The Province of Wexford

Lets start with what most of us know about Parkinsons disease (PD). Comparatively common in older adults, its a neurological disorder estimated to affect nearly 2% of those over age 65, estimated by the National Parkinsons Foundation to be one million Americans in 2020. Public figures, such as the popular actor Michael J. Fox, who has PD, have increased the publics awareness and understanding of the disease. Now lets consider the side of PD less talked about: Parkinsons Disease Dementia (PDD). Usually, the condition is depicted as auditory and visual hallucinations of imagined occurrences, delusion, and paranoia that follow the more visible motor dysfunction typical of Parkinson's. In fact, the dementia component of PD usually does not appear earlier than a year or more after the diagnosis. The average time from onset of Parkinsons to signs of dementia may be around ten years if certain studies are correct. The phenomenon may also be more common than most people think. Thats why, to recognize April as Parkinsons Awareness Month, were focusing on the dementia phase of the disease.Recognizing PDDThe University of California, San Francisco, Weill Institute for Neurosciences Memory and Aging Center outlines the symptoms of PDD: 1Trouble focusing, remembering things or making sound judgementsMay develop depression, anxiety or irritabilityMay hallucinate and see people, objects or animalsSleep disturbancesThe Alzheimers Organization states that an estimated 50 to 80 percent of those with Parkinsons eventually experience dementia as their disease progresses. There's no single test or combination of tests that can give a conclusive diagnosis of PDD, which may partly account for the wide range in the statistics. An original diagnosis of Parkinsons will be based on movement irregularity, with PDD symptoms at least a year off. This puts greater importance on working closely with a physician for an early diagnosis. Sadly, the deterioration of brain cells by PDD can't be stopped or slowed. Drug therapy can alleviate some of the symptoms.The Difference Between Parkinsons Dementia and OthersThe difference among various dementias can be confusing, and dementia should never be self-diagnosed instead of consulting with a neurology specialist. First, consult your primary physician. The International Parkinson and Movement Disorder Society provides a directory of movement disorders specialists to search for a specialist in your area.Dementia with Lewy bodies (DLB) is a spectrum of dementia-related to Parkinson's, which is also characterized by the formation of Lewy bodies, clumps of protein that form in the brain. PDD symptoms resemble DLB, which also causes changes in thinking, behavior, and movement. The difference between PDD and DLB is that with DLB behavior and cognition impairment symptoms occur first, whereas Parkinsons will present as movement impairment with dementia appearing later.2 While the cause of PDD is unknown, scientists think the progression of Lewy body protein build-up first affects motor control, and eventually, enough nerve cells die that the first signs of dementia appear.Different clumps of protein form in a brain affected by Alzheimer's Disease (AD). Another difference between Alzheimers and similar dementia is that Parkinsons tends to affect attention and executive function more than memory. An essential and hopeful distinction: although the symptoms are similar, people with PDD are not at risk of developing Alzheimers Disease, according to the Pacific Brain Health Center. Nor is long-term memory likely to be as affected. The characteristic loss of recognition of loved ones and a general awareness that affects Alzheimers patients is not typical of PDD.3Aging and ParkinsonsJohns Hopkins Medicine states: The older you are, the greater your risk of developing Parkinson disease.4 The Michael J. Fox Foundation, in its downloadable brochure Navigating Cognitive Changes in Parkinsons, also notes "Cognitive changes from Parkinson's often are different or more than you'd expect with age." The example they offer is a helpful illustration of the difference between ordinary changes in memory function due to age and those caused by Parkinson's. Ordinarily, you'll forget where you left your keys, and this may become more common as you age. By contrast, forgetting what your keys are used for or how to use them signifies a more severe dysfunction related to dementia.Caregiving at HomePeople with PD may get along well with home caregiving with the help of a spouse for years. The onset of PDD can change this significantly, primarily in disrupting the ability to communicate. Be prepared that the disorientation will change a persons behavior. They may not be able to be left alone and may become moody, impulsive, and annoyed. A few simple communication techniques are recommended for the caregiver:Establish a daily routine. Having meals, exercise, and activities at roughly the same time every day avoids annoyance and anxiety in your loved one.Simplify living areas. Reduce distraction and shadows.Keep the home brightly lit.Remain calm and empathetic. Remember, it's the disease and not a conscious decision that creates erratic behavior.When evaluating the move to an Assisted Living or Memory Care community, consider that all the above features are incorporated into a well-designed, quality care residence.Try to establish a gentle regimen for your loved one with PDD. It will be difficult to change old habits, and those that are not harmful might be comforting. But some boundaries may need to be set to add years of a higher quality of life. These are things to encourage the person with PDD to do: Be socially active Engaging with friends exercises your cognitive skills, remembering names, etc.Get involved in the residence Maintain a sense of self-worth.Exercise regularly Exercise also releases natural brain chemicals that can improve emotional well-being.Eat a healthy, balanced diet High protein meals can benefit your brain chemistry.Train your brain Play brain games online puzzles are great or playing cards with your caregiver.Reduce stressSleep wellTake care of medical conditions Diabetes, high blood pressure, and high cholesterolcan damage your brains blood vessels and lead tothinking and memory problems.Check on mood and motivation.Review your medications Certain prescription and over-the-counter medications can confuse some people. Consult your physician.Drink in moderationDon't smoke Smoking is related to Alzheimers and other cognitive disorders.Caregiver stress shows up on your face and in your manner in subtle ways that nonetheless are easily picked up by your loved one. Give yourself a break. Dementia will place demands on your relationship, and this is natural. You should get enough sleep and regular nutrition. Seek counseling from your specialist to help you stay on even keel. Assisted Living, Memory Care and Nursing HomesThere are no long-term care residences exclusively for people with Parkinson's. Assisted Living and Memory Care residences are typically equipped for their particular needs because of the prevalence of the disease. There will very likely become a point where loved ones will not care for themselves in significant ways, such as getting dressed and preparing food. Dementia, of course, will further inhibit their abilities. Assisted Living is a good option for earlier PD stages. Still, the onset of dementia, which can take years, will require Memory Care for optimum therapy and assistance with daily living. It is worth considering whether an inevitable move from Assisted Living to Memory Care is desirable or if Memory Care is the best initial choice. Memory Care residences should include specific physical design to aid dementia patients in navigating to and from and within their rooms or apartments. Staff should be highly trained and compassionate. Programming should rely on the best medical practice and cognitive science. Either Assisted Living or Memory Care, or a nursing home, will provide meals, assistance with daily living routines, and emergency care. The costs and level of care among the three vary widely. Interview the residence director and health care director to assess the level and quality of care the residence can provide. For More Information About Parkinson's:If you or your family has questions about Parkinsons disease and Parkinsons Disease Dementia, want information about treatment, or need to find support, consult your primary care physician and contact any of the following organizations:The American Parkinson Disease Association.800-223-2732apdaparkinson.orgNational Institute of Neurological Disorders and Stroke800-352-9424braininfo@ninds.nih.govwww.ninds.nih.govMichael J. Fox Foundation for Parkinson's Research800-708-7644www.michaeljfox.orgParkinson's Foundation800-473-4636helpline@parkinson.orgwww.parkinson.org

