The Holidays with Alzheimer's

The Alzheimer's Association offers the following tips to help you and your loved one with Alzheimer's Disease enjoy the holiday season.

Adjust your expectations
No one, including yourself, should expect you to maintain every holiday tradition or event.

  • Give yourself permission to do only what you can reasonably manage
  • Choose holiday activities and traditions that are most important to you
  • Host a small family dinner instead of a throwing a big holiday party
  • Consider serving a catered or takeout holiday meal. Many grocery stores and restaurants offer meals to go.
  • Start a new tradition. Have a potluck dinner where family or friends each bring a dish

Involve the person in the festivities
There are many manageable activities the person and you can do together, such as:

  • Wrap gifts
  • Bake favorite holiday recipes together. The person can stir batter or decorate cookies.
  • Set the table. Avoid centerpieces with candles and artificial fruits and berries that could be mistaken for edible snacks.
  • Talk about events to include in a holiday letter
  • Prepare simple foods such as appetizers
  • Read cards you receive together
  • Look through photo albums or scrapbooks. Reminisce about people in the pictures and past events.
  • Watch a favorite holiday movie
  • Sing favorite carols or read biblical passages

When the person lives in a care facility
A holiday is still a holiday whether it is celebrated at home or at a care facility. Here are some ways to celebrate together:

  • Consider joining your loved one in any facility-planned holiday activities
  • Bring a favorite holiday food to share
  • Sing holiday songs. Ask if other residents can join in.
  • Read a favorite holiday story or poem out loud

With some planning and adjusted expectations, your celebrations can be filled with joy and magical moments to cherish forever.


Brown Bagging It

 A brown paper bag may hold the key to medication safety, according to health experts.

 "A 'brown bag checkup' is the best thing patients can do to avoid medication mistakes and cut down on unnecessary medications," says Douglas Paauw, M.D., Professor of Medicine at the University of Washington.

 The checkup involves putting all of your medications in a brown paper bag and bringing them to your doctor or pharmacist. The bag should include over-the-counter and prescription drugs, herbs, vitamins, dietary supplements, and topical treatments such as ointments and creams. "This kind of checkup is good for anyone who takes medication, but particularly for older adults who are more likely to be taking several medications," Paauw says.

Edie Hurley, nurse manager with Montgomery County Aging and Disability Services, supports the idea of the brown bag checkup. "At least make a list and bring that in," she says.

 Your doctor or pharmacist should check for appropriate dosing, problems caused by interactions between drugs and whether each drug is being given for the right reason.  They should also check for duplication.  It is common for more than one drug to contain the same ingredient.  For instance, taking two products that contain acetaminophen raises the risk of liver damage. Other common problems include expired medications and medications that are no longer needed.

 In one case, an older patient mistakenly thought her diabetes medication was for headaches. "So she took her diabetes medication only when she had a headache, when she should have been taking it every day," according to Hurley.

After you and your doctor settle on what you should be taking, the next thing is to know the names of all of your medications and what they are for. Your list of medications should be updated and reviewed with your doctor each time you change a medication or add a new one.

Experts suggest that you keep a list of medications in your wallet and let a family member know that you have it. Be ready to take that list out at the dentist's office, at appointments with specialists, or in an emergency.

 Another good place to record them is the Vial of Life method. The Vial of Life consolidates basic health information such as medical history, allergies, medications, etc. in one place. It is designed to hang by a red magnet on your refrigerator door in case emergency personnel need to treat you. You can request a free Vial of Life by calling our office.

 Modern medicine has made our lives better in many ways. People taking many different prescriptions need to be aware of potential dangers and take steps to avoid them.


