Death and Dying

Dealing with Death

Death is an unavoidable part of life that affects everyone in some way at some point in their live, whether we experience death from the passing of a loved one, a close friend, or simply someone we worked with.  The grieving process is what we all go through just after the death of someone close.  Bereavement is the state or condition caused by loss through death.  Grief is the sorrow, hurt, anger, guilt, confusion, and other feelings that arise after suffering a loss.  The way in which we express our grief is called to mourning.  (Cavanaugh & Blanchard-Fields, 2010).  There are four main aspects of grief that people must go through to accomplish the process of coping with a loss: the reality of the loss, the emotional turmoil, adjusting to the environment, and loosening the ties with the deceased.  It is much easier to go through the grieving process when the death is expected, when the death is unexpected it becomes much more difficult to handle.  (Cavanaugh & Blanchard-Fields, 2010).  One to two years is a normal amount of time for someone to grieve after the death of someone; however this time period may vary with the person, depending on specific factors like age and closeness to the deceased.  People deal with death in different ways.  In United States, we hold events that are meant to celebrate the passing of the person, such as funerals, wakes, and memorials.  After these events people tend to remember the individual in a number of different ways.  For example, some individuals carry an object around as a reminder of who they have lost.  The best way to deal with the loss of a loved one is to surround yourself with other loved ones and friends.  (Cavanaugh & Blanchard-Fields, 2010).  Surrounding yourself with loved ones and close friends helps with the grieving process by knowing there are still people involved in their lives and to help them remember the good times that were shared with those who have passed rather than sitting around wishing they were still alive.  Often when an individual passes away there are many different kinds of resources to aid in the processes of death and grieving.  At Maple Crest there are pamphlets on how to deal with death and what they are experiencing and how to accept it and move on, such as, As death Approaches and When Death is Near.  There are also experienced people to talk to, to aid in the process and help get them through the tough times being experienced. 

 

References

Cavanaugh, J. C. & Blanchard-Fields, F. (2010). Adult development and aging. Belmont, CA: Wadsworth. (Cavanaugh & Blanchard-Fields, 2011)

Death and Dying at Maple Crest

            Death and dying are things that are unavoidable when working at a nursing home. While death is a normal process of life, it is something that is very uncomfortable for people to talk about.  By treating death as a taboo topic, we don’t allow ourselves to make peace with the end of our lives.  This cheats individuals of the opportunity to make plans at the end of their life and to have an open dialogue with family members about end of life plans.

A term that is used by researchers is “good death”.  Now the term good death may be confusing because normally when thinking about death we only think about sadness. The term good death refers to when a person is not only kept free of pain but retains a high measure of control, autonomy and independence over his or her fate (Scarre, 2012). He or she retains the ultimate say over what treatments should be administered, and when those treatments should stop (Scarre, 2012). A dying person should be enabled, wherever possible, to make her final dispositions as she wishes, and attain a state of bodily and mental peace (Scarre, 2012). Maple Crest does a good job of giving residents a voice by allowing them to have a say so in their treatment plans (if they are cognitively fit) and in the daily activities that they participate in.

At St. Joseph’s Hospital Health Center in Syracuse, New York, they have instituted a program called “Seeds of Hope” (Kowal, 2013).  This program was instituted by a nurse named Susan Baum who through her own personal experience of losing a loved one and the culminating professional experiences of witnessing numerous natural and imminent deaths of critical care patients throughout her career (Susan Baum, 2014). As a part of this, program patients receive handmade blankets from the hospital volunteer group.  Family and friends honor their passing loved one by personally making handprints of them that are laid over poetry created by the staff.  All families receive Forget-Me-Not seeds that are packaged with an appropriate poem or prayer.  Along with the handprints, some families have asked for locks of hair and ventilator water (representing the last breath of their loved one).  Families stay and reminisce around their loved one while sharing a meal or conversation.  Every family receives a bereavement guide as well as personal mailings from staff-of words of encouragement and counsel-for up to one year after their loved ones passing (Susan Baum, 2014).

