Adult Family Home Care

The simple act of caring is heroic.

– Edward Albert

Dementia Toolbox Journal

Toolbox Journal

Way Down Upon the Swanee River

Friday January 21 2022, 4:53pm


What music did you grow up with?

Church Hymns? Beethoven and Mozart?

As a teenager what did you hear repeatedly so it wore a path in your brain cells?

As a caregiver, do you know their music memories?

In the forties Glenn Miller’s band crooned “Don’t sit under the apple tree with anyone else but me.”

Even if you can’t carry a tune, start singing after a meal while you are cleaning up the dishes. “No, no, not with anyone else but me…” and you will get smiles.

In the fifties Paul Anka sang “Put your head on my shoulder, hold me in your arms, baby.”

“Unforgettable, that’s what you are…” Nat King Cole.

Tennessee Ernie Ford, “Sixteen tons and what do you get? Another day over and you’re deeper in debt.”

If you don’t know all the words, I betcha the person or people you care for will. And the memory will escort them back to when they could walk, and dance, and were able to live active lives. They were important.

Way down upon the Swanee River,
Far, far away.
That's where my heart is yearning ever,
Home where the old folks stay.

Are Your Systems Stuck

Tuesday January 18 2022, 2:19pm

In our AFH we stored tableware in one drawer and separated the knives, forks and spoons.

The sharp knives were protected in a wooden form. They were kept in a bottom drawer for safety.

The cooking spoons, spatulas and such were in two top drawers.

Our systems saved us time looking for a particular implement.

There was no right way or wrong way. The system was simply what we agreed to do.

Through the years your family has leaned on ways of doing things. Dementia changes that.

Your loved one’s needs are not the same. As their reality forces you to change, take a deep breath and reevaluate.

A system is a way of doing something until it no longer works.


Kindness and Patience

Tuesday November 16 2021, 10:37am

Aging affects the brain where we hold control and filters. When our filters fail, we say words and express opinions that are hurtful to others.

When patience and kind words disappear from our present functioning, we need more understanding and patience from those who live with us. 

Short tempers are not necessarily an indication of Dementia. They may come from a person’s frustration with herself, or emotions as she reviews her life and remembers failures.

A person with Dementia deserves kindness and patience in the most effective and respectful way possible. No one will say this is easy. But patience will encourage better behavior than anger and harsh words.






Sunday November 14 2021, 10:34am

Have you told your husband what’s for dinner three times and he asks again?

He may have memory loss or simply be distracted by what he’s doing.

Denial can be costly. So pay attention.

Don’t nag or ridicule. Simply pay attention.


Friday November 12 2021, 11:15am

Molly C.

Well, my doctor has confirmed my suspicions. I have Alzheimer’s.

I have often forgotten I left the stove on to boil eggs when I stepped outside to water the window box.

But what is different now is the amount of time it takes me to get dressed in the morning, clean the kitchen after dinner.

My daughter invites me to go for lunch and I forget. When she calls wondering where I am, I am at the grocery store wandering back and forth in front of the meat case.

My husband says he can handle the day-to-day requirements when I can no longer keep things straight. But he already seems resentful when I fail to follow through with my usual responsibilities.

My mother experienced the symptoms for eight years before she needed total care.

Alzheimer’s has been named as my enemy. I will fight my losses in every way I can.


Holiday Gifts for Your Aging Parent

Thursday December 10 2020, 2:59pm

Thanks to A Boomer's Guide to Eldercare.

Posted: 08 Dec 2020 08:19 PM PST

 Playing Santa isn't the easiest role in the world. Especially when you're buying or making a gift for your aging parent or loved one.

The following gifts emphasize both ease and affordability. Your loved one doesn't need a lot of "stuff." They have had a chance to accumulate and to move from "more" to "less." Here are a few gift ideas that don't take up much room but can make a big impact for the right person.

A cupcake, a flowering plant or a jar of candy to share. A book, if they like reading and you know what kind of books

 A puzzle - there are certain ones for people with dementia. Preferably one that is personal. If they like birds for example, a bird puzzle.

Pictures of your parent's family from years ago can be made into a puzzle.

 A hand towel for kitchen or bath.

 A wide brimmed sun hat

 Warm mittens

 All natural hand cream- for someone who doesn’t have dementia. 

 A visitors journal 

 Water coloring kit, if they would appreciate it. 

 Coloring or activity book.

 Bathrobe or slippers

 Gift certificate to get their nails done 

What are you gifting this year in a time of separation and coronavirus? 



What Can I Do to Avoid Dementia?

Wednesday October 21 2020, 2:58pm


There are many claims for natural products, like coconut oil to reduce the chances of developing a form of dementia.

Unfortunately, these supplements and life habits may increase your general health, but do not affect the brain.

In studies, fats like coconut oil could indirectly result in higher levels of a protein called acetylcholinesterase. Most current treatments for people with dementia aim to lower the level of this protein.

The NHS of the UK advises against consuming large amounts of coconut oil as it contains high levels of saturated fat which can lead to high cholesterol levels.

The ALS continues to fund research into the possible causes of dementia which may help us avoid brain damage as identified in the more than 60 symptom bundles of dementia.

