Dementia Information

PLANNING HOLIDAYS WITH ELDERS WITH DEMENTIA

2011-12-01T07:04:00.000-08:00

When you have a loved one with a type of dementia such as Alzheimer's in the family, you may be dreading the upcoming holiday season. That feeling is certainly understandable given that these elders often act unpredictably, and unintentionally say hurtful things to family members. I would like to offer some tips to help you survive the holiday emotionally intact:
- Give up the idea that you can have all of the traditional foods and activities this year. You may have to pick and choose a few of the least upsetting for the elder. Large crowds of people (family) cannot be tolerated for very long, and they certainly will not remember names or relationships and will become agitated when asked to do so. Always give them clues such as "Dad, here's the boy wonder of the family, my little brother Davy and his family."
- If the elder believes a daughter is his wife, and calls her by his wife's name, you may be able to simply laugh and say something like "Dad, I'm not Mom! I know I look at lot like she did when she was younger, but I'm Alice, your oldest daughter." If that doesn't work and the the elder still insists, you must agree, and slowly change the subject. Possibly changing your appearance in some way will help him let go of his belief.
- Tone down the noise on all activities. Rousing family sing-a-longs may only upset the elder, not only because of the noise level, but because they may not be able to participate as they used to. Small children running about making noise can also upset the elder who may think they are being injured if they are squealing or screaming in delight.
- If your parent has dementia and the tradition is for you and your family to always visit for a week or two and stay at the family home, you will all be more comfortable if this year you choose to stay elsewhere and just visit the family home daily. Routines are very important to elders with dementia, and when "new" people are introduced into that daily routine, they become more confused and upset.
- Remember that your goal, and the goal of everyone in the family, is to keep the elder with dementia safe, happy, calm and treated with dignity at all times. They cannot change the way they are responding to their environment. You and the rest of the family, whose brains are not damaged, are the ones who must do the changing and work to achieve the goal at all times. That means if the elder insists it's not December, but February instead, then you must apologize and say something like "Oh, I'm sorry. I am really confused here. Of course, you're right. I think you would enjoy coming with me now and ..." It will serve no purpose whatsoever to try to continually reorient that elder to your reality and they will only become agitated and possibly combative if you continue to try.
- Never say "Do you remember..." You are just setting them up for failure and frustration when they cannot remember. Instead, give them clues such as "I remember when this picture was taken, that's me, and that's you...." Keep photo albums out where they can be easily accessed. The long-term memories are still there, and they will enjoy looking through the photos and remembering. If they do not remember, or tell you you're wrong, don't argue, simply apologize, and move on to the next picture.
- Preserve rest periods for the elder if that is their routine. They can become more confused and unsteady on their feet when they become over tired.
- If the elder is starting to become agitated, first check for all the likely reasons such as needing to use the bathroom, hungry, thirsty, too much noise, etc., and then remove them to a quiet place and bring up some wonderful memories that you know will help them become calm again. Possibly remembering a favorite pet, or the story of a treasured vacation. Don't correct errors in the their stories. This is their new reality and trying to change it for them will only upset them.
- Music is stored in a different area of the brain, and so many elders with dementia who can no longer speak or know what words mean, can sing an entire well-remembered song. Be sure to tap into those songs.
- If you have small children who will attend a holiday mealtime with you and the elder with dementia, it's a good idea to prepare them in advance for some behavior that they will notice and comment about. For example, if the elder can no longer use utensils to eat with and will use their fingers, you may have to tell the child in advance that "Grandpa is having some trouble with his brain, and sometimes he can't remember how to use his fork and spoon. We know you're a big boy now and no longer eat with your hands, but that is the only way Grandpa can eat right now. We must all just remind Grandpa that we love him and help him in any way we can."
- Traveling with an elder with dementia will challenge your patience and the abilities of the elder. If you must travel, it will be much easier and safer if you have a third person present to help you.
- Allow the elder to participate in any way they can. If Mom used to always make the holiday bread, can she still participate by gathering ingredients and helping knead the dough?
You and your loved ones can still create many new and happy memories of the holiday with the elder with dementia when you keep the above tips in mind so the elder does not become overstimulated, more confused or angry. It becomes a matter of letting go of past expectations, and embracing this elder exactly where they are today.
HAPPY HOLIDAYS!

DEMENTIA DRUGS INTERACTING WITH MANY COMMON MEDS

2011-11-10T16:01:00.000-08:00

I recently had an article printed in the Alzheimer's Reading Room (great source for information at www.alzheimersreadingroom.com) where I discuss how many commonly used medications will interact with and work against the anti-dementia meds in the cholinesterase inhibitor class (Aricept, Exelon, and Razadyne). There is a classification of drugs called "anticholinergics" that will essentially cancel out the intended therapeutic effects of both drugs when given together. These anticholinergics are found in many types of medications. Here are a few:

Antispasmodics, such as Levsin, Donnatal, Bentyl
Bronchodilators such as Atrovent and Spiriva
Antiemetics such as Dramamine, Bonine and Antivert
Antiparkinson drugs such as Kemadrin, Artane, Cogentin
Sleep aides such as Sominex, Nytol, Unisom
Cough and cold preparations that contain diphendydramine
Atropine which is found in some heart medications and eye drops
Urinary incontinence meds such as Ditropan, Toviaz, Vesicare and Detrol

I have only listed a few of the brand medications from each category, and there are many, many more. If your loved one is taking a drug that might be in a category, be sure to ask the physician, or the pharmacist about this interaction with their anti-dementia med. With the thousands and thousands of medications out there to choose from, your loved one's healthcare provider may forget about this interaction that will render both drugs useless, so please be sure to check on this when any new medication is introduced even if it's for a simple cough, or a sleep problem.
The other drug classification used for dementia is the NMDA receptor antagonist and that is Namenda. It works in a totally different way than the cholinesterase inhibitors, so it is not affected by these other drugs.

BILINGUALISM DELAYS ALZHEIMER'S ONSET

2011-11-08T11:58:00.000-08:00

I have seen several research articles lately that discuss new evidence that bilingualism is thought to delay the onset of Alzheimer's symptoms. In Medical News Today (http://www.edicalnewstoday.com/releases/235998.php) in mid-October, researchers at St. Michael's Hospital in Toronto found huge differences in the brains of bilingual people as opposed to unilingual people. They found twice as much damage in the bilingual brains and despite the fact that both groups were similar in levels of education and cognitive skills, the bilingual people's brains seemed to be able to handle twice the level of atrophy without displaying twice the level of decline. Dr. Tom Schweizer, who headed the research, feels that the constant switching over in the brain from one language to another enhances the creation of more neuronal networks. In this study, they examined CT scans of patients with AD, and he hopes to repeat the study with a larger patient sample and by using MRIs to observe brain changes. He mentions in the article that previous studies through observation found that bilingualism seemed to delay onset of the AD symptoms by about five years, but that this is the first study to actually find the physical proof in the CT scans of the damage and delay.
I keep thinking how nice it would be to be able to speak Spanish, and now I'm thinking I ought to move forward on this and get started!

BLOOD TEST TO PREDICT ALZHEIMER'S DISEASE

2011-10-14T09:35:00.000-07:00

It's always encouraging to me to see news about how the world is progressing in it's battle against Alzheimer's and other dementias. I recently read an article in Medical News Today (http://www.medicalnewstoday.com/articles/232361.php) that discusses how Dr. Robert Nagele, at the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine developed a blood test to determine if a person does or does not have Alzheimer's disease.
This test involves examining blood samples that measure the antibodies the body makes when cells die, so it's a relatively simple test. Their studies showed the test correctly identified 96% of those tested with Alzheimer's, and correctly identified 92.5% of the people in the study who did not have Alzheimer's. They are speculating that the test could be available within a year and may cost around $200.
Early detection of Alzheimer's would facilitate early treatment, and hopefully delay of the progression of the disease. It would also allow families more time to plan for their future and their finances.
There are other laboratories in various stages of testing looking at this type of test, so it sounds pretty hopeful that we will soon have some options for diagnosis that are not so invasive and don't require brain biopsy.

COACH SUMMITT'S DIAGNOSIS OF ALZHEIMER'S

2011-08-30T15:26:00.000-07:00

For some reason, I keep thinking about Coach Pat Summitt and her recent diagnosis of early onset dementia. Last week, I wrote a small blurb about how I feel her courage in pursuing the diagnosis, as well as going public with it, will inspire many families to do the same and thus move forward with their lives rather than huddle in fear of the unknown. But, I keep thinking about it and feel compelled to put my thoughts down in this blog.
Once the media frenzy dies down, the Summitt family will face each day just like any other family dealing with dementia. It appears that Pat will be surrounded and helped by multiple people around her so she can continue to coach for as long as possible, and that is certainly a blessing for them. This too, can be a lesson for others who may not have access to all those helpful assistants. If you want your loved one to be as independent for as long as possible, then seek out ways to help them do that. Is it friends who schedule daily/weekly outings? Is it neighbors or relatives who truly want to help? Is it members of your church who want to help? If you can afford companion care, that's wonderful, but if you can't afford it, then for the sake of your loved one (and your own mental health), take advantage of those friends, neighbors, relatives or church members who wish to step in and help on a regular basis. Please do not think you're taking unfair advantage of them because they too, are getting something out of the relationship with you and your loved one. They feel satisfied and fulfilled that they are helping a fellow human being. They want to give back, and remember that you will have the opportunity to also give back to them once your life is not so consumed with caring for your loved one.
Coach Summitt's son, Tyler is a young man who will walk on this dementia journey with his mother even though I'm positive he would wish for nothing more than a normal life of his own and good mental health for his mother. He will need an awful lot of support in order to not lose his own identity and his future on this journey. As his mother's dementia progresses, his caregiver burdens will increase, as well as his stresses. He must make plans for time away from his responsibilities as a caregiver in order to be a better caregiver. This too, is a lesson for all caregivers. It will be the most difficult "job" you will ever do, but you compromise yourself and your loved one's safety and happiness when you cannot step away and recharge. I think it's okay to think that nobody can take care of your loved one as well as you can, but I don't think it's okay to turn away those people who want to help. Everyone will benefit from more people coming in to help and keep your loved one socialized.
I wish the Summitt family many, many happy and productive days ahead, as I wish every family struggling with dementia the same. It is possible, and I pray you are all able to achieve that goal.