            Maple Crest also addresses the needs of the family members of their residents by providing them with them with “Care Notes”. Care Notes cover a variety of topics such as getting through the first week after the funeral, grieving the loss of your parent, sources of strength after the death of a spouse and using good memories to help heal grief among other topics. Through care notes, family members are able to prepare themselves for the death of their loved ones and how to deal with some of the emotions that come with death process.  Care notes also help family members realize that the feelings that they are feeling are normal after the loss of someone that they loved and cared deeply about.

          

 Death and dying are two topics that many people are uncomfortable talking about. Maple Crest however finds a way to address this topic with its residents and their family members. By providing the residents with a sense of self control in their lives they are allowing them to face death on their terms and thus create an environment where they can die in peace. In addition, by  providing their family members with the Care Notes, they are also helping them prepare for the death of their loved ones. By implementing some of the aspects of the Seeds of Hope program Maple Crest will able to take their death and dying care a step further and provide residents, family members and staff with appropriate care when dealing with death and dying.

 

References

Kowal, C. (2013) Helping your patient's family deal with death. Retrieved from http://www.nursetogether.com/helping-patients-family-deal-with-death

Scarre, G. (2012). Can there be a good death? Journal of Evaluation In Clinical Practice, 18(5), 1082-1086. doi:10.1111/j.1365-2753.2012.01922.x

Susan Baum (2014) Retrieved from http://daisyfoundation.org/daisy-award/daisy-nurses/2011/10/baum_susan

 

 

Social Cognition and Meals at Maple Crest

For nursing home residents socialization is a big part of daily life. The increased percentage of depression in adults over 55 is not an unavoidable part of aging but something that positive social interaction can help to stave off (Margrett, et al., 2010). In a review of a study concerning depression in the elderly (Margrett, et al., 2010) suggests that in those nearing 100, an appreciative view of their maintained abilities can lead to a more positive outlook overall This indicates that positive interactions where residents focus on what they can do rather than what they can’t are powerful in keeping them mentally engaged.

            At Maple Crest breakfast, lunch and dinner are served “family style”. This gives each resident not only the power of choice but the opportunity for essential interactions with peers and staff. In many households the dinner table has traditionally been the gathering place for all occasions. Likely many residents can recall passing stories around the table along with the main dish. Instead of an unfriendly and alienating cafeteria atmosphere, the dining area at Maple Crest includes large circular tables situated to allow for clusters of residents to gather around and share a meal together.

            For many, there is no precedent for interactions in nursing homes. When confronted with new situations people tend to fall back on previous experiences, using what they have experienced in the past to base new interactions off of or social knowledge (Cavanaugh & Blanchard-Fields, 2010). While being confronted with a whole new way of life and having no social knowledge to rely on for many interactions could be depressing, the simple act of sharing a meal together can give comforting context to many residents. Similarly, when individuals are accustomed to forming their own menus and determining their own meal times, it could be distressing to move into a new facility where this is predetermined. While it is necessary to have some of these factors set up ahead of time in order for cooks and staff to orchestrate dining for all residents, Maple Crest provides as many options as possible in order to give each resident their own choices. Every lunch and dinner comes with several options which can be put together in several ways resulting in a number of different meal combinations available to each individual. The power to choose between chicken or beef, yams or mashed potatoes, and baked beans or mixed veggies all in one meal is significant when depending on others for many other tasks in one’s life. Maple Crest has done a remarkable job of offering options and comfort simultaneously, creating daily opportunities for the mental enrichment of all their residents.

References

Cavanaugh, J. C. & Blanchard-Fields, F. (2010). Adult development and aging. Belmont, CA: Wadsworth. (Cavanaugh & Blanchard-Fields, 2010)

Margrett, J., Martin, P., Woodard, J. L., Miller, L. S., MacDonald, M., Baenziger, J.,…& Poon, L. (2010) Depression among centenarians and the oldest old: Contributions of cognition and personality. Gerontology, 56, 93-99. doi: 10.1159/000272018

Memory and Alzheimer's- Course Concepts

What is Alzheimer’s disease?

