Category: #parkinsonsdisease

How to decrease wandering and aggressive behaviors

Our bodies are made to move. When we sit for long periods our body hurts. Our joints and bones hurt. We simply do not feel good. Now, imagine that you have a disorder or chronic health condition that makes movement more difficult or you can’t remember to exercise. Your body still needs movement to relieve pain and relieve excess energy.

September 28, 2022

Move more, hurt less. Move more, rest better. Movement and exercise for the care receiver will make the care giver’s life easier.

Is your loved one restless? Do they wander? Are they withdrawn? Hurting? Regular exercise and movement will help decrease these issues. Do something every day. We often think about things to keep the mind busy, but we sometimes forget about the body. It takes both to make an impact on their well-being.

Those dealing with Parkinson’s disease know that movement and breathing exercises help them to maintain strength and independence longer. They seem to be more open to exercise classes and doing workouts at home. Why? Probably, because they have all of their mental faculties, it is their body that is failing them and they want to be as independent as possible.

Those dealing with a dementia, such as Alzheimer’s disease, are experiencing brain failure. They become less and less aware of what their body needs. They forget that their body needs movement and exercise. Over time, they lose the ability to reason through the many steps it takes to exercise. These folks need reminders and workout buddies to help them achieve their goals. Many times, they can mimic what they see.

What they can do safely is of great importance. As with any exercise routine, a physician needs to be consulted. Maybe, a visit to physical therapy and/or occupational therapy is a good idea. PT’s and OT’s can help with an exercise program that can be done at home. Any exercise needs to be done appropriately. Form matters. Consistency matters. Never giving up matters.

Rock steady boxing has great results for folks that are dealing with Parkinson’s. Deep breathing exercises and vocal exercises are important too. Walking is good for everyone. Being outside is good for everyone. Playing in the dirt (aka, gardening) is good for almost everyone.  So, what, if you have to modify things? Being adaptable is a plus.  

Walking, weightlifting and dancing are great exercises for folks that are dealing with any type of dementia. The body needs to work in order to get tired. If we don’t get tired, we get restless. We can’t sleep and we get a little testy. Now, imagine that your brain is failing and you can’t reason out these things. You only know how you feel at this moment in time. You have to get your “willies” out somehow. You wander, you follow people around, and you ask the same question over and over.

Don’t forget about brain use activities. They are important too. Coloring, making something, building something, and doing a puzzle are all important, too.

I know that some of you are thinking, “I just want to get X, Y, and Z done.” Let your loved one help, give them a job. Be fully present and engaged with them. It won’t take any more time and it may even take less time because you won’t have all of the interruptions.

People before things.

Help your loved one to take care of their exercise needs. Develop your routine and stick to it. Put yourself in “time-out,” when needed. Think outside of the box. Who can exercise with them for about 30 minutes every day? Total visit time would probably be 1 & ½ to 2 hours. I bet you can find other family members or friends that can do that visit.  You have to tell folks what you need help with.

Those that have requested to stay at home (age in place), for as long as it is safe for all…will need to be fit, and have some strength and endurance. When they become “dead weight,” or can no longer toilet themselves, they will have to begin the transition to assisted living and nursing homes. It is possible to keep them at home with 24/7 in-home care.

Strength and balance exercises are very important.

The health benefits of exercise include:

  • Improved mood
  • Better sleep
  • Reduced likelihood of constipation
  • Reduced wandering
  • Reduced aggressive behavior
  • Reduced risk of falls
  • Increased maintenance of motor skills
  • Improving heart health
  • Improved strength
  • Improved balance

You may start with 5 minutes a day and increase a minute or two every week.

Dancing counts. Playing golf counts. Running errands counts. Riding bicycles counts. Walking on a treadmill counts. Yoga or Tai chi counts. Vacuuming and folding laundry counts.

For the mind:

  • Do a puzzle
  • Play a board game (Connect Four, Chutes & Ladders, Checkers)
  • Read a book aloud to them
  • Play a card game
  • Reminisce (ask them about childhood, hobbies, work life)

Pat

Are you engaged with your loved one or are you just doing chores?

Think about it. Are you really having a conversation or are you just placating them so that you can get crap done? As the care giver or care partner are you even aware that your care receiver has needs that you can easily meet while you are handling tasks? I get it. A lot of us are task-oriented and do not want to be bothered with other things while we are doing our tasks. That would be great if our care receiver was not a human being. Take the time to talk with them.

September 14, 2022

Most of the tasks you will be doing, will not take a lot of brain power or concentration. Some tasks will, and you will need quiet time to concentrate, but not a lot of them. It does not take brain power or concentration to do laundry, wash dishes(place in or take out of dishwasher), cook something, sweep or mop, etc. You can be engaging your care receiver by talking, telling stories, or singing together. Paying bills, comparing EOB’s with medical bills and figuring things out, will take concentration and brain power. You do need quiet time for those types of things. To get that quiet time, engage your loved one before you get started. Take 10-15 minutes to be fully present with them.

Remember, they can sense your attitude and feelings towards them even if they have any type of dementia. If they have a physical disability or injury, and they need a little help, they still like to be engaged in conversation or stay up-to-date with what is going on with you, the community, and the world.

We talk a lot about dementia patients, but let’s focus on care receivers that have a physical disability, such as stroke survivors.

They need help and encouragement.