SHOULD WE DRINK MORE COFFEE TO AVOID ALZHEIMER'S?

2011-08-10T13:22:00.000-07:00

Wouldn't it be nice if it was discovered that by drinking 4-5 cups of coffee per day we could reduce our risk for, or delay the onset of Alzheimer's? The latest news is to keep on drinking your coffee! In a June 22, 2011 edition of Medical News Today (www.medicalnewstoday.com/releases/229287.php), an article entitled "Protection Against Alzheimer's Disease Boosted By Mystery Ingredient in Coffee," was published. It seems Drs. Chuanhai Cao, and Gary Arendash from the University of South Florida have found that some ingredient in caffeinated coffee decreases production of those abnormal beya-amyloid proteins in the brains of Alzheimer's mice. They've narrowed it down to a growth factor in the coffee called "GCSF" and discovered that increased levels of this growth factor in the blood of these mice improved their memory. The mystery component responsible for the improved memory does not appear to be present in other products with caffeine, so they believe it is linked to the coffee plus the caffeine (instant caffeinated coffee was not tested).
Most experts believe that Alzheimer's actually starts in the brain several decades before any symptoms are seen, so Drs. Cao and Arendash feel moderate consumption of caffeinated coffee (4-5 cups daily) could offer a protective effect, which could be increased even more by adding other lifestyle changes such as increased physical and mental activity. Again, they're still dealing with mice, but coffee has been around a long, long time and many people are able to drink it without any problems, so if it's found to offer a protective effect in the brain against Alzheimer's in human, what a great preventative "treatment!"

ALHEIMER'S DRUG COMBO GETS NOD AT INTERNATIONAL CONFERENCE IN PARIS

2011-07-29T12:30:00.000-07:00

I was so happy to see that the Alzheimer's Association International Conference in Paris this year presented a symposium which highlighted the increasing evidence of functional and cognitive benefits seen when patients with Alzheimer's are taking a combination of one of the cholinesterase inhibitors (Aricept, Exelon or Razadyne), plus Namenda. The experts concluded that this combination is the best option we have today to help preserve cognitive and functional abilities, and studies are on-going to see at just what stage this combination intervention is most beneficial and for how long. So, if your loved one is on one of these medications, ask the physician to add the other for an increased benefit. These two types of drugs work in completely different ways in the brain, and they are both more effective together than either one is when used alone.
Also, something I recently learned is that a person can build up somewhat of a tolerance to the cholinesterase inhibitors over a period of years, so it may be beneficial to bump up the dose if they're not already at the maximum dose.

NEW GUIDELINES FROM AMERICAN GERIATRICS SOCIETY FOR MANAGING BEHAVIOR PROBLEMS IN ELDERS WITH DEMENTIA

2011-07-15T13:51:00.000-07:00

Far too often, those family docs who many elders have been seeing for years just can't keep up with advances in medicine. This can mean that your parent or spouse does not get a "dementia work-up" when signs and symptoms are clearly present, nor does that elder get the medication that could help slow down the progression of their dementia. The American Geriatrics Society has recently made available their newest tool to help clinicians not only diagnose, but treat dementia and the psychosis and behavioral problems that can accompany it. It is titled Guide to the Management of Psychotic Disorder and Neuropsychiatric Symptoms of Dementia in Older Adults, and can be viewed on their website at www.americangeriatrics.org. A smartphone version of this valuable tool, called GeriPsych Consult will be available soon.
Dementia is not the only subject covered in this Guide. Bipolar disorder, depression, and schizophrenia are all included along with the behavioral symptoms that are often associated with different types of dementia, including Alzheimer's.
I especially like the way the AGS has put much of this information into Tables for easy comparison. For example, seven antipsychotics are listed in a Table which shows side effects (and they ALL have multiple side effects) that makes it easy to see which drugs should not be given to a diabetic, or someone with a seizure disorder.
I was especially happy to see the AGS has suggested under "Agitation or Aggression" to "Always consider nonpharmacologic strategies first..." and they go on to list a number of things that will always made the person with dementia escalate in their agitation. The AGS also makes note of the Black Box warnings on these drugs and how they are being used "off label" in people with dementia, and they go so far as to include a "summary of studies regarding excess mortality associated with antipsychotic medication use in patients with dementia."
This is critical information for all healthcare providers to have access to, and now it's at your fingertips also! Thanks AGS!

SUNDOWNING IN DEMENTIA

2011-07-08T08:22:00.000-07:00

We've often heard the term "sundowning" used to describe the animated behaviors of some people with dementia, usually at the end of the afternoon and early evening hours. This can involve agitation, restlessness, combativeness, refusals to sit down and eat and a host of other behaviors. There are no widely accepted answers as to why this occurs in some people with dementia and several theories have been proposed. Some believe that when the sun goes down it triggers these behaviors in some people, or that it's a disruption of the sleep-wake cycle clock in the brain. Others think it is linked to fatigue, but it presents significant problems for the caregivers of those elders.
I have not seen any studies come out about this disorder until recently in Medical News Today (http://www.medicalnewstoday.com/releases/229757.php) where Tracy Bedrosian at Ohio State University conducted studies with mice that showed sundowning-type behaviors had a biological basis. They found higher levels of an enzyme called acetylcholinesterase, as well as differences in two other proteins in the brains of the aged mice exhibiting the symptoms of sundowning. This is good news because it means there is a good chance it can be successfully treated if the cause is biologically based. While it would be years before the leap from mice to men could occur with any treatment, to me it's very hopeful that they're even working on this problem and that they may have found a starting point for treatment in the mice.

CINNAMON AND ALZHEIMER'S

2011-07-01T07:19:00.000-07:00

Researchers in the Department of Zoology at Tel Aviv University recently published their findings on how an extract found in cinnamon bark (CEppt) can inhibit development of Alzheimer's. Professors Ovadia, Gazit, Segal and Frenkel published this article in the journal PLoS ONE, and I found this information through Medical News Today (URL:http://www.medicalnewstoday.com/releases/229809.php).

The researchers conducted their studies on mice who were genetically altered to develop Alzheimer's, as well as fruit flies. After giving the extract in water for four months, they found decreased levels of development of Alzheimer's and activity levels and longevity were then comparable to healthy animals and flies. They stated the extract breaks up amyloid fibers, as well as inhibited the formation of the oligomers and fibrils that lead to plaque in the brain of Alzheimer's victims.

As always, it's a HUGE leap from mice and fruit flies to man, plus you would need to take a toxic level of cinnamon in order to receive the therapeutic benefits seen in the studies. BUT--it's exciting to know that this simple spice, which is already known to have benefits for taming blood sugars, and preventing viral infections, is now being studied as a possible prevention or cure for Alzheimer's--most likely without side effects! Time will tell as the researchers continue their quest and we'll keep hoping.

THE FEAR OF INHERITING ALZHEIMER'S DISEASE

2011-06-13T08:39:00.000-07:00

So many people in my audiences ask me some variation of this question: "What are my chances of inheriting Alzheimer's if my father and his father both had it?" There is not a quick, cut and dried answer to that question because there are many factors that come into play. First of all, how do they know for sure those relatives actually had Alzheimer's? Did they perform brain biopsies after death? They could have just as easily suffered from multi-infarct dementia from strokes in the brain. Secondly, even though you can inherit the genes for Alzheimer's, it's not a given that you will actually express those genes. There is an inherited form of Alzheimer's but it's actually quite rare. I'm talking about the "early-onset" version of Alzheimer's that strikes in people between the ages of 30-60 who have inherited those specific genes and will have a 50-50 chance of developing Alzheimer's. Only about 5% of all people with Alzheimer's actually "inherited" it in this manner. In "late-onset" Alzheimer's, symptoms begin to appear after the age of 60 and age is actually the biggest risk factor here. After age 85, chances are almost 1 in 2 for getting Alzheimer's.

THERE IS SOME GOOD NEWS HOWEVER!

Even if you inherit the genes, and are over age 60, there is much you can do to avoid getting any type of dementia. Anything that decreases blood or oxygen supply to your brain will increase your chances of getting a type of dementia, including Alzheimer's. Diseases or disorders such as diabetes, obesity, high cholesterol/triglycerides, high, chronic stress levels, high blood pressure. All of these will restrict blood and oxygen flow to your brain on a regular basis and this is shown to greatly increase your chances of developing a dementia. It might not be Alzheimer's--it might be multi-farct or vascular dementia from strokes in the brain. We tend to forget that there are other types of dementia out there--but dementia is dementia, and it's progressive and fatal. So, avoiding all those diseases or disorders, having a regular exercise regimen to keep that blood pumping up the to brain, and keeping that brain active and stimulated will greatly decrease your chances of getting a type of dementia.

I recently came across a study in Medical News Today (www.medicalnewstoday.com) entitled "Weight Loss After Gastric Bypass Surgery Reduces Expression of Alzheimer's Genes." It's talking about what I just mentioned above--reducing the risk of obesity--in this case via gastric bypass surgery--was found to decrease expression of the genes known to be linked to Alzheimer's.

Use that fear you might have to draw that line in the sand and motivate you to do everything you can to reduce your chances for getting any type of dementia. Every little thing you do to improve your health will help.

Good luck to you as you begin TODAY to better care for your brain and your body!

