By Rev. John McFadden, M. Div., Valley VNA chaplain
Up to half of us are likely to experience varying degrees of forms of dementia, so it is unfortunate that the popular press focuses so exclusively on the hope or assumption that we will be the lucky ones to age without cognitive change or loss. Together with my wife, Dr. Susan McFadden, a gerontologist, much of my vocation has come to focus on what constitutes spiritual meaning within the reality of dementia. Our core idea is that our personhood is rooted in our relationships—with God, the natural world, other people, the arts—and therefore continues even when memory and executive function changes or fades.
Alzheimer’s Disease has sometimes been termed “the theological disease” because of the fundamental questions it raises about selfhood. At one point in human history, lepers were considered unclean and disallowed from entering temples or touching others, and therefore denied direct access to the presence of God. In our era, selfhood and one’s divine image are almost exclusively associated with cognition. Cognition is essential to the abilities we have been taught give our lives worth and meaning: productivity, autonomy, and independence. Dementia is the most feared illness among persons over the age of 65 because it threatens our identity as selves and our role as productive, contributing members of the community. The constructs of modernity tell us that “becoming a burden on others” marks us as a failure at the task of successful aging.
We are creatures created in the divine image not because we physically or intellectually resemble the Almighty One, but because God remains in faithful relationship with us in all circumstances and conditions. God’s goodness can be experienced within the reality of cognitive loss, even as it can be within physical disability, chronic pain, or heartrending grief. What follows are these three essential points:
- If we should forget God, God will not forget us.
- If we forget God, our community of faith can remember us to God.
- Our friends and family can bring God’s presence into our lives through means that do not require us to grasp that presence cognitively.
As individuals, we must reject the stigmatization of dementia and overcome our own fear of it. A first step is to reflect on our own definition and role of friendship in our lives. Do our relationships primarily form around usefulness or pleasure, defined much like a series of business transactions where what we give and receive has value amongst both parties? The fear of developing dementia is in part the fear of being abandoned by friends because we will no longer be able to contribute anything “useful” or enjoyable to the relationship.
Now consider the only form of friendship that is complete, put forth by Aristotle; that is, the friendship of virtue, a friendship whose goal is to help one another live good and ethical lives. A virtuous friendship is centered on genuine commitment to help one another become better people. We wish good for our friends, we seek to guard and protect them, we commit to spending time with them, we share common choices and decisions centered in our efforts to live virtuous lives, and we share in our friends’ joys and sorrows. In a virtuous friendship, we are not free to abandon our friends who journey into dementia.
Next week, I will share a list of seven tips on how to value, visit, and engage friends with Alzheimer’s disease or dementia. To learn more about our chaplaincy at Valley VNA, or to inquire about in-home care or assisted living for people experiencing Alzheimer’s Disease or dementia, please call (920) 727-5555. We offer a wide range of services and support for both seniors in need of care and their caregivers.
By Gina Larsen, guest
At any age, an adult needs quality rest to be healthy—about eight hours per 24-hour period, to be exact. Sleep patterns change as people get older, as does a person’s ability sleep deeply and even dream. Problems with sleep in elderly people typically include difficulty falling asleep, less time spent in the deeper stages of sleep, early-morning awakening, and less total sleep time.
Why Does Sleep Matter for Older People?
1. If an older person doesn’t get enough good quality sleep and turns to sleeping pills or alcohol to fall asleep, there is a significant increase in the risk of falls and accidents.
2. Sleep deprivation causes increased sleepiness and may cause cognitive impairment.
3. Sleep apnea, when a person’s breathing is disrupted during sleep, is linked to chronic fatigue and increased risk of high blood pressure, heart attack, stroke, obesity, and diabetes.
4. In persons with dementia, severe sleep disruption often leads to nursing home placement.
The good news is that you don’t have to simply accept disturbing sleep changes as part of aging. Sleep problems are often an indication of an underlying lifestyle, medication, or medical issue; therefore, addressing these health and wellness concerns has the double benefit of also improving one’s sleep and daytime energy levels. Consider how these factors might affect your or your loved one’s ability to get a good night’s rest:
1. Poor sleep habits:
Keep a steady schedule for going to bed and waking up. If not, you will be tinkering with your body’s internal clock, or circadian rhythm. Daily exercise and exposure to daylight can help reinforce one’s own circadian cycle. Exposure to 30-60 minutes of sunlight in the evenings will help an older person stay up longer and avoid early-morning waking (6:30 a.m. versus 4:30 a.m., for example). If it’s hard for a person to fall asleep and get up at an appropriate time, take measures to ensure the bedroom is dark at bedtime and that sunlight streams into the room in the morning. Other schedule snafus are napping too much or staying in bed when you’re not sleeping.
