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Question of Month

Alzheimer’s disease – behavioral therapies

All medical providers list behavioral treatments as the primary treatment for Alzheimer's Disease. But due to the fact that it is not a pill the emphasis on its value is frequently forgotten. There is a treatment that works today today and can grow with the patient and household as Alzheimer's disease advances which is to find the very best team of caregivers you can. Discover the best caregiver you can who can support you with the ups and downs of this progressive process that is Alzheimer's condition and the many associated but less labeled part of aging that go with it. We suggest you find the most complete care team possible and develop ongoing relationships with them. In fact, the best treatment comes when you can find a care team that includes the administrator, owner, managers, and caretakers who can become relations to your loved one and family.   Family-style Alzheimer's Caregivers   The social connections are essential to get even more caring and psychological communication from both caretaker and homeowner. Without a social connection and current relations gatherings to share care is generally more ordinary and ends up being job oriented which is devoid of sensation, sharing, and emotional connectedness. For instance, each physical task holds the opportunity to share a social connection if the care group knows the close friends, household, and comings and goings of each resident. When that level of social connection exists the physical task of helping with person care can consist of conversation about local's marvelous kids, a recent household call or occasion. Those social connections and interaction considerably enhance the sensations of trust and being taken care of that are the basis of the behavior modification all suggest as the primary treatment for Alzheimer's illness and all disease. Aarp   Wikipedia definition Eden Project or Alternative    Examples of Alzheimer's and Dementia Care homes with Family Style care. http://tlcsr.com Family-style domestic care houses http://tlcsr.com/ResidentialCareHomes.html Tender Loving Care Senior Residence IF YOU ENJOYED THIS POST – LIKE AND SHARE IT.   Dr Shawn McGivney

Alzheimer’s Disease Treatment. – Pills

In this section we talk about Alzheimer's disease treatment and focus on the medications. Aricept and Namenda Pills like Aricept, (Donezepil), Namenda and Exelon might assist if you have an extremely pure case of very early age Alzheimer's which tends to have fewer co morbid concerns that need to be considered. Tacrine ( Cognex) Tacrine (Cognex) was the first of this course however had a lot of adverse effects it never became a basic treatment. Then when Aricept was presented with less adverse effects and adverse effects like stress and anxiety that were more challenging to see and different form the process of dementia it became popular as an expect the therapy of Alzheimer's illness. In fact, one has to be careful when studying the advantages observed from all of these medicines to confirm that they are assisting. Exelon Patch, Exelon Other medicines in this course include galantamine (Razadyne - formerly referred to as Reminyl), rivastigmine (Exelon). They also prevent the enzyme acetylcholinesterase that damages acetylcholine and consequently enhance the concentration of acetylcholine in the blood and tissues. Remember pills are just a small part of Alzheimer's Disease Treatment. Aricept  , Exelon Patch   http://www.aricept.com/ http://www.webmd.com/drugs/drug-14335-Aricept+Oral.aspx?drugid=14335&drugname=Aricept+Oral, http://en.wikipedia.org/wiki/Exelon Namenda XR Memantine is a oral medication for treating patients with Alzheimer's disease. Other medications made use of for Alzheimer's disease affect acetylcholine, among the neurotransmitter chemicals that afferent neuron in the brain use to communicate with one another. Memantine's impacts are independent of acetylcholine and acetylcholinesterase. Glutamate is the main excitatory neurotransmitter in the brain. It is thought that too much excitement of afferent neuron by glutamate may be responsible for the degeneration of nerves that occurs in some neurological diseases such as Alzheimer's condition. Like other neurotransmitters, glutamate is produced and released by afferent neuron in the brain. The launched glutamate then travels to close-by nerve cells where it attaches to a receptor on the surface of the cells called the N-methyl-D-aspartate (NMDA) receptor. Memantine blocks this receptor and therefore lowers the results of glutamate. It is assumed that by obstructing the NMDA receptor and the results of glutamate, memantine might secure afferent neuron from excess stimulation by glutamate. Typically physicians incorporate Namenda with other medications but the advantages of this strategy need to be recorded by the care team who see the client regularly. We applaud more research however want to focus on our belief that the most cost effective and best treatment plans are not pill based however caregiver and individuals based. http://en.wikipedia.org/wiki/Memantine Pills Pale in Alzheimer's Treatment efficacy compared to People While physicians typically do not concern themselves with stabilizing costs total in a homeowners care strategy one ought to consider if the $50-100 / mo co pay might be better spent by paying to have a friend take that person out for lunch once a week or spending for a more skilled and socially linked caregiver. Be sure to follow our blog and read the next part in Alzheimer's Disease Tips.  Alzheimer's Disease Treatment Caregivers and Behavioral therapy   Check out Tender Loving Care Senior Residence as an example of superior treatment through continuity of care. Thanks for the Like and Share Dr Shawn McGivney  

