Aging Pro’s Challenges and Solutions

Dr Cheryl Mathieu

The Shriver Report: A Women’s Nation Take on Alzheimer’s was just released. The Report is a collaboration between Maria Shriver and the Alzheimer’s Association, exposing the epidemic’s effect on women as caregivers, advocates and people with the disease. Maria is getting people talking about Alzhiemer’s disease!

Alzheimer’s is a women’s issue. According to the report, women make up two-thirds of the people with Alzheimer’s in the U.S. and account for 60 percent of the unpaid caregivers for people with Alzheimer’s. This means that 10 million women either have Alzheimer’s or are caring for someone with Alzheimer’s. 40 percent of the caregivers interviewed said they felt like they had no choice in assuming the caregiving role. These numbers continue to grow, daily.

Alzheimer’s disease is costly. Governments, businesses and families spend $300 billion a year on Alzheimer’s disease. Yearly, it costs about $56,000 to care for someone with Alzheimer’s, which is typically paid for by families. Daughters, sons, spouses will give up their jobs, savings, time, health, and sanity to help care for loved ones with Alzheimer’s.

A woman with Alzheimer’s has unique challenges. Since women tend to live longer, they are more often widows who may not have a spouse to care for them as the disease progresses. She may be caring for other family or friends, so as she declines the others will need to find different caregivers. Women tend to be the “glue” in the family, and as her disease progresses her family may no longer remain as cohesive.

A woman as a caregiver for someone with Alzheimer’s experiences challenges as well. She is more likely to be depressed, and according the Report, 68 percent of women who were caregivers experienced emotional stress, and 51 percent of them said they suffered from physical stress. Most caregivers don’t self-identify as caregivers. They just think a loved one needs help and they are going to help. They don’t know they need to ask for help, and don’t realize what a toll caregiving is taking on their lives and health. Caregivers often put aside their own needs and dreams to take care of their loved ones. Daughters experience a role reversal, now needing to take an in-charge position with their parents.

How can we relieve the emotional stress on families? Caregivers need support, education and resources. The needed resources are often available, but it’s very difficult to find them when you need them. That is why I launched www.AgingPro.com. It brings all the resources, professions, education and support for eldercare to one place. Lack of information promotes fear. Care coordination is also crucial, and part of the Healthcare reform legislation. Certified Geriatric Care Managers provide an invaluable communication link between doctors, community care providers, persons with Alzheimer’s and their family. Care Managers are invaluable, yet for some are not affordable. Pilot community care coordination programs do exist, and we need more. We need more support groups, both in-person and online. Adult day respite programs need to focus on early and moderate stage memory loss, not just later stages.

How can we prepare for Alzheimer’s possibly hitting our own family? Few want to talk about it. Some don’t even want to say the word. Yet it’s a natural part of life and will affect all of us in one way or another. I’m referring to Aging. Aging has become a taboo subject in our American culture, something we pretend isn’t there. If you read the paper, watch TV, or go on the Web, you mostly see images of youth, thinness, wealth and beauty. However, we are beginning to realize our population is aging – and so are we.
I’m here to tell you that getting older can be a positive experience and have its own unique rewards. Contrary to the whispered implications, it doesn’t have to be a time of withering away and going to a nursing home. Fun, happiness, success and fulfillment aren’t just the things of youth; they can be enjoyed abundantly throughout life. Older adults can stay independent, active and vital as they age. Getting older CAN mean getting better, if you have the right attitude, information and resources.
So first, we need to be willing to have discussions about aging, starting in our families and communities. Ask each other – when you get older, where do you want to live? What is your ideal vision? It is very helpful to create a “Plan B.” Just as we would prepare for an earthquake, we prepare for the potential of Alzheimer’s in the family. Plan A is what you’d like to happen, Plan B is what you will do if Alzheimer’s strikes you or your family. Plan B is created by: educating yourselves about the signs and symptoms of the disease; pre-planning your legal matters (creating a will, trust and durable power of attorney for healthcare and finances); saving money for your long-term-care, or purchasing long-term-care insurance; educating yourselves about the choices of housing and care; and locating the professionals and resources available to help out along the journey.