The typical person in their later sixties and older takes several medications for chronic conditions. These may be drugs to regulate blood sugar, thyroid, blood pressure, cholesterol, allergies, mood, or any of hundreds of other mild-to-serious conditions. Your comprehensive blood panel is your and your doctor's way of monitoring the effect of the drugs prescribed, as well as whether they're working or not or if they may be interacting with one another. And, besides, you're changing. How do we know you're changing? You're aging. Your liver and kidneys break down and eliminate drugs from your body, and your liver and kidneys are aging. You may lose muscle and gain fat, affecting how drugs work. All of this can complicate the effectiveness of meds and, especially important, create harmful side effects. So, consider these medication tips  after you see your doctor. 1. Take Medicine as Prescribed with Regular Discussions with Your Health Care Provider On that all-important visit with your doctor, be involved. The doctor or nurse should ask you if your meds have changed or if you've stopped or started either prescribed medicine or over-the-counter drugs or supplements. They all count! If you're taking something prescribed by another doctor that's not on your primary's list speak up. Take only prescription meds your health care provider has prescribed. None of this, "Here, try one of mine" from your golf partner. Taking someone else's medicine can be very dangerous. This is particularly true of pain medication, which could worsen your condition or cause addiction. You probably know opioids are highly addictive but are not the only ones. The interaction of drugs is unpredictable. Your doctor has the proper outlook on your entire series of medications. Please don't stop taking or skip prescribed medications because you think you don't need them anymore, feel they've stopped working, or think they're causing a side effect. Consult your doctor about any side effects. Take side effects seriously. In the United States, 125,000 people die annually from incorrectly taking their medications! Talk to your pharmacist or health care provider about ways to help you take the proper dosage on time every time. It's typical to forget to take your meds. But it's not okay. Many antibiotics must be taken after the infection stops or after you stop feeling the symptom. Hence the instructions to take every dose until they're gone. If you're a family member or caregiver reading this, please provide the person under your care with prefilled pillboxes and automated reminders attached to pill bottles, or subscribe to a pill packaging service that sorts, packages, and delivers by individual dose. 2. Store Your Meds Safely and Keep Current Keep all medicine up and away from children, wherever you store them. Around 10,000 children are accidentally poisoned by prescription meds every year, and a child dies every 12 days from such poisoning. If you have questions about safely storing your medicines, contact your pharmacist or health care provider.Store meds in a safe, cool, dry place. A high drawer reserved for medications in a dresser or cabinet is good. Be careful that meds that need to be cooled are stored in the fridge, but give them a shelf where children can't reach them. There will be storage instructions on the bottle. Due to fluctuating heat and humidity, a bathroom medicine cabinet may be the worst place. Even if meds are not expired, improper storage can render them ineffective or unsafe.Remember we talked about how you're changing as you age? So is your medication. If you have an old bottle of aspirin that's been haunting the top shelf of a kitchen cabinet for a couple of decades, don't use it. Some meds lose their effectiveness, but others can degrade into toxicity. Check the expiration dates. There are proper ways to dispose of unused medications. Throwing them in the trash is not one of them. Discarded drugs can end up in the water supply and may be eaten by wildlife or pets. See any disposal instructions that may be on the side of the bottle. Many pharmacies have disposal sites where you can drop the old drugs. You can search for "medication disposal sites" or see the FDA's webpage that instructs you on the options of disposing of meds.3. Be Aware of Potential Medication Interactions and Side Effects, Even Unexpected InteractionsGrapefruit juice is always good for you. Here's something you may need to learn about grapefruit juice. The grapefruit has these beneficial enzymes that naturally protect it from the effects of insects and other harmful stressors. Unfortunately, these same enzymes inhibit the breakdown of certain medications in the human stomach, making some drugs ineffective or even toxic. So, what's good for the grapefruit is only sometimes suitable for the patient. Don't let this stop you from enjoying your morning grapefruit. Ask your doctor because this has been studied, and there's a list of drugs more likely to interact. And we only bring this up to illustrate how seemingly harmless or good-for-you foods and supplements can seriously interact with your medication. Ask your doctor about any potential adverse interactions.Prescription drugs can affect each other dramatically. For example, nitroglycerin, which treats angina, should not be taken with many erectile dysfunction medications, including Viagra and Cialis, because serious interactions can occur. Your pharmacist can also advise you about potential medication interactions and side effects.You may also have a medical condition that makes a particular medication risky. Again, your healthcare provider armed with your health record, a physical exam, and blood work is the best call here. Even herbal supplements you get off the shelf at the grocery store, though you're free to take them without a prescription, can interact. It may surprise you, but 40 percent of the drugs behind the pharmacist's counter are derived from plants used as natural remedies since ancient times. Grapefruit juice is used to prevent gout attacks, for example. Go figure. So, supplements are drugs, too, and they deserve the same caution as prescription meds when mixed with others.Not surprisingly, alcohol is a common offender. The NIH warns that "mixing alcohol with certain medications can cause nausea and vomiting, headaches, drowsiness, fainting, or loss of coordination. It also can put you at risk for internal bleeding, heart problems, and difficulties in breathing." In other words, alcohol, whether it has sedative or stimulant effects on any person, should be considered a drug when taking other medication. If you're experiencing something you suspect is a medical condition, such as memory loss or difficulty, dizziness, or sleepiness, particularly for seniors, the medication may mimic the symptoms. Before you skip or stop taking the meds, consult your doctor. Ask your healthcare provider if any new health problems you are experiencing could be due to your medications at your regular physical. 4. Keep a Medication List There are many good reasons to keep a list of your current medications besides remembering which ones you're taking. Making a list is an excellent excuse to go through your cabinet or drawer and collect all your medicines. You can check duplicates and expired prescriptions (Don't mix expired medications with new ones!), find out if you need to take one you've forgotten about, and add any non-prescription medicine or supplements (including vitamins) you need to update your doctor on.Keep the list with you. And keep it current. Give a copy to a friend or relative for sure your emergency medical contact person in case of emergency and when you're traveling. Note any medicines you're allergic to or have had bad reactions to. Wear a medical alert bracelet for severe medicine needs (like insulin) or allergies. Store your medication list on your cell phone in a notepad app. If you're fortunate enough to have a healthcare provider who has your prescription record online, this can save you a lot of headaches when filling out medical forms even at the dentist. These forms almost always ask for the dosage, too, so those should be included. A medication list should include the following:Your prescription medicine's brand name or generic name.Over-the-counter medication, herbal preparations, and supplements that you take regularly or on occasion.Condition you're treating with the medication.The dosage (for instance, 300 mg).How often do you take it?Anything you're allergic or reactive to.The phone number of your pharmacy.Most people see more than one provider. Even if they don't ask, share your list with each provider and ensure it's updated at each visit. It's okay to suggest it to your provider, and it's essential, and it would be worth scheduling an annual review of medications with your primary care physician.Some meds are expensive, and sometimes there are generic alternatives. It also matters which insurance you use and where the pharmacy might get the medicine. These days, a good pharmacy can check the price of drugs from one provider or another. Using prescription discount cards (they're free) also can get you a surprising discount sometimes. Ask your healthcare provider if there is a less expensive, effective alternative.Also, tell your doctor if the medication doesn't work. If you're taking pain medication, it should lessen the pain. It could be a simple fix. New drugs are being developed all the time. Your primary physician is the one to ask. They may say it's safe to try it. Before you try a new brand-name pharmaceutical, you know the price. A drug that costs two dollars in its generic form may be $600 in its brand version.

