The person with Alzheimer's - activities

University Degree Subjects allied to Medicine

Activities

Activities are the things that we do, including getting dressed, doing chores, and even paying bills. They can represent who we are and what we’re about. For the person with Alzheimer’s, they can mean the difference between feeling loved and needed and unloved and unnecessary.

When planning activities and daily tasks to help the person with Alzheimer’s organize the day, think about:

The person with Alzheimer’s

What skills and abilities does the person have?
What does the person enjoy doing?
Does the person begin activities without direction?
Does the person have physical problems?

Your approach

Make the activities part of your daily routine.
Focus on enjoyment, not achievement.
Determine what time of date is best for the activity.
Offer support and supervision.
Be flexible and patient, and stress involvement.
Help the person remain as independent as possible.
Simplify instructions.
Establish a familiar routine.

The environment

Make activities safe.
Change your surroundings to encourage activities.
Minimize distractions that can frighten or confuse the person.

Structuring the day

When structuring the day, consider the following activities:

Morning activities

Wash up, brush teeth, and get dressed.
Prepare and eat breakfast.
Discuss the newspaper or reminisce about old photos.

Afternoon activities

Prepare and eat lunch, read mail, and clear and wash dishes.
Listen to music or do a crossword puzzle.
Take a walk.

Evening activities

Prepare and eat dinner.
Play cards or watch a movie.
Read a book or magazine

Communication

People with Alzheimer’s disease often find it difficult to express themselves and understand others. They may:

Have difficulty finding the right words
Use familiar words repeatedly
Invent new words to describe familiar objects
Frequently lose their train of thought
Experience difficulty organizing words logically
Revert to speaking in a native language
Curse or use offensive words
Speak less often
Rely on nonverbal gestures

Tips for enhancing communication

Show that you are listening and trying to understand what is being said
Maintain eye contact
Encourage the person to continue to express thoughts even if he or she is having difficulty
Be careful not to interrupt
Avoid criticizing, correcting, and arguing
Be calm and supportive
Use a gentle, relaxed tone of voice
Use positive, friendly facial expressions
Always approach the person from the front, identify yourself, and address him or her by name
Speak slowly and clearly
Use short, simple, and familiar words
Break tasks and instructions into clear, simple steps
Ask one question at a time
Allow enough time for a response
Avoid using pronouns and identify people by their names
Avoid using negative statements and quizzing (e.g., “You know who that is, don’t you?”)
Use nonverbal communication such as pointing and touching
Offer assistance as needed
Don’t talk about the person as if he or she wasn’t there
Have patience, flexibility, and understanding

Home Safety

When caring for an individual with Alzheimer’s disease at home, safety and accessibility are important concerns. There are simple steps you can take to make the home safe for the person with Alzheimer’s.

Make potentially dangerous places less accessible

Lock or disguise hazardous areas.
Install door locks out of sight.
Use special safety devices, such as child-proof locks and door knobs, to limit access to places where knives, appliances, equipment, and cleaning fluids are stored.

Accommodate for visual changes

Diffuse bright light by removing or covering mirrors and glass-top furniture, and cover windows with blinds, shades, or sheer draperies.
Add extra lighting in entries, outside landings, areas between rooms, stairways, and bathrooms because changes in levels of light can be disorienting.
Place contrasting colored rugs in front of doors or steps to help the individual anticipate staircases and room entrances.

Avoid injury during daily activities

Monitor the temperature of water faucets and food because the person may have a decreased sensitivity to temperature.
Install walk-in showers, grab bars, and decals to slippery surfaces in the bathroom to prevent falls.
Supervise the person in taking prescription and over-the-counter medications.

Beware of hazardous objects and substances

Limit the use of certain appliances and equipment such as mixers, grills, knives, and lawnmowers.
Supervise smoking and alcohol consumption.
Remove objects, such as magazine racks, coffee tables, and floor lamps, to create safe wandering areas and reduce the possibility of injury.
Clean out the refrigerator regularly and discard inedible food.

