Tag Archives: Alzheimer’s Care

Dr McGivney’s new solutions for Alzheimer’s family caregivers.

Dr McGivney’s new solutions for Alzheimer’s family caregivers.

angry-caregiver Its common knowledge: Helping to care for a sick or dying loved one exacts a steep emotional toll. Many studies find  that caregivers rate their stress level as high, and many acknowledge they have less time to spend with family and friends. This is not new news.

Most experts also note that family caregivers should take care of themselves first.  They caution that not doing so might put the family care giver at  risk of emotional exhaustion, health problems and even caregiver burnout which can lead to more stress full interactions with the one you are caring for and your own family.

Common caregiver tips

Put your physical needs first.

Take a break.

Deal with your feelings.

Find time to relax.

Connect with friends.

 

Ask for help.

Call on community resources.

Get organized.

 

Stay positive.

 

What all of these great suggestions lack is the how do you do it.

They skirt the real questions of how to pay for it, how to get the skilled team of staff you need and then how to retain as much senior control over their life as possible while having the plan for the future.   None of the above “tips” address the facts that caregiving is time consuming, expensive, and very emotionally charged especially for family caregivers.

Senior-Man-son-worried senior-couple-checkers

The fact is senior care and care giving is time consuming, skilled and expensive. 

As your parents age and undergo the usual cognitive changes and often times changes compounded by dementia with paranoia those changes increase the stress for family caregivers who have to deal with the fact and  normal emotional resistance all humans have to accepting defeat and losing control over their lives. 

 

Less well known Alzheimer’s Disease Behavior Triggers – Being the son or daughter!

Any father or mother is upset by knowing or just feeling they have lost the role of father to a son or daughter and now are the child.  That is not a feeling any of us ever are prepared for and is a root cause for many difficulties for family caregivers.

In fact the son is taking more control of the parent’s life and decision making but it is out of necessity.   That is a very difficult thing for normal human parent’s minds to accept.  That goes against all emotional survival training our parents have learned thought out life.  In all cases, the go to emotional and coping approaches of be positive and think better things are coming no longer work.  We need to accept that to fix it.

Beleidigter-Senior  pouting-senior

 

 

 

Other triggers for needing more Dementia Care

The trigger and worsening of that understanding or exaggerated belief often comes when a family notes mom or dad needs more help than incidental family assistance.  For example mom can’t reliably take her pills and  someone else needs to fill the pill box and remind her two or three times a day to take the pills.  The issue of safe driving or signing an estate plan and essentially giving away all of your money with no known, expected, proven extended family care plan or extended family care team to reasonably rely on for care of the parent as they age.

If we ask ourselves how would our nuclear family care for us if we were in an car accident right now and we needed that amount of help we would correctly be concerned too.  Would we all just give away our life savings?  Would we trust the family could provide the complex broad based care that we need and which will increase in the future?

Look for places that show commitment, build professional social relationships and accept some extended social responsibility.  Extended family care teams.

While many places advertise age in place or “we care” few advertise we want to be responsible, or we can visit you when you are out of our facility, or  we want to have all family call us any time.  Most managers delegate that work to a staffer but in fact health care and senior care are very personal items that is it hard to delegate. Second, senor care is inherently complicated by complex medical issues that most managers do not know how to approach.  All of which leads to super specialized but disjointed, difficult to use and trust systems of health care.

In the old days the doctor did a lot of outpatient, social work and coordination of care but with the loss of the old fashioned doctor you need other choices that can bring back that sense of responsibility for care and expectation of ongoing care.

The new solution for caregiver stress that save money, offers more complete care, and reduces stress for the entire multi – generational family.

Will be in our next post. Hint find an extended family care team and setting which is the one stop shop for all of your senior care needs.  The senior care value buffet.

See you in my next post. Like, shares, comments appreciated.

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Dr Shawn McGivney

Alzheimer’s disease – behavioral therapies

Alzheimers-caregiverAll 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.

 

Nice-CaregiverFamily-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

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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.

doctor-patient-team

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.

 

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Dr Shawn McGivney

 

 

 

ALZHEIMER’S DISEASE LAS VEGAS: HOW WILL NEW ALZHEIMERS TEST HELP YOU?

Alzheimers-disease-kf

At-home test may help diagnose Alzheimer’s

NEW TEST TO DIAGNOSE ALZHEIMER’S.  4 pg test, with written questions to answer and drawings.

 

While this article brings up another new tool the doctor can use to prompt himself to ask a wide range of questions in the interview it is not new.   A doctor always uses interview questions coupled with history and medical exam to narrow down all causes of cognitive loss so I am not sure how new this is.

