Monday
Mar182013

Calling all Teens who need help dealing with Alzheimer's Disease

It has come to our attention that the Alzheimer's Foundation of America (AFA), in their mission to to provide optimal care and services to individuals confronting dementia, and to their caregivers and families, through member organizations dedicated to improving quality of life, has established a division within their organization for teens.  AFA Teens educates, engages and supports teens with direct, online education and interaction. Embracing teenagers' thirst for the Internet, the division's hallmark since 2003 has been its dedicated Web site (www.afateens.org) which today receives about 35,000 to 45,000 hits each month. The site conveys information about the disease and caregiving tips in the peer-friendly and practical language that teens need while providing teens with several creative outlets for their thoughts and emotions. There is a moderated message board and Facebook page where teens can post observations and concerns and receive advice from AFA social workers, and teens may submit creative contributions, such as poems, essays, videos and scanned artwork, on an ongoing basis.

Currently there are no chapters in the DC Metro area.  To learn more about the organization and create a local AFA Teen chapter please go to http://afateens.org/create_chapter.html.

 

Tuesday
Mar122013

Is it Alzheimer's OR Age-Related Changes?

According to the website of the Alzheimer's Association, there are 10 early signs and symptoms of Alzheimer's Disease (AD).  Individuals may experience one or more of these signs in different degrees. Please see a doctor if you notice any of them in you or a loved one.  With early detection you can get the maximum benefit from available treatments and have more time to plan for the future.  However, some of these sign/symptoms may be mistaken for normal age-related changes to cognitive functioning.  Read below to learn the difference.

1.  MEMORY LOSS THAT DISRUPTS DAILY LIFE: One of the most common signs of Alzheimer's is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; increasingly needing to rely on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.   What's a typical age-related change? Sometimes forgetting names or appointments, but remembering them later.

2.  CHANGES IN PLANNING OR SOLVING PROBLEMS: Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.  What's a typical age-related change? Making occasional errors when balancing a checkbook.

3.  DIFFICULTY COMPLETING FAMILIAR TASKS AT HOME, WORK OR LEISURE:  People with Alzheimer's often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. What's a typical age-related change? Occasionally needing help to use the settings on a microwave or to record a television show.

4.  CONFUSION WITH TIME OR PLACE: People with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.  What's a typical age-related change?  Getting confused about the day of the week but figuring it out later.

5.  TROUBLE UNDERSTANDING VISUAL IMAGES AND SPATIAL RELATIONSHIPS:

For some people, having vision problems is a sign of Alzheimer's. They may have difficulty reading, judging distance and determining color or contrast, which may cause problems with driving. What's a typical age-related change? Vision changes related to cataracts.

6.  NEW PROBLEMS WITH WORDS IN SPEAKING OR WRITING:  People with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a "watch" a "hand-clock"). What's a typical age-related change? Sometimes having trouble finding the right word.
7.  MISPLACING THINGS AND LOSING THE ABILITY TO RETRACE STEPS:  A person with Alzheimer's disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time. What's a typical age-related change? Misplacing things from time to time and retracing steps to find them.
8.  DECREASED OR POOR JUDGEMENT:  People with Alzheimer's may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. What's a typical age-related change? Making a bad decision once in a while.
9. WITHDRAWAL FROM WORK OR SOCIAL ACTIVITIES: A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced. What's a typical age-related change? Sometimes feeling weary of work, family and social obligations.
10.  CHANGES IN MOOD AND PERSONALITY: The mood and personalities of people with Alzheimer's can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. What's a typical age-related change? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.
(above info taken from www.alz.org)
The care and support services of Buckley's for Seniors are available to make things easier for you and your family to live the best life possible with Alzheimer's or dementia.  Please call our office - 703-390-0535- to find out how we can help.  
Wednesday
Feb272013

