March Care A Gram. Awareness of Pain in Patients with Dementia Marie MacDonell, RN - Education Program Manager

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March Care A Gram A Special Monthly Newsletter for Caregivers Volume 16, Issue 3 EDUCATION CORNER Awareness of Pain in Patients with Dementia Marie MacDonell, RN - Education Program Manager Persistent pain is common in our society, especially among our senior citizens, who are more likely to suffer from problems such as chronic bone and muscle conditions as they age normally or from injuries. Many of our seniors have taught themselves to tolerate their aches & pains over the years and seldom mention or complain about them. Men are especially prone to denying or hiding their pain & discomfort due to the mistaken idea that it is not masculine to mention such things. The person with dementia is very likely to have trouble communicating his or her feelings or thoughts and this can mean the inability to tell you if a physical problem, such as discomfort or pain, exists. If your loved one has dementia, determining if he or she is experiencing pain may be up to you. Careful observation can reveal important clues to let you know that he or she is experiencing discomfort or pain. It is a difference in the usual behavior of the patient for which you are watching. Common Pain Clues Facial Expressions: Frowning, looking frightened, grimacing, wrinkling his or her brow, keeping eyes closed tightly, blinking rapidly, clenching teeth/jaw, squinting or exhibiting any distorted expression. Verbalizations/Vocalizations: Moaning, groaning, sighing, grunting/ chanting/calling out, breathing noisily, asking for help, speaking or making noises very rapidly, or becoming verbally abusive. Body Movements: Rigid or tense posture, fidgeting, pacing or rocking back and forth; restricted movement, gait or mobility changes, rubbing the body (especially the same area); pointing or repeated movement of a limb. Inside this issue: Awareness of Pain in the Dementia Patient (cont d) Educational Conference Caregiver Survey Monthly Activity Calendar 2 3 4 Monthly Menu 5 Family Nurse Consultants ACC Support Group Schedule March Special Events 6 6 Creative Corner 8 7../2 At Alzheimer's Community Care Character Counts! The mission of Alzheimer s Community Care is to promote and provide specialized, quality, compassionate care within a community-based environment to patients and caregivers living with Alzheimer s disease and related disorders. Sponsored by Alzheimer s Community Care, Inc. and the State of Florida Department of Elder Affairs, State of Florida Agency for Health Care Administration and the Area Agency on Aging Palm Beach/Treasure Coast Inc.

Page 2 March Awareness of Pain in Patients with Dementia (Cont d) It's spring fever. That is what the name of it is. And when you've got it, you want - oh, you don't quite know what it is you do want, but it just fairly makes your heart ache, you want it so! ~Mark Twain Behavioral Changes: Refusing food or showing any appetite change; change in sleep/rest periods; pacing or wandering; not performing usual routines, suddenly whispering or yelling. Mental Status Changes: Crying, showing increased confusion or irritability, acting distressed When Does the Pain Occur? During movement: Signs could be grimacing or groaning during personal care (such as bathing), walking, or transferring (from bed to chair, for example) Without movement: Does your loved one appear agitated or have other behavioral changes, such as trouble sleeping, loss of appetite, or reclusiveness, a particular time of day/night? What Seems to Make it Better? Does the patient demonstrate relief if a certain position or movement is done; do they hold a part of their body; standing; sitting; lying down; squatting; leaning against a wall? Is there anything that you do that seems to give them a less anxious or relieved expression? If you see any of these signs, make notes about what you observe. Then, talk to your healthcare provider as soon as possible and tell them what you have noticed and give examples. It is also important to provide your healthcare professional with a history of all over-the-counter medicines your loved one now takes and has taken in the recent past. Keeping a written list of all medications and dosages relieves you of trying to remember, or being inaccurate. Science has never drummed up quite as effective a tranquilizing agent as a sunny spring day. ~W. Earl Hall Be sure to ask your practioner about the problem of constipation in conjunction with the taking of pain medications. It is very common due to the action of the drug in the body, and the common patient responses of sleepiness, reduced mobility and diminished fluid intake. Constipation may be the cause of the patient s discomfort. The practioner may tell you about a plan of increasing fluids, stool softeners, fiber enhancers and assuring enough mobility/activity for the patient. Adapted from: (The Management of Persistent Pain, Resources for Older Adults and Caregivers. The American Geriatrics Society Foundation for Health in Aging web site. Available at http://www.healthinaging.org/public_education/pain)

