The Whitworths of Arizona, bringing science to you in everyday language.

Friday, June 22, 2018

Constructive Caring, #6: Dealing with Externals

The past blogs have mostly been about how you can think and act more constructively and make your own life and that of the PlwD's* happier, healthier and just plain easier. But sometimes, life intervenes and things beyond your control happen that are difficult to deal with. Nevertheless, you still have the power to choose how to deal with these unhappy events. By making conscious choices about how you view them, and how you think about them you can limit their negative effect on you and on your loved one.
  • Look for the blessings. Instead of complaining, look for how the situation adds something to your life...interest, learning, experiences, etc "The worst service I ever had" becomes, "I'm glad we went there. Now I'll know not to go again!" "I lost again. I'm so unlucky." becomes "I sure had fun playing that game with you."
  • Look for the silver lining even when things are truly bad and painful. You will naturally have some negative feelings--and rightfully so. Nevertheless, instead of allowing yourself to wallow in the negativity, look for that silver lining. "My mother has passed away and I really miss her but I feel so fortunate to have had her in my life."."
  • Avoid feeling guilty. People often use guilt as an effort to control past events--it doesn't work. Your guilt will not change anything except to make you feel worse. Instead make a conscious choice to find something to feel better about. Instead of "I feel so bad that I wasn't always a good daughter, think, "We had some great times together."
  • Look for the humor. Sometimes you may have to dig to find the positives but make it a fun challenge. "This trip is so disastrous that I know we'll laugh about later."
Criticism. One of the most difficult things a care partner has to deal with is criticism from family and even friends of a situation that they may not know as much as about as they think they do. Even when meant well, criticism can be difficult to deal with and if a person is already into self-blame, it can be catastrophic. Here are some guidelines to making criticism a little easier to deal with:
  • Listen carefully. This is often the hardest part, especially if you don't believe the criticism is fair.
  • Take a deep breath and think before you respond.
  • Who is this about? "Is this about me, or them?" Is the them the PlwD*, who feels bad, and sees you as responsible for everything. Is the them a family member who is in denial or uneducated about the situation?
  • Can this help me? Even if it is more about the other person than you, could the criticism be constructive? How? Will it add more information, more ideas? Or will it add to your own self-blame, guilt or worry?
  • Choose to reply or let it go. Feel free to ignore a criticism if it isn't helpful.
    --With the PlwD, you may have to respond in some way so that they feel heard, but then you can move the conversation on into something more positive.
    --With uneducated family members who see Showtime** as the PlwD normal behavior, you will have to decide if they will accept or understand further education about LBD. Printed handouts from the LBDA or a medical source may work better than your own explanations.
  • If you reply, stay positive, ask questions as needed and say "Thanks." Saying "Thanks" does not mean that you agree with the person, only that you appreciate their interest.
    --With a PlwD who is blaming you because of a delusion, you must not deny the accusation. Instead, become an improv actor and say you are sorry. (See blogs on dealing with delusions)
  • Review. Make a conscious choice to accept the critique as constructive if you can find anything of value in it. Then plan how you will make any needed changes. Otherwise, consider it destructive and therefore, not worth your time.
  • Let it go. Once you know of the issue (if there really is one), and have decided how to deal with it, the criticism's job is done.
Next week: On to happier topics, like how to have enjoy being positive and have fun with it.

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

We love and welcome comments but we will not publish any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures and marijuana.

** Showtime: When a PlwD is experiencing a period of more than normal awareness. Often occurs with visiting family members or during doctor visits.

* Acronyms:
AD: Alzheimer's disease
BPSD: Behavioral and psychological symptoms of dementia
DLB: Dementia with Lewy bodies, where cognitive/behavioral issues occur first
LBD: Lewy body dementia, an umbrella term for both DLB and PDD
LBDA: Lewy Body Dementia Association. LBDA.org
MCI: Mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
PD: Parkinson's disease
PDD: Parkinson's disease with dementia, where mobility issues occur first
PlwD: person/people living with dementia
PlwPD, LBD, PDD, AD, etc.: person/people living with PD, LBD, etc.