CREATING A CAREGIVER SUPPORT GROUP

2011-05-22T12:22:00.000-07:00

As a dementia consultant, I know just how helpful it is for family members and friends of a person with any type of dementia to become part of a caregiver support group. I tell them that it can literally help to save their lives! The stresses caregivers are subjected to on a daily basis will usually lead to burnout and health problems such as hypertension, obesity, stress ulcers, and worsening of existing health conditions. It's often because these dedicated caregivers just feel as if they have no time to tend to a possible health problem of their own. I'm urging you through this blog to pay attention to your health and take steps to see that you remain healthy, because what will happen to your loved one if you die or are so incapacitated you cannot care for them? That is not an unusual scenario for stressed out caregivers. So please consider attending a caregivers support group near you on a regular basis. This is one of the best, free ways for you to help maintain your health and sanity. If you don't have a support group in your area, consider starting one! It's really not difficult once you have several people who are willing to commit to attending. Local churches, or local government buildings will usually serve as the host site for a meeting such as this for free. Here are some tips to help get you started:

- Poll local churches to find out if there are people who would be willing to join;
- Get contact information from those people and before the first meeting, conduct a small poll to collect data on what days of the week, what times, and how often they would be willing to attend. You want to ask for first and second choices for this information, and ask that they be willing to attend at least 3 or 4 meetings initially;
- At the first meeting, decide how long your meetings will be (usually 1 1/2 hours), as well as if you will be okay with some of the people with dementia being present along with their caregiver, or if they are willing to chip in a few dollars to have someone entertain those elders in another area during the meeting since it can make it a bit challenging if that elder understands what is being said and becomes upset. You might also wish to bring name tags for the first few meetings. Decide if there will be snacks/coffee, and if so, who will bring them.
- Set some ground rules such as taking turns being the "moderator" for the meetings. One or two months is a good time for that. Moderators make sure the discussion keeps moving; gently breaks in if someone is monopolizing the time; arranges for guest speakers if that is something the group wants; and makes sure the facility is open/closed and in order for each meeting. You must also all agree that everything said at the meetings will be held confidential--this is very important, and should be re-stated at the beginning of each meeting.
- Decide if you will have pre-set topics you will be discussing, or if you will just be talking about whatever is going well or not so well with you. Don't force people to talk, but encourage input and allow people the freedom to express their frustrations.
You may be discussing very serious issues such as assisted suicide, nursing home placement, grief over the loss of intimacy and the person you knew, incontinence, or even fear of a loved one if they're becoming combative. These are very difficult issues to wade into and sometimes nobody has an answer, but often just the tellling of a frustration will help make it a little less powerful.
What you will begin to find in a setting such as this is comfort. It's really comforting to know that there are other people out there who are dealing with some of the exact same issues you are. It's also a comfort when you hear that your loved one is not as bad off, or doesn't act out in ways others might. The tips and advice you get are priceless. You may have been struggling with how to get your wife to stop using her underwear and use the "pull-up" disposable underwear, and when you bring this up at the meeting, someone may say "my wife was doing that too, so I just packed all her underwear away and only put the pull-ups in the drawer for her. When she got upset, I promised her we would go to the store to buy new underwear, so she was willing to put on the pull-ups 'temporarily', and then forgot all about the shopping. Now she doesn't make a fuss about it anymore." The time and frustration that suggestion has just saved you is a very small example of how you could benefit in a caregiver support group.
I have had countless clients, nationwide, who balked initially at attending a support group, but once they did attend, thanked me for pushing them to join. I have also seen many caregivers who continued to attend the meetings after their loved one had passed away because they still had so much more to contribute.
These support groups can help in countless ways and if you can just make yourself go to a few of them--or start a group--you will be so glad you did--and guess what? Your loved one will also benefit because you're not quite so stressed out! As always, let me know via email if you have questions I haven't answered in this blog about starting up a caregiver support group.

10 THINGS YOU SHOULD AVOID SAYING TO A PERSON WITH DEMENTIA, & WHAT TO SAY INSTEAD!

2011-04-14T16:15:00.000-07:00

1. "NO!" Avoid the negative and try to rephrase it in a benign way such as "Let's try it this way..."

2. "Don't do this/that!" You're treating them like a child. Instead say "What if we try it this way?"

3. "You can't..." Again, treating them like a child--how would you rephrase that if you were speaking to the President? Try "I have an idea, do you think this might work?"

4. "I don't want..." They really don't have the ability to care what you want! Try "I'm not feeling up for that just now, but maybe in an hour or so--thank you though!"

5. "You need to hurry..." They have lost the ability to "hurry" on your time schedule and will only become upset if forced. Try to remain calm, pleasant, and unrushed. Break down the steps of the task, and always allow extra time for all tasks. Being able to hurry is a thing of the past for them.

6. "Don't you remember me?" Obviously they don't and now you've just made them feel awful for forgetting. Always give hints when you arrive: "Hi Tom! It's me, Harry, the guy you used to always try to beat on the gold course!" "Hi Mom, it's your beautiful, youngest daughter, Annie here to keep you company."

7. "You've already told me that 10 times!" Again, treating them like a child. Smile, and act as if it's the first time you've heard it and then change the subject, otherwise their feelings are hurt and they may get angry.

8. "You never...anymore." They've likely lost the ability to ever do/say what you're wanting. Don't go there. You're just opening the door for hurt and a possible argument. It's okay to grieve the loss, but not where they can see or hear you because they can't help you with it now.

9. "Don't tell me you forgot it again!" Obviously they did, but they can't help it, and you're scolding them like a child. Instead, you take the blame and minimize the importance of it. "Oh, I must have forgotten to tell you! I'm so sorry! I'll reschedule it for you."

10. "Remember now, you're not supposed to be driving." Count on them NOT to remember that! Hide the keys and disable the car. Blame the decision on the doctor if you need to, but realize this is a huge loss of independence for this person so tread gently, but firmly.

Try to always be kind, gentle and calm with this person. Anything else could easily lead to frustration, agitation and failed attempts.

Looking Beyond Dementia to Personal Preferences

2011-03-31T16:08:00.000-07:00

Every person with dementia is still an individual who has certain tastes, needs, and desires and who will act and react in a different way from others. None of them were raised the same way or had the same life experiences, so they will all respond to any given circumstance based on their own personal history. One common example of this is "Frank," who always arose early every morning of his adult life to tend to farm chores. His internal alarm clock may still be working, and he still awakens every morning around 5 a.m. You should arrange your work schedule so that you can easily accommodate Frank’s desire to get up early. On the other hand, "George" likes to sleep in until at least 7:30 a.m. If you continually attempt to get George up and into the dining room by 7 a.m., you will probably have a very unhappy resident on your hands, and it will affect whether or not he eats his breakfast. Again, can you arrange your schedule so George is the very last person you get out of bed before breakfast? One area in which individuality is often most apparent is during activities. Not everyone likes to play Bingo, so you should not attempt to convince them to join in that activity if they tell you they don’t care to play Bingo. You should know your residents’ likes and dislikes, and modify their favorite activities so they can still enjoy them in the facility. If Annie loved to sew, there are many modified ways she can still do that, or at the very least, can she sort a jar of buttons for you? The dining room is another place where individual preferences must be honored. If June can’t stand meatloaf and mashed potatoes, then ask her if she would like a sandwich instead. A refusal to eat a meal because a resident doesn’t care for that type of food should always be taken seriously and a replacement should be offered. You cannot tell yourself that you’re “spoiling” them by allowing them to refuse certain foods because they will probably not recall this conversation by the next mealtime. All they know is that they don’t care for the food offered, and some really nice person is asking them if they would like a sandwich instead. Remember, they cannot necessarily tell you they don’t like a particular food and would prefer something else — that’s why you should always make an alternative suggestion when they refuse a particular food. The goal is to get them to eat and not lose weight, so your goal would be accomplished by honoring their wishes. Remember too, that when presented with too many choices, a person with dementia will be unable to decide. A great example of that is in the dining room. If your food arrives in the dining room on carts and trays, and you put down an entire tray full of food in front of most people with dementia, the sheer number of choices will render them incapable of deciding, and thus, not eating anything. That is why you should present them with only one food item at a time. “Do you want cake or pie?” is an appropriate choice but only if they are able to answer you. If their dementia has progressed to the point where they really cannot make even that simple decision, then there is no need to ask. In the early stages of the disease, different types of dementia will present with different behaviors and symptoms. As the dementia progresses, the behaviors will begin to be pretty much the same. To learn more about customizing care to meet the specific ramifications of the type of dementia, consider the Master Key for Dementia Training, Love, Laughter & Mayhem in Eldercare Facilities.

ALZHEIMER'S & STROKE BRAIN DAMAGE VACCINE IN THE WORKS!

2011-03-08T17:08:00.000-08:00

An article in Medical News Today seems hopeful to me that we may some day in the near future have a vaccine that will not only protect against stroke damage in the brain, but also against the cognitive damage in Alzheimer's disease. Researchers at Tel Aviv University's Department of Neurobiology at the George S. Wise Faculty of Life Sciences are currently testing this nasally delivered vaccine on mice with no signs of toxicity. Apparently the drug in the vaccine stimulates the immune system to gear up to fight against vascular damage in the brain by activating large numbers of macrophages, which are a natural mechanism to clean up any damage (in this case, the amyloid proteins in the brain) detected. Promising results in these animal models has shown that this action by the macrophages can help prevent further damage in the brain.

As I always caution, it's a HUGE step from mice to men in the testing for new drugs, but I still think this is very hopeful news.

Dr. Dan Frenkel is the lead researcher, along with students Veronica Lifshitz, Ronen Weiss and Tali Benromano. They also worked with MRI specialist Prof. Yaniv Assaf and his student Tamar Blumenfeld-Katzir of Tel Aviv University's Dept. of Neurobiology. The article URL is found at http://www.medicalnewstoday.com/articles/217776.php

CAN DRINKING APPLE JUICE DECREASE NEGATIVE BEHAVIORS IN PEOPLE WITH DEMENTIA?

2010-06-25T16:46:00.000-07:00

WOW! Wouldn't it be great if it were that simple! This small study in the American Journal of Alzheimer's Disease and Other Dementias, published by Sage, and conducted by Ruth Remington, RN, PhD, et al. found a modest, but statistically significant argument for giving people with dementia apple juice to drink (two 4 oz. glasses daily) in that it decreased behaviors such as agitation, anxiety and delusions by approximately 27%. It is to be noted that this was a small study, funded by the apple juice industry, and we certainly cannot claim these results as a cure in any way, but gosh, wouldn't it just be great if by simply giving your loved one apple juice twice a day, they were calmer and had a better quality of life? I say, why not try it. You have nothing to lose and potentially a lot to gain. Good luck--and let me know if you do try it and if you see any differences.

