Saturday, September 15, 2018

Understanding How Memory and Language Skills are Entwined



In  the  broadest  sense,  memory  is  the  ability  to  retrieve  information  from  specific  areas  of  the  brain.  Types  of  memory  fall  into  two  categories    long  term  memory  and  short  term  memory.  The  kinds  of  information  associated  with  long  term  memory  are  the  names,  places,  and  dates  that  compose  our  personal  history.  Long-term  memory  also  includes  such  things  as  the  skills  we  have  learned  as  well  as  the  acquisition  and  us  of  language.   

When  Dementia  damages  our  long-term  memory  banks,  we  forget  such  things  as  our  address  and  birth  date,  and  may  no  longer  remember  how  to  drive  the  car  or  to  use  the  washing  machine. 

When we  lose  access  to  our  collection  of  learned  information  and  built-in  skills,  we  require  assistance  to  live  safely  at  home.  Short-term  memory,  or  working  memory,  is  the  ability  to  retain  small  bits  of  recently  learned  information,  such  as  phone  numbers,  login  codes,  and  street  addresses. 

People  who  have  short-term  memory  deficits  may  not  remember  they  have  already  taken  their  medication  or,  just  an  hour  ago,  ate  lunch. 

The  ability  to  recall  and  use  language  is  one  of  many  ways  to  assess  the  progression  of  Dementia.  In  addition,  specific  kinds  of  language  difficulties  can  help  clinicians differentiate  Frontotemporal  Lobe  Dementia  from  other  types  of  Dementia  such as  Alzheimer’s  disease.

Language  difficulties  most  often  associated  with  Alzheimer’s disease  are  difficulty  in  finding  the  right  words,  describing  objects  rather  than  calling  them  by  name, repeated  use  of  familiar  words,  relying  on  gestures  to  express  ideas,  and  reverting  back to  speaking  a  native  language.   

Unlike  Alzheimer’s  disease,  people  who  have  Frontotemporal  Dementia often  have  difficulty  in  using  and  understanding  spoken  and  written  language.  Language  problems  include  repeated  mispronunciations,  such  as “sork” for  “fork”  and  the  inability  to  make  appropriate  associations  between  names  and  objects.  If  your  parent  is  not  able  to  associate  an  object  with  a  word,  he  or  she  may  point  to  a  sandwich  and  call  it  a  baseball.  People  who  have  Frontotemporal  Dementia  are  not  aware  of  how  they  have  changed. 

Using  words  and  phrases  such  as “this,” “that” and  “over  there” in  the  place  of  specific  nouns  and  descriptions  are  language  deficits  typical  of  many  types  of  Dementia.

Memory  loss  and  language  difficulties  often  make  communication  awkward, difficult,  and  frustrating.  It  doesn’t  take  long  before  “never  mind” replaces  your  efforts  to  engage  in  conversation. 

Here  are  a  few  tips  from the Alzheimer’s Association you  can  use  to  improve  communication  between  you and  your  loved-one.

As you  will  read,  most  are  expected  norms  of  polite  conversation. 

·      Give  your  loved-one  the  time  to  formulate  a  response 

·      Engage  in  one-on-one  conversation 

·      Converse  in  a  quiet  space  with  few  distractions 

·      Maintain  eye  contact 

·      Avoid  criticizing  or  correcting  misinformation 

·      Listen 

·      Avoid  arguments 

·      Speak  slowly 

·      Give  step-by-step  instructions 

·      Use  written  notes  to  prevent  the  frustration  and  confusion  of  remembering  details. 


 Contributor:  Janet  Yagoda  Shagam,  PhD,  is  a  freelance 
medical  and  science  writer  and  the  author  of  “An  Unintended  Journey:  A  Caregiver's  Guide  to  Dementia.” Available  through  Amazon.

The  opinions  expressed  by  contributing  authors  are  not  necessarily  the  opinions  of  the  Dementia  Society,  Inc.  We do  not  endorse  nor  guarantee  products,  comments,  suggestions,  links,  or  other  forms  of  content  contained  within  blog  posts  that  have  been  provided  to  us  with  permission,  or  otherwise.  Dementia  Society  does  not  provide  medical  advice.  Please  consult  your  doctor.  