For more information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Friday, June 15, 2018

Constructive Caring, #4: Changing Habits

OK, you've lowered your stress level, belong to a great support group, and are aware of some negative thinking habits that you want to change. Now what? Will those negative thoughts just disappear? Sorry, it doesn't work that way. Negative thinking is a habit that takes commitment, time and effort to change. However, people do it all the time and you can too!

To change a habit, you need to notice a specific behavior and make a conscious, personal commitment to change it to a viable alternative. Write this down and tell someone else. Then do it. Reward yourself when you succeed and be gentle with yourself when you forget, and keep trying until the change becomes a habit. (Reference)

Now let's break this down:
  • Notice: You have to be aware of what isn't working before you can change it to anything else.
  • Conscious: Negative thinking is often automatic, like a PlwD's.* But because you can think abstractly, you can make purposeful choices that put you on the road to change.
  • Personal: This is about you, not the PlwD or anyone else. Changing for someone else is like trying to make a bed with a ten-foot pole. It can be done, but not very easily, not very well and the effort seldom lasts long enough to get the job completely done. 
    "I will notice when I use all or nothing thoughts and stop using them."
  • Specific: The more specific your commitment is, the more effective it will be. Chose one specific type of negative thinking and focus on changing it to something more constructive.
    "I will notice when I use extreme, all or nothing, words like "always," "never" in my thoughts and stop using these words."
  • Viable alternative: If you try to stop a behavior or a way of thinking without providing a replacement behavior, you leave a vacuum. Your brain will backfire and go into its default mode of worry. The replacement also has to be something that will work for you. If it isn't, your brain will balk again and the change won't happen.
    "I will notice when I use extreme words in like "always," "never" and change them to more accurate words like "sometimes," "this time."
  • Write it down. Once your commitment statement is complete, reinforce it by writing it. Now the information gets to travel to your brain via another pathway. It is also something you can look at every day and use as a reminder.
  • Tell someone else: You are more likely to stay on track if someone else knows about your commitment. Utilize your positive friends as role models and sounding boards. They can also confront any exaggeration of "mistakes" into "failures."
  • Do it. Making a change requires overcoming the fear that you won't do it right, or that you might even fail and practicing the change over and over.
  • Reward yourself. When you catch yourself exaggerating, stop and say something more accurate, give yourself a verbal pat on the back, a compliment--and mean it. "Hey, I did it. I'm getting more specific by the minute!" Your brain views sincere compliments as positively as it does a material gift.
  • Be gentle. When you forget and exaggerate--and you will!--be as compassionate with yourself as you would be with a friend. Use the experience as a learning tool. Feel the guilt long enough to own the mistake. Then worry about it long enough to consider how to keep from doing it again. With that, the value of guilt and worry is over. Let them go.
  • Keep on keeping on. Notice, commit, practice, reward, share, and do it again and again. Don't expect to change overnight. Researchers now say that it can take 2-6 months to change a habit. So be patient, keep working, keep rewarding yourself and keep talking about your successes.
Eventually, you will find that you are automatically using more accurate words instead of extreme words. You aren't making conscious choices anymore, it just comes naturally. It's a habit! With that done, you can start over and change another habit.

With each negative thinking habit you change to something more constructive, you will also experience some longer lasting rewards. Every so often, stop and take inventory. Are you happier? Do you feel better? Is your health better? What about your loved one? Is the same true for them? Are there fewer negative behaviors? Are they more content? And finally, own the constructive changes you've made and give yourself lots of credit.

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

We love and welcome comments but we will not publish any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures and marijuana.

* Acronyms:
AD: Alzheimer's disease
BPSD: Behavioral and psychological symptoms of dementia
DLB: Dementia with Lewy bodies, where cognitive/behavioral issues occur first
LBD: Lewy body dementia, an umbrella term for both DLB and PDD
MCI: Mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
PD: Parkinson's disease
PDD: Parkinson's disease with dementia, where mobility issues occur first
PlwD: person/people living with dementia
PlwPD, LBD, PDD, AD, etc.: person/people living with PD, LBD, etc.

