Tag Archives: Dementia

columbus day with seniors assisted living facilities

Columbus Day 2017

Today is actually a fun time to pause and have a couple of minutes to consider our seniors assisted living facilities. reach out and connect with them. Hang out along with your family’s member preferably. Enjoy the time.
Get in touch with our seniors assisted living facilities
Get in touch with, connect & share this with friends and family, let them recognize you’re considering them. Below at TLC our team emphasize the huge perk of being a relied-on support person along with friends to be a component of the general contentedness to loved ones for our residents
Take a moment to connect with our seniors assisted living facilities this Columbus Day, 10-9-17.
We urge friends and family to contact as well as check out their senior loved one whenever they are able in order to help stay connected. Our team additionally recognizes that lots of friends and families have a lot of various other obligations and may not have the capacity to devote as much time as they like. With the help of all close friends and family members checking out & phoning our team can keep the very best lifestyle possible for each of our locals.
We ask you to share the sense of community our seniors enjoy.
See us online at Tender Loving Care Senior Residence or Tender Loving Care, Costa Brava Memory Care as well as share our neighborhood with others you come in contact with.
Many thanks
  COLUMBUS DAY IN THE UNITED STATES The first Columbus Day celebration took place in 1792, when New York’s Columbian Order–better known as Tammany Hall–held an event to commemorate the historic landing’s 300th anniversary. Taking pride in Columbus’ birthplace and faith, Italian and Catholic communities in various parts of the country began organizing annual religious ceremonies and parades in his honor. In 1892, President Benjamin Harrison issued a proclamation encouraging Americans to mark the 400th anniversary of Columbus’ voyage with patriotic festivities, writing, “On that day let the people, so far as possible, cease from toil and devote themselves to such exercises as may best express honor to the discoverer and their appreciation of the great achievements of the four completed centuries of American life.” In 1937, President Franklin D. Roosevelt proclaimed Columbus Day a national holiday, largely as a result of intense lobbying by the Knights of Columbus, an influential Catholic fraternal benefits organization. Originally observed every October 12, it was fixed to the second Monday in October in 1971. ~History.com~

Alzheimer’s Dementia and 90 + study reveal the new data on Alzheimer’s.

Alzheimers-diseaseThis article on Alzheimer’s and  and related 60 minutes show are devoted to follow up of a study at UC Irvine that followed retrospectively a neighborhood of 14, 000 people.   Living to 90 and beyond – click here UCI mind and related articles and links   The sixty minute summary of the 90 + research reveals that activity, social connection, matter even if just in little however constant bursts.   UC Irvine is studying a senior community where they have a distinct group of fourteen thousand senior citizens that completed a survey a decade ago. They are attempting to look retrospectively exactly what took place to them.  

No surprises smoking cigarettes are bad and workout in moderation is good.

But this is a good research to give you hope. 15 minutes of light cumulative workout or walking made a difference, and came to a head at 45 minutes. They also noted that the exercise does not need to be continuous. Keep in mind the study is watching those who are left so the results are tilted to healthy seniors.  

Being overweight is better than underweight.

Kept in mind that while they saw that being overweight was good they cautioned that was not morbidly obese. We can add that when you are obese you likewise have more muscle and the extra muscle is more vital than the fat is bad to give you much better function, flexibility, immune system etc. Being any underweight likewise may suggest other condition. Exactly what we also have to be clear is being 20 % over weight is ok it is much better not to be actually obese. As all of us understand everything in small amounts.  

Exactly what was interesting to these researchers was that Alzheimer’s is not as typical as they believed.

While the researchers for decades have actually stated that Alzheimer’s condition is the most usual form of dementia that could not hold true. They are finding signs that little strokes in even more usual and Alzheimer’s illness is less usual.   Add in typical people have plaques and tangles and there was no CT or imaging machines to find little strokes in the early days of defining Alzheimer’s illness. Therefore one can see that Alzheimer’s is over identified. Vascular illness is common and is the leading cause of death without a doubt so of course that affects intellectual condition as well.  

Alzheimer’s Disease or Dementia or other labels can be misleading

  I don’t like  these labels because there are no good therapies. Obviously, general avoidance is needed in all cases. The fact is no matter what sort of dementia you have all dementia labels will considerably impact your life.  Alzheimer’s dementia or multi infarct or little stoke dementia the problems are comparable. How will you get the assistance you need. Family caregivers and a family style care group are the very best responses.   caregiver-teamIn addition I like to re-focus readers on getting the best household care group and care setting possible as you begin to need any quantity of assistance for any reason to ensure the best care and life style possible for you as you age and need more care.  

Vitamins did not help however alcohol did correlate with longer life expectancy.