Be prepared for emergencies

Keep a list of emergency phone numbers and addresses for local police and fire departments, hospitals, and poison control help lines.
Check fire extinguishers and smoke alarms, and conduct fire drills regularly.
If the person with Alzheimer’s tends to wander, enroll him or her in the Safe Return, a nationwide system designed to identify, locate and return to safety persons who are memory impaired. Identification products, including wallet cards, jewelry, clothing labels,lapel pin, bag tags

Hygiene and Personal Care

People with Alzheimer’s disease may need help with routine activities related to grooming and hygiene. The need for assistance can be very difficult for them because it signifies a loss of independence and privacy.

It is also difficult for caregivers, especially when they assist with activities that interfere with the individual’s privacy. On this page, you will find tips on handling grooming and hygiene tasks for an individual with Alzheimer's disease.

Bathing

Bathing is often the most difficult personal care activity that caregivers face. Because it is such an intimate experience, the person with Alzheimer’s may perceive it as unpleasant, threatening, or painful and, in turn, exhibit disruptive behaviors such as screaming, resisting, and hitting. These behaviors often occur because the person doesn’t know what bathing is for or doesn’t have the patience to endure such unpleasant aspects as lack of modesty, being cold, or experiencing discomfort. Try the following:

Do everything you can in advance to make the process easier, such as increasing the room temperature and having bath towels nearby.
Make the person feel in control. Involve and coach him or her through each step of the process. You may need to experiment to determine if the individual prefers showers or tub baths and what time of day is best.
Create a safe and pleasing atmosphere. Place nonslip adhesives on the floor surface and grab bars in the bathtub to prevent falls. Test water temperatures in advance to prevent burns.
Respect the person’s dignity. Some individuals may be self-conscious about their nakedness. Allowing the person to hold a towel in front of the body, both in and out of the shower, may ease anxiety.
Don’t worry about the frequency of bathing. It may not be necessary to bathe every day. Sponge baths can be effective between showers or baths.
Be gentle. The person’s skin may be very sensitive, so avoid scrubbing and pat skin dry instead of rubbing.
Be flexible. You may experience the most difficulty when attempting to wash the person’s hair. Use a washcloth to soap and rinse hair in the sink to reduce the amount of water on the person’s face.

Toileting

It is common for persons with Alzheimer’s disease to experience loss of bladder and/or bowel control. This can be caused by many factors, including medications, stress, a physical condition, the environment, and the person’s clothing. If incontinence is a new problem, consult your doctor to rule out potential causes such as a urinary tract infection, weak pelvic muscles, or medications. If the problem continues, try to:

Provide visual cues. Signs may assist an individual in finding the bathroom. Placing colored rugs on the bathroom floor and lid covers on the toilet may help the bathroom stand out. Avoid having items nearby that can be mistaken for a toilet, such as a trash can.
Monitor incontinence. Identify when accidents occur and plan accordingly. For example, if they happen every two hours, get the person to the bathroom before that time. To help control incontinence at night, limit the intake of liquids after dinner and in the evening.
Remove obstacles. Make sure clothing is easy ...

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Provide visual cues. Signs may assist an individual in finding the bathroom. Placing colored rugs on the bathroom floor and lid covers on the toilet may help the bathroom stand out. Avoid having items nearby that can be mistaken for a toilet, such as a trash can.
Monitor incontinence. Identify when accidents occur and plan accordingly. For example, if they happen every two hours, get the person to the bathroom before that time. To help control incontinence at night, limit the intake of liquids after dinner and in the evening.
Remove obstacles. Make sure clothing is easy for the individual to remove.
Provide reminders. Because the person with Alzheimer’s may forget to use the bathroom, you may need to remind him or her periodically. Also watch for visible cues such as restlessness or facial expressions that may indicate the person needs to use the bathroom.
Be supportive. Help the person with Alzheimer’s retain a sense of dignity despite incontinence problems. A reassuring attitude will help lessen feelings of embarrassment.

