New Report Reveals Alzheimer's Will Cost Nation $200 billion in 2012

The recently released Alzheimer’s Association 2012 Alzheimer’s Disease Facts and Figures report says that caring for people with Alzheimer’s and other dementias will cost the United States an estimated $200 billion in 2012. This includes $140 billion paid by Medicare and Medicaid. 

In addition, Medicare payments for an older person with Alzheimer’s and other dementias are nearly three times higher and Medicaid payments are 19 times higher than for seniors without these conditions. These costs will only continue to soar in the coming years given the projected rapidly escalating prevalence of Alzheimer’s disease as the baby boomers age.

 

The facts outlined in the report also underscore the need for investment in research. While the estimated costs of Alzheimer’s to the country are $200 billion, only one percent of this, $2 billion, is what scientists say is needed to make significant inroads in Alzheimer’s research that can begin to solve the crisis. To learn more about the information released in Facts and Figures, visit alz.org to watch a video summarizing the report.

Facts and Figures also includes a special section focusing on individuals living alone with Alzheimer’s. While Alzheimer’s imposes profound challenges on individuals and their families, for the one out of seven individuals with Alzheimer’s who live alone these challenges are even more formidable. An estimated 800,000 individuals have Alzheimer’s and live alone, and up to half of these individuals do not have an identifiable caregiver.

The Alzheimer’s Association provides a wealth of resources, programs and materials to assist individuals who live alone and their families, including:

Helpline: Available 24/7, this free call center (800.272.3900) offers information and support from master’s level clinicians.

Care consultations: The Alzheimer’s Association offers care consultations to individuals and their families living with Alzheimer’s and other dementias. Care planning is essential to provide those with the disease information about medical and non-medical options for treatment and support services.

ALZConnected: ALZConnected, powered by the Alzheimer’s Association, is the first dedicated online social networking community for anyone affected by Alzheimer’s disease; it provides a safe place for people to connect with others in similar situations 24 hours a day, 365 days a year at no charge.

For more information and resources to support those living alone with Alzheimer’s, visit the Alzheimer’s Association website at alz.org. 

Choosing Home Care Services that Meet Your Needs

by Anne Pagnoni

Making the decision to hire a home care service to provide care for your loved one is an important decision and can, at the same time, be very difficult. If an illness or recovery from surgery requires nursing care or physical therapy, a physician may order skilled home care services that provide both skilled providers and personal aides. Your decision is then based on the obvious medical determinations made by the doctor. But what if you as the family caregiver must determine the extent of care needed without the help of a doctor?

Each home care situation is unique. In the beginning, family or friends step in to help with simple tasks and support for aging seniors who want to stay in their homes. As long term care needs progress, more time is required to manage those needs. Physical and mental conditions change with aging making usually routine hygiene and daily living activities difficult for an aging individual. Even with the healthiest of seniors, the ability to drive a car, shop for groceries or do general housekeeping eventually needs to be relinquished to the responsibility of another person.

In one example, Karen, would stop by her parents' home on her way to work every morning and again on her way home from work in the evening. She checked in the morning to see that they were up and ready for the day and Karen would take a shopping list for things they needed. In the evening she delivered the needed items she had purchased during her lunch break and sometimes she fixed a meal when one was not prepared by her mother. This worked well until Karen began to notice her father did not shave or dress during the day and both parents were forgetting their medications. Karen felt more time and supervision was needed in their care but with her own family and job, she could not do it. Non-medical or personal home care services would be a good option for Karen to consider.

Before starting your search for a non-medical or personal home care company, determine what the care needs are and how much time each week will be required for assistance from the company. You may want to consult with the family physician and other family members as well as experienced social workers or care managers to determine needs. Most home care companies, as well, will help you do an assessment at no charge. With your care needs in hand, you are ready to begin your search.

The National Association for Home Care & Hospice (http://www.nahc.org/home.html) gives the following guidelines and checklist in searching for a home care company.

•How long has this provider been serving the community?

•Does this provider supply literature explaining its services, eligibility requirements, fees, and funding sources? Many providers furnish their home care clients with a detailed "Patient Bill of Rights" that outlines the rights and responsibilities of the providers, clients, and family caregivers alike.

•How does this provider select and train its employees? Does it protect its workers with written personnel policies and malpractice insurance? Does it protect clients from theft or abuse by bonding its employees?

•Does this provider assign supervisors to oversee the quality of care clients are receiving in their homes? If so, how often do these individuals make visits? Who can the client and his or her family members call with questions or complaints? How does the company follow up on and resolve problems?

