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The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease, Other Dementias, and Memory Loss in Later Life

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease, Other Dementias, and Memory Loss in Later Life - Nancy L. Mace, Peter V. Rabins I had read through this book last year, but didn't make notes on it then. I think the whole book could be a note. . .The mgt of wandering. "If you are considering a day care center, we urge you to do so early in the illness. Day care center and nursing homes have found that people adjust best when (1) they do not stay long the first few visits, (2)the caregiver stays with them the first few times, and (3) someone from the program visits them at home before the transition. Leaving a confused person alone to adjust and asking the family not to visit at first may add to the person's panic.When a person with dementia finds himself in a new place, he may feel that he is lost, that you cannot find him, or that he is not supposed to be where he is. Reassure the disoriented person often about where he is and why he is there. "You have come to live with me, Father. Here is your room with your things in it," or "You are at the day care center. You will go home at 3:00."When we give this advice, families sometimes tell us, "It doesn't work!" It doesn't work in the sense that the person may continue to insist that he doesn't live there and keep trying to wander away. This is because he is memory-impaired and does not remember what you told him. He needs to be gently and frequently reassured about his whereabouts. It takes time and patience to get him to accept the move and gradually come to fee secure. He also needs this frequent reassurance that you know where he is. A gentle reassurance and your understanding of his confusion help reduce his fear and the number of catastrophic reactions he has. Our experience with people who are hospitalized for dementia is that frequent gentle reassurance about where they are sometimes helps them become more comfortable (and easier to manage). However, this may take several weeks. Because changes may make the person's behavior or wandering worse, it is important to consider changes carefully. You may decided that a vacation or an extended visit is not worth upsetting the confused person. p.125If you think the person is wandering because he is restless, try giving him some active tasks like dusting or stacking books. p. 127Sleep disturbances and night wandering. "If the person is napping during the day, he will be less tired at night. Try to keep him occupied, active and awake in the daytime. If he is taking medication to control his behavioral symptoms, these may be making him drowsy in the daytime. Discuss with the doctor the possibility of giving him most of the medication in the evening instead of spreading doses throughout the day. This may provide the behavior control without making the person sleepy during the day. If he must sleep during the day, try to get some rest yourself at the same time. Often people with dementia are not very active and don't get much exercise. It may be helpful to plan a regular activity program -- a long walk for example -- in the late afternoon. This may make the person tired enough to sleep better at night. Some families find that taking the person outside in the fresh air and sunlight, especially in the morning, helps. A car ride makes some people sleepy. Day care centers are one of the best ways to keep a person active during the day." p.130-131