It's summertime, and the livin' is…well, never quite easy, like the song says, if you're the caregiver to someone with Alzheimer's. When temperatures rise – my town's forecast today is for the mid-90s – so do seasonal concerns.
Are these on your radar?
Summer Alzheimer's Worry #1: Body odor.
Unpleasant to think about…but even more so to notice. People with Alzheimer's not only neglect self care but if aggressive, they can resist the efforts of others to help them stay clean. If bathing has become an issue, hot weather tends to make it all the more contentious.
Solutions: When someone you're caring for fails the sniff test, above all resist making it a huge battle. Better to back off (and endure) a day or two, and then come at it again. For better cooperation, try suggesting sponge baths as a way to cool down (rather than as a necessity to keeping clean). A complete bath is recommended at least once a week; if it's become a real problem, you could hire an experienced home health aide to supervise it under "doctor's orders" – clean skin doesn't just smell better; it's important for health reasons.
(And while someone handles bathing, be sure to seize the opportunity to whisk the worn-for-four-days clothes into the laundry and replace with fresh ones.)
Summer Alzheimer's Worry #2: Dehydration.
The problem: People with dementia can simply forget to drink. Or they may be unable to recognize or communicate thirst. Some people with certain health conditions or a dread of incontinence conditioned themselves years ago not to drink very much lest they need to "go," exacerbating the problem. Hot weather makes people sweat more and further ups the dehydration risk.
Solutions: Don't just hand a tall cool lemonade or glass of water to the person. It's apt to be forgotten. Sit down and talk, gently encouraging sips every so often. Have a glass yourself; seeing you drink may encourage the person to parrot you. Serve water with meals as well as snacks of juicy fruits (orange slices and grapefruit are good).
Be mindful of the weather when you go out; older people tend to be more vulnerable to heat. Give Mom or Dad a nice hat to wear. Don't let them sit in the car while you run errands (not a great idea for someone with dementia anyway, even if the person isn't prone to wandering, you never know when it might start).
Summer Alzheimer's Worry #3: Late Sundown Syndrome.
The problem: For some dementia sufferers, sundown syndrome (a period of agitation in the evening) can ease up in summer because there's a shorter period of darkness before bedtime. For others, however, the long summer evenings mean more activity and more opportunity to become overtired before bed –- which is one of the potential triggers for this pattern of behavior.
Solutions: Try to stick to the regular year-round schedule for bedtime. But do let a daytime napper rest; don't disturb him or her. Also take advantage of the long daylight hours to encourage the person to get a little exercise (being mindful of the heat). In general, slow the pace on hot days. In the evening, keep the house cool with an air-conditioner, and dark (drawn shades made with black-out linings, if necessary).
Summer Alzheimer's Worry #4: One more person to keep an eye on around pools.
The problem: Wandering. Impaired judgment. The same basic "attractive nuisance" lure that draws toddlers to water. My Dad, for example, can't bear to see leaves floating on the surface of the in-ground pool. Never mind that he's 87 and in somewhat fragile condition. He likes to slip out of the house to grab a pole to rake the leaves away.
Solutions: In addition to basic ways to handle someone who wanders, practice what one caregiver I know does: If you can’t beat 'em, join 'em. If you can't, say, drain a pool because kids use it, let go of household duties in summer and hang outside with everyone. Get in the water with the elder if you can. It may relax you both and will certainly tire the older person, making later wandering less likely.
Summer Alzheimer's Worry #5: Vacation? What vacation?
The problem: The world goes on holiday but you find it hard to be footloose when you're tethered to someone's 24/7 needs.
Solutions: Ask someone to stay in your home, whether a family member or paid caregiver. This provides continuity for the person with dementia while giving you a complete change of scenery. You might have to be forward-to-the-point-of-feeling-rude about asking, but do. Call in your chits; somebody must owe you. Stay more than a night or two to really recharge. You might feel guilty--for a little while. But you need this.
People with dementia often welcome new things to do and fresh people to see, too; don't underestimate this. Encourage day visitors. Maybe a relative can host the person for a few days (which can be confusing and worsen symptoms, but you won't know until you try it). Don't have family? Some people report that a silver lining of Alzheimer's support groups is meeting others in the same straits; you may be able to do a co-op-type trade-off so that you each can get away.
Anything else get you hot and bothered in the summer?