Minding Our Elders®

Another study shows stress hormones likely increase Alzheimer’s risk

If we’re alive, we are coping with a significant amount of stress. Yet stress hormones have been shown to have a negative effect on our health. Now, the recent article, "Stress may increase risk for Alzheimer’s disease: Stress hormones lead to Alzheimer-like protein modifications,” brings to light epidemiological studies by scientists at the Max Planck Institute of Psychiatry in which the scientists hypothesized that adverse life events, which generally cause stress, may be one trigger for Alzheimer’s disease.

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Study says exercise key to preventing Alzheimer’s

A recent paper published in the Journal of Biological Chemistry reported on some encouraging results about the benefits of exercise. Researchers at Kyoto University Graduate School of Medicine in Japan concluded exercise is something we can do right now to help prevent Alzheimer’s disease. While the study was done on mice, the researchers feel strongly that people will show similar results.

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9-year study concludes preventing or managing diabetes prevents cognitive decline

As far back as 2006, the New York Times was reporting on the deepening link between diabetes and Alzheimer’s disease. Now, new results from a study led by researchers from the University of California San Francisco show that there is a link between the risk of cognitive decline and the severity of diabetes. 

An article on the UCSF website reports on a 9-year long study by researchers at the University of California, San Francisco (UCSF) and the San Francisco VA Medical Center. The Health, Aging, and Body Composition (Health ABC) Study enrolled 3,069 adults over 70 at two community clinics in Memphis, TN and Pittsburgh, PA beginning in 1997. All the patients provided periodic blood samples and took regular cognitive tests over time.

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Reminiscing powerful “drug” for people with dementia

I love stories. When I was a teenager, I’d encourage grandparents to relate stories of their young years struggling to survive on the wind-swept prairie. When I grew older, I was fascinated by the stories my parents and in-laws told of their early years of growing up during the Great Depression. Little did I know at the time that peoples’ stories would become the springboard for my life’s work. Now there is mounting evidence that encouraging our elders to reminisce about their past is therapeutic as well as enjoyable.

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Coping with criticism from your loved one

Caregivers frequently turn their lives inside out in order to care for their loved ones in decline. I know, because I've done it. The number of elders who depended on my help increased throughout the years, to a total of seven, though the most I cared for at one time was five. I also had two children and work part time writing as a freelancer. Each care situation was different. I started with an aged neighbor, then moved on to a childless aunt and uncle, my in-laws and eventually my parents. All of them appreciated me. However they each had moments when, because of their own misery, they’d lash out at me in some way.

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Alzheimer’s diagnosis not always accurate

Dear Carol: My dad was diagnosed with Alzheimer’s disease three years ago. Recently, after the elimination of some medications Dad had been taking for years, the doctor changed the diagnosis to vascular dementia. In some ways, dementia is dementia, I guess, but still the doctor said as dad’s disease progresses the difference will become more apparent. I’m wondering how common this type of mix-up is with a dementia diagnosis. – Paul

Dear Paul: Actually, an error in dementia diagnosis is quite common. Peter Lichtenberg, Ph.D., head of Wayne State University's Institute of Gerontology, wrote in a paper published in a recent edition of the journal Clinical Gerontology about this problem. 

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Drug free management of sundowning in people with Alzheimer's

Sundowning, sometimes called Sundown Syndrome, is the label given to late day anxiety, irritability, disorientation and general agitation in people with Alzheimer’s. Sundowning frustrates home caregivers and professional care staff alike, as they often feel completely unable to comfort the person affected. Researchers and care staff alike are looking for answers. One nursing home in particular has made some dramatic changes in end-of-day care, resulting in a major reduction in the need to medicate residents for late day anxiety. Home caregivers can learn from their work, as well.

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Hidden financial costs when we quit our jobs to care for our loved ones

I don’t need a study to tell me that leaving the workforce to become a family caregiver has cost me, financially.  All I have to do is look my puny projected Social Security. Over two decades of my adult “productive” years have been spent caring for elders and children while not working at paid employment. Eventually, I did go back into the workforce, even though I was still a primary caregiver for three elders and one young adult with health issues. While I certainly was aware that I wouldn’t get any Social Security or retirement benefits for the years outside the traditional workforce, I also knew that our family didn’t have the money to pay agencies to do what I did for my loved ones.

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Family mediator can help you over the rocky road of caregiving

Even siblings who grew up together with fondness for each other often have different ideas about what the right care for aging parents incorporates. When siblings have clashing personalities, or family issues have driven them apart, finding middle ground on anything can be extra challenging. However, the reality is that for many families the time eventually comes when adult childrenmust make decisions for their parents’ living arrangement, medical care and even end of life treatment. We have more options for care than we did a couple of decades ago, but with options comes the need to make decisions.

Read more about family mediators and how they can help:

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Administration on Aging programs provide assistance for caregivers nationwide

Nearly any family caregiver has felt isolated and alone at one time or another. For many, that feeling is chronic. Friends don’t understand the strain we are under. Some people get no support from their extended family or friends. Where can we turn when there seems to be nowhere to turn? Believe it or not, many resources are at your fingertips on the Administration on Aging website. 

The National Family Caregiver Support Program 

The National Family Caregiver Support Program (NFCSP) is one resource every caregiver should look into. The links to the NFCSP support features can be found on your state website as well as the Administration on Aging site. The NFCSP provides grants to states and territories, based on their share of the population of people aged 70 and over, to fund a range of supportive services that assist family caregivers caring for a loved one at home.