INTERVIEW ON U SMILE RADIO SHOW

2010-06-06T09:10:00.000-07:00

Lesly Federici is a phenomenal person. She's known as "The Green RN;" a childbirth educator, both locally in New Jersey and also as a "virtual birth coach;" she hosts an internet radio show called U Smile Radio; she's a Reiki Master, and an Advanced Clinical Hypnocounselor!
Lesly interviewed me on her show Thursday evening, June 3rd at 9:00 p.m. EST, and the link to the show is:
http://www.blogtalkradio.com/usmile
The interview lasted 55 minutes and we had a great time. Check out this interview to find out more about me and my business.

IS INCREASED ABDOMINAL FAT RELATED TO DEVELOPING DEMENTIA?

2010-06-06T09:07:00.000-07:00

I came across an article in Medical News Today (www.medicalnewstoday.com) about a recent study published in Annals of Neurology. Dr. Susanne Sorensen headed this study at the University School of Medicine in Boston of more than 700 middle aged people with increased amounts of abdominal fat. They did find an inverse association between the visceral fat levels in the abdomen and total brain volume. The higher the amount of visceral fat, the lower the total brain volume and when brain volume shrinks, it's a strong predictor of dementia. They point out though, that when people carry excess abdominal fat, they are also at much higher risk for high blood pressure, high cholesterol and diabetes--and these are all major risk factors for getting a dementia.
While more studies are required to say definitively that increased abdominal fat leads to dementia, we need to keep studies like this in mind when we're concerned about "inheriting" Alzheimer's Disease. We need to continually associate in our minds the fact that if we don't watch our weight, our blood pressure, cholesterol, and blood sugar levels, we're at much higher risk for shortening that journey to dementia.

PSYCOACTIVE DRUGS VS. ANTI-DEMENTIA DRUGS

2010-05-28T17:07:00.000-07:00

I just came across a small study by Tomislav Majic and colleagues from Charite Hospital in Berlin, and I feel I just have to comment on this. They noted that as a person's dementia worsens, disruptive behaviors, depression, and apathy tend to increase. In this study they analyzed data on 304 dementia patients from 18 facilities in Berlin. They found that while the anti-dementia drugs (the cholinesterase inhibitors Aricept, Exelon and Razadyne, and an NMDA receptor antagonist--Namenda) were rarely prescribed, patients instead were usually being treated with neuroleptic drugs. One definition of a neuroleptic drug is a "tranquilizer used to treat psychotic conditions when a calming effect is desired." These drugs can have serious and life threatening side effects and should only be given when less harmful drugs have failed. That's why the FDA has given them all "Black Box Warnings." It's now the "gold standard" for the best dementia treatment options that one of the cholinesterase inhibitors PLUS Namenda be given together. That combination has been shown to reduce agitation and aggression and slow the progression of cognitive and functional decline over either drug alone, and over no treatment. Of course, non pharmacologic options should always be ongoing--things such as tailored activities, exercise, established routines and a well trained staff to be able to appropriately redirect a person with dementia. I have seen what these drugs can and cannot do, and if this person with dementia is my loved one, I want them on the anti-dementia meds. That's the best we can hope for now since there is still no cure. We can only hope to slow the progression a bit and at the same time, increase their quality of life. The argument for anti-dementia drug combination therapy was made by a study sponsored by NIH (National Institute for Health). This was not a drug company sponsored study. It was carried out in the Memory Disorders Unit at Massachusetts General Hospital and conducted by Dr. Atri, et al. The results were published in the September 2008 issue of Alzheimer Disease and Associated Disorders and included data from 382 AD patients collected over the course of 15 years. They were trying to see if there really was any measurable benefits to giving these two anti-dementia meds together versus only a cholinesterase inhibitor, or versus no treatment. They measured cognitive performance over time as well as functional dependence over time. For cognitive results, the data showed that untreated patients had 3 to 4 errors per year on testing. The combination of Namenda plus a cholinesterase inhibitor decreased that deterioration by 2 errors per year. When 1 error per year could mean the difference between a person remembering the name of their relative, this is very significant. For functional outcomes, the combination therapy again showed increased abilities over the period of decline over just the cholinesterase inhibitor alone, or no treatment. That could mean the different between a person being able to stand up when asked to at the end of 4 years. This has huge implications for facility caregivers as well as family members.
I must disclose to you that I am on the Speaker's Bureau of Forest Labs for their dementia drug Namenda, however, even if I were not, my experience has shown me without a doubt that these drugs do help and do not have the severe side effects of the antipsychotics. I have no qualms whatsoever about recommending these anti-dementia drugs, and I urge you to ask your physician to try them before resorting to the more dangerous drugs. It's always, always, always a guessing game when it comes to which drugs will work with dementia, but if meds are required, you should always opt for the least harmful drugs first.
Dr. Majic's article was seen in the current issue of Deutsches Arzteblatt International (Dtsch Arztebl Int 2010; 107[18]: 320-7).
We have to do better at treating these elders in facilities, and combination therapy of the anti-dementia meds is a huge first step, so I urge you to push for it.

WILL I STILL LOVE CHOCOLATE?

2010-05-22T15:58:00.000-07:00

Can you imagine life without 1 or 2 of your favorite flavors? Researchers Katherine Piwnica-Worms, R. Omar, J. Hailstone, and J. Warren used jelly beans to test subject's ability to discriminate and identify flavors, as well as to assess combinations of flavors as to whether they were appropriate and pleasant. An example they used was the combination of vanilla and pickle. Their research finds evidence that there is a loss of meaning for flavors in patients with "semantic dementia." This is a degenerative disease that affects the temporal lobes of the brain, and the meanings of the words become lost. So, if my temporal lobes were being affected by this type of dementia, and you asked me if I wanted my favorite chocolate ice cream, I would have no idea what you were asking me. And even if you gave me that favorite flavor, I would not necessarily be able to identify it as something I love. This research helps provide clues to some of the abnormal eating patterns some people with dementia develop, such as faddism, or possibly a pathological sweet tooth.
I asked an elderly woman one day when we were driving back from a family reunion, if she wanted to stop for a milkshake. She readily agreed, but when I asked her what
flavor she wanted, she was unable to understand my question. She couldn't remember that she loved chocolate. I ordered chocolate for her and she enjoyed it immensely, so I took comfort in that. It hurt to think she couldn't remember chocolate, but I rejoiced to see that she did still enjoy it that particular day.
We never know what area of the brain will be affected next by dementia. We must continue to alter our perception of what this person wants or likes because they may have just decided they want pickles and vanilla ice cream--and they would actually probably enjoy it.
This article is titled "Flavour processing in semantic dementia" and can be read in Cortex, Vol. 46, Issue 6 (June 2010) published by Elsevier.

RADIO INTERNET SHOW INTERVIEW

2010-05-14T04:52:00.000-07:00

I want to let people know that I will be interviewed tomorrow - May 15th, 2010, by Jacqueline Marcell on the popular ‘Coping With Caregiving’ Internet radio program. We will be discussing my recently published book "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia," as well as the HUGE one day book launch set for June 10th where purchasers on that one day will receive a TON of bonus gifts worth hundreds of dollars.

The show features interviews with four healthcare professionals and can be heard live worldwide from 3-4:00 pm Pacific Time, with my interview at 3:30 pm PT (6:30 pm ET), segment 3. To listen in, simply click on one of the ‘On Air Listen Live’ buttons at the top of www.wsRadio.com/CopingWithCaregiving.

If you miss the live broadcast, by Tuesday May 18^th you can listen-on-demand to the online archive anytime. If you need assistance with listening to Internet radio, please see www.wsRadio.com/how-to-listen.cfm.

The host of the 7-year old program, Jacqueline Marcell, took care of her parents who had Alzheimer that went undiagnosed for over a year, compelling her to dedicate her life to eldercare awareness and reform. She is an international speaker and author of the best-selling book ‘Elder Rage’ www.ElderRage.com.

If your area of expertise is relevant to caregiving, health or aging issues and you would like to be considered for the program, email Jacqueline at J.Marcell@cox.net for the details--tell her I sent you!

Please forward this announcement to those who may have an interest--and I hope you will listen in and send me your comments!

INCREASED RISK FOR DEMENTIA IN SPOUSE CAREGIVERS

2010-05-14T04:31:00.000-07:00

While scrolling through Medical News Today, I found an interesting 5/8/10 article on a paper about to be published in the Journal of the American Geriatrics Society this month. Dr. Maria Norton of Utah State University and her colleagues found that spouse caregivers of people with dementia were six times more likely to go on to develop dementia than caregivers of spouses without dementia. We already know that caregivers sometimes are not very good at taking care of themselves and suffer much higher rates of physical and mental disabilities, but this is the first study to look at their risk for dementia.
This was a relatively small study, with 1,221 married couples who were followed over a period of 12 years. They were age 65 and older, all living in Northern Utah. None of them had dementia at the start of the study, and adjustments were made in the study for socioeconomic status, age, gender, genetic factors, etc. In follow-up, "30 cases (60 individuals) of dementia were diagnosed in both spouses, plus 125 where only the husband developed it, and 70 where only the wife developed the condition."
They found that for male caregivers of a spouse with dementia, their risk for developing a dementia was 11.9 times higher, and for women, it was 3.7 times higher. What we don't know is just how much of this risk is due to caregiver stress, and how much the shared environment played a part in it.
Something we need to keep in mind while looking at these numbers, is that MOST of the participants with spouses who developed dementia, did NOT go on to develop dementia themselves.