Reference: Communication:  Tips  for  successful  communication  at  all  stages  of  Alzheimer’s disease.


Tuesday, August 28, 2018

Making Sense! Spotlight On Hearing


Making Sense! Spotlight On Hearing

Hearing connects us to the world, helping us communicate, work, socialize and be alert to potential danger. Hearing impairment, likely affecting over 30% of seniors, touches all aspects of daily living. It contributes to depression, loneliness, poor job performance, and in the long run, may lead to Dementia. It is thought by some, that untreated hearing loss could be responsible for 9% of Dementia worldwide. The good news is that healthy lifestyle choices that include correction of hearing loss, might possibly delay or prevent one-third of Dementia cases.  

Here is a guide to understanding hearing loss and what to do about it:

What causes hearing loss? 

  • Age
  • Genetics (family history)
  • Chronic illness (type-2 diabetes, hypertension, cardiovascular, autoimmune and infectious diseases)
  • Medication (diuretics, antibiotics, chemotherapy, others)
  • Environment (noise, pollution, industrial chemicals)
  • Head trauma
  • Smoking
  • And more ...

We can’t change our genetics, but we can take steps to affect the other factors. 

What are the types of hearing loss? Peripheral hearing loss occurs in the ear, while central loss involves parts of the brain that process auditory signals. Hearing loss is often a mix of both types.

How does hearing loss cause Dementia? It increases social isolation, reduces stimulation to the brain, and/or it may arise from the same brain changes that cause dementia. 

What does testing involve?  

To be thorough, take three tests:

  • Ear testing: wear headphones while identifying short sounds played at different volumes and pitches.
  • Central auditory processing (CAP) evaluation: checks speech reception and word recognition using the Staggered Spondaic Word Test (SSW) and the Synthetic Sentence Identification with Ipsilateral Competing Message test (SSI-ICM).
  • Cognition: The Montreal Cognitive Assessment (MOCA), available online, for free, in multiple languages and dialects, is one page and takes ten minutes. MOCA detects mild cognitive impairment and early dementia.

What treatment is available? 

  • Hearing aids make sounds louder and easier to pick up. 
  • Middle or inner (cochlear) ear implants boost signals that go to the brain. 

Treatment slows mental decline and improves cognitive test scores, so sooner is better. 

What lifestyle strategies support hearing? : 

  • Moderate alcohol consumption
  • Bone-strengthening exercise
  • Antioxidant (Mediterranean, DASH) diets
  • Stop smoking

Correcting hearing loss improves life enjoyment, daily function, and brain health. Take action today to help counter this modifiable risk for Dementia.

Contributing Blogger: Jennie Ann Freiman, MD, author of The SEEDS Plan.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.

References:
  www.ncbi.nlm.nih.gov/pubmed/29964378    
  www.ncbi.nlm.nih.gov/pubmed/29735277
  www.ncbi.nlm.nih.gov/pubmed/29212633
  www.thelancet.com/commissions/dementia2017?code=lancet-site
  www.ncbi.nlm.nih.gov/pubmed/29937713
  www.ncbi.nlm.nih.gov/pubmed/30011159
  www.ncbi.nlm.nih.gov/pubmed/29430246
  www.ncbi.nlm.nih.gov/pubmed/28894825
  www.ncbi.nlm.nih.gov/pubmed/27806352
  www.ncbi.nlm.nih.gov/pubmed/29937713

Sunday, July 15, 2018

Have Fun, But be Mindful of Summer's Dangers



Who doesn’t love summer? For many of us it means trips to the beach, longer daylight hours, more socializing with family and friends, picnics, outdoor activities and more. But the lazy, hazy days that summer brings – specifically in sizzling temperatures – also can pose some serious health risks to seniors. Here are some tips to allow for a safe summer season.

Hydrate, Hydrate, Hydrate!
Keep your water bottle near you (and filled) at all times. Seniors are more susceptible to dehydration. As we age, our body naturally loses water, so that by the time we reach 80 years of age, we have 15 percent less water than that of a 20-year-old. Aside from that, our kidneys function less efficiently, and we tend to lose our sensation of thirst. Dehydration can manifest itself as dry mouth, troubled speech, lack of sweat, or confusion.

