Saturday, October 17, 2020

Normal Aging or Something More?

 

It can be difficult to separate the normal aging process from the progressive and steep declines typical of Dementia. Examples of genuinely age-related changes are thinning and graying hair, sagging skin, and alterations in vision, hearing, and taste. Other changes, such as heart disease and certain types of memory loss, are not a normal part of aging.

The normal aging process may affect memory by changing the way the brain stores and retrieves information. While healthy aging does not affect long-term memory, it may affect short-term memory by making it difficult to remember such things as the name of a new acquaintance or misplacing keys or eyeglasses. Occasional word-recall difficulties, rather than frequent ones, are another indicator of healthy aging.

How people evaluate isolated events is one way to distinguish normal memory lapses from those caused by dementia. At one time or another, everybody loses a car in a parking lot. With normal forgetfulness, we chalk up those moments of frustration to the number of look-alike cars or having our thoughts elsewhere. A person who has Dementia is sure someone has moved the car.           

Name recall and word-finding are other ways to distinguish memory losses caused by the normal aging process from those resulting from Dementia. A person with occasional age-related memory difficulties might ask for a reminder or wait a moment for the right word to show-up. A person with Dementia frequently has trouble finding and using the right word. To compensate, he or she may use either an awkward substitution or a description in place of the word. For example--a furry animal that purrs to replace the word “cat.” Further, there may be a noticeable decline in his or her capability to maintain a conversation.

Clinicians use the term “impoverished “to describe the Dementia-related changes in language complexity and vocabulary.

The ability to use household items is another indicator of Dementia. Most people find it annoying or frustrating when upgrading a home appliance to one that is heavy in technology or with new features. The source of annoyance often stems from changes in vision or the reduction in dexterity that arthritis may cause. However, people who have Dementia no longer know how to use their familiar dishwasher or drier.

When considering whether a set of symptoms indicates dementia or normal aging, one must evaluate whether the symptoms are a nuisance, problematic, or debilitating. This is best accomplished with the help of appropriate medical professionals and input from caregivers and loved ones.


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. www.DementiaSociety.org

Saturday, September 19, 2020

Sleep. Manage a Risk Factor.




At one time or another, everybody has bouts of sleeplessness. House noises, screaming babies, caffeine, or a bed partner who snores, often make it difficult to fall asleep and stay asleep. Eventually, you learn to limit the amount of coffee you drink, the screaming babies grow up, and the snoring bed partner, well...still stores. Other causes of chronic sleeplessness are sleep apnea, acid reflux, jet lag, swing-shift employment, and ongoing stress that causes sleeplessness. 

Discoveries made by Oregon Health and Science University researchers show that sleep deprivation increases the risk of dementia later in life and may quicken its progression for those who already have the disease.1 Their data show that insufficient sleep increases the production of beta-amyloid proteins that compose the plaques associated with various kinds of dementia. 1  

Taking a different approach, University of California Berkeley Sleep and Neuroimaging Lab researchers have evidence demonstrating the importance of deep non-REM (rapid eye movement) sleep, in preventing memory loss. 2 The deep non-REM sleep phase, among other functions, appears to prevent the buildup of beta-amyloid proteins. Their work shows there is a correlation between the accumulation of beta-amyloid proteins, sleep disorders, and Alzheimer disease. 2

Also, insufficient sleep is a risk factor associated with other health conditions that include obesity, heart disease, and diabetes - all of which increase the likelihood of dementia later in life. 

What to do??

First of all, remember that risk factors do not cause disease but increase the likelihood of having dementia sometime in the future. Second, and most importantly, modifying behaviors and habits associated with dementia, such as smoking and obesity, can reduce risk.

Sufficient sleep depends on the age of the individual. For adults, seven to 10 hours of sleep per night is considered healthy3  However, for adults older than 65-years of age, six to eight hours of sleep per night is both normal and healthy. 3

Many older people, believing less than 8 hours of sleep per night is abnormal, resort to using sleeping pills. Unfortunately, using medication to assure sleep both increases the risk for dementia and worsens dementia for those who have the disease.