Functioning with a Dementia Umbrella

Thursday September 17 2020, 11:51am

Functioning with a Dementia Umbrella

Millions of people are living under the dementia umbrella. Millions more are at the beginning of their decline, but have not yet been diagnosed, nor have their encroaching impairments been identified.

 Picture stepping into a rain shower that is threatening to become a violent, wind battering storm. You open your umbrella only to find the fabric is frayed and loose from one of the wire ribs.

You can’t repair it and need at least some coverage.

Returning home, you hang the umbrella in the closet and forget about it.

Six months later the situation repeats itself. But the damage isn’t bad enough to worry about. You make a mental note to buy a new umbrella.

You get the picture. In the next few years, you attempt to make the damaged umbrella protect you from the rain.

You take the umbrella from the closet. When you open it, two wire ribs and bent and you receive only partial protection. You are confused. Something is wrong. You close the umbrella and try again with no improvement.

Many collections of syndromes huddle under damaged umbrellas. Alzheimer’s, vascular from strokes, Lewy Bodies, Down’s Syndrome, Huntington’s Disease and more than forty more.

While there is no cure, there are behavior treatments that relieve depression and anxiety.

This website is written for those of you who care for loved ones with one of these forms of dementia. Email me if you need something specific.

Inappropriate Behavior

Wednesday August 19 2020, 12:39pm

A recent re-run of Gray’s Anatomy showed the Emergency doctors treating an older woman who thought she was carving a chicken as she had done thousands of times.

But it wasn’t a chicken. It was her hand now bleeding profusely.

The doctor who treated her was handsome and solicitous. She pushed the small box of tissues from her tray to the floor.

He picked it up. She pushed it off again. The action kept him close to her and responding to the tissue box.

Her daughter pointed out that her mother suffered from Pick’s disease. Frontotemporal dementia.

Different parts of our brain do different work.

The frontal lobe of the brain controls emotions and inhibitions. Damage to it results in unexplained emotional outbursts. The person may hit or may hug inappropriiately.

The frontal lobe also enables us to make plans and evaluations.

The temporal lobe controls language and coordinates with the frontal lobe to control behaviors.

A person with Pick’s disease may show poor judgment, develop a taste for sweet foods, stuff themselves with bread or potatoes, demonstrate inability to judge when an activity becomes dangerous.

There is no cure.

Homeostasis:  More than a Big Word

Friday August 7 2020, 4:47pm

 Homeostasis is more than a 5-syllable word that’s fun to say.

 Think of an old-fashioned scale with a platform balancing on a centered point. When the weight is equal on each side, the platform looks horizontal and evenly balanced.

 Back in 1926 a psychologist, Walter Cannon presented the word to describe an organism’s ability to regulate various physiological processes to keep internal states steady and balanced. defines homeostasis as “The tendency of the body to seek and maintain a condition of balance or equilibrium within its internal environment, even when faced with external changes.”

 A simple example of homeostasis is the body's ability to maintain an internal temperature around 98.6 degrees Fahrenheit, whatever the external temperature.

 When an organism maintains equilibrium, it continues to live and grow. There is stability.

 Balance is an easy way to think of homeostasis.

 For example, “All work and no play makes Jack a very dull boy.”

 Or, a budget demands balance between income and expenditures.

 Family hierarchy structures demonstrate balance or imbalance as members work through conflict and cooperative relationships. As conditions negatively change, the balance achieved by family members may become unbalanced due to stress.

 Causes of stress factors vary.

 Retirement, financial difficulties, illness may be handled when family members communicate and cooperate.

 When dementia becomes a factor, the scale tips and balance becomes difficult to maintain.

 When brain cells are destroyed by disease or injury, the individual’s homeostasis is off balance.

 As they tumble from the scale, they affect each member of the family.

 Adult children who have built independent lives receive the phone call that their parent has fallen.  They are asked to leave their familiar, balanced positions and come.

 Loss of homeostasis is how caregivers are created.

 If you are the offspring who accepts the responsibility for a parent who has become ill, you will have many questions for medical and financial experts.

 Picture yourself emotionally picking up your parent’s walker and using it to maintain your balance while negotiating this new terrain.

 Support from one or two friends who will listen, reading books and joining support groups* with others in similar caregiver positions become essential. Decisions are best not made in a vacuum.

 Achieving an accurate diagnosis may be difficult. If your parents’ doctor is not trained and educated in geriatrics and dementia, find another doctor.

 Caregiving is not for the faint of heart. It makes demands, pushes and pulls one off balance.

 We received a phone call from a family in Texas. Their parents were staying with a sibling in Washington and needed more help than the family could give. Did we have room?

 After new residents move into our adult family home, we learn the behaviors that were not written in the initial evaluation.

 We took notes. We wrote short vignettes describing the wife’s behavior. She hit her husband. She pushed another resident away from the kitchen cupboards and demanded “this is mine.”

 We made an appointment with their doctor. By the time we were reading the third vignette, the doctor said he had heard enough and prescribed a new medication.

 The medication was not a cure, but it did calm the wife so we could more easily redirect her when necessary to protect the other residents.