To counteract that, seniors should drink at least a half-ounce of water for each pound they weigh. So, a person weighing 160 pounds should drink 80 oz., or 10 8-oz. glasses of water, to stay hydrated. If spending time outside, seniors should up that quantity.

Sunburn Woes
Older skin is more susceptible to the effects of sun exposure. It’s thinner and has a reduced healing factor when it comes to sunburn. Also, certain medications that seniors take can make them more vulnerable to unsafe sun exposure.

To guard against sunburn, apply sunscreen heavily and often, using a product with an SPF of at least 15. If you must spend time in the sun during the hottest part of the day (10 a.m. to 4 p.m.), reapply more often.

Preventing Heat Exhaustion and Heat Stroke
As we age, our internal temperature regulation system doesn’t work as good as it did during our days of youth. As a result, heat exhaustion – when our core temperature reaches 100 degrees – can come about quickly and unexpectedly. Symptoms may include nausea, dizziness, a rapid pulse and muscle cramps. If left untreated, that condition could quickly escalate to heat stroke, a life-threatening condition.

Seniors are particularly vulnerable to these heat-related conditions. To prevent them from occurring, drink plenty of water and wear loose-fitting, breathable clothing – cotton and linen are great options – when going outside.

Making the right choices when it comes to your health will allow you to enjoy all the best that summer offers.

Source: Visiting Angels, a national agency, providing families with in-home elder care services.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.

Friday, June 15, 2018

Stay Sharp for Safe Driving



The fitness of your mind and body must work together in order to drive safely. Follow these tips from AARP to keep yourself sharp, healthy, and ready for the road.

Your eyesight is key to all aspects of driving, but you may not realize how complex vision actually is. Good vision, both near and far, is needed to identify road hazards, road signs, and view your dashboard.

Visual acuity is how clearly or accurately you can see. There are many conditions that affect visual acuity, especially as we age. Here are a few conditions to keep watch for:
  • Colorblindness and cataracts may cause problems when identifying traffic signals or brake lights of other cars while driving.
  • Decreased contrast sensitivity is the visual ability to see objects that are not outlined clearly or do not stand out from their background. Examples are difficulty seeing pedestrians and road signs, especially in poorly lit roads or in fog.
  • Decreased useful field of view refers to the amount of visual information that can be processed in a brief glance using both eyes. The ability to process information slows with age, particularly for situations in which the environment is very complex, e.g., a busy roadway.
  • Decreased depth perception and peripheral vision is the ability to judge the distance of objects in relation to ourselves and the ability to see outside our immediate field of view.  Both tend to decrease with age and are essential in everyday driving situations, such as judging the distance and speed of approaching cars when merging or seeing a car approaching you from either side.

With that in mind, it is incredibly important to get regular eye exams to maintain good eye health.

Over time, we can lose the ability to quickly assess and react appropriately to the demands of driving. From something as simple as fatigue to minor memory loss to something as complex as Dementia, our brain health, and overall mental well-being are crucial to the task of driving.

Your ability to carry out the following processes should be gauged in assessing your driving fitness:
  • Attention and reaction time
  • Concentration (paying attention to changes in your driving environment)
  • Ability to process information quickly and accurately
  • Problem-solving skills (how to get help if you have a flat tire)
  • Memory (how to get to the doctor’s office)
Stimulate your brain by trying new activities. Try testing your memory and problem-solving skills; it can be something as simple as taking a new route to a familiar location. A study by the National Institute of Health recently found that people who had cognitive training for memory, reasoning or speed of processing had 50 percent fewer car accidents than those in the control group.

Driving is a demanding activity that requires your full attention to many things at the same time. Eliminate distractions inside the vehicle and minimize activities that require you to take your eyes off the road or take both hands off the wheel, especially in heavy traffic. Some suggestions:
  • Put your cell phone on silent and tuck it away so you are not tempted to answer a text or phone call while driving.
  • Pre-set your radio with your favorite radio stations. That way you won’t have to look away from the road to change the station.
  • Don’t eat, drink, or smoke while driving.
These important tips will keep you sharp and ready to drive. Driving is demanding, so take measures to ensure good vision, brain health, and reduce distractions while on the road.