Alzheimer’s is very difficult to diagnoses as a single pure entity and in fact most often Alzheimer’s overlaps a lot with many other things like Dementia, Parkinson’s, Neurological issues, wide based gait, and cns vascular disease to name some.  Indeed, aging and benign forgetfulness also is in there to complicate the diagnosis and all the life causes of poor mood as one ages and declines in function.  In fact, a depressed mood in many ways is “normal” when faced with the end of life and loss of your friends, own abilities, and prospects for the future.  To call all of this Alzheimer’s or anything to me is misleading and instead I would prefer we focus on the treatment of having the best, most consistent, care team possible to deal with all chronically ill people no matter what the label.

I am also not sure how they will treat cognitive loss differently from how they do today if you find it.  The current meds Aricept, Namenda, Exelon are hit or miss at best.

HERE IS WHAT WORKS AND HAS WORKED FOR ALL MEDICAL CARE AND ALZHEIMER’S CARE IF INDEED “ALZHEIMER’S” EVER EXISTS BY ITSELF WITHOUT OTHER MEDICAL, SOCIAL, FINANCIAL AND LIFE ISSUES.

The one treatment that works for all humans is caring and relationship building with the best care team you can find.  If you jump from one doctor to the next or the doctors don’t feel invested enough to stick with you as their / your treatment ideas are implemented and evolve you can imagine the care might be disjointed, incomplete and there by less effective.

Medicine is a process of trying various treatments and then following closely the response and adjusting those treatments.  People change, treatments change or evolve, and emotional health is all about relationships so that is the best and most cost effective treatment for all chronic disease and Alzheimer’s disease.

If you have a personal care team with a team leader or doctor who is active in sticking with you and willing to lead and make care decisions you can adjust to all diseases and emotional issues that arise.  Instead what we see is referral of the work and risk of the care and decision making to the next doctor.  In some ways that is kind of like warren buffets weapons of mass destruction and selling the toxic mortgages down the road to the next sucker but in this case we are hurting the humans and are passing along human suffering.  Homes are tangible products which in most cases are used and lived in and not decaying as a human being would which the service contract or mortgage is passed along.   In that case do not harm is the harm.  Being unwilling to make the diagnosis and try a treatment is more risky than not trying and just doing nothing or “no harm”.    You never know what will happen and what will change after you make the first choice of treatment to try that is why medicine is an art and clinical process and requires continuity of care and a steady relationship with the doctor to follow, adjust, and evolve your multiple level of treatments.  Even if your first treatment works you would not stop there but will add, adjust, modify treatment constantly.  There is no one flow sheet to follow.  All humans are complex beings and the choices in treatment are even more complex when you include the finance, social and emotional elements of those treatments.

 

Those who read my blog will recognize this quote that really sums up all medical and human caring:

“If you treat the disease you win or lose but if you treat the person you win NO MATTER WHAT THE OUTCOME.” Patch Adams, the movie Patch.

That last part is the key.  If the doctor and patient stick together, work together, in all care settings dealing with ALL PHYSICAL, MEDICAL, EMOTIONAL, SOCIAL, AND  COMPLEX OVERLAPPING LIFE ISSUES then you and those around you who care and are active in the care process are likely to feel  that they have made a difference and done the best possible in these difficult situations.  One might even say they feel good about whatever happens.

 

We all have the choice to choose our care setting and there by care team.  If you instead choose the insurance first then you really have no idea who or what care you will get.  Also if the doctor is the direct employee in practice of the insurance company and he has less or no expected interdependent relationship with the patient and their social system then it is likely both will act to protect themselves first and the care will be less consistent.  The patient might save money since that is all they can do and the doctor / representative of the insurance company might save time and pass the toxic risk / work of providing care, trying, making decisions to the next doctor.

GOOD NEWS!  WE ARE IN CONTROL.  WE CAN CHOOSE OUR CARE SETTING AND CARE TEAM!

We all can visit many care settings and choose the one we want to pay for.  If we have Medicaid or are on a government program we still can choose by visiting many providers of that care type and choosing one closest to our most frequent visitor and the best one.  We all need to make the time and take the time for this search when it comes.

I hope all are empowered by this.  You can choose!  All doctors and care settings are not the same.  Your control is by visiting many and choosing the best care team possible.  Indeed, in the end you might find it is cheaper to pay a fixed price than the bait and switch model of a relatively lower advertised cost for the room and then add ons for the care or assistance and medication management etc.

What do you think?  Share your views here.

Check out these fantastic Residential Care and Alzheimer’s Care Services.  Remember to consider all of these in your search for a care team since they all provide care —Residential care, Assisted Living, Home Care, Hospice Care, Dementia Care, Alzheimer’s Care, Memory Care and Nursing Homes all offer custodial care but what varies is the care team you choose when you choose any care setting.  Who is doing the day to day training, supervision, and support and hands-on management and who is doing the custodial care?   Look for the care team to get the best Assisted Living, Residential Care, Home Care, Retirement Community, Hospice Care, Dementia Care, Alzheimer’s Care and Memory Care in any care setting.  Look beyond the setting label and find out who you are getting before you buy.

