Episode 77 - Activities to Do with Your Parent Who Has Alzheimer's Dementia With Judy Levy

Activities to Do with Your Parent

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Hi, I'm Diane Carbo with Caregiver Relief, where we are here to provide support, education and resources to help you navigate the challenges of caregiving. Today, we have a very special episode focusing on engaging activities you can do with a parent who has Alzheimer's dementia.

Joining us is Judith A. Levy. She's ED. M, which is Educated in Master's Degree, I'm assuming, and more importantly to me as a nurse, forgive me, Judy, but you're an occupational therapist, right? Yes. Yes. And that I relate to because I did rehab for so many years and that's a wonderful profession. She's a highly experienced occupational therapist with over 40 years in adult rehabilitation.

Judith has worked in hospitals, long term care facilities, assisted living centers, and home care settings. She has also trained home health aides and lectured in occupational therapy programs. But beyond her professional expertise, Judith understands the caregiver journey on a deep personal level. She spent 10 years caring for her own parent with Alzheimer's dementia.

God bless you, girl. That's a challenge. So in this episode, Judith will share valuable insights on the meaningful activities that can not only enhance engagement, Promote well being, but even support fall prevention for individuals with dementia. So whether you're looking for simple ways to connect, improve mobility, or create moments of joy, this conversation is for you.

Okay, let's get started. What an introduction. Thanks. Well, you know what? I am very impressed. I'm so excited about your book and about your experience. And I want people to know because our caregivers need so much support out there because, you know, you provide practical therapeutic and enjoyable activities that can make a difference in a caregiving experience.

So Judy, can you share a little bit about your background in occupational therapy and what led you to focus on Alzheimer's dementia caregiving? Oh, boy, , I worked a long time. I started at New York hospital and I was a therapist working in adult rehab there. And then I got assigned over to hospital.

I don't think it was hospital for special. I don't remember what it's called then, but it was Jerry's kids. And I worked with children that had disabilities and I ended up at New York hospital being the OT that covered the developmental program for children that were disabled and then we moved to New Jersey.

And I thought, oh, I was a newlywed and we were thinking if we had children, I didn't want to be working with disabled children because it was too hard to think about being pregnant and see disabled children. And I got into doing, assessments of facilities for OT programs at that point. Oh, wow. And that switched me all together and I ended up doing long term care in a facility.

And then I did nursing home assessments and home care. I seem to have done the gamut of OT, but for the majority of my practice. For about 40 years, I did adult rehab. I loved working adult rehab and to say I was good with stroke. I was really good with stroke patients. Then my mother got dementia and my mother got dementia when she was 88.

And she had it a total of 10 years and nobody in my family lived to be 88 so nobody had any that I knew of any dementia or cognitive or senile dementia, whatever they called it at the time symptoms because nobody lived that long. Yes. And we initially, we didn't, I didn't pay attention to it. It's kind of like, initially, you just kind of discount what you're seeing and you don't look at it objectively.

Like, if you're in the hospital, you get a patient, you look at them like a. Different framework than your mom or your dad. Exactly. Exactly. Yes. . So then I got into dealing with dementia and the changes in my mother made me change how I dealt with the issue of dementia. So I wasn't a therapist that would go to the hospital and see somebody that had cognitive issues and then go home and say bye bye. I'm going home. I'm going to do my shopping or whatever I'm doing. It was my mother and you don't go home and you don't say goodbye and it doesn't really leave you.

It's with you all the time. Yes. And it's, it's a whole different perspective having it be your patient as opposed to having it be your mom. So. 100%. I too, I will tell you, I did adult rehab. I loved adult rehab and then I went into long term care and also had a grandmother in her 90s who developed dementia.

And when you see it from a patient point of view versus a personal point of view, your whole attitude and approach changes. And now everybody's different when they have dementia, but I love that you actually focus on activities that shape your perspective for individuals with dementia.

Can you tell me why it's important to keep individuals with Alzheimer's engaged in activities? I am a very concrete thinker. So, but I'm arts and crafts and the issue with my mother. We had a caregiver living with her around the clock, when she started with her symptoms of dementia, she was inappropriate and how she made friends and she made friends to come visit her.

Through the yellow pages. And if they had an ad that had a cartoon and she thought they were interesting, she would call them up and it was lovely. And the people that she met were lovely, but I wasn't so pleased with it. And we ended up getting somebody to live with her because it doesn't end at five o'clock behavior changes at six o'clock with sundowning different things that you have to deal with.