STUDY FINDS WAYS TO REDUCE RISK OF MILD COGNITIVE IMPAIRMENT

2010-05-02T16:03:00.000-07:00

Isn't it great there are dedicated people out there in the world who are working very hard to find answers to awful diseases like Alzheimer's and other dementias? Mayo Clinic has recently published a case-controlled study of whether a combination of physical exercise (of any type) plus computer use would help reduce the risk of acquiring mild cognitive impairment (MCI). Both of those activities have been shown in previous independent studies to reduce the risk of acquiring MCI, but it now appears the combination of the two produce an even greater protection: "The joint effect is more than the expected arithmetic sum," said Yonas Endale Geda, M.D. who was the study's lead investigator. MCI often progresses to Alzheimer's, so this is exciting news! Get out there and take brisk walks, then come home and turn on the computer for awhile! You'll be doing your brain a favor! Happy surfing!

LATINOS HAVE INCREASED RISK FOR DEVELOPING ALZHEIMER'S DISEASE

2010-04-24T10:52:00.000-07:00

Many people are terrified at the thought of possibly developing Alzheimer's as they age--especially if they now have, or have had, a family member with the disease. With the aging of the baby boomer population in the U.S., the incidence of Alzheimer's is predicted to reach epic levels as the chances of developing a dementia are now almost 1 in 2 after the age of 85.
A small study by a team of researchers at Banner Alzheimer's Institute; TGen; Arizona State University; Mayo Clinic Arizona; Univ. of Arizona; Univ. of California San Diego and the Arizona Alzheimer's Consortium "provides support for the relationship between the APOE4 gene and the risk of Alzheimer's Disease in Latinos." This study followed brain imaging with PET scans and was published in the Archives of Neurology.
According to the Alzheimer's Association, Latinos are currently about 1.5 times more likely to develop Alzheimer's disease than Anglos. Of great significance is the projection that by the year 2050, the number of Latinos affected will increase by 600%. What is pushing these numbers up? It's multi-factorial.
I often have clients or guests at conferences ask me if they are at increased risk of inheriting Alzheimer's because their parent has it. I tell them that even if they do "inherit" the gene or genes, it doesn't mean they will ever actually get Alzheimer's. I also tell them their chances of having a stroke and developing multi-infarct dementia because of cardiovascular disease, diabetes, obesity and/or hypertension is probably actually greater than their chances of getting Alzheimer's. I believe this helps them put their fear of Alzheimer's into perspective and hopefully motivates them to look at and modify their current lifestyle. Very few of the people asking me these questions look to be at an ideal body weight, vibrant and healthy, so there is usually always room for improvement in those areas.
The study mentioned above notes that Latinos have a higher incidence of all of those diseases which undoubtedly contributes to their increased risk for Alzheimer's. Again, it's that "wholistic" view of the body. Avoid fearfully focusing on any one disease and instead try to make improvements in your entire lifestyle. Your heart and your brain will be much more healthy and happy.

PREDICTING ALZHEIMER'S DISEASE MAY NOW BE EASIER & CHEAPER THAN EVER

2010-04-15T07:29:00.000-07:00

One of the local guys here at Penn State University, associate professor of psychology, Michael Wenger along with researchers at Mayo Clinic College of Medicine have developed a low-cost method of assessing shrinkage in the hippocampal areas. Currently, the best way to assess the size of the hippocampus (where our short-term memories go to be stored/sorted into long-term memories, and is also important in spatial navigation) is with MRI (magnetic resonance imaging) testing. As you can imagine, using MRI simply to detect changes in the hippocampus is quite cost prohibitive and not easily available to many people. These researchers got together and combined engineering , statistics and psychology to come up with a way to measure how long it takes a subject to recall objects during a test called FCSRT (Free & Cued Selective Reminding Test). This looks at something called "hazard function" which is an engineering term, and gives them probabilities that a task not yet completed will be done in the next interval of time. This study was specifically looking at people who were diagnosed with MCI or mild cognitive impairment and they were able to track progression of the MCI. This could mean a very low-cost method of diagnosing Alzheimer's disease in the earliest stages. The researchers say these results are still preliminary but are very encouraged by the fact that during their testing, the results were confirmed by MRI. They plan to continue with their study of this method looking at mental impairments related to other deficiencies as well. The National Institute on Aging provided funding for this project.
In my opinion, this is exciting news because any time you can give a person with a diagnosis of Alzheimer's (and their families) more time to prepare for the future, the better off they will all be. Education is key and you can't make your wishes known if your don't know your diagnosis.

"MUTANT" RATS MAY HELP STUDY ALZHEIMER'S!

2010-04-09T14:22:00.000-07:00

What a title! I've just learned that Professor Claudio Cuello and his collaborators at McGill University (Montreal, Quebec, Canada) have managed to create rats that can mimic Alzheimer's disease in humans. They have genetically manipulated these rats so that peptides typical of Alzheimer's accumulate in their brains. This will allow researchers to detect and study the evolution of deficits seen in memory and learning in Alzheimer's. While scientists have been able to produce mice with the peptides, apparently rats are smarter than mice and their behaviors are much more predictable, so when the disease progresses in the rats, the progression through the phases can now be measured. This research was published March 29, 2010 in the April edition of the Journal of Alzheimer's Disease. Who would have thought RATS would be helpful to us in our quest to conquer Alzheimer's?

BATHING PEOPLE WITH DEMENTIA TIPS

2010-04-01T12:26:00.000-07:00

I know bathing issues are one of the most frustrating aspects of caring for a person with dementia. If you don't subscribe to my free Newsletter (The Journey Through Dementia Newsletter), you didn't see the tips I listed there just recently. This topic is so important, I've decided to copy those tips here for a wider audience:

- Adhere to their long-time routine if possible (showers vs. baths; morning vs. evening, etc.)
- Keep the bath area WARM--more warm than you like it--it's much easier to get their clothes off if they're not cold;
- Have distractions in the tub/shower area such as a rubber duck so you can ask "Now where did this come from?" Hand it to them and keep up a dialog about it;
- Don't get their head wet until the very last minute;
- Hand them a washcloth and allow them to do whatever they can with it--anything in their hands will serve to distract them;
- Don't ask them if they're ready for a bath--simply prepare the room, lead them in and keep talking about something they're interested in;
- If this is your spouse, take a shower with them;
- Have towels or cotton robe warmed by the clothes dryer ready to use immediately after getting out of the water;
- Put music they enjoy on in the bathing area, and encourage singing along;
- Keep up the chatter about topics of interest to them, and ask them questions;
- If they've developed a fear of the water in the bathtub, try a gentle seated shower with the spray directed on their feet;
- A good old-fashioned "wash-up" at the sink can keep them just as clean as long as they're getting their hair done in some other manner.
- Remember--the goal of the talking is to keep their mind off the bathing;
- The more distracting things you can have in the bathroom, the better your chances of keeping them calm;
Remember--what works well today, may not work at all in a few weeks. Just keep trying.
If you would like to sign up for my free Newsletter, please go to my website and click on the "Join my list" button.
Best of luck with the bathing issues!

HOPE FOR ALZHEIMER'S BLOOD TEST

2010-03-26T18:11:00.000-07:00

In a recent search of the web on Alzheimer's news, I came across a 2/12/2010 announcement from OPKO Health, Inc. of their development of "a simple diagnostic blood test for Alzheimer's disease." You can find out more about OPKO and this news by searching "OPKO Health, Inc."
I want to caution you, though, this is not yet news we can take and run with even though their preliminary findings indicate the test was approximately 95% accurate. They are wisely couching their news in "forward-looking statements." This includes the use of words such as "expects," "believes," "could," "estimates," and others. The upshot is that once further testing is completed, the test may or may not actually perform as it is hoped it will.
I am telling you about this because I consider it to be a sign of the progress being made in the field of dementia and Alzheimer's. We must not give up hope that some day we will not only have a blood test for Alzheimer's, but we will have a cure.

IT'S PUBLISHED!

2010-03-18T11:11:00.000-07:00

It's finished! I'm thrilled to tell you "LOVE, LAUGHTER, & MAYHEM - Caregiver Survival Manual For Living With A Person With Dementia" has been published and can now be ordered through the printer, BookLocker, at www.booklocker.com/books/4585.html. It will also be available through amazon.com, barnesandnoble.com, and my website in the near future. The fastest way to obtain it is to order directly from the printer at BookLocker at the exact link noted above.
It has taken me more than two and a half years to complete this book, and once I wrote the stories I was reluctant to change them in any way. The last chapter is a story about my father and sadly, he passed away almost exactly one year ago from his dementia and other illnesses--long before I was finished with the publication process. I like to think he's watching over me now and because he knew I was writing a book, that he's proud of my achievement. This book is dedicated to him and to all of the other people with dementia who have enriched my life and helped to give me direction.
I look forward to hearing how this book has helped change your life, as well as the life of your loved one with dementia--my goal is to help make your lives happier and healthier. Cindy

FREE TIPS ON DEMENTIA CARE AVAILABLE!

2010-03-11T08:31:00.000-08:00

I have begun to create a series of "Free Tips" videos which can be accessed from my website. These are short, informational and very informal videos of me speaking from my living room. The first one talks about getting out of your reality and into the reality of the person with dementia. The second one is about the importance of hydration in people with dementia. I'm currently working on the third one and in it I talk about a few things to avoid doing with people with dementia. My plan is to create 8-10 of these videos, available free to anyone, and to also have written transcripts of them available for purchase for just a few dollars. I hope you are able to benefit from this information and I welcome any comments you have about them.

I'M BACK!

2010-03-04T16:11:00.000-08:00

Hello Everyone: First, I apologize for being away from my blog for so long. My reason for the absence is that my first book, "LOVE, LAUGHTER, & MAYHEM - Caregiver Survival Manual For Living With A Person With Dementia" is about to be published. I'm self-publishing through BookLocker and hope to have the book in my hands by mid-March. This book is a collection of stories about people with dementia I have known, loved, and worked with in my many years as a nurse. Every story has a lesson to teach, and this book will teach family caregivers lessons about how to better interact with, and care for their loved one with dementia. I have worked on this book for the past two years, and I am now giving it birth. See my website for previews of the Table of Contents as well as two of the stories from the book.
You will read the story about my father and his dementia in this book, and I have dedicated the book to him. Dad died on March 13th, 2009 and I am thinking how fitting it is that my book should be published this month. It is my hope you will learn many things from my stories, and I would love to hear from you about how it has affected your life as well as the life of your loved one with dementia. Cindy

RADIO INTERVIEW!

