For more information about the author, click to view their website: https://www.saintalphonsus.org/location/saint-alphonsus-regional-medical-center-boise-1
and Dementia – What’s the Difference?
People often ask, what is the difference between Alzheimer’s
Alzheimer’s is one of many types of dementia. In fact, it is
the most common type of dementia. Dementia is the umbrella term for diseases
that present as a decline in memory and/or thinking skills resulting in
impairment of daily functioning observed over six or more months. Dementia,
also called major neurocognitive disorder, can be caused by many different
medical and neurological conditions. Other types of dementia include but are not
limited to vascular dementia, Lewy Body dementia, frontotemporal dementia and
Alzheimer’s dementia is due to amyloid plaques and tau
tangles in the brain that cause cell dysfunction and death eventually resulting
in loss of daily function. It develops over more than 20 years before it starts
to cause symptoms. People often first notice trouble with short term memory.
While all of us can experience some difficulty with short term memory as we
age, memory loss is worrisome for possible dementia when it interferes with the
ability to complete routine daily tasks such as managing finances, medications,
driving, or cooking.
You should see a health care provider if you are worried
about memory loss so they can explore this with you further. Your health care provider may be able to
identify reversible or treatable causes of memory loss that are not dementia
such as depression, a sleep disorder or medication side effects. Your provider may choose to run some blood
tests and conduct head imaging (brain scan) to further understand cause(s) of
your memory loss.
Aside from brain autopsy we do not have one definitive,
widely available test for Alzheimer’s disease.
This means a health care provider will do a series of tests to determine
the most likely cause of your symptoms.
There are some recent advancements in blood tests, cerebral spinal fluid
tests and head imaging that help us with the diagnosis of Alzheimer’s dementia,
but these are not often covered by insurance. These tests will likely be
covered by insurance in the future once we have more effective treatment
options for the disease.
Currently there are only a few treatment options for Alzheimer’s
dementia, none of which cure the disease. These medications are only thought to
slow the cognitive decline in select group of individuals. One group of
therapies are called acetylcholine esterase inhibitors such as donepezil
(Aricept) or rivastigmine (Exelon) The other class is NMDA receptor blocker
called memantine (Namenda). These two classes of drugs have been around a long
time with limited benefit.
Recently a new class of Alzheimer’s drugs have been
approved, anti-amyloid monoclonal antibody infusion therapies; aducanumab and
lecanemab. Aducanumab was the first to
be approved which did demonstrate a reduction of amyloid in the brain but studies
resulted in no clinical data to support that it provides any observable benefit
to the patient. The other medication lecanemab reduced amyloid in the brain as
well and demonstrated minimal to moderate slowing of cognitive decline in clinical
trials. Neither of these two newer drugs are covered by insurance but they may be
covered in the future. Veterans
Administration does currently cover lecanemab for veterans who meet specific
criteria. There are many more
anti-amyloid and anti-tau drugs in the clinical trials, and I suspect we will
see more diagnostic tests and treatments for Alzheimer’s gain FDA approval over
the next several years.
Most importantly, everyone should know that 40% of all
dementias can be prevented or the onset delayed by adopting a healthy lifestyle
and addressing potentially modifiable risk factors (e.g., hypertension,
diabetes, hearing loss). There is
scientific evidence to support that the following are effective ways to reduce
your risk of developing dementia; regular exercise, a healthy Mediterranean
diet, weight loss, treating heart disease especially hypertension, getting
restorative sleep, quitting smoking, avoid excessive alcohol use, early
treatment of hearing loss, and stay socially and intellectually engaged.
By the end of 2023 Saint Alphonsus will be starting a new
state of the art Memory Center where we will provide a thorough
multidisciplinary assessment of memory loss, explore access to the latest tests
and treatments and offer you enrollment in our comprehensive Brain Health
Program. For more information, please continue to check this website. You can
however see one of geriatrics teams today for a memory assessment as well.
