Co-Journaling and Communication

Reflecting on the positive things in life is such an important part of mental health. When caring for someone elderly, particularly someone with Alzheimer's disease, it can be very challenging to remember to take the time to focus on the positives. We suggest co-journaling to help you and your loved one think about and reflect on the things that are important or pleasing each day. Moreover, co-journaling can help you track and identify patterns in activities that are especially enjoyable to your loved one.

What is co-journaling?  It is the act of creating a shared journal with someone else. In this case, co-journaling is used to assist someone who is unable to create a journal on their own. In co-journaling, the caregiver or relative takes the lead by asking targeted questions and jotting down the responses along with his/her own thoughts and feelings from the day. Then, the caregiver fills out pages for the same or similar questions. The result of co-journaling is a side by side journal that helps reveal a rich and shared life. For families that live far apart, consider keeping a co-journal via phone over the year that can become a special Christmas or birthday gift for your loved one.

At Elderbridge Gifts, we carry journals that are designed to help with this task by identifying a set of simple questions caregivers or family members can ask and answer each day.

A note about co-journaling with Alzheimer's: In early stages of Alzheimer's or other forms of dementia, your loved one may enjoy journaling on their own, but as they progress to later stages, you or other caregivers can help to fill in the answers each day. You can also help them remember pleasant activities or experiences by reading from older journal entries.

Here are some of the daily questions from "Me: A Personal Journal"

• News and events with my family and friends:
• I am excited about:
• I am concerned about:
• Physically and mentally, I feel:
• People/Things that brightened my day:
• What I did to brighten someone else's day:
• Goals / ideas for a better tomorrow:

Here are some of the daily questions from "Daily Devotions: A Prayer Journal"

• Today I feel:
• Today I am grateful for:
• Inspirations, prayer, scriptures, quotes:
• I said a special prayer for:
• Prayers answered:
• Donations of the Heart (acts of kindness, caring, sharing, and forgiveness)
• What I would like to see happen tomorrow:

We hope that co-journaling enriches the time you spend talking with your loved ones.

Its Fall: Bring on the Birds!

When Mom was in the moderately severe stage of Alzheimer’s disease and could no longer walk, she loved to sit in front of the backyard window and watch the birds. Seeing a bright red cardinal delighted her. She’d point to the birds and say “Oh Look!” all morning. Even though she didn’t have the language to tell us what she was seeing, it was clear that she was pleased and engaged. To make sure that we had a steady supply of birds each day, Dad and I hung a feeder not far from the window. My dad, who served as her fulltime caregiver, took care of filling the feeder and sweeping the shells off the patio. All that my mom needed to do was watch and enjoy the show.

My dad found bird watching as absorbing as my mom, but for a different reason. He’s very “scientific” so he liked learning about the various species that dropped by their yard throughout the year. He bought a bird guide and a small notebook to log what he’d seen. Watching the birds feed became a comfortable shared activity each day, and one that brought both of them pleasure. He’d tell my mom about the birds as he identified them, and she’d point out the ones she liked or thought were pretty. Later when we’d call or visit, we’d hear about the amazing show in the backyard. Dad taught my kids to identify quite a variety of birds – something they’ve retained into their teenage years and adulthood (amazing, since they remember so little I’ve told them).

Fall is a great time for bird watching and bird feeding. Birds are on the move, so species you might not ordinarily see may drop by for a visit. As the weather turns cold and food sources disappear, back yard feeders offer birds a lifeline.

For great tips on bird-watching and back yard feeders, see Project Feeder Watch at the Cornell Lab of Ornithology. If you are a bird enthusiast, you can turn your backyard bird-watching into a scientific endeavor to provide data to scholars who study birds and their migration patterns. The project focuses on tracking birds during the winter months.

At Elderbridge Gifts, we offer a line of bird-watching products designed for all ages and all stages of aging. We carry Parasol bird feeders, exclusively, because of their beauty and quality. We also carry bird watching books and bird watching journals. We also carry the Identiflyer electronic bird song identifier to help people learn the source of the birdsongs that they hear in the yard or beyond.

If your loved one lives in a nursing home, check with staff to see if they will allow a feeder to be hung outside the window. Many facilities are agreeable to this, and it brings great pleasure to those who spend most of their life indoors.

Here are some additional resources on birds
Audubon Society’s “Bird Feeding Basics”
The Cornell Lab of Ornithology “All About Birds”

Calming Agitation without Medicine: Music and Hand Massage

There are two things you should know about me. First, I’m an academic. Second, my mother had Alzheimer’s. I’ll get to how these are related in a moment.

