How to work with your siblings to care for your aging parents

It’s hard to watch your parents decline in health. Sometimes, it can be hard to cope with their health changes as well as manage the differing views and abilities of your siblings at the same time.

AGE of Central Texas is offering a free workshop, “Partnering with Your Siblings to Better Care for Your Parents,” on Saturday. Psychologist David Zuniga, who has focused on end-of-life care, caregiving and was at one time a Zen Buddhist chaplain working in hospitals, will speak.

David Zuniga is a licensed psychologist and a previous faculty member at the Integrative Medicine Department at The University of Texas MD Anderson Cancer Center.

Working as a family on care for Mom and Dad has become more complicated as people are living longer and there are more options for care and treatment, Zuniga says. Plus, families are spread out geographically and adult children are working longer hours. Then add the financial stresses of falling behind economically or not having the same level of access to health care.

It can become very stressful when Mom or Dad needs more assistance.

The family dynamics that existed when you children were growing up might not have changed and sometimes even step-siblings can complicate it.

“All siblings, all families, from the time you are born, there is a natural inherent tension and competition,” Zuniga says. “That’s part of the human condition.”

As kids, siblings bicker over toys, he says. As adults, the stakes are bigger and they bicker over type of care and who gets to make the decisions. Often, siblings fall into their natural roles. One might be more likely to handle the finances, another might be more apt to do the physical work of caregiving.

“Our brain becomes conditioned to have the same thoughts over and over again,” Zuniga says. “‘My brother gets all the credit.’ ‘My brother is lazy.’ Automatic thoughts and judgments may impact behavior. You may not even realize it.”

Parents don’t help with this, either. Sometimes they automatically label their kids and continue to label their kids as “the independent one,” “the helpless one,” “the smart one.”

David Zuniga will be talking about working with your siblings on Feb. 10 in Lakeway.

Those labels, those identities get carried over even when it’s the children who need to parent the parent.

Try getting on top of some of those beliefs as soon as you find yourself thinking them. “When you don’t talk about things, they fester and grow,” Zuniga says. That’s why open communication between siblings is important. “Family meetings are life-saving,” he says.

If it’s possible, have parents before they can no longer express their wishes, make their health care decisions known. The American Bar Association has a free health care decision making toolkit available. We’ve also written about Austinite Debbie Pearson’s “Age Your Way” and “Blueprint to Age Your Way” that lets you share your wishes and likes and dislikes with your family.

Parents should have medical power of attorneys set up, as well as advance directives for medical care, and a financial power of attorney.

When parents make their own decision, it takes some of the stress and conflict out of it. “It’s not that you’re making the decision, it’s that you’re honoring your parents’ wishes,” he says.

Sometimes, when there is conflict, it’s good to bring in a mediator. “It often takes courage to ask for help,” Zuniga says. “We all need help.”

If you are in the position of having to make the decisions, make sure the other siblings are well-informed of what is happening and why. In families where there are multiple siblings, sometimes one group of siblings gets pitted against another sibling or another group of siblings. Sometimes there are siblings that get left out of the process as well.

That’s where creating an open channel of dialogue can be helpful, whether by email chain or conference call.

Sometimes, though, siblings can become too enmeshed in the care. They need a break. That’s where the siblings who aren’t the primary caregivers can offer help. They can help do research into treatments or care; or give their sibling a vacation from caregiving.

Often, when Zuniga talks to families who are dealing with their parent’s care, they will tell him: “Don’t talk to me about self-care. … I don’t have time for self-care.”

Self-care, though is important. “Do it for your loved one,” he says. “Stress is real. It can actually impair your neurological function. You won’t be able to care for the person you love as much.”

Zuniga recommends meditation or contemplative prayer, even if you just do it 30 seconds in the morning.

What happens when siblings are all aligned, but it’s the parents who aren’t in agreement over their care? “Your parents are going to want their autonomy and their freedom,” Zuniga says. “Their freedom might be the single most important thing to them.”

For you, it’s about their safety. Are they leaving the stove on? Are they falling a lot or leaving doors unlocked? If they are unsafe and you can document it, you can get adult protective services involved, but it’s much easier to come from a place of love and work your way toward a different care or living scenario with their buy-in.