How can government, business, nonprofits and the press effectively call attention to the threat of Alzheimer’s and implement solutions? More education and awareness campaigns can be created – public service announcements, television series on different eldercare topics (similar to the new “Hoarders” series), celebrity involvement – to help shift the old negative stereotypes of aging and eldercare, and to help the millions of caregivers that don’t know how to access the services or find the support they need. Maria Shriver, the aging field needs your voice!

An example of a creative television show might be Extreme Makeover, Grandma Edition. Make over the home of an older person  –  repairing and/or modifying their homes so they can continue to live independently. There are many inspiring stories of need and courage among caregivers and elders!

Businesses can provide eldercare services and counseling and care coordination as part of their Employee Assistance Programs (EAP). Non-profits can provide more grant money to elder care topics. Solutions to Alzheimer’s now include: information, support and best practice guidelines.

The topic of Women and Alzheimer’s is so important. It is where the pain points of love, guilt, money and time intersect – a perfect fit for press, government, the press and business to join in the cause.

The issues in women and Alzheimer’s eldercare are many-faceted and deeply layered. More money for Alzheimer’s research is needed. More support and education is also needed, on all eldercare topics. Most family caregivers for the elderly feel trying to do what’s best for their loved ones. They don’t know where to turn to get help. The stress of caregiving affect their work, finances, and physical and mental health. Caregivers, women, need a place to connect, to learn, be inspired and empowered. AgingPro.com is that place, the “Waiting for superwoman, caregiver edition.”

15 million people provide care for someone with Alzheimer’s Disease – a 37% increase from last year.

5.4 million people have Alzheimer’s Disease.

Every 69 seconds someone new develops Alzheimer’s, which will increase to every 33 seconds by 2050.

The amount spent on Alzheimer’s (and other related dementias) is $183 billion, and $11 billion increase over 2010.

Most caregivers are family members, who give financially, emotionally, physically. 80% of care provided in the home is by unpaid caregivers. The personal toll of this disease is

Alzheimer’s is the only top 10 cause of death that has no effective prevention or cure.

Making early financial and long term care decisions can help families deal with the details of caring for someone with Alzheimer’s.

Geriatric Care Managers can assist with assessment, planning, education, referrals and support. They are your trusted ally, and can help decrease the stresses associated with caring for someone with dementia.

http://tinyurl.com/49lyhtr

This is a great article about Clearing the Fog at Nursing Homes – how behavioral interventions (and hands-on caring) changed residents from zombies to engaged adults at one nursing home in Two Harbors, Minn.  http://tinyurl.com/4oxw9kv

As the article states, behavioral interventions can be more costly to implement than prescribing, yet in the long run it can save money – not to mention the increased quality of life for the residents and families.

Even if your loved one with dementia is not in a nursing home, there are behavioral modifications you can use at home that might help them live a better life. Caring, and a loving touch can make a bigger difference than you might think.

Lots of other great information and inspiration on this site!

Determining when a person with dementia needs someone else to manage their money, or when someone is no longer capable of entering into a legal contract is not always easy. There is no exact answer or solution. Often doctors, lawyers and financial advisers are working in a “gray area.”

If you have concern that a loved one may not be capable of managing their money on their own, you may want to talk to them directly about it. Many times they will deny there is any trouble, and will say they don’t need help. Chances are they know they need help, and they are afraid. They don’t want to lose their independence or dignity. Some people won’t know when they need help. Talking about it opens the door for accepting assistance.

A next step would be to accompany your loved one to their physician’s visit, notifying the doctor ahead of time of your concerns. It is often times easier for an older person to accept a directive from a doctor rather than an adult child.

If your loved one needs help, you can assist in many ways, ranging from: monitoring their accounts online for suspicious transactions; helping them write their checks and managing the checkbook, and taking over all of their bill paying and financial responsibilities. Watch for potential elder fiduciary abuse through junk mail schemes, such as letters telling them they won the lottery or notices asking them to send money to “save their social security.”

This article touches on some of the thoughts and questions involved in the topic of elders and their finances. http://tiny.cc/ledrf

A geriatric care manager can be an excellent ally when talking to a loved one about difficult topics, or assess the situation neutrally and professionally.

Trust your instincts and watch for signs that your loved one may need more assistance. Be sensitive and compassionate, keeping in mind it is probably a sensitive and powerful issue for everyone involved.

