Category Archives: Alzheimer’s

A Test for Alzheimer’s

Earlier this year Ohio State University Medical Center released the Self-Administered Gerocognitive Examination (SAGE). This self administered test is meant to identify individuals with mild thinking and memory issues at an early stage. That’s really important because cognitive changes that are caught really early can be treated much earlier and generally have better treatment outcomes. This fifteen minute test can be taken at home and involves simple tasks like making change, listing items, making comparisons, and drawing geometric shapes. These activities test reasoning, problem solving skills and memory. When the Journal of Neuropsychiatry and Clinical Neurosciences released the study about the SAGE test, the demand for the test online was so huge it crashed the computer server at Ohio State University. That underscores the need for easily accessible and useful testing for cognitive issues like Alzheimer’s and other forms of dementia. Dr. Douglass Scharre, the neurologist who developed this simple test, claims it is just as accurate as other commonly used but lengthier and more complicated cognitive tests.

All this being said, you need to be aware that all the media hype surrounding this test is just that — hype. This test by itself can’t formally diagnose Alzheimer’s disease nor any other forms of dementia. At worst, you could interpret the results as a false positive and panic that you’re getting dementia. At best, it can identify some possible cognitive issues that may be developing. It could then serve as the needed push to have a frank conversation with your doctor. Taking the test can also provide a baseline for comparison with later testing. It can flag problems that can be monitored over time. Your family doctor remains the first and best source of information and evaluation of any cognitive issues that arise. How do you feel about taking a self-administered test for dementia? Share below and visit us at http://www.trilliumhomecare.com

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Is It Reversible?

As our parents or someone we care for age, we may notice some behaviors and symptoms often associated with Alzheimer’s. Perhaps our loved one has gotten a bit forgetful or just can’t think of someone’s name or the correct word during a conversation. Maybe they seem to be getting a lot of “senior moments”.  It’s very easy to panic and assume they may be getting Alzheimer’s.  Actually, that panic is a good thing.  It may motivate us to get our loved one in to see their doctor.  If Alzheimer’s is the cause of their symptoms, early treatment may slow the progression of this disease.  Even more importantly, if it isn’t Alzheimer’s, it may be totally reversible.  Yes…….reversible.  That’s why it’s important to get the right diagnosis quickly. 

Early diagnosis is necessary so treatment can begin before any permanent damage to the brain occurs.  The most common cause of reversible dementia is medication.  The aging body reacts differently to medications.  The liver doesn’t work as well in terms of metabolizing the drugs and the kidneys are slow to eliminate them from the body.  This combination makes the amount of drugs in the body accumulate quite quickly.  Multiply this retention by the higher number of drugs consumed for a variety of medical problems and you end up with a lot of medication in your system at any given time.  The drugs that can cause dementia like symptoms include: corticosteroids, sedatives, antihistamines, heart medications, and antidepressants.

A low level of Vitamin B12 is another culprit.  A very low level of this vitamin causes pernicious anemia.  The first symptoms of this type of anemia are slowness, confusion, and apathy.  Sound a lot like Alzheimer’s, doesn’t it? B12 injections can eliminate the deficiency and get rid of those symptoms.

Another common disorder, a thyroid hormone imbalance, causes dementia like symptoms.  Hyperthyroidism, which is an overproduction of thyroid hormones, as well as hypothyroidism, which is an underproduction of thyroid hormone, both cause what looks like dementia.  Removing the thyroid or a thyroid replacement medication can often reverse the dementia.