You can start by talking to them about what their goals are. Is it to stay in their home no matter what? Is it about quality of life or quantity of life?

Families are not all about sibling rivalry and tension, though. “Family has a unique role that one one else has,” he says. “They can be there for each other in a way that no psychologist or psychiatrist can.”

If siblings are talking to one another, there can be great strength, laughter and joy during these years, Zuniga says.

Partnering with Your Siblings to Better Care for Your Parents

When: 10 a.m. to noon Feb. 10

Where: Keller Williams Lake Travis Market Center, 1921 Lohmans Crossing Road, Suite 100, Lakeway

Cost: Free, but register at ageofcentraltx.org

Recommended reading

“How We Die: Reflections on Life’s Final Chapter,” Sherwin B. Nuland ($17, First Vintage Books)

“Being Mortal: Medicine and What Matters in the End,” Atul Gawande ($26, Henry Holt and Co.)

“On Our Way: The Final Passage through Life and Death,” by Robert Kastenbaum ($36.95, California University Press)

“Staring at the Sun: Overcoming the Terror of Death,” by Irvin D. Yalom ($17.95, Jossey-Boss)

“When Breath Becomes Air,” by Paul Kalanithi ($25, Random House)

Recommended websites

ageofcentraltx.org

drdavidzuniga.com

For advance directives planning

American Bar Association, americanbar.org, search under Tool Kit for Health Care Planning

Texas Health And Human Services, hhs.texas.gov/laws-regulations/forms/advance-directives

For coping with illness

Society for Health Psychology, www.apa.org/about/division/div38.aspx

Would you pay extra for a stamp to benefit Alzheimer’s disease research?

The U.S. Postal Service has released a new stamp, which will benefit Alzheimer’s disease research. You’ll pay 60 cents for the first-class stamp, a 11-cent increase from the typical first-class stamp rates. Funds raised will go to the National Institutes of Health to distribute them.

“The Postal Service is proud to issue this stamp today to help raise public awareness of Alzheimer’s,” said Postmaster General Megan J. Brennan in a press release. “Proceeds from its sale will help support urgently needed medical research into this incredibly debilitating disease.”

The stamp is an update of the 2008 Alzheimer’s Awareness stamp.

This is the first stamp to raise funds for a cause. Last year, the Postal Service got approval to create the Semipostal Stamp Program. The next stamp will support post-traumatic stress disorder causes and be released in 2019. The Postal Service intends to release a total of five stamps before 2023.

Would you pay extra for a stamp that supports a cause?

RELATED: How close are we to a cure or better treatment for Alzheimer’s?

RELATED: Dell Medical School, Seton receive research grant to study Alzheimer’s

RELATED: Austinite’s Gathering inspires network of Alzheimer’s respites

 

 

 

 

Why haven’t we found the cure, better treatment for Alzheimer’s?

This week a report from 2015 that stated these statistics: 

“Between 1998 and 2014, there were 123 unsuccessful attempts to develop drugs to treat Alzheimer’s – or as some call them “failures.” In that time frame, four new medicines were approved to treat the symptoms of Alzheimer’s disease; for every research project that succeeded, about 30 failed to yield a new medicine.”

The group representing drug companies updated that report, with a report on Thursday that said that there are 87 potential treatments in clinical trials.

Connie Andrews and Corrina Barrick dance together during The Gathering, an Alzheimer’s respite at Westlake Hills Presbyterian Church.
Shelby Tauber / AMERICAN-STATESMAN 2015

Will any of them be successful? Why has it been so difficult to make headway into this disease.

We asked Dr. David Paydarfar, neurology chair at Dell Medical School, who is the lead investigator of a study on Alzheimer’s disease that is looking at people before they are diagnosed. 

He has two theories:

  1. We need to be intervening much sooner, way before anyone is diagnosed, to stop the disease from progressing.
  2. There actually might not be one Alzheimer’s. There might be different kinds and the drug treatments that work for one might not work for all. The drugs we’ve been testing might actually have been effective but only for a subset of the disease.
Dr. David Paydarfar is the chair of neurology at Dell Medical School at UT Austin.