Please ask your primary care provider for a referral to Saint Alphonsus Geriatrics
By Kara Kuntz, MD, Geriatrician, Saint Alphonsus
How to Prevent Family Conflict Over Aging ParentsWhen it comes to aging parents, certain topics are often at the forefront of the conversation senior living, health care, and financial planning, to name a few. However, there is one topic that is very common but not as openly discussed: family conflict. This type of conflict usually occurs among adult children as their parents or family members go through the aging process. Disputes can also occur between parents, grandchildren, aunts, uncles, cousins, or others. Disagreements often stem from the stress, sadness, denial, anger, or uncertainty people often feel when their loved ones start to need help.Family conflict over aging loved ones is especially prevalent in the state of Florida, which has such a large senior population. In fact, family conflict became such an issue that the Florida Chapter of the Association of Family and Conciliation Courts launched the Elder Justice Initiative on Eldercaring Coordination. This dispute resolution process was specifically created for families experiencing conflict over the care, autonomy and safety of Florida seniors.Clearly, family conflict over aging loved ones is a real issue that impacts seniors. While it is not uncommon, it can be prevented with the proper preparation, communication, knowledge, and guidance.This article will cover several aging-related topics that can lead to family conflicts, and how to best solve or prevent these issues. After all, the best outcomes for seniors occur when there is harmony and teamwork among their adult children. Situations that Can Lead to Family ConflictProblem: Uneven balance of caregiving responsibilitiesAdult children of seniors often have to handle many matters related to their aging parents. These can include taking on the role of a family caregiver, accompanying parents to medical appointments, making healthcare decisions, managing finances, driving them to all their obligations, managing their nutritional needs, performing household maintenance and chores, and many other duties.When multiple adult children are involved, it is natural for one child to take on more of the caregiving load than the others. This is often the case when one child lives much closer to their parents than the others.But when these duties are not evenly distributed among the children, some start to develop feelings of anger or bitterness toward their siblings.Solution: When feelings of bitterness and resentment start to develop, have a civil discussion with your siblings about the issue. Rather than being accusatory, try to make a plan to solve the problem. Write out all the responsibilities required for taking care of your aging parents, and specifically delegate each duty to certain people. Make sure everyone is on board with the agreement and is assigned a role that is achievable for them. Keep the list somewhere everyone can access it, whether it be a printed copy for each family member, or even a shared Google Doc. Plan to have frequent check-in meetings to make sure everyone is doing their part and discuss any concerns that have arisen.For example, one child who lives nearby can be in charge of driving their parents to appointments, while another child who lives farther away can take on the role of managing their finances. Or, if one person is unable to physically help, perhaps they would be willing to contribute financially to help make the other childrens roles a little easier whether that be by paying for respite care, a geriatric care manager, hospice care, or another service. Problem: One sibling is being excluded from the decision-makingSometimes, one child will take over most of the decision-making for their senior parents, causing the other siblings to feel as though they are being left in the dark about these important issues. Solution: In these situations, communication is key. In a calm manner, tell your sibling how you are feeling. It could be that they are simply unaware of their actions. Or, they might have thought they were making their siblings lives easier by not involving them. Explain your point of view and that you want to be more involved in matters relating to your aging parents. From there, you can work together to make an arrangement that you are included in.Problem: Disagreements about the amount of care neededFor some people, it can be hard to come to terms with the fact that their parents needs and abilities are changing. This can lead to denial or avoidance of the situation which is not only harmful for the seniors, but can also cause disagreements between adult children.In other situations, some adult children may believe their parents are able to safely age in place in their own home, while others may think senior living would be the best choice.Solution: Sometimes a professional outside opinion is all it takes for people to come to an agreement about their parents care needs. Consult your parents doctors for a professional report about their health status and changes in ability. It is also wise to contact an expert senior advisor like Florida Senior Consulting to conduct necessary assessments and make professional recommendations for the senior. A senior advisor can also help inform about all the possible options, whether that be in-home care or senior living. Along with involving outside sources, siblings can work together to research the situation at hand. For example, if the seniors are experiencing memory issues like dementia, adult children can research this topic to learn what level of care is often recommended in these situations. This method is always a good place to start and helps everyone be on the same page about their loved ones needs.Problem: Disagreements about end-of-life care and estate planningEstate planning and end-of-life care can be uncomfortable or delicate topics to discuss. Because of their complexity, these matters can often lead to disagreements among adult children.Solution: In these tricky situations, it is often best to leave the decisions up to your parents. If possible, have them choose a power of attorney and set up advance directives like a living will and health care surrogate designation before a crisis occurs. This will prevent any future conflicts that could arise among family members if these designations are not in place.If a crisis occurs and your parents do not have these documents or their estate in order, it is best to contact an elder law attorney, a financial planner that specializes in elder affairs, and possibly a family mediator to help with inheritances. These professionals can help get the situation sorted out without the risk of a conflict developing between family members.Next Steps for Adult Children to Help their Aging ParentsDont let conflicts about your aging parents tear your family apart. In difficult times, it is important for families to come together so the seniors in your life can receive the best care possible. This positive outcome is only achieved when the adult children work together as a team. After all, as Helen Keller once said, Alone we can do so little; together we can do so much.If you and your family need guidance on how to best help your aging loved ones, always contact a professional. Florida Senior Consulting will help you every step of the way, from deciding the right plan for care, finding the best assisted living community, packing, moving, and everything in between.Our expert senior advisors are local to Florida and will help you and find the best care possible.Call (800) 969-7176 or visit FloridaSeniorConsulting.com to get started today.Senior living on your terms. The choice should be yours.
