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JOAN’S BLOG – THUR/FRI., OCTOBER 27/28, 2011 – ROUTINE IS THE KEY

This is a lesson I learned early in the Alzheimer journey, and one that continually surfaces to remind me of its importance. If you are new to caring for a spouse with Alzheimer’s Disease, I cannot emphasize how important routine is to maintaining peace and tranquility in your home. If you are a veteran, a reminder never hurts.

Try to imagine living in the head of your spouse with Alzheimer’s Disease. You cannot learn anything new. You cannot remember what you did a minute ago. You cannot remember what you are supposed to do next. I know I would be confused and frightened. Routine removes some of the fear and uncertainty.

In the case of a “well” person, routine can be painted with a broad stroke. It can mean that you wash up and brush your teeth before you get dressed; you go to work at 8 AM; you come home at 5PM. It can mean that you do your grocery shopping on Wednesday and your laundry on Saturday. In the case of someone with Alzheimer’s Disease, “routine” is defined in much tinier segments, and if one of those segments is upset, it can result in everything from simple confusion to a full blown rage attack.

Everything related to Sid’s life is planned and executed by me. It is a lot of work, but I have found that the work is better than the consequences, which range from a forgotten glucose reading to a temper tantrum. The following is an example of one of those minute segments to which I referred above:

Sid eats the same thing for breakfast every day – fresh blueberries; yogurt; sugar free juice; natural peanut butter and sugar free jelly on whole wheat toast. I set up his place at the counter with a placemat, spoon, knife, napkin, glass, his pill box, and his glucose meter. I put the bread in the toaster oven, but do not turn it on until he is seated. I put a plate in front of the toaster. When he is ready, he gets out of bed, gets dressed, and pushes his walker to the refrigerator. He places the juice, yogurt, peanut butter and jelly on his walker seat. He walks to the counter where the toaster oven rests, reaches over the counter to the bar counter, and places everything next to his placemat. He complains loudly that his shoulders hurt. He then takes his walker and pushes himself around the counter to sit on the bar stool. I have tried to explain that it would be easier and less painful to push everything around to the bar stool, sit down, and put the items up on the bar counter. His answer – This is the way I do it.

So what happens if I make one small change? This morning, he was engaging in his usual complaining about his shoulders as he reached across the counter to place his items up on the bar counter, I took his meter, placed it on his walker, and told him once again that it would be better to take everything around the corner on the walker. After he ate his yogurt, I inquired about his glucose level. Oops. Because his meter was not on his placemat, which routine dictates, he forgot to measure his blood.

If I happen to be busy with something else, and I do not have his place set up when he comes to breakfast, he is able to take the needed items out of the refrigerator, because that is his routine. However, he inevitably goes to the counter, forgetting the placemat, glass, pills, and meter, because that is usually set up for him. Depending upon how confused he is that particular morning, he will get the forgotten items in one trip or four. He may get the glass, and forget everything else, thus requiring more trips. Extra trips equal more frustration. More frustration equals a tantrum.

What I have described to you is one hour in our day. Everything he does for the rest of the day must be “in routine” or I suffer the consequences.

If your spouse is experiencing frustration, anger, tantrums, agitation, I would suggest setting up a full daily routine, consisting of the tiniest of segments and see if that helps the situation. I am willing to bet it will make both your lives calmer.

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©Copyright 2011 Joan Gershman
The Alzheimer Spouse LLC
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