November is National Caregivers Month

Below are some great action ideas in support of caregivers everywhere from "mothers matter/caregivers count":

  • Organize and schedule a visit with your local elected leaders and representatives to discuss the issues facing caregivers in your community. Review legislative policies that will provide support. Use these concepts to create a Caregivers Bill of Rights for your state.
  • Write a letter to the editor from yourself or your group outlining the importance of economic justice for caregivers in your community.
  • Host a "sandwich generation" gathering to recognize the challenges and discuss strategies to help adult children who provide care for their aging parents. Develop an easy-to-do action such as a petition drive directed at your state's elected leaders.
  • Create a community forum and invite local home health care providers and other caregiving organizations to discuss the current status of caregiving in your community. Invite policy experts to talk about legislation and initiatives that can help both paid and unpaid caregivers. Develop a plan of action and/or a set of recommendations.
  • Start a caregiver awareness group at your workplace to encourage the adoption of workplace policies that include flexible work schedules and paid leave options for employees who are family caregivers.
  • Distribute flyers on economic justice for caregivers at local clinics, community centers and care facilities.
  • Celebrate/recognize caregivers in your community, in your organization or chapter, and in your family. Host a party to create thank you cards for caregivers. Have members bring the names and addresses of people in the community who take care of others and send them a thank you card.
  • Identify a community care center (Residential Rehab Center) or community space and hold a Caregivers Count awareness event. Invite caregivers in the community to a "thank you" event and recognize them with tributes from friends and family members.
  • Be present at local town hall meetings and ask your representative what s/he is doing to promote legislation that will help working families, small businesses, and workplaces to develop more family-friendly caregiver policies.

Buckley attends Care Coordination Summit at National Press Club

In her ongoing effort to provide the best possible care management for our clients and to gain valuable insight and tools to improve the performance of her company, Buckley is attending the 3rd Annual Care Coordination Summit presented by Dorland Health where she will

  • Hear from leaders who are at the center of healthcare innovation.
  • Discuss the strategies organizations are using to improve patient-centered care.
  • Share her views and insights on new models of care in a relaxed, open environment geared to enhance learning.
  • Identify best practices and models she can apply to improve care coordination from all access points in the post-reform era.
  • Analyze the impact of healthcare disparities on effective care coordination.
  • Discover opportunities for individuals, organizations and entrepreneurs to share the value they can bring to a disruptive healthcare industry.
  • Identify new delivery models, like medical homes and accountable care organizations, and opportunities to improve performance of the healthcare workforce.
  • Determine the importance of addressing behavioral health issues as part of holistic care coordination.
  • Uncover new strategies to prevent avoidable readmissions.
  • Become part of the solution through the Center for Healthcare Innovation.
  • Recognize tools and resources that engage and empower patients to be active members of the healthcare team.
  • Describe the key role and competencies professionals will need to coordinate care in the burgeoning patient-centered model.
  • Apply industry-leading techniques to optimize and ensure efficient use of healthcare resources.

She is excited to join her peers for this unique summit where she will learn from experts at the point of care who are advancing solutions and meeting challenges through innovative best practices.   Look for her to share  more information here after she returns.


Can I Get Paid to Care for a Senior Family Member?

As the number of family members providing care for aging parents increases, the solutions to find help with loss of income because of time off from employment for caregiving has become a major concern for many.

The demands on both the time and energy needed to provide the needed care can make it impossible to maintain both a full time job with full time caregiving.

Seeing a need to give support to family caregivers the federal government Administration on Aging created the National Family Caregiver Support Program.

State Area on Aging division manages this program on the state and community level to offer support services that include:

  • Information to caregivers about available services;
  • Assistance to caregivers in gaining access to supportive services;
  • Individual counseling, organization of support groups, and caregiver training to assist caregivers in making decisions and solving problems relating to their roles;
  • Respite care to enable caregivers to be temporarily relieved from their care giving responsibilities; and
  • Supplemental services, on a limited basis, to complement the care provided by caregivers.


Medicaid Cash & Counseling Program

A Medicaid approved assistance program called Cash & Counseling may be used to provide funds to hire personal care aides as well as purchase items or services, including home modifications that help them live independently.

The website gives the following information about the program:

"For Medicaid eligible seniors, the process begins with an assessment in the home to determine the senior's home care needs; this includes interviews with caregivers and possibly the senior's physicians. A determination of how many monthly care hours are required is made. The benefit amount is calculated using that determination and cost of care for that geographic area. This amount can be increased or decreased as the senior's needs change. A family care giver may need to qualify as a home health aid by the state to receive these funds."