FirstLight Home Care is a renowned provider of non-medical home care services, offering a range of solutions designed to meet the unique needs of each client. Their team of dedicated caregivers is passionate about fostering independence and ensuring the well-being of those they serve.Services Offered:1. Companion Care: FirstLight Home Care understands the importance of companionship for overall well-being. Their caregivers provide friendly and supportive companionship, engaging clients in meaningful conversations, games, and activities.2. Personal Care: Recognizing the significance of personal dignity, FirstLight's caregivers assist with activities of daily living, including bathing, grooming, and mobility support. These services are tailored to maintain a sense of independence and dignity for clients.3. Dementia Care: For individuals living with dementia, FirstLight Home Care offers specialized care services. Caregivers undergo extensive training to provide compassionate support while promoting a safe and familiar environment for those with cognitive challenges.4. Respite Care: Family caregivers often need a break to rest and recharge. FirstLight Home Care offers respite care services, allowing family members to take time off while ensuring their loved ones receive the care and attention they deserve.5. Transition Assistance: Moving from a hospital or rehabilitation facility to home can be challenging. FirstLight Home Care assists in easing this transition by providing support during the initial period, helping clients regain their independence.6. Travel Companion Program: FirstLight understands that travel can be daunting for seniors or those with special needs. Their Travel Companion Program offers assistance for individuals who want to explore the world, ensuring a comfortable and secure travel experience.Quality of Care:FirstLight Home Care is committed to delivering exceptional care through highly trained and compassionate caregivers. Their rigorous hiring process ensures that caregivers possess the necessary skills, empathy, and dedication to meet the diverse needs of their clients.Client-Centered Approach:What sets FirstLight Home Care apart is their emphasis on individualized care plans. Each client receives a customized care plan based on their unique preferences, needs, and lifestyle. This client-centered approach ensures that the care provided aligns with the values and goals of those receiving it.Conclusion:FirstLight Home Care in Minneapolis is more than just a care provider; it is a partner in enhancing the lives of individuals and families. Through their comprehensive range of services and commitment to personalized care, FirstLight stands as a beacon of support, promoting independence, dignity, and a higher quality of life for all those they serve. Call us for more information and help at 612-473-3227.
Caregiver Stress Awareness in Hospice CareBy: Joelle Jean, FNPCaring for a loved one who is terminally ill and on hospice is emotionally and physically taxing. In 2015, an estimated 39.8 million caregivers provided unpaid care to an adult with a disability or illness. The estimated value of the service supplied by caregivers is up to $470 billion since 2013.Caregivers may deny help from others, perhaps out of guilt or obligation. However, 1 out of 6 caregivers report not being asked what they need to care for themselves. Caregivers can work up to 8.3 hours per day or 66 hours per week during their loved ones last days of life. Often, this is in addition to working a full-time job and caring for their own immediate family.Caregivers are at risk for depression, severe fatigue, or burnout, or even health issues such as hypertension, stroke, obesity, or weight loss due to stress.What is a caregiver?A caregiver, also known as an informal caregiver, is an unpaid individual or group of individuals who provide care to a loved one. Caregivers can be a spouse, family members, partner, friend, neighbor, or combination of these individuals.A caregiver assists their loved ones with activities of daily living which include:BathingDressingEatingToiletingShoppingHousekeepingTransportationMedical tasks such as giving medications, changing wound dressings, and managing painA caregiver can also play a significant role in coordinating care for their loved ones. Many are appointed power of attorney or the primary decision maker for their loved ones, managing finances, property, and most suitable medical care for the individual. What causes caregiver stress or burnout?There is no clear definition of caregiver stress. The Merriam-Webster dictionary defines stress as a physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in disease causation. Burnout can be a response to stress, defined as extreme emotional exhaustion. According to stress.org, stages of burnout are:EnthusiasmStagnationFrustrationApathy or loss of interestA caregiver with stress or burnout exhibits signs of feeling overloaded, overwhelmed, emotionally drained, tiredness, detachment from the person they are caring for, and a reduced sense of accomplishment.Who is most affected by caregiver stress?Caregiver stress affects the person or people directly caring for their loved one. Stress can also affect caregivers in different ways. For example, one caregiver may find specific tasks stressful or overwhelming while another caregiver may find the task relaxing and rewarding.What are the signs and symptoms