2008-05-17T18:36:00.000-07:00

I've just had a radio internet interview by Jacqueline Marcell, author of "Elder Rage or Take My Father...Please!" You can access this interview and others on wsRadio at http://www.wsRadio.com/CopingWithCaregiving. Jacqueline's excellent book led me to contacting her, and in our discussion she offered to have me join her on her program. This interview will be archived and accessible free of charge. Details to follow as to how to access the archived interviews!

I'M WRITING A BOOK!!

2007-11-10T12:54:00.000-08:00

Everyone has wonderful stories, and I've decided I have so many great stories about all those wonderful people with dementia I've known over the years, that I need to put them into a book. There are lessons to be learned in every story, and that too, is part of the book. I don't know yet what the book will be titled, or when it will be finished, but I've started on it, and am disciplining myself to work on it daily. I would love to hear from you if you have a great story to share about your loved one with dementia, and if you share it with me, I may include it in my book! So, send me an e-mail and tell me your funny, happy, sad, or inspirational stories, and I'll be "hibernating" this winter working on putting it all together.

NEXT DPW APPROVED DEMENTIA SEMINARS:

2007-02-14T16:56:00.000-08:00

Just today finalized the cities for the next three DPW approved dementia seminars. This will essentially be the same seminar I gave last year, but this year I am moving some of them to different cities and will likely only give 6 instead of 8.
Tuesday, March 27th at the Holiday Inn Express in Altoona
Thursday, April 12th at the Inn at Jim Thorpe in Jim Thorpe (between Allentown and Wilkes-Barre)
Friday, April 13th at The Travelodge in Lancaster
I need to finalize menus and assess what my costs will be and I will then post the prices for these seminars. I wanted to post this blog because I've had some people call me to question when and where the next seminars will be. I plan to send out a mass mailing to the surrounding counties, and that mailing should be going out by February 22nd. I'm also having my website completely changed and I hope to be able to offer you the option of registering, as well as paying for the seminars through the website. In the meantime, if you have questions, please e-mail or call me. Thanks for visiting my site!!

ARICEPT NOW FDA APPROVED FOR LATE STAGE ALZHEIMER'S

2006-11-29T08:05:00.000-08:00

Eisai and Pfizer, Inc. have recently received FDA approval for Aricept's use in late stage (severe) Alzheimer's disease. This is a pretty important move since Aricept is the number one prescribed drug in the treatment of Alzheimer's. Check out more information about it at http://www.aricept.com. Of course, there are some people who cannot tolerate this drug, and if that's the case with your loved one, I would encourage you to try Exelon or Razadyne. I would also encourage you to consider adding Namenda to the Aricept since it's been shown to be very effective at helping preserve cognitive abilities for a longer period of time. Please remember that it's always a "guessing game" when it comes to using drugs in people with dementia. Your physician should always start doses out low and increase very slowly to accurately observe any side effects.

CHANGES COMING!

2006-11-29T07:59:00.000-08:00

I'm in the process of having some big changes made to my website in order to make it more user-friendly, and efficient. Thank you to everyone who has taken a moment to contact me and let me know how I've been able to help you--that means a lot to me and that's why I'm in this business! Stay in touch and keep the comments coming. Cindy

STAFF TRAINING VIDEO NOW AVAILABLE

2006-11-29T07:43:00.000-08:00

I'm proud to announce that my staff training video (BRINGING NURTURING TO MEMORY CARE), is completed and can be purchased by contacting me by e-mail (keithc@mindinmemorycare.com) or by phone (814-235-0691). Feedback has been very positive! I accept VISA, Mastercard, money order or business check and I am willing to consider a payment plan to make it easier for you to access this valuable training source. The introductory cost is $400.00 plus $6.00 S & H (PA residents must pay 6% sales tax). It consists of 2 DVD's, runs 2 hours and 28 minutes and includes a written test--so easily amounts to a 3 hour training. Just think of how many of your staff can benefit from this easily accessible training source! Your biggest benefit will come from the increased comfort your staff will feel when working with this challenging population, as well as less agitation and aggression from your residents with dementia. Please check out the information contained in the Outline listed below on this blog.

FACILITY STAFF DEMENTIA TRAINING VIDEO!!

2006-08-14T09:16:00.000-07:00

GOOD NEWS!! I plan to have my front-line staff dementia training video entitled "BRINGING NURTURING TO MEMORY CARE" videotaped this week. It will then take a couple of weeks to be edited and put into videotapes and DVD's, and I will be able to offer it to anyone interested in purchasing it. I'm excited about this first venture into such an unknown area for me. I believe the video will be about 3 hours long, and the outline of information is as follows:

BRINGING NURTURING TO MEMORY CARE

(1) Dementia Facts
(a) Over 40 different dementia types and what they have in common
(b) Most common types: Alzheimer's, Lewy Body, Multi-Infarct
(c) Different dementia types = different behaviors
(d) Effects of aging baby boomers on dementia statistics

(2) Your "Objective" with this population: Maintain or improve the health, happiness dignity & safety of every person with dementia
(a) Based on the Objective--the needs you must see to in this population
· Why their needs are different--hydration; maintaining weights; activities; safety issues including falls; how to avoid negative outcomes with these special needs
· Looking at "Resident Rights" in a new light based on this Objective
· How your actions can easily be interpreted as abuse or neglect with this population
· Your actions determine the outcome for every encounter
· YOU ARE responsible if you are injured by a person with dementia, or if a person with dementia is injured by you during care

(3) The "skills" you must have in order to work effectively and safely with this population
(a) Nurturing, patient, loving
(b) Good work ethic
(c) Willingness to learn about your residents
(d) Resident oriented and not task oriented

(4) Common, incorrect caregiver responses to people with dementia (scenario)
(a) Treating them like a child
(b) Lecturing and re-orienting
(c) Impatience
(d) Anger
(e) Blame

(5) Communicating with impaired brains
(a) Your body language speaks louder than your words
(b) Get in their reality and out of your own
(c) Validate feelings and emotions
(d) Redirection vs. commands
(e) Offering choices

(6) Finding the "triggers" behind behaviors
(a) Examples of triggers for certain behaviors
(b) Triggers can be positive or negative
(c) Communicating with other team members for problem-solving and support

(7) Behavior changes in people with dementia
(a) Know the resident's "normal" behavior
(b) Sudden deviation from "normal" could indicate an illness or pain
(c) Depression and dementia
· How to differentiate
· Why it is important to have depression treated

(8) Specific behaviors, how to manage them, and possible triggers behind them
(a) Sundowning
(b) Pacing/fidgeting
(c) Packing repeatedly
(d) "Shopping" in other people's rooms or closets
(e) Hoarding/hiding
(f) Refusals to take medications
(g) Refusals to bathe
(h) Disrobing in public
(i) Suspicious/paranoid behaviors
(j) Agitation
(k) Shouting, screaming repetitively
(l) Sexual inappropriateness
(m) Repetitive questions
(n) Exit-seeking
(o) Combativeness

(9) Some things you should never do when interacting with people with dementia, and what you can do instead:
(a) Command or force
(b) Argue or try to reason with them
(c) Shame them
(d) Speak or act in a condescending manner
(e) Say "I told you..." or "You can't..."
(f) Talk over them as if they are not present
(g) Laugh AT them
(h) Take anything a person with dementia says or does personally

(10) Some things to always do when interacting with people with dementia:
(a) Greet pleasantly, smile, touch gently or hug
(b) Tell family one positive thing about their loved one every time you see them
(c) Communicate what works well with other team members, and to family
(d) Step away when you feel frustrated
(e) Treat the person with dementia with dignity and respect as an elder

(11) Conclusion

UPCOMING DEMENTIA SEMINARS

2006-08-14T09:04:00.000-07:00

My seminar written for personal care home administrators and assisted living directors (and approved by DPW for 8 CEU's) entitled "Happy, Safe, Healthy & Dignified Residents With Dementia" is currently being offered in the following cities:
Monroeville, PA - Holiday Inn - Thursday, September 7, 2006 - $171
York, PA - Holiday Inn - Wednesday, September 13, 2006 - $150
Pottstown, PA - Quality Inn - Tuesday, September 19, 2006 - $164
Wilkes-Barre, PA - Hilton Garden Inn - Friday, September 29, 2006 - $168
All seminars include continential breakfast, lunch, snack and workbook
Please contact me to register to attend this very well received seminar!

PROGRESS BEING MADE IN IDENTIFYING ALZHEIMER'S

2006-06-11T15:08:00.000-07:00

Scans such as PET (positron emission tomography) scans have been used to detect changes in glucose and oxygen use in the brain, as well as blood flow in the occipital lobe which could point toward a diagnosis of Lewy Body dementia. Recently, researchers at UCLA successfully used PET scans in conjunction with a radiotracer named 18F-FDDNP to chart the spread of lesions in the brain in Alzheimer's patients. Individuals with MCI (mild cognitive impairment) were included in the tests, and while "a more limited pattern of 18F-FDDNP distribution" was found in these cases, the use of this radiotracer with PET scans in the future will help to diagnose Alzheimer's with greater accuracy in clinical settings. UCLA researchers Jorge R. Barrio and Gary W. Small lead these exciting studies.

GIFT BOOK FOR DEMENTIA CAREGIVERS

2006-06-07T10:10:00.000-07:00

Publisher Buttonberry Books offers a new mini gift book for caregivers of persons with dementia. Portions of the proceeds from the sale of the books will be donated to Alzheimer's and dementia organizations around the world. It's called "Nurturing Nuggets For Dementia Caregivers: 25 Supportive Stratigies In Caring For Persons With Dementia." It's listed on the Nurturing Nuggets website at nurturingnuggets.com for $6.95. I love that word "nurturing" as you know from my business title "M.I.N.D. in Memory Care" stands for "Moving In Nurturing Directions in Memory Care."