Paydarfar says we need to get a better sense of what causes Alzheimer’s. He likens it to decades before when researchers thought that smoking was causing ulcers when actually it was bacteria.

“Research might be barking up the wrong tree,” he says. “Is there something that we’re missing?”

We also might be developing treatments that are one size fits all when really we need many different treatments for many different kinds of dementia.

Years ago, anyone with dementia was given an Alzheimer’s designation and then researchers started figuring out that in one kind of dementia that is now called vascular dementia people were actually having damage from a series of ministrokes. It wasn’t what we thought of as Alzheimer’s at all.

To make more breakthroughs in treatment of Alzheimer’s or what we’ve been calling Alzheimer’s, Paydarfar is looking at better predicting with certainty down to the exact person who will get the disease. He and other researchers are trying to find biomarkers. Knowing with certainty that a person is going to get Alzheimer’s will help scientists develop treatments that are preventative rather than restorative.

He’s also looking at improved imagery of the brain that will allow us to better track the progression of the disease as well as to better track the progress of treatments.

He also wonders if the disease is not a reaction by the body’s immune system to an infection or inflammation. He points to people with vascular dementia who experience a worsening of symptoms every time they have a minor infection.

While there’s nothing coming down the pipe from drug developers that has gotten beyond stage two or stage three in trials, he remains an optimist. In his career as a neurologist, he has seen remarkable strides made in the treatment of multiple sclerosis and in the treatment of strokes.

“I came into neurology at a time when there were very few treatments for any neurological diseases,” he says. He remembers hospitals with entire wards of people with MS. Now they are getting treatment at home.

And in strokes, “prevention and treatment when it’s happening has just been breathtaking.”

He hopes for a substantial breakthrough in the next five years. “I’ve seen it happen twice now,” he says. “With the right investment, leadership and talent, I feel very optimistic.”

Walk to End Alzheimer’s

8 a.m. Sunday

Travis County Expo Center, 7311 Decker Lane

Register at act.alz.org

Why is access to diapers so important? Austin Diaper Bank reminds us

We’ve written a lot about the Austin Diaper Bank in the last month. When Hurricane Harvey hit, you rushed to do something, and one thing that Austin and folks from around the country did was donate diapers. Austin Diaper Bank has now sent more than 780,000 diapers for babies and adults to Hurricane Harvey-affected areas.

Criss Cole Rehabilitation Center volunteer, Melinda Cook packs stacks of diapers for distribution in 2016 at the Austin Diaper Bank. Jessalyn Tamez / AUSTIN AMERICAN-STATESMAN

Why are diapers such a big deal? They are one of those things not covered by the Women, Infant and Children Program (WIC) or the Supplemental Nutrition Assistance Program (SNAP) or what we like colloquially refer to as food stamps. They also aren’t covered by benefits like Medicare or Medicaid (unless you are a child who has incontinence passed the age of which you should be potty trained).

So, if your family is living in poverty or you’re an older adult on a fixed income, you don’t get help with buying diapers without having a program like the Austin Diaper Bank. The bank collects diapers and delivers them to 40 different local nonprofit groups from Georgetown to San Marcos. Since it started in 2013, it has donated 750,000 diapers locally.

This week is Diaper Need Awareness Week and to call attention to the need out there, the Austin Diaper Bank is having an open house 4-7 p.m. Friday at its offices at 8711 Burnet Road, Suite B-34. www.austindiaperbank.org

“Diaper Need Awareness Week is a great time for the public to learn how the diapers distributed year-round by the Austin Diaper Bank make a difference for thousands of Central Texas families who struggle to afford diapers,” said Holly McDaniel, the bank’s new executive director, in a press release. “Diaper need impacts an estimated 12,000 babies and toddlers in Travis County alone, in addition to a growing number of adults.”

Without clean diapers, babies cannot attend childcare programs, which means that their caregivers cannot go to work. Adults and babies without clean diapers also are at risk for infections and disease.

Come to the bank Friday, drop off some diapers and learn more about the need.

