The 36-Hour Day

by Mace, Nancy L.; Rabins, Peter V.

• ISBN13: 9780801861482
• ISBN10: 0801861489
• Format: Hardcover
• Copyright: 1999-04-01
• Publisher: Johns Hopkins Univ Pr

Summary

"I welcome with enthusiasm the third edition of this book for families and friends of patients with dementing illnesses. It has served well in its prior appearances and should accomplish even more with this edition." -- Paul R. McHugh, M.D., in the foreword Through two editions, this best-selling book has remained the "bible" for families who are giving care to people with Alzheimer disease. The 36-Hour Day has offered comfort and support to millions of people in North America and, in translations and adapted editions, throughout the rest of the world. For this third edition, the authors have retained the structure, scope, and purpose of the original book, while thoroughly updating chapters to reflect the latest medical research and the current delivery of care. Topics that have been added or extensively revised include: Updated terminology and statistics ? New material on the evaluation of persons with dementia ? Updated changes in laws on driving ? A new section on hospice care ? New information on assisted living facilities and financing care ? Information on other types of dementia ? The latest findings on eating and nutrition ? New medical research in areas such as drugs, genetics, and diagnostic tests. The revised appendices include: New bibliographic references ? websites ? Updated addresses of associations and state offices. Praise for previous editions: "The best guide of its kind." -- Chicago Sun Times "An excellent book for families who are caring for persons with dementia... A book that physicians can confidently recommend to the families of their patients." -- Journal of the American Medical Association "Excellent guidance and clear information of a kind that the family needs... The authors offer the realistic advice that sometimes it is better to concede the patient's frailties than to try to do something about them, and that a compassionate sense of humor often helps." -- New York Times "An excellent, practical manual for families and professionals involved in the care of persons with progressive illnesses... The book is specific and thought-provoking, and it will be helpful to anyone even remotely involved with an 'impaired' person... Highly recommended, especially for public and nursing libraries." -- Library Journal " The 36-Hour Day has served its readers well. The revised edition should be even more useful both to family caregivers and professional health care providers." -- HMO Practice "The reader who is familiar with the first edition will recognize the strengths that continue in the revised edition -- numerous case examples, practical advice, thoroughness of coverage, and communication of caring and humane attitudes while presenting information that may be sensitive and upsetting to families." -- Clinical Gerontologist