When you're young, you may desire with multiple floors and big kitchens for entertaining friends and raising your family. We want beautiful yards with gardens and lush landscapes; dogs, cats, fish, and all kinds of things. As we age, those things might become difficult to maintain and upkeep; like cooking meals, bathing, laundry, running errands, taking medicine, operating electronics and even once-easy tasks like using household appliances all become tougher and tougher.The first questions is not how to get into assisted living with no money. Rather, it is; Am I ready - or is my parent ready for assisted living?  Its Tough Making the Move to Assisted Living for you or your loved one, We Can Help!Legend Senior Living Associates have fielded many questions from loved ones about how to move a parent with dementia to assisted living.  Its necessary when things that your parents used to do are now impossible to do independently or when their quality of care decreases to the point where its dangerous and potentially life threatening for them to not have some sort of aid.More than 15 million Americans are currently devoting love, time and care to aging loved ones with Alzheimers and Dementia care needs and sometimes it can be difficult, expensive, and time consuming; thats why assisted living residences are there to give you a helping hand! Heres list of 12 symptoms and signs its time for assisted living:Aggression with dementia or Alzheimers is one of the first signs that its time to start considering placement in assisted living , simply to ensure the safety of everyone. A condition called Sundowning often causes aggression or agitation in the evening.When caregiving is causing Caregiver Stress or burnout these signs can be just as telling as other symptoms. This stress is often damaging to the emotional relationship between you and your loved ones.When you notice an increase in care needs, or escalating care (like helping get someone to the bathroom or helping support most/all a persons weight) that can put a caregiver at risk.Wandering (especially in later stages of dementia) is one of the leading risks of slip and fall hazards.Ensuring seniors are eating healthy, balanced meals, getting vitamins, and have a supply of fresh nutritious food in the refrigerator and pantry that isnt expired. Many aging adults and those with memory needs forget to remove old, expired, or spoiled food.Aging adults with memory care needs or other seniors taking medication dosage correctly and at the right time. Assisted living residences provide seniors medication management and medication problem avoidance. Medical staff at assisted living residences also know things like the safest NSAID (like ibuprofen) for seniors (over 65 years) as well as other medications.When you need medical care or supervision for your loved one in the case of an emergency. Assisted living residences are perfect when theres a risk of a potential health issue, slip and fall, or wandering as theres always staff available and medical help a few minutes away.To keep important financial tasks like paying bills on time, as well as opening and disposing of mail to prevent mail fraud or identity theft.To help seniors get around without hurting themselves. Senior drivers often exhibit physical and mental changes as they age; like slower response time, losses in clarity and vision, drowsiness due to medications, reduction of the ability to focus, or may even judge distances incorrectly and these mistakes can be deadly. Assisted living residences provide free transportation services and safety for everyone on the road.When your loved one struggles with dressing, changing clothing, or is unable to shower or groom themselves. Often, seniors that arent in assisted living homes can go days without showering or changing clothes.When your aging loved one isnt engaging in their favorite hobbies, talking and socializing, or going out and about.If your loved one is exhibiting depression, loneliness, isolation, or the inability to cook or clean without assistance. This goes along with being unable to do the things they once loved to do. Making a Transition to Assisted Living for Seniors Also Makes the Transition Smoother on YouWhile making the decision to move a senior into assisted living is a tough choice, making a transition now rather than later helps adjust and keeps your ageing loved ones safer. You can start the touring process with assisted living communities; finding friendly staff, comfortable features, activities and friendships for your loved ones, as well as a clean environment with a pleasant dining experience and peace of mind.Youll soon find that assisted living residences only require a small initial adjustment before theyre the best opportunity for socialization, dining, activities, personalized care and effective care action plans in place (leaving you in charge without physically doing it all yourself) which is a large burden off of your shoulders.

Mistakes to Avoid When Looking for an Assisted Living CommunitySearching for the best assisted living residence is tough, especially when your parents and loved ones are making the change. Fortunately, there are ways to help them learn how to find and choose an assisted living facility. Most of these come down to the following three steps:Determining what they needFinding locations that match their needs and signing up for toursUtilizing multiple resources to find the right locationWell help you focus on finding the right residence to keep your loved one safe, happy, and secure as soon as possible with as little worry as possible. There are a few common mistakes people make when considering an assisted living community.1. Making the decision based on superficial reasonsAssisted living is about more than a pretty building. Often, adult children choose living establishments they think their parents would enjoy without adequately thinking about their health and wellness needs.If your mom or dad is unable make the decision, very carefully weigh all the options available before making it. Most of the time, transportation, safety, and comradery with similarly aged adults are exactly what your parent wants. 2. Being unrealistic about health and memory needsIf your mom or dad has dementia, think about what they need now, rather than what they used to enjoy. Memory issues cause adults to become reclusive, scared, and confused. Aging causes stressors and other worries. Choose a residence that can best protect them, rather than one that is overly fancy.Many residents come to us because they chose places that didnt offer the quality of care or level of services that they need. We always recommend adult children seriously consider their parents health needs and ask doctors about the support seniors need as they age.3. Going it alone in the searchIts usually prudent to get several opinions regarding the best assisted living options. Theres a good chance other family or friends have gone through the same process. You might also consult qualified senior living advisors. Legend Senior Living provides advisors to help navigate the process every time we show people our community. Our senior living advisors are generally very helpful when it comes to the process of choosing the right home, even if Legend may not be the right fit for your particular needs.4. Not knowing what to look forStart your search online, but make sure to talk to people. When doing your research online, make sure the residence offers the following resources:Nutritious prepared mealsCompanion services that provide company, personal assistance, and supportLife enrichment activities to indulge, learn, and growWellness and other activities to keep seniors engaged and activeBut go to the source, too. Make sure to make time to visit the residences youre considering. On your visits, we suggest you talk to the people to see exactly how it operates. Speak privately with staff and residents to get their opinions about the level of care and their overall satisfaction. Cheerful residents are always a good sign to look for in an assisted living home.5.  Choosing the first residence you findYoull find that every residence is unique. We recommend visiting at least three homes before you make a decision. This allows you to compare, do your due diligence, and get a clearer picture of standards and options available. Take note of residence standards, their cultures, and how they treat people. Most of all, consider your peace of mind and the safety of your loved ones.Legend Senior Living Is here to answer your questions and give you a tourGenerally speaking, most questions about assisted living focus on how many members are on staff, how the staff handles maintenance, and activity schedules. Security for aging adults with memory needs is something to consider as well.At Legend Senior Living, we understand whats important to you family, friends, good care, and compassion. We understand the need to live your life and your standards for independence, dignity, and the right to personal choice. 

By the time you read this, the reported deaths from COVID-19 and its variants in the U.S. will be close to 900,000. As staggering as that statistic is, its 400,000 short of the number of Americans killed by Heart Disease in the same time period. Heart disease is the leading cause of death for men and women of most racial and ethnic groups.Lets not allow the topic to overwhelm the fact theres a miracle inside your chest. Weighing about as much as a grapefruit, the heart is a powerful pump that drives five to six quarts of blood to every microscopic part of your body every second. And if it fails for even a second, the body is very unforgiving. Even though its the one piece of machinery driven by the brain, we tend to treat the heart like a kitchen appliance that we take for granted. Rarely serviced, rarely cleaned, and overworked until it burns out. Although heart bypass and transplant have become routine since the pioneering operations in the 1960s, its not like replacing the coffee maker you neglected too long. One Thing at a TimeThe better way to treat your heart with the respect it deserves is to start with changing just small habits. That way, youll avoid the relapse from trying to change everything at once and falling back to unhealthy heart habits inside of a month. The most obvious: if youre a smoker or heavy drinker, work on that first. Imagine a small team of remodelers arriving at your heart to do a makeover. The first thing theyre going to say is, Well, we cant do anything with the plumbing until we clear the smoke. Look for Help During Heart MonthQuitting smoking and reducing alcohol is never easy, but this is probably as good a time as any during the year to start a cessation program with help. February is American Heart Month, so youre likely to be reminded frequently of heart health and offered tips on modifying your routine to help your heart and prolong a happy life. If you only look to one place, trust the American Heart Association  www.heart.org. Prediabetes and Heart DiseaseWhats your blood sugar level? If you dont know, you should find out from your doctor if youre not already monitoring it yourself. You could be pre-diabetic without knowing it or showing any symptoms. Theres a good chance you could avoid becoming diabetic and reverse your pre-diabetic blood sugar to normal with relatively little change to your diet and a slight increase inyour activity. Diabetes has long been linked to heart disease, but recent studies suggest that reversing prediabetes is also linked to fewer heart attacks and strokes. [Reversing Prediabetes linked to fewer heart attacks, strokes, heart.org, Jan. 