People acquire habits and behaviors that unknowingly make it difficult to fall asleep and stay asleep. The National Sleep Foundation offers the following tips to get a good night’s sleep. 3

⦁ Stick to a sleep schedule – even on the weekends.
⦁ Develop a relaxing routine to prepare your body for sleep. 
⦁ Use your bed only for sleep and sex. 
⦁ If you have trouble sleeping, avoid afternoon and early evening naps.
⦁ Exercise daily.
⦁ Make the room where you sleep comfortable and free from disturbing noise or other distractions. 
⦁ Sleep on a comfortable mattress and pillows. 
⦁ Avoid alcohol, cigarettes, and heavy meals in the evening. 
⦁ Wind down - an hour before bed choose a calming activity such as reading. 
⦁ If you can't sleep, go into another room and do something relaxing or immensely boring until you feel sleepy. 


Notes:

1. How a lack of sleep can increase YOUR risk of dementia: Lack of rest prevents the brain clearing out toxins that trigger Alzheimer's', http://www.dailymail.co.uk/health/article-3387246/How-lack-sleep-increase-risk-dementia-Lack-rest-prevents-brain-clearing-toxins-trigger-Alzheimer-s.html (accessed May 17, 2016)

2. Lack of Sleep May Lead to Dementia: New Research Finds It Makes Brain Vulnerable, http://alumni.berkeley.edu/california-magazine/just-in/2015-06-02/lack-sleep-may-lead-dementia-new-research-finds-it-makes (accessed May 17, 2016)

3. Healthy Sleep Tips, https://sleepfoundation.org/sleep-tools-tips/healthy-sleep-tips (accessed May 17, 2016)


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 or guarantee products, comments, suggestions, links, or other forms of content within blog posts provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org




Monday, August 31, 2020

Medications: Help, Hurt, or Both?


In the United States, more than seven million people have mild cognitive impairment (MCI) or have dementia. According to Xueya Cai and colleagues, nearly half of these individuals have two additional chronic diseases that require they take five or more medications.1

As a consequence of age-related decreases in kidney and liver function, older people tend to excrete medications at a slower rate and are therefore more likely to experience stronger, and not always reversible, drug-induced side effects. Another factor is the potential for complicated interactions with the other prescribed and over-the-counter medications that older people may take. Research indicates that as people age, they become more sensitive to drugs that act on the central nervous system.2 

One group of medications, the anticholinergics, have recently come under increased scrutiny. This class of drugs slows or prevents the transmission of nervous system information to and from the brain. Some commonly used over-the-counter (OTC) medications, such as antihistamines for cold and allergy symptoms are anticholinergics. Prescription anticholinergic medications relieve symptoms associated with depression, muscle spasms, motion sickness, as well as those used to modify the behaviors associated with mental illnesses such as schizophrenia and bipolar disorder.

It is important to understand that memory loss and confusion along with dizziness or drowsiness may be symptoms of medication side effects, rather than dementia.  Therefore, the clinician must receive from the patient or his or her family a list of ALL prescribed and over-the-counter medications, as well as any dietary supplements and herbals, he or she may take.

 Anticholinergics can also interfere with the effectiveness of medications used to slow memory loss or long-term use, putting people at higher risk for MCI and dementia later in life.1,3 One example are the drugs used to treat overactive bladder: the “gotta go gotta go” kind of urinary incontinence. Medications such as Detrol® and Cymbalta® slow transmission of nervous system information to and from the brain and thereby quiet the unrelenting sensation of “gotta go."

The medications used to slow the memory loss associated with dementia do just the opposite. Drugs such as Aricept® and Namenda® increase communication between nerve cells in the brain. Taking both types of medications at the same time can worsen dementia.

A Wake Forest University of Medicine study shows that nursing home patients receiving individual medications to modify dementia symptoms and improve continence lost the ability to perform basic living skills, such as dressing and feeding themselves, 50 percent faster than those receiving dementia medications alone.4 

One must evaluate the overall risks and benefits of taking a medication known to affect the risk for dementia later-in-life or, in the short-run, worsen the disease. Be sure to discuss with your doctor any concerns about taking a medication that may increase dementia risk. Do not stop taking prescribed or recommended over-the-counter medicines without first consulting with your doctor.
Notes: 
1. Cai Z, N Campbell et al, “Long-term Anticholinergic use and the Aging Brain”, http://www.ncbi.nlm.nih.gov/pubmed/23183138, (accessed April, 25, 2016)

2. Drug-Induced Cognitive Impairment: Delirium and Dementia, http://www.worstpills.org/includes/page.cfm?op_id=459 (accessed, April 25, 2016)

3. Higher dementia risk linked to use of common drugs, GroupHealth Research Institute, https://www.sciencedaily.com/releases/2015/01/150126124721.htm (accessed April 25, 2015). 

