sounds harsh and I may take some heat for being so blunt. In way of explanation I will describe our experience.

Priscilla’s day in November of 2013 started at the doctor’s office as she had not been eating. Her blood pressure was quite low and therefore off she went to the emergency room. My father and I sat with her in the cold emergency room for 7 hours during which the stroke team was activated for a middle aged man and 5 ambulances arrived. This level of activity is not unusual for emergency rooms these days and given decreased staffing that has come with Medicare and Medicaid shortfalls, it translates to waiting. My mother did not have an obvious “emergency” so attention was sporadic. Six hours in and her blood work came back with an elevated cardiac enzyme. Heart attack? Not sure. Fluid around her lungs seen on an x-ray. Pneumonia? Not sure. But enough to admit.

During the 2 week stay my mother was on complete bed rest for 48 hours and reached a point of being so weak she could not sit up or maintain sitting on her own. Blood was drawn every morning at 5 am. Every morning. Every single morning she was woken up and poked with a sharp needle at least once but more often 2 or 3 times as she does not have easy veins to poke.

She lost 17 pounds. She stopped talking and ate only sporadically. She was confused and I believe she was scared. All she wanted was to be with her family, mostly my father. If you know my mother, she is the sweetest lady you know.  She never wants to trouble anyone, even her children. She always puts us first. But when we asked her if she wanted us to stay overnight she did not hesitate to say yes. This was a clear statement of “I’m scared.”

There were nights when we were not certain of whether my mother would see the sun rise in the morning.

It turns out my mother did have a heart attack but was never seen by a cardiologist. Not to blame. She is not a candidate for surgery and is on all the correct medications already. There was nothing the cardiologist could do. Four different hospitalists attended to her care, all excellent, all with nothing to add.

And at the end of the 2 weeks, too deconditioned and weak to go to the one place she wanted to go—home, she had to go to rehabilitation. Another 7 week journey and finally home to be with my dad.

So I have to ask: what if my mother passed away during the hospital or rehab stay? Then the one thing she wanted most, to be with her husband at home, would not have been completed. To me and to my family, that is poor quality of life.

So when it came time to talk hospice we were ready. We are certain we are not giving up or predicting death. Only God knows when this inhalation will be followed by our very last exhalation. Meanwhile steps are in place to stay home through thick and thin.

When nothing more can be done to increase our days, we should increase the quality of our days. Be with the ones you love and be treated in a manner that rejoices in your life.

“You remind me of your dad.”

Or as I have heard it through the years “Tu me rappelles de ton pèrecomme deux gouttes d’eau!” (you remind me of your father like two drops of water!) This was a common observation from friends and relatives that have known my father Lionil from his youth to his passing in 1973. More than genetics, I believe what they saw was the character of a man in his children. My dad wanted a better life for his growing family. So, he looked for opportunities in the United States and found a manufacturer and a sponsor in Nashua. He counted the risk, took a chance and we immigrated to New Hampshire. My dad worked 2nd shift which gave us time together when we weren’t in school. From my boyhood, I have fond memories, of picking apples as a family from a local orchard, going on family picnics, and connecting with family in Quebec, Canada. Sundays was always a  time together. In the early years, John, our sponsor, would join us and Dad would break out the harmonica and play a couple of “reels” tapping his feet. The Sunday gathering of friends and family continued until his passing. In his brief time here with us, my father Lionil left a lasting legacy found in the character of his children.

For me, I was fortunate to have two great men in my life that I called ‘dad’. One who modeled a caring father in my boyhood, the other who lead me through my days as a young man and father until his passing in 2010. The other man was Carl, my father-in-law. As Nancy would say her dad provided a sense of safety, a man of few words but rich in wisdom. Like my father, Carl would have a family gathering every Friday night. The ladies would have a game of “Canadian Rummy” and the ‘guys’ would have a game of Pool, or play a challenging round of Ping Pong. We would then break around the wood stove tell stories and laughing a lot! it was a time of connections with family and friends. Carl’s grand-children fondly remember “Friday Nights.” (they have their stories to tell about their ‘papa’). I credit Carl for giving me vision and encouragement as a man when “things didn’t quite make sense”. I like to think that he provided the missing oar in the water to help me steer through uncertain waters. When I ponder the words “You remind me of your dad” I think of it as a tribute to the character of the two men whom I have been privileged to have called dad.

To all the dads that help make a difference for their children and grand-children….Happy Father’s Day!