Choosing a Nursing Home for your Loved One

What a daunting thing to be tasked with the responsibility of finding the right skilled nursing facility (SNF) for your parent or loved one!  U.S. News and World Report ran a recent article which contained a valuable checklist of questions to ask and things to look for during a visit to an SNF.  The article in its entirety can be found here

http://health.usnews.com/health-news/best-nursing-homes/articles/2013/02/26/how-to-choose-a-nursing-home?s_cid=related-links:TOP  

The checklist with introductory comments is below:

"When you visit a nursing home to check it out, coming prepared so you know exactly what to ask, see, and do is critical. You’ll want to conduct at least five separate interviews and tour the buildings and grounds. You can look over U.S. News’s checklist, then click here to download it and print it out  to take with you. You can personalize it after downloading by adding and deleting items.

Questions for a top administrator or director of nursing:
Problems or special needs:

  • How would your home deal with my father’s [dementia, weight loss, disability following stroke, or ____________________ ]?

Toileting

  • How do you handle incontinence?
  • How often do staff members help incontinent residents use the restroom?
  • Are many in diapers?
  • Do you ever use catheters?

Nutrition

  • How flexible is your menu—can residents make choices and are all Monday meals the same, for instance?  
  • How do you identify residents who are losing weight?
  • What do you do to make sure residents are eating, especially those who have lost interest in food?
  • Can residents eat meals whenever they want, or are meals only at scheduled times?
  • Are healthy snacks available?
  • Does your home honor religious or cultural dietary restrictions? Could you show me a sample menu of a [gluten-free, dairy-free, Kosher, low salt, or ______________] diet?
  • How do you ensure that your meals meet high nutritional standards?

 Falls

  • What do you do to prevent falls?
  • How often do residents fall?
  • What do you do when there’s a fall?

Health inspections

  • Please show me your last three survey inspection reports.
  • How has your home fixed any problems that were identified?
  • How quickly were the problems addressed?

Medical care

  • How often is a doctor on site?
  • Are dental services available?
  • How do you keep track of residents’ medical records?
  • If you have computerized health records, have you ever had any problems with the system?
  • Do residents receive preventive care such as annual flu and pneumonia shots?
  • Does your home arrange for regular hearing or vision screening?
  • If Mom has a medical need, who contacts the doctor?
  • If Mom needs to see her doctor, who arranges for transportation?
  • What hospital arrangements do you have for emergencies?

Staffing

  • What is annual rate of your nurse and nurse aide turnover?
  • What do you do to try to improve turnover?
  • How often do you use agency temp nurses?
  • What proportion of families would you say hire private nurses to supplement your staff nurses?
  • How often do nurses update doctors on residents’ health status?
  • What kinds of background checks do you perform prior to hiring?
  • Do you have volunteer programs?
  • Do you have a relationship with local schools or houses of worship?

Worrisome or missing data

  • I would like to discuss a few problems I’ve found out about such as [a high percentage of residents with moderate to severe pain; NA entries; etc.].

Safety

  • Do you have an emergency evacuation plan?
  • Do you hold regular fire drills?
  • Who helps residents with bathing?
  • Do you do nightly bed checks?
  • How often does the staff check on residents during the day?

Overall direction

  • What improvements have you put in place in the past year?
  • What other improvements are planned?
  • Do you often have to put residents on a waiting list?
  • Where would we direct our questions and concerns if we were to enroll our dad here?

Questions for the nursing staff:
Workload

  • How many residents do you care for?
  • Is that too many or about right?
  • About how much time do you try to spend with each resident?

Employee feedback

  • Do you like working with older people?
  • Is this a good place to work?
  • Do you get training and continuing education?
  • What do you get if you take part?

Questions for residents:
Quality of life

  • Do you have friends here?
  • Are you as busy as you want to be?
  • Does the home arrange outside activities for you?
  • Can friends and family visit whenever they want?  
  • Do you get to suggest or plan activities?
  • Do your visitors ever bring pets with them?

Nursing staff

  • Do you like the nurses and aides?
  • Do you have the same ones most of the time or do they change a lot?
  • Do they help you to the bathroom, and if you need help, do you get it in time?