Dental care

Good oral hygiene can be a challenge for individuals with Alzheimer’s. Brushing is sometimes difficult due to the individual’s inability to understand and accept assistance from others. To help the individual:

Provide short, simple instructions. “Brush your teeth” may be too difficult. Instead try: “hold your toothbrush,” “put paste on the brush,” and “brush your top teeth,” etc.
Use a mirroring technique. Hold a brush and show the individual how to brush his or her teeth.
Monitor daily oral care. Brush teeth or dentures after each meal and floss daily. Remove and clean dentures every night, and brush the person’s gums and roof of the mouth. If the person refuses to open his or her mouth, try using oral hygiene aids available from your dentist to prop the mouth open. Strained facial expressions during dinner or refusal to eat may indicate oral discomfort.

Caregivers are essential in helping the person maintain oral hygiene, noticing any problems, and seeking help from a dentist. Notify the dentist in advance that the person has Alzheimer’s, so that an oral care routine can be developed.

Dressing

Physical appearance contributes to everyone’s sense of self-esteem. Clothing can be a form of self-expression, so it’s important to consider the person’s tastes and dislikes. To help the person with dressing:

Simplify choices. Each morning, offer two choices of shirts and pants for the individual. Keep the closet free of excess clothing.
Organize the process. Lay out clothing in the order it needs to be put on, or hand the person each piece while giving short, simple instructions. Don’t rush the individual; it will only create anxiety.
Be flexible. If the individual wants to wear the same outfit repeatedly, try getting a duplicate of the outfit or have similar options available.
Choose comfortable and simple clothing. Cardigans or shirts that button in front are sometimes easier to work than pullover tops. Substitute Velcro™ for buttons, snaps, or zippers that may be too difficult to handle. Make sure the individual has comfortable shoes that are not slippery.

With all personal care activities, it is important to incorporate the individual’s past routine whenever possible into the current one.

As you assist the person, be patient and creative. An approach that worked one day may not work the next, so be flexible.

Late-Stage Care

Comfort, dignity, and respect — these are important words for caregivers to remember in ensuring quality of life during the late stage of Alzheimer’s disease.

At this point in the disease process, people typically lose the ability to talk and walk and experience difficulties with eating. Families and care providers play a critical role in making tough decisions that ultimately respect the person’s end-of-life wishes and at the same time maintain the person’s dignity and comfort.

Advance directives

Ideally, discussions about end-of-life issues should take place while the person with the disease still has the capacity to make decisions.

People with Alzheimer’s have the legal right to limit or forgo medical or life-sustaining treatment, including the use of mechanical ventilators, cardiopulmonary resuscitation, antibiotics, and artificial nutrition and hydration. These wishes can be expressed through advance directives.

Two common forms of advance directives are a living will and a durable power of attorney for health care. A living will states the individual’s choices for future medical care decisions. The durable power of attorney allows the person with Alzheimer’s to designate a surrogate, usually a trusted family member, to make specific decisions about treatment on his or her behalf.

Family members should not equate the refusal or withdrawal of treatment, including treatment for life-threatening illnesses (infections, hemorrhaging, heart attacks, etc.) as euthanasia or assisted suicide. In fact, aggressive medical treatment may feel like torture to an individual who is in unfamiliar surroundings and does not understand the intentions of the care providers.

If there are no advance directives in place, families and care providers should try to make decisions consistent with what they think the individual’s wishes would have been. Typically, nursing homes and hospitals have ethics committees that can facilitate the decision-making process if there is a conflict between family members or with the care provider.

Artificial nutrition and hydration

People with Alzheimer’s may also refuse to eat and drink. Such cases should be evaluated to make sure that they are not due to conditions, such as constipation, kidney failure, nausea, and fluid and electrolyte imbalance, that could be reversed with medications.

