A Cure for What Ails Many Parkinson's Patients

Recently, I met with a group of team leaders for the upcoming, Moving Day. Moving Day is an event which benefits the National Parkinson's Foundation and has recently been making local headlines as we approach our very first Moving Day event to be held on November 2 at the Koka Booth Amphitheater in Cary. The team kickoff event was everything I hoped it would be; full of tear filled stories, and unflagging optimism in the face of a terrible challenge. At one point, as is often the case, Michael J.Fox's name came up. I have found there to be a general gratitude among the Parkinson's community for the awareness he has brought to a disease which for a long time has lurked in the shadows despite the overwhelming number of people diagnosed. There is, however, some frustration, with Fox's foundation and some of the attention that he has brought to Parkinson's disease. That frustration appears to be that people assume that what Michael J. Fox struggles with is indicative of ALL Parkinson's patients. That is simply not the case. Parkinson's, much like Alzheimer's disease, affects each person in a dramatically different manner. People who don't know this incorrectly assume that everyone with Parkinson's must shake uncontrollably. If the physical manifestation of this assumed characteristic isn't present then the person is driven to make other and even more incorrect asumptions about the severity of the person's Parkinson's or how far the disease has thusfar progressed. Ignorance.

That being said, there are some common themes that many people struggling with Parkinson's experience. Among them, the loss of dexterity. Simple tasks like opening a jar or buttoning a shirt can become incredibly difficult. For former NC State Football Coach, Don Horton, that moment came during an away game when time was of the essence. Fortunately, former NC State Quarterback Russell Wilson, noticed Horton's difficulty buttoning his shirt and stepped in to lend a hand. When Don Horton returned home he opened up about the trouble he had had to his wife, a former children's clothing designer, and an idea was born.

MagnaReady Shirts are men's dress shirts equipped with magnets in place of buttons to make getting dressed easier for people struggling with Parkinson's and any number of other disabilities. From the outside they look like an ordinary dress shirt complete with buttons and all. The best attribute of this shirt is something that you will hopefully never notice.

There is currently no cure for Parkinson's but MagnaReady Shirts offer the next best thing; a daily victory in the battle for independence.

 http://www.newsobserver.com/2013/03/29/2788830/husbands-parkinsons-disease-inspires.html

New Test Could Prove Effective for Early Diagnosis of Parkinson's

Parkinson's disease, much like Alzheimer's disease, is not diagnosed until symptoms appear. Each year, 60,000 Americans visit their physicians with irritating little symptoms such as a tremble in their fingers or lip only to hear those dreaded words: Parkinson's disease. There is no way to predict who will get Parkinson's disease. There is no way to prevent someone from getting Parkinson's disease. There is currently no cure for Parkinson's disease. But new research is now giving hope that there may be an earlier way to diagnose Parkinson's disease. By measuring the amounts of five protein biomarkers in spinal fluid, doctors may be able to identify patients with Parkinson's disease far earlier in the process. "The earlier patients are identified, the more likely that new therapies, including targeted drugs that are designed to replenish waning dopamine levels, can be introduced. The hope is that such treatments might eventually reduce or even prevent some of the disease’s more advanced and debilitating symptoms."
 http://healthland.time.com/2013/08/27/promising-first-test-to-detect-parkinsons-disease/

Senior Fraudsters Arrested in Our Area

Ten people are in jail in Raleigh/Durham for defrauding seniors after being arrested as a part of "Operation Nail It", a task force targeting con-artists who victimize seniors by pretending to do home repair work. Earlier this year, Home Instead Senior Care put a number of resources out into the community as a part of our campaign to help prevent senior fraud. In home repair scams, a serviceman will typically come directly to the home unsolicited and point out some repairs that desperately need to be completed. They will usually demand payment up front for the "services" but in actuality the only service they provide is the removal of funds from a victims bank account. Hear one senior's tragic tale of fraud below:

http://abclocal.go.com/wtvd/story?section=news/local&id=9188886

For tips on how to protect the seniors in your life from con-artists like this go to: www.protectseniorsfromfraud.com

