Alzheimer's Family Services Articles RSS Feed

AFS, Covenant Hospice Embark onFamily-Centered Joint Project

Mon, 02 Nov 2009 20:00:00 GMT

Hi. My name is Holly Herring. I am the Family Centered Care Services Project Manager at Covenant Hospice. I am currently working on a project with Alzheimer’s Family Services.

We are in the process of developing a family centered care model for our caregivers and their loved ones. Over the next several months, I will be investigating various services, such as music therapy, massage therapy, in-home physician/nurse consultations, pain management consultations, companion services, dietary consultation, legal assistance, educational workshops, exercise program, and many others, to address the needs of our caregivers, as well as the person with Alzheimer’s.

I need your help!

I want to hear from you, the caregivers! You are on the front lines everyday, providing care to your loved ones. I want to know what you need from Alzheimer’s Family Services to feel supported and prepared while providing that care.

I have already begun the process of contacting caregivers throughout our service area, but if you have not heard from me, don’t wait! I would love to hear from you. This is your chance to make an impact on Alzheimer’s care and support within your community!

If you are interested in participating in this exciting project, please fell free to contact me at 850-208-7126. Be on the look out for updates as the project moves forward!

Holly Herring, Family-Centered Care

Services Project Manager, Covenant Hospice

Nov 2, 2009 2:00 PM

Check out these ADULT DAY CARE Options!

Mon, 02 Nov 2009 20:00:00 GMT

Council on Aging of West Florida Adult Day Health Care Center- The Oaks Adult Day Care

Located in Pensacola, the Oaks Adult Day Care is the only licensed adult day care facility in the Escambia and Santa Rosa area. The center provides a protective, stimulating environment for older adults with physical and cognitive impairments and respite for caregivers. The staff receives on-going, specialized training in areas such as Alzheimer’s disease and other forms of dementia. The center is open Monday through Friday from 7:30 a.m. until 5:30 p.m. Those not eligible for government funded programs may attend the center on a private pay basis. Contact Sandie Holtry at 432-1475 ext. 180 or sholtry@coawfla.org for more information.

Magnolia Manor Senior Day Program

Located in Fort Walton, Magnolia Manor offers a warm and inviting environment for all. Magnolia Manor is a state licensed and locally owned and operated adult day care. The idea behind Magnolia Manor is three fold: 1) give the caregiver a chance to take care of their needs; 2) create an atmosphere for each patient that is relaxing and enjoyable and; 3) offer an affordable alternative to in home care. Magnolia Manor allows caregivers to pay for care by the hour or by the day. The facility is opened Monday through Friday 8am to 5pm, but the staff is able to work with those who may need a more flexible schedule. For more information on Magnolia Manor please contact Sara or Valerie at (850) 362-6556 or visit their website at www.magnoliamanor.biz

Friendship House

Located in DeFuniak Springs, the Friendship House provides a warm and caring environment during the day for adults with special needs. Respite care or full-time day care is available, with breakfast, lunch, and snacks prepared on site. Each Client has an individual Care Plan, which is developed with family input, to provide for maximum potential in cognitive, physical, and social areas. Available activities include exercise, crafts, gardening, bird watching, photography, and quiet time. A large yard with white picket fence provides a safe and attractive area for outside activities. Visitors are welcome, and with advance notice may enjoy a meal with our “family”. The daily rate of $45 includes all meals and services. An hourly rate and a full-time monthly rate are also available. The Friendship House is located at 353 Juniper Lake Road, DeFuniak Springs, FL 32433. For more information, stop by our facility or contact us by phone, fax, or e-mail. Phone: 850-892-0565 Fax: 850-520-4651 E-mail: friendshiphouse@panhandle.rr.com State of Florida AHCA Adult Day Care License #9115.

Daybreak Senior Services

Open since June 2009, Daybreak Senior Services has been creating a brighter day for its members and those who care for them. Located in the beautiful residential neighborhood of Poquito Bayou in Shalimar, Florida our adult day program offers a great care alternative to in home or long term care options. We pride ourselves in offering meaningful, fun and therapeutic activities in a warm and friendly environment. We have a social worker, recreation therapist and certified nursing assistants at our center to provide the best services possible to our members. If you would like more information about our program, please visit our website at www.daybreakseniorservices.com, or call us at 850-613-6933. We look forward to hearing from you.

Nov 2, 2009 2:00 PM

November is Alzheimer’s Awareness Month

Mon, 02 Nov 2009 19:00:00 GMT

compiled by Staff of Alzheimer’s Family Services

In observance of Alzheimer’s Awareness Month we have compiled a list of services Alzheimer’s Family Services provides Pensacola and Northwest Florida.

Project Lifesaver

A person with Alzheimer’s disease may wander away from home at any stage of the illness. Many become “lost” trying to get “home” wherever that may be. Studies show that approximately 60% of Alzheimer’s patients will wander, and 70% will wander repeatedly. This can be a very dangerous situation and it represents a critical emergency. The patient is at the mercy of the elements, be it cold, heat or dehydration. Failure to take necessary medication can also result in serious problems. Project Lifesaver is a transmitting device used to track wandering Alzheimer’s patients and quickly and safely return them to their homes. The program works in conjunction with local law enforcement, fire departments, and search and rescue teams. The patient is fitted with a transmitter no bigger than a watch, which is worn on the wrist or ankle. Should the patient wander off, the caregiver can simply call 911 to begin a search. Search times that have normally been as long as days are reduced to less than an hour because of Project Lifesaver. For more information or enrollment in the program, please contact the AFS office and ask for the social worker.

Education and Workshops

AFS realizes the need to educate caregivers, healthcare professionals and our community about Alzheimer’s disease. Awareness and knowledge are accomplished through workshops/seminars, speaking engagements, participation in health fairs, talk television and radio shows and much more. Any group can reserve a speaker by calling the AFS office.

Support Groups

Alzheimer’s Family Services offers monthlysupport groups in Escambia, Santa Rosa, Okaloosa, and Walton counties in Florida, and in Escambia County, Alabama for families affected by Alzheimer’s disease. In many cases in the Florida areas, respite care can be provided so that a caregiver can attend a support group meeting.

Volunteer Services

Volunteers determine the success of Alzheimer’s Family Services. Little is accomplished through this organization without the assistance of our volunteers. To volunteer your time and talents, contact AFS at (850) 478-7790.

Newsletter

AFS stays in touch through its newsletter, “The Caring Times.” This newsletter has a circulation of more than 1,700 each month. It contains important dates, current information on the disease, caregiver tips and notes of encouragement. If you or someone you know would benefit by receiving this free newsletter, please call the AFS office. Back issues are available on the web at www.alzfamserv.org. You can also receive the newsletter electronically; just let us know by sending an email to: afs@alzfamserv.org.

Lending Library

AFS has a lending library of books, videos, and activities regarding Alzheimer’s and related memory disorders available to anyone in need. Resource donations may be made in memory or in honor of a loved one. Gifts will be acknowledged.

Referral Services

Calls and visits are received daily from persons seeking help with placement, financial or legal assistance, medical information, and support groups. One-on-one counseling and group counseling are available upon request.