For more information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Friday, June 8, 2018

Constructive Caring, #5: Staying On The Path

Blogs in this series have been discussing ways to be a more constructive care partner, how to work towards being more positive. This isn't something that stops. It gets easier, but it still requires vigilance. Staying in that pleasant valley of positivity is not automatic. Roadblocks like stress and isolation still lurk just around the bend, ready to push you back up that mountain of negativity, where the terrain is steep and rocky, the air is thin and the weather uncertain at best. But don't despair, the closer you get to being positive, the easier it is to stay that way. Ways to do that are the focus of this blog.

First a very quick review of some of the stuff in previous blogs:
  • Keep on monitoring your stress, surrounding yourself with positive people, making conscious choices, and turning negatives thoughts into positives ones.
  • Live a healthy life, where you take care of your own health, psychological and social needs as well as you do the PlwD's.
Next, here are some more from one of my favorite bloggers, Eric Barker:
  • Foster optimism. Care partners cam get caught up in irrational expectations, wanting life to go back to how it was. This keeps you stuck in failure and disappointment. Accept what is and you will be able to see many more possibilities.
  • Face your fears. Hiding from fear makes it worse. Face it and you overcome it--and that is a euphoric feeling!
  • Practice spirituality. Whatever your spiritual beliefs, practice them actively. It will give you strength and joy.
  • Use role models. Find people you want to be like and imitate them. If you know some you don't want to be like, use their behavior as a guide for how not to live.
  • Be a lifelong learner. Take time each day to learn or experience something new. Keep your brain sharp and it will give you solutions when you need them most.
  • Be cognitively flexible. Humans tend to find a way to do things and when that doesn't work anymore, they simply try the same thing but with more effort. Be willing to try something else. Step back and look at the problem a different way.
  •  Have meaning in your life. It is easy to get mired in the exhausting, time-consuming work of caregiving. However, the job can also be very rewarding. Take a deep breath and look for the rewards and the purpose. Remind yourself why you are doing this. How does this job have meaning for you? How do you find it rewarding?
It does get easier. With time and dedication, making conscious choices to be positive become habits that seem almost effortless. Well, maybe not THAT easy....you still have to continually deal with all those care partner roadblocks, but that gets easier too. The further out of the bad weather and rocky terrain of negativity you get, the easier the load is, even though you have the same tasks.

Next week: Overcoming the external stuff.

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

We love and welcome comments but we will not publish any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures and marijuana.

* Acronyms:
AD: Alzheimer's disease
BPSD: Behavioral and psychological symptoms of dementia
DLB: Dementia with Lewy bodies, where cognitive/behavioral issues occur first
LBD: Lewy body dementia, an umbrella term for both DLB and PDD
MCI: Mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
PD: Parkinson's disease
PDD: Parkinson's disease with dementia, where mobility issues occur first
PlwD: person/people living with dementia
PlwPD, LBD, PDD, AD, etc.: person/people living with PD, LBD, etc.

For more information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Friday, June 1, 2018

Constructive Caring, #3: Conscious choices

The second blog in this series was about a couple of roadblocks to being a more constructive care partner. While it is true that positive thinkers function better over time than negative thinkers, our own brains make that an uphill battle. Last week's blog was about how our brains see negative stuff as urgent and how they resist change. Anything that causes negative emotions quickly and emphatically grabs our attention and is rushed into long-term memory. (Go back and read it if you haven't already.)

This means that without some conscious effort, what we think and say is likely to be mostly negative. Add other roadblocks a care partner faces, such as stress and isolation, and you may feel that trying to think constructively requires far too much effort in an already overburdened life. It doesn't and the rewards are huge. Because you can make conscious choices, you can gradually decrease your negative thinking by consciously doing and saying things that make you feel good, happy and contented.