In today’s society a common disease that is talked about with older adults aging is Alzheimer’s disease. We have all heard the commercials on television and the new research on the news. Alzheimer’s disease is a type of dementia, which is a term for memory loss that causes problems with thinking and behavior (Cavanaugh & Blanchard-Fields, 2011). It is actually not an age related disease that most people think it is. Alzheimer’s is a degenerative disease that the symptoms worsen over time. There are two stages of Alzheimer’s which are early onset and late onset. It all depends on how old someone is. If they are diagnosed with Alzheimer’s and are younger than 65 than that would be considered early onset, and anything 65 and older is late onset (Alzheimer’s Association, 2014). Alzheimer’s disease can even lead to death as it is the sixth leading cause of death in the United States. Alzheimer’s effects memory by how the brain is set up. The brain is set up as a communication network. Brain cells operate like tiny factories. They gather supplies, create energy, construct equipment and get rid of waste. From doing research, scientists are not sure where the trouble starts in the brain with a person who has Alzheimer’s and it prevents the factories in our brains from running well (Alzheimer’s Association, 2014). Just like in any factory if one thing breaks down or does not run well can cause problems in other areas too.

Living with Alzheimer’s

            Finding out that you have Alzheimer’s could set off emotions including anger, denial, resentment, fear, isolation, and possibly depression. It is common, but they can be treated. Everybody deals with diagnosis differently. Some may find writing in a journal helpful, while others may find seeking out help from family, friends, doctor, or a counselor. Know that you or a loved one with Alzheimer’s disease is not alone. A helpful way to deal with this is to have a good support system and to not wait for help to find you, but for you to go out and seek the help (Alzheimer’s Association, 2014).

Safety Concerns

Having Alzheimer’s disease and dementia can be difficult to live with since it does impair the person’s memory. The older adult may not remember family members’ names which can be frustrating if the family member gets upset at them for not knowing their name (Alzheimer’s Association, 2014). A safety concern while living alone with Alzheimer’s could be remembering how to cook which is very important to the family member’s safety. A fire could start very quickly and with memory loss they could forget how to dial 9-1-1 or get out of the house. Another common safety concern with people who are diagnosed with Alzheimer’s is the risk of wandering. Getting confused and agitation can make people with the disease become lost (Alzheimer’s Association, 2014). It is very dangerous especially when living alone as there is nobody watching for changes that may increase the risk of wandering. Something helpful could be a MedicAlert jewelry as when they get lost and a citizens find them, they can call the toll free number on the bracelet to get them home safely (Alzheimer’s Association, 2014). Balance can also become impaired so a person could fall a lot and then not remember what happened when going to see the doctor when they get it checked out.

References

Alzheimer's Association. (2014). Retrieved from http://www.alz.org/alzheimers_disease_1973.asp.

Cavanaugh, J. C. & Blanchard-Fields, F. (2010). Adult development and aging. Belmont, CA:Wadsworth.

Attention and Memory at Maple Crest

Maple Crest Manor and Assisted Living is a long term care facility in Fayette, IA, that cares for many different types of people with many different needs. Maple Crest not only offers support and care for its residents, but it also offers support and assistance for the families of the residents. Maple Crest provides care for many types of residents, including those that suffer from dementia and Alzheimer’s disease.

 Dementia is a term that describes a wide range of symptoms associated with a decline in memory or other skills involving thinking that are severe enough to reduce a person's ability to perform everyday activities (Alzheimer's Association, 2014). These activities can involve paying bills, taking medication, and eating meals. There can be many forms of dementia. Alzheimer’s is the most common form of dementia and accounts for 50 to 80 percent of dementia cases. Alzheimer’s causes problems with memory, thinking, and behavior. Alzheimer’s affects many people ages 65 and up, and it continues to get worse over time. In beginning and mild cases, one may have slight memory loss that causes them to have difficulty remembering newly learned information, and as it advances symptoms become severe including disorientation, mood and behavior changes, and the inability to carry on conversations or respond to their environment (Alzheimer's Association, 2014).

