Exciting News in the Battle Against Alzheimer's!

I typically hesitate posting medical journals or studies on this blog because I assume that those reading it probably don't have the time to sift through the jargon and medical terminology. However, this is some exciting news on the Alzheimer's front that I think needs to be shared. Out of respect for everyone's time, I will briefly summarize my understanding of the findings as well as post the actual article below.

Scientists have previously identified a gene, APOE4, which is known to increase the risk of developing Alzheimer's later in life. Individuals who possess one copy of the gene are three times more likely to develop Alzheimer's and those who possess more than one copy are ten times more likely. That discovery was made in 1991. This is not news.

The exciting news is the recent discovery that people who have the APOE4 gene experience changes in the way that 215 other genes express themselves before they actually develop Alzheimer's.  This is exciting for a number of reasons. Mostly, it means that scientists can begin to look into early ways to intervene BEFORE symptoms appear. All of the treatment options for people with Alzheimer's currently are behind the proverbial eight ball. Once you develop the disease THEN doctors look into ways that they can slow the progression. There is currently no feasible way to predict who will get it. There is no way to prevent people from acquiring it. There is no way to cure people who have it. In a world of gray skies and dim possibilities, this is finally some sunshine from behind the clouds.

http://www.bloomberg.com/news/2013-07-24/path-of-alzheimer-s-disease-risk-gene-tracked-scientists-say.html

Parkinson's Didn't Stop an Astronaut From His Space Walk

This is an amazing story about astronaut Rich Clifford, who was diagnosed with Parkinson's Disease when he was 42 yrs old. He went on to fly in another space shuttle mission and complete a lengthy space walk in spite of his diagnosis. After 15 yrs of staying silent on the subject, he now tours the country to raise awareness for Parkinson's and to tell his own fantastic story.

http://thechart.blogs.cnn.com/2012/11/14/parkinsons-didnt-stop-his-space-walk/

China Mandates That Children Care For Their Parents.

The People's Republic of China made waves recently by enacting "The Law of Protection of Rights and Interests of the Aged." Among other things, this law mandates that children visit their parents regularly in order to provide for their financial and spiritual needs. Senior issues are an area of critical concern for China. Currently, they have approximately 185 million people over the age of 60. By 2050, the elderly are predicted to account for more than a third of the entire population. Read more about it below.

http://www.cnn.com/2013/07/02/world/asia/china-elderly-law/index.html?iref=allsearch

AARP says that 1 out of 4 Retired Early to Care for a Spouse

One-in-5 employees age 45-74 say they expect to take time off of work to care for a spouse, a parent or relative in the next five years, AARP officials say.

An AARP report, "Keeping Up with the Times: Supporting Family Caregivers with Workplace Leave Policies," also said 1-in-4 retirees said they left the workforce earlier than planned to care for an ill spouse or other family member.

"The aging of the population, changing workforce demographics and increasing demands on family caregivers are colliding at the expense of working caregivers," Lynn Feinberg, senior strategic policy adviser with the AARP Public Policy Institute and author of the report, said in a statement.

Read more: http://www.upi.com/Health_News/2013/06/19/One-in-5-employees-age-45-74-must-quit-work-for-caregiving/UPI-41721371620805/#ixzz2Xzilse9x

Want to Improve Your Memory? Eating smart really can help you keep your brain sharp.

Antioxidants! Omega-3s! Anti-inflammatory diets! Can something you eat really help you remember — again — where you put your cellphone or reading glasses? If you add blueberries to your morning oatmeal or sip a glass of red wine at dinner, will your brain cells stay healthier longer?


http://www.aarp.org/health/brain-health/info-06-2013/worried-about-your-memory.html?intcmp=HPBB1J