Low Testosterone Shown To Increase Risk For Parkinson's

In a recent study, a drop in the testosterone levels of male mice caused them to manifest symptoms that appear to be very similar to those found in Parkinson's Disease. Male testosterone levels typically peak in the mid-30's and then decline around 1% each year thereafter. The decline can be made more sudden by other factors such as stress or other life events. Low testosterone has also been linked to an increased risk for Alzheimer's. Given that men are already known to be 1.5 times more likely to develop Parkinson's, the link to lower testosterone levels seems to make a lot of sense.

http://www.medicaldaily.com/articles/17863/20130728/mouse-study-shows-link-between-low-testosterone.htm

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

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

Woman Marries for the Fourth Time at 80 Yrs Old

A local woman made headlines this week when she married for the fourth time at the age of 80. When a local news station interviewed her recently, they asked her a myriad of questions about life, marriage, happiness, and of course her new husband. 

 The interviewer asked her questions about what it felt like to be marrying again at 80, and then... about her new husband's occupation. "He's a funeral director," she answered.

"Interesting," the newsman thought.

He then asked her if she wouldn't mind telling him a little about her first three husbands and what they did for a living. She paused for a few moments, needing time to reflect on all those years. After a short time, a smile came to her face and she answered proudly, explaining that she had first married a banker when she was in her 20's, then a circus ringmaster when in her 40's, and a preacher when in her 60's, and now - in her 80's - a funeral director.

The interviewer looked at her, quite astonished, and asked why she had married four men with such diverse careers.

She smiled and explained,

"I married one for the money, two for the show, three to get ready, and four to go."

 

- Thanks to HISC franchise owner Karin Lindblom for sending this to me.

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

6 Kids and Counting

The rumors are true. I have six children. Let me rephrase that. I have six, beautiful, perfectly healthy, intelligent sons. To say that I am blessed doesn't nearly encapsulate all that I have been given. The fact that my wife and I have brought six children into this world with little to no medical complications is miraculous. The fact that we have even been able to conceive six times is amazing. And yet, the one reaction that we consistently receive from those around us is pity. The pity is especially profound when people find out that we have six BOYS. "Oh you poor thing!" "You  must have been just desperate for that girl." "Oh your poor wife!" And my personal favorite: "Don't y'all know what causes that?"

The last several weeks have been emotionally draining for me. I am, by nature, an empathetic person and tend to carry emotional baggage for the people in my life. There has lately been much baggage to carry. I have close friends that have lost babies, are facing the possibility of losing a baby, are facing the possibility of losing a young child, or have been trying desperately for years to have a child to no avail. Each night they come home to an empty nursery or find themselves curled up in a vinyl hospital chair praying that God will somehow intervene.

I believe that we live in a fallen world. I believe that this world was created perfect and pure and that  because of our rebellion against the Creator things have deteriorated to this point. I believe that death and disease and sickness and heartbreak were not the Creator's intent. I believe that there is a battle being waged between good and evil because I see the evidence of it all around me. It is everywhere I look.

And then I see my children. I see my six, beautiful, perfectly healthy, intelligent sons. For whatever reason, God has gifted my wife and I with the ability to bring good things into this world. Each one of my sons stands in defiance of a world where babies die and people hurt. Their laughter and joy reminds us all of a purity lost but not forgotten.  I have no doubt that we battle an enemy who seeks to kill and destroy. I have seen his victories in the lives of those who matter most to me. Each of my sons is a victory over his wicked agenda. Each of my sons is a reminder that the Creator of life has not forgotten us. In a cruel and dark world, they are a beacons of goodness and light. My children strengthen my hope in the God who promised that he will return and make all things new again.

And so for the people who seem so bewildered by the size of our family, for those who are perplexed by our ever-increasing brood, for those who in word and thought pity us for the "burden" we have to raise a large family, I would point you to the book of Psalms chapter 127 verses 3-5.

"Behold, children are a heritage from the Lord, the fruit of the womb a reward. Like arrows in the hand of a warrior are the children of one's youth. Blessed is a man who fills his quiver with them! He shall not be put to shame when he speaks with his enemies in the gate."

