November Is National Alzheimer’s Disease Awareness Month

November Is National Alzheimer’s Disease Awareness Month

Stages of Alzheimer’s: What to Expect

One vexing thing about Alzheimer’s, especially in the beginning, is how its effects differ from person to person. The individual you’re caring for might not experience every symptom or behavioral change, and the disease’s timetable can vary. A particular Alzheimer’s stage may last years longer for one person than for another, and symptoms can be experienced at earlier or later stages. Because Alzheimer’s is a progressive disease, however, it always starts with mild symptoms and gradually worsens as time moves on.

Mild (Early-Stage) Alzheimer’s Disease

During this first Alzheimer’s stage, someone with the disease is likely to continue his or her usual activities, with Alzheimer’s-related changes being written off as “getting older,” “stress,” being “tired,” or just “simple mistakes.”

Memory: Memory lapses are typically the first sign, often years ahead of later symptoms. At this stage, it’s common to forget things more often or have trouble remembering details about even familiar topics. Of special difficulty will be recalling recent events and people met later in life, as well as learning and retaining new information. That’s why asking repetitive questions is a hallmark of the disease, as is writing notes to oneself about things like where the car is parked. It’s also common to repeat comments and stories within minutes without realizing it. At the same time, long-term memory, such as childhood recollections, may remain fairly detailed.

Communication and Social Skills: Someone with Alzheimer’s may have trouble finding the right word. Often people in this early Alzheimer’s stage are aware that something is amiss, though they may not be sure what’s wrong. They tend to shy from situations where they feel put on the spot or vulnerable to embarrassing mistakes, such as social outings, time with friends, or even telephone conversations.

Everyday Life: At this stage, they’re easily confused and distracted. They may find it hard to keep track of the time and miss appointments or favorite TV programs. Abstract thinking and making sound judgments become more difficult. They may lose the initiative to participate in activities that were once desirable (hobbies, a job) or routine (cooking, writing checks). They may misplace objects regularly or store them in unusual places, then forget where they put them.

Personality: Someone at this stage may seem to be acting unlike his or her old self. They may become irritable or angry when disease symptoms are disruptive or embarrassing. Mood swings are common and usually stem from frustration.

Other: You’ll notice “good” days where the person you’re concerned about seems unchanged and “bad” days when he or she is having trouble coping — especially in situations that are new, unusual, or otherwise stressful. At this stage, it’s common to get lost, leave a stove burner on, lock one’s self out of the car or house, or experience other such incidents.

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Moderate (Middle-Stage) Alzheimer’s Disease

Symptoms characteristic of early-stage Alzheimer’s disease now become more evident as they worsen, become more frequent, and are harder to “cover up.”

Memory: Repetitive statements and questions are very common and they occur within minutes of each other.

Communication and Social Skills: As ongoing memory lapses combine with greater difficulty in tracking conversations and contributing meaningfully to them, some people become more timid socially and more apprehensive about speaking up. Others become less inhibited and demonstrate less tact in social situations. In this Alzheimer’s stage, it becomes common to confuse people, especially if they resemble one another (like a mother and daughter). Cognitive impairment and declining hand coordination affect written communication; someone who once wrote letters and sent birthday cards no longer is interested. Many middle-stage Alzheimer’s sufferers stop reading. Even previously favorite TV programs may be too hard to follow.

Everyday Life: Expect more difficulty with abstract thinking and with making good judgments. He or she may have trouble following written directions, such as cooking from a recipe or filling out a form. (Verbal instructions are more challenging, and problems with them are usually evident earlier). Even routine, familiar activities that involve a sequence of steps, such as brushing one’s teeth or getting dressed, may be difficult to complete. Someone who’s still driving is at increased risk because of disorientation, decreased coordination, problems judging spatial relationships, and slower response times. Failing judgment makes him or her vulnerable to poor decisions regarding safety, health, or finances. Personality: Mood changes and personality alterations become more obvious, especially late in the day or when he or she is tired. They may become distrustful of loved ones, including you, or they may make unfounded accusations. Anxiety is common and is sometimes expressed by rummaging through drawers, aggressive behavior, yelling, or wandering through or away from the house. Hallucinations or delusions occur. Depression is a risk, often characterized by changes in appetite and sleep habits (he or she may be a lot hungrier or less hungry than usual, for example…or sleep much more or less than usual. Other: During middle-stage Alzheimer’s, it’s common to get disoriented in familiar environments as well as unfamiliar ones. Unplanned or new activities can be especially troubling. The sense of smell may be less sensitive, and incontinence becomes more common.

Severe (Late-Stage) Alzheimer’s Disease

By this final Alzheimer’s stage, it’s common to be bedridden and completely dependent on others, as the person can no longer reason or manage the most basic self-care.

Memory: As memory problems worsen, they begin to affect recollections from even the distant past. He or she may no longer recognize even close family members, including a spouse or children. He or she may not even recognize his or her own self when looking at photos or in the mirror and may consistently forget to take medicine and do everyday tasks like tooth brushing.

Communication and Social Skills: As language skills decline, many people at this stage speak nonsensically. They may make strange sounds, hum, or moan. Or they might cease to speak altogether. It’s likely by now that the person you’re caring for is quite socially withdrawn and has abandoned many previously enjoyed and familiar activities.

Everyday Life: Even relatively simple, necessary activities, such as eating and taking care of personal hygiene, require assistance. Both gross motor skills, (walking and sitting up) and fine motor skills (buttoning a shirt, holding a spoon) are affected. Falls and injuries are a risk as coordination and depth perception decline. Repetitive movements and actions are common. Someone at this stage spends a lot of time sleeping.