“I’m so worried about my Dad. He is forgetting things lately and seems confused. How can I find out if he has Alzheimer’s? And if he does have it, what do I do?”

As a geriatric care manager, I frequently receive calls just like this. Fear of the unknown can be the most troublesome part of caring for someone you love when they begin to demonstrate changes in behavior. The following information can decrease your stress and help you ensure that mom and dad get the best care possible.

Each year a million people start a mental decline called mild cognitive impairment (MCI) with memory loss somewhere between normal aging and Alzheimer’s. Although Alzheimer’s disease is the most common form of dementia in the U.S., there are many reasons why someone’s memory can decline. Some of these causes are treatable. Generally, Alzheimer’s disease has a gradual onset of symptoms over months to years and a worsening of cognition. If the memory loss or confusion comes on quickly, this could indicate that something other than Alzheimer’s is going on. You’ll want to ask for a thorough evaluation by someone who specializes in memory impairment as a first step – this could be a psychiatrist, neurologist or a geriatrician.

The evaluation will include testing for conditions that look similar to dementia – but aren’t, such as:

• Delirium (sudden onset confusion due to infection, medication, acute illness)
• Depression (which can sometimes include memory problems)
• Thyroid problems, metabolic abnormalities (abnormal glucose and calcium, kidney and liver failure)
• Vitamin B 12 deficiency, symptoms of a progressing chronic disease (low oxygenation due to lung disease, anemia or heart disease).
• Urinary tract infection (the symptoms of which can appear like dementia).

Imaging the brain can also be helpful to check for a tumor, stroke, or increased pressure on the brain. These tests can help determine the cause of memory loss, and if it’s treatable.

Once dementia is confirmed, the next step is to determine whether it is Alzheimer’s. (There are different kinds of dementia, other causes of memory loss and then there are declines that are still considered “normal aging.”) If it is Alzheimer’s, there are medications that might be helpful in slowing the progress of the disease. People with Alzheimer’s may do better in the long term if they have early intervention. And do stay in touch with your loved one. If they exhibit any of the behaviors listed here [http://www.agingpro.com/articles/article.php?id=10126], it may be time to consider getting them live-in help or moving them to an assisted living facility.

This may be a difficult time, but there is information and loving support available for you and your loved ones. There are books, support groups, websites, geriatric care managers and others who have gone through this before you to guide you every step of the way.

Remember, take care of yourself!

Alzheimer’s is a women’s issue. According to the report, women make up two-thirds of the people with Alzheimer’s in the U.S. and account for 60 percent of the unpaid caregivers for people with Alzheimer’s. This means that 10 million women either have Alzheimer’s or are caring for someone with Alzheimer’s. 40 percent of the caregivers interviewed said they felt like they had no choice in assuming the caregiving role. These numbers continue to grow, daily.

Alzheimer’s disease is costly. Governments, businesses and families spend $300 billion a year on Alzheimer’s disease. Yearly, it costs about $56,000 to care for someone with Alzheimer’s, which is typically paid for by families. Daughters, sons, spouses will give up their jobs, savings, time, health, and sanity to help care for loved ones with Alzheimer’s.

A woman with Alzheimer’s has unique challenges. Since women tend to live longer, they are more often widows who may not have a spouse to care for them as the disease progresses. She may be caring for other family or friends, so as she declines the others will need to find different caregivers. Women tend to be the “glue” in the family, and as her disease progresses her family may no longer remain as cohesive.

A woman as a caregiver for someone with Alzheimer’s experiences challenges as well. She is more likely to be depressed, and according the Report, 68 percent of women who were caregivers experienced emotional stress, and 51 percent of them said they suffered from physical stress. Most caregivers don’t self-identify as caregivers. They just think a loved one needs help and they are going to help. They don’t know they need to ask for help, and don’t realize what a toll caregiving is taking on their lives and health. Caregivers often put aside their own needs and dreams to take care of their loved ones. Daughters experience a role reversal, now needing to take an in-charge position with their parents.