My children are a blessing. They are a rich reward that someone else paid dearly for me to receive. I will cherish them as such and continue to welcome every blessing God chooses to send my way.

What Good is Long Term Care Insurance?

I have heard countless horror stories about insurance. It seemed to be ubiquitous during the debate leading up to the passage of the new healthcare law. Insurance companies are out to get us! Evil corporations are profiteering on the misfortune of others!

Unfortunately, the positive aspects of being insured never receive the same fanfare as the tales of woe which are politically useful when public servants are attempting to push an agenda. I suppose they don't make for interesting news stories. "Stay tuned to hear about how a father purchased insurance for his family and then received the benefit to which he was entitled when his son broke his arm at a middle school soccer game." Next.

At Home Instead Senior Care, I have the opportunity to visit with families each day who are faced with the fiscal reality of what it takes to provide quality care for their aging parents. Most are thrust into being a family caregiver without any warning or forethought. They wake up at 3am to a phone call letting them know that their relationship to their parents has forever changed. They thought they had more time. Many have no plan in place. As a result, they will spend the years to come in a constant tug-o-war between the desire to give their parents the best care available and the financial reality of providing that care. Sacrifices will be made. Compromises will be agreed upon. Regrets will endure.

Other families will never face that music. They will likely wake to the same phone call at 3am. Their lives will probably also change with little or no warning. They also thought that they had more time. But they have a plan in place. Years ago, their parents saw the proverbial writing on the wall and purchased a Long Term Care Insurance(LTCI) policy for themselves. Their children will still work to give them the best care available but will never be forced to make the same heartbreaking decisions as others in similar situations. They will have tools and resources at their disposal as a result of their parents' foresight.

There are horror stories about every type of insurance policy not providing benefits in the way in which it was expected but those stories are the rare exception and not the rule. The reality is that most of us go through life paying for insurance policies which protect us against things from which we will likely never suffer.  Most people will live their lives without ever suffering a catastrophic injury or illness. And yet there is a tremendous sense of urgency to be insured 'just in case.' A LTCI Policy is the one type of policy that is not a 'just in case' arrangement. You will get older. You will need help. It is only a question of when. And when that time comes, how will your children provide for you?

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

Dementia Observations

I was watching on of my favorite "lazy Sunday afternoon movies' this weekend, A Few Good Men. At one point in the movie, the lawyers are discussing their case when Tom Cruise's character says: "It doesn't matter what you think. It only matters what you can prove!" Sometimes art really does imitate life. But then again, sometimes it doesn't.

There are a number of things that I have learned in my years at Home Instead Senior Care. Some lessons I have learned correlate with specific scientific studies and factoids which validate my amateur assertions. Most of the time, however, my experience has taught me things that medical science may not publish.

This is one of those times.

There is an old adage about Alzheimer's and dementia which states: "Once you've seen one case of Alzheimer's, you've seen one case of Alzheimer's." That is true. And while every person who battles with Alzheimer's has a unique story to tell, there are some fairly consistent themes. Alzheimer's is typically a steady progression. It may be a fast progression. It may be a slow progression. In every case I have seen, it is a steady progression.

Here is a theoretical (and in no way related to a real person that I spoke with recently) example.
A previously competent father falls one morning and is admitted to a hospital for observation. After being discharged, he is sent to a rehab facility where he can receive medical attention for his wounds until they are healed. Within days of admittance into the facility, he begins to show massive signs of confusion and is hardly able to carry on a conversation. The family contacts me and says- 'He won't be able to return home now that his Alzheimer's has progressed.'

This is not the Alzheimer's that I have seen. Whenever there is an immediate drop in cognitive function, there is almost always another cause. There might be a stroke or some other type of event. Most commonly, it is a result of medication changes in my experience. Senior's kidneys work less efficiently and therefore make them more susceptible to the effects of 'pharmacological tinkering.'

So if you see someone who was as 'sharp as a tack' yesterday and 'doesn't know he's in the world' today, chances are that it isn't Alzheimer's.