4. Dual Treatment to Treat AD Symptoms and Behaviors, https://www.sciencedaily.com/releases/2008/04/080430134230.htm (accessed, April 25, 2016)

For Further Reading
Medications to Avoid in the Elderly, http://www.virginiageriatrics.org/consult/medications/medsList.html (accessed April 24, 2016) 

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. www.DementiaSociety.org


Sunday, July 19, 2020

Fortify Your Brain through Use


“Use it or lose it" is a common expression we hear referring to physical and athletic abilities, maintaining hands-on skills, or the capabilities that come with formal education. Similar to how physical fitness and improves health and quality of life, brain fitness as a product of intellectual stimulation may reduce risk or help slow or lessen the impacts of Dementia.

Researchers and healthcare professionals use the terms “brain reserve” and “cognitive reserve” to describe the protective factors that brain anatomy and education have on the onset and progression of dementia. Often, researchers and clinicians do not distinguish between the two and use the term cognitive reserve. However, there are subtle differences between the two kinds of reserve. One can think of brain reserve as computer hardware and cognitive reserve as operating software.

Brain reserve, rather than reducing risk for Dementia, is brain resiliency or the ability to maintain adequate function in the face of increasing brain damage. In this case, researchers believe it is inborn brain architecture along with the number of neurons and connections between brain structures that create resiliency.

Physical methods such as using microscopes to examine pieces of brain tissue and medical imaging technologies to locate areas of high and low brain activity are the ways researchers assess brain reserve. 

Cognitive reserve is the affect brain exercise has on making the brain better able to resist the behavioral and intellectual declines Dementia cause. Researchers and clinicians use behavioral assessments, such as the mini-mental status exam, to evaluate cognitive resiliency. 

Brain fitness is one of the best ways to reduce the risk of age-related dementia. And should Dementia enter your life, brain-fitness may help to slow or lessen the impacts of the disease. Participating in physical activities such as baseball, flying radio control airplanes, hiking, or dancing requires both coordination and the ability to make split-second decisions.
 
Hands-on learning refers to making something or acquiring a new skill. Whether self-taught or with the assistance of a knowledgeable person learning how to build furniture, watercolor, construct a raised-bed garden, or to become proficient at using Photoshop, requires high-level thinking and problem solving, concentration, and creativity. 

Levels of participation in both physical, hands-on activities and formal education reduce the risk for Dementia and make the brain better able to resist the behavioral and intellectual declines of Dementia. 

Sadly, the progressive nature of Dementia eventually overwhelms the cognitive reserve that once supported adequate behaviors and abilities. When this happens, there is a rapid decline in cognition as well as in the ability to perform tasks of daily living such as getting dressed without assistance.

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. www.DementiaSociety.org

Friday, June 26, 2020

Caring Touch as a Way to Communicate


A crying baby elicits a predictable response from its parents or grandparents. An adult swoops in, lifts the baby in their arms, and snuggles, cradles, maybe even rocks the baby as the cries diminish, their breathing settles, the baby calms. As babies become children and even young adults, soothing and reassurance comes by way of hugs, pats on the back, a quick shoulder rub, or a hand laid on a forearm. These seemingly simple touches have enormous effects because they are hard-wired in human development. It should not be surprising then, that physical contact is a vital tool for those caring for loved ones with Dementia.

No matter one’s age, human touch enhances communication by expressing emotion and offering reassurance. In a scientific study, a “sender” was asked to convey a range of emotions - happiness, sadness, surprise, disgust, anger, fear, etc. – by touching the “receiver’s” forearm from behind a curtain. Receivers were able to accurately identify the emotion 48 - 83% of the time(1). No words spoken, no facial expressions visible – only variations in touch!