Loan and Supply Closet

AFS maintains an inventory of non-medical equipment (shower chairs, wheelchairs, walkers, etc.) for loan. Incontinent briefs, and Ensure may also be available. Contact the AFS office to borrow or donate such equipment. Current needs: Ensure and large briefs.

The Caregiver’s Handbook

AFS provides the Caregiver’s Handbook at no cost upon request. The handbook contains information about Alzheimer’s disease, caregiver tips, signs and symptoms, contact information, and resources. Donations to ensure future printings of the handbook are appreciated.

Memory Screens

Alzheimer’s Family Services regularly conducts memory screens at various locations throughout its service area. Screenings are an essential tool to aid in early detection of Alzheimer’s or other related dementias. Memory screens cost $15; an appointment is required. Contact AFS at (850) 478-7790 to schedule your appointment.

Nov 2, 2009 1:00 PM

Activity Corner: Keys to Keeping it Simple This Holiday Season

Courtney Cook — Mon, 02 Nov 2009 19:00:00 GMT

Activity Corner: Keys to Keeping it Simple this Holiday Season

Courtney Cook, BSW

The hustle and bustle of the Thanksgiving holiday can present some special challenges for families coping with a loved one with Alzheimer’s disease. However, with a little planning you can minimize disruptions and have a joyful holiday celebration for all.

Keep it simple. The Holidays often bring with it a feeling of being rushed. These changes in routine and rushed feeling can often bring mental exhaustion to the members of the family who are not experiencing Alzheimer’s so image how much of an effect these small changes have an Alzheimer’s person. You may want to rethink holiday traditions and simplify. Opt for soothing and quiet activities rather than flashing lights and loud noise. Even a holiday football game or parade can be disrupting for an Alzheimer’s patient so think of other options to keep the mood joyous for all.

Keep it safe. If you are currently a caregiver for an Alzheimer’s patient, you probably know that Alzheimer’s patients can see thing very different from what they really are in reality. Make sure to safety proof your home before having an Alzheimer’s patient as a guest. Avoid artificial fruit, which can be mistaken for the real thing. Remove rugs which can lead to falls and have locks on the doors for places that pose a risk to the Alzheimer’s patient.

Engage the person with Alzheimer’s. Encourage and allow the family member with Alzheimer’s to participate in the activities of the day. Have them fold napkins, grease a cooking pan, or help peel potatoes. However, if your loved one does not wish to help, allow them to spend the day how they safely wish.

Stick to daily routine. Try your very best to keep things in their usual place and stick to your daily routine as much as possible. Also, don’t forget to administer medications. This will reduce your loved ones anxiety making it a much more pleasant time for all.

Tell friends and family ahead of time. Prepare family and friends who may be coming to festivities about your loved one’s status ahead of time. By doing this everyone will be more prepared.

Test the waters. If you loved one with Alzheimer’s lives in a facility and you are thinking about bringing them home for the holiday celebrations, it’s a good idea to try bringing them home for a short visit beforehand. For many people with Alzheimer’s, being removed from familiar surroundings can be a very upsetting experience. If the home visit seems to stressful, think about having small groups of family and friends visit the loved one in their own environment.

Delegate: Caring for a loved one who has Alzheimer’s is an around-the-clock job. Allow family members to take on some responsibly during their visit. Let members take on chores around the house like preparing meals. Or, delegate a family member a day to be the loved one’s companion and have them monitor how they are doing.

Fisher Center for Alzheimer’s Research. (2005). Giving Thanks This Thanksgiving. Retrieved October 15, 2009 fromhttp://www.alzinfo.org/newsarticle/templates/archivenewstemplate.asp?articleid=94&zoneid=6

Nov 2, 2009 1:00 PM

Wandering

Tue, 06 Oct 2009 20:00:00 GMT

Wandering is relatively common in patients with middle stages of Alzheimer’s disease. They often have an urge that they must go somewhere. However, due to their memory impairment they run the risk of getting lost. For the caregiver this can at times be nerve racking and quite stressful. Below are some facts and tips that can help you cope with a wandering loved one.

Environmental factors that can lead to wondering:

Loud noises or a lot of distractions
Lack of stimulation can lead to boredom.
Being in a new environment

What you can do: Try to find a quiet place for them, but not one devoid of any stimulation either. Keeping them entertained by giving them a task, such as folding clothes can give them a sense of belonging as well as decrease wandering. When being placed in a new environment, it is important to provide constant reassurance that they are safe and remind them of where they are.

Psychological causes for wandering:

Hallucinations
Depression

What you can do: hallucinations are not uncommon in people with Alzheimer’s disease. When this occurs try to gently calm them down, agitation only makes it worse. If they experience hallucinations, it is important to talk to your doctor as this could be a side effect of their medications.

Other common causes:

Hunger
Thirst
Need to use the bathroom

If the wandering seems to be purposeful (i.e. they appear to be looking for something), then the wandering might be due to them needing something. This is especially common for those taking blood pressure medications that increase urinary frequency. They might be looking for the bathroom but can't remember where it is.

Preventative measures:

Investing in locks for doors and windows that require a key is useful
Try to keep your loved ones environment as familiar as possible
Keeping your loved one entertained
Purchasing a ID bracelet with the persons name and an emergency contact number in the event they are found by someone else.
Project Life Saver: consists of a small watch sized device worn on the wrist. It contains a small transmitter that can be tracked in the event they become lost. This is available through Alzheimer’s Family Services.

Sources:

Mayo Clinic staff, Alzheimer's: Understand and control wandering. Dec, 2007. Web address: http://www.mayoclinic.com/health/alzheimers/HQ00218

Accessed Nov. 21, 2008

Mace, N., Rabins, P., The 36-Hour Day 4^th ED. Baltimore, MD: JH press, 2006

Oct 6, 2009 3:00 PM

Incontinence

Tue, 06 Oct 2009 19:00:00 GMT

Incontinence, which is the inability to hold ones urine, is an embarrassing, yet common problem. It is especially common in individuals with advanced stages of Alzheimer’s disease. In many instances there is nothing the caregiver can do to prevent incontinence. However, there are steps one can take to reduce the occurrences of incontinence as well as reducing the negative health effects associated with incontinence. In this handout some of the common causes of incontinence are discussed as well as some precautionary measures the caregiver can take. It may be helpful to ask yourself the following:

Does it happen with activity?

What to look for: if it is associated with laughter, coughing, sneezing or physical exertion.
What can you do? This is known as stress incontinence and is caused by weak bladder muscles. This type is particularly common in women with multiple child births. Having them go to the bathroom more often can help keep the bladder less full and therefore less prone to leakage.

Are they unable to get to the bathroom fast enough?

What to look for: sometimes they will warn you they need to go, but by the time you get to the bathroom they have already wet themselves. This is called urge incontinence. Often times the desire to urinate comes on suddenly and leaves little time to go to the bathroom. If they complain of pain on urination, this could be a sign of a urinary tract infection.
What can you do? Try to limit the distance and number of obstacles between the person and bathroom. If an infection is suspected you should seek medical attention. Also, try to reduce bladder irritants such as carbonated beverages (e.g. soda) and coffee. Irritants and infections make the bladder more prone to contracting and thus leaking urine.