[Opinions expressed therein are observational in nature and do not constitute a medical diagnosis. Lair Family Ventures LLC dba Home Instead Senior Care are not liable for any damage done if reader adopts what was previously stated as an opinion as a matter of fact. But seriously people, why would you look to a blog to diagnose or treat anyone. I'm flattered. But seriously?]

The Wonderful Wizard of Hos-pice

Last week I found myself visiting with the daughter of an aging parent. After reviewing their situation, I mentioned that it might not be a bad idea to contact a hospice organization. As soon as the word "hospice" escaped my lips, I found myself face to face with a hysterical daughter who sobbed uncontrollably at the imminent passing of her father. That wasn't what I said!

At Home Instead Senior Care, we often partner with hospice organizations. Home Instead is dedicated to the mission of helping people live life on their own terms. So is hospice. Home Instead recognizes that there are certain realities that are naturally associated with the aging process that cannot be avoided. So does hospice.

Many people think about hospice as a place but in actuality it is a philosophy of care. Hospice can help patients and their families begin to deal with whatever is happening to them on their own terms and in their own time frame. If life is a journey, think of hospice as a travel agent. Hospice helps coordinate community resources and helps you to know where to go in order to get the very best of everything. While most of us try to cheat death at every turn, there has only ever been one man who has managed to defeat death. That makes the human mortality rate pretty close to 100%. If you are the child of an aging parent and are approaching the point where care is more important than cure then I would highly suggest getting in touch with a hospice organization. They are truly wonderful people and have been a tremendous comfort to to the clients we have partnered with them to serve.

It's Not A Toomah!

Don't you just hate armchair physicians? Well intentioned people who roam the streets and speak half-truths into the lives of those around them, usually without being asked, drive me crazy. I generally resent unsolicited advice of any nature but on the healthcare front I find myself especially agitated by pseudo-doctors who feel the need to diagnose and offer treatment suggestions whenever I sneeze, cough, or just feel a little off.

Seniors face a number of challenges with regards to the normal aging process. Certain things just start to wear out after about 70-80 years. When I meet with the family of a prospective client, I take care to question where each claimed illness has been diagnosed. Specifically with regards to dementia, I find that many seniors are living life under the impression that they have Alzheimer's or dementia. Out of all the illnesses that befall the elderly, none is more terrifying than this one. A disease which causes you to lose your memories and any sense of who you are is not a diagnosis that should be lightly made. Yet we see countless examples of this at Home Instead Senior Care. We see huge numbers of seniors who live in fear of Alzheimer's disease because they momentarily forgot where they put their house keys and some well intentioned person mentioned dementia as a reason.

If you happen to be one of those people who feels the constant urge to offer possible explanations to anyone who is suffering from anything at any given time, please pull Alzheimer's and dementia out of your little black bag of non-authorized diagnosis doom. While I appreciate your desire to help it is only fair to point out that you lack the medical training with which to squeeze a pimple and therefore have no business diagnosing a disease that has befuddled the brightest minds in the medical community for over a century. It's not a toomah!

Gimme the Candy!

To say that there are an abundance of children in my neighborhood would be an understatement. Our house sits on the corner of two cul-de-sacs which, in total, represent 32 children. Halloween is kind of a big deal. Nevertheless, I am guilty of two Halloween sins. First, I turn my lights off before the candy is really gone. Once the stash of candy has run down to the dregs, I flip the light off and retreat to my lazy boy (aptly named) where I work to avoid the stomach ache which will undoubtedly follow the consumption of that many Sour Patch Kids. Second, I lie to my children. My oldest son has a peanut allergy and we therefore must screen all of our children's loot to ensure that there are no peanut candies hiding in the mix. Over the years, my wife and I have taken increasing liberties with the screening process. My kids are now convinced that there are many candies that could potentially spell disaster for people with a peanut allergy. Such as: Gummy Savers, the aforementioned Sour Patch Kids, Smarties, Rolo's, Swedish Fish, Airheads, Nerds, Sweet Tarts, Now-n-Laters,  and anything with dark chocolate in it. These are a few of my favorite things. Following the onslaught of our neighbor's goodwill, the kids all come back home and dump their goodies onto the living room floor where I scour the contents of their respective pumpkins, removing all "risky" items. Safety is important on Halloween.