And the other issue my mother got into was she called the police nonstop. I know those stories. I've got all the time. So she would call Judy, Judy, Judy, and then she called the police. You have to come help me. I'm being abused. So one time I was at my mother's house. And the caregiver was giving her a manicure, and I was meeting with my sister in the kitchen with the visiting nurse that we had, and the doorbell rings, and it was the police.

And they said, we hear that there's a, an issue of, of abuse in this house. And I said to the policeman, just, just arrest me. Just take me. Take me away. Get me out of here. It took a long time to realize that we should just unplug the phone in her bedroom. Yeah, so I didn't look at it that she was nonstop calling the police and I was running back and forth.

But so I ended up, we moved her closer to me so I didn't have to drive back and forth each time she did call the police. But we made the house, the unit that she moved into, we decorated with her furniture. She didn't know that she wasn't in her house anymore. That's beautiful. That's beautiful. So she was closer to me, the onsite was easier to be there and we didn't have the responsibility of taking care of the house anymore.

And I know not everybody can do something like that, but it, it worked out. Well, in our situation. Yes, and you can only talk about 1 situation because each person's situation is different. Absolutely. But the issue of her calling the police and the issue of her nonstop calling seems to be a phase that people that have dementia go through.

Absolutely. Absolutely. You're correct about that. And it didn't occur to me until I step back and look at it that. Oh, my God, just unplugged the phone. So we unplugged the phone. We could still contact the caregiver because she could get the phone in the kitchen or her own cell phone. And we told my mother that her phone was broken and that we were working with the phone company to get it fixed.

And that was the end of the issue., it was just removed as an issue. So it was like one thing off my plate. Yes. And then I wanted her busy, and it was fine when I did the activity with her. Well, it wasn't always that, which I'll give you an example in a minute, but I wanted to make sure that the caregiver knew what I would really, what Judy the OT would like my mother to be doing as an activity.

So one of the things that we were doing is we were playing dominoes at her dining room table, and her dining room table was glass. And here's where I was like a ditz, her table was glass and I would set up an activity on the table and I thought I was so brilliant and she would look at it and she would go, God, my shoes are gorgeous.

And I couldn't figure out what I was doing until I put a tablecloth on the table. So the issue of distractions with somebody that has dementia, depending on what you want to do, if you have an activity that you want to do, you have to remove distraction. And one of the distractions that we had was that she was looking through the glass table instead of looking at the activity on top of the glass table.

You know, that's why your knowledge and experience is so important because even a health care professional such as yourself who knows how to approach things when it comes to your family, you will much and I'm guilty of this as well. So, so Judy, how can caregivers select the right activities for their loved one?

It doesn't really matter what you do as long as you do something because your loved one loves you, even though they don't know who you are, possibly, and what they want to do is please you. And what they want is to spend time with you. So, once you get out of your head that you have to do something outrageously wonderful and just realize that you're being there is wonderful.

 I'm going to talk from two sides of my head. The issue is the therapist is that you want to be where the person can see you. You want to be where the person can hear you. You want as few distractions as possible. You want to turn off the radio. You want to turn off the television.

If they're looking out the window, you can close the shades. You want to have a controlled area that's quiet. And as distraction free as you possibly can do it. I also recommend family caregivers, or the caregivers in the home, turn down the volume on the phone, their cell phones and stuff, because that's always a big distraction as well.

And that's really important. That's a great one. Before our speaking this morning, I, I removed all the phones from the area, turned off my cell phone and turned off the ringer in my head for my hearing aid, so it's not going to ring in my head. There you go. There you go. But the other issue to get in with, with whoever you're working with, be it a client or your parent or your father or your brother or your child or whomever you're working with is you want to make sure that they can see you.

And so, that's some people might've had a stroke and they can't see the one side. People have hearing aid hearing loss and don't have hearing aids. Yes. So you have to have your voice specific. And some people can't see far across the table question. It may be too far for them to focus and you need to sit to 1 side of them.

Yeah. So that's getting into your positioning in relation to the person that you're working with. I also want to recommend I'm sorry, I don't mean to interrupt, but I also want to recommend when they get to a point like this, where you're right easily distracted. They also may not understand what you're saying and giving directions and all and they can't understand or. They focus on your body language, they focus on your anxiety, your stress. So you have to also be a person who takes lots of deep breaths when you're focusing on doing an activity, breathe and smile, even though you don't feel like it, because they're going to pick up on your feelings and your Energy and that makes for a better experience as well.

