Interspersed chapters of "profiles" of families' stories with Alzheimer's between the usual caregiver/ science backgrounds. Some of the background material is recycled from other sources such as the 36-hour day. So there isn't necessarily "new" material here if you have read a lot of books on Alzheimer's. But I did find the family profiles moving and did pick up various bits from the other chapters too. Activities for early/midstage: out to lunch and a music appreciation class every Tuesday. Regular visits to the local food bank where they assembled food boxes for the homeless. A singing group at the community center. "You cannot care for a person with Alzheimer's disease by yourself. This bears repeating: You cannot care for a person with Alzheimer's by yourself. You need help -- and lots of it." p. 104 Managing behavior problems: The 6 R's (from the 36 hour day): - restrict (coax, persuade, insist)Restriction often works, but it may make some people more agitated.- reassess. Irrational outbursts may be signaling a real complaint. - reconsider. - rechannel. - reassure. - reviewKnob covers for doorknobs to prevent opening doors that should not be opened. Obsessive behavior / repetitive actions."The deteriorating brain sometimes "gets stuck," and the result is obsessive or repetitive actions. If the action is not hazardous, there's nothing wrong with letting it continue for as long as you can stand it. When you must intervene, a "stop" command may work, but it might not. Many caregivers find that gentle touch is a better way to go -- leading the person by the arm away from the activity while pointing out something distracting: "Thank you for folding the napkins. Now let's walk the dog." p.250Phone issues. "To deal with phone issues, consider turning off all ringers and letting a phone machine answer your calls. That way you get accurate messages and can return calls when you're able. You might consider carrying a cell phone and asking people to call you at that number." p.254Evaluating a residential care facility- Is it conveniently located?- Is it licensed and accredited?- Forget the lobby decor.- Use your nose. How does the staff deal with incontinence?- Check the menu.- Check the bathrooms. Are they clean? equipped with grab bars and other aids?- What portion of residents have Alzheimer's?- How do staff members deal with your loved one's specific problems? Talk with some of the nurses and ask how they deal with specific problems.- Note the resident-to-staff ration. - Pay attention to how staff interact with residents.- Do staff members have questions about your loved one?- Pay attention to how staff interact with each other. Happy staff are a good sign of a well-run facility.- Who develops the care plan? Federal law requires that residential care facilities have individual care plans for each resident. Can you participate? As the disease progresses, how will the care plan change?- Look for a mental health professional.- Observe the activities. - Look at the hallways. The shorter the better.- Look at the room doors. Look for individualized doors with distinctive colors and personal touches.- Is there a secure wandering area?- Look for community involvement. Clergy, students, outside volunteers? Some variety keeps patients interested and helps prevent behavior problems.- Ask about visiting policies.- Ask how staff handle behavior problems. - Ask about medical and dental care.- Ask about medical emergencies. Is there a physician on call? Which hospitals does the facility use?- Ask about end-of-life decisions. (Do they respect DNH, DNR, etc?)- Ask about smoke detectors, fire alarms, and the evacuation plan.- Ask about disaster planning (if a tornado, flood, etc. strikes).- Get fee information in writing. What is included? What is extra? Under what circumstances might fees increase? How far in advance would you be notified? How does the facility work with Medicare, Medicaid, long-term-care insurers?- Review the contract with a lawyer. You need an advocate for you and your loved one.- Keep asking questions. Even after your loved one has moved in, continue to be observant and raise any issues that come up with you. -- Befriend the staff. They deserve your respect and support. If you help and praise them, they are more likely to take more personal interest in your loved one. p.264-266Moving the person in. Make sure you have the legal authority to move the person. Laws differ from state to state, but all states allow legal guardians of demented individuals to place them in residential care. You may need to consult an attorney. p.268Intensive communication programs"The breakfast club". Name each food, talk about your experiences with the item. Name, discuss, reflect. Discuss the food, how it was prepared, any thoughts triggered. Clear the table and introduce a topic of conversation (chosen in advance) that elicited both short- and long-term memories from the participants. Over 12 weeks, the participants became more communicative with improved language skill. More sociable, more interested and involved in the club. p.161-162Gingko balboa.Exercise, massage. Music therapy. Pet therapy. Aromatherapy. Classical music suggestions. Bach: Air for g-string. Jesu, joy of man's desiring.Beethoven: Pastoral (symphony no.6), Moonlight sonata, PathetiqueBrahms: LullabyChopin: Nocturne in GDebussy: Clair de LuneHandel: Water musicLiszt: LiebestraumeMozart: "Laude Dominum" from the VespersPachelbel: Canon in DSaint-Saens: The Swan from Carnival of the AnimalsSchubert: Ave MariaVivaldi: The four seasons. Soundtracks: Born free, Chariots of fire, The sound of music.Willie Nelson: Stardust, Sweet memories.