One of the more difficult decisions for families to make is whether or not to withhold nutrition and hydration in response to a patient’s refusal to eat or drink. Many families and care providers believe that it is appropriate to do everything in their power to get the person to eat or drink. The use of feeding tubes and intravenous (IV) hydration is often assumed to prolong life when in fact it could be lengthening the dying process. In addition, if these artificial means are used, families will eventually be faced with the tough decision about whether or not to withdraw such treatment.

Treating infections

Pneumonia and urinary tract infections are common in the last stage of Alzheimer’s. The person’s advance directive should indicate whether preventive measures such as pneumonia vaccines and antibiotics may be used. If the Alzheimer patient does not wish to receive these, care providers can use medications to reduce pain and make the person more comfortable.

If the patient cannot talk, it is important to look for behavioral clues such as depressive or psychotic symptoms, anxiety, and sleep and activity disturbances that may indicate he or she is experiencing pain.

Restraints

Restraints may be used in long-term care settings and hospitals as a means to control Alzheimer-related behavior problems such as wandering, agitation, and combativeness. They are also used to prevent patients who are receiving artificial nutrition from pulling out the feeding tube.

Although restraints are intended to protect the safety of the patient, their use can cause harm as well as jeopardize the individual’s independence and dignity.

According to the Joint Commission on Accreditation of Health Care Organizations (JCAHO), an organization that evaluates and accredits health care organizations, studies have demonstrated that effective programming can eliminate the need for restraints.

Physical restraints restrict the person’s ability to move and, as a result, can cause incontinence, loss of muscle tone, pressure sores, depression, and decreased appetite.

People with Alzheimer’s have the right to receive care without the use of physical or chemical restraints that are not needed to treat a medical condition. Care providers have an obligation to try alternatives to restraints, such as diversions for aggressive behavior or safe places to wander.

Hospice care

People with Alzheimer’s disease will likely be in and out of nursing homes and hospitals as the disease advances. One unique care option is hospice.

The underlying philosophy of hospice focuses on quality and dignity by providing comfort, care, and support services for people with terminal illnesses and their families.

Hospice places an emphasis on maximizing patient comfort and providing counseling and bereavement services to the family before and after their loved one dies.

Long-Distance Caregiving

Caring for a loved one who lives far away can be emotionally and financially exhausting.

Concerns about your loved one’s safety, nutrition, health, and care may seem overwhelming. You may also feel guilty and anxious because you cannot be there every day to see how the person is doing.

This page offers advice on coping with long-distance caregiving and considerations for when it's time to move your loved one into an assisted living facility.

Determine what services are needed

If the person with Alzheimer’s disease lives alone, it is important to monitor his or her ability to manage various daily tasks. Visit the person with Alzheimer’s disease to determine what kind of assistance he or she may need. Make the following observations:

Is there appropriate and adequate food available?
Is the person eating regular meals?
What is the condition of the living environment? Has it changed?
Are the bills paid?
Do friends and relatives visit regularly?
Is the person maintaining personal care routines such as bathing and grooming?
Is the person still able to drive safely?

If you are unable to answer these questions, the person’s doctor, neighbors, family members, and friends can be good sources of information.

Turn to others for help

Establishing an informal support system can help ensure the person’s safety and give you peace of mind.

Family members and friends can provide companionship. Ask them to visit once a week or so, depending on how far away they live.
Neighbors can check regularly on your loved one. Ask if they will remain alert to anything unusual such as the smell of smoke or the sound of an alarm coming from your relative’s home.
Community organizations, such as churches, synagogues, neighborhood groups, and volunteer organizations, often provide companion services.

Make the most of visits

Few long-distance caregivers are able to spend as much time with their loved one as they would like. The key is to make periodic visits and use your time effectively:

Make appointments with your loved one’s physician, lawyer, and financial adviser during your visit to facilitate decision making.
Meet with neighbors, friends, and other relatives to hear their observations about how the person is doing. Ask if there have been any behavioral changes, health problems, or safety issues.
Take time to reconnect with your loved one by talking, listening to music, going for a walk, or participating in activities you enjoy together.