Dementia and Alzheimer’s not only affects the one being diagnosed, but the ones close to that person as well. Many seek out the support of others who understand what they are going through, and through support groups, can learn strategies on coping and even learn possible solutions to help their loved ones (Alzheimer’s Association, 2014). One of the support groups that Maple Crest offers is “Pearls of Hope.” “Pearls of Hope” is an Alzheimer's and dementia support group for anyone with loved ones who are suffering from these diseases. This group meets the second Tuesday of each month from 6:30-7:30 p.m. at Maple Crest. This support group covers many topics related to dementia and Alzheimer’s, and has a guest speaker on each topic each month.

Another program Maple Crest is involved with is Christmas Stories. This is a program that is in collaboration with Upper Iowa University. Upper Iowa students came and interviewed many of the residents at Maple Crest about their most memorable Christmas Stories. This program is a chance to promote memory activities to keep residents healthy.

This program specifically triggers their autobiographical memory, which is a form of long term memory. Autobiographical memory is when one remembers information and events from our lives (Cavanaugh & Blanchard-Fields, 2010).  These memories give a person identity and provide personal history. Autobiographical memory involves episodic and semantic memory. Episodic memory is the recollection of information from a specific event or point in time, and semantic memory is knowledge and facts of one’s past (Cavanaugh & Blanchard-Fields, 2010). 

Examples of many of the residents’ stories can be found below. Notice how the stories involve many parts of the autobiographical memory.

 

Mildred’s Most Memorable Christmas

Mildred remembers a Christmas in the 1920’s, when she wanted a sled. Her uncle lived with her family at the time and was helping with the farm. Her uncle told her if she wanted a sled she would have to write a letter to Santa. Mildred was at the age she wasn’t sure if there was a Santa, but decided it was worth a try to write a letter. On Christmas Eve, she checked under the tree on her way to church and there wasn’t any sign of a sled. Then, the next morning on Christmas there it was! A Flexible Flyer! A few years later she learned it was her uncle who has purchased the sled. He paid $6.25 for it.

 

Helen’s Most Memorable Christmas

   When asked to tell us her favorite Christmas memories, Helen smiled and sat back to reminisce. One of her fondest memories is from when she was eight years old. She moved to a ranch during her second semester of school to live with her grandparents. She remembers Christmas morning when she tried to wake up the entire family. Once she got everyone roused from their beds, she convinced them it was time to open presents. She received a wrist watch and a doll that year. She loved the gift and knew that having a wrist watch in the third grade was a big accomplishment; it even had a leather strap. This was during the great depression so even the smallest gifts were treasured, and you took great pride in the things you owned.

 

Onalee’s Most Memorable Christmas

At the age of three, Onalee wanted a pony more than anything. Little did she know that she was about to get what she wished for. It was the Christmas before she would turn four in January. On Christmas Day, her father carried in a little Shetland pony and put him under the tree. It didn’t take long for Onalee to fall in love and name the pony Buster. She remembers her friend Jean coming over and wanting to ride Buster. When Onalee said yes, Jean jumped on and Buster took off toward the shed where the kept him, not listening to anyone’s commands. Onalee’s three brothers always had a good laugh because Onalee and Buster were two of a kind; ornery as heck and didn’t listen to anybody.

 

B.J. & Louie’s Most Memorable Christmas

B.J. and Louie’s favorite Christmas memories are of when they lived in Scottsdale, Arizona with their daughter, Melle. They would have a small Christmas with the family. Their most memorable Christmas involved going to yard sales and buying up goodies for little Mexican girls. They would load it up in the van and drive down to Mexico. Once they were there, Louie would dress up as Santa Clause and give each girl a present. The girls loved seeing Louie and B.J., but B.J. and Louie loved seeing them light up just as much.