I thought this blog was about seniors?

Relax, I'll get there.
One of the parts of the natural aging process is the reduction in the body's ability to taste things. This is due to a number of factors such as a reduction of saliva production as well as a reduction in the actual number of taste buds. Frequently, you will see older people dumping unholy amounts of salt, pepper, vinegar, Tabasco, etc. onto everything they eat. They don't decide to begin bathing their food in hot sauce because they have suddenly gone cajun at the ripe old age of 65. They do this because it is the only way they can taste the foods. The reduction of a senior's ability to taste their food has a couple effects which merit words of caution. First, it is no fun for older adults to eat so they don't. The only thing worse than eating by yourself is eating a meal you physically can't enjoy by yourself. Proper nutrition is important at every stage of life but probably most of all for seniors, some of whom are managing chronic conditions. These conditions can be greatly exacerbated by poor nutrition. At Home Instead Senior Care, our caregivers pay special attention to the nutritional needs of seniors and work to make meals more enjoyable. They do this not only through companionship but also by working to make mealtime more of an event. Eating out of microwaveable cardboard container stinks even with good conversation. Setting a nice table goes a long way toward making meals more palatable even if it is only for the eyes.

Ok. But how does this have anything to do with Halloween and your crimes against children?

Hold on to your hats because I'm about to bring it all home.
Riddle: If you are unable to taste anything except for things that are exceptionally salty or sweet and suddenly find yourself with an abundance of Halloween candy, what will you probably eat?
Answer: All of the leftover Halloween candy.
The days following Halloween are great times to visit the senior in your life and check in on the nutrition front. Look to make sure that there isn't a ton of candy left over which could pose a significant health threat in the absence of other foods. Plan a trip to the grocery store to provide nutritious companions if not alternatives to the belly full of Snicker's Minis that will represent the first thing your senior has been able to taste in weeks.

If the senior in your life is unreceptive to this kind of assistance then I would encourage your children to be more insistent about that second or third treat in the basket. Arm them with kind words like: 'It's for your own good,' and 'Because we care.'

Have fun and be safe tonight, dear readers. Happy Halloween!

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.

A Turn For the Worse

If I had a nickel for every time I heard the phrase "Since she has been at the hospital, Mother's dementia has taken a turn for the worse," I would be a very wealthy man. The idea that hospitals cause dementia is an amazing phenomenon to me that way too many people accept at face value as a universal truth of aging. Hospitals do not cause dementia. Granted, with the size and confusing layout of most hospitals even I forget how to get back to the parking garage from time to time. The fact that so many seniors never have the opportunity to return home from a hospital stay due to the mysterious "dementia monster" attacking them upon admission is troubling. The fact that this absurd logic is never even challenged is downright maddening.

What causes dementia is, in fact, a mystery. Scientists know that the greatest risk factor is advancing age but beyond that the entirety of medical knowledge on the subject resorts to what can be most aptly described as a "best guess scenario."The sudden, rapid progression of dementia is a far less complicated matter to investigate than actual dementia. So allow me.

In the normal aging process, senior's bodies begin to function differently than they did  in younger years. Kidneys do not function as efficiently as they once did. This particular facet of aging, I believe is responsible for a huge percentage of the post hospital rehab admissions today. Imagine this scenario:

A woman, age 94, has lived independently since her husband's death two decades ago. She continues to be fairly engaged in the community and has a caregiver who comes in twice a week to keep her company and assist her with errands and chores around the house. At times, she has troubling recalling certain things but the things she forgets will generally come back to her and do not interfere with her daily life. She is a model for aging with independence. One day she slips and falls while retrieving the mail. Due to the brittle nature of her bones, she fractures her left hip requiring surgery. The surgery goes extremely well, especially considering her age, and the doctors all say that after some quick rehab she should be fine to return home with limited assistance as before. Not so strangely, she begins to show confusion following surgery. It is gradual at first and then increases rapidly. The doctor's offer a simple explanation. Sometimes in a hospital situation, a senior's dementia takes a turn for the worse. AAAAAAAAAAAAAGH!! With respect to the kind hearted medical professionals, allow me to postulate another theory. This particular 94 year old has avoided medications for most of her life wherever possible. She takes a baby aspirin every morning and a multivitamin because an episode of Donahue told her that doing so might reduce her risk of certain cancers. Suddenly, due to her hip fracture, she is being given an anesthetic for the actual surgery, a sedative to help her sleep at night, a medication to prevent constipation, and Oxycodone to ease the pain. When you combine that cocktail with the knowledge that her kidneys are not filtering these drugs effectively, another possible diagnosis presents itself. She isn't suddenly demented. SHE IS HIGH!!

I wish I could tell you that this woman eventually stabilized and was able to return home. I wish I could tell you that she wasn't discharged to a skilled nursing facility where she was administered a daily dose of instant-dementia for the rest of her days. Most of all, I wish I could tell you that her's was a unique story. But alas, I am unable to make any of these statements and instead sit here at the keyboard typing, collecting a nickel for every time that I hear that someone's dementia has taken a turn for the worse.

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!

The Foul Ball

This is the story of an unbelievable experience I had while caring for one of our clients. It appears as it was published in Fifteen-501 The Magazine.

"As the owner of a senior care company, I've learned that spending as much time as possible with clients keeps me in touch with what I believe to be the heartbeat of our business. While most still live in their homes with our assistance, many clients reside in facilities. For the latter, we provide a much-needed escape from the monotony that can have a devastating effect on the morale of those who, despite their outward appearance, feel no different than they did 40 years ago.

I had the privilege of taking one such client, Mr.H, to a Durham Bulls baseball game last season. Mr.H, who lives in an assisted living facility in Chapel Hill, has moderate dementia. As with many who suffer from this condition, there are things about his life that are clear as a bell and others that elude him: He can't tell you what he did for a living for 35 years or how he came to be in Chapel Hill, but he can tell you what it was like to storm the beaches at Normandy, how cold the water was, and how he prayed that he would make it to the beach before he was shot down because he didn't want to die drowning.

He can also tell you what it was like to watch Babe Ruth take batting practice during the late 1920's, and how the effortlessly the slugger knocked 10 or 12 balls over the fence. In medical circles, they call these memories "moments of clarity." A s a student of history, I don't mind the repetition of stories, so we spent the first five or six innings of the game talking through some of these moments. He asked me several times whether I had ever caught a foul ball, and mentioned how he couldn't believe that in 83 years of attending baseball games he'd never caught one himself.

As the day wore on, the heat finally got the best of us. After the seventh inning stretch, we decided to call it quits. He asked the foul-ball question again as we were leaving, and I replied that we'd have to wait until next time around. At that exact moment, we heard the crack of the bat and both turned to look. the ball floated in the air toward us in almost slow motion, and after what seemed like an eternity, it landed-- literally--at Mr.H's feet. I bent down, picked it up, and handed it to him. He had caught his first foul ball.

The ride back was quiet to say the least. The entire experience was surreal. He spent most of the time tossing the ball between his hands, smiling, quietly uttering, "Eighty-three years. I can't believe it. Eighty-three years."

When we returned to the facility, he shook my hand, thanked me again and began to walk inside. After four or five steps, he turned around and looked down at the ball, then back at me.

"Maybe you can come sometime and we can have a catch," he said. "Sure," I replied. "It would be my pleasure."

I know Mr.H might not remember that I was the one who took him to the game that day. I know he might not be able to recall what teams were playing. I do know, however, that he'll remember the day that he caught a foul ball. I know that as cloudy as his mind might be, that moment has joined the pantheon of Babe Ruth and Normandy, and I was there to see it. I got to see an 83-year-old become just another boy at the ballpark. I watched a man come alive, if only for a moment.