Nourishment

  • Do you ever need help eating?
  • If so, do you always get help without waiting too long?
  • Are you often thirsty?
  • Do you have a special diet? (If yes:) Do you like the diet choices?

Questions for other families:
Nursing staff

  • What are your loved one’s medical concerns?
  • Does she get enough of the right kind of care?

Falls

  • Has she ever had a fall here? (If so:) What happened, and were you satisfied with how it was handled?
  • How confident are you that it won’t happen again?

Toileting

  • Does he receive the help he needs to go to the restroom?
  • Have you ever come to visit and found him sitting in his own waste?

Nutrition

  • Does your loved one need assistance eating?
  • Does he get help? Does he have a good appetite?
  • If not, does the nursing home do anything to help stimulate his interest in food?

Medications

  • How well do you think the staff here manages your loved one’s prescriptions?
  • Have there been medication-related problems?
  • If he is drowsy, confused, or inattentive, do you believe he may be receiving too many drugs or the wrong ones—or too much of one or more drugs?

Quality of life

  • Does your loved one participate in activities?
  • Are there options beyond bingo and movies?
  • Are there activities suited for different levels of cognitivity?
  • Do residents take excursions outside the home?
  • Is your loved one dressed in her own clothes when you visit, or is she wearing a hospital gown?
  • Was your mom able to bring personal belongings, such as pictures or furniture, with her when she entered the home?
  • Is there enough storage space, such as closets?

Ratings

  • Can you help me understand some aspects of the ratings or the health inspections that aren’t clear? How significant is __________ violation? How would you evaluate the way the home handled the problem?

Personal evaluations

  • Do you think this home will be able to meet my dad’s needs?
  • Is there anything you know about this nursing home that you think would help me make my decision?

Questions you can answer on your own:
Visitors

  • Is the parking lot full?
  • Are grandchildren or family and friends around?

Resident engagement

  • Are there lots of activities available?
  • Is the facility creative, regularly offering outings to museums or baseball games, art classes, or gardening on the grounds?
  • Do volunteer musicians and other entertainers visit regularly?
  • Do children or young adults from classrooms or youth groups come to do crafts, perform, or participate in other activities with residents?  
  • Is there a beauty salon or barbershop?

Quality of life

  • Are residents dressed in hospital gowns or their own clothes?"

Buckley is also available to assist you in determining which skilled nursing facilities in the DC metro area might best suit the needs and desires of your family.

Thursday
Dec062012

Santa Claus is coming to town! Are you ready?

Each year getting older adults gifts (or yourself for that matter) can actually be counter-productive, especially if there are hoarding and/or cluttering tendencies. How many times have we heard the “I don’t need anything” line, and a desire to give gets even more clouded by feelings of obligation or tradition? And in today’s climate, resources are tight for many, so here are some thoughts on capitalizing on two trends affecting all of us - the aging population and the economic downturn.

10 Aging in Place Gifts that cost only your time: (make a coupon or book of coupons presenting some of the following)


1. One home safety inspection: Then on the coupon date, go over The CDC/MetLife foundation Check List for Fall Prevention and Home Safety with the home owner and identify possible needed home modifications.  See prior post for link to this Check List
2. To put up/take down Christmas lights
3. Be their chauffeur for a day (you will drive them in their car anywhere they desire)
4. Walk the dog each week for a year
5. Cut the grass every two weeks/or shovel snow
6. Give a caregiver the weekend off and you do the caring
7. Cook dinner in-home one night for the senior
8. A deep-cleaning of the home
9. Tech-session (computer tutoring) help them set up a Facebook page or email
10. Wash/wax/change oil/vacuum the car