This program is executed by each individual state Area on Aging Services division. It is a relatively new program and is not yet available in all States. Check with your state Area on Aging Services department for availability.

Using the Veterans Aid and Attendance Pension Benefit

A totally overlooked source of money to pay family caregivers to provide care at home is the Aid and Attendance Pension Benefit. This money is available to veterans who served during a period of war. Pension money is also available to the widows of these veterans. This benefit, under the right circumstances, can provide up to $1,949 a month in additional income to pay family members to provide care at home.

Getting the aid and attendance benefit to pay for family caregivers is not an easy task. This is because there must be a caregiver contract in place, a physician medical evaluation done, income and asset qualifications met and proof of medical expenses provided. Submitting the correct forms and documentation can easily be completed with the help of a VA Accredited Consultant who understands the process.

Long Term Care Insurance Benefit

If the senior being cared for has a long term care insurance policy that covers home care, payment to the care giver from this source could be arranged. Some policies require the care provider to be through a licensed home car agency, but others will pay for individual aides certified as such. This would require some training by the family member to become certified. There are policies that pay a daily benefit amount to the insured to use as they want to pay for their care. Check with a long term care insurance professional about types of policies.

Caregiver Contract

In some cases the senior parent has the funds to pay for care. If a family member is giving care it is very important that a caregiver contract be in place. A signed and dated agreement will outline the services provided as well as the amount of pay for these services. The contract will eliminate questions about what is expected from both parent and caregiver as well as providing a legitimate contract and payment record of services to qualify for Medicaid.

Attorney John L Roberts, in his article titled "Caregiver Contracts that Protect Elders and Their Family Members" states:

"A written Caregiver Contract is a good idea for every family that wants to protect family harmony, and make sure everyone in the family understands how care is being provided to an elder.

The family member who provides care can save an elder from needing nursing home services, and may also protect assets if nursing home care is needed in the future. Elders who want to cover all of these bases must have a written Caregiver Contract. Whenever adult children and other family members are providing valuable care, only a written agreement will protect assets from nursing home care costs and qualify the elder for Medicaid."

In having the parent pay a family member for caregiving, it will be an employer/employee situation and payroll records must be kept with payroll taxes paid.

This can also be set up by an elder law attorney at the time the contract is done.

Final Note

Taking the time to create the caregiver contract, research the government and state services that are available to caregivers and using community resources will make the family caregiving experience less stressful.

"The 4 Steps of Long Term Care Planning" from the National Care Planning Council



Nationally, one third of people over age 65 and half of those over age 80 will fall each year, making falls a serious health threat for seniors. Falls can cause serious injuries like hip fractures, which can mean long-term recovery in a hospital or nursing home, and a reduced quality of life for people who fall.  Falls are also a costly injury. 

In 2009, falls among Maryland seniors resulted in over $225 million in hospital out-patient visits and hospital admissions charges.

About half of all falls happen at home, according to Centers for Disease Control and Prevention data. “One of the most common causes of falls is a home with tripping hazards,” said Odile Saddi, Director of the Montgomery County Area Agency on Aging, “Yet, a few simple steps can make your home a much safer environment.”

To reduce the risk of falls, here are some things you can do:

  • Remove things you can trip over (papers, books, shoes) from the stairs and places where you walk.
  • Remove small throw rugs.
  • Keep items you use often in cabinets you can reach easily without using a step stool.
  • Have grab bars put in next to your toilet and in the tub or shower.
  • Use non-slip mats in the bathtub and on shower floors.
  • Improve the lighting in your home. As we get older, we need brighter lights to see well. Hang lightweight curtains or shades to reduce glare.
  • Have handrails and lights put in all staircases.
  • Wear shoes both inside and outside the house. If you wear slippers, be sure they fit snugly.

For information from NIH Senior Health on decreasing falls risk, go to Search for “Falls and Older Adults” and check out the videos.



Does your loved one have old prescription glasses they no longer use?