As a caregiver, the suggestion “Let’s get ready to go” may be easier to accomplish if accompanied by a warm hand on a shoulder. A gentle touch by a caregiver can improve compliance with requests, and offer reassurance when fear or concern is detected. Human touch increases the feeling of wellbeing by decreasing cortisol levels (the "stress“ hormone) and increasing oxytocin levels (the “love” hormone). If our goal is to care, comfort, and protect our loved ones with Dementia, the power of simple touch cannot be ignored.

From simple to professional, therapeutic massage intensifies the benefits of simple touch and introduces several more. Regular therapeutic massage lessens physical pain, decreases the physical symptoms of stress, reduces depression symptoms, improves immune function, and enhances attentiveness1. Because of these benefits, therapeutic massage should be on the menu of options for a loved one living with Dementia.

Lastly, we must not overlook the value of social interaction and connectedness delivered by a caring human touch. Humans are, after all, social animals. No matter the advances in technology, it is clear that when human touch is withheld, a void remains that cannot easily be filled with spoken words or digital screens.  

Note 1: Field, Tiffany. 2011. Developmental Review. (30) 2010 367-383. Touch for socioemotional and physical wellbeing: A review.    Accessed May 29, 2020, from https://www.radboudcentrumvoormindfulness.nl/wp-content/uploads/2019/02/artikel-4.pdf

Contributor:  Karen Ogden, DSA Team Member

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. www.DementiaSociety.org

Monday, May 25, 2020

A Little Help Here! Assistive Technologies for Caregiving


For many of us, the words “medical alert” immediately brings to mind the campy 1980s television commercial where “Mrs. Fletcher” cries out her trademarked line. It is a grim reminder that, according to the National Safety Council, falls are the leading cause of accidental deaths among people seventy-five years of age and older. 1

Older adults fall when they lose their footing, trip on rugs, or miss a stair. Changes in balance, vision, and muscle tone, resulting from or in addition to medication side effects, are other risk factors. Dementia adds another layer of risk when your loved one no longer associates wet floors with falls, the odor of burnt food with fire, or connects landmarks to location. 

Caregivers worry about these and other safety issues. When a caregiver does not live nearby, these concerns become especially worrisome. 

There have been remarkable improvements in alert systems since the days of "I've fallen and cannot get up." Modern assistive technologies include a suite of smartphone apps communicating with video and other monitoring systems. These apps can notify a caregiver their loved one is less active than expected, has left a defined area, if a home appliance has not been turned on or off, even when their blood pressure has exceeded their normal range. 
 
Other kinds of assistive technologies help people in the earlier stages of Dementia stay in his or her home for as long as is possible. Video calling allows for virtual check-ins while smartphone apps and voice-activated assistants can remind people to take their medication.  

Some assistive technology systems use recorded verbal reminders, while others provide visual instructions and larger key-pad buttons. Therefore, it is crucial to choose a system or device that matches your loved one's ability to use them.

Older, less advanced technologies continue to provide a safety net. Stand-alone GPS tracking devices can provide location information for your loved one, should wandering be an issue. Some states continue to provide a public service using television, radio, and the internet to broadcast missing person information. The value of simple medical identification bracelets or accessories shouldn’t be underestimated. They offer peace of mind that your loved one will receive appropriate care and assistance if in trouble.

Assistive technologies, though they may keep your loved one as safe as is possible, they do not replace friends and family, a warm smile, a calming hug, or a gentle touch.

Caregivers welcome the respite from unrelenting worry and stress assistive technologies can provide. However, ethical issues must be considered, including seeking informed consent to install assistive technologies in a person's home. The dignity of the individual, respect for privacy, as well as acknowledgment of his or her advance directives are other areas of ethical concern. 

For More Information:


AARP. June 2018 Tech Solutions That Make Life Easier for Dementia Care. https://www.aarp.org/health/dementia/info-2018/technology-caregiving-dementia-patients.html

Notes:
1. Slip, Trip and Fall Protection for Older Adults, http://www.nsc.org/learn/safety-knowledge/Pages/safety-at-home-falls.aspx (accessed March 26, 2016) 

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. www.DementiaSociety.org

Sunday, April 19, 2020

Read! Exercise for Your Brain



Most people have an innate desire to learn, and language is the primary tool for learning. Reading is an important mechanism for the delivery of information to the brain to be solidified as acquired knowledge. Reading is critical for your own personal and cultural development because it relates to so many factors in your life. The benefits are broad and significant.