26, 2021.]While youre at it, get your cholesterol tested and routinely monitor your blood pressure.If youre worried you might be at risk for heart disease, ask your doctor to perform a simple cholesterol test to let you know if youre at risk and should adjust your diet. Home blood pressure monitors are not expensive, theyre digital, and theyre easy to use. Blood pressure stations are common in supermarkets now, and you can also check your weight and pulse. Womens Heart HealthWhy the emphasis on womens heart health? The American Heart Association tells us that cardiovascular disease is the No. 1 killer of women, causing 1 in 3 deaths each year about one woman every minute. They devote an entire website to womens heart health: Go Red for Women (www.goredforwomen.org). Here are just a few of the common misconceptions about womens heart health:Myth: Heart disease is for men, and cancer is the real threat for womenFact: Heart disease is a killer that strikes more women than men and is more deadly than all cancer forms combined. While one in 31 American women dies from breast cancer each year, heart disease is the cause of one out of every three deaths.Myth: Heart disease is for old peopleFact: Heart disease affects women of all ages. For younger women, the combination of birth control pills and smoking boosts heart disease risks by 20 percent. Heart defects are more common than you might think: 1.3 million Americans alive today have some form of congenital heart defect and at least nine of every 1,000 infants born each year have a heart defect. Even if you live a completely healthy lifestyle, being born with an underlying heart condition can be a risk factor.Myth: I run marathons no way I could be at risk.Fact: Factors like cholesterol, eating habits, and smoking can counterbalance your other healthy habits. You can be thin and have high cholesterol. The American Heart Association says to start getting your cholesterol checked at age 20. Earlier, if your family has a history of heart disease. Age and Heart HealthMany things, like wine and most people, grow better with age. The heart, however, takes more tending than a glass of fine wine. Avoid things that weaken your heart beyond the normal aging process. These are the usual suspects: smoking and tobacco use, lack of exercise, diet, alcohol, overeating, and stress. Some preexisting conditions you cant control: irregular heartbeat, congenital (inherited) heart defects, sleep apnea (although this may be a product of obesity or alcohol consumption).Viruses and MyocarditisMyocarditis is an inflammation of the heart muscle mostly caused by a virus, including COVID-19, and can lead to left-sided heart failure. The left ventricle of the heart is the part that pumps oxygen-rich blood back to the body. This valve tends to stiffen with age. Thats one of the many reasons why age combined with a preexisting condition puts you at greater risk of death from COVID-19. Even survivors of the novel coronavirus infection can sustain permanent heart damage. All people must protect themselves and others from COVID-19 by observing precautions, not just because of its immediate lethality but also because of its impact on the heart, known and unknown. How to Start with Your HeartThe factors involved in heart health and the onset of heart disease are many, varied, and complicated. But the common preventions (listed here, from the Mayo Clinic) are simple. You probably already know them by heart, so to speak:Not smokingControlling certain conditions, such as high blood pressure and diabetesStaying physically activeEating healthy foodsMaintaining a healthy weightReducing and managing stress Those may seem like six significant challenges, especially if you take on all six. But you should notice something else about them. Almost every one of them can affect the other five. So, if you pick one, youll find it easier to take on the next one. People who quit smoking usually discover that they have more energy within the first week, and exercise becomes easier. A little exercise and switching out one unhealthy food will help with weight, stress, blood pressure, and diabetes. Easy does it, especially if youre 65 and older. Youve spent a whole life learning one way. You can take your time. Learn to enjoy your healthier heart. But start today.First, Get a Checkup!Most of the questions this article has raised in your mind (Whats my blood sugar level? Whats my blood pressure? I used to smoke am I at risk?) can all be answered in a single doctors visit with simple lab work done a few days before. Schedule it now, before you start a program of exercise and diet. And schedule a regular exam per your doctors recommendation. Relieving the stress of not knowing will be a good start on your way to a healthier heart.

Around this time of year, virtually all religions celebrate significant events of birth, new beginnings, festivals of everlasting light and sacred histories, our identity as a people who we are. Also universal is the tradition of gift-giving to one another. The tradition may symbolize the spiritual gifts we all enjoy without condition. One of these is Independence. As the founders expressed it in our Declaration of Independence, we are endowed by [our] Creator with certain unalienable Rights, meaning they are given to us at birth.  Independence is at the very core of our identity as human beings, whatever our cultural origins. To be deprived of it is to take away our identity. To get it back is one of the greatest gifts we can get. We made Independence the core of our mission at Legend Senior Living. Its the first word in our three key values for a seniors quality of life: Independence, Dignity and Purpose. Independence was also the cornerstone principle when Legend founder Tim Buchanan pioneered the very concept of Assisted Living more than 30 years ago. At the time, seniors and their families just could not reconcile the love of their lifelong homes, and their personal freedom and dignity with living in a place that seemed opposed to the very notion of independence: the nursing home. It took a fiercely independent entrepreneur to say, Youre right. Thats just not good enough. There has to be a way. And if there was no way, then we would make one.But what would this look like? We had to throw out all of the conventional notions about aging and write a new history that provided for the particular needs of seniors and independent senior lifestyles where the necessary care or new solutions for memory-related disease and cognitive challenges could be provided for by modern, effective, compassionate methods.The first innovation was private apartment living, but as part of a residence that saw to all of the requirements of the complete individual lifestyle. The very idea of the Individuality of aging was a revelation. Before this, the organization was designed to serve the facility, not the resident. No matter ones level of mobility or cognitive functioning, everyone lived in the same, sterile surroundings. No wonder seniors compared it to warehousing. Who cares what the merchandise feels like?This history is important because it tells the story of how the proper mission with the right innovations can grow and evolve. The more we know about medical science and cognitive functioning, the more we can apply that knowledge to assisted living and memory care. And weve seen those innovations at Legend. They have shaped our architecture, our therapy, our hiring and training, even our management structure. When you look at Legend and any other senior living company, youre looking at two very different approaches inside and out. And the difference all begins with the concept of Independence.Physical IndependenceWhen you hear the two words together, the mind may leap to being able to get around. We tend to think of that as the measurement of the end of independence. Moms not able to get around on her own anymore. Mobility is one aspect of physical independence, one that plays a big part in the purposeful design of our residences. Wider halls, numerous resting and conversation places, handrails, strategically designed apartments, abundant natural light and well-designed color schemes all aid mobility.Mental IndependenceSome people seem born to be caregivers. Others acquire a sensitivity and understanding over years of paying attention. Youve known these people. They always know what to say. They put you at ease. They seem to be able to calm and heal with a look. If we were not making the most of having more than thirty years of experience in caregiving and senior living, wed be ignoring one our greatest assets, the rich insight into how we live as we age and how we cope with loss and change, what simply keeps us going and what truly brings us joy.We thrive as a senior living provider on our dedication to the science of aging and cognitive research. The difference that human understanding brings sets us apart. We look for and cultivate this innate talent in our Legend Associates, who earn their status as Legend Experts in Senior Living and Legend Experts in Memory Care with training, mentorship and through a work culture that encourages friendship and love of community.So, what does all that have to do with mental independence? Ironically, mental independence relies greatly on others. The first thing to understand is that being independent does not mean being alone. A caring, skilled Associate can tell that someone may still be dealing with the loss of a spouse not long before theyve made the move to a senior living residence. They can tell the difference between someone who thrives in privacy with their reading or crafts and shares the experience and another who is more socially active.  For either resident, we always work to draw the person out into the broader community. Naturally, Legend is endowed with entertainment and exercise amenities, theaters and game spaces, but we also dedicate a management professional to Life Enrichment. The single focus of this position is growth, socially, culturally and spiritually. Residents choose their interests and explore them in activities, outings and events.They live their independence through expression, communication, volunteerism and by simply being recognized for who they are.Legend Senior Living owns and operates over 40 Legend and Windsor senior living residences in six states. This article may have been an unusual way to describe them. We havent described a single piece of furniture or told you about the patios and bistros, after all. But that would not be describing what Legend is. Not at our heart. Every residence has its own character and is reflective of the locale and the culture, whether its Jacksonville, Florida or Oklahoma City, Oklahoma. In that, were a lot like the individuals who make their homes here. You should meet them. The description should come from them. It will be as individual as their own happiness, their own experience of Dignity, Purpose and Independence.Independence is not a decoration to hang on a tree, a keepsake we take out once a year and look at with nostalgia. It is the shining light of individuality we are endowed with at birth, that which makes us who we are, and that shines on, everlasting. It should grow brighter with age, and never dim. That is life at Legend. Visit the living room just off the entrance at any Legend residence this time of year. There, next to the glowing fireplace, a towering tree stretches its branches heavenward, populated with many shining lights. Many lights, one tree, a perfect symbol of Independent, happy individuals coming together as a community. May your season be as bright as our hearts this year.