You can choose to stop a negative thought and choose a different way to consider the issue. Make your goal thinking "in a different way," not "thinking positively." That's because 80% of us have naturally negative brains that get scared about "thinking positive" and backfire with worry. Instead, think "work on changing to something more helpful, something that feels better, something fun even."
  • Be specific and accurate.  Extreme or catastrophic thoughts are usually too polar to be accurate. Being more moderate helps you be more specific, and thus more accurate and allows you to see the positives, and to see the negatives in more perspective. "All the time" becomes "today." "Never" becomes "not right now." "Terrible" becomes "not quite what I had in mind." "Failure" becomes a single mistake.
  • Look for the challenge, instead of looking for the worst that could happen. "I'll never be able to do that," becomes. "What do I need to learn to be able to do that?" "This cake is terrible" might become "I think adding vanilla would improve this cake." "I'm such a failure" becomes "I need to learn more about how to do that job."
  • Be your own friend. When you realize you are put yourself down, stop and say to yourself what you'd say to a friend. Instead of "Well that was stupid!" say, "We all make mistakes." Instead of "I'm just not good at that," try, "I'm still working on that." Instead of "I'm so dumb." try "I don't understand." 
  • Look at the broader view and accept that some things just happen instead of playing the self-blame game. You are not responsible for every little thing that goes wrong. Accept that feeling guilty won't change the past and worrying won't change the future.
Making these changes doesn't happen over night. It takes time to change any habit, and negative thinking is a habit. We used to think it took about three weeks but new research is saying more like two to six months! So give yourself credit for the changing you do manage and keep working at it.
Next: Changing negative habits to more constructive ones.

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

We love and welcome comments but we will not publish any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures and marijuana.

* Acronyms:
AD: Alzheimer's disease
BPSD: Behavioral and psychological symptoms of dementia
DLB: Dementia with Lewy bodies, where cognitive/behavioral issues occur first
LBD: Lewy body dementia, an umbrella term for both DLB and PDD
MCI: Mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
PD: Parkinson's disease
PDD: Parkinson's disease with dementia, where mobility issues occur first
PlwD: person/people living with dementia
PlwPD, LBD, PDD, AD, etc.: person/people living with PD, LBD, etc.

For more information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Friday, May 25, 2018

Constructive Caring, #2: Identifying the Roadblocks

The first blog of this series was about the many advantages of being a positive care partner. However, that isn't always easy, as any care partner knows.
  •  Living with negativity can be like being is high on a mountain, where there isn't enough oxygen, the path is steep and rocky and the weather is so bad that you can't see more than a few feet in front of you.
  • Every step you take is scary and every step gets harder because you are getting more and more tired. But you feel stuck. You feel like you just have to keep climbing. 
  • But you don't. Once you recognize your power of choice, you can stop, make a conscious choice to be positive and head back down the mountain. 
  • The weather will get better, your path will be less steep, the scary rocks will turn to gravel and your energy level will improve. 
  • Being negative uses up your energy and makes you feel tired and hopeless. The longer you stay negative, the harder life gets. 
  • In contrast, the longer you stay positive, the easier life gets. You literally do have more oxygen, for example. You still have the same tasks but they seem easier and more doable.
This blog discusses some of the roadblocks that keep you from getting down that mountain where positivity makes life easier.

Roadblock #1: Stress. Choices, especially conscious choices require abstract thinking. That's something we learn to do as we grow up and use all the time without even realizing it. However, when you get so caught up in caregiving that you become stressed and overwhelmed, you lose the ability to think clearly or be flexible.
  • These stress-related, dementia-like symptoms immobilize you and keep you stuck making the same choices you've been making, even when what you are doing becomes continually harder and less rewarding. 
  • You will likely need help to escape the stress/negative thinking/more stress cycle. This is often a crisis of some sort. Sometimes, it is a confrontation from family or friends but all too often it is an accident, such as a loved one's fall or the care partner's injured back. 
  • Once you've decreased your overwhelming physical, emotional and mental burden, you can do other things. But getting help comes first. Care partnering is not a one person job. 
GET THAT HELP!

Roadblock #2: The company you keep. As humans, we tend to pick up and reflect the attitudes of those around us. Like yawns, both negative and positive emotions are contagious.
  • Round one: When the PlwD* loses the ability to make choices, negative thinking becomes their norm. As their closest companion, you will pick up and experience that negativity too.
  • Round two: An expert at perceiving other's feelings, The PlwD takes on your negative emotions as their own and mirrors them back to you, often as BPSD.*
  • Round three: You react negatively to the behaviors and it goes on and on, round after round.
But you have the power of choice! You can choose to interrupt this cycle.
  • Add positive people to your life, even if just online. 
  • With them as role models, you will find it will be easier to combat that immobilizing stress, think more positively and then feel better. 
  • The PlwD will mirror your positive feelings just like they did your negative ones and they will feel better too.
VIEW HAVING POSITIVE PEOPLE IN YOUR LIFE AS IMPORTANT AS GETTING THE RIGHT MEDICAL TREATMENT!