Personality: Because the changes have become so marked, he or she may seem nothing like his or her old self. Sometimes jolly people turn crotchety, while formerly stern people may become docile and benign. By the last stages of Alzheimer’s, many people express no emotions at all.

Other: Monitoring health, nutrition, and safety as well as general caretaking is now a round-the-clock task. He or she may lose significant weight (because eating is difficult) and acquire infections or fall ill easily (because of general weakness). People weakened by this final Alzheimer’s stage more often die from another health problem (pneumonia, secondary infection, cancer) than they do from Alzheimer’s itself.  

Telltale Signs it Might Be Time for Assisted Living

The decision to help an aging adult move out of a current home is a complex one both emotionally and practically. Above all, you want the person to be safe and well. There are many factors that can play into you’re feeling more confident about whether circumstances suggest your loved one should no longer be living alone.

Although every situation is different, reviewing the following signs listed below will give you valuable information in helping make a decision.

  • Big-Picture Signs

Keep the big red flags in mind. Certain situations make it more obvious that it’s wise to start thinking about alternate living arrangements.

Look for:

Recent accidents or close calls. Did your loved one take a fall, have a medical scare, or get in a fender bender (or worse)? Who responded and how long did it take? Accidents do happen, but as people get older, the odds rise of them happening again.

A slow recovery. How did the person you’re caring for weather the most recent illness (for example, a flu or bad cold)? Was he or she able and willing to seek medical care when needed, or did last winter’s cold develop into untreated bronchitis?

A chronic health condition that’s worsening. Progressive problems such as COPD, dementia, and congestive heart failure can decline gradually or abruptly, but either way, their presence means your loved one will increasingly need help.

Increasing difficulty managing the activities of daily living (ADLs) and instrumental activities of daily living (IADLs).  ADLs and IADLs are the skills needed to live independently dressing, shopping, cooking, doing laundry, managing medications, etc. Doctors, social workers, and other geriatric experts evaluate them as part of a functional assessment, which is one way to get an expert’s view of the situation. Difficulties with ADLs and IADLs can sometimes be remedied by bringing in more in-home help.

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  • Up-Close Signs

Give your loved one a big hug. Clues aren’t always visible from a distance…especially when you don’t see the person every day, you might learn more through touch.

Look for:

Noticeable weight loss. Does the person feel thinner? Does clothing look and feel looser? Many conditions, from depression to cancer, can cause weight loss. A person who is having trouble getting out to shop or remembering how to cook (or to eat) can lose weight. Also be sure to check the refrigerator and observe meal-prep skills.

Seemingly more frail. Do you sense anything “different” about the person’s strength and stature when you hug? Can your loved one rise easily from a chair? Does she or he seem unsteady or unable to balance? Compare these observations to the last time you were together.

Noticeable weight gain. Common causes include an injury slowing the person down, diabetes, and dementia (when someone doesn’t remember eating, he or she may indulge in meals and snacks all day long). Someone with money troubles may choose fewer fresh foods and more packaged goods or dried pasta and bread.

Strange body odor. Unfortunately, a close hug can also reveal changes in personal hygiene habits. Causes range from memory trouble to depression to other physical ailments.

Changes in appearance. Does the person’s hair and makeup look normal? Are their clothes clean? Someone known for crisply ironed shirts who’s now in a stained sweatshirt may lack the dexterity for buttons or may have lost the strength for managing an ironing board and iron. A formerly clean-shaven man with an unkempt beard may be forgetting to shave (or forgetting how to shave).

  • Social Signs

Think realistically about the person’s social connections. Social circles tend to shrink with age, which can have health and safety implications.

Look for:

Signs of active friendships. Does your loved one still get together for lunches or outings with friends or visits with neighbors, or participate in religious activities or other group events? Does he or she talk about others or keep a calendar of appointments? Lack of companionship is associated with depression and heart problems in older adults. If friends have died or move away, moving to a place where other people are around could be lifesaving.

Signs that your loved one has cut back on activities and interests. Is a hobby area abandoned? Has a club membership been given up? A library card gone unused? There are many reasons people cut back, but dropping out of everything and showing very little interest in previously frequent involvements, is a red flag for depression.

Days spent without leaving the house. This sometimes happens because the person can no longer drive or is afraid to take public transportation alone and lacks a companion to come along. While many older adults fear being “locked away” in a retirement home, many such facilities offer regular outings that may keep them more mobile and active, not less.

Someone who checks in on a regular basis. If not you or another family member, who does this? Is your loved one willing to consider a home-safety alarm system, a personal alarm system, or a daily calling service?

A plan for a worst-case scenario. If there’s a fire, flood, or some other major natural disaster, is someone on standby to assist? Does your loved one understand the plan?

  • Money Signs

Rifle through the mail. Your loved one’s mail can offer an often-overlooked clue to how he or she is managing money a common early warning sign of a cognitive trouble.

Look for:

Snowdrifts of mail in various places. Finding lots of mail scattered around raises concerns about how bills, insurance, and other matters are being managed. (Piles of mail are also a potential safety concern due to a tripping hazard).

Unopened personal mail. Everybody skips junk mail, but few of us can ignore a good old-fashioned, hand-addressed letter.

Unopened bills. This can indicate that your loved one is having difficulty managing finances one of the most common first signs of dementia.

Letters from banks, creditors, or insurers. Routine business letters aren’t worrisome. But it’s alarming if they’re referring to overdue payments, overdrawn balances, recent accidents, or other concerning events.

Thank-you messages from charities. Older adults are often vulnerable to scammers. Even those who have always been fiscally prudent are vulnerable if they’re having trouble with thinking skills (a common sign of Alzheimer’s disease). Some charities hit up givers over and over, and your loved one may not remember having donated the first time.

Lots of crisp, unread magazines. The person may unknowingly have repeat-renewal subscriptions that he or she doesn’t need.

