Planning for care after an Alzheimer's Disease Diagnosis

Alzheimer's Disease is not an easy one for the senior with the diagnosis or their family.

The very best strategy, though, is to talk about the disease and to develop a plan of action for managing the memory loss and the care needs.  This will allow the senior to feel they are still involved in the decision-making and enable the family to implement safety measures from the beginning (i.d. bracelet, medication management, regular caregiving schedule).

And, even more importantly, this will allow the senior's family to talk to prevent misunderstandings which could cause gaps in care because perhaps not everyone has the same strategy.   Usually there is "water under the bridge" with various family members after years of living.  These realities must be addressed.

One Salon columnist very openly shares his desire not to be the caregiver for his Mother-in-law, who has just been diagnosed with Alzheimer's Disease.  It is nice to find someone express their honesty - he is definitely not alone.

Often when families hire a Senior Home Care Agency to provide care services, they are able to lessen the stress for family members because a third-party caregiver simply doesn't come with the baggage a family caregiver brings.  Each family must find the right solution for them but the first step is to start the conversation.
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10 Signs of Alzheimer's Disease

Everyone has their own story of how they discovered a loved one was experiencing memory loss.  One of my girlfriends tells the story of a family friend who picked her daughter up from school and said she thought the weather was cooling and it would be a perfect night to make chili for dinner.  So they went to the grocery store to buy the ingredients and went home to enjoy a dinner of chili.  The next night the Mom picked up her daughter from school and again said the weather was cooling and she thought it would be a good night to make chili for dinner.  She forgot they had chili the previous night.  When this happened a third time, the family began to compare notes and realized something was not right. 

The Alzheimer's Association offers many wonderful educational programs to help seniors and family members understand how to best deal with this disease - knowledge is power, especially when you have the luxury of early diagnosis. 

The 10 Warning Signs of Alzheimer's Disease, courtesy of the Alzheimer's Association:

1) Memory loss

2) Difficulty performing familiar tasks

3) Problems with language

4) Disorientation to time and place

5) Poor or decreased judgment

6) Problems with abstract thinking

7) Misplacing things

8) Changes in mood or behavior

9) Changes in personality

10) Loss of initiative



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Elder Care Abuse

The number one type of elder care abuse is actually financial abuse.  As a former owner of a senior home care agency, I witnessed many situations where the family members went beyond the call of duty to assist a senior loved one with their care needs.  I also saw situations where sometimes just one family member was inappropriately trying to take advantage of the senior's kindness and financial generosity.

Unfortunately, seniors are an easy target for those looking to take advantage, especially when they are lonely and hungry for friendship and attention from anyone who will offer it.  At the same time, there may be adult children who have drug or alcohol addictions which lead them to take advantage of a senior parent with memory loss or who has no one else to turn to for assistance.  I had one client who was retired and living on a healthy pension as a retired government employee but his daughter with a cocaine addiction continually stole his checks and nearly every piece of furniture in his house before the state appointed a court-ordered guardian. 

If you are caring for a senior or have a senior neighbor of friend who you feel is being abused, either from physical neglect or financially, the first step is to call your local elder abuse hotline.  They will professionally step in to assess and manage the situation for the senior's benefit.  Confidentiality is provided.

You can find the contact in your state on Caregiverlist's "by state" list.

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A Banana a Day.......

A new study presented on Saturday at the American Society of Nephrology's annual meeting, found consuming too little potassium may be as big a risk factor for high blood pressure as eating too much sodium.

This study supports previous studies that also made this conclusion about potassium and blood pressure.

 "The lower the potassium in the urine, hence the lower the potassium in the diet, the higher the blood pressure," lead study author Dr. Susan Hedayati, of the University of Texas Southwestern Medical Center at Dallas, said in a news release issued by the conference organizers. "This effect was even stronger than the effect of sodium on blood pressure."


 The link between high blood pressure and low potassium was strong even when age, race, and other cardiovascular risk factors, such as high cholesterol, diabetes and smoking, were factored in. About half the study participants were black, and they tended to consume the least amount of potassium in their diet, Hedayati said.

 Laboratory research for the study suggests that the WNK1 gene may be responsible for potassium's effects on blood pressure. More research is being done to test how fixed levels of potassium in a diet affect blood pressure and the gene's activity.

 Meanwhile, the researchers urged people to consume more potassium and less sodium. "High-potassium foods include fruits such as bananas, and citrus fruits and vegetables," Hedayati said. "Consuming a larger amount of these foods in the diet may lower blood pressure."

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Paying for Long-term Care

As a senior or a senior caregiver, you have learned that Medicare does not pay for long-term care needs in a nursing facility nor in the home. 