MY CURRENTLY SCHEDULED SEMINARS APPROVED BY PA DEPT. OF PUBLIC WELFARE:

2006-05-15T08:48:00.000-07:00

Meadville, PA - Days Inn Conference Center (814-337-4264) - Thursday, June 22
Altoona, PA - Holiday Inn Express (814-944-9027) - Wednesday, June 28
Williamsport, PA - Best Western (800-369-4572) - Tuesday, July 11

The seminars run from 8:00 A.M. - 5:00 P.M. with two breaks and a short lunch period. They have been approved by DPW for personal care home administrators and assisted living directors, and will provide 8 CEU hours toward the annual 24 hours required. Please call or e-mail me to register to attend (814-235-0691 or keithc@mindinmemorycare.com). The outline is as follows:

HAPPY, SAFE, HEALTHY & DIGNIFIED RESIDENTS WITH DEMENTIA

(A) Dementia Diagnosis:
(1) What is it and what does it feel like to have it?
(2) Warning signs prior to diagnosis and how dementia is diagnosed
(3) Different types of dementia = different behaviors exhibited
(4) How dementia differs from/resembles brain injuries, MR, or other impairments

(B) Your "Objective" with this population:
(1) Based on the objective, what are the needs you must see to?
(2) Pain; Hydration; Maintaining weights, happiness and safety; Wandering
(3) Common, incorrect caregiver responses;
(4) Caregivers need to look at Resident Rights in a different light when dealing with dementia

(C) Staff Interventions - develop scenarios of common staff responses to dementia residents
(1) "What If" scenarios to plan for positive outcomes
(2) Potential for allegations of abuse/neglect by caregivers of this population

(D) Dementia Facts and Figures
(1) How much does it cost you if your residents show aggression?
(2) Let's look ahead to 2025 and your facility's dementia population
(3) Staff dementia training-- how much is enough & how to tell if training is inadequate

(E) Trickle-down effects of management, and effective management tips
(1) What kind of manager are you?
(2) What worked well for me in a dementia dedicated assisted living facility
(3) What motivates staff to stay with you and improve your quality of care?
(4) "Better Jobs/Better Care Demonstration Grant" domains and criteria for recruitment/retention of quality caregivers

(F) Multiple ways to improve your care for people with dementia and other disabilities:
(1) Eden Alternative, Wellspring Program, Pioneer Movement
(2) Snoezelen Room
(3) Benefits of these changes to residents, to staff and to your bottom lines
(4) Other ideas to create a safer, more pleasant environment for your impaired residents
(5) Activities in your facility and effects on depression

(G) Summary; Discussion; Q & A; Feedback

NEWSPAPER ARTICLE BY CINDY KEITH

2006-01-31T13:12:00.000-08:00

WHAT SHOULD WE DO ABOUT MOM?

Since Dad died 2 years ago, Mom has been more forgetful and is missing important appointments despite having put them on the calendar. She just doesn't seem to be herself and lately, I've noticed that she's forgotten conversations with me about recent family events. She's had two fender-benders in the past year, the last one resulting in a nasty bump on her head. I don't think she's taking her medicines properly because I find pills lying around the house, but she resists my efforts to monitor them and tells me her doctor is keeping tabs on her. She's pretty adept at covering up her mistakes, but I sense she's worried too since I've heard her joke to her sister in Ohio that she thinks she's getting "Old Timer's Disease." My siblings live in different parts of the country, and none of us want to admit this is happening, but now I'm really concerned about her safety. We don't know what to do next.
This is a common scenario being played out in every city across the country. None of us want to think of the possibility of a devastating diagnosis like Alzheimer's or some other type of dementia, and how each family deals with the problems and questions that arise will be as diverse and individual as each family is unique.
Your objective will be to maintain Mom's dignity, health, happiness and safety, and she first needs to be thoroughly evaluated by her physician. A "dementia work-up" would include a history along with blood tests to rule out a problem that can mimic dementia. Depression, thyroid disorder, vitamin B12 deficiency, and medication reactions are just a few of the possibilities which can be treated successfully. Memory tests such as a mini-mental state exam, including a clock-drawing test are important and should be done for a baseline evaluation, as well as in follow-up to monitor memory status. PET and CT scans or an MRI can show abnormalities in the brain such as strokes, lesions or excess fluid, all of which could account for her symptoms. Someone should accompany her to these appointments, and her doctor should be informed about the family's concerns.
In any case, a durable healthcare power of attorney must be appointed in order to access medical information or make medical decisions for her, if needed.
Waiting for the crisis to happen before acting is being "reactive" where "proactive" would be finding some answers to try to prevent a crisis. Since people don't know what they don't know, accessing those professionals who can provide answers will give families some control over what may happen. It will never be easy or comfortable to find the answers, but meeting your objective may depend on what you do before the crisis. Future articles on this topic will address some of the specific challenges faced by families dealing with dementia.
Cindy Keith, RN, BS, of M.I.N.D. in Memory Care can be reached at 814-235-0691

SENATOR HILLARY RODHAM CLINTON AS CO-CHAIR

2006-01-15T16:05:00.000-08:00

Senator Hillary Rodham Clinton was appointed co-chair of the Congressional Task Force on Alzheimer's Disease last year. Because of the increasing numbers of people who are going to be diagnosed with some type of dementia, the government recognizes the importance of increased research and awareness of dementia. Senator Clinton feels one key issue to be addressed now is in working to find solutions to alleviate the tremendous burdens assumed by the caregivers of people with dementia. She urges people to contact their senators and representatives and urge them to support the Lifespan Respite Care Act. Among other things, this Act would help to develop a statewide system for caregivers regardless of their age, disability or Medicaid status. It would also provide more information to people about respite care services. Senator Clinton says that this bill "picks up where the National Family Caregiver Support Program leaves off."

SOME ENCOURAGING NEWS ! !

2006-01-15T15:50:00.000-08:00

There are many studies on dementia being performed and published on an on-going basis. Some good news coming out of those studies is that progress is being made in tracking down some pathways for Alzheimer's and other dementias--which may lead to ways to prevent the disease. Scientists are working on a vaccine for Alzheimer's and it looks promising in the animal testing stages now. Some of the drugs currently on the market are being shown to slow the progression of dementia, including some of the cholesterol-lowering drugs. Another study looks at the possibility of Alzheimer's being a neuroendocrine disorder, meaning it may be linked to abnormalities in how the brain handles insulin. It may be a few years until these studies lead to effective treatments for people, but we need to focus on how much is now being discovered, and work together to see that these important studies receive the funding and the support they need.

EARLY-ONSET DEMENTIA

2006-01-10T12:43:00.000-08:00

People who are diagnosed with some type of dementia before the age of 60, often in their 40's or 50's, sometimes spend years attempting to find the correct diagnosis for their declining abilities. Some physicians will quickly dismiss their fears of having Alzheimer's disease or some other type of dementia as "you're much too young to have that" without ever ordering the tests that may help confirm that very diagnosis. Their complaints of mood swings, personality changes, increasing forgetfulness and even gait changes are usually attributed to depression, stress, or working too hard. There are some indications from studies that an inability to accurately draw the intersecting pentagons or do the clock-drawing on the mini-mental state exam are a better indication of some type of dementia, than the final score on the test itself. In other words, a person may score high on the test, but still not be able to accurately draw the required pentagons or clock face. My advice to anyone suspecting a type of dementia, is to find a doctor who will listen and perform the tests needed. If the score on the MMSE is high or "normal," but the drawing is incorrect, I would push for brain scans to look for changes there.
People with early-onset dementia often have more insight into their situation than do people who were diagnosed later in life, and also face many more challenges dealing with family dynamics. Their diagnosis may come at a time when they are still rearing children, have jobs that require extensive travel, and they often have not had time to accumulate any "retirement" savings to help with expenses.
The good news is that even after the diagnosis of dementia, these people can still lead productive lives, and can still contribute to their families and support groups. Knowing what their future brings, people with early-onset dementia can plan more effectively for it. It will never be easy, but educating families and friends can make a world of difference.

AFA QUILT TO REMEMBER

2005-12-27T08:22:00.000-08:00

The Alzheimer's Foundation of America wishes to pay tribute to all people who have passed away, or are currently living with dementia, to their families and to their caregivers. In the tradition of the world famous AIDS Memorial Quilt, the AFA Quilt to Remember is the first ever national dementia-related quilt of this stature. There will be no cost to contribute a panel, and if you're not able to physically put a panel together, monetary donations are always welcome to offset the cost of touring the quilt throughout the United States.
The panels, along with your personal story and a copy of your panel maker application (www.alzfdn.org) can be sent to: AFA Quilt to Remember; Alzheimer's Foundation of America; 322 Eighth Avenue, 6th Floor; New York, NY 10001. Panels will be accepted on an on-going basis, and will begin display of the first portion in the fall of 2006.
You may also contact me for further information regarding this worthy project. I would like to hear your ideas for your panels, as well as hear your stories surrounding your loved one with dementia.

HOLIDAY MEMORIES

2005-12-26T08:14:00.000-08:00

Here's hoping that you and your loved one with dementia are having a peaceful holiday season. Despite all the pressures on you and your family at this time of the year, it is possible to enjoy some quiet moments with a person with dementia. It's important to remember that while Mom or Dad used to love being in the middle of the huge family gatherings, this is likely to only make them feel more scared or agitated right now. Their damaged brains are unable to take in all of this activity, and they would benefit more from one on one, quiet moments of reflection and reminiscing about past happy holidays. Focus on enjoying those few quiet moments.

NUMBERS OF PEOPLE WITH DEMENTIA INCREASING

2005-12-26T07:46:00.000-08:00

The latest issue of the Lancet reports that worldwide "a new case of dementia arises every seven seconds with the number of people with dementia set to double every 20 years." Most of these people live in developing countries with China and the European Union currently having 5 million each and the U.S. with 2.9 million. These figures include all types of dementia, and speak to the importance of all countries planning for the increases in the numbers of people with dementia. The U.S. is facing a surge in numbers because of the aging of the baby boomers, since age is the biggest risk factor for getting some type of dementia--a 1 in 3 chance after age 85--which researchers are saying is getting closer to a 1 in 2 chance.