First, the mental stimulation of reading is vital for brain health. It is quite literally exercise for the brain. Synapses fire, neurotransmitters are released, and hormones begin circulating. Reading material that evokes an emotional response actually stimulates the brain to produce hormones specific to the physical expression of those feelings. 

Next, memory is improved by reading. When you read a novel, for it to make sense, you must remember different characters and plot elements. Keeping all of these things in play has your short term memory working hard. This also requires, and so with repetition improves, the focus and concentration you need to follow the action through the course of the story. 

And don’t forget that the escapism offered by novels can also be an excellent stress management tool.

Analytical skills are also engaged through reading. Stimulating novels keep you involved - trying to figure out where the story is going. Technical books, however, require that you reason out how all the different pieces of information come together as a concept, procedure, or system. 

Reading also improves writing ability as vocabulary and variations in sentence structure are introduced or reinforced.  

The bottom line is that reading to learn something new is better for your brain than simply reading for entertainment. Still, even an entertaining novel offers the mental stimulation you wouldn't find passively watching TV or streaming media.

Contributor: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit https://apexbraincenters.com/cognitive-decline-asheville-nc/.

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. www.DementiaSociety.org

Sunday, March 22, 2020

Art as a Spice to Life



It's so easy for family caregivers to get stuck in the daily routines of their loved one's care. Each new day brings the same as the last– make breakfast, dole-out medication, struggle with their hygiene, and manage challenging behaviors. The sameness can contribute to your emotional and physical exhaustion and strain your capacity to be a warm and loving son, daughter, husband, wife, or friend. Taking the time to be mindful of creative needs can give both of you a refreshing mini-vacation from illness. 

Making and finding art opportunities for your loved one may not be as difficult as it may appear. Watercolors, paper, brushes, and a kitchen table and you are good to go. Share the creative process with your loved one. Making art together also makes memories.

Many community and senior centers offer art classes for people in early and mid-stage dementia. Contact your local Agency on Aging or other organizations that provide local support and counseling services for people who have dementia and their families.

Another easy way to find art programs is by searching the internet using keywords such as "art and dementia". Narrow your search by including the name of your state, city, or town. If you come up empty-handed, just ASK. You have everything to gain when you explain to senior center directors and directors of other organizations the need for art programs customized to meet the needs of people who have dementia.

Other options are the art education programs that many museums and, some galleries, offer. The Museum of Modern Art (MoMA), in New York City, has set the standard for making art accessible to those with Dementia. With the guidance of specially trained museum docents, visitors explore selected museum collections where they can see and, when appropriate, touch wall art and sculpture. Interactive installations may invite viewers to experience sight, touch, and sound. The conversation about art and the environment is another facet of the MoMA program. However, feelings and memory – not art history – are the inspirations for meaningful interactions and conversation

The MoMA website gives a complete description of the MoMA Project. (https://www.moma.org/meetme/modules/index ) Search the internet to locate nearby programs. Type in the name of the state followed by descriptive words such as “museum,” “Alzheimer,” “Dementia,” and “outreach.”

The year after my mother’s death, I decided to volunteer some of my newly-realized free time to the dementia community. I developed a curriculum that I hoped the “artists” would find satisfying and challenging. The outcome was a brief presentation to a local support group was four eager participants and their spouses. The three men and one woman had various types of dementia. Over the year, the artists learned basic design principles, made relief prints, painted self-portraits, and designed and printed T-shirts for themselves and their family members. Donations covered the cost of supplies.

I expected the spouses would take their off-duty time to run errands. But as it turned out, they formed an impromptu support group and spent the class time in a nearby coffee shop. Soon, “just coffee” morphed into family dinners. One of my most precious moments was when one man told me that the art class made him feel that he was becoming something rather than losing what he had once been.

Want to Know More?

1. “I Remember Better When I Paint.” https://www.youtube.com/watch?feature=player_embedded&v=54AtoQVGfwU (Accessed February 26, 2016)

2. Hayes, J. and S. Povey, The Creative Arts in Dementia Care: Practical Person-Centered Approaches and Ideas. London, England: Jessica Kingsley Publishers, 2010.