As you prepare to celebrate the holidays this season, you may notice some changes in your parents or senior loved ones if you havent seen them in a while. They may seem more forgetful, depressed or confused.  Do they have Alzheimers disease or Dementia? Alzheimers disease is a progressive neurodegenerative disease which is both debilitating and life-changing. Is it time to start researching assisted living or memory care communities? Fortunately, there are warning signs your loved one may have Alzheimers disease or Dementia that can help you determine if its time to look at visiting a community, or at least visiting a doctor. 10 Early Indicators of Alzheimers Disease and Dementia in Seniors: -Forgetfulness and Short-Term Memory LossThe early effects of memory loss cause people to forget entire conversations from just moments before. Dementia and Alzheimers disease typically affect short term-memory first (memories that took place just a few moments ago). One of the most telling signs of memory issues are when those suffering forget important dates, the ability to remember their family members or ask for the same information repeatedly. -Increased Confusion or Increased Lack of ConcentrationConfusion about times and places can be one of the first indicators of memory loss. Tasks can take much longer than usual, people may forget where theyre going or how they got there or even be unable to navigate to familiar places. This leads to forgetting to track time, seasons and even the passage of time (which leads to forgotten appointments). -Items Show Up In Strange Places or Loved Ones Are Losing ThingsWe all lose things - but those suffering with the early stages of Dementia or Alzheimers disease lose keys or other things in strange places (like the refrigerator). To compound the issue, those affected may lose items and forget how to retrace their steps. Situations can further escalate to paranoia or theft accusations against caregivers. -Difficulty Doing Common TasksAnyone with memory loss or early signs of Dementia might not remember the coordination associated with cooking a favorite recipe, playing a familiar game, driving a vehicle or performing a hobby. Often, early signs of Alzheimers disease or Dementia are noticeable in depth perception, misjudged distances, and seeing colors- attributing for clumsiness, having accidents, falling or other serious health concerns. -Speaking Problems and Other Language IssuesIssues with memory loss can also cause problems with processing and forming language. This can be apparent in conversations and writing. Your loved ones often compensate for this by using stand-in words or their own terms to avoid describing objects and difficult actions. Sometimes, those suffering will stop abruptly during sentences or when engaged in conversation. -Loved Ones Having Problems with Abstract ThinkingThose suffering from memory loss sometimes have difficulty remembering numbers or doing math problems that are traditionally easy for them like simple change calculations, balancing checkbooks, or performing addition and subtraction. -Lapses of Judgement / Issues Making DecisionsWhile making a bad judgement call or having a difficult time making decisions isnt necessarily a sign of Alzheimers or a sign of Dementia, it could be one of the signs your senior parent or loved one might have Dementia. This could include your loved one falling for offers that are clearly scams, spending a reckless amount of money, or dressing inappropriately for weather conditions or following up on simple plans. -Personality Changes, Mood Swings, Frustration, Fear and Anxiety  Sometimes, those suffering with memory care needs have mood swings and show changes in personality. This can cause those suffering to get scared, act fearful, be depressed, become angry, overly anxious or even worried. This can even cause a calm, confident adult to become immediately tentative, shy, and confused especially when theyre outside of their comfort zone - like in a public area. -Loss of Grooming Ability or Changes in Personal HygieneDeclining attention to personal care (infrequent bathing, wearing the same clothes day in and out, not brushing teeth or hair) are often precursors to dementia. The same is true about cleaning the home - if a homes cleanliness declines suddenly, it could be a sign of a memory issue. -Loved Ones Withdrawal from Friends and FamilyOne of the biggest red flags is when seniors start withdrawing from social opportunities and activities that they enjoyed in the past. Legend Senior Living has found that seniors with dementia and Alzheimers disorder avoid being around people to avoid drawing attention to their memory loss, lapses in memory, or difficulty communicating because of memory loss. These symptoms can seem pretty normal as we engage and interact with our loved ones however, they can also be very telling in understanding how memory loss such as Dementia and Alzheimers disease affect our loved ones.  If you notice these symptoms in your loved one, we encourage you to seek out additional care options and services that ensure your loved one is getting the care they need to live their best life.

Lets Get Heart Smart  February Is American Heart MonthBy the time you read this, the reported deaths from COVID-19 and its variants in the U.S. will be close to 900,000. As staggering as that statistic is, its 400,000 short of the number of Americans killed by Heart Disease in the same time period. Heart disease is the leading cause of death for men and women of most racial and ethnic groups.Lets not allow the topic to overwhelm the fact theres a miracle inside your chest. Weighing about as much as a grapefruit, the heart is a powerful pump that drives five to six quarts of blood to every microscopic part of your body every second. And if it fails for even a second, the body is very unforgiving. Even though its the one piece of machinery driven by the brain, we tend to treat the heart like a kitchen appliance that we take for granted. Rarely serviced, rarely cleaned, and overworked until it burns out. Although heart bypass and transplant have become routine since the pioneering operations in the 1960s, its not like replacing the coffee maker you neglected too long.One Thing at a TimeThe better way to treat your heart with the respect it deserves is to start with changing just small habits. That way, youll avoid the relapse from trying to change everything at once and falling back to unhealthy heart habits inside of a month. The most obvious: if youre a smoker or heavy drinker, work on that first. Imagine a small team of remodelers arriving at your heart to do a makeover. The first thing theyre going to say is, Well, we cant do anything with the plumbing until we clear the smoke.Look for Help During Heart MonthQuitting smoking and reducing alcohol is never easy, but this is probably as good a time as any during the year to start a cessation program with help. February is American Heart Month, so youre likely to be reminded frequently of heart health and offered tips on modifying your routine to help your heart and prolong a happy life. If you only look to one place, trust the American Heart Association www.heart.org. Prediabetes and Heart DiseaseWhats your blood sugar level? If you dont know, you should find out from your doctor if youre not already monitoring it yourself. You could be pre-diabetic without knowing it or showing any symptoms. Theres a good chance you could avoid becoming diabetic and reverse your pre-diabetic blood sugar to normal with relatively little change to your diet and a slight increase inyour activity. Diabetes has long been linked to heart disease, but recent studies suggest that reversing prediabetes is also linked to fewer heart attacks and strokes. [Reversing Prediabetes linked to fewer heart attacks, strokes, heart.org, Jan. 26, 2021.]While youre at it, get your cholesterol tested and routinely monitor your blood pressure.If youre worried you might be at risk for heart disease, ask your doctor to perform a simple cholesterol test to let you know if youre at risk and should adjust your diet. Home blood pressure monitors are not expensive, theyre digital, and theyre easy to use. Blood pressure stations are common in supermarkets now, and you can also check your weight and pulse.Womens Heart HealthWhy the emphasis on womens heart health? The American Heart Association tells us that cardiovascular disease is the No. 1 killer of women, causing 1 in 3 deaths each year about one woman every minute. They devote an entire website to womens heart health: Go Red for Women (www.goredforwomen.org). Here are just a few of the common misconceptions about womens heart health:Myth: Heart disease is for men, and cancer is the real threat for womenFact: Heart disease is a killer that strikes more women than men and is more deadly than all cancer forms combined. While one in 31 American women dies from breast cancer each year, heart disease is the cause of one out of every three deaths.Myth: Heart disease is for old peopleFact: Heart disease affects women of all ages. For younger women, the combination of birth control pills and smoking boosts heart disease risks by 20 percent. Heart defects are more common than you might think: 1.3 million Americans alive today have some form of congenital heart defect and at least nine of every 1,000 infants born each year have a heart defect. Even if you live a completely healthy lifestyle, being born with an underlying heart condition can be a risk factor.Myth: I run marathons no way I could be at risk.Fact: Factors like cholesterol, eating habits, and smoking can counterbalance your other healthy habits. You can be thin and have high cholesterol. The American Heart Association says to start getting your cholesterol checked at age 20. Earlier, if your family has a history of heart disease.Age and Heart HealthMany things, like wine and most people, grow better with age. The heart, however, takes more tending than a glass of fine wine. Avoid things that weaken your heart beyond the normal aging process. These are the usual suspects: smoking and tobacco use, lack of exercise, diet, alcohol, overeating, and stress. Some preexisting conditions you cant control: irregular heartbeat, congenital (inherited) heart defects, sleep apnea (although this may be a product of obesity or alcohol consumption).Viruses and MyocarditisMyocarditis is an inflammation of the heart muscle mostly caused by a virus, including COVID-19, and can lead to left-sided heart failure. The left ventricle of the heart is the part that pumps oxygen-rich blood back to the body. This valve tends to stiffen with age. Thats one of the many reasons why age combined with a preexisting condition puts you at greater risk of death from COVID-19. Even survivors of the novel coronavirus infection can sustain permanent heart damage. All people must protect themselves and others from COVID-19 by observing precautions, not just because of its immediate lethality but also because of its impact on the heart, known and unknown.How to Start with Your HeartThe factors involved in heart health and the onset of heart disease are many, varied, and complicated. But the common preventions (listed here, from the Mayo Clinic) are simple. You probably already know them by heart, so to speak:Not smokingControlling certain conditions, such as high blood pressure and diabetesStaying physically activeEating healthy foodsMaintaining a healthy weightReducing and managing stressThose may seem like six significant challenges, especially if you take on all six. But you should notice something else about them. Almost every one of them can affect the other five. So, if you pick one, youll find it easier to take on the next one. People who quit smoking usually discover that they have more energy within the first week, and exercise becomes easier. A little exercise and switching out one unhealthy food will help with weight, stress, blood pressure, and diabetes. Easy does it, especially if youre 65 and older. Youve spent a whole life learning one way. You can take your time. Learn to enjoy your healthier heart. But start today.First, Get a Checkup!Most of the questions this article has raised in your mind (Whats my blood sugar level? Whats my blood pressure? I used to smoke am I at risk?) can all be answered in a single doctors visit with simple lab work done a few days before. Schedule it now, before you start a program of exercise and diet. And schedule a regular exam per your doctors recommendation. Relieving the stress of not knowing will be a good start on your way to a healthier heart.