 

Want to know more about the brain and Alzheimer’s? University of Texas offers new series

The University of Texas College of Natural Sciences has a new education series it’s calling “Brainstorms” all about the brain. The first one is Saturday, and it’s all about Alzheimer’s and other memory disorders.

“The Forgetting Brain” will feature Neuroscience Department Chair Michael Mauk talking about his own experience after his father was diagnosed with Alzheimer’s and how it affects families.

 

Phylis Sanchez and Connie Andrews do a workout routine during The Gathering, an Alzheimer’s respite at Westlake Hills Presbyterian Church in 2015. Shelby Tauber / AMERICAN-STATESMAN

He’ll also share recent research developments and how researchers are now thinking about memory that might change the way Alzheimer’s is treated in the future. In Austin, Dell Medical School at UT and Seton Healthcare Family are now doing research on Alzheimer’s disease through a state-funded grant from the Texas Council on Alzheimer’s Disease and Related Disorders to participate in the Texas Alzheimer’s Research and Care Consortium.

Mauk’s talk will be 3:30-5 p.m. Saturday in the Thompson Conference Center Auditorium, 2405 Robert Dedman Drive. (Find free parking in Lot 40.) You don’t have to RSVP to attend, but you can at http://txsci.net/utbrainstorms.

You also can sign up for future “Brainstorms” talks:

3:30 p.m. Oct. 14

6:30 p.m. Nov. 9

3:30 p.m. Jan. 27

6:30 p.m. Feb. 15

3:30 p.m. March 24

3:30 p.m. April 21

6:30 p.m. May 17

My year of transformation: How I lost 50 pounds and why I did it

Today marks the day one year ago when I finally had to realize that there were things that I could not fix, people I could not please, but I could work on my weight.

It’s been a rough five years in my family. Like many moms, I’m juggling parents who are aging and have had several rounds of hospitalizations and teenagers who are struggling and also have had to be hospitalized. Sometimes it’s just not fun in my house.

What I could do is put myself first, or at least not dead last. I chose to work on my weight first, because it was staring me in the face.

On May 3, 2016, I weighed what I weighed when I had walked into the hospital to deliver my children — who are now 13 and 16. The scary thing was I didn’t have a baby to deliver this time. Or a baby to nurse to get the weight off. I had to do it on my own.

Nicole Villalpando, late April 2016                   Nicole Villalpando, May 3, 2017, 50 pounds lighter

Yes, I was thinking of my family when I decided to make a big change. I wanted to be there for their graduations and weddings and their children, but really, I had to do it for me. I had to do it so that my blood pressure, which will always be above average (thanks genetics!) can be controlled with a low dose of medicine, not multiple pills. I had to do it so that I didn’t become diabetic like all the members of my father’s family before me. I had to do it so I had energy and wasn’t short of breath. I also had to do it so I could button my size 12 pants, which really should have been a size 14.

I chose Weight Watchers because I knew it had worked for me twice before. (We all get off the wagon sometimes; some of us spend a decade off that wagon). But more than what program I chose, it was about changing my mindset.

Working on my weight was “me” time, not children time, not spouse time, not work time, not multiple nonprofit organizations time. It was me focusing on me. It was focusing on food as fuel not as a way to try to magically fix all those awful feelings of failing as a mother, failing as a wife, failing as a co-worker, failing as volunteer.

It was owning my imperfections and working on one thing I could control and letting go of the things I couldn’t control.

I didn’t make a big announcement. I didn’t really even tell anyone unless they asked me when they started to see my face thin out. I just quietly worked on me.

By January 17, I hit my goal weight. I now wear a size 4 pants, which has never happened in my life. I have energy and have reduced my blood pressure medicine to 1/2 a pill a day. Even by my annual checkup in October, my blood panel was back to normal, especially for cholesterol.

I continue to go to Weight Watchers meetings because I know that’s what I need to make sure I continue to have a designated space and time to focus on me.

Losing the weight didn’t solve any problems at home, at work, at any of the organizations I volunteer with. I still have some days that are less than great food wise. I still have days when I can’t get the exercise in.

What losing the weight has done is help me evaluate my “have to” lists. I don’t have to be up until 2 a.m. working on a project I don’t want to do for an organization that isn’t making me feel good about myself. I don’t have to try to fix my children. I can give them the tools, give them guidance, but ultimately, they’re going to make the decision to help themselves or to not help themselves. My job is to support them, but also to let them fail.