The Shriver reports asks some questions, and I have the following answers:

How can we relieve the emotional stress on families? Caregivers need support, education and resources. The needed resources are often available, but it’s very difficult to find them when you need them. Lack of information promotes fear. That is why I launched www.AgingPro.com. It brings all the resources, professionals, education and support for eldercare to one place. Care coordination is also crucial, and part of the Healthcare reform legislation. Certified Geriatric Care Managers provide an invaluable communication link between doctors, community care providers, persons with Alzheimer’s and their family. Care Managers are invaluable, yet for some are not affordable. Pilot community care coordination programs do exist, and we need more. We need more support groups, both in-person and online. Adult day respite programs need to focus on early and moderate stage memory loss, not just later stages.

How can we prepare for Alzheimer’s possibly hitting our own family? Few want to talk about it. Some don’t even want to say the word. Yet it’s a natural part of life and will affect all of us in one way or another. I’m referring to Aging. Aging has become a taboo subject in our American culture, something we pretend isn’t there. If you read the paper, watch TV, or go on the Web, you mostly see images of youth, thinness, wealth and beauty. However, we are beginning to realize our population is aging – and so are we.
I’m here to tell you that getting older can be a positive experience and have its own unique rewards. Contrary to the whispered implications, it doesn’t have to be a time of withering away and going to a nursing home. Fun, happiness, success and fulfillment aren’t just the things of youth; they can be enjoyed abundantly throughout life. Older adults can stay independent, active and vital as they age. Getting older CAN mean getting better, if you have the right attitude, information and resources.
So first, we need to be willing to have discussions about aging, starting in our families and communities. Ask each other – when you get older, where do you want to live? What is your ideal vision? It is very helpful to create a “Plan B.” Just as we would prepare for an earthquake, we prepare for the potential of Alzheimer’s in the family. Plan A is what you’d like to happen, Plan B is what you will do if Alzheimer’s strikes you or your family. Plan B is created by: educating yourselves about the signs and symptoms of the disease; pre-planning your legal matters (creating a will, trust and durable power of attorney for healthcare and finances); saving money for your long-term-care, or purchasing long-term-care insurance; educating yourselves about the choices of housing and care; and locating the professionals and resources available to help out along the journey.

How can government, business, nonprofits and the press effectively call attention to the threat of Alzheimer’s and implement solutions? More education and awareness campaigns can be created – public service announcements, television series on different eldercare topics (similar to the new “Hoarders” series), celebrity involvement – to help shift the old negative stereotypes of aging and eldercare, and to help the millions of caregivers that don’t know how to access the services or find the support they need. Maria Shriver, the aging field needs your voice!

An example of a creative television show might be Extreme Makeover, Grandma Edition. Make over the home of an older person  –  repairing and/or modifying their homes so they can continue to live independently. There are many inspiring stories of need and courage among caregivers and elders!

Businesses can provide eldercare services, counseling and care coordination as part of their Employee Assistance Programs (EAP). Non-profits can provide more grant money to elder care topics. Solutions to Alzheimer’s now include: information, support and best practice guidelines.

The topic of Women and Alzheimer’s is so important. It is where the pain points of love, guilt, money and time intersect – a perfect fit for government, the press and business to join in the cause.

The issues of women, Alzheimer’s and eldercare are many-faceted and deeply layered. More money for Alzheimer’s research is needed. More support and education are also needed on all eldercare topics. Most family caregivers for the elderly are trying to do what’s best for their loved ones. They don’t know where to turn to get help. The stress of caregiving affects their work, finances, and physical and mental health. Caregivers  need a place to connect, to learn, be inspired and empowered. AgingPro.com is that place, the “Waiting for Superwoman, Caregiver Edition.”

Preparation can help the trip to the doctor go more smoothly.  Here are some tips for success:
1.    Schedule the appointment at the best time of day for your client.  For example, the client I work with functions better in the afternoon.  There were times when we had to reschedule morning appointments for the afternoon because she didn’t want to get up, and therefore she wouldn’t cooperate with me.

2.    Ask the doctors office staff when their office is generally the least crowded.  Some clients may be upset by a full waiting room, or they just might not like crowds.  Visiting the office when there are fewer people will cut down on the time you will have to wait too.

3.    Bring along something for your client to eat, drink or do while you are waiting.  Any activity he or she enjoys can really help to pass the time.

4.    Have a friend go with you to the doctor so one of you can be with the client while the other is talking to the doctor.

5.    Call the doctors office on the day of your appointment before you leave to see if the doctor is running late, and adjust your arrival time.

Planning ahead before the appointment with the doctor can really make the visit a more positive and relaxed experience.