Absolutely. Absolutely. So, one of the thing as far as setting, I haven't even gotten to an activity, but setting up for an activity is how they're sitting in the chair that they're sitting in. And this is the therapist to me. Do their feet reach the floor? Can they see over the table? And as I get older and I'm getting shorter and the table's getting higher, I feel like the chair has to be a little bit higher.

So how is their sitting balance? Are they falling to the side? Did you put them in a chair with or without arms? Are they still in their wheelchair? It can the wheelchair go up to the table, or can you remove the side arms from the wheelchair so that they can get closer to the table to do what it is that you want.

So, in addition to positioning somebody and putting the brakes on the wheelchair. So they're not rolling back in the middle of something that you're doing. You want to make sure that they can hear you. That they can see you, that their feet reach the floor, that they're not at risk of falling out of the chair that they're in, and that you can engage them in the activity that they want.

It's not something that they hate doing. And then you're ready to begin. So that's all the way to start. That's all to start. Now what if you're at, you have a family member who how do you get them to sit? Sometimes there are just people that just want to walk. And And, and you have to keep them busy.

How do you suggest, do you have any suggestions to draw them into an activity? You mean the caregiver versus the patient? Oh yeah, to draw the patient, yes, the patient with Alzheimer's into an activity when they're just walking around and, you know, just looking at the world. I would do a walking activity.

Okay, great. Instead of doing a sitting act. And so the same thing goes if they're with a walker, if they're just ambling on their own, and that would get into fall prevention. But that's a whole other topic. If they're walking, I would walk into the closet. And I would say it's chilly today. Let's see if we can figure out where your sweaters are and pick one sweater, which sweater would you like?

So it'd be directed towards something or it could be. Here's laundry. Let's stand up. Can you help me fold this sheet? That's a big 1. I know with. Little old ladies. I laugh because I'll give them a dust rag or give them socks to fold or, or a towels to fold. They're so happy doing that. I had one, one sweet little old lady, God bless her.

She was a southern, southern lady and she just loved to clean and everybody thought it was so abusive, but she was happy. She was happy just dusting everything in the house. You know, she, I didn't care if she took all day long and she did 1000 times as long as the activity kept her moving and having activity and action, you know, doing something what she feels is productive and meaningful in her life.

That was important to me. Right, so it's not your focus of, oh, you want to sit down and do X, you have to look at what your client or your loved one is interested in doing. And if they like dusting, that's it. Yeah. I love a Swiffer duster. I know. They're like super. I used to do something with some stroke patients when I was trying to get them to have increased arm motion.

And I would put shaving cream on a mirror up high and ask them to get the shaving cream off the mirror. Oh, wow. So they had to, they stood in front of the mirror and they had to literally reach up high. Oh, that's a hint to get their arm up to clean it. My mother and I did something it was sitting and she, she had no physical limitations, none, but cognitively she knew who I was and her attention span was usually good for maybe 5 to 10 seconds.

And so an activity was really important to get her to focus in on something. She was a contract bridge player. This was like a woman that was like, it was very difficult to see. Yeah, we did the hokey pokey. I got CDs from the library and they had books on tape and things from the Association for the Blind that you could order.

You could rent a CD player, or they had it for free rental of George Burns and Gracie Allen. Oh, my Lord. Yes. And Lawrence Welk. Yes, Lawrence Welk. And singing. So we would sing and we would, she would listen to old comedy sketches and she knew the people and it was, that was a good one. But dancing, oh, we had a good time dancing.

We did the box step. We did the hokey pokey. We walked around the apartment and we named pieces of furniture. And. I mean, that's an activity. It doesn't have to be. We're going to sit down and draw X, Y, Z today. That's not important. We made window box with plastic flowers. Oh, so. We got flowers from the store from Michael's or Joanne's or whoever you have near you.

And we set up window boxes that didn't have to be watered and didn't have to be pruned, but the flowers were big enough so that she could see them without any issue. For men that use tools and stuff, I know this, some people are insulted when they think of this, but it really works. The children's plastic tool belts and the hammers, and the plastic hammers, and the big nails and stuff are really a good activity for men that want to just be do what they're used to do, make things, and even if it's just they're hitting on that same wooden peg a million times a day, it makes them happy.