Consider carefully before moving a loved one into your home

The decision to move the person to your home is influenced by many factors. Here are some things to think about before moving the person into your home:

Does he or she want to move? What about his or her spouse?
Is your home equipped for this person?
Will someone be at home to care for the person?
How does the rest of the family feel about the move?
How will this move affect your job, family, and finances?
What respite services are available in your community to assist you?

Moving a person with Alzheimer’s disease from familiar surroundings may cause increased agitation and confusion. You may want to talk with your loved one’s physician or a social worker or call your local Alzheimer’s Association chapter for assistance before making a decision. In some situations, an assisted living or a residential care setting may be a better option for the individual.

Caring for a loved one in a facility

Whether your loved one lives in an assisted living or a residential care facility, it is important to maintain ongoing communication with the care staff and friends who visit regularly.

Work with the managing nurse and physician. Agree on a time when you can call to get updates on the person’s condition and progress.
Call family, friends, or other visitors and ask for their observations.
When you visit, meet with the staff members who have primary responsibility for your loved one’s care.

Resolving family conflicts

Caregiving issues can often ignite or magnify family conflicts, especially when people cope differently with caregiving responsibilities.

Family members may deny what is happening, resent you for living far away, or believe you are not helping enough. There may also be disagreement about financial and care decisions.

To minimize conflicts, try to acknowledge these feelings and work through them.

Have a family meeting. Talking about caregiving roles and responsibilities, problems, and feelings can help ease tensions. You may want help from a professional counselor or clergy.
Recognize differences. Some family members may be hands-on caregivers, responding immediately to issues and organizing resources. Others may be more comfortable with being told to complete specific tasks.
Share caregiving responsibilities. Make a list of tasks and include how much time, money, and effort may be involved to complete them. Divide tasks according to the family member’s preferences and abilities.
Continue to communicate. Periodic family meetings or conference calls keep the family up-to-date and involved. Discuss how things are working, reassess the needs of both the person with Alzheimer’s and the caregiver, and decide if any changes in responsibilities are needed.

Many long-distance caregivers feel guilty for living far away from the person with Alzheimer’s. This guilt, compounded by the grief related to seeing a loved one’s decline, may make it difficult to emotionally recover from a visit. It is important to seek support from family, friends, a counselor, or the Alzheimer’s Association to help deal with these feelings.

Music, Pet and Other Therapies

Music, pet, and other types of therapies can help enrich the lives of people with Alzheimer’s disease. Pets, for instance, have been shown to reduce depression and boost self-esteem. Art provides an outlet for expression. Music stirs memories, emotions, and when accompanied by singing, encourages group activity. Create guidelines for all activities in order to ensure their effectiveness.

Music therapy guidelines

Identify music that’s familiar and enjoyable to the listeners.
Use live music, tapes, or CDs; radio programs, interrupted by too many commercials, can cause confusion.
Use music to create the mood you want.
Link music with other reminiscence activities; use questions or photographs to help stir memories.
Encourage movement (clapping, dancing) to add to the enjoyment.
Avoid sensory overload; eliminate competing noises by shutting windows and doors and by turning off the television.

Pet therapy guidelines

Not everyone will react positively to animals. Those who owned pets previously tend to be more responsive.
Match the animal’s activity and energy level with that of the individual. For example, a lively dog might be appropriate for someone who can go out for a walk; a cat may be more appropriate for a person who is less mobile.

Tracking Symptoms

As a caregiver, you may wish to track the changes your loved one experiences as a result of Alzheimer’s disease and how you addressed these changes. The information you record from day-to-day may be helpful when you meet with physicians and providers of adult day services or long-term care. In addition, you may find it helpful to review from time-to-time, to remind yourself of caregiving strategies that have worked.