 Homeostasis is not easily achieved with dementia, nor is it permanent. But it is vitally important to maintain at some manageable level.



Phone Visit with the Doctor

Thursday April 16 2020, 9:41am


Due to coronavirus concerns many doctors are not seeing patients in their office as usual. Your loved one with dementia may become anxious over this change and other virus repercussions she may see on Television.

Think carefully about ways your loved one - who we will call Mary - needs to be prepared.

If you have access to Skype or other video-conferencing services, you may include Mary in the experience. Seeing another family member on the screen may be exciting and comforting. From there to a call with the doctor will be a manageable move.

A phone conversation may be presented the same way. Call Mary’s friend and take turns speaking and listening on the phone.

Be prepared with questions and information for the doctor. Your list may include items like behavior, appetite, or fluid intake change, sleep patterns or energy changes. Have Mary’s hallucinations increased? Has she fallen?

Take Mary’s temperature and blood pressure within an hour of the call.

The doctor will ask whether anyone has possibly exposed Mary to the virus and whether she shows symptoms.

This time of isolation is a warning to us that we no longer live the normal, unconcerned lifestyle we have before the virus.

Be prepared and take care of your health.


Bathroom Tips

Tuesday March 10 2020, 2:39pm

Dementia changes the way objects are viewed.

An approaching care worker wearing a white scrub top may be interpreted as a floating head above approaching legs.

Similar handicaps may be observed with toileting.

A person accustomed to a white toilet may interpret any white bucket as a toilet. Our waste baskets are all colored and made of easily washable plastic.

A white toilet may disappear. Consider using painter’s blue tape as a contrast to signal “this is the place.”

Or trade out the white seats for colorful green or pink.


Grab bars should be permanently fixed where they can be used for our person to stand and sit.

A convenient towel bar may be pulled off the wall and used as a defensive weapon when the person with dementia does not understand why you are taking down her pants.

Hoarding tendencies may include unrolling long strips of tissue paper which then block the toilet. When required, we separate toilet tissue squares and layer them in a plastic tissue box.

Likewise, the person with dementia may hoard dinner napkins and use a stack of paper napkins at the toilet.

We then switch to cloth napkins when the paper napkins are misused.  

We do not recommend throwing away your money.


Make your choice:

Bake cookies and offer your residents a fun, busy activity separating TP,

or pay for a $300 plumber’s visit.



Thursday February 6 2020, 10:41am

Mindfulness: It's something for caregivers to think about

When we're stressed, we can do mindless things.

I'm not talking about losing cell phones, or glasses or keys to the car or house. I'm talking about temporarily losing ourselves.  Stress, through caregiving, grief or our own negative thoughts, can make us do mindless things..

At other times I've been scattered and disconnected from life. Maybe you have, too. We multi-task, engage in continuous thinking, and rehash the past or rehearse the future. Our minds are off-center and we miss what is happening in the present.

According to "The Mindful Advisor," by Eric Zook and Stacy Zook, CSA Journal, Winter 2015, 4-12, "This is what causes to burn ourselves with the iron or stove, drop dishes, or have a car accident."

The Zooks are among the proponents of a mainstream movement called Mindfulness.  It's the art of being in the moment without a desire to change the situation. That means refraining from judging ourselves or the events or people in our lives.  It means staying in the present, neither exaggerating it or denying it.

Says Social Worker Jeannie DeSmet, "When we're mindful, there's less need to escape a painful situation. The motivation is to care, not to cure."

The benefits of mindfulness for the caregiver and others are reduced stress, increased immunity and overall health, better concentration, improved creativity and innovation.

One way to aid in mindfulness is to practice deep breathing, which anchors our minds. As we do, we can stop, look, and listen, observing our emotions and paying attention to them.

Set a timer for two to five minutes and bring your attention to your breathing. Just notice the breathing; don't try to change it in any way. Once you have settled into a relaxed easy breathing, count down from ten to zero. Each full inhale/exhale counts a one. Don't worry if your mind strays; just come back to your breathing and start over at ten. Continue this exercise until you can make it to zero at least three times in a row. Then start the next workout session at fifteen.

Other ways to build mindfulness is to pay attention as you walk, drive or eat. The key is paying attention. When you walk, go slowly, outdoors or indoors, using stairwells. Be mindful of the act of walking.

Our residents will feel the difference when we are mindfull as we care for them. 

I promised to keep Mom at home

Wednesday January 22 2020, 2:03pm

Choosing to keep your vulnerable adult in their own home has many advantages.

Support groups are often available where participants share encouragement and stories about In-Home Care.

The Senior Information & Assistance (I & A) is a free information and referral system for adults age 60 and older and for family and friends helping care for the older adult.

Find the local I & A office and other government resources.

Way Down Upon the Swanee River
Are Your Systems Stuck
Kindness and Patience
Holiday Gifts for Your Aging Parent
What Can I Do to Avoid Dementia?
Functioning with a Dementia Umbrella
Inappropriate Behavior
Homeostasis:  More than a Big Word
Phone Visit with the Doctor
Bathroom Tips
I promised to keep Mom at home