It keeps them busy, and they think they're being productive, and that's the, the important thing. The other thing that's good for men, too, is there's a, they, they sell them, but you could make them on your own with heavy cord that you get from a Home Depot, tie knots, and to have them undo the knots. Oh, wow.

Knots, knots are really good. So that's something it's two handed activity can be done sitting or standing. It's purposeful because you have this problem. Can you help me out? And if it's big enough, it's tactile so that you're feeling the cord to actually work 2 hands to get the not out. That's that's not a bad 1.

We had 1 thing with men where the man was really a baseball lover and. He liked to go to professional baseball games, but it wasn't realistic anymore. And what we did is had him go to the town's Little League games. Oh, wonderful. So we took a chair, we took water, we made sure he went to the bathroom ahead of time.

He had a jacket, and we sat as long as he could watching the baseball game. You know, the future for our seniors is going to be virtual reality where they can actually sit and watch a baseball game. With their glasses on not partake or anything, or maybe move to catch a ball or something. But I have a very, a good friend of mine who is really involved in VR and they're doing it to approach seniors because we have so many of them right now and we don't have enough people to provide care for our seniors. Things that they can do where they can just sit and the experience comes to them.

And I think that's going to be incredibly awesome. There's some there's a program called the live inside. I don't know if you're familiar with it. It's based out in New York. Yeah, it's a really good 1 with music and headphones and listening to music. I have a hard time personally. I don't like things on my head.

Yeah, so I get I don't like the feeling of being closed in like that. So it., you have to know your, clients. Exactly. Exactly. I, I and I also wanted to mention while we're talking here, there comes a time when and, and everybody's different, but the patient with dementia may not, again, I say they may not understand, but their reasoner is broken.

They, they don't know how to make choices. So you, and you can overwhelm them very easily. So, You know, you only want to give one or two choices, not say, hey, do you want to do this, this, or this today? Because that's just too much. Like when you were bringing them into the closet to decide what to wear, it would want this one or this one.

You know, you've got to limit your options and choices because they can't. They don't have the connections anymore in their brain to make a decision like that and people need to understand that. So, because I just was on a group with a bunch of dementia caregivers, and they didn't know these things.

And I thought, oh, you know, we, as health care professionals are trying our best to get the. Education out there on on the different types of ways to approach or talk to a person with dementia. And yes, they're all different. But you know, we have to be aware that, you know, and if they argue with you, just step away, take a break because, like I said, their reasoner.

Their ability to reason is broken, and there is no there's no way for them to rationalize anything. It's just emotions. And that's why, again, I remind the caregivers, because you get tired, you're stressed and overwhelmed, that they pick up on your personality, your stress level, and and your facial expressions.

If they don't, even if they don't understand what you're saying, the tone is so important and it can make your day so much better if you're just a little positive and, kind and you know, I know there's times when you just wanna scream. Will you make up your mind or, you know, especially like when you're trying to bathe or, or do something you know, it's very frustrating and you have to, one of the things I, I encourage my, my caregivers.

Is to tell them, hey, you know you have to change your perspective. You change your perspective, you change your world, and it makes it easier for you. So, because we have to comply to their world, and that's hard for many caregivers. It's overwhelming for many caregivers, because if they're full time caregiver, if they're in a facility, and they've got 12 or 14 patients that they're responsible for to have them bathed and dress before breakfast, they're ready to shoot themselves the, the biggest thing that you can do is if you're working with somebody and they have family members is asked the family member to help you and give them a specific task and a specific time limited time to come help you. So, if you wanted. Make a meal for somebody you can invite the son for breakfast or breakfast is kind of early, but I would invite the son for brunch or lunch and say, would you please bring a dessert with you?

And then you can work with their mom to make the menu to go to the market. Or to look through the newspaper to find the items that you're looking for and circle them and then get the items that you need. And make a lunch for your loved one. So you've got a whole week's activity planned just on asking the son to bring a dessert for you.

Now, I'm going to approach that the home care point of view when you're still at home with your family member. I lived with a lady with macular degeneration, whose husband had developed dementia and she loved to cook and bake and she would put all the ingredients out measured. And she would have him help her every day.