  • Driving Signs

Take a drive with your loved one behind the wheel, if he or she is still driving. Often, the ability to drive is practically a requirement for living independently in our culture (or the arrangement of alternate transportation options).

Look for:

Nicks or dents on the car. Notice the car body as you get in or out. Damage marks can be signs of careless driving.

Whether the person promptly fastens his or her seat belt. Even people with mild dementia usually follow the basics of driving. It’s obviously worrisome if he or she is forgetting this step.

Tension, preoccupation, or being easily distracted. The person may turn off the radio, for example, or be unwilling to engage in conversation while driving. He or she may avoid certain routes, highway driving, or driving at night and in rain a safe kind of self-policing, but also signals of changing ability.

Warning lights. Check out the dashboard as you ride along. Does the car have sufficient oil, gas, antifreeze, windshield-wiper fluid?

  • Kitchen Signs

Go through the kitchen, from the refrigerator, to cupboards, to the oven. Because people spend so much time in this room, you can learn a lot.

Look for:

Stale or expired foods. We all buy more than we need. Look for signs that food is not only old but that is unnoticed. For example, mold, sour milk that’s still used, or expiration dates that are well past due.

Multiples of the same item. Ten bottles of ketchup? More cereal than can be eaten in a year. Multiples often reveal that the shopper can’t remember from one store trip to the next what’s in stock at home.

A freezer full of TV dinners. Your loved one may buy them for convenience sake, but frozen dinners tend not to make for a healthy diet. If there’s not much fresh food in the house (because it’s too hard for the person to procure or cook), your loved one might be ready to have help with meal prep or delivery services.

Broken appliances. Check them all: stove, refrigerator, microwave, coffee maker, toaster any device you know your loved one uses (or used to use) routinely.

Signs of fire. Are stove knobs charred? Pot bottoms badly singed? Do any potholders have burned edges? Also look for a discharged fire extinguisher, smoke detectors that have been disassembled, or boxes of baking soda near the stove. Accidents happen. Ask for the story behind what you see. Accidental fires are a common home danger for older adults.

Increase use of take-out for simpler cooking. A change in physical or mental abilities might explain a downshift to simpler recipes or food choices.

  • Around-the-House Signs

Look around the living areas. Sometime the most obvious sign is hard to see because we become so used to it.

Look for:

Lots of clutter. An inability to throw anything away may be a sign of a neurological or physical issue. Obviously, it’s more worrisome for a person who has been consistently neat vs. a chronic slob. Papers or pet toys strewn about the floor represent a definite tripping hazard.

Signs of lax housekeeping. Spills that haven’t been cleaned up are a common sign of dementia, meaning the person most likely is lacking the follow-through to be tidy. Keep an eye out for cobwebs, bathroom mold, thick dust, or other signs of slackness. Physical limitations can mean your loved one needs housekeeping help or a living situation where this is taken care of for him or her.

Bathroom grime and clutter. A common scenario: Your loved one makes an effort to tidy up living areas, but overlooks the bathroom. Or the guest bath is clean, but not the one the person uses all the time such as a master bathroom.

  • Pet Care and Plant Care Signs

Be sure to check out how other living things in the home are faring. An ability to take care of pets and plants goes along with self-care.

Look for:

Plants that are dying, dead, or have just disappeared. Most of us have seen plants go brown sometimes. Keep an eye out for chronic neglect especially in a former plant-lovers home.

Animals that don’t seem well attended to. Common problems include: dogs with long nails, cat litter boxes that haven’t been changed lately, or dead fish in the fish tank. Poor grooming, overfeeding, and underfeeding are other red flags.

  • Home Maintenance Signs

Walk around the yard. Yard maintenance…or lack of it…can yield clues that your loved one isn’t faring as well at home along anymore.

Look for:

Signs of neglect. Look for discolored siding or ceilings that might indicate a leak, gutters choked with leaves, broken windows or fences, dirty windows.

Newspapers in the bushes. Are papers being delivered but ignored? Sometimes people pick up those they see on a driveway or front steps, but not those that may land in the yard.

Mail piled up in the mailbox. Go out and check. Surplus mail is an indication that your loved one isn’t retrieving it regularly.

  • Get Help Looking for Signs

Get the input of others who know your loved one in order to collect a fuller picture of reality. Gently probing about what others think isn’t nosy, you’re simply being loving, concerned, and proactive.

Look for:

Input from those in your loved one’s circle of acquaintances. Talk to old friends and close relatives to get their sense of how the person is faring. Listen for stories that hint that the person doesn’t get out much. Comments such as, “She doesn’t come over anymore.” Or “She quit book club,” are potential red flags. Also pay attention to comments that indicate ongoing concerns, like “Has he had that heart test yet?” or “We were worried the day the ambulance came.”

Medical insight. With appropriate permission, your loved one’s primary doctor may share your concerns about his or her patient’s safety at home or they may be able to alleviate those concerns or suggest where to get a home assessment.

A second opinion. A social worker or professional geriatric care manager visits older adults’ homes and does informal evaluation. While your loved one may initially resist the notion of a “total stranger” checking on them, try pitching it as a professional (and neutral) second opinion, or…ask the doctor to “prescribe “ it. Some people wind up sharing doubts or vulnerabilities with a sympathetic, experienced stranger that they normally would by very reluctant to admit to their own adult children or family.

  • Caregivers’ Signs

Finally, realize that some of the information you collect is intangible it has to do with feelings and emotions, and the stress levels of everyone involved.

