Herald and Journal, Oct. 15, 2001

Staff for Alzheimer's patients need to 'live in their world'

By Lynda Jensen

Birds chirp cheerfully for visitors who walk through the wide, open spaces and naturally lit rooms of Lakeview Ranch, rural Darwin.

Easy chairs abound. Friendly dogs and cats mill about, looking for attention, and perhaps a treat in someone's pocket.

It is here - in this innovative senior care center - that victims of Alzheimer's spend their remaining days in comfort and understanding.

The "innovative" part of Lakeview Ranch isn't the furniture, pet therapy, or solarium, owner Judy Berry said.

It's the staff, who are specifically trained to handle and understand the insidious disease, Alzheimer's, she said.

Alzheimer's is a progressive, irreversible neurological disorder that has no cure.

The disease takes over a person's mind and causes the mental death of a person, right before the loved ones' eyes, Berry said.

Memory loss, and personality changes are two of many symptoms of the disease, Berry said.

Personality changes

In fact, some people who spent their whole lives being passive can become suddenly belligerent or violent in their later years, because Alzheimer's can remove inhibitions, she said. This may shock family members.

This isn't the person's fault, Berry said. It's the disease, which causes its victims to be fearful when they realize that things aren't as they remember them, and that their reality is changing from what they understand, she said.

Many Alzheimer's patients live in the past - such as 50 years ago, when they were rearing young children.

"We have people here who think they're living during World War II," she said.

One resident at Lakeview carries a doll around with her, because she thinks it is her baby that grew up decades ago, Berry said.

This is a break in reality that happens with advanced Alzheimer's patients, Berry said.

What happens most often is that well-meaning family members will correct the Alzheimer's victim - in the example of the Lakeview resident, telling her that her daughter grew up 50 years ago and that she didn't have a baby anymore. This only made the woman feel more confused, frightened, and agitated, Berry said.

Forcing reality onto them will frighten Alzheimer's victims, since they previously thought they knew what they were doing, but are being told an unwanted truth that they can't understand and will soon forget, Berry said.

One woman that Berry remembers was continually told by her well-intentioned relatives that her late husband was dead, even though she thought he was still alive.

This woman's husband died 40 years ago, Berry said.

Every single time the woman was corrected about this fact - that her husband was dead - it was like she was being told for the first time. This, despite the fact that the woman's husband died decades ago, Berry said.

This caused a needless cycle of shock, grief, and mourning for the hapless woman, who was caught in the grip of a disease that made her unable to remember the fact that her husband was dead, but who was thrown into the cycle of deep-seated grief and mourning by people who didn't understand the disease, Berry said.

The fear of changing reality for the victim acts as a basis for unpredictable behavior, Berry said.

"You need to live in their world," Berry said.

Other lessons that Berry knows well: to keep the residents' surroundings the same, such as furniture in the same place, structured activities that are designed not to frustrate them, and also not to over-stimulate Alzheimer's victims.

At Lakeview, there is also a high ratio of staff to residents, three to 10.

There are one or two other places that offer this kind of ratio in the Twin Cities, Berry said, but she stressed the importance of having a staff that understand how to handle dementia,which is the kind of disease that Alzheimer's is classified as.

Staff that understand dementia, combined with enough staff numbers to give some personal attention, is the trick, she said.

"You can be the most caring individual in the world, but if you don't understand it, it doesn't help," she said.

All of this for the same cost as a nursing home, Berry said. The cost is about $4,500 per month, she said.

Berry knows the bitter reality of Alzheimer's because she was forced to watch her mother, Evelyn Holly, die of the disease six years ago.

Sweet freedom

Her mother used to enjoy walking freely about, but in a nursing home this was not possible.

Frequently, Berry found her mother quietly crying; under the influence of drugs to calm her.

Drugging patients seems to be the best answer in modern medicine for unpredictable behavior, Berry said. She didn't like this answer.

In stark contrast to this, residents at Lakeview enjoy a different kind of freedom, coming and going as they please, since they are able to walk into the large backyard, which is chock-full of wildlife and flowers.

A barn adjoins the property and is full of every kind of farm animal imaginable, from chickens, geese, and llamas, to pot-bellied pigs and peacocks.

The animals are used for pet therapy, which calms and provides enjoyment for residents, Berry said.

There is a circular trail that leads to a giant oak tree, with a bench to rest on.

Other benches are available as part of extensive landscaping donated by the daughter of a Lakeview tenant.

Amazingly, five out of the 10 tenants at Lakeview were considered combatitive at other facilities, Berry said. The same tenants at Lakeview are happy and content, with few problems reported.

Berry works tirelessly to find a better ending to the story of Alzheimer's.

Guilt of a caregiver

Berry is well acquainted with the heavy weight of guilt that comes with being a care-giver, since she attempted to take care of her mother for two years before she went to the nursing home.

At first, Berry tried to care for her mother in a mobile home parked on their property. This didn't work, she said. She tried other arrangements, but was mystified by a disease that she didn't understand.

Statistics show that 70 percent of care givers die before the spouse that is afflicted with Alzheimer's, Berry said. The stress of trying to keep a spouse going can become too much, she said.

She herself was unprepared for the level of care needed for a person afflicted with Alzheimer's, she said.

Currently, Lakeview Ranch is working in conjunction with several partnerships - including the University of Minnesota, with its animal assisted therapy classes - as well as other organizations.

The Cokato Lions Club sponsored an auction Saturday to raise money for a van for Lakeview residents, Berry said. If it rains, it may be rescheduled next Saturday at the Cokato Elementary, she said.

In fact, many things the residents enjoy are because of donations or community sponsorships.

For those who wish to contribute toward the van, please send donations to: Lakeview, 69516 213th Street, Darwin, MN 55324.

The death of her mother was before Lakeview was established. The facility is dedicated to her memory.

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