10 Aging in Place Gifts under $30

1. Home Smoke Alarm battery changes every 6 months
2. Change out lower watt bulbs with 3 higher/brighter energy-saving ones
3. Replace 3 toggle light switches with 3 rocker-style ones
4. Put in a Lever handle door opener to replace an old round doorknob
5. Install a toilet seat raiser
6. Put non-skid strips in the tub/shower
7. Paint the steps a brighter color (or paint the ends ofthe steps a bright contrasting color)
8. Place 2 Sensor LED Lights; one at the top and bottom of the stairs
9. Install a Duro-Med Expandable Door Hinge
10. Add a Wide Angle Peephole Viewer in the front door

10 Aging in Place Gifts Under $100

1. Rubber Threshold Ramp with Beveled Edges
2. The Memory Plus amplified BIG button phone
3. Replace old worn bedroom slippers with new with non slipsole ones
4. Clamp-on tub rail
5. DRILL-FREE Slide Bar with Handheld Shower and Showerhead
6. Snapfon “ez ONE” Cell phone for seniors w/ big buttons
7. Switch Sticks Walking Cane
8. Outdoor Motion Sensor Solar Security Light
9. Toro Electric PowerShovel
10. Jitter Bug (GreatCall) Phone

So happy shopping for one of these gifts of aging-in-place for the older adults on your holiday list!

Monday
Nov192012

Over the River and through the Woods to Grandmother's House we go...

Thanksgiving is almost upon us and we all have so much to be thankful for, especially if we still have our aging parents/grandparents in our lives.  As we get ready to gather together on Thursday, it might be good to consider that there are ways we can engage everyone who comes to visit on Thanksgiving – young and old alike.

Below are some ideas that might help to make everyone feel included and needed and have some fun along the way: 

  • How about asking grandma to peel the potatoes,  light the candles, decide the seating arrangements and arrange place cards
  • Aunt Betty could send the kids out to the back yard, supervising them as they collect leaves and then help them artfully arrange them as part of the centerpiece or mantle decorations
  • Grandpa and grandson could work a puzzle together – in fact, if there is room, several puzzles of different complexities could be started and folks can join in at whatever their comfort level
  • Uncle Harold could be asked to supervise the cutting of construction paper cut-outs (leaves, turkeys, etc.) that will be used for writing everyone’s reasons to be thankful.  He can have one of the younguns go around and distribute them to guests and another collect them to later be read during dessert.  (We like to put them all together in a decorative bowl which is passed around the table.  Each guest picks one and reads it aloud and the family tries to guess who wrote it)
  • More ambitious families could arrange for family members to draw a mural. What to put on it is up to you can and getting ideas from everyone can be as much of an intergenerational activity as the art work itself. After you’re done, you’ll want to roll it up and pass it on to next year’s host. 
  • If the weather is good, try a scavenger hunt with teams across the generations, or if your house is large enough try an indoor scavenger hunt if the weather is too chilly for an outdoor search.
  • If you have some musicians in the family, charge them with coming up with some intergenerational songs to play for a family sing-along.  You may want to print up the lyrics for some of the “old favorites” and certainly don’t forget to include “Over the River and through the Woods”!
  • A game of charades is a great way to bring families together across the generations.  It would require some advance time to set up but would be well worth the investment.  Using small file cards or slips of paper write phrases, names of books, movie titles or other well known quotations, one on each card. Make up as many as you can think of but try to keep the ages of your family members, particularly the youngest and the oldest,  in mind.  Will they know the phrase you are writing, will they be able to guess the words as they are acted out? Not every card will have perfect quote for everyone but work for a balance.

Wouldn’t it be great if we could make this year different by putting a little time aside now to plan how to bring generations together at Thanksgiving through activities created for intergenerational sharing. Yes, it will take some extra effort to figure out how to make it work and we certainly don’t want to deny certain football aficionados their games, but if we time things right, we can create some magical memories for everyone.  And isn’t that what family time is all about?

Tuesday
Nov132012

Time keeps on slipping, slipping, slipping...