The costs of care can easily be $80,000 per year in a nursing home and full-time senior care services in the home can be from $35,000 to $73,000 per year, depending on if you have hourly care or 24-hour live-in care.

One of the best ways to manage these costs is to purchase a long-term care insurance policy.  Long-term care insurance can be purchased piece-meal, to meet your budget needs.  Over time, it is more economical to pay a few thousand dollars a year for a long-term care insurance policy rather than to have your assets drained by paying for the expenses out-of-pocket.

If you work for a corporation, find out if purchasing a long-term care insurance policy is an additional employee benefit which is offered.  Many state government employees and university employees are offered this benefit.

You can also read answers to popular long-term care insurance questions by Caregiverslist's long-term care insurance expert, Chris Lynch.


Obama's Grandmother Passes

Regardless of your political choice for president, you can share in the sadness of Barack Obama's Grandmother passing away just a day before the election.  Madelyn Payne Dunham, 86, died peacefully in her Honolulu home on Sunday night, after battling cancer.  She chose to stay at home with care provided by a caregiver.

Hospice training teaches that emotionally, it is easier to go through the process of grieving when you are able to plan for the death and say goodbye ahead of time.  Barack learned this, he said, when he did not make it to his Mother's side before she passed away.  As he did not want that to happen again, he took time off from his historic campaign to visit his Grandmother a couple of weeks ago.

Still, death of a loved one is never convenient or easy, even with knowing ahead of time.  While visiting France one summer, I went to dinner at a small country restaurant.  The owners were a married couple who made the rounds to all the tables to chat with their guests.  Upon learning that I worked in senior care, they told me to be sure to visit the bathroom before I left.  There was a mural painted on the bathroom wall that included the 17th Century Nun's Prayer.  I later had my Mother write it in calligraphy and framed it for my Senior Care Agency's office wall.  Many caregivers who passed through the doors asked about it and requested a copy and now it is included as a resource on Caregiverlist.


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Balancing Act

Quick reminder: be sure to vote tomorrow and be sure to check in with any seniors you know to offer assistance in getting to and from the polls.

Falls become more common for all of us as we grow older.  The increase in falls for seniors is not all related to loss of muscle strength, but to the steady decline of some of the contributors to good balance:   vision, proprioceptors on the bottoms of the feet that communicate position information to the brain, and tiny hairs in the semicircular canals of the inner ear that relay gravity and motion information to the brain  (who knew ear hair was good, right?).

There is a simple exercise you can do to test your capability for balancing (and it is more difficult than you might think it should be regardless of your age):  Stand with your eyes closed and lift one foot up, bent at the knee in front of you (as if taking an exaggerated step up) and hold it for 15 seconds.  Then try it for 30 seconds.  If you can do this, you are in great shape and all is in balance! 

The Anti-Aging Plan book discusses this and more, based on many lessons the physcian for the Biosphere team and his daughter learned in Biosphere 2.


Aging Well

What are the secrets for healthy aging?

My second cousin and her husband are visiting this weekend, while attending a wedding.  We are friends as second cousins because my Great Grandmother lived to be 101 and was her Aunt.  We have a generation gap because Great Grandpa was the oldest child and my cousin's Grandmother was his younger sister by 18 years.  Our ancestors lived long lives - not easy lives as they grew up in a cabin that was homesteaded in 1862 with no indoor plumbing and tried to earn a decent living as farmers.  They always told us that hard work was the secret to healthy living but definitely good genes help too.

It is interesting that many people who were born in the beginning of the 20th Century have lived long lives - even without all the modern luxuries we enjoy.  Yet, not everyone today is living longer, even with our knowledge of healthy living.  Many aspects of aging are made more difficult when a senior is overweight or has failed to exercise or eat the right foods.  Many seniors also may have quit smoking years ago but because they did smoke for 20 or more years, they now are suffering from emphysema or lung disease. 

High blood pressure, high cholesterol and other age-related diseases can often be slowed or reversed with proper diet and exercise. 

Are you taking care of yourself now, at whatever age you are?  There are many health issues we all cannot control but if you are eating right and exercising and controlling your stress level,  you will increase your odds of living well as long as you live.  It is especially important for Caregivers to take the time to care for themselves.

My favorite resource for healthy living is Dr. Andrew Weil.  He is well educated (Harvard) but also has been in the trenches and understands the challenges for healthy living in America.  He has traveled the world to meet with herbalists and local doctors to learn other culture's secrets for living well and living long.  He believes in healthy aging, rather than anti-aging - because the fact is, we are all going to age.  His website offers recipes, vitamin information, and answers to health issues.