Look for:

How you’re doing. While the decision for your loved one to remain in his/her home is not primarily about you the son, daughter, grandchild, caregiver your own exhaustion can be a good gauge of a decline in older adults’ ability to care for themselves. Keeping someone at home can require lots of hands-on support or care coordination, and this is time-consuming. If your loved one’s need for care is just plain wearing you out, or…if a spouse or children are feeling the collective strain of your caregiving activities, these are major signs that it’s time to start looking at other options.

Your loved one’s emotional state. Safety is crucial, of course, but so is emotional well-being. If someone living alone is riddled with anxieties or increasingly lonely, then that may tip the scales toward a move not solely based on health and safety reasons. If your loved one has a full life, a close neighborhood and community connections, and seems to be thriving, it’s worth exploring as many in-home care options as possible before raising stress levels by pressing a move from a beloved home.

If on the other hand, your loved one is showing signs that living alone is a strain, it may be time for a talk. Broach the subject of where to live in a neutral way and you may find that your loved one harbors the same fears for current and future safety and security that you do. Find out what your loved one fears most about moving and about staying before launching into your own worries and what you think ought to be done.

Seniors Find Better Health & Happiness with Assisted Living

While many aging parents are wary of leaving their family home to move into assisted living, the truth is that a senior living community could be better than living at home when it comes to quality of life, social life, and overall wellness.

Adult children who notice that mom and dad are needing more care may question how to handle their parents’ changing health needs. Inevitably, the day comes to assess whether our parents need more than they have in their family home environment.

Benefits of Senior Living

Many seniors are resistant to assisted living, often stating that they don’t want to be put in a “home!” However, a little education about the wonderful senior living communities and options available today, in addition to touring communities like The Classic, can help families and their senior loved ones choose the best option for their unique situations.

In fact, research shows that aging parents and seniors prefer assisted living over other types of care, as these communities have expanded their market by providing fun convenience, retirement, and socialization services.

Better Health & Happiness Are a Way of Life in Assisted Living

Senior living is a great step for seniors who need more socialization and help with daily needs than the family can provide at home.

There are many types of senior living care. As an example, The Classic offers assisted living and independent living as well as memory care all on one campus. Each of these options can offer entertainment, fitness, and living arrangements for the stage parents may need.

Listed below are a few compelling reasons why Assisted Living at The Classic can contribute to better health and quality of life for a senior loved one.

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  • Chef-Prepared, Nutritious Meals

Assisted Living offers nutritious, chef-prepared cuisine that can be catered for specific medical conditions and needs. Residents are served three meals a day and can be tailored to their changing health needs.

  • Help With Daily Living

When a senior loved one lives at home, family caregivers are also generally responsible for helping with activities of daily living (ADLs) such as bathing, dressing, and eating. In other cases, the family or the senior themselves must bear the cost of a home care aide. Both of these options can cause strain on the family. In contrast, one of the most basic benefits of assisted living is helping older adults with these ADLs so that they can continue to function as independently as possible.

  • Intellectual Stimulation

Offered at The Classic are many opportunities for learning, such as book clubs, cooking presentations, gardening, and more.

  • No Stress of Housekeeping and Transportation

Keeping up with appointments, daily chores, and housekeeping are often stressful for not only seniors, but also family members. The vast majority of these burdens are relieved for Assisted Living residents at The Classic as weekly housekeeping and transportation services through Abby Vans is offered.

  • Physical Activity and Fitness

The Classic offers regularly scheduled exercise sessions led by trained instructors as well as access to gym equipment in the Fitness Studio.

  • Safe Living Environment

Often, home modifications and in-home care are required for a safe living environment in the family home, which can be very costly. Assisted living is designed for accessibility and mobility, while offering expert care and medical attention if needed.

  • Social Activity

Living at home can be isolating. Seniors often find it difficult to maintain their social relationships when they are retired. Assisted living offers socialization through planned activities and outings, such as cultural events and field trips. Daily living in the common areas also offers fun and socialization for seniors.

Transitioning to Assisted Living

Don’t all the emotional and logistical challenges of finding senior living overwhelm you. Making the decision to move to an Assisted Living community is becoming much easier as families are increasingly learning more about the benefits and services offered at communities like The Classic.

Five Helpful Tips for Moving Your Senior Parent

Five Helpful Tips for Moving Your Senior Parent

Moving a senior parent can be a major challenge. Not only can emotions often be highly charged, but the complicated logistics of deciding how and when to conduct a move to senior living can add even more pressure to already difficult experience.

Here are five tips to give you and your senior parent peace of mind before, during, and after your move:

  • Deal with one room at a time.

Trying to facilitate an entire move at once can feel overwhelming, especially when that move involves possessions acquired over a lifetime. To make things easier, organize and pack one room at a time, starting with the smallest or least-used room. Taking care of that first room will give you and your parent a sense of completion and help you maintain optimism throughout the rest of your packing.

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  • Find capable moving help.

While family and friends are often willing to help load and unload, it’s often worth hiring help on moving day. College students are often happy to work a few hours for a fraction of the cost of a full-service moving company and their energy and strength can make everyone feel better about what will almost certainly be an emotionally difficult day.

  • Focus on the positive.

Transitions almost always come with some sadness. That’s okay. Give yourself and your parent a moment to pay respects to the life they’ve lived but consistently think about the possibilities of life going forward. Help your parent remember that it’s never too late to meet new people, start a new hobby, or learn a new skill. With some gentle persistence and a little imagination, moving can be an amazing new beginning for your parents and your family.

  • Get a head start.

It’s easy to underestimate the time it will take to prepare for the move. Beyond the time to actually gather supplies and pack, you need time with your parent to consider what to keep and what to let go. We recommend starting to organize your move at least six weeks before your moving day. Having plenty of time to make decisions really helps manage everyone’s emotions.

  • Let go what you can.