Could it be their medications?

What to look for: if the symptoms began after a change in the medications were made. Addition of blood pressure medications or “water pills”.
What can you do? Certain medications can increase urinary frequency as a result the incidence of incontinence may go up. If this is the case, you should discuss this with your physician to see if something can be done.

Other tips:

Although adequate hydration is important, one should be careful of overhydration. Try to limit their fluid intake as bed time approaches.
If they have arthritis it may be difficult for them to undue buttons or pull down a zipper. Try pants that have elastic banding instead.
Do not get angry or get frustrated with them.
Try to anticipate by taking them to the bathroom often (e.g. every 2hrs).
Consider using adult diapers to help maintain an acceptable level of hygiene.
In men, an enlarged prostate could be the culprit. Your doctor should be able to assess if this is the cause.

Sources:

Mayo Clinic Staff, Urinary incontinence July 1, 2008. Web address: http://www.mayoclinic.com/health/urinary-incontinence/DS00404/DSECTION=risk-factors Accessed Nov. 21, 2008

The Merck Manual Online Medical Library: Urinary incontinence, October 2007. web address: http://www.merck.com/mmhe/sec11/ch147/ch147a.html?qt=incontinence+AND+alzheimer%27s+disease&alt=sh Accessed Nov. 21, 2008

The National Institute on Aging "Caregiver Guide: Tips for Caregivers of People with Alzheimer's disease" September 01,2001

Oct 6, 2009 2:00 PM

Eating Difficulties

Tue, 06 Oct 2009 19:00:00 GMT

Eating difficulties are a common problem encountered in caring for one with Alzheimer’s disease. As the disease progresses, getting the person to eat may become more challenging. In this handout some of the common reasons for decreased appetite are addressed as well as some of the steps you can take to overcome this challenge. It may be helpful to ask yourself the following questions:

Is there something physically preventing then from eating?

Things to look for: Ill fitting dentures, sores/diseases of the gum, jaw pain can also be a cause.
What can you do? Your dentist can address issues with dentures such as adjusting them. For sores in the mouth or jaw pain you should visit your family doctor for advice.

Do they have another medical problem?

Things to look for: diabetes, acid reflux, heart disease or constipation.
What can you do? Adequate control of underlying medical conditions is very important. Making sure they are taking their diabetes medications is very important as well as checking blood sugar levels. Acid reflux can usually be treated with over the counter antacids (e.g. Tums, Prilosec). If constipation is frequent, a visit to your doctor is advised.

Are they depressed?

Things to look for: loss of appetite, decreased interest in things they normally take interest in, isolation, etc.
What can you do? Interact with them as much as possible; try to engage them in activities to make them feel useful. If the symptoms persist, seeing a psychiatrist is advised.

Has their eating environment changed?

Things to look for: they appear distracted by objects in the environment (i.e. looking around, analyzing objects in room).
What can you do? Try to feed them in a familiar place, preferably wherever they are accustomed to eating (e.g. dinner table). Also try to minimize visual as well as auditory distractions such as the television, radio and telephone calls. The timing of meals is often overlooked, but it is important to adhere to an eating schedule. Alzheimer’s patients tend to do better when they have a schedule, this also applies to other activities as well (e.g. bathing, going for a walk, shopping, etc.). adequate lighting is also very important and often overlooked.

Is it the food?

Things to look for: they appear disinterested in the food, do they pick at it, turn their head when you try to feed them.
What can you do? : Keep in mind that their memory might be fading, but their food preferences haven’t changed. Try to give them foods that they are familiar with and enjoy. Ask yourself “is this something I would eat?”

Do they appear confused?

Things to look for: they may appear to hang up with certain tasks, such as which utensil to hold. They could be distracted by patterns on the plate, napkin, etc.
What can you do? : give them simple one step commands on using each utensil. Try to use plates and napkins with simple designs or just plain white dinnerware. Try to be patient, if you get agitated, so will they.

Other tips:

Adjust the consistency if they are having difficulties with chewing or swallowing. Soft foods such as scrambled eggs, applesauce or pureed food are preferable. Try to avoid hard foods such as nuts, corn, carrots because they may be too difficult to chew and can become lodged in the throat.
Help them maintain good posture while eating
Ensure adequate hydration during warm weather.
Use bowls instead of flat plates when possible and try to use utensils with large handles that are easier to hold by someone with arthritic fingers
Use of nonskid place mats under plates can help keep the plate from sliding on the table.
Important! You should become familiar with performing the Heimlich maneuver. It is quick and easy to learn and it can save the life of a loved one in the event they choke on a piece of food.

Sources:

McDaniel JH, Hunt A, Hackes B, Pope JF., American Journal of Alzheimer’s Disease and Other Dementia. 2001 Sep-Oct;16(5):297-302.

Mayo Clinic Staff, Alzheimer's: Making mealtimes easier Oct. 23, 2007, website: http://www.mayoclinic.com/health/alzheimers/HQ00217, accessed Nov. 21, 2008.

Oct 6, 2009 2:00 PM

Party On!: The Socialization Factor in Healthy Aging

Caitlin Nasca — Thu, 27 Aug 2009 16:15:00 GMT

By: Kathy Laurenhue

A few decades ago, Barbra Streisand became famous singing, “People who need people are the luckiest people in the world,” but the reality is, we all need people, and research studies increasingly prove it.

When various experts are asked, “How can I age well?” the standard responses nowadays are almost universally: exercise your body and brain, eat a healthy diet, get enough sleep, cultivate a positive attitude, tune in to your spiritual side—and socialize with friends. In fact, the importance of socialization is increasingly grabbing attention, and may be as critical to longevity as giving up smoking and other unhealthy habits.

Consider these findings:

• A landmark UCLA study found that the “fight or flight” response that has long been accepted as the normal reaction to stress is generally a male response. Women are more likely to “tend and befriend,” and this alternative may be a contributing factor to their longer life expectancy.

• Research has shown that people with regular social ties are significantly less likely to demonstrate cognitive decline when compared to those who are lonely or isolated.

• University of Michigan researchers who tested 3,610 people between the ages of 24 and 96 found that even 10 minutes of social interaction improved cognitive performance.

Avoiding isolation is especially important for caregivers whose stress levels often feed physical and mental ailments. As well-said by one former caregiver, Juanita Tucker: “Each of us needs time for self, for friends, for fun, for recreation. Fulfilling these needs will not take away from our loved ones. Indeed, it will nourish and enrich us, and enable us to give more.”

So if people need people for healthy aging, how can we nurture those relationships?

Here are a few ideas:

Make physical exercise a group exercise. Taking a daily walk is good for your body and brain, and taking a walk with a friend may compound your sense of well-being. It is much easier to get your daily exercise if you do something you enjoy with someone you enjoy. Walk, swim, play croquet or bowl—whatever floats your boat. If you can’t get out due to weather or disability, electronic games such as Wii cleverly offer the opportunity to play old favorite sports in the comfort of home—and with companions.