So you see, panicking about what looks like Alzheimer’s can be a good thing.  If your loved one is diagnosed with Alzheimer’s, early treatment will help slow its progression.  If the symptoms are caused by some other underlying condition, the cognitive problems may be reversible or well managed.  In either case, the sooner you know, the better the results will be.  What’s your experience been?  Share below and visit us at http://www.trilliumhomecare.com

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Missing the Clues

As our parents or someone we care for age, we may start to notice some changes in their behavior. There are times when they just don’t seem like their old selves.  In the midst of conversation we sometimes have to fill in a word or name for them.  No problem…..after all, your memory fails as you get older.  Maybe we notice a stack of unopened mail or unpaid bills.  Once again, you can chalk it up to an aging memory.  And then there was the time Mom sent that telemarketer a ridiculous amount of money and got nothing for it.  In her defense, she is a very trusting person and he was a really smooth talker….how could you not help someone in need?  When you look at these incidents one at a time you can easily rationalize that they occur occasionally and at irregular intervals.  As these symptoms of dementia (we hate to admit that’s what they are) continue we will eventually have to stop ignoring them and take action.  At that point, lots of the past behaviors take on a different meaning.   Getting lost on the way to a grocery store our aging loved one has frequented for the last 20 years is not a part of getting older.  Neither is the seemingly gradual decline in personal hygiene or grooming.  We excused the extra bolts on doors and locks on garden gates we were asked to install as simple precautionary measures taken by a senior citizen living alone when in fact it may have been a sign of paranoia that often accompanies dementia.  Perhaps all those times Mom or Dad didn’t want to go to a family gathering or return a call from an old friend weren’t the result of just being tired.

The problem is that as all these events go on around us, we go on living our busy lives going to work and raising our families. These behaviors start slowly and it’s so easy to excuse them and deny that maybe something is wrong.   After all, no one wants to think their loved one has Alzheimer’s or some other form of dementia.  We want to believe it’s all just a part of getting old.  As caregivers, we have to let that mindset go.  We are doing our loved ones a disservice if we minimize their symptoms. We end up robbing them of an early diagnosis and the opportunity to actively participate in any decision making about their future lives.  In addition, an early diagnosis translates into early treatment that can slow the progression of this disease and keep your loved one at home longer.  It’s important not to miss the clues.   Visit us at http://www.trilliumhomecare.com

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Am I Getting Alzheimer’s

As we get older, we may start to notice some “senior moments”.  So just which row did we park the car in while at the mall?  Who hasn’t forgotten at one time or another where they set their car keys?  Lets see….is today Wednesday or is it Thursday? Darn it….I forgot the electric bill was due yesterday!  As these moments occur, it’s natural to start wondering about Alzheimer’s and other forms of dementia.  Nowadays, there are a lot of web sites offering tests and quizzes to help us decide if we have a variety of illnesses including Alzheimer’s.  There are some that even allow us to submit a variety of symptoms and then obtain a list of possible causes or diseases.  Baby boomers are a much more computer literate group of people than their parents ever were and they increasingly turn to the internet for all kinds of information including medical advice.

That being said, there are a lot of reasons to catch the onset of Alzheimer’s early.  One of the most important reasons is to rule out other causes of memory loss such as a Vitamin B12 deficiency or thyroid problems.  Many of these causes are treatable if not reversible.  Knowing if you’re in the very early stages of Alzheimer’s allows you to start treatment earlier which is important because  medications for Alzheimer’s have been shown to be more effective the sooner they are begun.  An early diagnosis allows you to prepare for the inevitable effects of Alzheimer’s which is currently incurable.  You’ll have time to make medical and financial decisions and those who care about you will have time to develop a better understanding of how your behavior will change. This is an important consideration for literally millions of people.  According to the Alzheimer’s Association there are over 5 million Americans dealing with Alzheimer’s and this number is expected to balloon to over 7 million by 2025.

