“I need more help” is an absolutely true statement. But what can actually help to move from being vague to clarity and possibly more help is to identify where the actual breakdown is: - supervision - meals - transportation - medication management - personal care - housekeeping - nighttime support - appointments - companionship - caregiver respite - decision-making - finances/legal planning I like to think about asking for help as if I'm setting up a job description, what actual tasks can someone else help with that will actually reduce your stress, exhaustion, decision overload? If you look at the statement “I need my siblings to help more,” it shows a need, but no one understands what's needed, they're not sure how to help. However if you share that “I need someone to take Mom to her Thursday appointment at 2pm and stay with her Saturday afternoon for 2 hours, so I can leave the house,” it's clear and allows someone to consider their schedule and skills specifically. I have time on Saturday I can do that. “Specific needs are easier to plan for than general overwhelm.” Consider this during your week, What would make the biggest difference today?

Dementia is a progressive disease, but it's neither predictable nor uniform. And therefore, families often postpone difficult decisions because nothing feels urgent enough yet, until suddenly everything is urgent. Areas should include these topics: - living alone - driving - increasing supervision - finances - bringing in help - respite - moving - caregiver capacity A difficult conversation held early gives you choices. The same conversation held during a crisis often gives you fewer. If your strategy is to monitor medication errors, falls, and increasing confusion, hesitating with a “Let’s see how it goes approach” then I'd challenge you to explore: What conversation have you been quietly postponing because you’re not sure it’s ‘bad enough’ yet?

Today's change is to choose one concern you and your family may have been arguing about and translate it into observable facts. Examples of concerns: Mom shouldn't be driving can translate into: Mom got lost twice coming home from the grocery store, drove over a curb last week, and couldn't explain what one traffic sign meant. That's a powerful distinction. Dad needs more help can be more clearly described as: Dad needs reminders for every meal and someone physically present for bathing. I'm doing everything (which can certainly be true) is more accurately described by saying: This week I handled 14 phone calls, three appointments, medications, groceries, laundry, and four evening visits. This week's One Change Challenge is to: Document one concern for seven days. Nothing complicated. Just make a note of: Date, What happened, and What help was needed That little record can become incredibly useful for: - siblings - physicians - therapists - care conferences - future planning If you missed the first 2 videos in this series you can check them out here--> Why Dementia Caregiving is Different: https://www.skool.com/dementiacaregivercollective/why-dementia-caregiving-is-different-why-families-can-look-at-the-same-person-and-see-different-realities?p=e53b4043 Become the Curious Observer: https://www.skool.com/dementiacaregivercollective/become-the-curious-observer-look-at-function-not-just-impressions?p=9181f08c Stay tuned for next week as we dig deeper into- When Knowing Isn’t Enough: How Families Make the Hard Decision

Today as the observer we are going to collect specific functional observations. Instead of “Dad can’t live alone anymore. Dig deeper, give more concrete evidence of why you believe that. This isn't to justify your thinking, it's to provide details of a changing brain, and declining function so that your loved one can get the assistance they need to be safe and as independent as possible Consider this instead: “Dad has left the stove on twice this month, missed four medication doses last week, and called me three nights because he couldn’t figure out where the bathroom was.” That's a very different conversation. These are common areas that allow us to see black and white changes they're experiencing: - medications - meals - finances - transportation/driving - personal care - household management - mobility/falls - orientation - judgment - nighttime functioning As compassionate caregivers, I believe that you are already filling in the gaps, today let's explore What are you already compensating for? This is a critical clue and piece of the caregiving puzzle. Though the family sees that Mom may still be able to manage her medications, the essential piece is because you are filling the pillbox, calling twice a day, checking the bottles, and ordering every refill. Similarly, Dad still cooks, only because someone shops, portions meals, labels everything, provides a safe toaster oven and checks on him afterward. Observers: What would happen if the support you are currently providing disappeared for 48 hours? Be sure to check back in on Friday for the One Change Challenge Remember, observation gives us information, not control. And sometimes that information is exactly what we need to make a better plan."

Not every change means the same thing. A gradual loss of familiar skills over months is different from a noticeable change over hours or days. And memory changes alone don’t tell the whole story, function matters: medications, finances, meals, driving, appointments, hygiene, navigation, judgment. I bet you as the caregiver often notice a collection of small changes before putting it all together to mean the caregiving situation itself has shifted. - more help needed with familiar routines - increased repetition - less interest in usual activities - more confusion in familiar places - new trouble with medications, meals, money, or appointments - increased falls or near-falls - sleeping more or less - withdrawing socially - caregiver needing to supervise more - The important question is not just, ‘Is this dementia getting worse?’ It’s also, What is changing in daily life because of it? What change have you noticed recently that you’re not quite sure what to make of yet? *** A sudden or significant change from baseline deserves attention and should not automatically be blamed on dementia. Infection, medication effects, dehydration, pain, metabolic problems, sleep disruption, and other medical issues can all change cognition or behavior. Sudden confusion or a major acute change can require prompt medical evaluation.