Put multiple minds together for brain aerobics.

Doing crossword puzzles or Sudoku is generally a solitary effort, but lots of brain-building activities can be done with others. Board games like Scrabble, Upwords, Trivial Pursuit and Smart Mouth, for example, are fun precisely because they involve combining the power of multiple minds. In residential care settings, trivia quizzes, word games, reminiscence discussions and other daily events are effective group activities because one person’s response may trigger another person’s insight, thereby enriching the overall effect.

Share a meal. Eating a healthy diet is important, and, yet, perhaps the greatest aid to digestion is the company of others. What’s that? You live alone? Invite a friend to lunch if you can. At the same time, technology allows people who are far away to share a meal by using inexpensive computer Webcams. I watch you eat while you watch me eat, and we both enjoy the conversation. If you aren’t yet proficient with technology, you can do a non-visual version with telephones.

Enroll in a special interest group. What’s your favorite thing to do? How can you share with others the enjoyment of doing it? Groups abound for virtually every interest, whether it’s playing bridge or ballroom dancing. Even if the normally solitary act of reading a book is your way of relaxing, consider joining a book club to share thoughts and socialize. Also contemplate not just what you enjoy, but what you need. Many people find that a support group for those affected by Alzheimer’s disease, for example, provides the unique camaraderie of people who truly understand.

Join an online group. If it’s difficult to get out and about because you live in a rural area, have health problems of your own or are caring for a loved one, the virtual world can open endless new opportunities. Here, too, more and more special interests can be accommodated, from Alzheimer’s disease-related chat rooms to Web sites that enable you to play Scrabble and other games with long-distance partners to your heart’s content. If you’re not computer savvy, come of age by taking a class or connecting with someone like a grandchild or teenage neighbor who knows how to navigate the Web.

Be a friend. Consider the quote by the late radio host Bernard Meltzer: “A true friend is someone who thinks that you are a good egg even though he knows that you are slightly cracked.” What we love about our friends is that they accept us as we are. They listen without judging. Anyone can learn to do that. Reach out. Sometimes all it takes is a simple invitation: “Come sit by me; I’d like to get to know you better.”

Volunteer. It’s possible to overcome your own troubles by helping others with their problems. One terrific way to make new friends is to volunteer for a cause you believe in.

In pondering socialization opportunities, remember to focus on what replenishes your spirit, not drains it. If a social activity adds to your stress, bow out. This advice also applies to people. Not all relationships are created equal. Wooden people who try to whittle others down can literally whittle down your health as well.

In reality, we can’t avoid all negative people, and we can’t always have the social interactions we might choose, but we can reframe our thinking. A nursing home resident can say, “Poor me; I’m surrounded by 50 sick, crabby people,” or he or she can say, “I am surrounded by 50 people I know nothing about. I bet each one has an interesting story to tell and would like me to be a willing listener.”

Socialization gives us a sense of belonging, of being part of a community—even if it’s a community of only three or four people. With community comes confidence: By this group I am valued; what I do with this group gives my life meaning. With confidence comes self-esteem and an increased sense of well-being.

But the greatest benefit of socialization is that people who share experiences are much more likely to laugh together, and laughter may be the best boon to longevity we have. So party on!

Aug 27, 2009 11:15 AM

Activity Corner: Kitchen

Courtney Cook — Thu, 27 Aug 2009 16:00:00 GMT

It’s a reality in our culture that women grow up in the kitchen. As young girls, we are taught to help out our mothers in the kitchen, as teens we begin to learn how to prepare simple meals, by the time women reached adulthood preparing meals is something that women are often tasked with for their growing family. As women with Alzheimer’s progress more and more into the disease process we often discourage working in the kitchen. This is a responsible decision as there are many safety issues that can happen in the kitchen. However, for many women and even some men this was their family role. Cooking was their way of caring for their family. The idea of not being able to cook can cause mild depression due to the challenge this poses with the person’s dignity and independence. For some this loss of independence can be as debilitating as not being able to drive. You can help your loved one regain some of their independence by involving them in other appropriate parts of the cooking process. Here are some ideas to help get you started:

Have your loved one help in the preparation of making salads, ice cream, Jell-O, pudding (try a hand mixer), no-bake cookies and pies, popcorn balls and other simple recipes.
Have your loved one wash fresh produce and put it into bags.
Have them help to grind nuts to use for baking.
Get their help peeling easy fruits and vegetables such as oranges
Get their help copying recipes from magazines onto cards.
Get their help to make a grocery list of items needed for recipes.
Have your loved one sort recipes and find pictures to illustrate them.
Get their help to empty the dishwasher (use melamine or plastic dinnerware).
Get their help setting the table or folding/ rolling silverware into napkins.
Have them assemble shish-kabobs with fruit or vegetables (use wooden ones with blunt ends).
Get their help shelling nuts or peas.

Aug 27, 2009 11:00 AM

Successfully Getting Over the 65+ Hill

Caitlin Nasca — Thu, 27 Aug 2009 16:00:00 GMT

THE SITUATION

“65” is often considered a turning point. And so it is as well for Alzheimer’s disease: with age the greatest risk factor for the brain disorder, the number of people with the disease doubles every five years beyond age 65. However, this milestone can also be looked at positively—a time to really concentrate on successful aging. By incorporating these 15 steps into your daily life, people over 65 (and under 65) can help protect their bodies and brains as they age.

THE SOLUTION

Develop a healthy attitude. You’re never too old to start taking care of your physical and mental health. Doing so can make the difference between another good decade or a decade of disability.
Exercise regularly. Studies show that a 30-minute walk each day is optimal.
Flex your mind. Learn new things and take new mental challenges throughout life.
Maintain social contacts. Loneliness is deadly for older people. A network of friends will stimulate the brain and the soul.
Stay psychologically fit. Depression is a common— but not a normal—part of growing older and may hasten the onset of intellectual loss. Talk with your doctor.
Quit smoking. Many older people have the attitude, “It doesn’t make any difference, the harm is done.” People can feel better and avoid smoking-related health problems by quitting cigarettes at any age.
Stay trim. Obesity in older persons can increase health problems, including driving up blood sugars and boosting the risk for dementia. Chronic obesity in middle age may increase the risk of dementia in later life.
Limit alcohol. Alcohol damages the heart, liver, muscles and nerves, and excess drinking can lead to falls and injuries. Limit consumption to one ounce per day. People with Alzheimer’s disease should not drink any alcohol.
Understand your medications. Frequently, doctors do not talk to other doctors so your medications may interact or overlap. You’re responsible for understanding your medications and asking questions about side effects.
Watch your diet. Eat a balanced diet and take an all-purpose vitamin. Calcium supplementation is important to maintain bone strength.
Find a doctor you trust. Look for a primary care doctor who understands health problems in older persons, since medication doses, medical management strategies and treatment philosophy is different than for younger individuals.
Take your doctor’s advice. Having a smart doctor doesn’t work if you don’t take the doctor’s advice. If you trust your doctor, then do what he or she says.
Keep your soul healthy. Spiritual fitness is as important as your physical and psychological health and can reduce the incidence of health problems.
Control your future. With a higher risk of experiencing a health emergency, older people should make their wishes known to family and document them.
Enjoy your life. Humor and joy will lift your spirit, strengthen your body and feed your soul.