The thing to remember is that just because you lost something, or forgot a word or someone’s name, doesn’t mean you have or are getting Alzheimer’s.  There are age related changes to your memory that you will develop as you get older.  By all means DO NOT put your faith in any online quizzes or tests promising to give advance warning of oncoming dementia or Alzheimer’s!!!!  According to the National Core for Neuroethics at the University of British Columbia in Canada, these online tests are absolutely unreliable.  They rate “poor or very poor” for scientific validity.  If you have concerns about memory issues, go see your doctor. Trust his medical expertise to help sort symptoms out.  If he confirms your fears, you’ll get a head start on treatment.  If he tells you your suspicions are groundless, you can relax.  It’s a win-win course of action.   Have you ever taken one of those self-diagnostic tests?  Share below and visit us at http://www.trilliumhomecare.com 

 

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The Silver Alert

You’d be hard pressed to find anyone these days who hasn’t heard of the “Amber Alert” which requires law enforcement to issue public bulletins to the media as soon as a child is reported missing.  If an adult is missing, the family has to wait 24 to 48 hours before they can even make a missing person’s report.  If you care for someone who has Alzheimer’s or some other type of dementia, you know the first 24 hours your loved one is missing can be the most critical.  There are almost 275,000 people in Michigan with some form of dementia and this number is expected to sky rocket as baby boomers age.  More than 60% of them will wander at some point.  This wandering will result in serious injury or death to almost half of them  within the first 24 hours they are missing.  Time is critical here and waiting 24 hours to report your loved one is missing will just stack the cards against their safe return.

 

Now there is hope.  In 2012, Governor Snyder signed the Mozelle Senior Or Vulnerable Adult Medical Alert Act into law.  It requires the police to take a report of a missing senior or disabled adult as soon as the department is notified. 

Before this law was enacted, the police were required to obtain documentation and signatures from appropriate people to verify that the missing person had dementia or was on life-sustaining medication.  This caused a delay in getting the name into the Law Enforcement Information Network system.  Now the word of the person reporting the missing senior is enough to get things rolling. The police are required to immediately forward all the information to all the law enforcement agencies that have jurisdiction in the area where the person disappeared.  This information also has to go to at least one media outlet in that same area.  With this new law  the search for a missing wanderer can begin well before that first 24 hour critical time period has passed.  For a caregiver faced with a missing wandering loved one, the odds for a safe return have just gone up.  Have you ever had to deal with a missing loved one?  Share below and visit us at http://www.trilliumhomecare.com

 

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Managing the Wanderer

If you care for someone with Alzheimer’s or any other form of dementia, you have a 60% chance of having to deal with your loved one’s wandering behavior. Those are pretty high odds and especially frightening for a caregiver. Let’s face it, you can’t be with someone every minute of every day and wandering may be impossible to prevent in all cases. Take heart because there are practical steps you can take to minimize the dangers.

First and foremost, make sure the home environment is secure. Be certain there are secure locks on the windows and all the exterior doors. A keyed deadbolt lock that’s placed up high or down low on the door may be out of your loved one’s line of vision and less noticeable. Hanging bells on the door will alert you if someone is trying to get out. Disguising the door by painting it the same color as the wall may serve to camouflage it and deter the instinct to go through the doorway. Hanging a “STOP” sign on the door can help bring out the long ingrained response of actually stopping. If your loved one gets confused in their search for a specific room like the bathroom or bedroom, it may help to hang a picture on the door of what’s behind the door.

Try to keep any visual reminders of traveling out of sight. Don’t leave car keys, shoes, and jackets, purses, or anything that may remind your loved one of going somewhere, in plain view. Pressure sensitive alarm mats can be placed in front of doors to alert you if someone tries to leave. These are also great placed beside a bed to let you know if your loved one gets up at night. Baby monitors throughout the house can help you keep track of your loved one when you’re in a different room.