Tender Loving Care Senior Residence

Or

Tender Loving Care Senior Residential Care, Costa Brava  –

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 THANKS FOR LIKING AND SHARING 

Dr Shawn McGivney

 

 

 

ALZHEIMER’S and DEMENTIA CARE COST MORE THAN CANCER OR HEART DISEASE!

CNNMoney reports on a New England Journal of Medicine article that notes the cost of Alzheimers  and Dementia care is already more than the cost of heart disease and will continue to rise.

http://tlcsr.com/blog-dementia-care

Read the article here Dementia Care costs top $100 billion
The headlines are clear.

A new study puts the cost of treating Alzheimer’s and other forms of dementia at $109 billion, making it more expensive to society than either cancer or heart disease.  Moreover, the current crisis will continue to grow rapidly as the baby boomers in America age.  What is less clear is the answer to that question of how to provide the care, in a humanistic and family oriented way, at a reasonable cost.  We want to suggest THE CURE TO THE INDIVIDUAL AND GLOBAL HEALTH CARE CRISIS.

TLCSR is the pilot study that answers the question! 

By focusing on continuity of care, people including care team, residents and family society benefits and the care provided is socially more complete.  That is how you get the best value for Senior Care dollars and fix the problem of the global and individual health care crises.  More good news is you dont have to wait for the goverment to help you find the Best, Most Cost Effective, Alzheimer’s and Dementia Care.  You can do it yourself right now!  Visit Tlcsr.com and tlcsr2.com to find out what to look for in all Senior Care Settings.

How can Continuity of Care and the TLCSR model of care be the cure for both the individual and global health care crises?

http://tlcsr.com/blog-dementia-care4

Our plan cures the issue not only of Dementia Care and Alzheimer’s care but helps fix the individual and global health care crisis.  We have seen a mis use of funds away from the direct care system to sub specialities many of whom say ” I only do this or that.”  That disjointed level of care leads to expensive and less comprehensive care.  A la Cart billing is good for the CEO, Stock holder and the companies bottom line but the servcie buffect, in-kind services, and mothers family style care is better for getting care when needed.  We are not blaming any one person since everyone has participated in getting where we are.  Doctor, Families, Individuals, insurance companies and the government.  What is needed is a better understanding of what care is.  How many of us have at one time or another under valued a caregiver, a mother, a domestic worker, who cares for us?  I have at times felt that as the “skilled” doctor I was smarter, better, than someone less educated.  By doing years of direct care for my own parents mother and  now father I see that caregiving is a skill!  Indeed, my wife and sister do it differently and in many ways better than I do.  Now after 10 years as a direct caregiver I am a much better caregiver.  My view is very unique in that few doctors are given the change to do direct care.

Care does include emotional and social care.

Feelings are the final expression of all Health care no mater what the label.  Indeed most studies specifically exclude feelings, emotional health, social and financial variables since they cant study them.  Even if we cant study them they are the most improtant factor in work, productivity, feeling good, family and social wellness.  Read our post on care vs caring or how are physical care and caring different as other reading. These are not the total answer but they start to provide guidance as to how we can value each other, family, mothers and caregivers more and in turn get more caring and value for our health care and life spending.

Tender Loving Care Senior Residence advertised Continuity of Care and complete care and not just urgent care or quick care.

Indeed, do you want a quick fix or heart felt care from someone who is INVESTED IN YOU FOR THE LONG RUN?

A hospitalist who cares for you for a week, then another doctor in rehab for a week, then …  In all cases you have to be your own doctor and coordinating the care.  While you know how you feel you probably do not really know which tests you would pay for if you were spending your own money.  The tests with the best value physically and emotionally to you.  You are not a doctor, you do not know how to quantify risk, benefit, or cost.

Did you know it is cheaper to buy many medications for cash, out of pocket than, to pay just the copay?  Yes, the co pay alone is more than paying cash!  Why you ask.  The systme makes more money. You have almost no way to know the details of what is needed, and the magnitide of the risks and benefits of your choices even if you are informed. That is why you need a doctor.  The probloem is the doctor directly or indirectly works for someone other than you. The relationsnip with you and the doctor is indirect and short lived.

Continuity of care can help all get more care, better care, for a better price or value.

That is especially true in Dementia Care where the care team is the best treatment for Dementia.

Find the most continuity of care and complete care, find the best individual members of your care team and you will get the best value for your Senior Care dollars.

