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• Spring 2008 Symposium
• Do People with Alzheimer's Experience Grief?
• Laurie White returns to Texas in 2008
• Alzheimer's Art Quilt Initiative
• Holiday Gift Acknowledgments

Our chapter will present “Walking the Positive Path:  Advances in Dementia Care,” our major annual spring symposium, on Wednesday, March 26, 2008.  As in recent years, the symposium will be held at the MacGorman Conference Center located on the campus of Southwestern Baptist Theological Seminary in Fort Worth.

This educational event highlights local professionals who will provide an array of breakout sessions addressing topics of interest for professionals and family caregivers.  Over the course of the day, attendees will have three breakout sessions with over 12 topics from which to choose.  There will be two primary tracks, one for caregivers and one for professionals.  However, attendees are welcome to choose any session.  The breakout sessions will cover a variety of topics with many practical ideas for improving the life of the persons with dementia as well as their caregivers.

Continuing education credits will be offered for the following disciplines:  Activity Professionals, Assisted Living Administrators, Long-Term Care Administrators, Nurses and Social Workers.  The cost of the workshop is as follows:    

The spring symposium will also provide the opportunity to learn more about senior services by visiting over 40 vendors in the exhibit hall.  You will have the opportunity to talk with representatives of local service providers such as memory care facilities and home care agencies.  You might even win a door prize!

Our keynote speaker for the spring symposium will be Geri Richards Hall, Ph.D., ARNP, CS, FAAN.  Dr. Hall is a clinical nurse specialist in gerontology with Banner Alzheimer’s Institute and adjunct professor with the University of Iowa, College of Nursing.  She has written many articles and editorials for professional journals.  She has also spoken at many professional conferences on topics such as “Managing Difficult Behaviors,” “Restraint Reduction in Acute Care” and “The Confused Driver.”

In addition to Dr. Hall’s keynote address, she will facilitate a problem solving session for caregivers and speak on “Non-Pharmacologic Options in Dementia Care.”

Mark your calendar for Wednesday, March 26, 2008.  You don’t want to miss this significant learning opportunity.  For more information contact Shelly Young, education coordinator in the Fort Worth office, at 817.336.4949 or click here.

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Do people with Alzheimer's Experience Grief?
By Howard Gruetzner, M.Ed., LPC

Many questions regarding loss surround persons with Alzheimer’s and their families.  Do people with Alzheimer’s grieve the losses of loved ones?  Do the effects of memory loss and cognitive impairment change both their perceptions and responses to loss?  What does grief look like in these persons?  Do most families understand how to respond to this experience?  Our understanding of how people with Alzheimer’s respond to a loss of a significant loved one is limited.  This lack of knowledge adds to the awkwardness and discomfort of family members managing loss.  That is quite evident when they are faced with a loss in which there are no guidelines to direct them in how appropriately and empathetically to respond to the feelings and behavior of the person with Alzheimer’s disease.

In the spring of 2006, Dr. James Ellor, Director of the Institute of Gerontological Studies at Baylor, and I discussed the need for more research in this area of Alzheimer care.  In the fall of that year one of his social work master’s students, Nicole Back, had a  similar idea and the three of us were able to put together a research project.  Two focus groups - one of family caregivers and the other professionals were used to gather data about situations of loss they had observed.  We presented our initial findings at the Joint Conference of the American Society on Aging and The National Conference on Aging in March of 2007.  Program participants demonstrated a high level of interest in this area of care and acknowledged the relative absence of research to guide professionals and families faced with some unfamiliar and unexpected grief responses observed in persons with Alzheimer’s disease.  The project was completed in the spring of 2007.  Preliminary findings presented below demonstrate the need for this kind of study and have encouraged us to continue this work.

For a loss to be followed by grief, there must be an individually specific and meaningful recognition of the loss.  Without awareness of loss, there can be no response to it.  This becomes a problem in moderate and later stage Alzheimer’s disease.  The study found that persons with dementia do experience grief at the time of a significant loss.  That was not surprising because many people expect persons with this disease to grieve the loss of a loved one, for example, a spouse or child.  However, often their grief responses were not expressed in ways that families would have anticipated.  In fact, because of differences from “normal” grief responses, families would find it difficult to understand and appreciate their loved ones’ responses to loss.  Such ambiguity presents problems of adaptation to loss for the person with Alzheimer’s as well as those family members who have their own grief to manage in addition to this unexpected response.