Source: AARP

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.

Tuesday, May 15, 2018

Keeping the Home Safe for Those Living With Dementia



Those living with Dementia often become less able to manage around the house as their condition progresses. For example, they may forget to turn off the oven or the water, how to use the phone during an emergency, which things around the house are dangerous, and where things are in their own home.

Prevention is key. It is more effective to change the person’s surroundings — for example, to remove dangerous items — than to try to change behaviors. Changing the home environment can give the person more freedom to move around independently and safely.

The National Institute on Aging provides these tips on creating a Dementia-safe home.

Simplify the Home
Get rid of clutter, too much furniture, exposed cords, and small throw rugs – anything that could lead to falls and injuries. Installing non-skid strips on floors can help. Shoes and slippers with good traction also help the person move around safely.

Minimize Danger by Addressing the Five Senses
Those living with Dementia may no longer accurately interpret what they see. Any objects – curtains or bedspreads, for example – that have busy patterns can cause confusion. Mark the edges of steps with brightly colored tape so people can see the steps as they go up or downstairs. Limit the size and number of mirrors, as they also can cause confusion.

People with Dementia may experience loss of touch or sensation, or may no longer be able to relate to feelings of heat, cold, or discomfort. Lower hot water heaters to 120 degrees to prevent burns. Put signs near the oven, toaster, iron, and other things that get hot. The sign could say, "Stop!" or "Don't Touch — Very Hot!" The person with Dementia should not use appliances without supervision.

A loss of or decrease in smell is common in people with Dementia. Check smoke detectors to make sure they are working properly, since those with Dementia may not be able to smell smoke. Also, check on refrigerated foods to make sure they have not spoiled.

People with Dementia may not taste as well as before. They also may place dangerous or inappropriate things in their mouths.  Put away or lock up things like toothpaste, lotions, shampoos, rubbing alcohol, soap, perfume, or laundry detergent pods. They may look and smell like food to a person with Dementia. Keep the Poison Control Center number (1-800-222-1222) by the phone.

Those living with Dementia may also lose their ability to interpret what they hear – even if they have normal hearing. This may result in confusion or over-stimulation. Don't play the TV or music too loudly, and don't play them at the same time. Loud music or too many different sounds may be too much for the person with Dementia to handle.

Click here for more on home safety and those living with some form of Dementia.

Source: National Institute on Aging

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.

Sunday, April 15, 2018

Helpful Tips When Escorting Those With Dementia in Public Places



Being in public with a loved one who lives with some form of Dementia can be stressful for the care partner if that person suddenly starts to express themselves in a way which others find out of the norm. Hey, it can happen, it's life, and it's okay. But, if Uncle Ned starts to take off his clothes in a shopping mall, or your wife, Alice, falsely accuses a stranger of stealing, what do you do? Worse yet, many businesses interfacing with their customers don’t understand the special needs of those living with Dementia, and instead of being supportive, may firmly ask them to leave the establishment.

If you dread the thought of taking your loved one out in public, you’re not alone. In a recent survey conducted by Home Instead Inc., franchisor of the Home Instead Senior Care® network, 74 percent of surveyed family caregivers caring for an individual with some form of Dementia said they and their loved ones had become more isolated as a result of the risks. Caregivers said the unpredictable behavior that can sometimes accompany Dementia made the idea of going out in public taxing.

Fortunately, more businesses are becoming “Dementia-aware,” and you can promote this trend by supporting these forward-thinking stores. Using some helpful tips will equip you with the knowledge and skills you need to venture confidently into a public setting.

Seek Out Dementia-friendly Businesses
These establishments have completed specialized training to better serve customers with Dementia illnesses and their caregivers. Employees of these businesses have been given insight into the various types of Dementias, how to respond to agitation in a customer with Dementia, how to use re-direction to regain focus of the customer who becomes disruptive, and how to help with decision-making by offering simple choices.