Ben

I am in a gym and surrounded by sweat, groans, and some tears. I, however, am not sweating at all. In fact, although my heart rate picks up every hour or so for about 6 minutes, I am still in my street clothes.

This is a high school gym and I am attending another Saturday high school wrestling tournament. I will be here from 8 am until maybe 6 pm to cheer on my 16 year old son. Today the hour long drive home is without snow so it is likely to only take an hour.

The house has not been cleaned yet and I am staring down 3 or 4 loads of laundry when I get home. Lucky for me my husband likes to cook.

Throughout the day my phone has been relatively quiet. A few work related phone calls. No calls from my dad. A call from my dad means I pick up immediately, saying a prayer that all is fine with my mother.

We have had 7 emergency room visits, each one lasting a minimum of 6 hours. We have had 6 hospital admissions, lasting from 3 days to 2 weeks. And 3 stays in rehabilitation ranging from a stay of 2 weeks to 7 weeks. This is all in the past 9 months.

To put it in perspective, July, August, and September were hospital free. 2/3 of the past 9 months have involved the hospital. All but one related to my mother. My dad can claim one week-long stay due to pneumonia, during which my sisters and I took turns sleeping at their apartment in assisted living as my mother cannot be left there alone.

This is the life of someone who is a daughter or a son of an aging parent, a mother, and who is still employed.

We run here and there. We cheer and film and buy more waters and Gatorade. We consider our calendars as we determine how we can make mom’s next doctor’s appointment, as all of the information shared during that visit can be overwhelming for all involved and our presence not only gives comfort but clarity.

According to a new Pew Research  Center survey “Nearly four in ten U.S. adults (39%) are caring for an adult or child with significant health issues.”  That is up from 30% of U.S. adults in 2010. Caring for a loved one is an activity that cuts across most demographic groups, but is especially prevalent among adults ages 30 to 64, a group traditionally still in the workforce.” http://www.pewinternet.org/Reports/2013/Family-Caregivers.aspx

If you are a member of this club of family caregivers, the “sandwich generation,” it is likely you know exactly what I am talking about and maybe, like me, you wouldn’t have it any other way.

The good news is that if we can figure out how to keep all the balls in the air, juggling without a miss that results in any big mess, if we can realize how to not only enjoy but love this role of family caregiver, we could actually be benefiting from this frenetic, crazy life.

In a study from the American Journal of Epidemiology, we may actually be happier and healthier than our non-caregiver friends and family. “Family caregivers were 18 percent less likely to die than non-caregivers over six years, the researchers found.” http://aje.oxfordjournals.org/content/early/2013/10/02/aje.kwt225.abstract?sid=194127f7-13f4-4190-b3b1-ff04f67f0afc

There are plenty of studies that show the negative effects of caregiver stress, caregiver fatigue and caregiver burnout, all terms used today to describe the downside of this juggling act. So, how do we keep the balls in the air and keep a smile on our face?

There are a number of resources and all start with asking for help. Here is a good start as a resource guide. http://www.helpguide.org/elder/caregiver_stress_burnout.htm

Remember that you will likely need help. Ask for it where and when you can. You may never want someone else to take your mom to the doctor but you might love someone who can clean her tub. Or pick up her groceries and cook a meal. Or just keep her company while you attend the all-day wrestling tournament. The key to asking for help is to be specific about what you need so that friends or those you hire to help feel more able to give the right assistance.

Hiring help may be more affordable that you realize, especially when weighed against the impact to your job and to your time with your children. Even 2 hours per week can take just enough of the load off and you begin to feel yourself breathing again and to be grateful for the opportunity to care for those you love and who have loved you.

The holidays are a time to gather with family and to share in the joy of the season. As a family ages grandma and grandpa can easily become quiet spectators, lost in the chaos of noisy rejoicing over the great PS3, Smart phone, or sweater, the turkey or ham, sweet potatoes, stuffing, and pies.

The greatest loss could be the next generations’ if we do not take time to ask about and really listen to the stories of our elders. These are the stories that join us as a family and to pass them down means not only to preserve the history but to remind our children that we are interesting, even fascinating people.

This Christmas my in-laws asked how my 16 year old son and his girlfriend met. Mitchell and Alanna shared that it was at a football game. Mitchell liked Alanna’s eyes and decided to walk up and introduce himself. Now 14 months later….well, we can’t really say the rest is history since 14 months hardly amounts to history unless you are 16. But this naturally led to the sharing of how my in-laws, Gene and Phyllis, met. And this is a good story.