Alzheimer's Disease International is an international federation made up of 75 Alzheimer associations around the world and is based in London. This federation works closely with the World Health Organization to compile data such as this on the prevalence of dementia worldwide. They help coordinate events for World Alzheimer's Day celebrated every September 21st, as well as produce and distribute written materials on dementia for use worldwide.

DEMENTIA CAREGIVER SPOUSES AND GINGIVITIS

2005-12-16T09:16:00.000-08:00

The November issue of Psychosomatic Medicine talks about an interesting study done by Dr. Peter Vitaliano, and others from the University of Washington School of Medicine in Seattle. They found that caregivers of spouses with Alzheimer's developed gingivitis at twice the rate of non-caregivers. The caregiver spouses also scored higher on measures tracking insulin levels (increased risk for diabetes), obesity and intra-abdominal fat. They point out that the chronic stress and gingivitis connnection was first observed in WW I with soldiers.
This is one more study pointing out risks due to the very high levels of stress involved in taking care of a loved one with dementia. Please try to maintain your health by keeping involved in activities that are important to you--and investigate adult day care services. Taking a loved one to day care several times a week helps keep them socialized, as well as giving you some time to yourself.

DEMENTIA AND TYLENOL

2005-12-16T09:01:00.000-08:00

A Medical News Today article (www.medicalnewstoday.com) published in the November issue of the Journal for the American Geriatrics Society talks about a study on the use of Tylenol in patients with dementia. The study observed 25 patients with moderate to severe dementia over an 8 week period. These patients were routinely given Tylenol for 4 weeks, and then a placebo for 4 weeks. They found that the patients receiving the Tylenol "were more active than the others...spent less time alone in their rooms and more time interacting with others."
Even though this is a small study, I feel it is significant, and I too, have noticed improved interactions and more calm and happy residents when I gave analgesics if I suspected they may be suffering from arthritis or headaches and were unable to tell us. If you are dealing with a loved one at home with some form of dementia, please keep this in mind and check with their physician to see if Tylenol given on an "as needed" basis is safe in combination with their other medications. Sometimes, a person with dementia who is having a difficult time getting settled and staying in bed at night, may in fact, be having discomfort that a simple Tylenol may alleviate.

CINDY'S MISSION STATEMENT

2005-12-13T14:33:00.000-08:00

It is my mission to serve you with integrity, to nurture your spirit, and to help you allow humor into your life, while I give you the tools to live and work in the world of dementia.

CINDY'S CHOICES

2005-12-13T14:29:00.000-08:00

In my business as a dementia consultant and facility staff trainer, I enjoy gathering families together via telephone conference calls, to tell them what they need to know in order to achieve the objective. I travel to facilities to train staff on how to BEST take care of this challenging population, and I have also traveled nationwide to deliver day-long dementia seminars through Cross Country Education. I am currently exploring other options to help educate families and facilities on ways to improve their caregiving.

In order to facilitate finding my site, I am including some of the phrases people or facilities might use to find me. They are as follows: Alzheimer's care consulting, Alzheimer's assistance, Alzheimer's aid, Alzheimer's service, Alzheimer's comfort, Alzheimer's support, Alzheimer's instruction, Alzheimer's teaching, Alzheimer's training, Alzheimer's education, Alzheimer's care, Alzheimer's guidance, Alzheimer's advice, Seeking Alzheimer's advice; Alzheimer's help, Alzheimer's care counseling, dementia care consulting, dementia care counseling, Alzheimer's consulting, and dementia counseling, dementia assistance, dementia aid, dementia service, dementia comfort, dementia support, dementia instruction, dementia teaching, dementia training, dementia education, dementia guidance, teaching dementia, dementia advice, seeking dementia advice, Alzheimer's answers, dementia answers, dementia help, encouraging dementia teaching, encouraging dementia training, staff dementia training.
While it's cumbersome to include all of these terms here, they all encompass a part of what I do to help people in a nurturing manner to either take care of a loved one suffering from some form of dementia such as Alzheimer's, or to see that facility staff members receive the training that is vital to keeping people with dementia and Alzheimer's safe, happy, healthy and maintain their dignity.

MY QUALIFICATIONS AS A DEMENTIA CONSULTANT & FACILITY STAFF TRAINER

2005-12-13T14:25:00.000-08:00

I have worked in the medical profession for many years, having started as a medical secretary. I became an LPN (licensed practical nurse), worked as a surgical nurse, and served as an office manager in a geriatric practice. I then received my RN, BS degree and worked in several different areas of nursing, but continued to be drawn to geriatrics and especially to people with dementia. My last position as a nurse was as a health care coordinator in a dementia dedicated assisted living facility (every resident had some type of dementia). I held that position for about four years. Following that, because I truly love working with people with dementia, and their families, I decided to start my own business, and M.I.N.D. in Memory Care was born….

M.I.N.D. IN MEMORY CARE

2005-12-13T14:23:00.000-08:00

After months of hard thinking and badgering my friends for help, I chose to call my business M.I.N.D. in Memory Care, with the meaning being "Moving In Nurturing Directions in Memory Care. "Nurturing" is what I'm all about and what I emphatically believe caregiving should be all about. Not only nurturing of the person with dementia, but nurturing of the families and friends as well. I know that the person with dementia will reach a point in their dementia when they live in the moment, don't recall they have dementia, and are relatively calm and comfortable--but the families and friends continue to suffer on a daily basis. By teaching and training, I know I can make life better not only for the person with dementia, but for everyone who loves and cares for them.

THE VALUE OF A DEMENTIA CONSULTANT

2005-12-13T14:17:00.000-08:00

When I ask my clients how helpful my consultation has been for them, they invariably respond "Oh my goodness, I can't tell you how much you've helped us." Every person with dementia remains an INDIVIDUAL, who comes from a different background, has different reactions, and has different family dynamics. Those differences will always remain, and when I listen to each individual story, I can then tailor my information on how to best meet that objective of maintaining the safety, happiness, health, and dignity of their loved one throughout the entire process. Issues such as how to make the home safer, how to deal with the car and driving, resources available to help families, how to handle refusals to take medications, to bathe, or dress--the lists can seem endless for families. I not only give them information, I give them choices, peace of mind and hope.

CAREGIVER OBJECTIVE

2005-12-13T14:16:00.000-08:00

If I had to give every caregiver of a person with dementia an objective, I would say it is "to improve or maintain the health, happiness, dignity and safety of that person with dementia." I don't just mean those caregivers at home--I include every caregiver in every facility who deals with this challenging population on a daily basis. The only way to achieve that objective is to have the KNOWLEDGE of how to best care for this ever-growing population.

PEOPLE JUST DON'T KNOW WHAT THEY DON'T KNOW ! !

2005-12-13T14:14:00.000-08:00

Especially when it comes to a devastating diagnosis such as dementia, people are not aware of how something so simple as STOPPING their attempts to re-orient their loved one, can significantly reduce their caregiving burden, as well as contribute to the comfort and sense of well-being of the person with dementia. Seeking out those professional dementia consultants (such as myself) and those agencies such as the Alzheimer's Foundation of America, will educate you how to BEST care for your loved one, and how to ease the burdens you will be forced to shoulder.

DIFFERENT DEMENTIAS = DIFFERENT BEHAVIORS

2005-12-13T14:10:00.000-08:00

In the early and middle stages of dementia, the behaviors you will see are often dependant on what type of dementia the person has--specifically, which area of the brain is being affected initially. The behaviors of a person with Lewy Body dementia will be quite different from someone with Alzheimer's dementia.

WHY GET A DIAGNOSIS?

2005-12-13T14:07:00.000-08:00

As a nurse, I have seen time and again how people with different types of dementia can improve once they have been diagnosed, and have started proper medications. Not only that, but the families now know what they're facing, and can plan accordingly. They can go through the crucial legal paperwork of getting durable healthcare power of attorney, form a plan in case emergencies happen to their loved one with dementia, and also think about joining a support group.

LEWY BODY DEMENTIA

2005-12-13T14:02:00.000-08:00

Did you know that Lewy Body dementia is now the second most common type of dementia? One of the reasons for the surge into second place over multi-infarct dementia, is that it wasn't clearly recognized and diagnosed prior to this. Many times Lewy Body dementia was thought to be Parkinson's dementia, or just received a generic "dementia" label. We now know that it's crucial to have the diagnosis of Lewy Body dementia either confirmed or ruled out. Why is that? It's because some of the medications used to treat behavior problems in other types of dementia can actually make Lewy Body dementia worse, and they may die earlier. There is an excellent website by the Lewy Body Dementia Association, Inc. at www.lewybodydementia.org.

MORE THAN 40 TYPES OF DEMENTIA ! ! !

2005-12-13T13:56:00.000-08:00

There are currently more than 40 different types of named dementias, but literally hundreds of things that can cause symptoms like a dementia. Everything from vitamin deficiencies to organ damage to inherited causes--that's one reason why diagnosis is crucial--it COULD be a cause that is reversible. To name just a few of the less common types of dementia includes Binswanger's Disease, Huntington Disease, Parkinson's, Pick's Disease, Wernicke-Korsakoff Syndrome, Creutzfeldt-Jakob Disease, Fronto-temporal Dementia, Vascular Dementia, as well as dementias associated with HIV, Alcoholism, and Down Syndrome.

"DEMENTIA" IS THE UMBRELLA TERM

2005-12-13T13:53:00.000-08:00

When people hear the word "dementia" they will often ask me if it's "anything like Alzheimer's disease." To make it more clear to them I tell them that "dementia" is the umbrella term, and that there are more than forty different types underneath that umbrella--with Alzheimer's being the most common type of dementia. So when people ask about "Alzheimer's care, Alzheimer's counseling, dementia care, dementia consulting" it's all the same thing! It's what I do best!