The Difficult Choice of Caring At Home

Yesterday, NPR ran a segment entitled “The True Cost of At-Home Caregiving.” The article brilliantly paints a portrait of what our clients and their families face each and every day. For many years, the accepted norm with regards to aging was that seniors would move in with their families when they were unable to live by themselves without assistance. Then the culture shifted. Parents began to place their children into daycare facilities and mother’s day out programs so that they could free themselves to pursue the all-important American dream. In return, when those parents aged, it became customary for their children to place them into nursing homes and facilities. As my father is fond of saying, “We placed our kids in institutions as soon as they were old enough so that we could be free to live our lives. Why are we surprised that, now that we are older and need assistance, they aren’t hesitating to return the favor?” However, the pendulum has swung back the other way. More and more families are making the difficult decision to move an aging parent into their homes and provide care themselves. This is due in no small part to the tremendous rise in the cost of caring for a senior in a facility. At first glance, a multi-generational living arrangement would seem to be a cost saver but, as any family caregiver will freely tell you, the cost is not always easy to see.
One of the things we recognize at Home Instead Senior Care, is the importance of the family caregiver. Many agencies address the needs of the client but largely ignore the person who many times needs our help the most, the family caregiver. It is one of my favorite questions to ask during an initial meeting. “How are you?” It is amazing to witness the reactions people have when they haven’t been asked that question in so long that they no longer know how to answer. Most of the time the family caregiver will deflect the question and continue to speak about the condition of their loved one. I ask again. “How are you?”
Caring for your loved one at home is a beautiful gift. It is also an extremely difficult task particularly where Alzheimer’s Disease or other dementias are present. Home Instead Senior Care can help. We work to give the respite care that families need on a short-term or recurring basis. We want daughters to be free to be daughters again.

Bundle Up Folks!

Two weeks ago, I spent the entire Sunday in shorts and a t-shirt playing basketball with my oldest three sons. This past Sunday, the clothing ensemble looked more appropriate to a typical January day but the weather was still remarkably warm coming on the heels of a snowy Friday morning which caused the cancellation and delay of  hundreds of schools and businesses across the Triangle. This morning's forecast warns of an extreme cold front moving through our area during the next few days. Tonight's temperatures are expected to dip into the low twenties and tomorrow night will reach into the teens. Daytime temps will offer very little respite from the cold. High temperatures are expected to be in the low 40's with wind chills that should keep most of us inside for the next 7-10 days. Brrrrr!

In light of the approaching winter weather, allow me to ask a question. What are you doing to make sure that the senior in your life survives? Pardon the Draconian language but extreme bouts of cold weather are potentially lethal for seniors.

Part of the normal aging process is a natural thinning of the skin. Gone are the days of being regarded as 'thick-skinned.' This change makes it more difficult for a senior to regulate the temperature of their own body. By itself, thin skin isn't particularly dangerous and is easy problem for which to compensate. The complications arise when you factor in some of the other changes and realities of the normal aging process. A senior nervous system doesn't process information as quickly as it did during younger years. As a result, a senior likely will not realize he is cold until the early effects of hypothermia have already set in. Furthermore, one of the early signs of hypothermia is muscle stiffness particularly in the neck, arms and legs. Have you ever met a senior who complains of being a little stiff? Ironically, the chronic aches and pains that most seniors have grown accustomed to ignoring are the very ones that should alert them of danger within their own bodies.

For a moment, we should consider the possibility that the seniors in our lives might also be taking prescription medications. Seniors account for 25% of all prescription medications taken in this country so it seems only reasonable that we consider this as a possibility. Many of the medications that seniors take can further inhibit the body's natural alarm systems placing seniors at an even greater risk.

Here are a few things you can do if you are a senior to protect yourself:

• If you live alone, arrange for a daily check-in call with a friend, neighbor, relative, etc.
• Wear warm clothing. Instead of tight clothing, wear several loose, warm layers. Wear a hat and scarf to avoid significant heat loss through your head and neck. Stay dry. Moisture from perspiration, rain, or melting snow can seriously reduce or destroy the insulating value of clothing because water conducts body heat over 25 times faster than air.
• Use extra blankets because hypothermia can develop during sleep.
• Eat nutritious foods and exercise moderately; proper diet and physical conditioning help protect you against abnormal heat and cold.
• Get proper rest; fatigue makes you more vulnerable to subnormal heat and cold.
• Drink adequate amounts of liquids, such as water. Limit your alcohol intake because alcohol speeds up body heat loss.

