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Friday, November 16, 2012

Traveling with Food Memories

By Steven Mattingly

I’ve created a BIG problem for myself in a couple of weeks.  Our community throughout 2012 has participated in something we call the “Passport Dining Series”.  Each month we have created a unique dining experience by visiting different parts of the world.  Among others we have had Breakfast in Paris, dined on the varied cuisine of Italy, and celebrated Bosnian cuisine.  Bet you didn’t see that one coming now did you?

The next place that we will visit doesn’t exist in the real world and that is the problem that I have created for myself.  Many who read this blog know that I am a former chef who realized early in his career that I wasn’t going to be the next Wolfgang Puck or even a mediocre executive chef.  I left the 90 hour work week of food and beverage when I came to my senses and began a career in the world of senior housing.  But the urge to prepare food for the masses never really leaves you.  My family will attest to that as does my expanding waistline.   So every now and then (it’s usually around the holidays) I have the hair brain idea that I will cook a meal for the community and that is what I am doing in two weeks.  The place I want to visit doesn’t exist anymore; it’s mealtime at my mother’s kitchen table located in the house that she and my father built on Rural Route 2, Saint Mary’s Road, Lebanon, KY  40033 more than 50 years ago. 
How can I tell the story of that place in the foods that I prepare?  Do I cook the fried chicken that my wife recalls my Mother lovingly showed her how to make when she was a very new bride more than 30 years ago or do I make the Sunday Dinner Pork Chops that she made just like her mother, my Memmaw.  I could make the Cincinnati style chili that was a cold night favorite or my all-time favorite of beef hash with fried cornpone (who knew she was ahead of her time frying polenta cakes).  I could make the 60’s favorite tuna Noodle Casserole from which I picked out all those little bits of mushrooms or the other 60’s dish of Macaroni and Cheese made with Velveeta.  I remember orange Jell-O cubes served as dessert with real whipped cream as much as I remember the chocolate birthday pies that she made for me each year.  Or the divinity fudge that was a Christmas staple along with the regional black walnut cake made with black berry jam. I could make her most famous disasters, the pickled bologna that eventually sat in the refrigerator until it truly turned green.  So many ways I could get to that special place.  It’s overwhelming to consider it all.

I committed to taking our community to this special place more than a month ago. It’s only a couple of weeks away and I still am trying to decide on the perfect menu that will be transport our community to the place that I called home.  What I have to remember is that just like when we all were growing up, the meal will happen, the warm hands and hearts of our care giving team will make sure that we get where we need to be at just the right time, and I will somehow just like my Mom did each and every day I ate at her table, create a memory for the community albeit a fleeting one for many.

As I get older and my vision of my life as a senior become clearer, I see how those little journeys that we have taken this year really are important to our community.  If even for a brief moment a special smell or taste or atmosphere provokes a memory, it’s a good thing.


Contributing author Steven Mattingly is the Executive Director of Pacifica Senior Living in San Leandro, CA.


Wednesday, November 14, 2012

Winter Holiday Season Caregiving Tips for Families with Loved Ones with Dementia




'Tis the season to be jolly. Or is it?

While those facing Alzheimer's disease or a related illness in their family might question the sentiment, experts say that it is possible to not only keep the cheer in the holidays, but also to savor them.

Some suggestions you might want to consider from the Alzheimer’s Support Organization:

·  Communicate concerns. In advance of the holidays, be candid with family and friends about your loved one's condition and your concerns, and enlist their support. In cases where resentment brews because one family member assumes the primary caregiving role, use this season of giving as an opportunity to discuss sharing family responsibilities and to strive for family togetherness.
·  Set realistic expectations. Consider both what the individual with dementia is capable of and what you, as a caregiver, can handle given your demanding role. Then, put celebrations into manageable proportions. This can help decrease stress and head off feelings of depression that stem from unrealistic expectations, both for you and your loved one.
·  Select appropriate activities. Be mindful of the individual's current mental condition and do special things that they can still appreciate. Engage your loved one in singing and dancing since these abilities tend to remain intact longer. Involve them in some rituals—whether it is lighting the menorah, decorating the tree or baking cookies. Try to spark memories by bringing out family photographs or heirlooms. But do not demand mental performance by asking them to name people, places or other facts. Rather, help stimulate memories by offering descriptions as you present each object.
·  Pare down traditions. With round-the-clock caregiving, it may not be feasible to juggle all of your religious and ethnic observances. You can still keep traditions alive; just reduce their number to avoid feeling overwhelmed and frustrated. Ask your loved one which traditions to choose; it is another way to involve them. Even though they may not recall later on, making the effort reinforces the fact that you care what is important to them and will make you feel better as a caregiver.
·  Adapt family gatherings. Since crowds, noise and altering routines can aggravate confusion and other behavioral problems, revising your get-togethers may be in order. For example, instead of entertaining the whole clan, limit the number of attendees at a holiday dinner or spread out several smaller gatherings on different days. Mark a calendar with upcoming visits to make your loved one feel special.
·  Stick with familiar settings. Because new environments can increase disorientation and pose safety concerns, discard restaurants or relatives' houses in favor of your own home. Likewise, if Mass is still important to your loved one, consider how they can participate. For example, take your loved one to an earlier, less crowded service; if they are unable to go to church, watch a Mass on TV or ask clergy to make a house call.
·  Head off problems. Avoid alcohol, which may cause depression, increase the risk of falls and add to the loss of brain cells. Try to schedule holiday activities or visits earlier in the day before the potential for sundowing - behavioral problems that typically occur toward dusk among those in the middle stages of dementia. And, in preparing for holiday celebrations, do not re-arrange furniture or create obstacles-both are accidents waiting to happen.
·  Limit holiday decorations. Decorations can still adorn your home, but in moderation. Hang cheerful ones that recall memories and family traditions. Do not overdo the ornaments on a Christmas tree. Remember that hauling out a lifetime of garlands, religious items and wall decorations can clause clutter and over stimulation, which can intensify disorientation and agitation. Ensure, even more than usual, that decorations do not block pathways or pose potential fire hazards.
·  Re-think gift giving. Devise ways to include your loved one, depending on their capabilities. You might take them to a store to buy presents, and offer extra guidance. Or, you can buy the gifts for them and wrap them together since many individuals with dementia like handling paper. In giving presents, pick ones appropriate for someone with the disease. Instead of something material, try things that are simple, personal and sentimental. For example, photographs and heirlooms provide the opportunity to reminisce—a gift in itself.
·  Welcome youngsters. While it is important to include children, it is just as vital to consider their feelings. Address the fear factor by helping them have special moments with their relatives. If their loved one uses inappropriate language or easily becomes angry during the visit, explain that this behavior is not personal or intentional; it is part of the disease. Youngsters' excitement about the holidays can be contagious. Singing songs together can strike a chord for someone with dementia. Or having an elder teach dominoes to children is a good way to foster interaction and make your loved one feel they have something to offer.
·  Join a support group. A forum to express feelings and socialize can help overcome sadness for both caregivers and individuals in the early stages of dementia. Unfortunately, the incidence of depression ranks high during and after the holidays. Consult with a healthcare professional if you detect warning signs of depression: tearfullness, poor eating habits, withdrawal, inability to sleep, and physical complaints.
·  Enjoy yourself. The greatest giftat the holidays: time. Ask a family member, friend or healthcare professional to keep your loved one company so you can relish some respite—time for some holiday shopping, a walk in the park, checkers with an old friend or whatever present you want to give yourself.


Contributing author Steven Mattingly is the Executive Director of Pacifica Senior Living in San Leandro, CA.