I learned a lot by my “failure” to put myself first-ish and be healthy. I still don’t always choose me, but I don’t always choose only them.

So, as we approach Mother’s Day, put one thing on your ever-growing to-do list: Figure out how to put you closer to the top of that list. What’s one thing you can do for yourself today? It doesn’t have to be huge. It could just be a Netflix binge or a walk with the dog. it could even be five minutes of quiet in your locked bedroom at the end of the day. No kids or spouses allowed.

Do it for you because you’re important, too.

 

 

Why do moms need friends? Rachel Flake and her five friends taught us why

Barbara Lightsey, Beverly Locklin, Carol Kolsti, Rachel Flake, Martha Burns and Suellen Mills reunite at Brookdale Westlake Hills on July 31, 2015. The 6 women have been friends since 1966, and kept up with each other through raising children, working for nonprofits, being ministers, and helping each other through cancer and life’s difficulties. Rachel Flake died on Sunday.
Shelby Tauber / AMERICAN-STATESMAN

In July 2015, I got treated to lunch with the Steel Bluebonnets. This group of six friends had been friends for 50 years. Their friendships outlasted careers, some marriages and some of the gifts they made for each other.

On Sunday, one of their members, Rachel Flake, died from lung cancer, having never smoked a cigarette. ” It was a shock for the other five of us and we have dreaded the phone call that we received this morning from her daughter,” fellow Steel Bluebonnet Barbara Lightsey wrote in an email to me.

Flake was the one who originally contacted me to help me bring their story to the paper. She was very proud of their story, their long-lasting friendships. They shared pregnancies together, and children’s weddings. They celebrated birthdays with a limo that got lost along the way and at an undisclosed location that turned out to be Chuck-E-Cheese.

In fact, Lightest wrote that Flake shared the story in “every hospital room, the wall in a rehab center, and on the wall in her bedroom was taped the entire newspaper spread of your article.  She showed it to anyone who didn’t already know about us.  It gave her such pleasure.”

And it gave me such pleasure to be able to meet these ladies and honor their friendship.

Lightest wrote: “The Bluebonnets were able to get together with her two weeks ago.  She was so weak, but she smiled and knew it would be our last time altogether.”

Rachel credited the group for helping her through divorce and for keeping her going after she had back surgery in 1995 and was in a coma.

As she started to recover, all she wanted to do was go down to a beach house in Port Aransas. “After the surgery, this group took me down there and drove me in a car down to the beach,” Flake told me.

She also said of this group and their annual Christmas parties: “It’s all very exclusive.”

Here’s to Rachel Flake and her Steel Bluebonnets, for reminding younger moms the importance of having lifelong friends.

 

Facing a loved one with memory loss like David Cassidy? Check out these resources including Saturday workshop

Singer David Cassidy, best known for his role as Keith Partridge on "The Partridge Family," says he is struggling with memory loss.” Dan Steinberg/Associated Press 2009
Singer David Cassidy, best known for his role as Keith Partridge on “The Partridge Family,” says he is struggling with memory loss.” Dan Steinberg/Associated Press 2009

The news out this week that former teen idol David Cassidy has dementia hits close to home for many Baby Boomers.

We’ve written a lot about Alzheimer’s and dementia, and we share some of our best stories below.

This weekend Riverbend Church and Alzheimer’s Texas will present its annual  GPS  Roadmap for Family Caregivers workshop. You’ll learn how to talk to people with Alzheimer’s, what senior living options and home health and hospice options are available and what legal documents are necessary to have.

The event is free and breakfast and lunch is provided. It’s 8:30 a.m. to 2:30 p.m. Saturday at Riverbend Church. Register at txalz.org.

Debbie Pearson is the founder of Nurses Case Managment and has written the book "Age Your Way" and "The Blueprint to Age Your Way," which is meant to help you make medical decisions and end-of-life decisions before you need to make them.
Debbie Pearson is the founder of Nurses Case Managment and has written the book “Age Your Way” and “The Blueprint to Age Your Way,” which is meant to help you make medical decisions and end-of-life decisions before you need to make them.

