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Project addresses early memory care

Laurel Hed

An Early Memory Care Project, addressing people in the initial stages of memory loss, has been launched in Hubbard County, Laurel Hed the caregiver support coach.

The goal of the grant-funded project is to become involved on a personal level as early as possible after diagnosis, Hed explained of her role.

Mild cognitive loss, the stage at which Hed offers support, can be isolating and frightening, she explained. It can begin as early as age 40. "At this point, people are very aware of the losses they are experiencing."

Physical conditions - cancer or a stroke, for example, are visible, more discernible. But memory loss, which often causes depression and anxiety, is more difficult, Hed stated.

Communication between the caregiver and the person with memory loss is key, she emphasized.

"Laurel is the toolbox for caregivers," explained Susan Ramse, director of Living at Home, host of the program. "She's the resource person," who provides education for the caregiver as well as services tailored to those in early-stage memory loss.

These may include guidance in financial matters, exercise, nutrition and advice as to when driving should be discontinued.

The program was officially introduced to St. Joseph's Area Health Services and Innovis Health last week, physicians and medical personnel key components in the support process.

Dementia is being diagnosed earlier, she said. "Now we need to help people live with it by providing resources."

A journey, side by side

Hed's first client confided that she felt fear, confusion and isolation after her diagnosis. But she hadn't verbalized this to her family.

Hed steps in as the support coach to open up communication, allowing all parties to express feelings.

When Living at Home is contacted by a family with someone in the early stages of memory loss, care coordinator Beth Waller conducts a "rapid screen" and then engages Hed, a licensed social worker.

The pair schedules a home visit, meeting with the primary caregiver and members of the family to explain what the program offers. That includes respite for caregivers and volunteers who will complete miscellaneous tasks.

"We start walking side by side with both the caregiver and receiver," Hed explained.

An assessment is conducted on the second visit to determine the level of memory impairment - normal, mild cognitive loss or dementia.

The test entails remembering certain words introduced at the beginning of the interview, a bit of math and reading the time via a clock with hands.

Hed reads a story that describes a woman's life in a chronological time span, ending in a quiz on specifics.

If the individual is suffering from dementia, he or she is not a candidate for this program, but Hed may continue as a caregiver support coach.

The next step with those with mild cognitive loss is to develop a plan of care, to develop goals. This is updated every three months.

"I write the plan in pencil," Hed said, "so we can erase."

She may counsel "Fred" to watch "Mary's" body language, to recognize when she needs to talk, to make eye contact and give her "permission" to speak her mind.

Then, Hed advises, offer full attention to what she has to say.

In the early stages of memory loss, an individual may have to think carefully to remember where they've placed something, make a conscious effort to stay in the kitchen when something's on the stove, or stay on the path if they head out for a walk.

"It can be exhausting to stay on track," Hed explained.

"A change in environment causes chaos," she said. The hoped-for trips after retirement are dashed. And staying home alone, if the spouse or family member works, may create fear.

And family members may see an eyebrow-raising change in behavior.

Hed recently learned at a conference why a person who's not used profanity during his or her lifetime suddenly begins brandishing vulgarites.

A young child learns swearing is socially inappropriate and tucks the forbidden vocabulary into a corner of the brain, she explained. When memory loss sets in, the "door opens."

In the early stages of memory loss, the person may be aware of the faux pas, and wonder, "where did come from?"

Blame it on unlocking the closet door in the brain.

She advocates exercise, a healthy diet, social interaction and mental activities, such as crossword puzzles, card games, gardening and other learning experiences.

"You can't make it go away, but you can help to maintain."

Ease of passage

Hed who, as a social worker, also assists hospice patients and with bereavement, offers "continuity of care." She maintains contact with families and caregivers up to 13 months after the loss of a loved one.

The program is in its "infancy stages," at this point, but she and Ramse plan to work with churches, home care agencies and senior housing personnel to "spread the word."

Hed predicts the Early Memory Care Project will "open doors in the community.

"We recognize more and more people are dealing with this," she said. "Maybe we can make the journey a little easier."