Check out this article from the SC Office on Aging about warning signs and dangers of hypothermia in senior citizens.  http://aging.sc.gov/seniors/HealthAndSafety/Pages/ColdWeatherTips.aspx

How Does Your Garden Grow?

I find some of my greatest life lessons in my garden. Last year, I built two raised bed gardens in my backyard. I had grand dreams of the food we would grow there. Initially, the garden I made was a thing of beauty. Rich black soil, the smell of fresh mulch, bees buzzing busily as they pollinated my crops. Each morning and evening I would water and preen by hand. In short order, my garden began to blossom. Then life happened. I got busy. I got too busy to continue to spend the amount of time that I had initially spent cultivating my garden. As a result, weeds and bugs began to invade. Before long, the fantastic thing I built was no longer.

So much of in-home care is a garden. Initially, we utilize a ton of resources to ensure that we are recruiting and training the very best caregivers available. The background check we run on all our applicants continues to be the most thorough available, the reference checks and drug screening we insist upon have set the standard for in-home care. But that isn't enough. We must continue to water and preen our garden lest the weeds and bugs should invade. This is the new battlefield for in-home care providers.

One of our two core values at Home Instead Senior Care in Chapel Hill is to exceed the expectations of everyone that we encounter. We call it our 4E's. Sadly, the expectations from seniors and their families are fairly low. They have become accustomed to a certain amount of tardiness, a certain amount of apathy, a certain amount of absenteeism when dealing with in-home care. Their experience with the industry has taught them what they can realistically expect. From day one, we fight against this "assumed reality" with our clients and our caregivers. From birthday and anniversary cards, to our P.E.A.Q. program, to our quality assurance visits, to our on-call policy, to our community involvement-Home Instead Senior Care is working to exceed the expectations of everyone that we encounter. As anyone who is happily married can tell you, relationships do not build themselves. Like gardens, relationships require constant effort if they are to grow.

Engaging the Lost Causes

When caring for people who are suffering from Alzheimer's and other forms of dementia, there comes a time when the person suffering loses the ability to communicate. During typical late stage Alzheimer's, a person may be bed or chair-bound, unable to speak, and in some cases completely unresponsive. Sadly, the temptation is to disengage from the person we love at this point. Why bother talking with them when they can't talk back? Why ask them questions to which they can no longer respond? While this approach is understandable to anyone who has dealt with this disease firsthand, it misses a huge opportunity to continue to connect with the people we care about.

During our Alzheimer's and Other Dementia training at Home Instead Senior Care, we deal specifically with late stage clients. We address the fact that just because the people for whom we are caring aren't able to verbally validate our attempts, we shouldn't be discouraged from continuing to interact with them. We should, however, amend the techniques we use in order to give them the maximum benefit of our involvement.

The techniques we use for late stage clients all revolve around the five senses: smell, touch, taste, sight, and hearing. These senses unlock a world of memories for the clients that we serve that we may never truly realize. For all of us, there are certain things which take us to another time and place.

-If I smell Cinnamon Butter Cake, I am transported back to my grandparent's house in Woodward, OK. I can see the large front door they had swinging open as my brother and I bound out of the car after a long drive up from Texas and into their waiting arms.
-The feel of a saxophone in my hands brings back memories of long band bus trips and cold competition mornings.
-The taste of tamales paints a portrait of Christmas in San Antonio that no artist could ever come close to rivaling.
-The sight of pictures of my kids in their toddler years brings smiles to my heart that last all day.
-If I hear the song "Two Princes" by the Spin Doctors, I find myself sitting in the back seat of Jana Davis' car on the way to school. She was a beautiful flute player in the high school band who as a senior agreed to give me a ride as a freshman so that I wouldn't have to ride the bus.

None of these journeys you can go on with me. For our dementia clients in their late stages, you can't go where they are headed either. You may never get the validation of knowing that you have given them the memory tool to take that mental trip. But we do not care for those in our lives in order to attain some personal validation, we care for them in order to provide them with the best possible quality of life. And on that mission, we never give up.