Imagine if you could help a child read; an adult succeed in his job; a senior maintain her independence; and provide a community with more opportunities to grow and thrive.  This is what the Lions Club aspires to do through its Eyeglass Recycling Program.

Does your loved one have old prescription glasses they no longer use?  Please consider donating them to a local Lions Recycling Center.  In the DC Metro area there are several locations.  Their Main Center is on the ground floor of  601 S. Carlin Springs Rd., Arlington on the grounds of the Carlin Springs Health Pavilion.  It is open from 10 a.m. to 4:00 p.m. on Tuesday and Wednesday, and on other days by appointment.  The phone number is 703-671-1919.  Their Annex is at 6756 Silver Maple Court, New Baltimore, VA 20187.  Hours can be arranged by appointment.  Phone 703-347-0017

Additional, eyeglass recycling in support of the Center occurs at the following locations:

  • The Lake of the Woods Lions Club in Fredericksburg, VA.  Please contact Lion Jerry Davis at 540-972-0596. 
  • The Park West Lions Club in Manassas, VA.  Please contact Lion Ed Robinson at 703-368-5563.
  • The Lion's District 22-C Eyeglass Recycling Center in Upper Marlboro, MD. Please Contact Lion Betty Moore at 410-394-3589 or Lion Susan Mathews at 301-297-8791

The 36 Hour Day - Sometimes We Wish We Had One...unless It's THIS Kind of Day!

We wanted to pass along a resource that one of our client’s adult children highly recommended.  She is on her second reading of a book called The 36-Hour Day: A Family Guide to Caring for Persons with Alzheimer Disease, Related Dementing Illnesses, and Memory Loss in Later Life and says it is a “must-read”.  The online reviews seem to agree:

"An excellent book for families who are caring for persons with dementia... A book that physicians can confidently recommend to the families of their patients." -- Journal of the American Medical Association

"Excellent guidance and clear information of a kind that the family needs... The authors offer the realistic advice that sometimes it is better to concede the patient's frailties than to try to do something about them, and that a compassionate sense of humor often helps." -- New York Times

"An excellent, practical manual for families and professionals involved in the care of persons with progressive illnesses... The book is specific and thought-provoking, and it will be helpful to anyone even remotely involved with an 'impaired' person... Highly recommended, especially for public and nursing libraries." -- Library Journal

"Continues to be the 'bible' of recommendation for any caregiver whose family member suffers from dementia." -- Bookwatch

The book is authored by Nancy Mace, M.A. and Peter Rabins, M.D. M.P.H. and is coming out with its 5th Edition in October of 2011.  Originally published in 1981, The 36-Hour Day was the first book of its kind. Thirty years later, with dozens of other books on the market, it appears to remain the definitive guide for people caring for someone with dementia. Its new edition features thoroughly revised chapters on the causes of dementia, managing the early stages of dementia, the prevention of dementia, and finding appropriate living arrangements for the person who has dementia when home care is no longer an option.  Send us your review should you choose to pick up a copy and read it!


Social Support Activities Lead to Better Quality of Life As One Ages

How important is social support as a person ages? This may seem like an easy question to answer. Most people would not choose isolation and loneliness versus spending time with companions. However, can lack of social support really hinder a person’s overall quality of life?

Lack of social support is related to negative impacts on health and well being, especially for older people. Having a variety of positive social supports can contribute to psychological and physical wellness of elderly individuals. Support from others can be important in reducing stress, increasing physical health and defeating psychological problems such as depression and anxiety.

When considering who provides social support for an elderly individual our first thoughts are of family members. While it is true that most support does come from family members, there are many circumstances in which family members cannot be supportive (stress due to responsibilities, illness, death, financial problems, job relocation). In the United States the fastest growing age group of individuals are those 85 years and older. Due to this fact, family supports will inevitable decrease for these older individuals. A need for community-based services is more important now then ever before.