They found many things. Vitamins in their group did not help you age much better however drinking a little alcohol of any kind did seem to make you live longer. While that seems like information I wish to know if the reason alcohol helped was due to individuals who consume alcohol had more free time to enjoy a glass of wine and were somehow more relaxed instead of the drinking per se? Those problems are vital in all research studies however are often specifically omitted in a control group. Considering that those big, typical, however hard to study things are hard to measure, specify, study and differ extensively they cannot study them. How do you quantify the amount of joy, joy, or despair? What is the scale one would use to compare the quantity of depression? Similarly money and relationships are hard to study. While you may believe income is simple to study it is not. While IRS reported income is another tangible part of income financial success consisting of possessions, household resources, back up properties, household income, expenditures, relative income and way of life are all much tougher to obtain sincere answers to. While researches do include some details that your physician can make use of to work up a treatment plan for you research studies are not the last word.  

Exactly what is missing in this and all medical research studies?

The research studies are not the final word and no study states exactly what any one person should do given their social, financial, other medical and psychological wellness concerns dictate.   The doctor who understands you and all of those “other” social, financial, numerous complex and overlapping other clinical issues, that make you a human being uses that data and treats you with time, works day in and day out with you, to try those suggestions out on you and keeps track of the responses and all the time is stabilizing the many adverse effects and threats against the advantage you and the physician are seeing. That is old fashioned art of medicine. The flow sheets, and over specialized care system do not have connection of care and follow up of exactly what works consisting of all the realities that a lot of research studies swelling into the control group and implies do not matter like social supports, psychological hygiene, multiple complex other clinical problems, and financial issues. That is why clinical medicine is an art.   doctors

Alzheimer’s and wellness research summary.

Excellent research to view on 60 minutes and UC Irvine site.  Unfortunately there is no easy answer and the observations are just that, general associations however they are in not near to perfect by themselves in treating an individual. The effect of each differs with each person, their social and medical conditions and obviously the financial supports.   Related Links Distinguishing ‘senior moments’ from Alzheimer’s   Thanks for reading, commenting and Likes / Shares 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. alzheimers-disease-pillsTacrine ( 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  

DEMENTIA CARE: LAS VEGAS DEMENTIA CARE COSTS PROJECTED TO RISE!

Dementia-Care-Costs

 Dementia Care Costs will be reflected in the cost of Dementia Care in Las Vegas too.  I wanted to share this NYT article Dementia Care Cost Is Projected To Double by 2040” by +Pam Belluck. This article is a good description of the aggregate dollar costs spent on Dementia Care and only begins to touch on the spiritual, social, and family costs of Dementia Care.  Unless we can improve the Dementia Care that is available to families so that families feel that the care teams are invested in caring for a member of their family team as an extended family many families will still choose to do the Dementia Care at home. By having Dementia Care Homes, or Dementia Care Facilities, that offer more family style care families can feel good about the care their loved one is receiving.  Now there is a dementia care shortage of Residential Care Homes that offer this type of care.  The more institutional settings of a big Assisted Living Memory Care Unit often are just too big for the administration and staff to know each resident and their families well. Another New Old Age Blog Article helps us see what to do. Studies Find Mixed Results for Dementia Units

http://newoldage.blogs.nytimes.com/2013/05/10/dementia-care-units-may-improve-care-studies-suggest/ You need to know who you are getting to know what you are getting in Dementia Care or any Senior care Service. Meet and know both the caregivers and the administration to get the best Dementia Care and value.

Mean Caregiver Or Nice Caregiver?

Mean-CaregiverNice-Caregiver

  The article implies that while big Assisted Living and Institutional Dementia Care units try to improve their image with unique names you need to look beyond the name to meet the care givers and administration who you are hiring.  We note that the above article is correct, Dementia Care is expensive, but we also note that to get the best care and value you need to know who you are getting to provide that Dementia Care in a Residential Care Home, Home Care or Dementia Care unit. Here are example of names Dementia Care Units adopt from this article –The Memory Care unit, The Reminiscence Neighborhood, Homestead.  Read the full article Studies Find Mixed Results for Dementia Units. They go on to say “That’s probably because there’s little standardization or regulation of what dementia units should offer and for whom, so some probably do a fine job while others just lock the doors. To complicate things further, many Assisted Living Facilities have specialized units for dementia, too.” That is the point we want to expand on to save you money and get you better social, emotional, and spiritual value for your private pay Dementia Care dollars.  Precisely because there is little standardization the care teams vary widely.  Indeed, you can’t know what you are getting when getting any service until you know who you are getting.  That is our message to meet and know the direct care team including caregivers and administrator and managers.

Two common mistakes to avoid when looking for Dementia Care in any care setting.

We know that all senior care is a service and has two parts both of which are important – the custodial care and the administration and management.  The two mistakes are to classify custodial care as unskilled when in fact it is a very skilled job.  The second mistake is not to assume the management are able or available to deal with problems and emergencies and  are interacting day to day with their care team that you are hiring.

Custodial care is in fact a very skilled service even if some mistakenly label it as unskilled or less skilled.