They would bake cookies, they would bake cakes muffins. But she, they, he would help stir, he helped put stuff in. She gave him one to one directions because he became unable to do anything but smile or look at you. So yes, I think, and, Many people, many family caregivers think, Oh, I can't do that. You know, I, I can't cook.

Well, you know what, if they're still at a situation where they can follow directions, you may have to take extra time. And again, that means patients, but you can put all the ingredients out one on one at a time and have them all ready. And then help them and it makes it such a positive experience all the way around.

I know at Christmas time, I had a couple of clients that had the grandmother with dementia come to the house. she was at the house and the grandkids and her and the daughter baked cookies. And then when it got too much where grandma was like, it was too noisy, the kids and stuff are getting so excited.

They had to remove mom to a quieter room in the house, but she had that experience. And I think that's really important. I think that couple sounded like they really loved each other. That's beautiful. I will tell you they really did it. It touches my heart when I see people like this. Yeah. Judy before we started, you and I talked about fall prevention and mobility and I think that's such a big.

Important subject. So I don't want to miss talking about that today. So I'd like to know how does regular engaging in regular activities help reduce fall risk for individuals with dementia. Okay. Let's see, a lot of issues of falling has to do with vision and balance. So in activity, if I go back to the hokey pokey where you're standing on one foot and shaking it around and holding on to the table, maybe to keep your balance while you're shaking one foot, just routine exercise increases your balance, increasing your balance improves your fall, your propensity, is that the word, to fall.

So there's a lot of issues for falls and there's a lot of issues just physically to concern yourself with with falls, primarily that your shoes fit properly and you don't have to have, you don't have to have dementia to to realize that your foot size has shrunken and that your shoes have gotten old and stretched and the treads might be worn out and you might need new shoes.

That tie on that fits your feet to prevent you slopping around while you're walking. You could have rugs in your house that need to be removed so that you're not tripping over a rug. If it's in front of your sink, if it's loose by your shower by your toilet, the side of your bed, you need to remove throw rugs because if somebody doesn't see them, it's easy to fall.

Yes. And this is just for all of us. The other issue is medically. So I'm going to talk about your feet and move kind of through your body. If you have edema in your legs, your feet might be swollen. You may not be able to put your shoes on properly. You may be having the back of your shoes that you're stepping so that your heels suppress the back of your shoes down.

You might have socks that are too tight that they're constricting blood flow. And you'll know, because you'll see. Dense around your legs from the socks, and that's easily fixed. Take a scissor and cut the edge so that the elastic is not putting pressure on your leg. If you have diabetic neuropathy, and you don't feel your feet, you may fall.

You may have from that poor circulation, you could have blisters or something on your feet that are protecting how your feet are touching the floor. I mean, this is just your feet. So moving up if you have hearing loss. And you don't have hearing aids, it can throw off your balance. If your eyeglasses are 60 years old, and you need to see an eye doctor, your depth perception, your visual acuity, everything, you could have macular degeneration, you could have double vision, you could have the wrong prescription, you could have somebody else's glasses that you picked up and put on.

Vision can affect your falling. So, we talked hearing, vision, circulation. A demon, your legs, the way that shoes feel the other thing that gets me and it's kind of new with the I'm going to whisper it. So mine doesn't pick up a L E X, a or yes. Okay. The problem is, is that they don't necessarily know where the sound is coming from.

And you may think it's the best thing in the world, but to somebody that grew up a hundred or 80 years ago, it's not something that they're familiar with. And it's disturbing to hear a voice coming from they're not sure where and they may turn and be startled and fall really good. Really? Really? Good idea.

I never thought about Alexa causing a problem, but yes, i, I believe, you know, I was sitting in a friend's house the other day and it's telling the person who owns it, Sue, take the trash out. I'm like, she's not here. I mean, I knew what it was, but, you know, I can see where somebody from with dementia can misconstrue that and become frightened or especially if they're prone to paranoia.

Yeah, that's a big thing with some, some with dementia, you know, they're paranoid. All right, who's talking, you know, and then they start off on their, their rants of, you know, space aliens and whatever. But yes, it's very real. It is very real. I had sent you a thing an article that I had written on a posting on LinkedIn and.

It kind of was the issue of the A. L. E. X. A. Watch. Okay. Oh, yes. I'm glad we're talking about this. Yes. And the issue was that my friend had on such a watch and he was dependent on this watch. And when he tripped, the watch didn't activate because he did what was called a soft fall and he got his hand out enough to stop him.