PREPARE IN ADVANCE

You don’t have to wait until your 65th birthday to start on the road to successful aging. Implement a heart-healthy and brain-healthy regimen at any age. Discuss strategies with your primary care provider.

Aug 27, 2009 11:00 AM

When is it Time to Find Placement for a Loved One?

Lynn Mortimer — Thu, 30 Jul 2009 18:00:00 GMT

By: Lynn Mortimer, Gulf Breeze Courtyard Assisted Living Facility

Having worked in this field for 18 years, I have learned the recurring traits of the family member looking for placement. It is usually a caregiver in a crisis situation. “Mom is in the hospital and they are discharging her today.” Prior, there have been many warnings. Spouses and family members tell the loved one that they will never “put them in a home” and are trying to keep the promise that they made. This is usually at the expense of the caregiver themselves either through declining health or sheer mental exhaustion.

If you answer yes to most of these questions, start looking for placement:

ŸHas your health declined as a result of caring for your loved one?

ŸIs there more one on one attention than you can keep up with?

ŸHas your loved one ever left the stove on or water running?

ŸHas your loved one ever wandered from home and gotten lost?

ŸHave there been repeated trips to the hospital?

ŸDo you ever lose your cool with your loved one?

ŸAre you spending more money than it would take in long term placement?

ŸIs your loved one refusing to eat, bathe, or any other activities of daily living(ADL’s)?

Having been a caregiver myself in the early 80’s, I am well aware of the promises made verses what is right for the individual in need. Sometimes you have to step back and look honestly at the quality of life that the loved one is receiving and if you cannot deliver all that is needed and you are at your wits end on what to do next, you owe it to yourself to become educated on long term care options. For my grandmother, the social aspects worked wonders. The whole time I was trying to care for her, it never occurred to me that her non-compliance to diet and hygiene would all change once she was around others in a structured environment. Be careful not to isolate your loved one while trying to do all that is required of you. It is easy to do.

If you answer no to most of these questions, start looking for placement:

ŸIs the environment stress free, allowing less agitation?

ŸIs my loved one getting the proper socialization? ie: church groups, outings, social interaction?

ŸAre you keeping up with your daily duties with spouse, kids and career while meeting the needs of your loved one?

ŸAre you able to physically lift your loved one while toileting or bathing them?

ŸDo you have time set aside each day for exercise and fun together?

ŸDo you set aside time each day for yourself?

ŸDo you supply programs that give them choices?

ŸDo you know the skills of redirecting frustrations during an agitation episode?

ŸIs my loved one compliant with medications and diets?

ŸAre you able to keep them busy all day, allowing better eating and sleeping patterns?

ŸDo you feel your loved one has a sense of accomplishment at the end of the day? Ie: a feeling of still being needed?

Many residents that come into my campus have been at home watching TV most of the day, causing them to eat poorly and sleep sporadically all day which keeps them from sleeping at night. There should be plenty of exercise even if they are in a wheelchair. Stretching and proper breathing throughout the day is very beneficial and a structured environment is less stress on your loved one. Once in a routine, they tend to follow it. §

Lynn Mortimer is the Marketing and Admissions Director at Gulf Breeze Courtyard Assisted Living

Jul 30, 2009 1:00 PM

Activity Corner: The Magic of Music

Courtney Cook — Thu, 30 Jul 2009 18:00:00 GMT

By Courtney Cook, BSW
Music is one of the best, most effective ways to create a calm, soothing environment. Along with the soothing effect of simply listening, participation also provides an opportunity for loved ones with musical or vocal skills to “show off” and boost their sense of worth and provide enjoyment to listeners. It’s not uncommon for patients who played piano much of their lives to be able to play entire songs flawlessly, yet not remember what they had for breakfast or have the ability to tie their shoelaces.

One of the hardest parts about caring for someone who has Alzheimer’s disease is watching the person slowly loose access to memories and, in a sense, loose their identity. For some Alzheimer’s patients, however, music can help the person to regain these memories. According to Consumer Health News, “the memories and emotions that people associate with familiar songs can be traced to the medial prefrontal cortex, a part of the brain where the wiring for memories and thoughts about music appear to be linked” (2009). Think about it this way, when you hear Elvis Presley’s song “Ain’t Nothing but a Hound Dog” what do you think about? A first date? A fun time out with friends? Because of the way the medial prefrontal cortex is formed we associate song with music. The same is true for a person with Alzheimer’s disease. A piece of familiar music serves as a soundtrack for mental movies that play in our head.

Music can allow for reminiscing of memories and can also serve as a deterrent from difficult or anxious behavior from Alzheimer’s patients. So what should you do if you want to use music in your caregiving role with your loved one? Here are some guidelines to get you started:

ŸPlay music that is familiar and enjoyable (this may mean playing music that was popular in your loved one’s prime)

ŸUse music that does not have disruptions likes commercials. Instead use tapes, CD, MP3s or live versions

ŸUse music to match the mood you’re trying to create

ŸLink the music to other reminiscing activities

ŸEncourage movement such as clapping or snapping

ŸEliminate competing noises such as the television, water running, or doors shutting as this could cause overstimulation

ŸBe aware that music can bring back frightening memories like service in times of war or the death of a loved one. Watch for signs of increased agitation.

“Why Music Triggers a Walk Down Memory Lane; Discovery of Brain Area Responsible for Link Could Lead to Alzheimer’s Treatment, study says (Report).” (2009, February 9). Consumer Health News.

Jul 30, 2009 1:00 PM

Respite Care Can make a Big difference: A Personal Story

Dawn Hood Patterson — Wed, 15 Jul 2009 15:00:00 GMT

By: Mr. Joe Ross

This letter was adapted from the testimonial delivered by Mr. Ross at our 2009 Mozart & Margaritas Event.

For the last 3 years I have been the sole caregiver for my 92 yr. old Grandmother, Mary Besal, who is in the end stages of Alzheimer’s Disease. Approximately 1½ years ago my initial contact with Alzheimer’s Family Services was with the Client Services Coordinator, Courtney Cook, who received my very desperate telephone plea for help. At the time of my call to Alzheimer’s Family Services I was seriously concerned about the well-being of not only my Grandmother but also of myself and whether I would be able to continue providing in-home care. Courtney promptly arranged a respite care-giver for my Grandmother to enable me to attend the monthly Alzheimer’s Support Group, held at the Bayview Senior Center.

Although I was initially pessimistic about the benefits of a support group, the Alzheimer’s Support Group, facilitated by Alzheimer’s Family Services Board Member, Katherine Murphy, has become an important part of my life. The Support Group is my lifeline to information and resources available thru AFS and other organizations, a much needed emotional support during my numerous times of stress and crisis, and most importantly it has allowed me to continue to provide quality in-home care to my Grandmother.