 

Bob’s Most Memorable Christmas

Bob’s favorite memory about Christmas is the year his dad got a second hand bike and fixed it up. He painted it, and it looked just like new. He had to share with four brothers, but man was it a great bike. They found out it didn’t have breaks, but his dad was able to fix that in a hurry. Bob also remembers the snowball fights with his brothers. It was all fun and games until someone got hurt, then it was dad’s turn to throw and he was a ball player, so look out!

Bob loves all the holidays during the season, everything from Halloween to New Year’s. He remembers going out to the timber on the farm and cutting down a scrappy looking cedar tree, but they worked just as well as evergreens. They never had much money, but they always managed to buy gifts for the kids.

 

Mardell’s Most Memorable Christmas

Mardell’s favorite Christmas memory is when her brothers played Santa. She had a big family and the boys would take turns. They would dress up and come walking from over the hill, towards the farm. She looked forward to seeing Santa each year. It wasn’t until she was older that she found out it was her brothers and not the real Santa.

 

Rhoda’s Most Memorable Christmas

Rhoda remembers always having lots of lovely Christmases! She loved decorating the house, and she always put up the tree. She remembers with all the kids that there were always lots and lots of new toys. She also remembers once the presents were opened the kids couldn’t wait to go outside and play in the snow.

 

Maple Crest Manor and Assisted Living is truly and positively promoting the health of their residents. These programs are only two of the many programs Maple Crest offers its residents, families, and communities. By offering these types of programs they are not only helping the residents by giving them the best possible care and helping them stay healthy, but they are also promoting family and community involvement and support.

 

 

References

Alzheimer's Association. (2014). Overview. Retrieved from http://www.alz.org/

alzheimers_disease_1973.asp

Cavanaugh, J. C. & Blanchard-Fields, F. (2010). Adult development and aging. Belmont, CA: Wadsworth.

Longevity, Health, and Functioning

How long will we live is a question in which many older adults face on a daily basis. Longevity helps with answering the questions in which come up along the way when dealing with the health and functioning of older adults. There are two types of longevity. They are average and maximum longevity. Average longevity is the average life expectancy. Maximum longevity is the oldest age to which an individual lives (Cavanaugh & Blanchard-Fields, 2011).

There are two factors influencing longevity, health, and functioning. The two factors are genetics and the environment. Genetic factors can determine whether an older adult will live along time. Studies show someone has the advantage of living a longer life if they have a family history of long-lived individuals (Cavanaugh & Blanchard-Fields, 2011).  Environmental factors can be diseases, lifestyles, social class, and environmental toxins. Environmental toxins can be classified as air and water pollution.

Gender differences can have an impact on longevity, health, and functioning. Studies show men live longer than women. Studies also show women have approximately a seven year advantage over men (Cavanaugh & Blanchard-Fields, 2011). Some researchers state this is because women have a larger support network, yet others have stated, men are more likely to smoke, drink alcohol, and have greater stress amounts than women which may ultimately count for gender differences in longevity.

Health is defined as a state of mental, physical, and social well-being, and not just the absence of disease or impairment (Cavanaugh & Blanchard-Fields, 2011).  Illness can be defined as a physical or mental disease or impairment. Self-rated health can be a more accurate measure of health than other measures. Men usually tend to rate their health worse than women do (Cavanaugh & Blanchard-Fields, 2011). In addition, previous research noted self-rated health is with a strong predictor of illness and mortality.

Quality of life is also an important aspect to consider when talking about health and varies between person to person. Some people find it challenging to rely on someone else to help them with their needs. Researchers look at two types of quality of life. They are health-related quality of life and non-health-related quality of life. Health related quality of life is how an individual’s life is impacted due to health. Non-health-related quality of life focuses on experiences, the environment, and activities which have an impact on the quality of life (Cavanaugh & Blanchard-Fields, 2011).

 There are many factors which can help with answering the question of how long people will live. Longevity, health, and functioning can have many interrelated causes which may lead to further understanding of approximately how long an individual can live. Studies of genetic and environmental factors can help with answering the questions of longevity, health, and functioning.