Alzheimer's and the Marvel of the Human Mind

Yesterday, I taught a group of our Home Instead Senior Care CAREGivers about Alzheimer's. As part of our C.A.R.E. initiative, we are teaching not only our caregivers but families as well.

As I taught the class, I couldn't help but notice one attendee who was not engaged in the material. After our initial period of instruction, we took a short break where I seized the opportunity to ask why she seemed so distant from the rest of the class. She replied, "This doesn't apply to me. I don't have any clients that have Alzheimer's."

It struck me just how typical that attitude is with regards to Alzheimer's and other dementia. And just how inaccurate. Since Dr.Alzheimer first discovered the plaques and tangles which are the indicators of the disease, there have been great advancements made. 100 years of medical research has brought an end to a number of formerly deadly diseases and chronic conditions. The human brain, however, remains an outlier. After a century of funding and research, scientists still stand in amazement at the marvel of the human mind.

As a Christian, it is my belief that I am not an accidental collection of cells that somehow, after a billion years of trial and error, managed to put themselves together in a manner that encompasses every facet of my functioning body as well as my personality. To take a hard look at the human body and believe that it is simply the result of chance requires, in my opinion, a far greater amount of faith than belief in a creator. I see intricate designs and systems which work in perfect harmony with one another. I see passions, desires, and creativity which make no sense in the scheme of "survival of the fittest" and would have likely been lost throughout the millenia if evolution were the only explanation for our existence. If the brutal battle for survival is solely responsible for our survival as a species then I think we should be a far less compassionate and reasoned people than we find ourselves. I digress.

On the matter of Alzheimer's and dementia, there is very little to show for 100 years of study. At this point, we cannot tell you who is more likely to develop Alzheimer's. We cannot tell you what causes Alzheimer's. We cannot therefore tell you how to prevent Alzheimer's. We are unable to effectively treat Alzheimer's. And we are unable to cure Alzheimer's. That is the reality of this tragic disease. The other tragic portion is the statistical inevitability that each and every one of us will be affected by it.

The greatest risk factor associated with Alzheimer's and other dementias is advancing age. The older you get, the more likely you are to develop symptoms. In 2011, the Alzheimer's Association reported that an estimated 5.4 million Americans of all ages have a type of dementia. Over the age of 65, the number of people with Alzheimer's narrows to one out of every eight. If you live to the age of 85 or beyond your risk of Alzheimer's increases to one out of two.

You may choose to bury your head in the sand and pray that you will not be one of the people struck with Alzheimer's. You may not have anyone in your immediate circle who is currently struggling with dementia. Since half of all seniors who live to be 85 will be stricken with this tragic disease, it is unreasonable to assume that you will not be affected in some way.

Join us for a family education event in Chapel Hill on December 4th and 6th from 6pm-8:30pm. The classes will be held at the Chapel Hill Carrboro Chamber of Commerce office, 104 S. Estes Dr. Chapel Hill, NC. Please RSVP to 919.933.3300 so that we can provide adequate materials for all in attendance. I look forward to seeing you there!

Still Funny

Several years ago, at our Home Instead Senior Care International Convention, a senior citizen named Mary Maxwell delivered the invocation. Part prayer, part hilarious rant about aging; it left us all howling with laughter. The Youtube video has since gone viral with almost 10 million views but I still crack up every time I watch it. Enjoy!

http://www.youtube.com/watch?v=vPFCn3itBFE

Both Sides

I have been blessed by so many things in my life. Among the most wonderful of these blessings is my wife. I like to think that we have 'a groovy kind of love.' We have had our ups and downs but after 11 years there have been far more ups than downs. After a decade, she still takes my breath away.

On Monday evenings, we host a church small group comprised mostly of younger couples. We enjoy sharing in the excitement of their marriages and in walking with them through the reality check that often occurs after about six months of living with a new spouse. Ah, young love.

At work however, I am privileged to be able to observe the other side of  love. I meet almost daily with husbands and wives who are living out their covenant vows in often painful and trying circumstances. I see wives who are doing everything possible to preserve the dignity of the man that they adore as his mind and body are ravaged by the effects of Alzheimer's disease. I see husbands drive daily to sit by the bedside of the love of their life and softly sing a song to which they used to dance. No longer able to walk, they hold hands and dance through their memories together. It is a poignant, beautiful thing that I get to see. It is a picture that moves me to cherish my bride even more.

