The Lesson of Daffodils.

I stood in my living room this morning looking out at the world. Dead leaves. Dead grass. Mud colored snow that had yet to melt away. No matter which direction I looked, the evidence of life was hidden from me; slumbering under a blanket of somber beige. There was dreary everywhere, everywhere except for my neighbors mailbox. There, in the midst of all this drab, were bright green shoots of daffodils already beginning to make their ascent toward spring.

It is a lesson I learn every year. Every spring I promise myself that next year my yard, my garden, my mailbox will host these optimistic plants. I make resolutions that I will plan ahead and plant before the ground freezes so that the happy daffodils will be there to greet me long before the rest of the world has begun to thaw. But then...life happens.

Stuff gets in the way. Good stuff. Important stuff. Necessary stuff. Stuff distracts me from the relatively simple task of putting some bulbs in the ground. As a result, I stand in my living room after an endless week of snow and ice looking for daffodils which I have neglected to plant...again.

I recently visited with a couple who is doing their best to care for each other without the benefits of any family to assist. With both spouses approaching their 90's, the fact that they have been able to live independently for as long as they have is nothing short of amazing. Unfortunately, as in so many cases, an event took place a few weeks ago which has changed the trajectory of their journey. One spouse gave too much and ended up paying the price of her own health. Now they are separated from each other in every way. Questions abound. Who will care for him while she recovers? Who will manage finances while she is away? Who will manage the many prescriptions and dietary needs that need daily tending? So many questions that needed to have been answered long before are now left to be decided by friends and neighbors. However well intentioned, this remarkable couple is on the verge of losing the one thing they fought so long and hard to retain: control over their own lives.

The warnings were there year after year. Make a plan. Designate a POA. Establish advance directives. Write a will. But then...life happened. Stuff got in the way. Good stuff. Important stuff. Necessary stuff.

And the daffodils are their remind the rest of us every spring.

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

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/

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?

Carnivore with a Side of Vegan

As a professing Texan (as if there was any other kind), I soundly reject all aspects of the plant based approach to survival. In my mind, heaven looks like an amazing cookout. Jesus, Moses, Noah, Paul, John and I are all sitting on a deck somewhere in Texas in mid-April. Perfectly marbled, 2 inch thick rib-eye steaks are sizzling their way to a glorious medium-rare and some of Texas' finest craft beer waits to be poured while we talk theology and Aggie football. Paradise.

Yet the growing number of studies being publishing which detail the tremendous health risk of an animal based protein diet have certainly gotten my attention. I read them all online with a skeptic's eye and then quickly delete my browsing history lest someone should suspect me of considering them as a viable alternative to carnivorism.

Recently, I found myself watching an excerpt from a speech given by Neal Barnard MD. In this excerpt, Dr.Barnard speaks of the huge health risk that a diet high in saturated fat poses. He goes as far as to state that minimizing the levels of saturated and trans fat intake substantially lowers the risk for Alzheimer's Disease and Mild Cognitive Impairment. While I do not personally subscribe to some of the more extreme steps that he and many of his colleagues recommend for reasons previously stated, I do believe that our country consumes far too much meat and far too few vegetables. Watch the video below but tell no one you saw it here.

The Fine Line Between Binging and Moderation

Researchers at Rutgers University have reported that binge drinking can decrease the development of adult brain cells by as much as 40 percent. Whew! I sure am glad that I don't have a binge drinking problem.

Not so fast. Also included in the study is information about the thin line that tends to separate drinking in moderation from what many consider to be binge drinking.

It has long been accepted as truth that a couple glasses of wine each day are a good way to promote cardiovascular and brain health. However, lead author of the study, Megan Anderson, cautions "Moderate drinking can become binge drinking without the person realizing it. In the short term, there may not be any noticeable motor skills or overall functioning problems. But in the long term, this type of behavior could have an adverse effect on learning and memory."

According to the National Institute of Alcohol Abuse and Alcoholism, men who drink 14 drinks a week and women who drink 7 are considered at-risk drinkers. While many people commonly assume that binge drinking is a strictly collegiate phenomenon, the statistics counter that assumption. According to the institute, 70 percent of binge drinking involved adults age 26 and older. "This research indicates that social or daily drinking may be more harmful to brain health than what is now believed by the general public."

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.

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!

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.

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/

9/11

We remember all of those who lost their lives on this day 11 years ago.