“I think so…but I’m not sure”

Matthew Pravetz, OFM Features

As part of its series on health, the HNP Wellness Committee offers information and guidance on dementia. This piece, part two of a series, was written by a friar who is a clinical anatomist. The previous article, “Where did I put my glasses …?” appeared in the April 28 issue of HNP Today.

In the previous Wellness Committee article, we discussed some of the signs, symptoms and science of dementia. If you think that your forgetfulness or increased confusion may be more than normal, it may be time to sort some things out.

The very first step would be to see your primary care physician. Your doctor knows you best and can determine if there are some changes that may need to be further explored. Perhaps the physician will refer you to a professional, who specializes in your specific symptoms, such as a neurologist for nerve disorders.

Getting Ready for the Doctor’s Visit 
These days, a visit to the doctor may feel rushed, lasting for only a “New York minute.” In spite of the fact that the time is short, much territory needs to be covered. A little remote preparation will be helpful in coping with what is already a stressful situation.

Preparing written lists can make efficient use of the history part of your physical. List some of the major causes of stress, including any recent changes in your life (moving to a new friary, the loss of a close friend or relative). Also, include personal symptoms that you have noticed creeping into your daily routine, such as loss of appetite, inability to sleep at night, too much sleep during the day, or confusion.

It is always a good idea to have, in your wallet, the names of medicines that you are taking. Include the dosage and who prescribed the medication to you.

The discussion with the doctor subsequent to examination can be so information packed that it may be a chore to soak it all up by yourself. It is often easier if you ask a friar to accompany you. He can listen and be an extra set of ears to validate everything that transpires.

Meanwhile, Back at the Friary 
When you get back to the friary, you might find that doing the usual things that you did for yourself, like taking medications, daily hygiene, driving the car or fixing your own lunch may be more difficult than they were in the past. It may be important to meet with the guardian and other friars to create a plan. In reality, dealing with and creating such plans may pose a community conundrum in the middle of today’s active ministry sites. However, guardians, in particular, should remember that there is professional assistance from the Provincial resource person — J. Patrick Kelly, OFM — who can provide support from the initial stage of evaluation as well as with ongoing professional services.

Social service assessments can determine the need for installing bed and bathroom safety rails or assisting with (or removing) some objects with which you are having difficulty or by which you may be getting hurt. It’s always good to make sure that health care legal issues are in order: living will, power of attorney. All of this may seem like a lot to handle, but brothers are very helpful — just ask!

Caring for a brother with dementia can be challenging and, at times, overwhelming. Being a caregiver can result in frustration. However, in light of the response to the many difficulties of being a caregiver, frustration is a normal and valid emotional reaction.

While some irritation may be part of everyday life as a caregiver, feeling extreme frustration can have serious community consequences. It may cause individuals to be verbally and perhaps physically aggressive toward the brother with dementia. His wandering or constantly repeating the same questions, however, are uncontrollable behaviors.

Even though you can control how you respond to these circumstances, you must recognize warning signs of your own frustration, which, in addition to lack of patience or the desire to strike out may include stomach or chest pains, headache, compulsive eating, or excessive alcohol consumption.

Lifestyle and Friary Remedies
One of the first things to do is to safety-proof the friary as a step to creating a stable environment. In addition, a calm friary atmosphere can reduce behavior problems. Being rushed to remember, or asked to perform tasks that are complicated, along with large gatherings of friars, noise, or for that matter, any new situation will cause anxiety for the brother with dementia. These situations tend to reduce his already compromised ability to think clearly.

Even in the middle of the busy ministry demands, the community can still assist the friar to remember by reminding. Reference to the time of day (i.e., “it’s afternoon”) is helpful in grounding. Clearly posting (and referring to) not just upcoming events, but things that have happened and daily activities which are necessary to complete on a daily basis will help with the question, “What next?”

holycross-rPerhaps a visit to a local senior center could encourage joining in with word games, jigsaw puzzles, songs from the past, reference to newspaper headlines, all which help to keep the mind focused.

Dementia behavior may be worse at night when the friar is more tired from daytime activity, strained by demands of the day, or perhaps confused because of a decrease in daylight (known as “sundowning”). Therefore, establishing a good, regular nighttime routine is helpful to reduce such symptoms. In fact, earlier in the day, watching that the brother limits caffeine intake and avoids daytime exercises and naps will also assist preventing nighttime restlessness.

While ministering to our brothers who are encountering the effects of dementia can be an enriching and very rewarding experience, it can also be stressful for the rest of the community. Caring for someone with a brain-impairing disorder can be more stressful than caring for someone with a physical impairment. It is essential that friars take time to care for themselves physically and emotionally.