But he, in fact, did fall. And when he fell, he hit his head and his phone moved. The watch didn't Activate, but the phone for some reason, I want to say it, but dialed it, but I don't know how it happened, but it called a relative in another state, and it showed a picture of him lying, bleeding on the driveway.

My Lord, and the relative that received the call recognized the cousin on the ground and called 911 in a different state. He was in New York. And they called the paramedics in California, and they sent the California medics to where the phone was. I don't know how it worked. Yeah, but it works, but it wasn't from where they thought it was going to work.

Yes. So I have another story similar to that that I think people need to be aware of the caregivers. I have a friend who's a, was a long distance caregiver her mom's in Asheville, North Carolina, and we're here in Myrtle Beach. And they're, they're technologically knowledgeable, I guess.

And they got Alexa all over the house. For her so that if she fell, she just had to say, you know, call 911. They did not do their research and she laid on the floor for like, 8 or 10 hours because she kept trying to get. Alexa to call 911 and this really upsets me and it needs to be addressed, but the it's I think it's through Google or one of those programs.

They do not have a direct law, unless you pay to be connected to the EMS service on it for a monthly fee. They will not connect you to emergency services with and I was looking at some of the fees and I was shocked some as much as 50 a month. And I find that really offensive because we're we have more seniors than youth in this world right now.

We have no one to take care of our seniors and the fact that these multi billion dollar companies can't provide a simple service for free for our, struggling seniors on, on Medicaid and Medicare, Medicaid or whatever it's just sad. And she lay there,, she could have died. And she didn't, but she had sores because, she literally could not move all eight hours.

A whole half of her body became, became pressure sores and a lot of skin sloughed off and stuff, but, you know, you think you have things in place. Caregivers think, you know, we're, we're good. And you have to take another step back and say, I didn't do enough research. I have, like, three thoughts on it.

The first is that, from what I understand here, if you only have a cell phone, they need to have cell phone triangulation to know where you are. If you need to call 911, you should call from a landline. Yes. Most people now don't have landlines, correct? They have cell phones, correct. So that's one thing. The, you can contact your local police department and tell them that you have a senior living alone at X and could they please do a check for you periodically?

I have two personal stories regarding. Lifeline life alert, whatever shoes. One is my mother in law who had macular degeneration and whose body was failing from major osteoporosis. She had one of the necklaces that you wear. Yes, that's had that, and she couldn't stand wearing it when she went to bed, she took it off and she went to go to the bathroom in the middle of the night and she fell in the bathroom and her lifeline was next to her bed and she couldn't get back to the bed to do it.

So if you have one, wear it. Yes. The other thing is my mother, who could have used it at once and not once she got further compromised from the illness, didn't like it because it wasn't pretty. So I said to her. Why don't we cover it with rhinestones? Oh, you're so smart. And she said, I'm not wearing that.

It shows that I can't remember something. So she had a different reaction to it all the time. If I had made it into a pin and decorated it and pinned it onto her, maybe that would have worked. Yes. But it, didn't work for her. The best laid plans, you know? Oh, hey, Judy, I have seniors that don't wear their hearing aids after they've paid five, six, 7, 000 for them because it makes them look old.

I had an uncle who, my dad's twin, was, was 92 and he decided he was going to go to the local senior center, says, For socialization after his wife died and says, I'm not going there because they're all old people and then I have, I have many clients say, I am not walking with that Walker because it makes me look old.

We have people I live in an over 55 community now, and there are some fantastic walkers and canes that people have. Has a leopard print cane. I love it. One woman has all covered designs and sparkles on her cane. It's a man. It's dressed up to look like it's a formal. It's a black and white, and he put a bow tie on it have all different kinds of.

Great, great stuff. And people, if they're going to be obstreperous, and they are going to fight you, you're going to lose. I have two things that make me crazy. One is tennis balls on walkers, which I hate. And the other thing is slings that don't fit properly, but I'm going to address the tennis balls with walkers.

Oh, I like to hear your story on this. Tennis balls with walkers were developed for children, in a group school where they all move their chairs at the same time and they put them on the chair so that the chairs wouldn't make noises. Children in the classroom since made their way to walkers. What happens with the tennis ball on the walkers?

This is one of my bugaboos is that if they use them outside, it wears off and it gets down to metal. Exactly. So it's metal on the ground and it scrapes up your floors. It ruins your floors and the tennis ball picks up all kinds of debris and trash and brings it into your house. I hate tennis balls on walkers.