Last September, we wrote about Austinite Debbie Pearson’s book “Age Your Way,” which talked about making your wishes known before you can no longer express what you want.

This month the companion workbook, “Blueprint to Age Your Way,” is out. It offers fillable forms that cover things like medications, personal wishes about medical care, favorite things, fears, concessions you agree to make when the time comes, service providers and business contacts, friends, financial accounts, real estate and business holdings, insurance, logins and passwords to accounts, funeral and burial wishes, obituary and more.

You can find it at Amazon.com for $39.95.

If you’re facing caring for a family member with Alzheimer’s or dementia, find these stories online:

Warning signs to look for and how to handle family gatherings

How to keep family members with Alzheimer’s active

How to prepare for a future with Alzheimer’s

How to parent your parent 

How to care for yourself when you are caring for a loved one with Alzheimer’s

And inside The Gathering Alzheimer’s Respite

Now you can go to the ob/gyn and get a facial, too

Imagine going to the gynecologist’s office and actually wanting to go there — and not because you can’t wait to talk about the baby you’re carrying. Now, imagine going there to get a facial.

Dr. Christopher Seeker of Austin Area OB-GYN & Fertility has opened Seeker Professional Aesthetics aka SPA inside his practice at 12200 Renfert Way, Suite 100 in the St. David’s Women’s Center.

Seeker says he’s been in practice for 30 years and has grown with his patients. They were in their teens and 20s when he was in his 20s and starting out as an obstetrician/gynecologist. They’ve had babies together and gone through surgeries together and aged together. Many of them were beginning to ask him what they could do about different areas of their bodies they didn’t like as they were aging or after having a baby.

Dr. Christopher Seeker of Austin Area OB-GYN & Fertility has opened SEEKER Professional Aesthetics inside his practice.
Dr. Christopher Seeker of Austin Area OB-GYN & Fertility has opened Seeker Professional Aesthetics inside his practice.

The SPA, he says, “is a natural extension with what we’ve done with these patients.”

Dr. Christopher Seeker and Casey Friesenhahn, his nurse practitioner, are the folks behind SPA.
Dr. Christopher Seeker and Casey Friesenhahn, his nurse practitioner, are the folks behind SPA.

“We’ve always tried to be cutting edge and strive to be a one-stop shop,” he says. Patients are used to going there for lab work, bone density scans, ultrasounds and mammograms. Now they can also get a beauty touch up.

When it comes to repairing the damage done by pregnancy, “technology has exploded in this area,” Seeker says. And it doesn’t have to be done by invasive surgery. He can use lasers to get rid of stretch marks or skin pigmentation problems, or even to repair gynecological damage done.

His office has had a carbon dioxide laser, the MonaLisa Touch, for about a year and has used it to restore vascularity, lubrication and support in the vaginal area as well as reduce urinary problems. It’s a five-minute procedure in the office verses doing a full surgery. Insurance will often cover it.

SculpSure uses a laser to melt fat cells.
SculpSure uses light to melt fat cells.

They also have the SculpSure technique, which uses a series of light packs each about the size of an iPhone that are strapped onto the area of fat you want to get rid of. The light burns through fat that the body then naturally eliminates about two to three weeks later. It also tightens the skin around where the packs were.

The SPA also offers many of the the other things you think of going to a spa for, like a facial, that insurance won’t cover. The SPA has a nurse practitioner and a facilist, who do most of the treatments, but Seeker does the procedures that use the carbon dioxide laser.

Even though there’s a lot the spa can do, Seeker is still making referrals to dermatologists and plastic surgeons. In fact, he says, he’s actually doing more of that as people do some cosmetic touch ups and then want to do more that the spa can’t do.

You don’t have to be a patient of the practice to go to the spa, and men can be served, too, but for the patients who are were already served by the practice, they “have some comfort in knowing who they are dealing with,” he says.

 

Know how to keep loved ones with Alzheimer’s active

We know that parents are often sandwiched and talking care of their parents as well as their children. From time to time, we write about the other side of parenting:

People have called Alzheimer’s disease and other forms of dementia “the long goodbye.” And it is tough slowly saying goodbye to your loved one every day, the loved one — the wife, the husband, the son, the daughter — who slowly stops recognizing you.