Letting go of possessions can be difficult, but reducing the number of things you have to pack will make moving day go so much more smoothly. Take time to help your parent decide which things they own that are no longer useful or don’t bring them joy. Donating to charities can bring a sense of moral purpose that makes letting go of things easier to do.

When Aging Parents Won’t Listen

Our parents always asked that we listen to them. But what happens when they refuse to listen to us? Some adult children are finding that their parents don’t always know best when it comes to their diet, driving, housing, medication, and more.

Dad or Mom Won’t Take Your Advice: Now What?

Recent research has found that 77% of adult children believe their parents are stubborn about taking their advice or getting help with their daily problems.

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If you are experiencing this scenario, you may want to consider the following recommendations:

• Accept the situation. You may want your mantra to be “it is what it is.” Said another way, “you can take a horse to water, but you can’t make them drink.” In other words, they are still adults with the right to make decisions — even if poor ones.

• Blame it on the kids (that would be you) or the grandkids. If mom isn’t willing to change her behavior for herself, would she do it for a loved one? One approach is to say to your parent, “you don’t want me to worry, right? This (fill in the blank) will give me enormous peace of mind. Please do it for me!”

• Decide how important the matter is. Is it a safety issue or something that is just inconsequential? As the saying goes, pick and choose your battles.

• Don’t beat yourself up. Try not to hit your head against the wall too hard. There isn’t a lot we can do sometimes but stand by, watch closely, and be able to jump in when needed.

• Find an outside outlet for your feelings. If you’re angry or resentful that dad’s not with the program, confide in, strategize with, or vent to, a friend, geriatric care manager, geriatrician, online support group, sibling, or therapist rather than your parents.

• Think ahead. Is there a milestone they want to be around for, such as an anniversary, graduation or wedding? Then bring it up!

• Treat them like the adults they are. Dealing with a stubborn parent is not the same as dealing with a stubborn child. Older people should be autonomous.

• Try to understand the motivation behind their behavior. Are they acting this way out of habit, to assert independence, or because they’re depressed or confused? What are they afraid of? 

Seven Tips for a Successful Move to Memory Care

Seven Tips for a Successful Move to Memory Care

With the increasing demands of dementia caregiving, a day may come when it is no longer possible to care for your loved one at home. Whether it is for safety, health, or financial reasons, you may feel that it is now finally time to move your loved one to a specialized dementia care community.

You have done everything right. Your hard work and discipline have paid off. You’ve contacted or visited several memory care communities. You were able to match the services that different care facilities had to offer with your loved one’s needs, and found the most appropriate fit. You interviewed the staff and administration, asked all the right questions and feel comfortable with their approach to dementia care and the quality of services provided. You have made financial arrangements and secured the means to pay for residential care for years to come. You had your trusted attorney read and approve the admission agreement and you are ready for the move.

So why does it feel so bad?
The logistic and administrative aspects of moving a loved one to a dementia care community are important elements of a successful transition. But we mustn’t forget the immense emotional toll that is also involved in the move.

For starters, you are the one who has to make the final decision. The person with dementia is often unable to participate in this decision because of the lack of insight brought on by dementia itself. He/she may not understand the need for care or recognize the amount of care needed. That is your job as a caregiver and is often a solitary responsibility. You will have to make this decision based not on who your loved one once was, but rather who they are today, after the onset of dementia.

This whole process may leave you feeling uncertain that you’re doing the best move for your loved one. Add to this uncertainty, the feelings of guilt and grief that you may be going through at this very moment. Even after all the research, soul searching, hard work, and self-discipline, moving still seems painful.

The following tips are meant to help ease the move for people with dementia and to better accommodate their special needs during this vulnerable transition time. Please note: there is no one singular “best” approach and what may work for one family, may not be successful for another. Use your own discretion on how to use these suggestions and consider your loved one’s personality when doing so.

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1.  Do not announce the move in advance—Avoid anticipation anxiety by not telling your loved one that they will be moving on during the next month or so. Wait until it is close to the move-in date to inform them, or even tell them only at the very moment of the move. Moving anticipation anxiety can cause extreme negative feelings that may escalate into extreme behaviors. By not giving them too much of an advance notice, you will promote a calmer state of mind for the transition.

2.  Use fiblets—Your loved one does not need to know right away that this will be their new home for the long run. They may be happier in the idea that the stay is just for a short period of time (say, you’re having the carpets cleaned this week, or the family will be out-of-town and in the meantime you have made arrangements to have them stay at a really nice facility). You can repeat the same information when asked again until they are used to the new surroundings. Collaborate with other visitors and staff so everybody provides your loved one with the same message and works together as a team to ensure a successful move.

3.  Use medication wisely—Consult with your loved one’s doctor to adjust their medications for those vulnerable days around the move. A good doctor should be able to prescribe anti-anxiety medication to make the transition much easier for them, and for you. You may want to start the prescribed regimen about a week before the move and start weaning them off the medication a couple of weeks after the move, as they become more familiar and comfortable with the staff and new surroundings.

4.  Bring familiar items to the new home—Decorate the new surroundings with some of your loved one’s own furniture, mementos and items that bring comfort, such as photos and familiar books. Objects and belongings should be packed and moved outside of view to avoid generating anxiety. Consider eliciting the help of a family member or friend to do some activity elsewhere, so you have privacy to make the decisions on what to bring. This is also a tender moment for you as well, and when in doubt about the sentimental value of an item, keep in mind that you can always bring it at a later date.

5.  Avoid visiting during the first week—Yes…it’s always hard to let go! But those very first days can be crucial when it comes to developing new relationships with staff members and other residents. Your presence may remind them that this is not really their family and compel them to ask you to take them back home with you — setting backward the already sensitive process of adaptation. Keep open lines of communication with staff and work with them to build up their relationship with your loved one, until your visits can be safely made on a regular and supportive schedule.