I did get to meet Dr. Weil a couple of years ago at a seminar on healthy aging which he and his associates at the University of Arizona hosted. They were all "mature" - in their 50's or older - and one thing I noticed is they all seemed healthy, and even more amazing, really happy - they were managing their lives well and the joy showed.

Dr. Weil has also written a cookbook with one of Oprah's former chefs and has a skin care line which is sold by Origins.  Check out his website and his products and you'll probably learn something new - he is a huge fan of mushrooms and all their benefits and even uses them as an ingredient in his skin care products.

And, feel free to share with us any tips you have for healthy aging.




Types of Dementia

Yesterday's Caregiverlist Blog post mentions the free memory loss testing at 2,000 locations nationwide provided by the Alzheimer's Foundation of America (a few drug companies are sponsoring this so it is free for seniors).

Why is early detection important?  Because it can enable the senior and their family to understand the progression of various forms of memory loss to prepare for the progression and to implement systems for safety and proper care.

What are the types of dementia?  Alzheimer's Disease is talked about the most but is not the only type.  This is why it is important to be diagnosed for the type of memory loss in order to receive the best treatment.

Other types of dementia and other diseases and disorders which will also cause dementia are:  Huntington's Disease, Pick's Disease, Frontal lobe dementia, Frontotemporal dementia, Lewy bodies, Normal pressure hydrocephalus, Vascular dementia, Parkinson's Disease, Subdural hematomas, brain tumors.

Also, some vitamin deficiencies and hypothyroidism can also cause some memory loss for seniors.

This is why it is vital to have proper diagnosis from a doctor trained in detecting the various forms of memory loss.  A senior can be restored to health with some forms of memory loss when properly diagnosed or with medications and treatments can be able to slow the decline of memory loss.

As an owner of a senior home care agency, I saw many elderly clients who were visiting their same family doctor they had gone to for years and because this doctor did not include memory evaluation during the visits, it went undetected.  Find out if your parent or grandparent or senior client you are providing care for is visiting a doctor who specializes in geriatric care - it does make a big difference.

Rush University's Geriatric Care Practice in Chicago is a wonderful example of an integrated approach to care for seniors.  A social worker meets with each client along with the medical doctor and their team includes professionals in psychology and other areas.  They also have an Alzheimer's Disease research department which offers support groups and participation in studies and their Anne Byron Waud resource center is free to seniors and offers everything you would want for a senior resource center.  They make sure seniors are prepared for their emotional and physical needs as they age. Check it out and find something similar in your area - if Medicare is paying the bill for the doctor, you might as well go to one specializing in senior care needs.


Free Memory Screenings at more than 2,000 locations

My Mother thinks that I am always keeping tabs on her memory. After working in senior care, I have seen first hand that early detection of memory loss can make a positive difference.  I have seen senior's memories improve after starting medications and developing a regular routine with a caregiver to guide them.  I have also witnessed the agony that memory loss can cause for the senior and their loved ones, especially when proper diagnosis of the type of dementia occurs too late.

It greatly helps family relationships when everyone understands what is happening when the memory loss first begins.  Sometimes during a conversation, my Mom will inform my Dad that I am really quizzing him on his memory.  My father has a better memory than I do and so far so good with Mom.  Her father suffered from memory loss, which was never formerly diagnosed as Alzheimer's Disease, although now, looking back, we are all sure that it was.  The early diagnosis and tests were not widely performed 20 years ago.  I remember that my Grandfather would "read" the Wall Street Journal upside down,- which actually might not be a bad idea with the recent market turmoil -a different view might be nice.  But that was just one example of some of the ongoing confusion he experienced.

On November 18th, the Alzheimer's Foundation of America (AFA) will offer free memory screenings at more than 2,000 local sites across the country as part of its 6th annual National Memory Screening Day.

This annual initiative is aimed at promoting early detection of memory problems and appropriate intervention.
The AFA encourages adults with memory concerns, a family history of Alzheimer's disease or a desire to establish a baseline score for future comparison to get screened and to pick up educational materials about memory concerns, successful aging and local resources.
Alzheimer's disease is now the sixth leading cause of death in the United States.
The face-to-face screening takes approximately five minutes and consists of a series of questions and tasks. Sites, spanning all 50 states, include the entire chain of Kmart pharmacies, senior centers, houses of worship, assisted living facilities and doctor's offices.
The results do not represent a diagnosis, and screeners encourage those with abnormal scores as well as those who still have concerns to pursue a full medical exam.
How are they able to pay for this?  The drug companies are sponsors - so another good reason to take advantage of the free memory screening since you are sort of paying for it anyway through your medication purchases.
If you are a caregiver for a senior, find out if there is a location in your area.
For information about National Memory Screening Day, including screening sites, visit or call 866-AFA-8484. 
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