The relationships you develop with your parents are often some of the deepest and most meaningful in your life. Which makes having a conversation about moving into senior living residences tough for all involved. It might be difficult for you to broach the subject with your parents, but keep in mind that its just as hard for them to hear it.No matter how prepared you or they might be, this is never an easy conversation to have. From your parents perspective, moving into a senior living residence might seem like a significant reduction in independence and freedom. After all, having lived alone for forty or fifty years gets a person used to a certain type of lifestyle. Its for that reason that you have to give them the best advice possible. Dont simply make the decision for them, bring them into the discussion and talk frankly about the situation and the options available. Weve learned a thing or two during our time at Legend Senior Living, and know a few tips for making this conversation a bit easier:Speak honestly and compassionatelyHelp your parents by being sensitive to their needs, wants, and fears, and include them in the conversation about their lives. Give your honest assessment, even if you know it may be difficult for them to hear.Make collaborative choicesPeople are more willing to make choices when they take part in the decision. Structure your conversation in a way that shows you arent trying to run their lives; rather that youre focused on their health, safety, and happiness, and welcome and respect their input in this decision.Set up senior living residence toursEncourage them to schedule tours of residences so they can meet people and see the environments firsthand. As they talk to residents, they can weigh their decisions based on whats important to them. Know the signs to help assess the situationIt can be hard to admit when your parents cant handle living on their own. Its important that you know the signs that determine its time to consider senior living. Here is a list of what to look for:Weight loss due to malnutrition or inability to feed oneselfFrailty of strength or statureWeight gain, potentially due to illness or inactivityChanges in behavior, appearance, or bathing habitsLoss of friendships, activities, or interestsUnopened bills, personal mail, or past-due noticesWhen daily living activities and independent living activities waneChronic, persistent health conditions or conditions that require daily monitoringSlower recovery for minor injuries or illnessesRecent accidents or incidentsSenior living means not worrying about when theyll get a nutritious meal, not having to worry about them forgetting to turn off the stove, a slip or a fall, or forgetting to take their medications. Be open and honest regarding your concerns about them living on their own. Theyll appreciate how much you value their safety, happiness, health, and independence. Senior living also ensures that your parents will have the assistance in the case of an emergency or accident. Its not only a residential situation, its peace of mind for both you and your parents that they will always be looked after.Even though the conversation might be difficult to have, its important that you have it. But make sure you approach it with kindness, compassion and understanding.

As our population ages, providing care for aging parents is becoming more common by the day.Over the past several years, we have seen a dramatic increase in adults providing care for their spouses or aging parents. While providing this service to your family can be rewarding, it can also take a toll on your personal life in the form of financial stress, having drastically less personal time, feeling drained and generally overwhelmed.The holiday season is a particularly stressful time for caregivers. Providing care to your loved one, taking care of your own family and making time for yourself is a delicate balancing act that can all too quickly fall apart. Its easy to dedicate too much time to the others while not enough for yourself, increasing the risk of burnout and fatigue. This type of caregiver stress can lead to a variety of personal complications such as:DepressionSocial isolationFinancial difficultiesStruggling to copeDifficulty providing care due to advancing Alzheimers, reduced physical abilities and other senior related health issues.When Caregiver Stress Becomes an IssueCaregivers are often so focused on their loved ones that they forget to think about themselves and their own lives. This is detrimental in many ways, and can lead to declining health, anger or frustration, fatigue and even drug and alcohol abuse.Over time, the effects of stress or caregiver fatigue have a huge effect on your overall wellbeing and health. On top of stress, fatigue, depression, or exhaustion, many caregivers do not get enough sleep, physical activity or proper nutrition because they are so busy dedicating their time to the care of someone else. This can even lead to a variety of future health problems such as obesity, diabetes, heart disease, and high blood pressure.8 Strategies to Reduce Caregiver StressWhile the emotional strain and physical stress associated with caregiving can be very taxing, simply taking advantage of the resources and tools available to you can help you provide better care for both your loved ones and yourself. Its important to remember that if you arent taking care of yourself, your ability to take care of others suffers too.Stay Connected with OthersSharing and vocalizing experiences can help caregivers manage fatigue and stress. Its important to realize that you can talk about your stressors with fellow caregivers, clergy, friends, and family.Seek and Accept Help from OthersOften, when individuals truly need support or assistance in tough situations they withdraw rather than joining support networks to get the help they need. Dont be afraid to reach out to these groups - they exist for a reason. Support networks come from the community, online support, local groups and other professionals.Understand What the Future Looks Like for You and Your Loved OneTalking to medical staff about the available options during aging, declining health, and disease can make a lot of difference. You can also obtain support from Aging and Disability Resources Centers. Additionally, there are other programs in the residence to talk to about aging adults and their caregivers. This will equip you with the information you need in order to fully understand your situation and caring requirements, and ultimately to provide more effective care.Find Respite and RelaxationGetting a break for a few hours or days is always beneficial - whether it be in a faith-based organization, a social group or health club. Dont feel guilty about spending this time on yourself either. While it might seem that you need to spend all of your time with your loved one, taking time for yourself is absolutely crucial in order to rest and recover. The more time you spend on yourself, the better shape you will be in to care for others.Practice Self-Care RegularlyParticipate in enjoyable and relaxing activities. This could include social outings, hobbies, art or other creative endeavors. Sometimes reading, listening to music, watching a movie, or simply relaxing can drastically improve your state of mind. The activity itself doesnt matter so much as the act of practicing self-care. Make it a habit; even 15 minutes per day will make a huge difference.ExerciseExercise is a miracle drug that can improve your mental and physical health in a big way. Being active improves your mood, reduces stress and minimizes your risk of contracting debilitating diseases. Its a crucial tool for staying in shape and remaining level-headed. Exercise everyday if you can. And remember that anything is better than nothing - even a long walk once a day will do wonders for both your body and your mind.Stay Healthy with a Regular ScheduleStress is the mind-killer. It can cause people to lose sleep, overeat or under eat, drink excessively, smoke and consume drugs. Maintaining a regular schedule is one way to combat this. Ensure that you get enough sleep, get to bed around the same time every night, and eat healthily. Maintaining a regular schedule will give your days a sense of structure and help you to remain grounded and healthy.Keep a Positive Perspective with Meditation and Other TacticsSometimes it can be tough to keep a positive outlook. That being said, there are tools such as meditation, conscious breathing and journaling that can be used to help reduce stress and encourage positivity. These techniques also help to reduce negative and fatalistic thoughts while also fostering feelings of gratefulness.