Volume 16, Issue 3 Page 3. 2012 Alzheimer s Educational Conference Join other Caregivers, Advocates and Health Care Professionals as we come together for our annual national summit Thursday, May 31st & Friday, June 1st Palm Beach County Convention Center 650 Okeechobee Blvd. West Palm Beach, Fl Registration for Caregivers is $50 for both days Breakfast, Lunch and all Breakout Sessions Included Bus transportation from Martin County is available To register please contact Kattie Fallon 561.683.2700 Ext. 136 CAREGIVER SURVEY During the month of March the Annual Anonymous Caregiver Survey will be mailed to you. This survey is an invaluable tool that we use to ensure that you and your loved one are receiving the best and most appropriate services to meet your needs. Please return the Survey by April 30th in the enclosed postage paid envelope

Volume 16, Issue 3 Page 6 Family Nurse Consultants0 Southern Palm Beach County Janet Zweiback, RN Belle Glade, South Bay & Pahokee Marie Jean-Louis (561) 924-7283 Boynton Beach, Janet Zweiback, RN Greenacres & Lake Worth, Wellington & Royal Palm Beach (Spanish Speaking) Janet Zweiback, RN West Palm Beach & Northern Palm Beach County Jo Ellen Smith, RN St. Lucie County Janice Tucker, RN (772) 460-9166 Martin County Dana Forman, RN (772) 223-6351 24 Hour Crisis Line - 1-800-394-1771 Alzheimer s Community Care - Support Group Schedule Boca Raton 10:00-11:30 a.m. Advent Square 4798 N. Dixie Hwy Boca Raton, FL 33431 Call Janet Zweiback, RN Boca Raton (men only) 1st & 3rd Thursdays 10:00 11:30 am Advent Square (Dining Room) 4798 North Dixie Highway Boca Raton, FL Call Janet Zweiback, RN Delray Beach 1st, 3rd & 5th Wednesdays 2:00-4:00 p.m. Seacrest Presbyterian Church 2703 N. Seacrest Blvd. Delray Beach, FL 33444 Call Janet Zweiback, RN Call Lantana/Lake Worth 1:30-3:00 pm Our Savior Lutheran Church 1615 Lake Avenue Lake Worth, FL 33160 Madeline Grossmayer Jupiter 2:15-4:00 pm First United Methodist Church 815 E. Indiantown Rd. Jupiter, FL 33477 Call Jo Ellen Smith, RN West Palm Beach Every Tuesday 1:30 3:30 p.m. 800 Northpoint Parkway, Ste. 101-B West Palm Beach, FL 33407 Call Jo Ellen Smith, RN Fort Pierce 1st & 3rd Fridays 10:30 am - 12:00 noon St. Peter s Lutheran Church 2900 South Jenkins Road Fort Pierce, FL 34981 Call Janice Tucker, RN (772) 460-9166 Stuart Every Thursday 1:00-3:00 p.m. Stuart Congregational Church 3110 SE Aster Lane Stuart, FL 34994 Call Dana Forman, RN Call (772) 223-6351 Stuart 2:00-4:00 p.m. Prince of Peace Lutheran Church 2200 N. Federal Hwy. Stuart, FL 34994 Kathy Walker, LPN Call (772) 692-6981 Port St. Lucie 2nd & 4th Fridays 1:00-2:30 p.m. First Congregational Church 2401 SE Sidonia Street Port St. Lucie, FL Call Janice Tucker, RN (772) 460-9166