For those of you old enough to have enjoyed the music of the Steve Miller Band, you no doubt remember the song "Fly Like an Eagle".   That "time keeps on slipping" refrain has special relevance to a project we'd like to share with you call TimeSlips which can indeed help put wings to the quality of life of many folks with dementia who have difficulty communicating.

TimeSlips (http://www.timeslips.org) is a story telling project that Anne Basting developed in the early nineties as a way to relate to people with dementia by inviting them to express themselves and connect with others.  This is done via an expressive photo that is used to prompt improvised storytelling.  The beauty of it is that it opens storytelling to everyone by replacing the pressure to remember with the freedom to imagine.

Anyone can use this technique to facilitate storytelling with people with dementia but to get the best results it is recommended that you take the training offered through the website.  If research is any indication, the training would be well worth your time and money.  These are some of the findings cited on the website showing that this kind of creative engagement has significant impact:

  • quantity and quality of engagement between the staff and residents in dementia units is improved (even among those who didn’t take the training or participate in the sessions)
  • attitude of staff toward residents is improved
  • communication and affect of people with dementia is improved

As Anne Basting so aptly states, "there's a real impulse to protect people with memory loss and dementia and help them get the facts right or the language right.  That's not what this is about.  This is about opening communication and inviting imagination from people, no matter what they say or do, and echoing it so that you're learning their language."

The Iona Wellness and Arts Center in Northwest Washingon DC has a TimeSlips program that meets weekly.  For more information on how to participate call 202-895-9448.

Thursday
Nov082012

Medicare Part D Open Enrollment Ends December 7

 

Do you have questions about Medicare Part D?

Do you understand Medicare Advantage (managed care) plans?

Should you change your prescription drug coverage?

Do you need extra help paying for medicine?

 

There are lots of questions surrounding Medicare Advantage Plans.  Five pertinent questions that should be considered are found in this article by Tom Murphy of the Associated Press http://www.philly.com/philly/wires/ap/business/investing/20121107_ap_5questionstoaskaboutmedicareadvantageplans.html

 

Answers to the above four questions and any others you may have are also available from the Senior Health Insurance Assistance Program (SHIP). Call 301-590-2819 for a free, confidential appointment, in-person or via telephone.

Wednesday
Oct242012

There's an App for that! (wheelchair accessibility around the world!)

For those with disabilities, traveling around the world is a little more difficult if not downright daunting. To find an accessible local business or service is difficult enough, but in a foreign country it is almost impossible – or at least it used to be.

That is until Raul Krauthausen of Germany, a wheelchair user himself, developed a free  app just for that. Called Wheelmap, the app shows wheelchair access places around the world and rates them on their accessibility.

Red, yellow or green tags indicate the level of wheelchair access of each location. Red has no wheelchair access, yellow has partial wheelchair access and green is totally accessible for wheelchair use. Gray locations mean that place has yet to be rated.

That’s where users can help. Since the app is also linked to the Wheelmap website, gallivanting travelers from around the globe can rate locations on their accessibility and even share tips.  You can rate anyplace you’ve been – buildings in your local town or those you have traveled to in your state, the USA or Canada. Major cities around the world are growing in ratings, but you can put your own city on the map!

This interactive feature has proved popular and expanded the list of accessible buildings. The app is quickly being used worldwide.

You can rate locations without registering, but must log in to add specific comments and share tips. It is still a work in progress, but you can help it grow!

Check out this great website at wheelmap.org.  The free app for your smartphone is available at The App Store or Google Play.

 

Tuesday
Oct162012

A Letter to my Adult Children

We came across this poignant letter by John Boden posted on the Boomer Living+ (

Dear Children,

Now that Medicare, Social Security, hearing aids, and white hair are a part of my life I realize that I see the world differently from this vantage point to which maturity has brought me. And that seems quite normal to me. What doesn't seem normal, and what I resist mightily, is the world, especially my children, treating me as old. You, nor anyone else, should think that just because I walk slower, have aches and pains, and sometimes forget why I came into the kitchen that I am now also an incompetent bumbling idiot and need direction, help, and supervision whenever you are with me.