 

References

Cavanaugh, J. C. & Blanchard-Fields, F. (2010). Adult development and aging. Belmont, CA:

            Wadsworth.

Rehabs and Therapies at Maple Crest

 

 

        At Maple Crest, there are different types of rehab exercises and therapies which are available for the residents at the facility. Rehab and therapy are a great tool which can help with the quality of life for an individual. Rehab and therapy can improve people’s functioning and well-being (Cavanaugh & Blanchard-Fields, 2011). With individuals being willing and taking the time to be a part of rehab and therapy they are improving their quality of life by becoming stronger and healthier, as well as improving their health, longevity, and overall functioning.

Some of the rehab exercises which are available at Maple Crest are restorative exercises, upper extremity exercises, lower extremity exercises, and restorative programs which can help with swallowing, speech therapy, and voice exercises. Restorative exercises are used to help with strengthening and flexibility of the residents through physical and occupational therapy. Upper extremity exercises include using therabands with different resistance strengths, pulleys, arm pedlars with weights, hand grippers, and playing catch with a ball. Lower extremity exercises include foot pedlars with ankle weights, seated and standing exercises, and ball squeezes.

Therapies that are available at Maple Crest are doll, horticulture, occupational, physical, speech therapies and more. Therapies can help with improving the quality of life for individuals by giving them a sense of accomplishment and increase their well-being. Some of the therapies which are available at Maple Crest help with giving the residents something to do within their day, and can be counted as activities to get them involved socially as well as cognitively. Some of the routines that are available for residents are physical therapy, occupational therapy, and speech therapy.

Doll therapy is used mostly with residents who have Alzheimer’s disease or dementia. Doll therapy has been observed to give a calming effect to patients, as well as let them nurture and care for the doll throughout the day (Doll Therapy for Alzheimer's Disease (Baby Doll Therapy), 2006). Horticulture therapy uses garden environments that residents can utilize within their environments. It is known for improving memory and cognition skills, as well as language skills and socialization. Horticulture therapy can also help with balance and coordination (Horticultural Therapy, 2014).

Physical therapy can restore and increase strength, flexibility, and range of motion. Physical therapy can reduce pain in which and individual feels as well (Physical Therapy for the Older Adult, 2014).  Occupational therapy can help with overcoming physical challenges as well as give them the opportunity to go back home. Occupational therapy can help someone who has fallen and broken a bone recover and learn the daily skills which are necessary to live out on their own again (Wilding, 2012). Speech therapy helps with giving older adults the opportunity to speak again after something such as a stroke. Speech therapy can help also help with giving older adults the opportunity of practicing their swallowing, as well as speech, which gives them the opportunity to refrain from restricted diets. Speech therapy allows for older adults to learn how to communicate their emotions (Judy, 2011).

Rehab and therapy programs are very important for older adults to take part in. These exercises can help older adults complete activities of daily living and increase independent living and self-reliance.
 

References

Cavanaugh, J. C. & Blanchard-Fields, F. (2010). Adult development and aging. Belmont, CA:

            Wadsworth.

 

Doll Therapy for Alzheimer's Disease (Baby Doll Therapy). (2006, April 25). Retrieved from Best Alzheimer's Products: http://www.best-alzheimers-products.com/doll-therapy-for-alzheimers-disease.html

Horticultural Therapy. (2014). Retrieved from American Horticulture Theapy Association: http://ahta.org/horticultural-therapy

Judy, D. (2011, April 19). Speech Therapists Can Help the Elderly. Retrieved from Tender Hearts Senior Care: http://tenderheartsseniorcare.com/senior-care/speech-therapists-can-help-the-elderly/

Physical Therapy for the Older Adult. (2014). Retrieved from Performace Physical Therapy: http://www.performanceptpc.com/olderAdult

Wilding, M. (2012, September 6). How Occupational Therapists Help Seniors Get Things Done. Retrieved from HealthWorks Collective: http://healthworkscollective.com/ecaring/48586/how-occupational-therapists-help-seniors-get-things-done