Prepare Explanations in Advance
If your loved one is prone to getting loud or agitated in public, plan in advance how you will explain this behavior to the strangers around you. Let them know they’re witnessing a disease process at work. Some caregivers print small cards to hand out that state the individual has a form of Dementia and to please forgive the outburst. The Dementia Society of America is about to publish it's useful and practical Aware Share Card. Please send us a note here if you would like some mailed to you upon their availability. Discretely handing a stranger an explanation card can also help preserve your loved one’s dignity.

Keep a “Go” Bag on Hand
Make outings easy on yourself by keeping a tote bag at the ready. Stock it with items your loved one routinely needs, including a couple of incontinence briefs, wipes, sunscreen, magazines, books or anything you normally find yourself reaching for when you take a short trip. By having this bag constantly at-the-ready, you can pick up and head out at a moment’s notice.

Pack Portable Snacks and Water
Keep healthy, grab-n-go snacks on hand, like apples, small containers of grapes, energy bars, cheese sticks or crackers. This benefits you as well as your loved one since frazzled caregivers often go for hours without eating as they attend to their family member’s needs. And don’t forget to take a couple of bottles of water to stay hydrated.

Learn How to Handle  Various Behavior
You can start by understanding the underlying need beneath a behavior. For instance, a person who tries to take her blouse off may be indicating she is too warm. Dealing with challenging behaviors associated with Alzheimer’s disease or other Dementias can put a strain on the caregiver, but knowing what to do - whether by distracting the person or changing the environment or activity - can make all the difference in the world.

Pat Yourself on the Back
Each time you take your loved one with Dementia out in public, you provide interactions that can lift his or her mood and soothe that person’s soul—and yours, too. You also perform a valuable service by showing other people (including businesses) the true face of Dementia and by educating them about how to interact with these special people. So pat yourself on the back. You deserve it!

Source: Caregiverstress.com, a resource of Home Instead Senior Care. Modified slightly from the original to present a more pan-Dementia perspective and to remove words and phrases that are not part of our communications. 

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.


Thursday, March 15, 2018

Points to Ponder for Seniors Making Housing Choices



One of the most critical choices older adults need to make is where they will live as they age. A variety of factors will go into making that decision. Do they have an active lifestyle? If their activity level changes, will there be support services available to them? What about location? How much will housing options cost? Should relatives be involved in the decision-making process? Whatever option is chosen, the best choice needs to ensure that the older adult’s health, welfare, legal rights and financial needs are protected.

Owning a home
Many homeowners hope to stay in the home where they have lived for many years, raising a family and staying close to family and friends. Some may downsize, but continue to live in the same area. Benefits include continuing relationships they have made through the years, the privacy offered by owning your own home, and being able to count on the home as a future financial resource. Challenges include keeping up with home maintenance or making modifications to be able to still live there comfortably and safely.

Renting options
Renting a room, apartment, or a single-family home can free the older adult of worries of expenses associated with home ownership. Some seniors may be eligible for state or federal rent subsidy programs – another plus. On the list of downsides, there may be restrictions when it comes to owning a pet and a loss of some independence for tenants.

Living in a group setting
Group settings provide housing, a range of in-home support services and some social activities. Assistance with personal care (bathing, dressing, or eating, for example) or activities related to independent living (housework, preparing meals, or managing money) is offered. Benefits include choosing from a variety of housing types (adult foster homes, assisted living facilities, and continuing care retirement communities, to name a few) as well as providing socializing opportunities. Challenges include a lack of privacy or lack of services should the older adult’s needs change.

Living in a nursing home
Nursing homes, or long-term care facilities, are for those who need 24-hour supervision, providing medical and personal care assistance. Organizations such as the National SeniorCitizen’s Law Center (NSCLC) and the National Citizens’ Coalition for NursingHome Reform (NCCNHR) can be used as resources in researching nursing homes.

Source: “Housing Options for Older Adults: A Guide for Making Housing Decisions” produced by the National Association of Area Agencies on Aging and written by Holly Robinson, associate staff director at the American Bar Association Commission on Law and Aging.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society of America does not provide medical advice. Please consult your doctor.