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February 2013

Chronic Pain Management in People With Dementia Complicated

The combination of chronic pain and dementia is difficult to manage. While advancing dementia can render an elder heartbreakingly vulnerable, chronic pain that can’t be expressed in words by the person with dementia multiplies the difficulty of compassionate care.  Since dementia can leave people unable to verbally express the fact that they are in pain, they may scream, kick or hit. They may act out aggressively because they don’t understand why they are in pain. They just want it gone. If caregivers misinterpret the reason for this “acting out,” there is a chance that the elder will not receive proper pain management for his or her chronic or acute pain.

Read more about chronic pain management for people with dementia:

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It's Spring: Time to Refresh Our Caregiving Routines

...Making pro and con lists of what is working and what is not working is an effective method of examining anything from budgets to weight loss. It can be just as effective for caregiving. Below I've provided a template for a hypothetical caregiver we'll call Ann. If you're up for a little self-reflection, Ann's list could help you jumpstart your own self-improvement project.

Read about giving your caregiving routine a once over:

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HRT May Prevent Accelerated Biological Aging for Alzheimer’s Gene Carriers

A little more than a decade ago, most physicians considered hormone replacement therapy an important part of treating postmenopausal women because of its ability to help control hot flashes, maintain bone health and lower the risk of colorectal cancer. Their enthusiasm for this treatment abruptly reversed in July of 2002, when the same physicians took their patients off HRT nearly across the board. An article in the New York Times explains what happened.

Read more about HRT therapy and how it may help some women:

 

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Medication Could Cause Slurred Speech, Drooling

Dear Carol: My mom has several medications to help with various health problems. Lately, her speech has been slurred and she seems to be drooling quite a bit. The symptoms appear to be the most pronounced shortly after she’s taken her medications, but she has some symptoms intermittently all day. She also complains of a headache nearly every day, so we are having her eyes checked next week just to be sure, although her glasses are quite new. Can medications cause these problems? – Mary Beth

Dear Mary Beth: Yes, the slurred speech, the drooling and the headache could be caused by a medication or an interaction between medications. It's wise to get your mom’s eyes checked to make sure that her prescription is correct. Taking her to her eye doctor will also give another professional a chance to evaluate her.  It doesn’t hurt to ask a pharmacist for some input, either, since pharmacists are specifically trained in medications and may catch medication interactions that a doctor could miss.  

Read more about how medications can cause problems in aging loved ones:

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Family Caregivers Provide Nursing Services with Little Professional Support

According to Carol Levine of the United Hospital Fund, a longtime researcher and caregiver herself, and Susan Reinhard of the AARP Public Policy Institute, few non-caregivers have any real idea of how much care an in-the-trenches family caregiver provides.  In a story by Paula Span on the New Old Age Blog titled  Caregiver, Plus M.D. or R.N.”, Carol Levine is quoted as saying, “The public perception is what you see in ads — people sitting by the bedside, holding hands, making lunch, smiling at one another…It has that glossy look. That’s not the whole story.”

Read more about how family caregivers provide nursing services:

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Eating Issues: How to Cope

Often, whether from physical problems or lack of appetite, eating loses its appeal to frail elders. Regardless of the reason their loved one has for not eating well, caregivers can be stressed by the situation. We know the value of nutrition. We know the feeling of hunger. We want to help them stay nourished. Professional caregivers, such as those in nursing homes, also struggle with the issue. However, nourishment needs to be provided in the right way, which often depends on why the person has trouble eating.

Read more about nutrition for people with eating issues:

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Alzheimer’s Disease Doesn’t Just Affect the Aged

Receiving an Alzheimer's diagnosis at the age of 75 can be a crushing blow. Imagine, then, what it would be like to receive such a diagnosis when you are 35, 40 or 45-years-old? You're at your prime in many ways because you've got experience in your work, yet are nowhere near retirement. You have children, maybe yet in grade school. You've got a mortgage, car payments and plans to travel when your kids are older. You're on a roll - until you realize that you are forgetting things. Important things. Eventually, you see a doctor and the diagnosis is early on-set Alzheimer's disease. 

A USA Today story titled Dementia's youngest victims often defy stereotypes, focuses on a  49-year-old nurse who found herself forgetting to pick up her grandchildren, forgetting plans she had with her husband and making mistakes at work. She thought it was stress.

Read more about younger onset Alzheimers:

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Vitamin D, Mediterranean Diet Help Lower Risk of Alzheimer’s

Two different studies have highlighted natural weapons we may have at our disposal in our fight against developing Alzheimer’s disease. One is Vitamin D and the other is our diet.  We’ve long known that vitamin D, generally absorbed through sun exposure but often supplemented, is necessary for bone strength. During the last few years, evidence has been accumulating showing that a low level of vitamin D likely contributes to cardiovascular disease, some cancers, strokes, depression and some metabolic disorders. Now, a review recently published in the journal Neurology, assessed 37 studies that evaluated vitamin D concentrations and cognitive function.

Read more about vitamin D and the Mediterranean diet as tools to avoid Alzheimers:

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NPR Investigates True Cost of Quitting Job To Be Family Caregiver

Many of who have vulnerable loved ones would prefer to provide hands-on care ourselves. For some, that means considering whether to continue with outside employment or quit a job to care for our loved one full-time. In Discovering The True Cost Of At-Home Caregiving, NPR’s series “Family Matters: The Money Squeeze,” the lifetime cost of quitting a paying job to care for a loved one in the home is closely examined.

Given the cost of hiring in-home care or placing an elder in assisted living or a nursing home, the idea of staying at home to care for a loved one can seem cost effective. Sometimes by cutting corners, a family can survive financially for a few years while one spouse stays home to care for an aging parent. Doing so can seem like a humane choice, one that speaks of love and filial responsibility. However, the NPR report forces us to take another look.

Read more about the true cost of quitting your job to be a caregiver:

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Serene Atmosphere Can Relax Care Receiver

Dear Carol: My sister, who I’ll call Mary, is the primary caregiver for our mother. Mom has late stage Alzheimer’s and is in a nursing home near Mary. Mary is understandably stressed by a demanding job, caring for her family and visiting our mom several times a week. I’m concerned because when Mary is around Mom in the nursing home setting, she seems rushed and her voice is sharp. Then Mom gets agitated and distressed. While I never criticize Mary’s approach, I’ve suggested that since Mom gets excellent care at the nursing home Mary should visit less often so she can have more time for herself, but she gets defensive. I visit Mom as often as I can. How can I convince Mary that if she is more rested, she and Mom are both better off? – Allison

Dear Allison: You seem to genuinely want to help your sister as well as your mom, so I’m assuming as I reply that you realize that your mom may have bad days even with exceptional care. That being said, I agree that a caregiver’s body language and tone of voice can make a big difference to our vulnerable loved ones and that your mom may be picking up on Mary’s stress.

Read more about how body language and atmosphere can help someone with Alzhiemer's:

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