6.  Take care of yourself—This is a very tender time for you too, so make sure your needs are being addressed as well. Get some extra rest and relaxation along with some exercise and fresh air. Visit friends and do something nice for yourself. You need to be cared for too, because the journey is not over yet. You are still your loved one’s voice and companion, only now you have a qualified team to do the hands-on care while you take a more consulting role.

7.  Remember that it too, will pass—As difficult as this transition is for your loved one with dementia, it is also very hard on you. In time, they will make new friends, bond with staff, enjoy the activities, move on and thrive. Later, they may still ask you to take them home once in a while and they may still feel lonely for a while. But ultimately, they will adjust, have much better care and enjoy their social life because you took the time to prepare and find the right care for them. And because of your efforts, they will have a better quality of life and be safe, comfortable, and content during their remaining years.

What Type of Physician is the Best for Helping Determine Cognitive Decline or Dementia?

What Type of Physician is the Best for Helping Determine Cognitive Decline or Dementia?

Have you ever worried that you or a loved one may be losing cognitive abilities with age? If so, you are not alone many adults over 65 have the type of cognitive decline or loss we regard as a “normal” consequence of age.

Normal Signs of Aging

According to the website, HelpGuide.org, the following types of memory lapses are normal among older adults and generally are not considered warning signs of dementia:

  • Becoming easily distracted or having trouble remembering what was just read, or the details of a conversation.
  • Forgetting names of acquaintances or blocking one memory with a similar one, such as calling a grandson by his father’s name.
  • Not quite being able to retrieve information that is “on tip of your tongue.”
  • Occasionally forgetting an appointment or walking into a room and forgetting why you went there.
  • Occasionally forgetting where things were placed that are used regularly, like eyeglasses or keys.

For many people, slight lapses in memory from time to time are a natural and normal part of the aging process; however you or a loved one are struggling with ability to perform everyday activities, or any behavior, memory or thinking skills, then there may be a bigger issue at hand.

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Symptoms of Cognitive Decline and Dementia

Cognitive decline and dementia are two common conditions that are not considered normal aspects of aging. According to the World Health Organization, nearly 50 million people worldwide have some form of dementia with nearly ten million cases added every year.

Cognitive decline and dementia differ from age-related memory loss in that they are degenerative diseases that will gradually worsen over time. For many people, symptoms of cognitive decline start out subtly and may only be noticeable to the person experiencing them.

Early-stage symptoms of dementia typically include:

  • Becoming lost in familiar places
  • Forgetfulness
  • Losing track of the time

When the disease progresses, the middle stage symptoms of dementia become “clearer and more restricting,” including:

  • Becoming forgetful of recent events and people’s names
  • Becoming lost at home
  • Experiencing behavioral changes, including wandering and repeated questioning
  • Having increasing difficulty with communication
  • Needing help with personal care

Symptoms eventually lead to “near total dependence and inactivity” during the late stage of dementia, including:

  • Becoming unaware of the time and place
  • Experiencing behavior changes that may include aggression
  • Having an increasing need for assisted self-care
  • Having difficulty recognizing relatives and friends
  • Having difficulty walking

Ways to Choose the Right Healthcare Professional

Choosing the right healthcare professional is critical if you’re concerned that you or a loved one may be experiencing dementia or another cognitive disease.

Make an appointment with one of the appropriate healthcare providers below to address your concerns:

  • Family Doctor or Primary Care Physician

According to an article published by U.S. News, making an appointment with your primary care physician (PCP) is the best first step to receiving comprehensive care. Primary care physicians should be able to get a complete medical history, family history, social history, current medication list and a review of any loss of abilities to perform day-to-day activities.

During an initial visit, your physician will most likely perform a full physical exam as well administer a cognitive assessment to gain a better understanding of your symptoms and rule out other possible conditions. Your physician may also order lab tests, including blood work, a CT scan or an MRI, as well as make a referral to a dementia-specific specialist for further testing.

  • Geriatrician or Geriatric Psychiatrist

According to the University of North Carolina School of Medicine, your best choice for a dementia-specific specialist is a geriatrician with a special interest in dementia, or a geriatric psychiatrist.

A geriatrician is a “primary care internist or family practitioner who specializes in complex conditions of older people and can provide care for all of an older adult’s medical needs whereas a geriatric psychiatrist specializes in the emotional and mental needs of older individuals. They conduct thorough memory, mood, sleep, and thinking evaluations. They are particularly good at assessing memory problems associated with life stress, anxiety, depression, excess drinking, or family conflicts.

If you are unable to obtain a referral to either one of these specialists (or your insurance will not cover the cost of these visits), your primary care doctor may refer you to a neurologist.

  • Neurologist

A neurologist has specialized training in diagnosing, treating, and managing disorders of the brain and nervous system. Some neurologists are specifically trained in diagnosing cognitive decline and dementia and so it is important for you and your family to ask your primary physician and conduct research for the appropriate neurologist to ensure you are being referred to the most appropriate specialist. During your initial consultation, the neurologist will perform more comprehensive tests to determine your mental fitness.

  • Psychiatrist, Psychologist, and Social Worker

Many people struggle following a diagnosis of cognitive decline or dementia. A psychologist or social worker can provide counseling and support and also help to address behavioral issues. They can also offer support to the family unit in order to best support the newly diagnosed individual. As mentioned above, the University of North Carolina School of Medicine suggests visiting a geriatric psychiatrist because they focus solely on the emotional and mental needs of older individuals.