2. Medications, alcohol, and caffeine:
Some drugs make it harder to fall or stay asleep, or even stimulate you to stay awake, including antidepressants (particularly selective serotonin reuptake inhibitors, or SSRIs), decongestants, bronchodilators, some blood pressure medicines, and corticosteroids. Alcohol may help you relax and snooze, but as you metabolize the alcohol, you will be prone to frequent waking and bathroom breaks. Avoid caffeine up for up to four hours before bedtime.
3. Worry, stress, or grief:
Aging brings many life changes. When you lose someone you love, move from your family home, or have a condition that changes your life, these issues can cause stress and even depression, which can hamper your sleep. Get help from your doctor or counselor to ease your distress.
4. Environmental factors:
Are stressors influencing your sleep-wake cycle, such as a barking dog, ringing telephone, too much light, or uncomfortable temperature in the bedroom? Make adjustments to create a more peaceful sleep setting.
5. Too much downtime:
If your activity level has decreased as you’ve gotten older, it may be more difficult to get to sleep. Activities need not be physical. Try engaging in interesting conversations, creative pursuits, or table games that engage your mind.
6. Sleep disorders:
Besides insomnia, these include sleep apnea, restless legs syndrome, periodic limb movement disorder, and REM behavior disorder. Your doctor can check if you have one of these conditions and help create a plan of care.
7. Illness or disease:
Acute and chronic medical illnesses, pain, and psychiatric disorders will cause sleep disturbances. Gastroesophageal reflux disease (GERD) is another common cause of sleep problems. Proper treatment or management of these health problems will help you achieve your best possible night’s sleep.
Has your loved one complained about poor sleep? Valley VNA In-Home caregivers can add healthy activity and companionship to a person’s routine. Our assisted living residents receive care and participate in activities that bring peace at the end of a pleasant day. Call us at (920) 727-5555 to learn more. Who knows? You might even sleep better at night knowing we are here to help!
By Gina Larsen, guest
I recently spoke to a chef who can trace his passion for food and culinary pursuits all the way back to his Sunday after-church walks with his grandpa. They’d be waiting for his grandma to finish preparing the noon meal, and the two of them would walk the property, sampling the fresh produce that had ripened just that week. His summers were one long food memory, from asparagus to apples, and never mind a bite of dirt here or there.
My mom remembers her grandpa’s garden, too, and the old cast iron sink he rigged up with a hose in the back yard for a first rinse of his homegrown vegetables before bringing them up to the kitchen. (If, by chance, you can recall the smell of a Chesterfield unfiltered cigarette, the two memories always go together, as does giving her baby doll a bath in that old sink.)
People age 70 or older grew up in a time when most families grew and preserved much of their own food. Many seniors still relish the opportunity to grow and eat fresh vegetables, smell rain-soaked soil, touch fragile blooms, or gaze upon a lush garden in the summer sun. Here are some thoughts on how to help keep the goodness of gardening in your loved one’s life, with a nod to the University of Minnesota Extension and their recommendations for creating healing gardens in care facilities, a place to soothe the body and mind:
If seniors are actively gardening:
● Purchase seed tape for easier handling and planting.
● Build and design raised beds that provide a place to sit or stand and garden.
● Use gardening tools that are optimally designed for gardeners who are seated. Curved or longer handles provide better grip and more leverage.
● Choose plants with different leaf textures, forms, and smells to stimulate the senses and memory.
● Be safe and garden early in the morning or late in the day. Avoid being out between 10 a.m. and 2 p.m. Drink plenty of fluids to prevent dehydration, and allow time for breaks in the shade.
If seniors are more apt to sit outside and simply enjoy the gardens, be sure to:
● Use warm, highly saturated hues (red, orange, yellow) that are easier for the elderly to see than cooler hues (blue, purple, green).
● Provide seating with back support and arm rests.
● Provide sunscreens, trellises, fences, walls, baffles, and plant materials to alleviate the harsh effects of the sun and wind in outdoor spaces.
● Provide transition areas between indoor and outdoor spaces, such as screen porches or overhangs, to provide protection from the elements, allow eyes to adjust to bright outdoor light, and provide a place to sit and view the activities without being involved in them.