Read more about benefits check up and other programs available:

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Hospital stay can prove fatal for people with Alzheimer’s

Last April, the journal “Neurology” reported on a study showing that people with Alzheimer’s disease who were hospitalized have more than double the risk of cognitive decline than the control group. 

Now, newer information makes the case that the hospitalization of a person with dementia presents even a greater risk than previously thought. According to an article in the Seattle Times, people with Alzheimer’s who are hospitalized are more likely to need nursing home care or even die within a year of their experience than those who are not hospitalized. If the person leaves the hospital suffering from a condition known as delirium, which is a state of increased agitation and confusion, the risk is even higher.

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Elders vulnerable to abuse in domestic situations

Most of us want the best possible care for our aging parents. There are many ways to provide good care, one of which is bringing our parent or parents to live with us, or taking our family to live with them. Sometimes that works out wonderfully. But sometimes it doesn’t. Not everyone is cut out for the day to day stress of hands-on caregiving, let alone 24-hour caregiving in their own home. What can start out as a loving gesture can end up a nightmare.

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Can caregivers be subject to abuse by their care receivers?

When we think of domestic abuse in a family where elders are cared for, we generally think that the elder is the most likely person to suffer abuse. Statistics would probably prove this to be a fact. However, there are many caregivers who can truthfully say that they are emotionally, verbally and even occasionally physically abused by their care receiver.

Being in a vulnerable state of health doesn’t necessarily turn a person who was historically abusive to family members into a sweet lamb. Even the best of us can get cranky when we don’t feel well. The frustrations of dementia can be even harder to cope with than physical pain. Good people can become hard to deal with when faced with these issues.

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Father's Day: Give the gift of your attention

...As years go by, most of us gain – or attempt to gain – perspective. By retelling personal stories, elders are often, consciously or subconsciously, trying to reframe their life from the perspective of time. If we give them the gift of attentive listening, we may find their often told stories more interesting, and we may even learn something new about them. Also, since our elders' history is part of our history, we may learn something new about ourselves.

Read more about giving the gift of attentive listening for Father's Day:

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Caregiving: creating a legacy to be proud of

...I've been a drugstore store clerk, a military librarian, a university library staff member, a stay-at-home mom, a humor columnist, a news researcher/librarian, an author and an eldercare columnist. I've also been a caregiver for many people, elders and children alike. I imagine one day some of those things will be mentioned in my obituary. But, in the end, what matters most to me? What, ideally, would I want people to write about me after I'm gone?

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Cutting use of antipsychotic drugs in Alzheimer’s

Once again, antipsychotic drugs are in the news. Often used to control symptoms of agitation and aggression in people with Alzheimer’s, antipsychotics occasionally have their place. However, during the last few years there’s been an outcry from agencies and the public that nursing homes and doctors have misused the drugs. Now, the U.S. Centers for Medicare & Medicaid Services (CMS) is officially aiming to cut the use of these drugs by 15 percent.

Read more about the CMS rules decision about cutting use of antipsychotic use in nursing homes:

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Historic event at White House raises awareness of elder abuse

Friday, June 15, is World Elder Abuse Awareness Day. In preparation for this important day, the White House Office of Public Engagement, in collaboration with federal partners from the Administration for Community Living/Department of Health and Human Services, the Consumer Financial Protection Bureau and the Department of Justice, is hosting a day-long symposium at the White House Thursday, June 14. The event will highlight the problem of elder abuse, exploitation and neglect. 

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Dementia Boot Camp: Training to Be a Caregiver, Part 2

We finally reached the top step. The woman holding my elbow didn’t have much to say. I was hungry for the sound of an unfiltered human voice, but I had to concentrate so hard on climbing the steps, as my sight was distorted by the goggles, that I probably wouldn’t have heard much, anyway. Besides, these headphones were isolating.

We passed through a doorway. Two other women were in a large room. They must have been aides. One aide stood beside a young woman in a wheel chair, likely one of the staff going through training. It was obvious they were waiting for me.

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Dementia Boot Camp: Training to Be a Caregiver, Part 1

Please wipe this mess off of my face. Please! 

Don’t go so fast, I can’t swallow! I’m not ready for a drink yet. 

Is this bite going to be hot or cold? Sweet or bitter? Pureed meat or pudding?   

Please wipe my face! 

Let me start at the beginning: A couple of weeks ago, I attended a training program at Bethany Homes, a care facility near my home. They make this sensitivity training program mandatory for their staff. Bethany uses a combination of “Dignity & Sensitivity: The Ultimate Boot Camp,” from Gemini Consulting and the “Virtual Dementia Tour” (VDT), a program from Second Wind Dreams. 

Because I am an elder care columnist, I volunteered to go through the training. When I arrived at my appointed time, I was excited and a bit stressed. I knew it wouldn’t be a picnic, but I also knew I wanted to have this experience. 

So it began.

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How do I accept that Mom needs hospice care

Dear Carol:  My mother is 82 and has been diagnosed with terminal cancer. She also suffers from mid-stage dementia. A friend of mine who died from cancer received wonderful care from an area hospice, and I’d like to see my mother have this kind of care. The problem I’m having is making myself go through the process. Mom knows that hospice means she has been designated terminally ill, though I don’t know how cognitively aware she’ll be when we put everything in place. Since she’s stated in the past that hospice is a good organization, I don’t know why I’m struggling with this.  -Sheila

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