Table of Contents

Foreword	xv	(2)
Preface	xvii	(2)
Acknowledgments	xix	(2)
Preface to the First Edition	xxi
1 Dementia	1	(12)
What Is Dementia?	5	(2)
The Person with a Dementing Illness	7	(3)
Where Do You Go from Here?	10	(3)
2 Getting Medical Help for the Impaired Person	13	(9)
The Evaluation of the Person with a Suspected Dementia	13	(4)
Finding Someone to Do an Evaluation	17	(1)
The Medical Treatment and Management of Dementia	18	(4)
The Physician	18	(1)
The Nurse	19	(1)
The Social Worker	20	(2)
3 Characteristic Problems of Dementia	22	(24)
The Brain, Behavior, and Personality: Why People with Dementia Do the Things They Do	22	(4)
Caregiving: Some General Suggestions	26	(2)
Memory Problems	28	(1)
Overreacting, or Catastrophic Reactions	29	(5)
Combativeness	34	(1)
Problems with Speech and Communication	34	(6)
Problems the Impaired Person Has in Making Himself Understood	35	(2)
Problems the Impaired Person Has in Understanding Others	37	(3)
Loss of Coordination	40	(3)
Loss of Sense of Time	43	(1)
Symptoms That Are Better Sometimes and Worse at Other Times	44	(2)
4 Problems in Independent Living	46	(14)
When a Person Must Give Up a Job	47	(1)
When a Person Can No Longer Manage Money	48	(1)
When a Person Can No Longer Drive Safely	49	(4)
When a Person Can No Longer Live Alone	53	(7)
When You Suspect that Someone Living Alone Is Getting Confused	53	(2)
What You Can Do	55	(1)
Moving to a New Residence	56	(4)
5 Problems Arising in Daily Care	60	(39)
Hazards to Watch For	60	(5)
In the House	61	(2)
Outdoors	63	(1)
In the Car	64	(1)
Smoking	64	(1)
Hunting	64	(1)
Highways and Parking Lots	65	(1)
Nutrition and Mealtimes	65	(9)
Meal Preparation	65	(1)
Problem Eating Behaviors	66	(1)
Mealtimes	67	(3)
Malnutrition	70	(1)
Weight Loss	70	(1)
Choking	71	(1)
When to Consider Tube Feeding	72	(2)
Exercise	74	(1)
Recreation	75	(3)
Meaningful Activity	78	(1)
Personal Hygiene	78	(7)
Bathing	80	(1)
Dressing	81	(1)
Grooming	82	(1)
Oral Hygiene	83	(1)
Bathroom Supplies	84	(1)
Incontinence (Wetting or Soiling)	85	(5)
Urinary Incontinence	85	(3)
Bowel Incontinence	88	(1)
Cleaning Up	89	(1)
Problems with Walking and Balance; Falling	90	(4)
Becoming Chairbound or Bedbound	92	(1)
Wheelchairs	93	(1)
Changes You Can Make at Home	94	(5)
Should Environments Be Cluttered or Bare?	96	(3)
6 Medical Problems	99	(20)
Pain	100	(1)
Falls and Injuries	101	(1)
Pressure Sores	101	(1)
Dehydration	102	(1)
Pneumonia	102	(1)
Constipation	103	(1)
Medications	104	(2)
Dental Problems	106	(1)
Vision Problems	107	(1)
Hearing Problems	108	(1)
Visiting the Doctor	109	(1)
If the Ill Person Must Enter the Hospital	110	(2)
Seizures, Fits, or Convulsions	112	(1)
Jerking Movements (Myoclonus)	113	(1)
The Death of the Impaired Person	113	(6)
The Cause of Death	113	(1)
Dying at Home	114	(1)
Hospice	115	(1)
Dying in the Hospital or Nursing Home	115	(1)
When Should Treatment End?	115	(1)
What Kind of Care Can Be Given at the End of Life?	116	(3)
7 Problems of Behavior	119	(29)
The Six R's of Behavior Management	119	(2)
Concealing Memory Loss	121	(1)
Wandering	122	(7)
Reasons Why People Wander	122	(2)
The Management of Wandering	124	(5)
Sleep Disturbances and Night Wandering	129	(2)
Worsening in the Evening	131	(2)
Losing, Hoarding, or Hiding Things	133	(1)
Rummaging in Drawers and Closets	133	(1)
Inappropriate Sexual Behavior	134	(2)
Repeating the Question	136	(1)
Repetitious Actions	137	(1)
Distractibility	137	(1)
Clinging or Persistently Following You Around	138	(1)
Complaints and Insults	139	(3)
Taking Things	142	(1)
Forgetting Telephone Calls	142	(1)
Demands	143	(2)
Stubbornness and Uncooperativeness	145	(1)
When the Sick Person Insults the Sitter	146	(1)
Using Medication to Manage Behavior	147	(1)
8 Problems of Mood	148	(16)
Depression	148	(1)
Complaints about Health	149	(1)
Suicide	150	(1)
Alcohol or Drug Abuse	150	(1)
Apathy and Listlessness	151	(1)
Remembering Feelings	151	(1)
Anger and Irritability	152	(1)
Anxiety, Nervousness, and Restlessness	153	(2)
False Ideas, Suspiciousness, Paranoia, and Hallucinations	155	(7)
Misinterpretation	155	(1)
Failure to Recognize People or Things (Agnosia)	156	(1)
"My Mother Is Coming for Me"	157	(1)
Suspiciousness	158	(2)
Hiding Things	160	(1)
Delusions and Hallucinations	161	(1)
Having Nothing to Do	162	(2)
9 Special Arrangements If You Become III	164	(4)
In the Event of Your Death	165	(3)
10 Getting Outside Help	168	(18)
Help from Friends and Neighbors	168	(1)
Finding Information and Services	169	(2)
Kinds of Services	171	(3)
Having Someone Come into Your Home	172	(1)
Adult Day Care	172	(2)
Day Hospitals	174	(1)
Short-Stay Residential Care	174	(1)
Planning in Advance for Home Care or Day Care	174	(1)
When the Confused Person Rejects the Care	175	(2)
Your Own Feelings about Getting Respite for Yourself	177	(2)
Locating Resources	179	(2)
Paying for Care	181	(2)
Should Respite Programs Mix People Who Have Different Problems?	183	(1)
Determining the Quality of Services	183	(2)
Research and Demonstration Programs	185	(1)
11 You and the Impaired Person as Parts of a Family	186	(19)
Changes in Roles	188	(3)
Understanding Family Conflicts	191	(3)
Division of Responsibility	192	(2)
Your Marriage	194	(1)
Coping with Role Changes and Family Conflict	194	(4)
A Family Conference	196	(2)
When You Live out of Town	198	(1)
When You Are Not the Primary Caregiver, What Can You Do to Help?	199	(1)
Caregiving and Your Job	200	(1)
Your Children	201	(4)
Teenagers	203	(2)
12 How Caring for an Impaired Person Affects You	205	(21)
Emotional Reactions	205	(12)
Anger	206	(3)
Embarrassment	209	(1)
Helplessness	210	(1)
Guilt	210	(3)
Laughter, Love, and Joy	213	(1)
Grief	214	(1)
Depression	215	(1)
Isolation and Feeling Alone	216	(1)
Worry	216	(1)
Being Hopeful and Being Realistic	217	(1)
Mistreating the Confused Person	217	(1)
Physical Reactions	218	(2)
Fatigue	218	(1)
Illness	219	(1)
Sexuality	220	(2)
If Your Spouse Is Impaired	220	(2)
If Your Impaired Parent Lives with You	222	(1)
The Future	222	(3)
You as a Spouse Alone	223	(2)
When the Person You Have Cared for Dies	225	(1)
13 Caring for Yourself	226	(13)
Take Time Out	227	(3)
Give Yourself a Present	228	(1)
Friends	228	(1)