•What are the financial procedures of this provider? Does the provider furnish written statements explaining all of the costs and payment plan options associated with home care?

•What procedures does this provider have in place to handle emergencies? Are its caregivers available on notice?

•How does this provider ensure client confidentiality?

If a home care company has not previously been recommended to you, ask for a list of previous clients and call for their experience with this provider.

Following up on these guidelines can help you determine the quality of personal care that is given. Many states license non-medical home care companies and require both legal and health standards to be maintained.

Read about individual home care companies in your area on the National Care Planning Council's website www.longtermcarelink.net.

Downsizing, Organizing, Handicap Remodeling, or Relocating

by Anne Pagnoni

When Robert and Anne bought their family home thirty years ago, their plan was to live through retirement in this home. They had furnished their home with refurbished antiques acquired from their many trips together. It was one of their cherished antique coffee tables that Robert tripped over, breaking his hip. Now with his return from the hospital in a wheelchair, the overwhelming task of making their home accessible for Robert’s wheelchair and safe for both of them faced Anne.

Remodeling for wheelchair access, organizing home furnishings and daily living items or downsizing and relocating to a smaller living area are monumental tasks that are many times thrust on senior home owners. Sometimes the need to do this is brought on by injury or age related illness. Home and yard maintenance can become a daunting chore for even the healthiest of seniors, requiring them to make a downsizing decision.

There is a large and growing industry of specialists who understand these challenges of elderly homeowners and are ready and willing to help with remodeling, organizing or the sale of the home and with the move to a new location.

A professional organizer provides skills in making the home safe and manageable. Relocating furniture, removing hazards such as electrical cords, throw rugs, heavy objects on shelves that might fall are some of the ways they make a home more senior friendly. They specialize in helping seniors part with items that clutter or have no valued use, so to make rooms less crowded or to make ready for a move to a smaller living space.

Handicap remodeling services and senior safety services offer help in adding wheelchair ramps and widening doorways. Bathrooms are made more accessible and safe, with hand rails, walk-in bath facilities and easier access to toilets.

If moving to a smaller retirement home or care facility is the best solution there is another senior specialty provider to call on called a Seniors Real Estate Specialist.

The Senior Real Estate Specialist concentrates more on a complete service package for the sale of the property and/or the purchase of a new living arrangement. The specialist also arranges for the services of a relocation specialist or Senior Move Manager to provide a complete, stress-free package for the elderly homeowner.

A move often requires downsizing and getting rid of a tremendous number of acquired possessions. The relocation specialist or Senior Move Manager, as they are often called, will typically provide a turnkey operation that includes assessing and identifying items to keep, arranging for auction or other disposal, cleaning the home, moving the belongings and setting up the new residence. The manager may also work closely with a real estate agent to arrange for the sale of the home and may also be involved in the financial transactions necessary to move into a new living arrangement.

All the help available to seniors may in itself be overwhelming. How do seniors choose the right service provider for their needs? How do they know they will hire someone qualified, responsible and honest? Area Agencies on Aging and State Better Business Bureaus are good resources to check out available service providers.

Family, friends and religious leaders can be valuable resources to seniors in referring service providers and helping to manage the hiring and supervision.

The National Care Planning Council’s website http://www.longtermcarelink.net/ provides educational articles and information on eldercare providers throughout the nation.

Who is Home Care Assistance?

This is who we are. The security guard. The friend. The caregiver.

“No way, I’ll throw her out of the house – I don’t need and I don’t want a caregiver,” Ed yelled at his daughter.

Linda knew her Father needed help — his Alzheimer’s was progressing and he was getting very forgetful of important things – like turning off the stove.

But he was adamant about not having help. Linda was getting desperate, afraid for her Father’s safety and health since he lived alone in a home that he didn’t want to leave.

Fortunately, Linda called Home Care Assistance and talked with a Case Manager familiar with the problem. They discussed her Father’s habits and enjoyments and found that Ed liked going out to lunch every day and occasionally, to a nearby Indian casino to play the slot machines.

OK, said the Case Manger – Ed doesn’t want a caregiver, but how about a security guard, would he accept that?

Together, daughter and our Home Care Assistance Case Manager convinced Ed that he would be a lot safer with a security guard – and he agreed.

One of Home Care Assistance best male caregivers (aka Security Guard Jim), took care of Ed in his home – and made sure that he was safe when they went out to lunch – and occasionally, to play the slots at the nearby casino!