If you suspect that you or a loved one is experiencing cognitive decline or dementia then starting with your primary care physician is the best first step. You shouldn’t however feel restricted by their opinion. If you are not happy with the results of primary care physician’s assessment, or, if that doctor does not seem to feel an evaluation for diagnoses and treatment of the cognitive problem is that important, then it’s time to get a second opinion.

Moving to Assisted Living Care

A decision to move to assisted living care raises many questions. You or your loved one may ask, “Is help really needed?”; “Will it be easy to make friends?”; or “Can loved ones and friends still stay close to one another?” The answer to these common questions is the same: “Yes!”

Whether you are a new resident or a loved one seeking more information, there are many ways to help make the transition successful.

Change can be challenging for anyone. It may take a few days to feel settled in, or a bit longer. The transition experience is different for everyone. You or your loved one will get there. The keys to success are preparation, a positive attitude, patience and understanding, and strong support network.

Everyone copes with change differently. Patience, support, and understanding are key themes that will help residents, loved ones, and friends adjust. Rest assured that the assisted living staff is experienced, ready, and willing to help with the process. Don’t be shy about asking questions or seeking assistance. It should be every assisted living care residence’s goal to help make your move a positive experience.

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Privacy Concerns

One of the biggest changes in moving to assisted living care is sharing space with people you don’t know. While this may seem uncomfortable, you’ll soon find that neighbors won’t affect your privacy. You’ll always have your own space. Loved ones and family members can visit, but you decide when. If you have questions or concerns about privacy or security, talk with facility staff.

 

Moving To Your New Home

Begin planning your move soon after choosing an assisted living care facility. Decide what furniture, clothes, and personal items you’ll bring and what ones you’ll store off-site, donate, or sell. Start packing well in advance of moving day. If you have a hard time making decisions about what to bring and what to leave, you’re not alone. Many residents struggle with this process. Try to remain positive and have loved ones and friends help you. Small prized possessions will go far in making your new home feel like home. When moving day arrives, ask loved ones and friends to help arrange and organize your new home. Arranging items to suit your preferences will make the adjustment easier.

 

Making the Emotional Transition

Moving is hard. It can make anyone feel stressed or overwhelmed. These feelings are generally temporary and disappear after you get settled in and develop your own routine. Give yourself time to adjust. Ask other residents if they have suggestions for the transition. Many folks find comfort in talking with a neighbor, close friend, or spiritual advisor. At first, you may tend to keep to yourself. This is normal. Try to get out and introduce yourself to other residents. Staying busy and participating in activities can make you feel more comfortable about your surroundings. Everyone is different. Some people embrace the move with open arms; others find it’s not so easy. If you feel adjusting is taking longer than you expected, you might want to have a care conversation with the assisted living care director or administrator.

 

Advice for New Residents

  • Here are some tips to make your move easier:
  • Read all assisted living care residence materials before you move in.
  • Try to meet with sales and marketing director, facility director, and/or staff before moving day.
  • Review all paperwork carefully before your move, so you can address any questions.
  • Obtain a list from the residence of suggested items to bring.
  • Pack wisely. Don’t bring everything.
  • Read and familiarize yourself with residence policies.
  • If the residence is helping you with your laundry, label your clothing to avoid any mix-ups.
  • Read the activity schedule and choose two or three programs to attend early on to meet neighbors and other residents.

 

Tips for Loved Ones and Friends

As a loved one or friend transitions to an assisted living care community, try to be involved before, during, and after the move. Residents don’t want to be treated differently. While their address has changed, they haven’t. The experience may be just as difficult for you as it is for your loved one or friend. These emotions are natural and expected. Keep these dos and don’ts in mind:

 

Do…

  • Help with sorting, packing, and moving when asked
  • Listen as your loved one or friend talks about what was left behind
  • Stay positive even if you don’t agree with the move decision
  • Recognize that moving to a new home represents a major change
  • Call and visit often, especially during the first few weeks
  • Provide support, patience, and understanding

 

Don’t…

  • Make decisions for your loved one or friend
  • Take over sorting, packing, and moving without being asked
  • Focus on your needs and wishes. The move is about the resident!
  • Criticize the decision to move to assisted living care
  • Make light of the transition
  • Rush into talking about selling the resident’s house
  • Make promises that you cannot keep
  • Be negative

Communication Strategies for Families Dealing with a Loved One’s Dementia

It can be very painful to witness the deterioration of a loved one with Alzheimer’s disease, or any other type of dementia. As the disease progresses, we see minor forgetfulness gradually morph into severe impairment and eventually our loved one’s individuality itself is compromised.

Understanding how to connect and communicate with our loved ones through this time is of the utmost importance. Learn more from these communication strategies for dementia.

Many people use the phrase, “empty shell of a person” when describing a loved one ravaged by the later stages of the dementia. Sadly, dementia does indeed transform people into shadows of their former selves, but those living with dementia are far from “empty shells.” Yes, the shell may become more and more difficult to open. Some days it might not open at all. But never forget that there is a beautiful, unvarnished pearl inside.

Understanding how to “open the shell” gives us opportunities to meaningfully connect with our dementia-afflicted loved one even for only a fleeting moment. Just as the right tools and a lot of technique is required to shuck an oyster, there is technique and artistry involved with communicating or connecting emotionally with a loved one who has dementia.

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Here are 10 tips on how to effectively communicate with someone who has moderate to severe dementia.