So to you Katherine Murphy and the members of the Bayview Support Group, Courtney Cook, all the Corporate Sponsors, and each and everyone here tonight who came to support Alzheimer’s Family Services I and my Grandmother thank you. Without your support I would not be here tonight.

Thank You & MAY GOD BLESS YOU!

Jul 15, 2009 10:00 AM

SHE IS HEAVY, SHE IS MY MOTHER

Dawn Hood Patterson — Wed, 15 Jul 2009 15:00:00 GMT

By: Dawn Hood-Patterson, MDiv

It is never easy to care for a loved one with Alzheimer’s disease, especially if you are the primary or sole caregiver. My grandmother-in-law was recently diagnosed with Alzheimer’s disease. There was a delay in the diagnosis, mainly because we, as a family, simply didn’t know what we were supposed to be looking for. Come to find out, we were not alone. A 2006 study, “I CAN: Investigating Caregivers’ Attitudes and Needs” Conducted on behalf of The Alzheimer's Foundation of America (AFA) and sponsored by Forest Pharmaceuticals, Inc. found that 40% of caregivers delay in finding a diagnosis for this very reason.

This study also concluded that many caregivers, as many as 45%, reported that “seeing someone they love lose their ability to function effectively” was the most emotionally taxing part of caregiving. This study also indicated that 96% of caregivers wished that they received more help with the day-to-day tasks of providing care.

My mother-in-law is the primary caregiver to her mother. Our phone conversations used to be filled with excitement over upcoming holidays, family events and special gatherings. We now have frequent conversations in which my mother-in-law expresses deep gratitude for the home health aides that have helped her as she cares for her mother. Though my mother-in-law has been able to remain relatively up-beat as she provides full-time care, the exhaustion is noticeable in her voice.

The “I Can” study also revealed that overall, the two most visited places that caregivers go for information concerning Alzheimer’s disease is the doctor of a loved one and secondly, an advocacy organizations (such as Alzheimer’s Family Services). This study shows that, “at the time of diagnosis, many caregivers felt sad and/or scared thinking about what the future might bring. Other emotions were felt by some and tended to vary by caregiver gender. Level of preparedness at the time of diagnosis varied from respondent to respondent.” 65% of caregivers expressed sadness, knowing that this disease would only cause their loved one to worsen. 39% of caregivers expressed concern about what the future might bring. This study has shown that our family is not alone in the battle for our loved one’s health.

Kristina Robison, Executive Director of AFS, advises that education is the most significant influence at this point. She encourages caregivers to read, attend support groups, and go to seminars, watch documentaries, and research online. Of course, you can call Alzheimer's Family Services (AFS) for guidance as well. We have a small library of resources available for check out and a social worker that can help with specific challenges you may be facing.

Kristina states, “This does not negate the need for respite – or relief. Knowing something – and dealing with it on a daily basis are two different things. Take breaks. Recruit family and friends to visit with your loved one while you take a few hours off.” Providing care in your home can be overwhelming when you factor in the economic and emotional costs. Remember to take breaks! It will help reduce stress and anxiety—for you and your loved one. It may be well worth the expense to higher a sitter service or Home Health Care workers. §

This study can be read, in its entirety:

Lewis, Felisha & Irvine, Jenny (2006). I CAN: Investigating Caregivers’ Attitudes and Needs. Harris Interactive, Inc. Retrieved June 17, 2009, from http://74.125.95.132/search?q=cache:AcK3NF_8Qm8J:www2f.biglobe.ne.jp/~boke/ican2996.pdf+caregiver+attitudes+and+needs+survey+alzheimer%27s+foundation+of+america&cd=9&hl=en&ct=clnk&gl=us&client=firefox-a

Jul 15, 2009 10:00 AM

Does It Seem Like Caring If I Say “No”?

Dawn Hood Patterson — Wed, 15 Jul 2009 15:00:00 GMT

By: Dr. Libby Bellinger, DMin, MDiv, MS, LPC

Ellen’s mother, who lives alone, insists that Ellen call her every evening. Ellen is busy many evenings and often finds it difficult to make the nightly phone call. When she learned about a program through her church where volunteers make the calls instead, she was delighted and immediately signed her mother up.

“I thought this would be a great solution,” Ellen said. “I can still call Mother most evenings, but when I can’t call, someone will still be checking on her. It also gives her someone new with whom to talk. But Mother is furious. She says if I really cared about her, I’d make time to call her and not rely on strangers. Maybe she is right; I don’t know what to do now.”

Ellen’s dilemma is one that adult children often face. How can they decide whether a parent’s demands are unreasonable, and how can they say “no” to such requests. Experts suggest a number of guidelines:

§ Evaluate your parent’s limitations and the other resources (friends, neighbors, community services, etc.) she/he has available. If you find your parent’s requests burdensome, ask yourself how much your help is really needed.

§ Consider the long range effects on your parents if you allow them to become unnecessarily dependent on you. Maintaining independence and involvement is strongly related to health and happiness in elders.

§ Accept your limitations. Although you may sincerely want to provide for your parent’s every need, it is unlikely you can do so. If you burn yourself out providing unnecessary services, you may not be able to help when your assistance is really needed.

§ Respect the dignity of your parents when you respond to their requests. Help them find and arrange for needed services for themselves, rather than taking over and making plans for them.

§ Agree to provide only those services you can manage gracefully and with good humor. Help provided grudgingly or in the spirit of a martyr will leave both you and your parent feeling angry and frustrated.

§ Stick to your decisions. If you consider a request unreasonable or more than you can manage, explain your position and make alternative suggestions. Don’t feel you must continually justify your position.

§ Realize you are not responsible for your parent’s happiness. Often people have trouble accepting the losses related to aging, and they look for someone to blame for their distress. Accepting this blame and feeling guilty about your parent’s dissatisfaction, doesn’t help you or your parent.

§ Let your parent know you care, even though you may not always meet all requests. Show your affection by spontaneously sharing special times, by touching and hugging, by calling to share good news, etc.

Dr. Libby Bellinger is the Associate Director, Meals & Wheels, Waco, Texas

Jul 15, 2009 10:00 AM

Activity Corner: Fly A Kite

Courtney Cook — Fri, 29 May 2009 21:30:00 GMT

Flying a kite is an activity that people of all ages can enjoy! For those with Alzheimer’s it’s also a great way to reminisce, provide visual stimulation, and help with fine motor skills.

Kites can be purchased at most discount stores or, for a fancier kite, try a hobby store. If your loved one is unable to hold the kite, bring along a comfortable folding chair. Have your loved one watch the kite as you fly it and it soars through the air. You can help to involve your loved one by talking about the experience, the surroundings, or the other people around you. You can also reminisce with your loved one about past times in their life when they might have flown a kite.

A couple of safety tips while flying your kite:

Never fly a kite near power lines

Don’t fly a kite in stormy weather

Never use a metallic flying line

Avoid flying a kite near or over people

Always be aware of your surroundings and mindful of others

May 29, 2009 4:30 PM

Activity Corner: Spring is in the Air!