To improve the quality of life available at home, today's best senior living gives equal weight to an independent lifestyle and compassionate professional care and offers a holistic approach to wellness, longevity, and happiness. Those looking for a Personal Care or Memory Care residence in the McCandless area have a unique advantage in that the same provider, Legend Senior Living, manages two nearby residences of equally high caliber. Ridgecrest and The Remington benefit from Legend's three decades of innovation in senior living. Both offer upscale, carefree, highly social environments. Each has its distinctive appeal.  The Ridgecrest lifestyle takes on the flavor of an adventure in a resort-style atmosphere. Friendship and fun are the objectives, aided by full-service amenities: a cocktail lounge, indoor pool, art studio, billiards room, putting green, bocce ball court, covered patio with fireplace, to name a few. The Remington recalls the elegance of classic Pittsburgh with its magnificent tray ceilings and sunlit manor house common areas. Splendid balconies, sunny courtyards, and covered patios encourage frequent gatherings with friends.  At Ridgecrest and The Remington, we believe in the power of community and engagement. That's why we've brought our signature Gold Leaf Dining to Both residences. Our chef-prepared cuisine, designed for health and taste, is served in a welcoming restaurant-style atmosphere. You'll savor the flavor of local favorites, international delicacies, and seasonal selections, all designed by a licensed nutritionist. Bistro-style dining makes for a fun meal between activities. And speaking of activities, our full-time Life Enrichment Coordinator creates a dynamic calendar of events and opportunities. From fitness classes to art workshops, there's always something to pique your interest and encourage new friendships.  Both communities feature Legend's proactive approach to Memory Care. Compassionate, expert associates employ innovative therapies that bring actual results, improved cognition and behavior, and the ability to create new memories. It's an empathetic approach, striving to be the resident's best friend, learning their Life Story.  In the Legend philosophy of wellness and quality of life, individuality is paramount. Complete independence comes with just the right amount of personal assistance. So, top-notch care is a given at Ridgecrest and The Remington. It comes down to "What's your style?"  Find our more at legendseniorliving.com.

Lets start with what most of us know about Parkinsons disease (PD). Comparatively common in older adults, its a neurological disorder estimated to affect nearly 2% of those over age 65, estimated by the National Parkinsons Foundation to be one million Americans in 2020. Public figures, such as the popular actor Michael J. Fox, who has PD, have increased the publics awareness and understanding of the disease. Now lets consider the side of PD less talked about: Parkinsons Disease Dementia (PDD). Usually, the condition is depicted as auditory and visual hallucinations of imagined occurrences, delusion, and paranoia that follow the more visible motor dysfunction typical of Parkinson's. In fact, the dementia component of PD usually does not appear earlier than a year or more after the diagnosis. The average time from onset of Parkinsons to signs of dementia may be around ten years if certain studies are correct. The phenomenon may also be more common than most people think. Thats why, to recognize April as Parkinsons Awareness Month, were focusing on the dementia phase of the disease.Recognizing PDDThe University of California, San Francisco, Weill Institute for Neurosciences Memory and Aging Center outlines the symptoms of PDD: 1Trouble focusing, remembering things or making sound judgementsMay develop depression, anxiety or irritabilityMay hallucinate and see people, objects or animalsSleep disturbancesThe Alzheimers Organization states that an estimated 50 to 80 percent of those with Parkinsons eventually experience dementia as their disease progresses. There's no single test or combination of tests that can give a conclusive diagnosis of PDD, which may partly account for the wide range in the statistics. An original diagnosis of Parkinsons will be based on movement irregularity, with PDD symptoms at least a year off. This puts greater importance on working closely with a physician for an early diagnosis. Sadly, the deterioration of brain cells by PDD can't be stopped or slowed. Drug therapy can alleviate some of the symptoms.The Difference Between Parkinsons Dementia and OthersThe difference among various dementias can be confusing, and dementia should never be self-diagnosed instead of consulting with a neurology specialist. First, consult your primary physician. The International Parkinson and Movement Disorder Society provides a directory of movement disorders specialists to search for a specialist in your area.Dementia with Lewy bodies (DLB) is a spectrum of dementia-related to Parkinson's, which is also characterized by the formation of Lewy bodies, clumps of protein that form in the brain. PDD symptoms resemble DLB, which also causes changes in thinking, behavior, and movement. The difference between PDD and DLB is that with DLB behavior and cognition impairment symptoms occur first, whereas Parkinsons will present as movement impairment with dementia appearing later.2 While the cause of PDD is unknown, scientists think the progression of Lewy body protein build-up first affects motor control, and eventually, enough nerve cells die that the first signs of dementia appear.Different clumps of protein form in a brain affected by Alzheimer's Disease (AD). Another difference between Alzheimers and similar dementia is that Parkinsons tends to affect attention and executive function more than memory. An essential and hopeful distinction: although the symptoms are similar, people with PDD are not at risk of developing Alzheimers Disease, according to the Pacific Brain Health Center. Nor is long-term memory likely to be as affected. The characteristic loss of recognition of loved ones and a general awareness that affects Alzheimers patients is not typical of PDD.3Aging and ParkinsonsJohns Hopkins Medicine states: The older you are, the greater your risk of developing Parkinson disease.4 The Michael J. Fox Foundation, in its downloadable brochure Navigating Cognitive Changes in Parkinsons, also notes "Cognitive changes from Parkinson's often are different or more than you'd expect with age." The example they offer is a helpful illustration of the difference between ordinary changes in memory function due to age and those caused by Parkinson's. Ordinarily, you'll forget where you left your keys, and this may become more common as you age. By contrast, forgetting what your keys are used for or how to use them signifies a more severe dysfunction related to dementia.Caregiving at HomePeople with PD may get along well with home caregiving with the help of a spouse for years. The onset of PDD can change this significantly, primarily in disrupting the ability to communicate. Be prepared that the disorientation will change a persons behavior. They may not be able to be left alone and may become moody, impulsive, and annoyed. A few simple communication techniques are recommended for the caregiver:Establish a daily routine. Having meals, exercise, and activities at roughly the same time every day avoids annoyance and anxiety in your loved one.Simplify living areas. Reduce distraction and shadows.Keep the home brightly lit.Remain calm and empathetic. Remember, it's the disease and not a conscious decision that creates erratic behavior.When evaluating the move to an Assisted Living or Memory Care community, consider that all the above features are incorporated into a well-designed, quality care residence.Try to establish a gentle regimen for your loved one with PDD. It will be difficult to change old habits, and those that are not harmful might be comforting. But some boundaries may need to be set to add years of a higher quality of life. These are things to encourage the person with PDD to do: Be socially active Engaging with friends exercises your cognitive skills, remembering names, etc.Get involved in the residence Maintain a sense of self-worth.Exercise regularly Exercise also releases natural brain chemicals that can improve emotional well-being.Eat a healthy, balanced diet High protein meals can benefit your brain chemistry.Train your brain Play brain games online puzzles are great or playing cards with your caregiver.Reduce stressSleep wellTake care of medical conditions Diabetes, high blood pressure, and high cholesterolcan damage your brains blood vessels and lead tothinking and memory problems.Check on mood and motivation.Review your medications Certain prescription and over-the-counter medications can confuse some people. Consult your physician.Drink in moderationDon't smoke Smoking is related to Alzheimers and other cognitive disorders.Caregiver stress shows up on your face and in your manner in subtle ways that nonetheless are easily picked up by your loved one. Give yourself a break. Dementia will place demands on your relationship, and this is natural. You should get enough sleep and regular nutrition. Seek counseling from your specialist to help you stay on even keel. Assisted Living, Memory Care and Nursing HomesThere are no long-term care residences exclusively for people with Parkinson's. Assisted Living and Memory Care residences are typically equipped for their particular needs because of the prevalence of the disease. There will very likely become a point where loved ones will not care for themselves in significant ways, such as getting dressed and preparing food. Dementia, of course, will further inhibit their abilities. Assisted Living is a good option for earlier PD stages. Still, the onset of dementia, which can take years, will require Memory Care for optimum therapy and assistance with daily living. It is worth considering whether an inevitable move from Assisted Living to Memory Care is desirable or if Memory Care is the best initial choice. Memory Care residences should include specific physical design to aid dementia patients in navigating to and from and within their rooms or apartments. Staff should be highly trained and compassionate. Programming should rely on the best medical practice and cognitive science. Either Assisted Living or Memory Care, or a nursing home, will provide meals, assistance with daily living routines, and emergency care. The costs and level of care among the three vary widely. Interview the residence director and health care director to assess the level and quality of care the residence can provide. For More Information About Parkinson's:If you or your family has questions about Parkinsons disease and Parkinsons Disease Dementia, want information about treatment, or need to find support, consult your primary care physician and contact any of the following organizations:The American Parkinson Disease Association.800-223-2732apdaparkinson.orgNational Institute of Neurological Disorders and Stroke800-352-9424braininfo@ninds.nih.govwww.ninds.nih.govMichael J. Fox Foundation for Parkinson's Research800-708-7644www.michaeljfox.orgParkinson's Foundation800-473-4636helpline@parkinson.orgwww.parkinson.org