Alzheimers Disease diagnostic criteria

While the requirements for diagnosing Alzheimers disease have been upgraded and now attempt to concentrate on identifying phases of senile dementia of the Alzheimer's type (SDAT) in fact that is really subjective. For example if they have mild memory loss that is early, even more amnesia that is affecting their life more that is moderate and when advanced, after a long 10 year course of decline then they call it severe. Virtually talking,  that is very little aid. Alzheimers Disease Diagnostic Criteria   Another mainly unstudied issue is the truth that plaques and tangles which are thought to be so important in at least early beginning Alzheimer's Disease before 60 yrs old are confused when you include the reality that before the 1980's and the introduction of CT of the head was started it was not used to include what in fact is a a lot more likely cause of cognitive loss which is small strokes. These can be called TIA, micro-vascular finding, or UBO's on MRI. What we do understand is that it is way to very early to say what Alzheimer's is and is not and how to separate out and quantify just how much of each part of aging that is influencing each of these Alzheimer's cases. New Alzheimer's diagnostic criteria. We applaud  this study effort and keep in mind a strategy to establish a tracer so we can in fact follow the plaques and tangles to lastly attempt to associate amount and sort of plaques and tangles which is the first step to in fact find Alzheimer's and then establish treatments. Without that are reacting to drugs and since plaques and tangles are so typical in normal brains the rest is much less scientifically and reproducible.   Missing diagnostic elements for Alzheimer's disease The diagnostic requirements are subjective and are complicated by constantly consisting of that "the signs and signs can not be due to any other issue." In fact, older people have many concerns like poor balance, some quantity of dysphoria from numerous sorts of loss numerous verging on mild depression. Alzheimer's disease and SDAT Resources   Alzheimer's research to define dementia is needed.  However, brain diseases are hard to study and mild alzheimers will be hard to distinguish from personality disorder and just mild mood disorders.  Unfortunately defining the stages of any process has wide variation and alzheimers disease stages are no different. Early senility, early-stage, early onset Alzheimer's Disease or moderate alzheimers are issues. In severe stage alzheimers one of the biggest issues in treatment are the related delusions, paranoia that come with it. Foundations like alz.org and the Alzheimer's association and all alzheimers research has value.  But right now and most likely forever, the best, most cost effective, treatment is finding the best care givers and care team you can.   National Institute of Neurological Disorders and Stroke   Family Style Alzheimer's care.   IF YOU ENJOYED THIS POST – LIKE AND SHARE IT.   Dr Shawn McGivney      

What is Alzheimer’s Disease?

Definition of Alzheimer's Disease Alzheimer's disease is a neurological disorder where the death of brain cells triggers amnesia and cognitive decrease. A neurodegenerative sort of dementia, the condition begins moderate and gets gradually even worse. Types of Dementia Like all types of dementia, Alzheimer's dissease is triggered by brain cell death. Alzheimer's is a neurodegenerative condition, which means there is progressive brain cell death that occurs over a course of time. Obviously if that cell death is because of little strokes or low blood flow that is actually more of a stroke. Many times that distinction is difficult to make with subtle vascular occasions. That difference becomes an issue about the anticipated efficacy of the medicines that are focused on increasing acetyl choline in the brain like Donepezil (Brand Aricept). It is thought that increased concentrations of acetyl choline are responsible for the enhancement seen throughout therapy with donepezil. Diagnostic confusion affects Alzheimer's treatment. One possible reason for the restricted impact over all of those given Aricept is that in fact they have strokes or a substantial part of vascular dementia which would not be expected to enhance. Pathological Changes in Alzheimer's The total brain size reduces with Alzheimer's - the cells has considerably less afferent neuron and connections. Nerve cells (neurons) in the brain. In Alzheimer's, there are tiny 'plaques' and 'tangles' in between and within brain cells. While they can not be seen or tested in the living brain affected by Alzheimer's disease, postmortem/autopsy will always show small additions in the nerve cells, called plaques and tangles:. Plaques are chosen from in between the dying cells in the brain - from the accumulation of a protein called beta-amyloid (you may hear the term "amyloid plaques"). The tangles are within the brain neurons - from a disintegration of another protein, called tau. While they think plaques and tangles are part of the picture it is yet unidentified how lots of plaques and tangles correlate with the quantity, kind, and degrees of amnesia, loss of adl's, or any of a much broader array of signs and signs. Likewise it is extremely fascinating to note that most regular 80 year olds who die from other causes but who had no or little memory loss at age 80 have considerable varieties of plaques and tangles at autopsy. Therefore, it is very tough to measure and differentiate how many plaques per high powered field on a microscope cause an offered level of signs and symptoms in each individual patient. All of these make it difficult to accurately define Alzheimer disease and the stages of Alzheimers Disease.  Alzheimer's  Educational Resources http://en.wikipedia.org/wiki/Alzheimers Alzheimer's foundation of America Alzheimer's Association   Thanks for the Like and Share Dr Shawn McGivney  