Courtney Cook — Fri, 27 Mar 2009 19:15:00 GMT

By: Courtney Cook, BSW

Nature can provide many benefits to the person with Alzheimer’s disease as well as to you: physical exercise, fresh air, and stimulation of multiple senses-sights, sound, smell, and touch. Get some fresh air and enjoy these fun activities outdoors!

Garden Together

Maintaining a garden of flowers, vegetables, or fruit can be fun and productive. The simple of daily care to flowers and place can give your loved one a sense of purpose and provide comfort in the routine. Many of these activities may still be familiar to the Alzheimer’s patient, so get their help with gardening projects. Ask questions such as, “Do you know what this flower is called?” or “Do you think this plant needs water?” You may be pleasantly surprised.

Spring time association game:

Have your loved one name things associated with spring! Here are a few to get you started:

Blossom Bloom Buds Leaves Parades

Baskets Seeds Bees Butterflies Showers

Birds Bunnies Garden Flowers Babies

Sunshine Wind Easter Kites Rain

Bonnets Cleaning Baseball Wildflowers

Something to talk about: Famous Bunnies

Peter Rabbit: The Easter Bunny is famous, no doubt, but probably the most famous bunny is Peter Rabbit! He is known in many countries around the world. He was created almost 100 years ago by an English woman named Beatrix Potter. He first appeared in a letter that she wrote to a young friend. Eight years later, she turned it into a book. There were many publishers that turned her down before it was finally published in 1902. For another 10 years she wrote and illustrated many children's books. After that, she became interested in the farm that she and her husband worked, and had little time for writing or drawing.
Peter Cottontail: The song "Peter Cottontail" was written by Steve Nelson and Jack Rollins about 46 years ago. These two men also wrote the popular story "Frosty the Snowman".
Bugs Bunny: The Bugs Bunny cartoon character was created in the late 1930's. He got his name from the person who created him, Ben Hardawary, whose nickname was "Bugs". Bugs Bunny has starred in over 160 animated cartoons. Do you know his famous saying?” What’s up Doc?" Who was the voice of Bugs Bunny? (Mel Blank.)
Brer Rabbit: Most Americans know the story about Brer Rabbit and the Tar Baby and Brer Rabbit and the Briar Patch. The folk hero of these tales was Brer Rabbit. He outsmarted all the other animals, especially Brer Fox. Joel Chandler was the first person to write folk tales about Brer Rabbit. Uncle Remus was an old storyteller he created to tell the stories in his books.
The Easter Bunny: The Easter Bunny is an ancient symbol of the joy of new life that
spring brings.

Reference:

Salazar, Gina (2004). The Activity Directors Office. Retrieved March 19, 2009 from http://www.theactivitydirectorsoffice.com/Gina_ActivityIdeasThatWork_April.html

Mar 27, 2009 2:15 PM

LOCAL ORGANIZATIONS CELEBRATE HOME CAREGIVERS

Jenna Harper — Fri, 27 Mar 2009 19:00:00 GMT

By Jenna Harper

During a time when everyone is pinching pennies, local elder care companies, community service organizations and area businesses have partnered together to give back to home caregivers of Alzheimer’s and dementia patients who spend countless hours each day caring for loved ones at home.

"Caregiving can be an emotionally and physically draining experience, especially when the person you are caring for requires constant supervision, said Alzheimer’s Family Services’ Executive Director Kristina Robison. “Respite - or relief - provides family caregivers an opportunity to take a break and rejuvenate. Studies in the field of Alzheimer's care show that when caregivers don't receive adequate time away from their daily duties, they are at risk for developing anxiety and/or depression."

The Caregiver Celebration Partnership (CCP) was formed as part of University of West Florida’s Leadership Communication Master’s program. Jenna Harper, organizer of the project, graduates from the program in May.

The CCP will offer several free services on a first come, first serve basis to home caregivers, including free respite, meals, house cleaning and lawn care.

Home caregivers who are interested in scheduling respite so that they can get out of the house for a few hours can enjoy free caregiving provided by Assisting Seniors, Visiting Angels, or TLC Caregivers. All three of these senior companion companies are licensed agencies who employ trained individuals equipped with the tools to properly care for those with limited physical abilities and those with memory disorders.

Home caregivers who aren’t interested in respite, but find that they no longer have time to cook, clean or maintain their lawn, allow Broadview Assisted Living to provide you a free, hot meal courtesy of Chef James. (Yes, they will deliver!) Gulf Breeze Courtyard, an assisted living facility that specializes in memory care, will also be providing free lunch and activities for loved ones. If cleaning or lawn care is your biggest challenge, volunteers of Dr. Ruby J. Gainer High School’s B.E.S.T. program will be happy to scrub your house or mow your grass. Graduate students from UWF’s Leadership Communication program will also be volunteering.

Finally, for all of the female caregivers who feel like they haven’t been pampered in years, let Mary Kay Cosmetics treat you to a free makeover. (No purchase necessary!)

If you or someone you know is interested in any of these volunteer services, call Jenna Harper with Broadview Assisted Living at 850-505-0111.

The above program is sponsored by the CCP from UWF and lead by Jenna Harper. To benefit from these "first come, first served" services, please contact Jenna directly.

For other respite needs, you may contact:

By Kristina Robison, MS

wAlzheimer's Family Services provides monthly respite for caregivers of Alzheimer's patients so that they may attend a caregivers support group. Schedules for groups are available at www.alzfamserv.org or by calling (850) 478-7790

wCouncil on Aging (850) 432-1475. They also provide an Adult Daycare program - see article One of a Kind Opportunity for Care and Respite.

wPrivate Pay Sitter Services - available in local phone books. Tip: ask about staff training and background checks, and ensure the agency is licensed.

Mar 27, 2009 2:00 PM

MEDICATION USE IN THE TREATMENT OF ALZHEIMER’S DISEASE

Fri, 27 Mar 2009 19:00:00 GMT

By Carrie Williams, PharmD

Symptoms of Alzheimer’s disease are divided into two categories: cognitive and behavioral. Cognitive symptoms include impairment of memory, language, judgment, planning, ability to pay attention and other thought processes. Behavioral symptoms do not affect every AD patient but may develop. Examples of behavioral disturbances are agitation, wandering, and hallucinations.

COGNITIVE SYMPTOMS

Below is a short list of factors that may be taken into account when cognitive-enhancing medications are being considered:

§ Stage of Alzheimer’s disease (mild, moderate, severe)

§ Other medical conditions

§ Ease of use - It is essential that these medications are taken as prescribed (daily, twice a day). It takes several weeks for these medications to reach a constant level in the body and if doses are missed the level drops and the medication may not be effective.

§ Tolerability/ Adverse effect profile of the medication

§ Cost

There are currently five medications approved by the U.S. Food and Drug Administration (FDA) that may slow the worsening of cognitive symptoms of Alzheimer’s disease (AD). Some research has also shown improvement of behavioral symptoms. These medications are divided into two classes that target different chemicals involved in carrying messages between brain cells.