● Situate plantings to provide views from windows looking out onto the garden for people who are unable to go outside.
● In the case of a memory garden, designed for those with dementia or Alzheimer’s disease, provide landmarks such as sculpture, a profusion of flowers, or a water feature to help orient the users of the space.
Plant, visit, or reminisce about a garden with someone you love. If you’d like to join us as a Valley VNA gardening volunteer or a resident gardener, call us at (920) 727-5555. You’ll be amazed at what blooms.
Three years after the Civil War ended, General John A. Logan of the Grand Army of the Republic issued General Order No. 11 on May 5, 1868, after observing families and comrades decorating the graves of Civil War soldiers who died in battle. Recognizing there was honor and healing inherent in this practice of adorning graves with flowers and ribbons, General Logan crafted what has become known as Logan’s Order that established Decoration Day, now known as Memorial Day, on May 30 of each year. It is believed that date was chosen because flowers would be in bloom all over the country.
It’s a Procession, Not a Parade
It’s been said a person dies twice. First, his or her physical death; and finally, the last time his or her name is ever uttered 
aloud. Mike Hert, 58, an Oshkosh man with 35 years of U.S. Army military service, 10 of them active duty in both Cold War Europe and post 9/11 in Iraq, Afghanistan, and the Horn of Africa, is earnest about explaining the meaning of Memorial Day. “It’s not set aside as the official start of summer or a three-day weekend up north. In fact, Memorial Day parades are not parades at all, they are meant to be processions where we honor the fallen,” he said.
Hert encourages every family to take a few moments to honor the dead, talk about their sacrifice, and tell children about the meaning of Memorial Day. “Then go have a brat and enjoy your kids and grandkids. Keep in mind that these men and women who died in service to our country never had a chance to have families or grandkids, and we do, because of them. That’s the meaning of Memorial Day – to remember. Don’t forget to stop, remember, and reflect.”
The Gettysburg Address & Gold Star Families
Hert serves as the junior vice commander of the Disabled American Veterans Chapter 17 of Oshkosh and Winnebago County. He is a mentor to vets who have a brush with the law and opt to participate in the Outagamie County Veteran’s Court, and he is the organizer and emcee of Neenah’s first Valley VNA Memorial Day Program on Friday, May 27, 2016 from 1 to 2:30 p.m. at Valley VNA in Neenah.
The Friday event is shaping up to be distinctively powerful, with a reading of Logan’s Order; and a reciting of the Gettysburg Address, widely believed to be the first official proclamation that memorialized American soldiers.
Mary Bosveld, a Valley VNA employee and Gold Star Mother, will be present to honor her daughter, Army Pfc. Rachel Bosveld, who was killed in Operation Iraqi Freedom. Gold Star Spouses and Gold Star Parents have lost immediate family members in combat operations while serving in the U.S. Armed Forces.
Lee Shuff, 84, a Menasha area Marine veteran of the Korean War and Vietnam, will speak about the Bible scripture, “Greater love hath no man than this, that a man lay down his life for his friends.” He will tell the story of his own friend who was tending to Shuff’s wounds on the battlefield in Korea when he was shot dead by a sniper. Shuff is a retired educator who went to school on the GI bill and is a sought- after speaker for school and community groups.
If You Go:
Memorial Day Program
Friday, May 27, 2016, 1 to 2:30 p.m.
Valley VNA, 1535 Lyon Drive in Neenah
Use the main entrance. The program will be indoors, seating is provided.
● Post the Colors by Patriot Guard escorting Mary Bosveld, Gold Star Mother of Army Pfc. Rachel Bosveld, Operation Iraqi Freedom, and U.S. Veteran Len Erickson
● Invocation & Benediction – Rev. John McFadden, VNA Chaplain
● General Logan’s Order No. 11, read by a 1LT Anthony Pinchk, 2/127th Infantry, Wisconsin Army National Guard
● Gettysburg Address read by Joe Aulick, Director of the Winnebago County Veterans Office
● Main Speaker – Lee Shuff, Korea and Vietnam Veteran, Purple Heart recipient
● Laying of the wreath with taps by Neenah High School band student
● God Bless America, led by Christie Feuerstahler, Valley VNA music coordinator
● Conclusion and Reception
By Julie Fries, RN, Valley VNA In-Home Client Care Coordinator
I’m Julie Fries, an RN at Valley VNA and client coordinator for all of our in-home care clients’ medical needs. I was asked to write about home safety for the elderly, a topic that goes far beyond grab bars in the bathroom. I help seniors and their families discover new and helpful ways that enable loved ones to live safely and happily in their homes.