Community-based services can be extremely useful for elderly individuals. Services for older persons can encompass many areas, but one of the most important areas as discussed previously is social support. Support for elderly persons can be found in many places including: senior centers, assisted living facilities, meal delivery, religious affiliations, adult day care centers, etc. These services can provide positive social supports that can help older persons defeat loneliness and isolation. However, social support must encompass more then physical presence or conversation. Studies have shown that social support services should contain quality activities. These activities should promote positive self-awareness.

Self-awareness is key to a person’s overall quality of life and satisfaction. Many leisure social activities can be used to help increase an individual’s self-awareness. Activities for elderly individuals may include reminiscence groups, journal writing, readings of favorite book passages, group exercise, singing groups, etc. Individuals may also feel more self-satisfied if they are part of the planning of social activities that take place.

Two of these community-based service centers that provide quality social support services for elderly individuals are discussed below.

Senior Citizen Centers

Today, there are estimated to be about 15,000 senior centers across the United States. Senior centers act as a focal point for older Americans to receive many aging services. The most common services offered at a senior center include health programs (including Zumba and Yoga), arts/humanities activities, intergenerational programs, employment assistance, community action opportunities, transportation services, volunteer opportunities, education opportunities, financial assistance, senior rights counseling/legal services, travel programs and meal programs. These programs and activities can help promote positive self-awareness.

Lori Beckle describes how participating in her local senior citizens center has given her the independence and life satisfaction she thought was lost when her husband died in 2009. “ I was devastated and so frightened for my future without Ed. He was my only friend and the one I turned to when I felt alone. My daughter invited me to attend our local senior center where a bereavement group was being held for those who had lost a loved one. I met Phyllis during the group and now I have a new friend I call when I become afraid. Phyllis has helped me develop the skills to get through the tough times and focus on my immediate happiness.”

Adult Day Care Centers

According to the National Adult Day Services Association (NADSA), there are currently more than 4,600 adult day care centers nationwide. Adult day care is a program in which activities are provided to promote social support and health services to an older adult during the daytime. Most centers operate Monday through Friday during daytime hours. Social support services at an adult day care can consist of musical entertainment and singing groups, group games such as cards, gentle exercise, discussion groups (books, films, current events), holiday/birthday celebrations and local outings. Not only are these social activities provided, but participants of the program can also develop lasting relationships with staff and other participants. Adult day care centers also provide meals and health services. Adult day care centers differ from other programs for elderly individuals, because they allow the participants to develop and increase self-awareness by encouraging independence.

Amanda describes her experience as a volunteer at her local adult day care center. She stated, “ I was involved in planning the activities for Thursday afternoons. I wasn’t sure what kind of activities my older friends would enjoy so I had them share their favorite activities they participated in when they were my age (23). I soon realized that I was hearing the most fascinating stories of hopping trains, college dances, swimming in the lake, etc We decided Thursday afternoons would be spotlights of each individuals’ lives as a twenty-something. One of the participants told me that Thursdays became a highlight for her week.”

Adult Day Care Centers and Senior Citizen Centers help to provide an elderly individual the opportunity to participate in social support activities. Social support activities found in these programs can be beneficial to a person’s quality of life and overall satisfaction. With a higher self-awareness and quality of life an individual can reduce the risks of mental and physical health problems as they age.


Art and Alzheimer's

Museum Outreach


Conversations at The Kreeger Museum
A Program for Individuals Living with Alzheimer’s Disease and Their Caregivers

The Kreeger Museum has developed an exciting new art program specially designed for people living with Alzheimer’s Disease (AD), their families and caregivers.  Modeled after the pioneering MeetMe at MoMA (Museum of Modern Art, NYC) program, Conversations at The Kreeger Museum provides a forum for dialogue and connection through looking at art.  Docents lead small interactive tours and discussions through the museum’s accessible galleries and grounds. The tours are intended to stimulate conversation and memories for participants and to create a sense of well-being.  During the program, visitors have exclusive access to the museum’s great architecture, sculpture, and paintings.  The program is free of charge not only individuals suffering from the disease but also to caregivers and family members who often face significant medical, emotional and economic challenges as a direct result of this devastating disease.  Conversations is the first museum program of its kind in the Washington, DC area.

To read the full article, follow this link:

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