Boston has the oldest subway system in North America, with the first underground streetcar traffic dating back to 1897. Today the whole subway network is owned and operated by the Massachusetts Bay Transportation Authority (MBTA). You may know it as the “T”. My mother-in-law does not know it by that name.

In the early 1960s, the then newly formed MBTA hired Cambridge Seven Associates to help develop a new brand identity. Cambridge Seven came up with a circled T to represent such concepts as “transit”, “transportation” and “tunnel.” Today, Bostonians call their rapid transit network “the T”, and it is the fourth busiest in the country, with daily ridership of 549,000 trips excluding the Silver Line bus. http://en.wikipedia.org/wiki/Transportation_in_Boston#cite

This story begins before 1960, when the “T” was still called the subway. It begins on a night in 1953, specifically May 14th, 1953, in Boston at the YMCA. Gene was living in town, there from Waterville, Maine to work and go to school. Phyllis, from Unity Maine which is about 18 miles from Waterville, was attending a different college. Both decided to go to a dance at the Y that fateful night in May.

Gene spotted Phyllis across the room and walked the distance to make his introduction. They danced and talked and he was enchanted. When asked, Gene told Phyllis he was from New Jersey. He doesn’t know why, maybe it just sounded better than Maine. Phyllis may have grown up only 18 miles from his home town but she still had her Maine accent. Gene was sporting his French Canadian twang and Phyllis just knew he did not sound like her so she believed him!

Well, the night got late. Gene, being the gentleman then that we still know him to be today, told Phyllis he would escort her home. Gene took Phyllis right to her door, kissed her and told her he loved her.

By this time it was midnight and all of the street lights were turned off and the nearest subway still running was 17 miles away. At this point in the story I asked Phyllis if it was called the “T” back then and she had never heard of the “T.” By the time the subway became re-branded, Gene and Phyllis were raising their family back in Maine and not quite up on the metropolitan changes going on in Boston.

Gene walked the 17 miles in the middle of the street, walking on the white line so as not to get lost. Somewhere on his journey he realized he was thirsty. He approached a gas station to buy a Coke out of a machine and as he reached into his pocket to take out his 10 cents, he suddenly was cornered by 2 policemen with guns drawn. Eventually they were convinced that Gene was just love sick and not robbing the gas station. They let him go but would not give him a ride home.

Gene arrived home at 5 am. He wrote a letter to Phyllis and then went to bed. And now we can truly say “the rest is history.”

Don’t let your family history be lost. Use this New Year to begin writing down the stories that make your family interesting and special.

Recently I wrote about gifts for family members who are living with Alzheimer’s Disease or another dementia. The gifts that I highlighted were fun and helpful gifts that add to the quality of life for not only those living with dementia but also for the family caregiver.

Before I continue to look at gifts for those with dementia I thought it would be fun to take a look back at Christmas advertisements of days gone by. The ads that would have caught the eye of the senior we are now caring for. These ads go back to the days when many of those we are caring for were children and move all the way up through the generations to the present time. It is a quick and easy way to look at changes in lifestyle over the years.

I noticed that Whitman’s Candies were a popular gift from the 1920’s through the 1950’s and we still see these candy boxes on the shelves today. Whitman’s Chocolates was started in 1842 by a 19 year old and by 1915 had grown to be “America’s best-selling chocolate” and today is still offered to those traveling on Air Force One and is also offered to guests visiting the White House. http://www.russellstover.com/jump.jsp?itemType=CATEGORY&itemID=201

Coca Cola had a big jolly Santa in many early ads, adding happy elves in at one point in time. By 1961 Pepsi begins to show up in the hands of a happy father under a Christmas tree with his wife and son. We also see 7-Up appear in 1964. So far I have not found a decade that does not have an advertisement for a fine liquor.

Advertisements for electronics can be found in the 1920s in the form of Radio Victrola and RCA Victor in the 30’s. A “Recordio” was sold in the 1950s to record the holiday “hilarity” and also play AM and FM radio. Kodak can be given as a gift throughout the 1900s. A Motorola TV is seen in an ad in 1950. It is large and the family gathered around one per household if lucky enough to own one. Today many are asking for a phone that can not only make calls, it takes pictures, videos, will hold shows and games, and connect you to thousands of people you know and do not know through email, Facebook, messaging, Twitter and more.