Some advice is so simple, it’s surprising. But if a person has been living in the same house for 50 years, new ideas can be very beneficial “ah-ha” moments. Try these tips:
1. Buy several nightlights and plug them in all along the route to the bathroom. A while ago, maybe one would suffice, but aging people need a better lit pathway.
2. Keep the walker close to the edge of the bed at night. Especially for people with moderate dementia, it will be a cue for them to use the walker on the way to the bathroom; otherwise, they may forget and try to go without it.
3. Did you know that shower seats come with a notch to hold a handheld shower nozzle so you don’t have to reach up and wrestle with the unwieldy hose?
4. Seniors can skip pill sorting entirely and have your prescriptions packaged in single-dose bubble packs right at the pharmacy.
5. You can hire a homemaking companion just for the jobs that are getting difficult, like changing the sheets on the bed and chopping fresh fruit and veggies for the week’s meals.
6. Install a grab handle between the storm door and the exterior door to help an elderly person boost up and over the threshold of his or her house.
7. Buy and install a high-rise toilet seat so it’s easier to sit down and get up.
8. If you are concerned about an older person’s ability to drive, shift that decision to the DMV. The DMV offers a vision test and re-evaluation for senior drivers. Restrictions can be placed on a person’s license to keep him or her safe, like no freeway driving, no night driving, or driving only within a defined geographic area.
9. The Veteran’s Administration may pay for up to six hours per week of in-home care if an elderly person is a veteran who has served in combat. This benefit can be a blessing to our elderly veterans.
Valley VNA offers free home visits to assess any elderly person’s home safety. Our goal is to offer you a resource person whom you can call when circumstances change and you want to explore a new level of care.
Sometimes feeling safe is simply knowing that you’ve got good people on your team. Call (920) 727-5555 to schedule a home safety assessment. We’ll step up to the plate and join your team.
By Joy Lautenslager, RN, Valley VNA Foot Care Nurse
Wiggle your toes. People don’t really think about their feet until they can’t reach them. Valley VNA is the longest consistently running foot care clinic provider in the region. Our clinics were established here in Neenah more than 20 years ago, and we’ve grown to offer them at a myriad of sites throughout the VNA service area. In fact, last year we provided nearly 6,400 soothing 20-minute sessions at 507 scheduled clinics throughout the region.
A typical Valley VNA foot care appointment includes a foot soak, nail trim, filing, foot massage, and treatment of minor corns or callouses. Most of my clients return every other month for the healthy, soothing, and social aspects of the traveling VNA foot care caravan. If we discover suspicious moles, cellulitis, or fungal infections in the course of a person’s foot care, we make referrals to podiatrists or suggest a follow-up with his or her doctor.
Experts recommend that seniors pay special attention to their feet because:
1. Feet lose cushioning as they age, and the skin and nails can grow dry and brittle. Many seniors have poor circulation, and this can slow the healing of foot sores.
2. Problems with feet can be the first sign of more serious medical conditions, particularly among older adults. Health problems, such as arthritis, diabetes, nerve issues, and circulatory disorders, may first be manifested in the feet. That is why it is important to pay attention to your feet and seek medical attention as soon as you notice a problem.
3. If left untreated, small cuts and sore spots on the feet can lead to more serious infections. Foot ulcers (open wounds on the feet) are common among senior citizens who fail to notice minor foot injuries early on. Reduced nervous sensation and circulation in the feet mean that the feet need to be inspected visually.
4. Failure to trim nails properly can lead to ingrown toenails and infections.
Each Valley VNA foot care nurse has her own style. (We used to have a singing nurse!) I have my own little bag of tricks, including a bit of essential oil, soft music, and a sweet treat for each of my clients. I come to know these people. We talk, and I hear life stories, or what’s weighing on their hearts. The best part of my job? When someone gets up and says, “That feels so good, I’m going dancing!”
There is a $23 fee per foot care session. Only certain types of foot care are covered by Medicare, and even then, the co-pay is higher than our fee. We see people who’ve been referred by their doctors, podiatrists, or have heard about us through friends or family.
You need not be a senior to schedule a foot care session. Anyone who has difficulty caring for his or her feet is welcome. To reserve your spot, view the schedule and call Valley VNA at (920) 727-5555.