The custodial, day to day, care which arguable provides the “quality of life” can be seen when you look at the in-kind feelings and experiences there ideas reflect  “the day to day I care”, the attitude of “I will sit with you, let’s talk about your daughter and grandkids” and the many conversations that could occur while doing the day to day personal care.  Beyond the important emotional health issues  there is more skilled care dealing with obtaining, faxing, recording, giving, and following up on the medications, the doctors’ order, and dealing with insurance and medical problems when they arise. Patient-Caregiver Care Givers are skilled and families need to understand that all caregivers are not the same.  The article quote above says there is little standardization which means beyond some very basic training of 8 hrs the training comes from the administration and care team itself.  Families need to understand that caregiving is very difficult for themselves and has devastating results on their own multi-generational  families and that finding substitutes to provide complex, very difficult, emotionally rewarding care requires each family meet the entire care team they are hiring for to help their loved one and entire extended family for the last chapter of life of one of their own family team members.

Skilled-Caregiver Caregivers are often mistakenly classified as Less Skilled or unskilled when in fact they provide the direct care, they implement all the doctors’ orders, and they are the eyes and ears of the doctors who make decisions based on what the care givers see, understand, and do.  Care givers are very skilled people

Because they have good social skills, are smart and able to learn the many complex tasks required to do medical related care they can easily move on and do something easier.  If you and the administration don’t treat them fairly they will move on since they are very skilled.  If you have staff turnover you are likely getting less skilled workers as is often the case in Assisted Living and Home Care.  The administration is investing less in all that extra training and paying for those with the outstanding social skills.   Even if there were standardizations we know that when it comes to caring, social connectedness, diligence, work ethic in any profession even professions with high amounts of standardization like becoming a doctor, lawyer, or politician there is a wide range of “skills” and “values”.  In all cases you need to meet the entire care team of care givers and administrators. Many say the caregivers are “less skilled” or “unskilled” in fact the behavioral treatments that provide most of the care and feeling good in dementia care come from the highly skilled caregivers who provide not only the custodial care but who understand, communicate, and implement all of the doctors’ orders.  Remember these caregivers understand the orders given by the internal medicine doctor, the psych doctor, the cardiologist, the urologist and many other doctors and the families all at once.  That takes a knowledgeable person who knows the medical terms, equipment and diseases and who has impeccable social skills, patience, and mother like skills to understand, implement and monitor all of those things for the many doctors who write the orders.  Caring for people with cognitive disorders and who not kids are is a very different emotional task than caring for kids where the parent or caregiver is the presumed responsible party.  It is the parent’s way or highway works in child care but in Dementia Care that is not the case.  The senior with mild cognitive loss generally has some mild paranoia and has at least some unrealistic expectations and it is the caregivers who have to adjust which is not an easy task

.  Indeed, it is even harder for families

to adjust because they were and still are “the kids” in the eyes of the cognitively impaired parents.  The son or daughter’s  job of reestablishing themselves as the parent when a senior has even mild loss of insight and judgment and paranoia will be very difficult.  That is why you need to look for the best care team of caregivers and administrative staff to get the best Dementia Care in any care setting including Assisted Living, Assisted Living Memory Care, Residential Care, and Residential Care with Dementia endorsement, Home Care, Hospice Care and Elder Care in general.

Mistake #2 – The Administrator and managers need to be available and directly connected to the care givers they are supervising. single-family-home

Many families make the mistake of assuming that the administrator and management will be available with little notice to deal with the expected problems and emergencies that occur in complex medical and custodial dementia care.  Families need to know the skilled people, administrators and managers are available and able to deal with medical related problems when they occur.  The administrator also needs to be available to their own staff and the residents on a day to day basis to work directly with and train the skilled care giver staff.  One simple test is to see if the administrator or managers are available to come down and talk to you on a tour when you want or are there for your tour?  If not they might also not be available to deal with the emergencies when they occur also.


new-direction

You don’t think about who is training the caregivers to do that complex skilled work noted above and who will intervene when the problems with medications, insurance, and the doctor arise?   That is generally the role of the administrator or manager and they need to be in close contact with the patients doctor and they also need to be able to understand what the doctor is saying and not saying which is not an easy task.  A two line note often does not consider what was considered in the process of getting to the two line note.   However, if the management has some medical experience it is more realistic that they can interpret the doctor’s notes and orders.   The care givers need constant feedback and assistance to get questions answered on a daily basis from a skilled person generally with medical experience so they can learn.  If a caregiver is working on the floor but never sees that skilled person, never or rarely interacts with the doctor or nurse at the bed side, it is unrealistic that they can know the many degrees of shortness of breath, what wheezing is, or leg edema is.  On the psych side knowing what delusions are and bizarre behaviors are requires not only the administrators bedside training but also you need to know that individual and need to be able to ask your coworkers if this has been going on for days or hours.  If you don’t have that team approach seeing subtle changes is next to impossible.  In dementia care like no other care setting team work of administrator and staff is of paramount importance.

Check out these fantastic Residential Care alternatives to the Assisted Living and Nursing Home Rehab.  Compare Family -Style care of a Residential Care Home to Nursing home and Assisted Living which are more institutional care models.

Residential care, Assisted Living, 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 of a 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  – Educational video links TLCSRLV youtube Channel.  Subscribe for free.  Alzheimer’s Care, Las Vegas: Find the best Alzheimer care home in Las Vegas. IF YOU ENJOYED THIS POST – LIKE AND SHARE IT. Dr Shawn McGivney