Many caregivers find it useful to keep a type of symptoms journal. For each day you are tracking, note the following:

Problems or changes in the following areas:

Memory
Behavior
Personality
Skills
Other

Caregiving strategies that worked? Strategies that did not work
Activities your loved one enjoyed
Any medications the person took that day (include prescriptions, over-the-counter, and herbal remedies):

Medication name
Dosage
When and how many taken daily

Caregiving Challenges

Alzheimer's disease can cause a person to exhibit unusual and unpredictable behaviors that challenge caregivers, including severe mood swings, verbal or physical agression, combativeness, repetition of words, and wandering. These behavioral changes can lead to frustration and tension, for both people with Alzheimer's and their caregivers. It is important to remember that the person is not acting this way on purpose, and to analyze probable causes and develop care adjustments.

Common causes of behavior changes

Physical discomfort caused by an illness or medications
Overstimulation from a loud or overactive environment
Inability to recognize familiar places, faces, or things
Difficulty completing simple tasks or activities
Inability to communicate effectively

Tips for responding to challenging behaviors

Stay calm and be understanding
Be patient and flexible
Don't argue or try to convince the person
Acknowledge requests and respond to them
Try not to take behaviors personally
Accept the behavior as a reality of the disease and try to work through it

Exploring causes and solutions

It is important to identify the cause of the challenging behavior and consider possible solutions.

Identify and examine the behavior

What was the undesirable behavior? Is it harmful to the individual or others?
What happened before the behavior occurred?
Did something trigger the behavior?

Explore potential solutions

Is there something the person needs or wants?
Can you change the surroundings? Is the area noisy or crowded? Is the room well-lighted?
Are you responding in a calm, supportive way?

Try different responses in the future

Did your response help?
Do you need to explore other potential causes and solutions? If so, what can you do differently?

Planning Ahead

As a family caregiver, you will be involved in helping to plan for the future legal, financial, and care needs of your loved one with Alzheimer's. Legal and financial planning should begin soon after a diagnosis has been made. The earlier you explore care arrangements, the most likely you are to find options that you and your loved one prefer.

Depression

Depression is a common cause of “reversible” dementia in older adults. Depression is four times more likely to strike those over age 65 than younger individuals.

It is found in 20 percent of persons with Alzheimer’s disease, in up to 50 percent of Alzheimer caregivers, and in 15 percent of adults over age 65. Sadly, most people never get help for this treatable illness.

Symptoms of depression

The presence of at least four of the following symptoms over a two-week period may indicate depression:

Depressed or irritable mood
Feelings of worthlessness, self-reproach, or excessive guilt
Suicidal thinking or attempts
Motor retardation or agitation
Disturbed sleep
Fatigue and loss of energy
Loss of interest or pleasure in usual activities
Difficulty thinking or concentrating
Changes in appetite and weight

Branch news

Christmas is looming on the horizon as I write. What happened to the summer? Even her in sunny Eastbourne, it passed all too quickly. We are looking forward and preparing for some changes in the new year but first let us talk about the more immediate matters.

Dementia Day came and went and we feel that it was a great success. With over seventy people attending, their returns showed that nearly everyone considered the day well spent. Sally Knocker, who described herself with an Italian phrase, "La piccola ragazza con la grande voce" (Little girl with a big voice) used that voice with good effect. No dull boring lecture this. In no time she had her audience out of there seats, taking an active part in ideas for enervating dementia sufferers in care homes.

Our Christmas party for people with dementia and their carers takes place in Hailsham on the 13th. of December and meanwhile the committee are considering changes in the New Year. Out Community funding ends in the summer. At the same time, we have to vacate our offices and say farewell to Sue Gross, our Carers Support Worker, who is taking well earned retirement. We are actively seeking to replace both plus secure future funding for the replacements. Meg Lansom, who has taken on many roles in the branch as well as doing a job and taking care of husband and family is seeking to lighten her load by resigning a secretary and office manager but still continuing with her role in producing our newsletter.

Our next Dementia Care Information program for Carers starts on the 23rd. January 2003 and consists of seven weekly sessions on Thursday mornings from 10.30 am to 12.30 pm at the church hall of St. Peter & St Saviours in South Street, Eastbourne

Under the title, "What do I do now?" the program deals with Caring, financial, legal matters and coping with stress.