I watched and encouraged you children as you grew and matured while you resisted my supervision and advice more and more each year. It seemed as I look back that it happened in a flash, you growing into mature adults directing your own lives rarely asking for advice and never asking for supervision. Hopefully I was successful in letting go and learning to watch, even if I didn't always agree with your decisions, as you lived with the consequences of your choices, both the good results and the bad results.

I am now beginning to realize you children are struggling with these same issues with me. From your point of view, you are watching me transition from a self-directed mature adult, who didn't need or want advice or supervision, into someone that is in need of more and more advice and supervision as I morph from that mature adult toward being that bumbling, incompetent idiot. Maybe that is a bit of an overstatement, but there are times when it feels that way to me as you are giving me unsolicited advice or assistance, even as I am resisting it.  Do you remember the line, "Please mother, I would rather do it myself" as you resisted advice and assistance from your parent.  Now it is your turn to hear me when I say, "Please child, I would rather do it myself". Just as you give your children space, you must also give me space.

That does not mean you should not keep your eye out, or that, when I am doing harm to myself or others due to disease that is causing diminished mental and physical incapacities, you will not need to take action.  It means that just like you being a good parent to your children who leaves them maximum of slack in their leash, allowing responsibility to increase and supervision to decrease, you should also do the same for me. Take upon yourself only the minimum responsibility and provide only the minimum supervision for me as long as possible.

The next time you think I could be doing something more effectively or efficiently, stop to think before you speak. Is what you are about to say going to be welcomed, or "Would he rather do it his way?" And the next time you are about to take over the task I am working on, again ask yourself, "Would he rather do it himself?"

You will win a big prize by using this approach, because if I am not constantly fending you off from intruding into my life, I will be much more comfortable accepting your advice and assistance when the time comes that I do need help. I bet you also feel the same way and welcome the help and advice that you have asked for much, much more than advice that comes to you unsolicited.  In fact unsolicited advice is often referred to as nagging.

Before you try to help or to give me advice next time, stop and think a minute.

Will he really want to hear it?

Wednesday
Oct032012

October is Domestic Violence Awareness Month 

It is not just women and children who fall victim to domestic violence. Domestic violence occurs to both men and women in later life when a person uses power and control to inflict physical, sexual, emotional or financial injury or harm upon those with whom they have an ongoing relationship.  The aggressors can be spouses, former partners, adult children, extended family or even caregivers.  The problem occurs in all communities to people of all backgrounds.

Abuse generally involves coercive tactics, such as isolation, threats, intimidation, manipulation and violence.  Often victims are told where they can go, whom they can see and how they can spend their money and might be controlled with violence or threats of violence.  Most victims will not readily disclose their situation to friends, families or professional so it’s important to recognize the warning signs of abuse.

A table of victim and abuser behaviors can be found at http://www.unified-solutions.org/Pubs/late_life_domestic_violence_what_the_aging_network_needs_to_know.pdf.  All the signs need not be present for abuse to be occurring - one or two may warrant a referral to Adult Protective Services. 

The National Center on Elder Abuse lists the following as ways to help (and not help) a person subjected to abuse excerpted from Building a Coalition to Address Domestic Abuse in Later Life by Albright, Brandl, Rozwadowski and Wall.

Take time to listen

Respect the victim’s values and choices.

Understand how difficult it is.  Offer compassion and hope.

Support the victim’s decision.

Tell the victim help is available.  Refer victim for support and assistance.

To ensure the victim’s safety, DO NOT:

  • Talk about the abuse in front of the abuser or others.
  • Call and leave messages that may make the abuser angry or suspicious.
  • Leave written information on abuse where the abuser can find it.
  • Gossip or tell others about the abuse unless the victim requests or gives permission or you are required by law or employment to report the abuse.
  • Judge the victim.
  • Tell the victim what to do.

Let’s all work especially hard this month to end the cycle of violence and abuse towards those most unable to defend themselves.