WE NEED YOUR HELP!

THIS AFFECTS ALL OF US RIGHT

NOW BY AFFECTING AT LEAST ONE PERSON IN OUR EXTENDED SOCIAL CIRCLES AND EACH OF US INDIVIDUALLY AS THE BABY BOOM WASHES OVER AMERICA.

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Dr Shawn McGivney

Dementia Care-Exercise, social interaction may trump meds for Dementia Care

I am glad that medicine is starting to study Dementia Care and emotional health and wellness as much as they are able

Many many not know that most studies SPECIFICALLY EXCLUDE FEELINGS, SOCIAL INTERACTIONS AND WHAT DOCTORS CALL TRANSFERENCE.  I understand why they do so.  They do so to allow them to focus on variables they can monitor, understand, and quantify.  The problem is that feelings and humanisms, social interactions are way to complicated and multi facited to study.  Love, Hope, Feelings productive, needed, wanted and belonging while essential to humanism and feeling good are very hard to define and quantify.  We all can agree that a picture is worth 1000 words and feelings are invaluable.  Symblols help us to see but social experience, education, enviroment, social values and many other things are needed for each person to produce that unique invividual feeling.

Read this article and then read my comments on the post.  Do you see how one might use this good research to modify how they look for Assisted Living and Senior Care?

Novel Exercise Program May Trump Meds for Dementia

Great article by Caroline Cassels  that confirms what common sense has told us for a long time.

People, all people, have feelings, emotional needs, and being more attentive to them can help all people including people with Dementia Feel better.

At one level that is scarey.

That the science doctors think is complete, their studies, actually fail to include the most powerfull variables to feeling good and getting better where better is feeling betterI often think of the power of family when I recall the old women who one minute is crying in pain from a broken arm, total body arthritis, and bone mets and then just seconds later, has no pain and is smiling when she is offered the change to hold her 3rd great grand child.  Many doctors, social managers, think of the dollar cost and these physical things which is the biggest short coming in my mind for health care today.

A much brighter use of this study is that to feel your best, get the best care, you need to interact with people

That includes staff and other residents.  That is a type of medicine or treatment.  Take a friend out for lunch and you pay.  That might be a better value than the co pay on a pill for depression.   People, friendships, the search for independence are never ending and ongoing up until we die.  Read this article and hear the physical claims but also read betweent the lines to see if you see some of the things I see.

They talk about combining eastern and western therapies. 

I saw straight social dynamics.  We had them sit in a circle.  Circle to me is very group oriented and social.  Indeed, we do an exercise program at Tender Loivng Care Senior Residence every day in a circle.  Less for the exercise and more for the emotional and social benefit.  What you call it really does not matter but the fact is people need people to feel good.  The physial place matters much less than the people.  A second example is our email program at tlcsr.  We do that more for the family to feel connected than the senior with mild dementia.  Some may say that is a semantic difference but we believe those social sensitivity differences make a big difference in how the entire social system feel and deals with aging now and then their own againg in the future.

Second, the author notes”the program focused on creating a “loving, nonjudgmental enviroment to promote postivie feelings and joy” and used music to enhance this effect.  I agree 100%.

What I was hearing is find the best caregivers and care team you can.  

Look for continuity of care to get the best care, and best value for any private senior care dollars.  Of course, we say repeatedly in this blog Continuity of Care  is the cure to the individual and global health care crisis and that includes Dementia Care, Alzheimer’s Care, and Memory care and ALL OTHER DISEASE LABELS YOU HAVE!

Quoting Patch adams again

“If you treat the disease you win or loose but if you treat the person you WIN NO MATTER WHAT THE OUTCOME.!”

Really look at the last part of that quote.  No matter what the outcome.  Seniors and all of us know we will die. Dying is not as scarey as being alone, abandonded, and shifted home, place, facility to facilty.  More accurately being shifted from one care team to the next!!  Being shifted away from the main care team, your family you have known for your entire life!  Look for a care team that can and will be able to stick with you, visit you, no matter where you go to get the best value and care possible as you age.  If you accept the sales pitch you did not look far enough.  Take the time to meet the entire care team from Doctor, Administrator, caregivers, med techs.  And ask if they interact with each other.  The more continuity of care in your broad based system the better you will feel and the more value you will get for THE SAME health care dollars.
Summary

dementia-careIn discussing these variations of interpretation though words and this blog I hope to raise awarness that all people, families, seniors and care teams need to value each other.  Realtionships, caring are a two way street.  Take the time to find the most continuity of care when ever anyone you love is forced by aging to need assistance and choose Dementia Care or any Senior Care Setting.  Not I did not say move. That focuses onthe physical place, instead use this post to focus on the care team and continuity of the people and care.

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By Shawn McGivney