Roadblock #3: Isolation. Reaching out may not be all that simple, however.
 Caregiving is demanding in time and energy, and "adding positive people to your life" may take a back seat to the other jobs you have to do. Then, when you do, it isn't unusual to find that old friends or even family can't relate with the things that take up your attention or worse, that they don't understand.
  • And so you stop reaching out and isolate yourself that much more. It becomes easier and easier to feed into that cycle of negativity between you and your loved one. 
  • That's where support groups come in. If you are fortunate, you have family and/or friends that can be there for you in a positive way. But often, no, usually, you need more. 
  • You need to connect with people who are experiencing the same things you are and are still managing to be positive. Even if you have a hard time getting out, you can go online and connect with positive people there. Many care partners use both local and online groups. 
FIND A CAREGIVER SUPPORT GROUP AND PARTICIPATE.

Roadblock #4: Our basic negativity. Negative emotions are naturally strong. They need to be to get your attention in times of danger and push us towards safety. These stronger emotions can take over, especially in times of stress, requiring you to make conscious choices to change from being negative to being positive. The next blog is about how you change the way you think so that you can turn around and go back down that mountain of negativity.

*Acronyms:
AD: Alzheimer's disease
BPSD: Behavioral and psychological symptoms of dementia
DLB: Dementia with Lewy bodies, where cognitive/behavioral issues occur first
LBD: Lewy body dementia, an umbrella term for both DLB and PDD
MCI: Mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
PD: Parkinson's disease
PDD: Parkinson's disease with dementia, where mobility issues occur first
PlwD: person/people living with dementia
PlwPD, LBD, PDD, AD, etc.: person/people living with PD, LBD, etc.

For more information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Friday, May 18, 2018

Constructive Caring, #1: Introduction

This is the first blog in a series about being a constructive care partner. At one time, I'd have said it was going to be about being a positive care partner, but times have changed. As researchers learn more, we learn to use different words. We all hear a lot about the value of being positive and it's all very true. Being positive makes you happier, healthier and even smarter. And, it makes you a more effective care partner. The more positive you are, the happier and more content your loved one will be.

But there's a glitch. Most people (80%) have brains hard-wired to be negative. Add the normal stress of caregiving, and even the few naturally positive care partners more likely than likely have negative brains. Telling a negative brain to "be positive" is too big a leap; it shorts out and goes into "worry," its default mode.

"Being constructive" is about working towards a goal, about gradually building a better life for you and your loved one, not a done deal like "being positive." That's our first work-around--watch for others! Negative people still have positive feelings--they just need noticing and nurturing. Sometimes, these get lost in the business of living, when the logistics of caregiving get in the way and the "fun" things aren't even noticed, let along enjoyed. (Reference)

The problem with negative emotions is that the brain views anything causing them as dangerous and therefore, urgent. These feelings grab our attention quickly and emphatically, overshadowing everything else. Then this "urgent" information gets pushed immediately into long term memory, bypassing much of the abstract thinking that keeps us on an even keel. Thus, negative thinking can be similar to that of the person living with dementia--and of stressed-out care partners: general, polarized, catastrophic, and personalized.

In contrast, equally important but non-urgent positives are processed slowly. Even after they get past those grabby negative emotions and manage to attract your attention, you have to keep them on your radar for over ten seconds to be remembered. A lot can--and does--slip by in that time. Work-around #2: Make a conscious choice to be aware of words, things, people and events that make you feel good. Once you notice them, make a conscious choice to pay attention to them and enjoy them.

"Why?" you ask. "Why should I spend my already limited time and energy on this? Why not just flow with it and accept the pain, the anger, the worry, the fear? Isn't that real life? Isn't it rather Pollyannaish to try to make it all more positive, uh, constructive?"