Caregiver Interventions Can Help Treat Those With Alzheimer’s and Dementia

With a new year, comes new innovations in the healthcare industry. The New York Times reports that recent research is stressing the importance of caregiving to those with Alzheimer’s. With no effective treatment for Alzheimer’s, dementia therapy is the caregiving performed by families, agencies or at assisted living facilities.

“There’s actually better evidence and more significant results in caregiver interventions than there is in anything to treat this disease so far,” says Lisa P. Gwyther, Education Director for the Bryan Alzheimer’s Disease Research Center at Duke University.

Research suggests that creating positive emotional experiences for Alzheimer’s patients reduces distress and behavior problems. Emotions exist even after cognition deteriorates, so changing things like food, art, exercise, or the aesthetics of a room can generate positive emotions. The Journal of the American Medical Association found that brightening lights in dementia facilities decreased depression and cognitive deterioration.

Additionally, the research is stressing the importance of a caregiver’s emotional state, so much that agencies are developing programs to provide caregivers with education and emotional support. This type of support is not only beneficial to the caregivers themselves, but to their patients as well.

Home Care Assistance similarly stresses the importance of emotional support to both the patient and the caregiver. This type of innovative research is an exciting start to 2011. Hopefully we will continue to see even greater breakthroughs in the treatment of those with Alzheimer’s and dementia.

Report Calls Alzheimer's the Defining Disease of Baby Boomer Generation

According to Generation Alzheimer’s, a new report released by the Alzheimer’s Association on Jan. 27, one in eight baby boomers will develop Alzheimer’s, a devastating, heartbreaking, costly disease. It’s no longer their grandparents and parents who have Alzheimer’s – it’s the baby boomers themselves.

A rapidly aging population and dramatic increases in the number of Alzheimer cases in the coming years underscores the urgency in dealing with a crisis that is no longer emerging, but here.

Generation Alzheimer’s also describes the effect Alzheimer’s has on families and friends. Beyond the 10 million baby boomers who will either die with or from Alzheimer’s, millions of caregivers will be devastated, not only by the progressive loss of their loved one, but also by the care they will provide – care that could negatively affect their health, financial security and their future.

Most people survive an average of four to six years after a diagnosis of Alzheimer’s, but many live for as long as 20 years with the disease. This often long duration places increasingly intensive care demands on Alzheimer and dementia caregivers – as many as 11 million nationwide.

Alzheimer’s disease will also have a profound effect on our nation, killing more than diabetes and more than breast cancer and prostate cancer combined. According to preliminary data from National Center for Health Statistics, the number of Americans that die each year from Alzheimer’s disease has risen 66 percent since 2000. In 2010, Alzheimer’s and other dementias cost American society – families, insurers and the government - $172 billion; during the next 40 years it will cost more than $20 trillion, enough to pay of the national debt today and still send a $20,000 check to every man, woman and child in America.

Generation Alzheimer’s calls for a federal government committed to a thorough, aggressive and innovative approach to ending Alzheimer’s.

For more information about Generation Alzheimer’s, Alzheimer’s disease or resources to help, visit the Alzheimer’s Association at alz.org.  To read the report, please click here:  Generation Alzheimer's. 

Support Groups for Caregivers

By Anne Pagnoni

Being a caregiver for a loved one is an overwhelming responsibility. Many caregivers hold full time jobs; juggle children with their many extracurricular activities; and maintain their own household with laundry, bill paying, meal preparation, grocery shopping, yard work, cleaning, etc. In addition to their own familial responsibilities, they are responsible for the care of another adult individual, who typically has multiple physical and cognitive limitations. While initially the caregiving responsibilities may not be too taxing, as the aging loved one's limitations increase so does the time that the caregiver needs to spend caregiving. Overtime the caregiver will become overwhelmed and will need a support system in place to help him or her through the rough times.

Professionally run support groups are an excellent resource for the caregiver. Caregivers have the opportunity to talk with each other and share tips on things that have and haven't worked. Professional facilitators are available to provide useful information on relevant caregiving topics and to steer caregivers in the right direction when looking for additional services. Support groups usually meet for a couple of hours either weekly or biweekly. But what about the caregivers who aren't able to make the meetings or caregivers who need support between meetings? How do they get the help that they need?

