Tips for Retaining Independence
As we have discussed many times, Alzheimer’s disease is a progressive disorder. Over time skills and abilities decline. What someone with Alzheimer’s can do one week is not necessarily what he or she can do the next week. So we all must acknowledge that a time will come when the patient with Alzheimer’s disease cannot live independently. What we as health care professionals and you as family and patient want to do is to delay the occurrence of this as long as possible.
We can include 3 general concepts in this regard. They can be summarized as follows; PLANNING, SELF-SUPPORT AIDS, EXTERNAL SUPPORT (but they are not mutually exclusive). Let’s discuss what is necessary for independence. What is it that you, the patient or potential patient, do on a day-to-day, week-to-week, month-to-month and year-to-year basis? Let’s review some of these by the stated categories:
Daily: dress, eat, take medications, do activities (hobbies, exercise, drive places, talk on the telephone [including saying “no” to solicitations]), maintain the safety of your living arrangement (doors and windows locked and shut when appropriate, and just as importantly, unlocked or open when necessary. People lock themselves out or can become ill from excess heat from not opening windows in warm weather)
Weekly: mow the lawn, shop for groceries, clean the place of living, socialize with friends, and go to church
Monthly: pay the bills, get prescriptions, go to the doctor,
Yearly: pay taxes, celebrate holidays
Unanticipated: medical emergencies, including falls. This is obviously a partial list and not everything here relates to everyone. However, each of these activities has its own underlying requirements of thinking, memory, arm and leg function, planning and decision making. Therefore, it is not possible to predict when a problem will occur or in what order the various disabilities may occur. Any or all can occur at any time during the course of the disease.
This is where planning comes in.
The time to anticipate the problems is before they occur. Therefore, planning may include arranging for meals, getting on a “no call list”, changing living arrangements, learning about alternative modes of transportation (rather than driving or public transportation), arranging for pill boxes to be used for medications and for someone to help supervise their use, arranging for cleaning and other household chores, making certain that socialization and brain stimulating activities continue, arranging for help with bills and taxes, having a Medic-Alert bracelet or some other type of direct ability to contact someone, (such as the alarm buttons that can be worn around the neck).
What are some self support aids? Notes....I was told when I was in Junior High School that, “The shortest pencil is longer than the longest memory.” I don’t know how well it applied to those of us studying grammar, but it sure does apply to me now and is invaluable for someone who is having progressive memory loss. Label draws to help you find things. Keep important numbers by the phone. Post reminders to lock doors, shut windows or take medications. Have step-by-step instructions on how to work appliances (such as the remote or the computer) and on how to complete routine tasks.
What is external support? People and organizations. For many patients the most important people are primarily family members. But, not everyone has family near by or family that can accomplish all the tasks necessary. Local organizations for the aged can be of assistance as can the Alzheimer's association.
Maintaining independence can be a team effort. Notes...by you, family or friends. Medication to help maintain memory...from the doctor. Meals on wheels...from a social service. Visits to maintain activity...from friends and family. Medication checks...from friends, family, pharmacy and doctor. Maintaining finances...from financial advisor and family (Make sure your will is finalized before severe impairment and save your family those long hours of argument over who will get Great Aunt Greta's china tea set. You know, the one with the roses on it and the cracked cups.)
The last comment is written in a humorous vein. Unfortunately, I have recently been involved in two disputes between children over a parent’s will. It is sad and is surely a situation that the parent would have hoped would not occur.
Therefore, plan, plan and plan some more. Arrange your support systems. Don’t leave things to chance, because if things go wrong, your independence may be one of the first things that you loose.