Nancy Turco has worked with Alzheimer's clients for 25 years.
Nancy Turco has worked with Alzheimer’s clients for 25 years.

Nancy Turco, executive director of the memory care center Arden Courts, has been working with people with dementia and Alzheimer’s for more than 25 years. She serves as a ambassador to the national Alzheimer’s Association, representing the Capital of Texas chapter.

She emphasizes the importance of keeping people with the disease active and engaged. She’ll talk about how to do that at an AGE (Austin Groups for the Elderly) of Central Texas workshop on Jan. 21.

It’s important for the activities to be about the process, not the end result. People with Alzheimer’s need ways to participate and be part of a community and not be judged in how they are doing. You don’t say, “Oh, no, you did that wrong” or “I got it” and push them aside if they haven’t folded the towels in the way you wanted them folded. You simply thank them and later fold the towels the way you wanted them folded when they aren’t watching.

What you’re trying to avoid is the depression that often comes in the early stages of Alzheimers when your loved one no longer feels useful anymore and knows what’s happening to them. “Everyone needs to feel needed,” Turco says.

At Arden Courts, Turco often gives the residents small jobs. Some even think that they work for her and have asked her about their paychecks. (The responses is always that she uses that new method of payment called direct deposit, and it’s been deposited in their accounts.) “We keep a sense of humor about it,” she says.

That might seem like a bunch of lies, but Turco calls them fiblets, and those fiblets are important to keep them active, not shame them and not have them worry.

Fiblets are part of the overall rule that you don’t argue with a person with Alzheimer’s. You always agree and you meet them where they are. That means that if a husband is looking everywhere for the wife that has been dead 10 years, you just say, “I haven’t seen her” or “Let’s go get a snack while you wait for her.”

“You have to live in the moment,” she says.

It’s really important not to give them truth that would be hurtful. One resident, who looked for her dead husband every morning, became difficult when she was in the hospital when someone at the hospital told her that her husband had been dead for years. It was like she was grieving him all over again.

Turco quotes Austin neurologist Dr. Ronald Devere, who often says: “Having dementia is like the first day of school every day.” You worry about what are you supposed to were, where are you going to have lunch, where are you supposed to be, what’s going to happen next.

Never use the words “do you remember?” or “remember?” because the answer is “no, I don’t” and they feel bad about that. Instead you reminisce and ask them to reminisce with you about an event that happened or things you used to do with them.

With any activity, give simple instructions. If you want to involve them in a decision, give them two or three choices that are all good choices. And if you have a preference, always give the choice you want last, because that’s the one they are most likely to remember.

Avoid doing things that could be upsetting to them such as listening to or watching the news. They might not remember what decade they are living in. Turco had one resident who watched a story about a fire in a subway station, and that resident immediately became upset because he thought his father, who worked for the subway when he was little, might be caught in the fire.

Here are some great activities that you can do with them:

  • Easy chores like folding the clothes and cutting coupons.
  • Puzzles, especially ones that don’t have a lot of pieces (but avoid having puzzles that look too babyish. These are adults.)
  • Cooking together (though you control the dangerous aspects).
  • Exercise like going for a supervised walk outside or doing chair exercises (Turco has created two DVDs of chair exercises set to older music).
  • Gardening.
  • Easy sports like indoor bowling.
  • Singing, dancing or listening to music, especially familiar music from their youth.
  • Reading to them.
  • Art.
  • Writing, even if it’s just signing their name.

Meaningful Activities for Persons with Dementia

10 a.m. Jan. 21

AGE, 3710 Cedar St.

Free

Register at 512-600-9275, or online at www.tinyurl.com/AgeJanuary2017

Learn more

Find more information and stories about caring for a loved one with Alzheimer’s disease or dementia on austin360.com, including:

The Gathering, Alzheimer’s respiteHow to Parent your Parent

How families can prepare for a future with Alzheimer’s

How to keep the harmony at a family gathering

A GPS for Parenting your Parents & Aging Family Members