Although it does involve some expense, fencing your yard is a good idea. Make sure there are locks on the gates and any outside paths shouldn’t lead right to the gates. This may actually provide a safe place for your loved one to fulfill that need to wander. It’s also a good idea to let your neighbors know about the wandering. The extra eyes and ears will be priceless if your loved one gets out. Sewing your loved one’s name and phone number in some inconspicuous spot on their clothing will help identify them if they get lost and someone tries to guide them back. A combination of these measures will go a long way toward keeping your wanderer safe but if they do get away, call the police IMMEDIATELY. What measures have helped you keep your wandering loved one safe? Share below and visit us at http://www.trilliumhomecare.com

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I Wish I Had Known

Years ago when my mother was in her late 70’s something changed.  She had been a widow for over 20 years and was quite self-sufficient and lived in her own home near her children. She worked in her yard, did her own cooking and grocery shopping, and took great care of her pet cat and dog.  Her major health complaint was her knees—she had bad arthritis in her joints and found it harder and harder to get around.  Her hands ached and often felt stiff. As I noticed small changes in her functioning ability it seemed natural for me to help out.  Her clothes didn’t seem to get laundered as often as they should have  been but I was sure the location of the washer and dryer in the basement made it hard for her to get to them with her bad knees and all. No big deal…I could throw a load in the washer and dry it before I left whenever I stopped by.  One day I realized there wasn’t much food in the refrigerator, just a bag of fried chicken fast food sandwiches.  She must have had a great coupon and walking behind a shopping cart was surely getting hard for her.  She liked my cooking so I just made extra and dropped it off on my way to work. In time, the house needed a thorough cleaning.  That darn cat and the dog sure know how to make a mess!  She started not paying her utility bills on time but she was “old school” and liked paying them in cash at the bank.  I’m sure she didn’t go to the bank because it was hard to walk all the way across the huge parking lot….I wrote checks for the bills when I stopped by and dropped them in the mail—no problem. And then one day she got lost on the way home from my house even though she had driven that route for 20 years.  I chalked it up to her distraction because we had had a disagreement when she was over. If someone had suggested to me that she had the beginnings of dementia I would have scoffed at the idea and told them they didn’t know what they were talking about.  She didn’t have any language problems and was never at a loss for words. She didn’t repeat questions and she knew to the penny exactly how much money she had in her bank account!  That sounds like a pretty sharp person to me. As the years passed she became more disorganized, forgot appointments, and couldn’t keep her medications straight. Her personality changed and she became more suspicious of everyone and everything around her. I began to wonder….does she have dementia or the beginning of Alzheimer’s? We never found out because she passed away before we could get a diagnosis.  The moral of the story is….If you suspect that someone you love or care for is changing somehow, talk to their physician. Your natural instinct to compensate for an aging parent or loved one may cause you to miss a true diagnosis.  Symptoms of dementia can   mimic several other diseases and health conditions. These symptoms are often treatable and reversible and the sooner you know something the sooner you can do something. If it is dementia, the symptoms can often be managed if diagnosed early enough.  I wish I had known. Please visit us at http://www.trilliumhomecare.com

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Who Is A Caregiver?

     As our parents get older it’s pretty typical of them to slow down a bit.  They may have some mobility problems or develop a chronic illness. Maybe they forget something now and then.  Slowly, almost unknowingly, you start to pick up the slack. Maybe the night before garbage day you give them a reminder call.  When you stop by, you bring in the mail or drop off some dinner leftovers that you know they enjoy.  After all, it’s no big deal.  Slowly, what you do involves more and more of your time.  You take them to their doctor appointments so you can hear first hand what the doctor has to say and help them keep their medications straight.  You start doing the yard work or making sure the snow gets shoveled.   In time, you become responsible for more aspects of their lives: the finances, household chores and medical management.  To you, this is a labor of love.  You’re grateful for all they’ve done to raise you and you’re “just doing the right thing”. You are needed.

     As time goes by, you have less and less time for your own life, your family, and your job.  You may feel resentful and then feel guilty because you are resentful. You may feel helpless and fearful—after all, how long can you keep this up?  It’s time to recognize that you’re not just “giving back” to someone you care about.

YOU ARE A CAREGIVER!  You have joined the ranks of the 21% of adults in the United States who provide unpaid care to an adult needing physical, financial, or emotional support.  Sixty to seventy percent of these caregivers are women and thirteen percent of these caregivers are over the age of 65. 