BRANCH SERVICES

HELP LINE At present administered from the office with cover by answering machine when office unmanned. Telephone 01323 727127

LIBRARY Books available to view in office or on free loan.

CARE SUPPORT PROGRAMME A series of meetings, usually of seven weekly sessions dealing with most aspects of caring for someone with dementia. Free to carers with help with transport and alternative care. Supported by a Community Grant until summer 2003.

COFFEE MORNINGS Monthly on the fourth Wednesday at the home of a past carer, Mrs Eileen Barton. Telephone office for info. There is a tendency for this to become over subscribed and plans are afoot to create a second venue. Carers meet from 10.30 am to Noon and exchange experiences. This has proved a valuable lifeline for many and a source of volunteers. As a welcome offshoot to our Care Support programmes, some carers have continued to meet in various venues to keep in contact.

OUTINGS From time to time, outings are arranged to places in the surrounding countryside. In December a party is organised. These are for both people with dementia and carers.

NEWSLETTER A bi-monthly newsletter is produced and distributed to carers etc.

WEB SITE. The editor is pleased to receive comments, both critical and supportive, also suggestions. See the Contacts page for the address

CONTACTS

Office & Help line:
Tel: 01323 727127
Fax: 01323 733343

Alzheimer’s Society, Venton Centre, Junction Rd.,Eastbourne, East Sussex, BN21 3QY

Chairman: David Sutcliffe 9 Milton Crescent, Eastbourne, BN21 1SP
Tel: 01323 724886 Email:

Secretary: New Secretary in January 2003

Treasurer: David May. Address ‘The Treasurer’ c/o the office (see above)

Care Support Worker. Sue Gross c/o the office (above)

Newsletter Editor: Mrs Meg Lansom 94 High Street Westham, East Sussex, BN24 5LJ

Web Page Editor: Sydney Hetherington. Tel: 01323 728554

NOTE: The office is generally manned on Monday, Tuesday and Thursday between the hours of 9.00 am and 4.00 pm. But there is a telephone answering machine which is regularly checked

Access:

By rail: Leave station by taxi rank exit (left at barrier). Continue alongside railway to next left turn

By road: From A22 follow Town Centre signs to Railways Station. As road bears round station, take first left

On foot: Leave the Arndale Centre by Sainsbury's exit, cross road and Junction Road is straight ahead.

Benefits for Carers and Parent-Carers

If the adult or child you look after gets Disability Living Allowance or Attendance Allowance, you may be able to claim Invalid Care Allowance.

Invalid Care Allowance (ICA)

ICA is paid to people who are aged between 16 and 65, and who spend at least 35 hours a week caring for someone who gets either Disability Living Allowance or Attendance Allowance.

ICA is not affected by savings, but some other Benefits may increase or decrease when ICA is awarded.

Carers who receive ICA can earn up to £72 from paid employment without ICA being affected.

Carers who receive ICA will receive a National Insurance (NI) credit each week which will count towards the Basic Retirement Pension. But this does not apply to married women who pay the reduced rate of NI.

You can get more information about ICA and an application form from your local Benefits Agency – please see the Phone Book for their telephone number.

Other Benefits

People with disabilities and their carers, or families with disabled children who are on a low income may be able to claim Income Support (IS). With IS you may also get disability or carer Premiums, which means extra money each week. There is also a Tax Credit for working people with disabilities who earn a low wage, which means more money each week. And there is a Tax Credit for working families who earn a low wage, and who have children, which again means more money. There are some other disability Benefits as well. To find out which Benefits you may be able to claim, ring the Benefit Enquiry Line On 0800 88 22 00, or contact your local Citizens Advice Bureau – you will find the telephone number in the Phone Book.