Participants of our focus groups reported three types of responses:  losses that were converted to metaphor, substitution loss and responses that suggest a threat to the self and self-interests of the person with Alzheimer’s.  When losses are converted into metaphor the loss of an object takes the place of the person who has died and becomes the focus of their concern.  Some feelings that might have been associated with the loss of the person are expressed about the loss of an object.  One example from the focus group is a woman who replaced the loss of her husband with the loss of a pen.  She insisted the pen had been stolen, and she was consistently distressed by this loss for several months until she announced that she had discovered her son had her pen and was very pleased with it.  That freed her from the painful loss of the pen (husband), and she never discussed it thereafter.

In substitution the person has the sense that someone has died but is unable to grasp or remember who died.  Another person such as a parent or sibling - lost but remembered from the past - is substituted for the loved one recently deceased.  Instead of referring to the relative who has recently died, the cognitively impaired person talks about the personal loss that happened long ago.  Family efforts to correct the person about who died were unsuccessful and mention of the recent loss stops.  After that the substituted loss is forgotten. 

For other persons with dementia the loss of the loved ones was perceived as a threat to the “self” and their future well-being and security.  So rather than reacting to the loss of the relationship and a past life with the deceased, these persons were more anxious about who would assume the helping role.  Instead of feelings about the sadness about the loss, the question was, “Who is going to take care of me now?”  This focus on self rather than on the person who has been lost is disturbing to families who do not understand this response.

Family members often expected persons with Alzheimer’s to have a stronger reaction to the death of loved ones.  They were surprised when the person’s response to loss was so detached and distant instead.  Some family members interpreted this as denial.  But denial presumes recognition of something for it to be denied.  These families had had many questions when they were faced with situations of loss.  Do you tell the person about the loss?  If they forget who died, do you keep telling them who died?  But whom could they ask?  We need to broaden our understanding of this area of care for the sake of families and their loved ones.  We need to learn how to respond to the many individual reactions to loss that people with Alzheimer’s disease experience.  More research in this area is clearly needed.  Many people with Alzheimer’s experience grief, but differently from what we expect.

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Laurie White Returns to Texas

Laurie White, MSW and founder of Dementia Care Consulting, is returning to Texas!  Don’t miss this great opportunity.  Ms. White will present a one-day seminar in Wichita Falls on February 27, 2008 and in Abilene on February 28, 2008.  She recently presented for our chapter in Waco and Hurst and received rave reviews for each presentation.

Ms. White’s seminar consists of practical problem-solving tools as well as basic information about the disease and its progression.  She has conducted presentations on dementia around the country and has co-authored two books: Understanding Difficult Behaviors and Moving a Relative with Memory Loss: A Family Caregiver’s Guide.

This seminar is entitled “Caring for Someone with Memory Loss: Choices, Challenges and Considerations.”  Ms. White will cover topics such as “Understanding the Person with Memory Loss” and “Moving a Relative with Memory Loss:  Challenges, Considerations and Choices.”

Registration fee is $20.  Professionals may receive continuing education credits for an additional fee of $10.  Continuing education credits are available for the following disciplines:  Activity Professionals, Assisted Living Administrators, Long-Term Care Administrators, Nurses and Social Workers.  Lunch is included.  For more information, contact Shelly Young, education coordinator or click here.  The registration brochure is also avialable here (PDF). 

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Alzheimer's Art Quilt Initiative

The Alzheimer’s Art Quilt Initiative will be on display at the Grace Museum and the Abilene Civic Center in Abilene from January 28 - February 28, 2008.  The Alzheimer's Art Quilt Initiative is a grassroots effort to raise awareness and fund research to find a cure for Alzheimer's disease.  All profit is donated to the Alzheimer's Association for research.  The Alzheimer's Art Quilt Initiative is accomplishing its goals with a nationwide quilt exhibit called "Alzheimer's:  Forgetting Piece By Piece."  It contains 52 quilts, each interpreting Alzheimer's in some way.  So far, an estimated 175,000 people have had the opportunity to see these quilts.  They will crisscross the country from August 2006 until July 2009.  A book and CD of the exhibit are available. 

Comments made by those who viewed this moving exhibit in other parts of the county include “Great interpretation of a heart-wrenching disease,” “Very powerful - an amazing exhibit,” “What a touching, emotional way to learn about Alzheimer's - everyone's fear!” and “Very moving - great tribute to the difficulty of this disease.”

For more information about this exhibit you may contact Libby Connally, regional director, in the Abilene office at 325.672.2907.  Or you may view more information by clicking here.

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Holiday Gift Acknowledgements

This holiday season, honor special friends, co-workers or loved ones with a gift in their honor to the Alzheimer’s Association - North Central Texas Chapter.  This lovely acknowledgement card, designed just for the holidays, will be sent to those you honor with your contribution.  A minimum of $10 per honoree is requested.  If you mail in your request, be sure to clearly print the name and address of the honoree and please indicate if the gift is for the holidays.  If you would like to contact us regarding this seasonal donation, please click here.

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