  • Recognize what you’re up against. Dementia inevitably gets worse with time. People with dementia will gradually have a more difficult time understanding others, as well as communicating in general.
  • Avoid distractions. Try to find a place and time to talk when there aren’t a lot of distractions present. This allows your loved one to focus all their mental energy on the conversation.
  • Speak clearly and naturally in a warm and calm voice. Refrain from ‘babytalk’ or any other kind of condescension.
  • Refer to people by their names. Avoid pronouns like, “he,” “she,” and “they” during conversation. Names are also important when greeting a loved one with dementia. For example: “Hi, Grandma. It’s me, Jeff,” is preferred over, “Hi. It’s me.”
  • Talk about one thing at a time. Someone with dementia may not be able to engage in the mental juggling involved in maintaining a conversation with multiple threads.
  • Use non-verbal cues. For example, maintain eye contact and smile. This helps put your loved one at ease and will facilitate understanding. And when dementia is very advanced, non-verbal communication may be the only option available.
  • Listen actively. If you don’t understand something your loved one is telling you, politely let them know.
  • Don’t quibble. Your conversations are not likely to go very far if you try to correct every inaccurate statement your loved one makes. It’s okay to let delusions and misstatements go.
  • Have patience. Give your loved one extra time to process what you say. If you ask a question, give them a moment to respond. Don’t let frustration get the better of you.
  • Understand there will be good days and bad days. While the general trend of dementia sufferers is a downward decline, people with dementia will have ups and downs just like anyone else.

June is Alzheimer’s & Brain Awareness Month

June is Alzheimer’s & Brain Awareness Month

Six Tips to Build Resilience and Prevent Brain-Damaging Stress

These days, we all live under considerable stress — economic challenges, job demands, family tensions, always-on technology and the 24-hour news cycle all contribute to ceaseless worry. While many have learned to simply “live with it,” this ongoing stress can, unless properly managed, have a serious negative impact on our ability to think clearly and make good decisions, in the short-term, and even harm our brains in the long-term.

The Problem

Recent studies show that chronic stress can also lead to depression, and even to a higher risk of cognitive decline and Alzheimer’s disease symptoms. Why? Under stress, the brain’s limbic system responsible for emotions, memory and learning triggers an alarm that activates the fight-or-flight response, increasing the production of adrenaline (epinephrine) and cortisol, which work together to speed heart rate, increase metabolism and blood pressure, enhance attention, the immune system and anti-inflammatory response, and lower pain sensitivity all good things when your very survival is on the line. When the stressful situation is over, the body resets back to normal.

However, under constant stress, the body is unable to reset. High adrenaline and cortisol levels persist, potentially causing blood sugar imbalances and blood pressure problems, and whittling away at muscle tissue, bone density, immunity, and inflammatory responses. These events block the formation of new neural connections in the hippocampus, the part of the brain responsible for encoding new memories. When these new connections are blocked, the hippocampus can actually shrink in size, hindering memory.

Too much stress can almost make us “forget” how to make changes that reduce that stress, limiting the mental flexibility needed to find alternative solutions and triggering general adaptation syndrome (GAS) better known as “burnout” which makes us feel unmotivated and mentally exhausted. This is why next time you forget someone’s name at a party, try not to obsess about remembering it. Instead, make fun of your DNA (we are all human, aren’t we?). The name in question is then more likely to appear in your mind when you less expect it.

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What Can You Do?

Rather than simply living with stress, learning how to effectively master our stress levels and build emotional resilience can not only help you feel and perform better on a daily basis, but also protect your brain from the long-term damaging effects of stress. Here’s how to do it:

  1. Get some exercise – Studies show that aerobic exercise helps build new neurons and connections in the brain to counteract the effects of stress. In fact, a recent study found that people who exercised very little showed greater stress-related atrophy of the hippocampus (the part of the brain that stores memories) compared to those who exercised more. Regular exercise also promotes good sleep, reduces depression and boosts self-confidence through the production of endorphins, the “feel-good” hormones.
  2. Relax – Easier than it sounds, right? But relaxation through meditation, tai chi, yoga, a walk on the beach, or whatever helps to quiet your mind and make you feel more at ease can decrease blood pressure, respiration rate, metabolism, and muscle tension. Meditation, in particular, is tremendously beneficial for managing stress and building mental resilience. Studies also show that getting out into nature can have a positive, restorative effect on reducing stress and improving cognitive function. So move your yoga mat out into the yard, or turn off that treadmill and take a walk in the park. Your brain will thank you for it.
  3. Socialize – When your plate is running over and stress takes over, it’s easy to let personal connections and social opportunities fall off the plate first. But ample evidence shows that maintaining stimulating social relationships is critical for both mental and physical health. Create a healthy environment by inviting friends, family and even pets to combat stress and exercise all your brains.
  4. Take control – Studies show a direct correlation between feelings of psychological empowerment and stress resiliency. Empowering yourself with a feeling of control over your own situation can help reduce chronic stress and give you the confidence to take control over your brain health. Some video games and apps built around heart rate variability sensors can be a great way to be proactive and take control of our stress levels.
  5. Have a laugh – We all know from personal experience that a good laugh can make us feel better, and this is increasingly backed by studies showing that laughter can reduce stress and lower the accompanying cortisol and adrenaline levels that result. Having fun with friends is one way to practice two good brain habits at once. Even just thinking about something funny can have a positive effect on reducing stress and the damage it causes to your brain.
  6. Think positive – How you think about what stresses you can actually make a difference. In one study at Harvard University, students were coached into believing that the stress they feel before a test could actually improve performance on graduate school entrance exams. Compared with students who weren’t coached, those students earned higher scores on both the practice test and the actual exam. Simply changing the way you look at certain situations, taking stock of the positive things in your life and learning to live with gratitude can improve your ability to manage stress and build brain resilience.

Living with high levels of sustained stress can have a profound negative impact on your psychological and brain health. While often there is little we can do to change the stressful situation itself, there are many things we can do to alter or manage our reactions to it. Managing stress and mastering our own emotions through simple lifestyle changes and the use of basic techniques that anyone can do can help reduce stress-related damage to the brain, improve emotional resilience and thwart cognitive decline as we age.