Residential Care and Assisted Living Caregivers Tips (part 3 of 3)

assisted living caregiver Care givers come in all shapes and sizes and in all senior care settings including home care, Assisted Living Facilities, Residential Care Homes and most commonly traditional families who are lucky enough to be able to care for their loved ones at home. When families and family caregivers don't have the time, skills, and physical plant or house set up then we look to other care settings for paid caregiving services.  In those settings Tlcsr always advocates that you meet the entire care team to see if they operate as part of an extended team and to make sure the day to day care givers are working side by side and are on a first name basis with the owner, administrator, and mangers who are suppose to be guiding them, training them, and providing the complex back up and support they need. Never forget care giving is a team event be it in your own family caregiving system or in a paid caregiving system.  Moreover, senior caregiving is like the sports you follow on TV and all players roles matter for the best outcomes.  Since you need the doctor, administrator of the broader caregiving staff, and need emergency and problem solvers for the insurance claims, getting the medicines, transportation, and many other things you need to think about caregiving teams. Part three: Both Paid Caregivers and Family Caregivers need to develop their care teams.  Those who supervise you as a caregiver need to include you in the care process and visa verse. Trust and team connectedness are earned more than they are purchased.  Work with your broad medical, administrative and extended care teams. Minimize tension and enhance the care you provide by enhancing communication with all other specialists' physician, pharmacist, registered nurses, owners and administrators and other caretakers. DISCOVER WAYS TO CONNECT WITH THE DOCTOR, PHARMACIST, AND INSURANCE BUSINESS AS AN INTEGRAL PART OF THE CARE TEAM. Discover ways to connect with the physicians and other members of the care team the doctor directs. You belong to a group that begins with the physician and center administrator. You are not alone, ask concerns and rely on them for support. By doing so you can improve care and minimize your very own anxiety in looking after ill individuals who are going to have medical, social and financial problems that you can not resolve and treat. You need to be and feel like you are part of a team. Find out the best ways to communicate efficiently with doctors. Organize clinical information so it's up to date and simple to find. Make sure legal files are in order.       Team building requires working together on a first name basis to know each other doctor, nurse, paid caregiver and extended family caregivers to earn each others trust. Trust cant be purchased, just like caring can't be purchased but is earned.  To enjoy work you need to trust and feel connected to your care team.  When the team feels connected the are will feel more like an extended family care team which is what every one should shoot for and look for.  You need to meet the team leaders and direct care staff to see and feel that connectedness, trust, and passion. We applaud other writers for suggesting these facts too. Caregiving is a skilled job and is not an unskilled one! We suggest reading material from +Anne-Marie Botek on Agingcare.com who always discusses how difficult all forms of caregiving are from nursing to custodial care giving.  We all are caregivers to those we surround ourselves with at home and work. For those trying to find caregiver jobs, they will be hired to participate in geriatric care, elder care, nursing home care and various medical related areas all of which are skills. We suggest employers extend training to caregivers for all job listings to ensure the highest levels of elder care.   Care giving is a team job! This article by Anne-Marie Botek starts to show the complexity of the care team in a nursing home or more institutional care setting with nurses, social workers, activity people and then the harder to find doctors and administrators. Who’s Who in Skilled Nursing: Staff Caregivers Should Get To Know What we want to suggest is that on that team you should look for a leader and a leader who knows the names of the care team you are buying or using. That is not easy. A big facility or institution operates on a business model and six sigma efficiency and if they don't value taking time to know their own team members names or to meet what some describe as "low pay" or less skilled people it is likely the care will be more assembly line in style and not have what we call Family-style care with social connectedness.  While the opportunity for training is lost also I believe the emotional and social loss might be even more important. Choosing the assisted living care team is a choice. It is up to each of us to look for that family-style care team and then to value it and pay for it.  One way we can recognize the skilled caregivers is to pay at least minimum wage.  Yes, until 1/2015 caregivers often got not just less than but much less than minimum wage.  It is unimaginable that any person can be their best if you show with pay and words that they are somehow "less skilled".  Just my view.  I value my care team and know each member by first name and hope that people can look for the same elsewhere.  I often compare any medical or assisted living care team to a professional sports team.  There are many members of the team with different complimentary skills but they realize you need all parts to win or in the case of Assisted Living Services provide the most family-like care possible.  My view is families know each other by name and share day to day simple experiences if your caregivers, team leaders are not doing that, the care might be less family-like and more assembly line.  Don't be the next DVD player on the line, be yourself. Summary By doing all of these you can improve the care you provide, feel even better personally about what you are doing, and integrated a future as a calm, reputable caretaker for those families caretakers touch so personally every day. Care giving is not simply a paycheck but is a social service and there are numerous in-kind social and psychological benefits that are shared amongst the caregiver, homeowner and the many prolonged members of each person's social system. We need to value those who care for us more in our own households and the extended family care teams we all connect with everyday in the health care system. Residential Care alternatives to the Assisted Living and Nursing Home Rehab.   Many do not know that Residential care homes are the most cost effective care choice by far.  Tlcsr is a great example of high quality care and value. Tender Loving Care Senior Residence - Educational video links Family caregivers  AARP- caregiving resource center     LIKE AND SHARE IT. Dr Shawn McGivney