That's my bias. There is a thing called a Walker glide. There's they come as they look like little skis. Yes. I'm very familiar with them. Yeah. And they come in different widths. So they fit the different tube width of the Walker. It either fits in or fits over to stay properly. If you just measure the width of the tube.

There's also like a plastic thing that. Sits into it, and it just makes the Walker slide. It doesn't cause you to fall. It's just an ease in it. And the friction I'll go back 1 more time to the tennis ball. The friction increases the degree of resistance to walking easily with the Walker so that if you're pushing with the Walker, and you have the resistance of the tennis ball, somebody who's got a Weakness in their arms have to push it harder.

It's tiring to use a Walker that has 10. I hate 10 as well. Some workers. So that's my thought. So, my, I have a friend, who has cancer and has been through all kinds of chemo, and she's weak, and she's using a walker, and she had tennis balls on it. And I said to her, I really suggest the walker glides, and she says, well, I don't know how I measure.

I said, so have your daughter give me a call. The daughter sent me, my mother is not going to get anything other than the tennis balls because it's going to make her fall. And I said, no problem. So when it comes to something that you feel passionate about and the person or their family doesn't want it, let it go.

You know what that I have to tell you I, I have many, and that is I think one of the most frustrating parts of, of being a professional and having the experience that we do Judy, because people can be so close minded about things and they don't understand. You know, they should have said, well, why, you know, why suggest this?

What makes a difference? But they initially, immediately shut it down. And this would be my family. Oh, well, you, you thought of it, so it can't be right. Right. You're going to forget you, honey. You don't know what you mean. Yeah. I'm the know it all big sister. So, you know, I don't know anything. And it's really sad because we have so much knowledge and we have It's a great experience.

And it always suggesting is well, give it a try. But I love the slides. I love I worked with many people that have had the slides and you're right. The tennis balls are not just ugly, but they do wear down and then they do scrape floors and that becomes a problem. Whereas the slide they just kind of glide along and it makes sense.

It makes sense. So, but I wasn't going to be able to change her daughter and I wasn't looking for a fight in her family. And it's like, you have to pick your babbles and yes, it's that's it. You just pick your battles. I tell my family caregivers decisions based on emotions. Are poor decisions. You need to take a step back, take a deep breath and look at things from a logical point of view and any because they're tired.

They're overwhelmed. They're afraid. There are so many things going on in their lives. They don't know how to do anything but be emotional. And bad choices and decisions are made because they just poo pooed any kind of logical approach to anything. So,, I just want to say as far as my thinking goes, when you're working with somebody that has dementia or some other disability, then you are the responsible person.

The issue of medical safety comes first. Yes, and that somebody needs a physical checklist of what to look for and the first place is to go to the doctor and to get a physical. The person needs a physical and then if you want anybody to intercede on your behalf, or you have a question, send a link to the doctor and ask for support to help you and follow up.

Yes, make sure that you write down all your questions before you go to the doctor. I suggest bringing a tape recorder or your cell phone and taping the visit with the doctor because you're going to take them and another family member is going to say, well, what did the doctor say? I don't believe you.

You can play back the conversation and. Once you've gotten the medical issues, so let's say your, your shoes don't fit because you've got edema in your feet. That's a medical issue. You want to take care of the medical issues and activity is kind of it's it's there and it's important medically is more important.

I agree. So one of the everything you recommend that I have a how to become a patient care advocate course and manual that I did for family caregivers. And I recommend all those things, you know, be pre preparing for a visit, sit down and decide what questions you need to do. In fact, I even have a med sheet for each visit so that you can sit down and prepare and write your questions down and have a summary of what went on at the visit.

But I do, strongly recommend every caregiver take and record., I want people that are seniors that are patients that we all have those family members that are very secretive and they're not going to share that information, but you can get them to record, record the conversation so that you know what's going on.

It makes all the difference in the world. Yes, the other thing, and I guess it kind of sums up my thinking, is to use your cell phone to take pictures of all the forms that the person has. So you have their power of attorney, you have their financial power of attorney, you have allergies, you have their medical diagnosis, you have all the contact numbers, all the medications and all the quantities of what you're taking and how much and how often in your phone.