  • Encourage them to do the exercises they have been given by their physical or occupational therapists. You have to rewire the brain and movement is key.
  • Allow them to do what they can do, even if they struggle. Unless they ask for your help, let them keep working on it. Be helpful, but not overbearing.
  • You may have access to a social worker or counselor, and use them for help and resources. An occupational therapist can help with identifying home modifications that would help.
  • New stroke side effects may arise after going home. Be alert and contact their doctor.
  • Understand that sometimes, the stroke survivor may have a little setback, before they move forward again.
  • Always push past the plateau. There may be a time (3-6 months after a stroke) that “getting better” seems to level off. It may seem that way, but the brain is still healing and working. Keep on, keeping on. Changing exercises or rehab strategies may help, too.
  • There may be emotional changes after a stroke. There may also be outbursts of laughing or crying due to pseudobulbar affect.
  • Report falls to doctor
  • Don’t give up, keep striving for the best. (Independence depends on this.)

As a care giver, learn as much as you can about your care receiver’s stroke. What areas of the brain were affected? What do those areas control? What to expect physically, emotionally and mentally.

Some of the symptoms that a stroke survivor may experience:

  • Loss of control of movement &/or feeling in some parts of the body (This usually occurs on the side of the body opposite from the side of the brain affected.)
  • Changes in muscle tone on the affected side of the body
  • Involuntary muscle contractions
  • Difficulty sitting, standing or walking
  • Reduced ability to balance
  • Problems with speaking and/or understanding speech
  • Confusion and/or poor memory
  • Decreased control over bladder, bowel or both
  • Difficulty swallowing
  • Reduced control over emotions

The following is from Johns Hopkins Medicine

What are the effects of stroke?

The effects of stroke vary from person to person based on the type, severity, location, and number of strokes. The brain is very complex. Each area of the brain is responsible for a specific function or ability. When an area of the brain is damaged from a stroke, the loss of normal function of part of the body may occur. This may result in a disability.

The brain is divided into 3 main areas:

  • Cerebrum (right and left sides or hemispheres)
  • Cerebellum (top and front of the brain)
  • Brainstem (base of the brain)

Depending on which of these regions of the brain the stroke occurs, the effects may be very different.

What effects can be seen with a stroke in the cerebrum?

The cerebrum is the part of the brain that occupies the top and front portions of the skull. It controls movement and sensation, speech, thinking, reasoning, memory, vision, and emotions. The cerebrum is divided into the right and left sides, or hemispheres.

Depending on the area and side of the cerebrum affected by the stroke, any, or all, of these functions may be impaired:

  • Movement and sensation
  • Speech and language
  • Eating and swallowing
  • Vision
  • Cognitive (thinking, reasoning, judgment, and memory) ability
  • Perception and orientation to surroundings
  • Self-care ability
  • Bowel and bladder control
  • Emotional control
  • Sexual ability

In addition to these general effects, some specific impairments may occur when a particular area of the cerebrum is damaged.

suffered a life-threatening stroke that left half her face paralyzed, a devastating loss for a talented

Effects of a right hemisphere stroke in the cerebrum

The effects of a right hemisphere stroke may include:

  • Left-sided weakness or paralysis and sensory impairment
  • Denial of paralysis or impairment and reduced insight into the problems created by the stroke (this is called “left neglect”)
  • Visual problems, including an inability to see the left visual field of each eye
  • Spatial problems with depth perception or directions, such as up or down and front or back
  • Inability to localize or recognize body parts
  • Inability to understand maps and find objects, such as clothing or toiletry items
  • Memory problems
  • Behavioral changes, such as lack of concern about situations, impulsivity, inappropriateness, and depression

Effects of a left hemisphere stroke in the cerebrum

The effects of a left hemisphere stroke may include:

  • Right-sided weakness or paralysis and sensory impairment
  • Problems with speech and understanding language (aphasia)
  • Visual problems, including the inability to see the right visual field of each eye
  • Impaired ability to do math or to organize, reason, and analyze items
  • Behavioral changes, such as depression, cautiousness, and hesitancy
  • Impaired ability to read, write, and learn new information
  • Memory problems

What effects can be seen with a stroke in the cerebellum?

The cerebellum is located beneath and behind the cerebrum towards the back of the skull. It receives sensory information from the body through the spinal cord. It helps coordinate muscle action and control, fine movement, coordination, and balance.

Although strokes are less common in the cerebellum area, the effects can be severe. Four common effects of strokes in the cerebellum include:

  • Inability to walk and problems with coordination and balance (ataxia)
  • Dizziness
  • Headache
  • Nausea and vomiting

What effects can be seen with a stroke in the brainstem?

The brainstem is located at the base of the brain right above the spinal cord. Many of the body’s vital “life-support” functions such as heartbeat, blood pressure, and breathing are controlled by the brainstem. It also helps control the main nerves involved with eye movement, hearing, speech, chewing, and swallowing. Some common effects of a stroke in the brainstem include problems with:

  • Breathing and heart functions
  • Body temperature control
  • Balance and coordination
  • Weakness or paralysis
  • Chewing, swallowing and speaking
  • Vision
  • Coma

Unfortunately, death is possible with brainstem strokes.

Over time, it may be harder for the stroke survivor to stay motivated during recovery. The two main contributors to this are apathy and depression. Apathy is a loss of motivation, concern, interest, and emotional response after a stroke. Feeling sad after a major life event that turns your world upside down is normal, depression seems to affect 30-50 percent of stroke survivors. Signs of depression include feelings of hopelessness and sadness that do not go away.

Help stroke survivors to stay motivated.

Set relevant and achievable goals

Address the emotional challenges and get help with medications and talk therapy

Help the stroke survivor understand about their stroke, the changes, the rehab, the plateau, etc.

Have a consistent routine, do it no matter how you feel about it

Find what motivates them

When motivation fails, discipline takes over – just do it

Pat