of caregiver stress?Often, caregivers are not aware of their stress or feeling of burnout. Signs and symptoms of caregiver stress can be subtle or obvious. It is important to identify caregiver stress so it can be eased.AnxietyAnxiety is a stress response, activating the fight or flight response that happens chemically in the brain. Physically, anxiety can be described as:Increased heart rateFeelings of doom or hopelessnessStomach pain and or spasmsHeadacheSweatingHeavy breathingFeeling weak or tiredWorryFatigueCaregivers suffering from stress may not realize they are fatigued. Fatigue is the bodys response to burnout and can be physical, emotional, or psychological.Weight changesStress can cause weight changes and affect eating patterns. Weight change can occur when dealing with caregiver stress. Rapid weight gain or unexplained weight loss is a warning sign of caregiver stress and should be addressed appropriately.IrritabilityCaregivers may become easily annoyed or short-tempered with loved ones, family members, or friends. Feeling irritable may be a warning sign of caregiver stress.Feelings of being overwhelmedFeeling overwhelmed or anxious is normal. Caregivers may become overwhelmed with the amount of care needed to provide to their loved ones. Trouble concentrating, changes in sleep patterns, and changes in eating habits may occur.DepressionLosing interest in activities can be a sign of depression due to the demanding responsibilities of caregiving. Signs of depression include:Little interest or pleasure in doing thingsFeeling down or hopelessChange in sleep patternsFatigue and tirednessThoughts of death or suicidePotential health risks as a result of caregiver stressChronic stress (or stress lasting for more than six weeks) can have lasting health problems. Caregivers exhibiting signs and symptoms of stress and burnout have a higher chance of developing health risks.High blood pressureCaregivers can suffer from high blood pressure due to the stress of caring for a loved one in hospice. If caregivers have already been diagnosed with high blood pressure, stress can make the disease worse. Uncontrolled high blood pressure puts caregivers at higher risk for:StrokeAtherosclerosis or disease of the arteriesHeart attackOrgan damageWeakened immune systemThe immune system is in place to protect the body from illness and disease. Stress can cause a weakened immune system. With a weakened immune system, caregivers can become sick or develop chronic illnesses such as:Inflammation throughout the bodyIncrease in fat in the blood and bodyChronic painFrequent colds and infections Short term memory lossStudies have shown that a symptom of chronic stress is the shrinking of the brain. Shrinking of the brain causes short-term memory loss. Short term memory loss affects learning, judgement, and memory process. Headaches and body painsStress can cause headaches and body pains. On a hormonal level, the increase of cortisol causes headaches even at rest. The physical nature of caring for a loved one on hospice- lifting, standing, walking, and rotating- can cause severe body pain or injury. How to relieve or prevent caregiver stress and burnoutSelf-care is imperative for caregivers caring for their loved ones in hospice. Self-care means caring for yourself, so you can improve your health to care for others.Exercise regularlyFinding the time and the energy to exercise might sound difficult. However, even carving out 30 minutes a day has positive effects on your health. Exercising whether it is running, walking, swimming, or doing yoga will lower blood pressure, increase energy, and improve mood.Asking and accepting help from othersAccepting help can be difficult for some caregivers. It is important to ask and accept help so that you are available for your loved one mentally and physically.Under most insurances and Medicare, respite care is available to relieve the burden of caregiver stress. Respite care will give short term caregiver relief to those who are in need.Eat and sleep wellEating and sleeping well are fundamental in protecting your physical and mental health. A well-balanced meal of fruits, vegetables, and plant-based foods is important for physical and mental well-being. Adding vitamins such as a multivitamin, vitamin D, or vitamin B-12 can also help improve your mood and energy.Having a good nights sleep has many health benefits. Feeling well-rested and energized will only benefit you, as the caregiver, and your loved one. Improved memory, mood, and overall well-being are all benefits of quality sleep.Seek out support groupsSupport groups add immense value to caregivers who are caring for loved ones in hospice. Joining support groups reassures caregivers that they arent alone. Support groups:Allow you to talk about your feelingsHelp you realize others are going through the same situationReduces stress and depressionTeaches coping skills and ways to divert stressMaintain personal relationshipsMaintaining personal relationships is as important as joining support groups. Meeting up with friends or family members allows you to relax. It also allows you to take time for yourself and time away from your loved one. Awareness of caregivers stress and burnout must be addressed and acknowledged for caregivers to feel supported and recognized for their challenging work. The hospice team and its services are a fundamental part of bringing this awareness to the forefront.