Volume 16, Issue 3 Page 7 Specialized Adult Day Service Centers March Special Events Boca Raton 5th - 9th St. Patrick s Day Decorations 6th Health Focus 8th Enjoy Hamantashen for Purim 16th St. Patrick s Day Party 20th Make Egg Shakers Welcome Spring with Vivaldi & Streamers 27th March Birthday Party TBA Pet Therapy Delray Beach 1st Make Green Jell-O 12th Paint Flower Pots 15th Make St. Patrick s Fruit Salad 16th St. Patty s Day Pizza Party 21st Health Focus 23rd Cherry Coke Floats Fort Pierce 1st Health Focus 8th Guitar with Dana 16th Pancake Breakfast 20th Spring Fling 28th Smoothies for Snack Greenacres 2nd & 9th Craft - Shamrock Wreath 6th & 8th Craft - Leprechaun Buckets 12th Health Focus 13th & 16th Craft - Spring Bird Ornaments 23rd Craft - Spring Flowers 30th Monthly Birthday Party Lake Worth 2nd Karaoke with Harold 8th Baking Coconut Buns 15th Craft - Bead Bracelet & Irish Door Hanger 20th Craft - Salvation Bracelet 21st Health Focus 29th Baking Corn Bread 30th Monthly Birthday Party Entertainment by Butch & Diana North Stuart 2nd Dress in Blue Day 5th National Cheese Doodle Day - Special Snack 8th Full Moon Trivia 12th Pet Therapy 14th French Toast Breakfast 15th Bruce & Harold Sing 23rd S Mores 26th Spinach Day - Special Snack 28th Health Focus 29th Guitar with Dana 30th Ice Cream Sundaes Pahokee 2nd Health Focus 5th Craft - Pine Cone Bird Feeder 14th Baseball Cap Fashion Show 16th Green Irish Jell-O Craft - Shamrock Fan 23rd National Chip & Dip Day - Special Snack Day Time Line Social Gospel Group - Palm Beach Gardens 1st Culinary Class - Peanut Butter Cookies 7th Pet Therapy 12th Culinary Class - Jell-O History of Jell-O 16th Celebrate St. Patrick s Day with Green Floats 26th Health Focus Stuart 8th Your Florida Yard with Fred 15th Entertainment by Mary Jo 16th Lucky Charm Party 20th Health Focus 21st Fun with Julie 22nd Entertainment by Dana Matthews 29th Gardening West Palm Beach 2nd Health Focus 13th Karaoke with Harold 16th Corned Beef & Cabbage Lunch St. Patrick s Day Party (Wear Green) 23rd Special Snack - Chips & Dip 26th - 30th Craft - Caregiver Appreciation Invitations 30th Monthly Birthday Party

Care A Gram Creative Corner (Activities to do with loved ones at home) As always, we encourage you to contact us with any feedback that you may have regarding our service. You can direct your comments to: Ron Radcliffe, Vice-President of Community Care Services 800 Northpoint Parkway Ste. 101-B West Palm Beach, FL 33407 Phone: 561-683-2700 Fax: 561-683-7600 E-mail: rradcliffe@alzcare.org We place a safety net around patients and caregivers every day. Stroll Down Memory Lane Help record your loved ones memories. All the places they have gone, all of the friends they have had and all the fun they have enjoyed are there, buried deep within each heart. Reminiscing bygone days is a pleasant stroll down Memory Lane. Help record some of their most precious memories on recipe cards or in a special book 1. When I was young my mom and I 2. The orneriest boy at my school was.. 3. I had a secret crush on 4. The summer we often got into mischief by. 5. My dad/mom and I used to.. 6. A pet I once loved was.. 7. We often visited 8. I traveled to... We re on the Web! www.alzcare.org Submitted by: Sheila Towns, Activity Coordinator Palm Beach Gardens Specialized Adult Day Service Center Find us on Facebook http:// www.facebook.c om/alzcareorg & Join us on Twitter