Residential Care and Assisted Living Caregivers Tips part 2 of 3

This is part two of Residential Care and Assisted Living Caregiver tips.  We all forget who the caregivers in our lives are, families and extended social system.  But we need to remember them, thank them and remember that they have emotional, social, and finanial needs also.  Money is often not the most important thing in life and in caregiving that is even more true. Mothers, Informal Caregivers of all types, and Senior caregivers are no exception.  Here is a recap of part one. Part one Recap.  Take care of your self. Part two: Use technology to maintain your own social and emotional health but do not use technology as a substitute for real, in person, human contact.  Technology supplements human contact and does not replace it. Use technology to stay connected to your own friends and family, and social support system. Be open to new technologies that can help you be even more connected for your residents but only after you take care of your own emotional needs. Recognize that care giving is a very skilled job. Just like sales, being a knowedgable doctor, computer expert are skilled so too is being a care giver.  The skills are hard to obtain and are often mis valued.  Making other people feel improtant, in control, giving people hope, and allowing others the life experience to make choices and live with them without judgement or imposing your wishes, wants, and expectation is the skill. You need to know about medical equipment and advanced communication techniques including how to reach many different people over many different methods including phone, phone messages, text, email, and fax. Usage innovation to stay linked to your own friends and family, and social support system.  In Assisted Living or Residential Care Homes you often are under staffed and can use Skype, a cell phone or the internet to get some much needed emotional relaxation and social support from your own friends and age appropriate acquaintances. Be open to new innovations that can assist you look after your loved one. Acknowledge that care giving is a really knowledgeable task. You have to find out about clinical devices and advanced communication techniques consisting of ways to reach lots of different individuals over numerous different techniques consisting of phone, phone messages, text, email, and fax. Lean how to use high tech equipment like baby monitors and other devices to view from a distance and afterwards blend that into regular personally contacts. These balancing acts are never ever easy, are always changing but those balancing acts of knowledge on all members of your group, social and emotional resources, and hands on contact are all parts of the innovative skills the best caretakers have. Innovation cannot replace a social relationship since that is required by all human beings to feel for another person however it does assist, expand and supply balance to both homeowner and caregivers psychological needs. Whether you are a paid caregiver like a hospice caregiver or a family caregiver you need to know and build your broader care team. Tune in next time for Part 3 of 3. Example of Residential Care alternatives to the Assisted Living, Nursing Home Rehab.  Compare Family -Style care of a Residential Care Home to Nursing home and Assisted Living which are more institutional care models. Always meet the care team form administrator and owner to direct care giver's before you buy or move in to know who and what you are getting. Tender Loving Care Senior Residence -   Educational video links TLCSRLV youtube Channel.  Subscribe for free. Home Care Info Eden Project or Alternative    THANKS FOR LIKING AND SHARING  Dr Shawn McGivney        

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