The first group of medications target an enzyme called cholinesterase. By inhibiting cholinesterase, they increase the amount of acetylcholine available in the brain. Acetylcholine is a naturally occurring chemical in the body and plays an important role in learning and memory. As an individual ages acetylcholine levels decline, a process that is believed to occur more rapidly with the progression of AD. This class of drugs includes Aricept® (donepazil), Razadyne® (ER) (galantamine), Exelon® (rivastigmine), and Cognex® (tacrine). All are approved for the treatment of mild to moderate dementia. Aricept is also approved for use in severe stages of AD. These medications may delay worsening of symptoms for 6-12 months in about half the people who take them. Patients should be evaluated for effectiveness of a cholinesterase inhibitor after at least 6 months of therapy.

Namenda® (memantime) is currently in a class of its own called NMDA – receptor blockers. It works on a nerve-stimulating chemical called glutamate, when not regulated, excess glutamate may lead to brain cell death. Namenda® blocks NMDA-receptors on nerve cells to prevent overstimulation by glutamate. It may be prescribed alone or in combination with a cholinesterase inhibitor. Other NMDA receptor blockers are currently in development.

Both groups of medications have side-effects that sometimes occur during the initiation of therapy. Side-effects that may occur with cholinesterase-inhibitors include nausea, vomiting, loss of appetite, or increased frequency of bowel movement. Cognex® is rarely prescribed in the United States because of a significant risk of liver toxicity. Headache, constipation, confusion, and dizziness are side effects that have been experienced with Namenda®. With the exception of Cognex®, the symptoms listed above are relatively minor and usually go away with time. Rare, but more concerning side effects, may include slow heartbeat, persistent dizziness, sudden weight loss, stomach pain, or yellowing of the skin. If you experience any of these symptoms you should report them to your doctor immediately. When starting any of these medications, a schedule will be determined to increase the dose slowly. This titration usually occurs over a few weeks and will vary depending on the patient and medication selected. If you experience any disturbing side effect, notify the prescriber to discuss your options. Adjustments to consider before stopping treatment may include: slower titration, timing change, or possibly trying another medication.

Finally, the goals of drug therapy include temporary improvement, stabilization, or slowing decline. No medications are available to stop the deterioration of brain cells, therefore drastic changes should not be expected. As discussed, not all patients will respond to medication treatment.

BEHAVIORAL SYMPTOMS

In different stages of AD patients may experience aggression, emotional distress, hallucinations (seeing, hearing, or feeling things that are not there). These feelings can cause severe agitation or even combativeness. All patients who develop these symptoms should receive a thorough medical exam, especially if symptoms appear suddenly. Pain, infection, problems with vision or hearing, or medication side-effects could cause an acute change in behavior unrelated to AD. Other situational or environmental changes could also contribute to fear or increased confusion.

Potential solutions (www.alz.org)

§ Monitor personal comfort. Check for pain, hunger, thirst, constipation, full bladder, fatigue, infections and skin irritation. Maintain a comfortable room temperature.

§ Avoid being confrontational or arguing about facts.

§ Redirect the person's attention. Try to remain flexible, patient and supportive.

§ Create a calm environment. Avoid noise, glare, insecure space, and too much background distraction, including television.

§ Simplify the environment, tasks and solutions.

§ Allow adequate rest between stimulating events.

§ Provide a security object or privacy.

If symptoms are thought to be associated with AD, first-line treatment should include environmental modification, task simplification, clear communication and other non-pharmacologic options. If these methods are unsuccessful, then medications targeted to specific behaviors can be explored. In patients with significant behavioral disturbances the risks of not treating these complications must be weighed against the risks associated with treatment. There are no medications approved by the FDA specifically for the treatment of behavioral symptoms associated with Alzheimer’s disease. This means that medications that are FDA-approved to treat other conditions may be prescribed “off-label” to treat similar symptoms in AD patients. “Off-label” use is a medical practice in which a physician may prescribe a drug for a different purpose than the ones for which it is approved. The “off-label” use of any drug should be done with caution and by physicians experienced with their use. Side effects can be serious and patients must be closely monitored. The minimum effective dose should be used and if the symptom has improved, periodic trials of medication withdrawal should be attempted.
Examples of medications used off-label for behavioral symptoms include anti-anxiety, antipsychotics, and mood stabilizers.

Antipsychotics: Riperidone(Risperdal®),Quetiapine (Seroquel®), and Olanzapine (Zyprexa®)

Anti-anxiety: Lorazepam (Ativan®), Alprazolam (Xanax®), Diazepam (Valium®)

Mood Stabilizers: Divalproex sodium (Depakote®), carbamazepine (Tegretol®)

If treatment is started with one of these medications be sure to discuss the side-effect profile and when/what specific improvements can be expected. Changes may not be significant for months depending on the treatment. To decrease the risk of complications, it is absolutely necessary to start with low doses and increase slowly if required.

All AD patients should be followed closely by a physician to monitor and adjust their personal treatment plan, including management of other medical conditions. The plan should be flexible and reevaluated on a regular basis. A personal journal that describes specific times and events is helpful to identify triggers and make changes. Take an accurate and up-to-date medication list to all appointments.

Mar 27, 2009 2:00 PM

One of a Kind Opportunity for Care and Respite

Sandie Holtry — Fri, 27 Mar 2009 19:00:00 GMT

By: Sandie Holtry, Council on Aging of West Florida

Council on Aging of West Florida’s Adult Day Health Care Center is the only licensed adult day health care center of its kind in the area. The center provides a protective, stimulating environment for older adults with physical and cognitive impairments and respite for caregivers. Positive outcomes for participants include increased interaction with peers and socialization, improved happier moods and behavior, greater sense of purpose in life, improved sleep habits, greater independence and increased motivation.

The center maintains a staff to participant ratio of 1:6 in accordance with State of Florida licensing requirements. The staff receives on-going, specialized training in areas such as Alzheimer’s disease and other forms of dementia. The center is open Monday through Friday from 7:30 a.m. until 5:30 p.m. The center’s daily routine includes breakfast, lunch, a snack, outside walks, exercise class, arts & crafts, table games, sports, card games, mental stimulation, special parties and celebrations and as well as regularly scheduled field trips to picnic areas, parks, museums, historical places, area attractions, bowling alleys and movie theatres. These well-supervised trips are not only fun, but trigger memories and promote socialization. Those not eligible for government funded programs may attend the center on a private pay basis.

Day on the Go is a new program of the center for higher functioning participants who can follow directions, have good endurance and capable of attending area attractions and events with limited supervision. Schedules are planned to allow for a full day of activity for participants as well as extended respite for caregivers. Each Day on the Go includes breakfast, exercise time, an outing and lunch. The cost is $65.

Upcoming Trips:

Friday, April 3: Gulf Island Naval Oaks Park Tour & Cookout

Friday, April 24: The Zoo

Friday, May 1: Big Lagoon State Park

Friday, May 29: Navarre Butterfly House

Friday, June 12: Munson Lake Swinging Bridge and Grist Mill

Friday, June 26: Weeks Bay Nature Walk

Please contact Sandie Holtry at 432-1475 ext. 180 or sholtry@coawfla.org to arrange a tour of the center or to sign someone up for Day on the Go. COA of West Florida serves Escambia & Santa Rosa County residents

Mar 27, 2009 2:00 PM