As for toys, Lincoln Logs sold for $1 to $3 in the 1920s. The 60’s are when we see ads for Barbie begin to appear as a favorite. My sisters and I loved our Barbie Dolls.

Times change, we see Santa smoking a cigarette in an advertisement in 1936 and then an ad appears for Christmas Seals in 1969, an organization to fight emphysema, tuberculosis and air pollution. Today I see advertisements for electronic cigarettes. What a day it will be when no Christmas ads are needed to address smoking. (sorry, a little personal opinion there).

We often hear from seniors that oranges were always a special gift and in the 1930s the ad for Sunkist oranges states that the “The Greatest Gift of All is Health.” Even my husband Randy, born in 1958, notes that an orange was always found in his stocking when he was young. This one has survived the ages as well as Whitman’s.

Take a look for yourself; this is a fun stroll back in time through advertisements at Christmas.

http://www.vintageadbrowser.com/xmas-ads

Each year most of us have one person with whom we struggle to find the perfect gift. At one point in our lives that person might be the family member known to be picky, or who has expensive taste while we are on a limited budget.

But eventually that person is the family member who is downsizing. Not only do they have everything they need, they have too much. Some of the downsizing even makes its way to your house.

Add a diagnosis of Alzheimer’s Disease or another dementia, and shopping just got that much harder. Often they loved family member with dementia no longer reads or golfs or knits or cooks. The same safe and comfortable clothes are worn over and over.

So how do you find the right gift for this person that you care for?

Well, The Alzheimer’s Store has great and meaningful options that could not only be a perfect way to say “Merry Christmas” or “Happy Hanukah” but may keep your loved one safe or make the life of the family caregiver easier.

Some items are surprising. Like baby dolls. A baby doll for an 85 year old? But listen to these testimonies from the store website:

My mother is in an advanced stage of Alzheimer’s. Her doll is her constant companion. In my mother’s mind, the doll is a living being. She cuddles it, talks to it, and exhibits less fearfulness at night when she sleeps with the doll. The familiar occupation of caring for “Little Debbie” seems to remind my mother of her role as an adult. The reduced level of agitation, and even more importantly, the comfort and happiness “Little Debbie” has brought my mother only makes me sad that I did not get her a doll sooner.” Jill – Caregiver for her Mother

And another comment: just received our doll…Lee…a short time ago. My husband’s eyes lit up, as they have not, for a long time. I put her in his arms where he cuddled her for a while, and then seemed to be sleeping. I tried to take the doll away and he grabbed her back to rock and “love” her. We have named her NAI AN. I had been afraid that he would scoff at such a gift, but, happily, and, somewhat sadly, I was wrong. He loves it. Regards, Marcia C.

These dolls are therapy for the family member with mid to late stage Alzheimer’s. According to the Alzheimer’s Association caring for the doll helps to bring about feelings of being useful again and the emotions that go with nurturing bring a sense of calm and contentment.

Or how about a mural that looks like a book shelf. It goes on the back of a door. Why you ask?

Well, 60% of those with Alzheimer’s or another dementia will wander and of those who wander, if not found in the first 24 hours, up to half will suffer a serious injury or death. Because dementia and Alzheimer’s cause brain tissue death, there is confusion about time and place. Many who wander are trying to get home or to a place that is familiar. They may not see their present location as home even if they have lived there for months. This wandering can cause family caregivers much worry and a sense of being unable to take their eyes off of their loved one.

So, if unable to find the door, the likelihood of wandering is greatly reduced. And this will help to eliminate the sense of frustration for the family caregiver who may at times feel as though they need or want to lock their loved one in. Since this can be unsafe, a room with shelves of books for a door is just the gift.

Other items include a handyman’s box with latches and clasps for manipulation. A weighted teddy bear that can be warmed or cooled in order to provide relief to achy joints while being soft and cuddly. A large clock that states the day clearly, a memory phone that holds 9 pictures so that your loved one can call you by simply pushing the button with your picture.

There are puzzle books with topics on Reminiscing through the 20th Century, A Walk in the Garden, and Hymns with pictures. All of the topics are relevant and provide opportunities for sharing and conversation.

As I browse through The Alzheimer’s Store online site there are numerous perfect gifts in a large price range. There really is no reason to be stuck for gifts for the one you love, even when that loved one may no longer know the season for giving is here.

As I looked through the store I chose my doll and if one day I am faced with the diagnosis of Alzheimer;s or another dementia, I will take Baby Casey.

For more ideas go to The Alzheimer’s Store at  http://www.alzstore.com/