So, I have, just personally, I have in my phone under the contacts, I have my name and under my name, I have all my medications and everything for me. Yes. And I have my husband's name and all the medications for him. Likewise, he has mine in his phone. So we had one time where we had to go to the hospital and they said, well, what medications are you taking?

And you can't think clearly about what you've got, but you have it all on your phone. So, take the time to do that. I'm I actually we're launching a product in the next few weeks called my vital vault and one of the pieces of my vital vault is it's getting your paperwork in order for everything.

But 1 of the pieces I'm doing is creating a digital and a physical crisis packet and in that crisis packet,, you would keep your medical history, your your POA, your. Information if you are going to donate your body to science, I know that sounds crazy, or your body donation or, you know, organ, organ donation.

Have all those things in one spot. With all the lists of all your medications,, your history, and your. All those types of things in place, even the list of the contacts and specialists that you have so that in a case of an emergency, you just run out the door, you grab your crisis packet and go.

But I also trying to have it so that it's in a digital form. So you can just say, here's the information and the facilities can look at it because I think that's important. The, what we had done for back in New Jersey is in the senior building, we put stickers on the door to all their units saying information can be found in the tube in your refrigerator, the vial of life, the vial of life, but the vial of life was kept in people's refrigerator and yes, exactly.

We put a sticker on their front door that said vial of life to be found in the refrigerator. Well, we're doing something like that where we're going to have a QR code. It's going to be my vital alert and it'll be a, take a picture of it, you know, with the QR code and it, all that information will pop up to them because you also need to have, if you're a DNR, you want that paper, but you also need a most or a post a physician ordered licensing treatment script, things that you need.

It's, they're easily accessible and And one more thing, I always tell family members have HIPAA forms ready. Don't date them, but get them from the doctor's office or the hospitals you may be going for. Have your family member fill them out and have them ready. They're signed and everything, but with a date so that The information if you don't have a power of attorney in place at that time, that you can they can release the information without having to go jumping.

Yeah. Yeah. So, well, Judy, I just, I'm so excited. I know you have a book. I do. And I'd like you to tell us a little bit about your book before we end so I'm excited with this because I looked at it and I, I think you have such valuable important information. It's a must read for everybody with anybody with dementia.

I'm going to take you home with me. The name of the book is called activities to do with your parent who has Alzheimer's dementia. I wrote it because I needed to because my mother had Alzheimer's dementia and. I found that I wanted the caregiver to know what I wanted them to do, and I wanted to find out if they did an activity, and if it didn't work, why not?

So, it is a book with suggested activities. Following each activity is a page that offers an assessment form so that you can say whether you did it after breakfast, it didn't work, after lunch, it worked. So, it would go into the setup, the time, the place, what you used to set it up. And it was something that would be passed between caregivers.

So if you had a caregiver that went off at 5 o'clock and you had another caregiver that came on, they just wanted to get out of there. They didn't want to stay and go over the activity. And when the agency sends somebody in to discuss it, they weren't discussing activity. They were discussing medical.

Yes, yes, yes. This is a means of. Transfer of information between caregivers and family members, so that they know what works and what doesn't. It also has a checklist of home safety ideas of caregiver burnout prevention ideas of how to set up an activity needed. It's just. I think it's really good. And I'm biased and it's, it's been well received.

And I think at the time that I wrote it, which was when my mother was, was really in her 90s already. Nothing existed, and I'm still not sure that anything exists now on the market that shows an activity and why it works and how to assess it. I think I'm pretty familiar with a lot of the books out there, and I think you're absolutely correct.

Yeah, yeah. So. That's the book and it's available on Amazon. We'll have a link on the site to it. Thank you. And it's also available on Barnes and Noble online. I don't believe it's in there. I will. I will have my team look it up and put it on there, too, if they want to. Thank you. It's in Noble. It's I like it.

As a daughter, I liked it. As a caregiver, I think it's necessary. As a therapist, I had. I think it's, beneficial. Pretty much. It met my need. Usually somebody that's done something like this has had a personal connection to it. They feel they have to do some. This was my response to dealing with my mother's dementia diagnosis.

And it's a blessing and your mom should be very proud of you. And I'm sure she. I know you're very busy and I really feel blessed to have had this conversation and to share your information with my listeners out there and to my family caregivers. Remember, you are the most important part of the caregiving equation.

Without you, it all falls apart. So please, practice self care every day. Learn to be gentle with yourself because you are worth it.