As my mother’s disease progressed, she often felt anxious or agitated, especially in situations that were unfamiliar or over-stimulating, such as rooms with a great deal of noise or activity. As evening approached, she frequently exhibited signs of “sundowning,” negative behavior or agitation that increased as sunset approached. We knew medication was an option, but we sought alternatives first. Mom was already taking a slew of pills everyday so we wanted to consider other alternatives before adding yet another medicine to her regime.

Here is where the academic part comes into play. When I seek answers, I typically turn to academic and/or clinical research. I like the scientific approach to determining the effectiveness of various treatments, and I particularly like controlled experiments. Fortunately, there is quite a cottage industry of scholars and clinicians studying how to reduce agitation in dementia patients, so the literature offers some helpful suggestions.

Today’s blog focuses on one of those studies “Calming Music and Hand Massage with Agitated Elderly” by Ruth Remington published in Nursing Research (2002) 51(5):317-323. The gist of the study is this: Remington ran an experiment to test whether hand massage, calming music, or both, influenced agitated behavior among nursing home residents with dementia (mostly moderate to severe dementia). The 68 subjects in the study were divided into four groups, one that received 10 minutes of calming music, one that received 10 minutes of hand massage, one that received 10 minutes of both hand massage and calming musing, and one that received neither hand massage nor calming music. She then assessed the effects of the four different “treatments” on the level of agitation in the patient.

Interestingly, the music selected for the calming music treatment was a “New Age arrangement Pachelbel’s Canon in D” one of my favorite pieces of music. Calming music is defined as one that has a slow tempo, non-vocal, repetitive musical themes, and soft dynamics (Remington 2002: 320). The hand massage treatment consisted of “slow strokes, even rhythm and light pressure to the back of the hand, palm and fingers,” applied for 5 minutes to each hand (Remington 2002: 320). The group assigned to receive calming music and hand massage received both simultaneously during a 10 minute period. The results of the study show that both music and hand massage significantly reduced verbal and non-verbal agitated behavior, but not physically aggressive behavior. However, the combined administration of music and a hand massage was no more effective than administering either one alone. For both hand massage and calming music, the reduction in agitation persisted for at least an hour after the treatment (the last time point assessed). The bottom line? The evidence from this study suggests that hand massage and calming music might help address issues of sundowning among Alzheimer’s patients.

My father didn’t need an academic study to tell him this. He knew that massage worked great for my mother! He would offer not only hand massages, but also foot massages. You could see her relax in just a few minutes. We kept a bottle of lotion nearby to combine hand or foot massages because her skin was often chapped and dry from the soaps used at the nursing home. We suspect that the scent of the lotion we used was calming as well. At least, the scent was calming to us!

For Elderbridge Gifts, we selected a number of lotions that we think work great for soothing hand and foot massages. The scent of lavender is well known for its calming properties so we offer Camille Beckman’s English Lavendar line. We love the scent of the Tuscan Honey line for its rich, slightly spicy, slightly sweet fragrance. For those who might be sensitive to smells or perfumes, we offer Camille Beckman’s Unscented Vitamin E line. All of these lotions are easily absorbed without leaving a greasy feel.

Here are some additional resources that address agitation and sundowning among Alzheimer’s patients.

Edyth Ann Knox. “Tips on Sundowning in Alzheimer’s Patients” ElderCare Online

Alzheimer’s Association “Sleeplessness and Sundowning”

Alzheimer’s Association “Agitation”

Introductions

We want to begin by telling you that we own an internet store that sells gifts designed for the elderly, particularly those with cognitive limitations such as Alzheimer’s or other forms of dementia. The motivation behind opening Elderbridge Gifts (www.elderbridgegifts.com) was simple. We are part of the sandwich generation – those who have children and aging parents – and realized that the challenge we face in finding gifts for our elderly relatives is not unique. Many of our friends face similar dilemmas. What do you get the parent who has a lifetime of stuff stacked in closets? How do you address the changing needs and interests of those you love as they age? What do you buy someone who is in a nursing home? What brings pleasure to someone who has limited mobility or cognitive function? How do you remind a parent who is far away that you are thinking of them?

Elderbridge Gifts was our way of trying to answer these questions, not only for ourselves, but for others. This blog is also part of that mission. Yes, we sell things. And, frankly, we hope you will buy things from our store – we’ve tried to select products that respond to specific needs of those with elderly relatives. But, the purpose of this blog is primarily informational to give you (and us) ideas to help bring a little more joy to the life of someone you love.

We welcome your comments and suggestions. They help us identify new products we should add to our store, and they help others who are searching for good ideas for gifts, activities or caregiving solutions.