Ah, but Pollyanna was a happy person! The advantages of being happy are great for the individual and even greater for a dementia care partner because you are "feeling for two." That is if you choose to be happy, your loved one will mirror this and feel happier too. That's the first advantage, but there are a lot more:
  • Your loved one's happier, more content attitude will result in fewer dementia-related behaviors.
  • With less energy wasted on energy-hogging negativity, you will actually have more energy for your job, your loved one, others, yourself and life in general.
  • You will be healthier. Positive people are less at risk for most diseases, including dementia.
  • You will be less stressed, thus have more energy and clearer thinking.
  • With a clearer mind, you will see the broader picture and make better decisions.
  • You will accomplish more, resulting in better self-esteem.
  • You will feel emotionally stronger and better able to face the tasks you must do.
While caregiving can still be overwhelming, you will find it easier when you do it with a positive, can-do attitude. The more positive you become, the more others will enjoy being around you and you'll find that your positive attitude will rub off on them.

Next week: more about negativity and making conscious changes.

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

We love and welcome comments but we will not publish any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures and marijuana.
*Acronyms
AD: Alzheimer's disease
DLB: Dementia with Lewy bodies, where cognitive/behavioral issues occur first
LBD: Lewy body dementia, an umbrella term for both DLB and PDD
MCI: Mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
PD: Parkinson's disease
PDD: Parkinson's disease with dementia, where mobility issues occur first

For more information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Friday, May 4, 2018

Dental Care

You may have noticed that your loved one isn't brushing their teeth so much anymore. Dental care is important for a variety of reasons. The bacteria from inflammation of the gums and dental plaque is linked with heart disease, pneumonia, stroke, diabetes, dementia and rheumatoid arthritis. It is important to maintain good dental hygiene and continue regular checkups. However, this can all become difficult and easy to skip.
  • If LBD* is involved, they may have forgotten the steps involved in brushing. "Do I put the toothpaste on the brush before or after I rinse it off?" "How do I brush?" "What do I do with all the fluid and foamy toothpaste that ends up in my mouth?"
  • Age, illness, some medications and dementia itself can decrease saliva output, creating "dry mouth" which can make toothpaste and mouthwash taste different, and possibly unpleasant. The efficiency of taste buds also fades with age, changing the person's taste preferences.
  • Your loved one may no longer understand the need for brushing and may not want to be bothered, especially since they may need to be helped to do it correctly. 
As you do with other activities of daily living, encourage the PlwD to do as much brushing and flossing as possible on their own and help only when you really must. Here are some tips that may help if you have to do the brushing:
  • Monitor your attitude. Make this as fun as you can and it will be much more pleasant for both of you. Try not to argue or be bossy. If, for instance, it feels awkward to do something so personal for a parent, get over it. The more comfortable you are, the more comfortable the PlwD will be--and the more accepting of your help.
  • To address the dry mouth issue, have your loved one rinse their mouth with water right before starting care.
  • Have them sit in a comfortable chair with you seated slightly behind them.
  • Use a soft toothbrush to gently but thoroughly brush their teeth.
  • Be careful not to tilt back the head when you brush. This can cause aspiration of liquid into the lungs.
  • An electric toothbrush is usually faster than doing it by hand and therefore, less annoying. If the noise of the brush or the vibrations produced by the fast-moving bristles is upsetting, you may have to revert to using a regular toothbrush.
  • Experiment with toothpastes and mouthwashes to find ones the PlwD likes. Brushing without toothpaste is still very effective. Mouthwashes help to control bacteria, but may irritate the gums. Try diluting the mouthwash with some water or else try another brand. Stop using mouthwash if it becomes an issue.
Thanks to Health After 50's article on Dementia Care: Oral Hygiene for most of the information in this blog.

We love and welcome comments but we will not print any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures.

* Acronyms:
LBD: Lewy body dementia
PD: Parkinson's disease
DLB: dementia with Lewy bodies
PDD: Parkinson's disease with dementia
MCI: mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
BPSD: behavioral and psychological symptoms of dementia

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.