Power of Attorney

At any point in our lives we can become incapable of managing our own affairs ~ through accident, ill health, the onset of mental illness or frailty. If a legal arrangement has not been made for their financial and legal affairs to be taken care of by family or friends, then their case will be referred to the Public Guardianship Office - a government body that will appoint an official to act in their interests. This could result in finances being frozen until the Office has made the appointment, and this might mean that bills cannot be paid or other commitments met for some time. The Public Guardianship Office will charge fees for the business they do on behalf of the client.

To prevent this happening, anyone who owns property, or has savings or investments is advised to make a legal arrangement to have their money and property managed before they become too mentally frail to make their own decisions. This legal arrangement is called an Enduring Power of Attorney.

What is an Enduring Power of Attorney?

It is an official document, made on a special form, by which one person (the Donor) gives to another person (the Attorney) the power to act on the Donor's behalf in all financial and legal matters, unless restrictions have been specified. For example, it would give the Attorney power to authorise repairs on the Donor's house; to buy or sell a house on behalf of the Donor; to invest the interest on the Donor's savings; to buy or sell stocks and shares.

An Enduring Power of Attorney can be made at any time before the onset of mental illness or frailty, or brain damage caused by illness or accident. It will only be put into effect if and when it is needed. It is too late to make an Enduring Power of Attorney once a person has suffered brain injury, or is very confused, mentally frail or mentally ill.

Who Can Be An Attorney?

Anyone aged over 18 who isn't bankrupt, and who is in good mental health can be an Attorney. A relative or friend of the Donor is ideal, but some people prefer to appoint a solicitor - a solicitor would, of course, charge a fee for all work done.

How Long Does an Enduring Power of Attorney last?

It lasts until the Donor recovers sufficiently to resume management of their own affairs, or until their death.

How To Make Arrangements

Ask your solicitor to make the arrangements for you, OR
Contact the Public Guardianship Office (see below). They have all the necessary forms and information booklets, and they also have helpful staff who can talk through individual needs and give expert advice.

You will have to pay a fee, whichever of the above means you choose. You could expect to pay £30 to £100, depending on how complicated the arrangements are. The cost can be reduced if you combine the Enduring Power of Attorney with making your will - this, of course, could only be done through a solicitor.

For more information, advice, leaflets or forms, please contact:

The Public Guardianship Office
Archway Tower
London
N19 5RQ
020 7664 7300
Website:

How To Get Help With Caring

Social Services can provide a number of services that make caring easier. For example, they can provide day care at a day care centre; home care; meals on wheels; a short break in a residential home (respite care); and, in some cases, finance to enable families to pay for care for their disabled person or child.

Services are slightly different for children and adults. The key to getting help is a Social Care Assessment for a child or a Community Care Assessment for an adult. This means that a social worker will visit you at home and decide what help your disabled child or adult needs.

At the same time, you should ask for a Carers Assessment. This means that you will be able to say how much help you feel you need.

The two assessments will be taken together and Social Services will write a Care Plan which gives details of the services they will provide. You should be given a copy of this. If it is not offered to you, please ask for your copy.

Following this, Social Services will make a Financial Assessment, which means that they will look at the savings and income of the disabled person, to see how much they can reasonably contribute towards the cost of services. In the case of children under 16, parents may be assessed.

You can apply for your first Assessment and Carers Assessment at any time, and you can apply for new assessments to be made if you feel that things have changed and more help is needed.

Social Services should look at the Care Plan regularly, to take account of changes in the illness or disability, or in the family situation. This is called a REVIEW, and should be done at least once a year.

How To Arrange An Assessment

The social workers who make the Assessments come from different offices. Where they come from depends on where you live, the age of the person you look after, and what kind of illness or disability they have. To find out which office you need to call, ring the Social Services Information Line on: 0808 808 7777. Tell them that you want to arrange Assessments, and ask them which office you need to contact.

Next, call the number you have been given and ask to speak to the Duty Social Worker. Tell them that you want to arrange an appointment for a social worker to make an Assessment for the person you look after, and a Carers Assessment for yourself.