     It’s important to recognize your role and to realize that you are not alone.  Acknowledge your feelings and talk about them.  Try to enlist help from family and friends.  Joining a caregiver support group online, at your local senior center or hospital can be very helpful.  Enlist the services of a homecare agency to help you with your labors or to provide some respite for you.  Know that what you do is important and a work in progress.  How did your role as a caregiver develop? Share below and visit us as http://www.trilliumhomecare.com

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The Wanderer

 

If you care for someone who has had a stroke, has Parkinson’s, or has Alzheimer’s, you may also be dealing with your loved one’s memory loss or confusion.  This memory loss or confusion can result in your loved one wandering away from home.  This behavior is incredibly dangerous and especially terrifying for you as a caregiver.  It’s estimated that at least 60% of those suffering with some form of dementia will wander away from home.  If not found within 24 hours, the odds that something deadly will happen to them greatly increase.  Even more frustrating is the fact that the wanderer probably won’t call for help if they get lost and won’t respond to someone calling their name when looking for them.

     There are some steps you can take to help deal with wandering.  Try to make the home environment more secure.  A fenced backyard with locked gates provides a safe area to stroll and wander in.  Make sure there are locks on windows while installing sliding bolt locks way up high or down low on the door out of the line of sight may prevent trips outdoors.  Sometimes just setting a child proof gate across the doorway may be enough to deter wandering.  You might want to install door chimes that ring when someone goes through a doorway, signaling you of your loved one’s attempt to leave. At night, a pressure-sensitive alarm mat placed next to the bed can alert you when someone gets out of bed.  Make sure any car keys are well hidden so there won’t be any getaways  in a car. Every extra set of eyes and ears is helpful so let your neighbors know if your loved one is a wanderer—-they may notice them well before you know they’re gone.

     For a nominal fee, you can register your loved one with the Alzheimer’s Association Safe Return Program which will provide an identification bracelet with a toll-free number that police can call to report finding your lost wanderer. When you report someone getting lost, their picture and medical information is easily faxed to law enforcement agencies.  You can register by calling 1-800-772-8672.  What other measures have helped you manage wandering? Share below and visit us at http://www.trilliumhomecare.com

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Feel the Rhythm

     Currently in America there are over 5 million people being affected by Alzheimer’s.  As this dreaded disease progresses, we as caregivers will notice that it gets harder and harder to reach and engage with our loved one.  We’ll also notice our loved one become more agitated when they are frustrated or are unable to express themselves. Agitation can also be a response to your loved one’s inability to handle stimulation around them.  

     According to the Mayo Clinic, new research suggests listening to music can help our loved ones who have Alzheimer’s. Music’s greatest asset is its ability to improve behavioral issues. The reason it can be effective while your loved one continues to lose cognitive functioning is because music is processed with every part of the brain. In fact, involvement with rhythm requires very little cognitive ability so your loved one will respond even in the later stages of Alzheimer’s. 

     Start out by making a music playlist.  Stick to the type and style of music your loved one used to listen to and is familiar with.  Better yet, if you know any specific pieces or tunes they enjoyed, use them.  If you know what was popular in your loved one’s young adult years, go with those too.  If your loved one is in the late stages of Alzheimer’s, try folk songs and music from their childhood.  Pay really close attention to how your loved one responds to the different pieces.  If they grimace or become agitated, remove that selection from your playlist.

      Match the type of music to the response you’re looking for.  If you want to calm your loved one during a mealtime or when getting ready for bed, choose soothing music.  Something with a slow tempo and little percussion would be a good idea.  If you are trying to stimulate you loved one to move more try using music with a quicker tempo and some percussion.  You can encourage movement by suggesting your loved one claps to the music or taps their feet. If your loved one seems to get agitated at the same time every day, try playing soothing music just a bit earlier – it may help ward off the agitation.

     Have you ever used music to help your loved one get through the day?  What worked for you? Please share below and visit us at http://trilliumhomecare.com   

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