Two members of our small group, Ben and Brittany recently walked through a moment like that earlier in their marriage than they had ever imagined. Complications surrounding the birth of their twins put the survival of the mother and both of the daughters in jeopardy. We give thank God that Brittany and both of the girls are home and doing very well. Today is Ben and Brittany's two year anniversary. Somehow I think that he will  hold her a little closer today than maybe he did before. Not because he didn't love her before but because he has now seen both sides.  The blinding affection of young love is intoxicating but fleeting. The mature resolute love that has been tested and yet endures is sacrosanct.

http://vimeo.com/15103432

Am I Going To Get Alzheimer's?

Alzheimer's disease is one of the most tragic things to potentially happen to a senior. But so many people suffer from the fear of Alzheimer's for years unnecessarily. While there are a multitude of theories and speculations regarding this disease, the disappointing reality is that we still don't know much about it. Sure we can tell you what it does, what it looks like, and how it generally progresses but we still can't tell you who is going to get it. We can't tell you who is most at risk. We can't tell you how to slow it down. We can't tell you how to stop it. After a hundred years of research, we can't tell you how to cure Alzheimer's disease.
The lack of concrete answers hasn't stopped us from inventing our own realities. I grew up watching my grandfather work the crossword every morning and adopted a 'use it or lose' mentality regarding Alzheimer's. Many others take fish oil supplements or avoid certain foods or chemicals. These may all be great habits to form but there is relatively little scientific evidence which suggests that they are anything more than wishful thinking.
For anyone with a genetic connection to it, the fear of inheriting Alzheimer's disease can become an all consuming force. Everything you forget somehow translates into a sure sign that you have the disease. Studies have shown that there are relatively few cases of Alzheimer's which can be attributed to genetics. Some studies put the number at less than 1%! Early onset Alzheimer's can be cause for alarm. These are situations where someone will develop Alzheimer's prior to turning 65. In those instances, there is a stronger probability that someone in their family might develop Alzheimer's as well. Those cases represent less 5% of all documented diagnoses and therefore shouldn't strike premature fear in our hearts. If someone in your family develops Alzheimer's well after their 65th birthday there is no significant cause for alarm as the biggest cause of the disease is increasing age. In fact, by the time someone reaches the age of 85, the odds of them developing Alzheimer's disease is around 47%.
So the simple answer to the question 'Am I going to get Alzheimer's?' is that we just don't know. If you live a long time you run a greater risk.
As a father of five young children, I have become increasingly forgetful in the last few years. At times it has caused me to ask the same question. Am I going to get Alzheimer's? But then I think about what Jesus said. ""Therefore I tell you, do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on. Is not life more than food, and the body more than clothing? Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they?  And which of you by being anxious can add a single hour to his span of life?  And why are you anxious about clothing? Consider the lilies of the field, how they grow: they neither toil nor spin, yet I tell you, even Solomon in all his glory was not arrayed like one of these. But if God so clothes the grass of the field, which today is alive and tomorrow is thrown into the oven, will he not much more clothe you, O you of little faith?  Therefore do not be anxious, saying, 'What shall we eat?' or 'What shall we drink?' or 'What shall we wear?' 32 For the Gentiles seek after all these things, and your heavenly Father knows that you need them all. 33 But seek first the kingdom of God and his righteousness, and all these things will be added to you. 34 "Therefore do not be anxious about tomorrow, for tomorrow will be anxious for itself. Sufficient for the day is its own trouble. Matthew 6:25-34

Wheelchairs at the Gym

Several years ago, my family took a trip to Disney World. My wife was eight months pregnant with our fourth child. Our three other boys were old enough to enjoy it but young enough to still be a handful. My mother-in-law and her significant other were with us as well. Initially, I was a bit dismayed by the last addition because her significant other was still recovering from a recent hip surgery and I was certain would slow us down dramatically. What I didn't realize was that anyone on a wheelchair or motorized scooter goes immediately to the front of every line- WITH THEIR ENTIRE ENTOURAGE! I am not proud of the way that we exploited his physical malady that day but I can say that with three kids and a pregnant wife we set a land speed record for most rides and parks in a single visit that still stands.