The typical person in their later sixties and older takes several medications for chronic conditions. These may be drugs to regulate blood sugar, thyroid, blood pressure, cholesterol, allergies, mood, or any of hundreds of other mild-to-serious conditions. Your comprehensive blood panel is your and your doctor's way of monitoring the effect of the drugs prescribed, as well as whether they're working or not or if they may be interacting with one another. And, besides, you're changing. How do we know you're changing? You're aging. Your liver and kidneys break down and eliminate drugs from your body, and your liver and kidneys are aging. You may lose muscle and gain fat, affecting how drugs work. All of this can complicate the effectiveness of meds and, especially important, create harmful side effects. So, consider these medication tips  after you see your doctor. 1. Take Medicine as Prescribed with Regular Discussions with Your Health Care Provider On that all-important visit with your doctor, be involved. The doctor or nurse should ask you if your meds have changed or if you've stopped or started either prescribed medicine or over-the-counter drugs or supplements. They all count! If you're taking something prescribed by another doctor that's not on your primary's list speak up. Take only prescription meds your health care provider has prescribed. None of this, "Here, try one of mine" from your golf partner. Taking someone else's medicine can be very dangerous. This is particularly true of pain medication, which could worsen your condition or cause addiction. You probably know opioids are highly addictive but are not the only ones. The interaction of drugs is unpredictable. Your doctor has the proper outlook on your entire series of medications. Please don't stop taking or skip prescribed medications because you think you don't need them anymore, feel they've stopped working, or think they're causing a side effect. Consult your doctor about any side effects. Take side effects seriously. In the United States, 125,000 people die annually from incorrectly taking their medications! Talk to your pharmacist or health care provider about ways to help you take the proper dosage on time every time. It's typical to forget to take your meds. But it's not okay. Many antibiotics must be taken after the infection stops or after you stop feeling the symptom. Hence the instructions to take every dose until they're gone. If you're a family member or caregiver reading this, please provide the person under your care with prefilled pillboxes and automated reminders attached to pill bottles, or subscribe to a pill packaging service that sorts, packages, and delivers by individual dose. 2. Store Your Meds Safely and Keep Current Keep all medicine up and away from children, wherever you store them. Around 10,000 children are accidentally poisoned by prescription meds every year, and a child dies every 12 days from such poisoning. If you have questions about safely storing your medicines, contact your pharmacist or health care provider.Store meds in a safe, cool, dry place. A high drawer reserved for medications in a dresser or cabinet is good. Be careful that meds that need to be cooled are stored in the fridge, but give them a shelf where children can't reach them. There will be storage instructions on the bottle. Due to fluctuating heat and humidity, a bathroom medicine cabinet may be the worst place. Even if meds are not expired, improper storage can render them ineffective or unsafe.Remember we talked about how you're changing as you age? So is your medication. If you have an old bottle of aspirin that's been haunting the top shelf of a kitchen cabinet for a couple of decades, don't use it. Some meds lose their effectiveness, but others can degrade into toxicity. Check the expiration dates. There are proper ways to dispose of unused medications. Throwing them in the trash is not one of them. Discarded drugs can end up in the water supply and may be eaten by wildlife or pets. See any disposal instructions that may be on the side of the bottle. Many pharmacies have disposal sites where you can drop the old drugs. You can search for "medication disposal sites" or see the FDA's webpage that instructs you on the options of disposing of meds.3. Be Aware of Potential Medication Interactions and Side Effects, Even Unexpected InteractionsGrapefruit juice is always good for you. Here's something you may need to learn about grapefruit juice. The grapefruit has these beneficial enzymes that naturally protect it from the effects of insects and other harmful stressors. Unfortunately, these same enzymes inhibit the breakdown of certain medications in the human stomach, making some drugs ineffective or even toxic. So, what's good for the grapefruit is only sometimes suitable for the patient. Don't let this stop you from enjoying your morning grapefruit. Ask your doctor because this has been studied, and there's a list of drugs more likely to interact. And we only bring this up to illustrate how seemingly harmless or good-for-you foods and supplements can seriously interact with your medication. Ask your doctor about any potential adverse interactions.Prescription drugs can affect each other dramatically. For example, nitroglycerin, which treats angina, should not be taken with many erectile dysfunction medications, including Viagra and Cialis, because serious interactions can occur. Your pharmacist can also advise you about potential medication interactions and side effects.You may also have a medical condition that makes a particular medication risky. Again, your healthcare provider armed with your health record, a physical exam, and blood work is the best call here. Even herbal supplements you get off the shelf at the grocery store, though you're free to take them without a prescription, can interact. It may surprise you, but 40 percent of the drugs behind the pharmacist's counter are derived from plants used as natural remedies since ancient times. Grapefruit juice is used to prevent gout attacks, for example. Go figure. So, supplements are drugs, too, and they deserve the same caution as prescription meds when mixed with others.Not surprisingly, alcohol is a common offender. The NIH warns that "mixing alcohol with certain medications can cause nausea and vomiting, headaches, drowsiness, fainting, or loss of coordination. It also can put you at risk for internal bleeding, heart problems, and difficulties in breathing." In other words, alcohol, whether it has sedative or stimulant effects on any person, should be considered a drug when taking other medication. If you're experiencing something you suspect is a medical condition, such as memory loss or difficulty, dizziness, or sleepiness, particularly for seniors, the medication may mimic the symptoms. Before you skip or stop taking the meds, consult your doctor. Ask your healthcare provider if any new health problems you are experiencing could be due to your medications at your regular physical. 4. Keep a Medication List There are many good reasons to keep a list of your current medications besides remembering which ones you're taking. Making a list is an excellent excuse to go through your cabinet or drawer and collect all your medicines. You can check duplicates and expired prescriptions (Don't mix expired medications with new ones!), find out if you need to take one you've forgotten about, and add any non-prescription medicine or supplements (including vitamins) you need to update your doctor on.Keep the list with you. And keep it current. Give a copy to a friend or relative for sure your emergency medical contact person in case of emergency and when you're traveling. Note any medicines you're allergic to or have had bad reactions to. Wear a medical alert bracelet for severe medicine needs (like insulin) or allergies. Store your medication list on your cell phone in a notepad app. If you're fortunate enough to have a healthcare provider who has your prescription record online, this can save you a lot of headaches when filling out medical forms even at the dentist. These forms almost always ask for the dosage, too, so those should be included. A medication list should include the following:Your prescription medicine's brand name or generic name.Over-the-counter medication, herbal preparations, and supplements that you take regularly or on occasion.Condition you're treating with the medication.The dosage (for instance, 300 mg).How often do you take it?Anything you're allergic or reactive to.The phone number of your pharmacy.Most people see more than one provider. Even if they don't ask, share your list with each provider and ensure it's updated at each visit. It's okay to suggest it to your provider, and it's essential, and it would be worth scheduling an annual review of medications with your primary care physician.Some meds are expensive, and sometimes there are generic alternatives. It also matters which insurance you use and where the pharmacy might get the medicine. These days, a good pharmacy can check the price of drugs from one provider or another. Using prescription discount cards (they're free) also can get you a surprising discount sometimes. Ask your healthcare provider if there is a less expensive, effective alternative.Also, tell your doctor if the medication doesn't work. If you're taking pain medication, it should lessen the pain. It could be a simple fix. New drugs are being developed all the time. Your primary physician is the one to ask. They may say it's safe to try it. Before you try a new brand-name pharmaceutical, you know the price. A drug that costs two dollars in its generic form may be $600 in its brand version.