Did you know that Dementia care costs around 1 percent of the world’s gross domestic product (GDP)?

“Achieving personal goals can help people in the early stages of dementia manage their condition, Alzheimer’s Society research has found.

Researchers at Bangor University, Wales found that people who received cognitive rehabilitation felt their performance of daily activities improved. Carers of those receiving the treatment also noted an improvement in their own quality of life.

Cognitive rehabilitation is a treatment where people with dementia work with health professionals to identify personal goals and develop strategies for achieving them. Goals were tailored to the participants’ specific needs and included things such as remembering details of jobs to be done around the house, maintaining concentration when cooking, learning to use a mobile phone and remembering the names of people at an exercise class. The cognitive rehabilitation group said they saw an improvement in their ability to carry out all of the chosen activities.”

Read the full story here

If you or someone you know has been diagnosed with dementia, you might consider setting some short term goals – that can be measured and realistically completed.  Small steps works best!

This is NOT a cure – this is a way to predict if you might get or have AD.

The question then is: What do you do if the test reveals you have AD or may get it? There are some medications out now that MAY slow the progression of the disease, but much more research is needed in this area. Some people will not want to know if they may get AD.

Good brain health through physical exercise, brain exercises, and healthy diet may be beneficial in reducing the risk of Alzheimer’s and vascular dementia.

Take good care!

Significant weight loss can be seen in about 40% of people with severe Alzheimer’s disease.  This has most often been attributed to depression and eating difficulties, but a study that was conducted in 2004 and is published in the journal Clinical Nutrition, has indicated that vision problems might be the cause.

Serving meals on brightly colored tableware may encourage greater food consumption among patients suffering from Alzheimer’s.  This study showed that people with Alzheimer’s disease experienced a 24% increase in food intake and 84% increase in liquid intake when served on bright red or brightly colored blue tableware and cutlery as compared to white tableware and stainless-steel silverware.

If you are having trouble getting your Alzheimer’s patient to eat, consider using high-contrast tableware.  This is an easy and inexpensive solution, which helps maintain the patient’s diet and promotes independence.

Bright ideas brought to you by Emily

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Zyprexa was Lilly’s best-selling drug in the U.S. in 2008, bringing in $14.6 billion. The documents were released as part of a $6.8 billion lawsuit over Lilly’s marketing of Zyprexa. Twelve states are also suing Lilly over the same matter.

1.  Physical activity – exercise (group or individual, walking, yoga)

2. Games, puzzles, crossword puzzles

3. Meal preparation (stirring, washing, mixing, tasting)

4. Housekeeping (folding, dusting, make the bed)

5. Music (listening to favorites, singing, live shows)

6. Work-type activities (safe items from the person’s professional work: a desk, papers to sort, tools)

7. Personal grooming (fix hair, do nails)

8. Gardening (watering, planting)

9. Massage (hand or foot, be sensitive to personal space issues)

10. Attending religious services

11. Magazines or books (pictures, familiar people or places)

12. Outings (art museums, coffee shop, beach)

13. TV (approprite and in small amounts, classic movies, Animal Planet, comedies like “I Love Lucy”)

14. Arts and crafts (meaningful and purposeful, not just to fill time)

15. Attend senior center or day care programs (when appropriate and the group’s ability levels match your needs)

16. Pet care (feeding, combing, petting)

17. Sorting (poker chips, coins, cards, silverware)

18. Engage with children (intergenerational activities)

19. Meditation and quiet time (soft music, low sensory input, holding soft animals and blankets)

20. Reminisce (structured discussions about old memories)

21. Eating (going for a favorite meal, ice cream shake)

Do you have other activities that have worked well?  Please let me know so I can post and share them with others!

DLB is a double whammy of a disease. People with DLB have behavioral and memory problems as in AD and, to a varying extent, also suffer motor symptoms, as seen in Parkinson’s disease (PD). However, the cognitive symptoms of people with DLB tend to fluctuate frequently, their motor symptoms are milder, and they often have vivid visual hallucinations and particular visuospatial (visual perception of spatial relationships among objects) deficits. In short, DLB is neither AD nor PD, and yet defining its distinct identity has been a challenge.

This is Part 3 of a nine-part series.

Go to full story: alzforum.org