In the video clip below, Mary Maxwell talks about some of the disadvantages of this type of posturing in places other than Disney. Happy Friday!

http://www.caregiverstress.com/2012/08/seniors-at-the-gym/

Three Crimes to Watch For

Home Instead Senior Care franchises across the country are in the middle of a public education campaign to protect seniors from fraud. According to a recent Metlife study, the annual financial loss incurred by seniors as a result of fraud is $2.9 billion. The Metlife study group the fraud perpetrated against seniors into three categories: crimes of occasion, crimes of desperation and crimes of predation.

Crimes of Predation-
This is what most people think of when they think about seniors being defrauded. Crimes of predation are crimes that spring out of relationships which were formed for the sole purpose of stealing from a senior. The fake charity that calls for a donation, the bogus repairman who "fixes" the shaky porch railing, the fraudulent termite inspector that treats for an infestation.

Crimes of Desperation-
These are the crimes that are rarely discussed. Crimes of desperation are typically committed by family or close friends. Usually, the person committing the crime is dependent upon the senior in some way financially. In my experience, I have seen children drain their parents finances or deprive their parents of the type of care they need because they don't want to spend what they already view as their inheritance. In these instances, the children don't believe that there is anything wrong with taking from their parents because they feel that they have somehow earned it.

Crimes of Occasion-
This type of fraud is usually committed just because the opportunity presented itself. The senior had money or something of value, the opportunity presented itself and the person took it.

For more resources on how to prevent crime against seniors visit www.protectseniorsfromfraud.com

A Sad (but fairly typical) Story

We are all familiar with the woeful reputation of Cinderella’s evil stepmother. Certain roles in a family structure are notorious in repute. They become historical punchlines- the old ball-n-chain, the in laws, the mother in law, the crazy uncle. They are funny to talk about because at some level and in some cases there is partial truth to them.
Recently, I spoke with a woman dealing with the care of her father. Her dad recently celebrated his 90th birthday and has started to exhibit some symptoms of mild dementia. He remarried about 15 years ago much to the chagrin of all of the children and the relationship between these adult children and their new “evil stepmother” never warmed. However, there was one topic on which they all agreed. They promised their dad/husband that they would never put him in a facility. This promise was to become the wedge that would drive the family apart.
Over the last several months, Dad’s condition has worsened. Not tremendously, but certainly to the point where the day to day aspects of providing care for him have become overwhelming for one person to handle. Suddenly, the promise to keep him at home is relative for his new wife. A nursing home seems the only acceptable solution. As one of the daughters told me this story her anger for her stepmother and the broken promise was palpable. This was not the plan. Dad deserves better.
One of the things we stress during our initial training sessions for new caregivers is the critical importance of taking care of the caregiver. As a caregiver, the rigors and demands of serving the increasing needs of a senior are staggering. The emotional toll of caregiving creates a level of stress to which even the most empathetic observers are oblivious. This stress manifests in different ways for different people. Upset stomach, insomnia, canker sores, back pain, headaches, loss of appetite, depression, among other symptoms are things to which we teach our caregivers to pay close attention. YOU ARE NO GOOD TO SOMEONE ELSE IF YOU DON’T TAKE CARE OF YOURSELF FIRST.
This “evil stepmother” is not truly evil in my opinion. Her desire is not to break the heartfelt promises of a family to an elderly man. She is a family caregiver who has reached her breaking point and been pushed beyond it. She wishes to put her husband into a retirement home because it is the only option she can see. It is the only relief in her sight. While any rational observer may be able to see that resources and help are available, she is no longer a rational observer. She is exhausted on a level that her “evil stepchildren” can’t comprehend. And the lack of understanding on both sides is what drives the wedge and fuels the stereotype.
Are you a family caregiver? For help managing stress visit- http://www.caregiverstress.com/