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 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. www.DementiaSociety.org

Saturday, February 29, 2020

Make the Time, Don’t Find the Time

If you've been a regular reader of the Dementia Society of America blog, you know that better heart health can lead to better brain health. Exercise is just one way to increase heart health, so, how do we make exercise a priority in our daily habits and among our countless distractions?

Most people are just kind of trucking through their day, trying to get through their tasks and to-do lists. That might involve getting their kids from school, work-related tasks, and hopefully having some time to spend time with friends or make a quick appearance at the gym.

One very telling trend is the number of people that buy a gym membership, yet fail to use it. While several different studies are posting similar statistics, it is estimated that 73% of people with a gym membership either fail to use it at all or use it so infrequently that it imparts no long term health benefits.

The usual trend is that there are a lot of people who sign up for a year-long gym membership as part of a New Year’s resolution. They get this membership with the best of intentions, but by the middle of January or early February, the vast majority of them have stopped going to the gym. One of the most common excuses use is that their lifestyle doesn’t allow them the time to work out regularly.

I have found that the key to developing a successful long-term exercise routine is to develop a mindset of making the time, instead of finding the time.

You should approach it with the same mentality you would if you were scheduling an office meeting every Monday, or making sure that you’re picking up your kids from school at the same time every day.

Some talk about how juggling their career and family, along with other responsibilities, can be a huge obstacle. While this does present challenges and imposes demands on our time, there are those with even more on their plate that still make it a point to make the time to exercise.

The bottom line is that you need to make the time to exercise, because if you try to find it; the day will get by you and you’ll end up sitting on your couch worrying about our waistline while your brain and everything else suffers as a result of not exercising the way you should.

Contributor: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit https://apexbraincenters.com/

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. www.DementiaSociety.org

Monday, January 27, 2020

Take into Consideration: Planning for the Long Term


Much of Dementia care boils down to anticipating and planning for challenges you will face.

As a first step, the person or persons responsible for a loved one's care must have the legal rights to do so. Legal permission involves becoming the designated power of attorney (POA), or under certain circumstances, the conservator and guardian.

The amount and type of long term care your loved one needs is one of the first decisions you and your family will make.

Concerning home care, who will be the primary caregiver? What happens if it becomes neither realistic nor safe to shoulder caregiving responsibilities alone? Is the next step hiring a paid caregiver? Is the paid caregiver one that you hire or one contracted through a home care service? What are the criteria that make it necessary to transition your loved-one from home to an assisted living facility?

Some individuals fervently believe they will be his or her loved one’s caregiver throughout the illness. However, as is often the case, circumstances change. Therefore, you must anticipate and plan for modifications in the type and amount of care your loved one may eventually need. 

Research the options before you need them!

Contact your friends to discover if they know of a reliable caregiver or affordable homecare support. Look into non-profit organizations that provide various types of home care services. Visit assisted living facilities, speak with the director, ask about the services included in their monthly fees, view their inspection reports, and tour the facility. Learn the differences between a continuum of care, independent living, assisted living, and memory or dementia care. Become familiar with the steps you must take before you can place your loved one in an assisted living facility.

It may be months or even years before you come to this cross-road. However, doing your homework will minimize the time and stress of needing to take, often on short notice, this big step.

Developing the “what, if then, or buts” of medical care is another feature of a long-term care plan. Will your loved-one receive care from his or her family doctor or a Dementia care specialist? Research palliative and hospice care to be sure that preconceived ideas do not color your views. Learn about the purposes for palliative and hospice care, the best time to initiate them, and how they impact quality-of-life and end-of-life care. These last decisions are prone to family conflict and long-lasting feelings of ill-will.

A long term care plan includes funeral arrangements as well as various estate considerations. It’s not ghoulish to plan for the funeral. Cremation, embalming with or without embalming fluid, and burial location – are a few of many examples of the difficult and emotional decisions families make.

Prepare yourself for the eventual transition from caregiver to the representative of the estate. What are the responsibilities and the steps you must take to close the estate?

A long term care plan helps families navigate the challenges that dementia care present. Be sure to frequently review, update, and revise your loved one’s long term care plan.

Contributor: Janet Yagoda Shagam, Ph.D., 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 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. www.DementiaSociety.org