Home Care Assistance of New Jersey has teamed up with an online caregiver support group designed to provide resources to caregivers and link them with professionals, who can share insight on particular caregiving issues. On Wednesday, September 1^st Home Care Assistance will be making an announcement regarding this partnership with information on how individuals can begin utilizing the site. Stay tuned for more information!

Applying for the Veteran’s Aid and Attendance Pension: My Personal Experience

My previous blog entry was about this exact government program – Veteran's Aid and Attendance. Read on to learn more about the application process for one family. Please keep in mind that this pension program also exists for a Veteran, who wishes to remain in his or her home with home care services.  –Anne Pagnoni

 

Applying for the Veteran's Aid and Attendance Pension
My Personal Experience
By Melissa Howell

12:20 a.m. The clock was blurry as I rubbed the sleep from my eyes to answer the phone.
"Hello", I said. A weak and frightened voice on the other end pleaded, "Melissa? Is Bryan there? I can't get out of my chair. Could you or Bryan come over?"

I sighed as I handed the phone to my husband and heard him say, "I'll be right over, Dad."
When Bryan left, I pondered on my father-in-law, John, and his situation. John had just come out of the hospital after a serious illness and although the doctor had assured us he would be fine, we quickly learned that he was not able to care for himself. He lived alone in a small apartment and had in-home health care assistance through his Medicare plan. They came once a day to help him with a shower and to aid him with incontinence. Bryan and I came over three times a day to help him with changing his clothes and to make his meals. In addition, we helped him with his bills and took him to his frequent doctor appointments. Tonight was the first time he had called to ask for help in the middle of the night. We needed to do something different. We were both exhausted between working our jobs and caring for our four young children and constantly running out to take care of John's needs. It was becoming more than we could handle. We realized we really needed to get him into assisted living.

John lived comfortably on an income consisting of social security and a retirement pension, but as we visited different assisted living homes in our immediate area, we quickly realized that this income was not enough. Assisted living was really expensive!

John had served in the Navy during the Korean conflict and we had heard through a friend that veterans could receive assistance through the Department of Veteran's affairs for health care. The catch was doing it correctly. Our friend referred us to a Veteran's Consultant from the National Care Planning Council to provide information for the challenging task of filling out the paperwork to receive this benefit. A Veteran's Consultant can provide general information on how a claim is filed. Our consultant told us about all of the necessary supporting documents we would need to make sure it was approved.  The paper work was pretty daunting, but we worked through each form thoroughly to be sure that we were providing all the information Veterans Affairs (VA) would need in order to expedite John's payments.

First, I obtained a medical report from John's doctor -- the most crucial step in the process. This form would prove that John needed aid and attendance. In our case, the doctor described his medical condition and then noted specifically his need for help with incontinence and showers, his lack of motivation to make meals for himself and his inability to leave the house alone. It was, however; important to us that the doctor wrote that John was mentally capable of making his own decisions, because we did not want to go through a delaying process of having VA assign somebody who would need to pay his bills for him (VA calls this person a fiduciary).

Another key thing was that John had to show evidence to VA that his care costs were close to or exceeded his income. Fortunately, John had a small amount of savings and he was able to pay in full for the first month's payment to his assisted living home. This was important, because the statement showing this payment was important evidence needed to present to VA. Since his assisted living cost exceeded his income by $1,000 per month, we arranged with the director, to pay what John could afford until the benefit from VA came in and then the director agreed to pay the remaining debt balance on the account at that time.

An important form was John's original DD-214, which was the official record showing that he had been honorably discharged from the military. I quickly found a certificate of honorable discharge (DD-256) but this was not the correct form. We searched through all of his files and boxes and couldn't find the DD-214. So I got on the Internet and found a website for the National repository where the official forms can be obtained. It appeared that it could take up to 6 weeks to receive an official copy. Fortunately, we found the original document folded in his wallet and we did not have to delay our process.

One of the forms my Consultant made me aware of was a VA power of attorney form (VA form 21-22a) that gave me the authority to fill out and submit the forms to VA on behalf of John. Although John was mentally sound, he was weak and tired and didn't really want to do anything but watch television and eat. With this form, I was able to communicate with VA in his behalf.
There were several other forms to fill out and after all the paperwork was finished, my Veteran's consultant gave us the address of where to send all of them. Our particular VA processing office was located in St. Paul, Minnesota.

After about two weeks, John and I each received a letter stating that VA was working on his case and they assigned him a case file number. After another two weeks, we received a letter stating that we needed to fill out some other paper work. I showed these to my consultant, who assured me, in our case, that it was standard procedure and that the paper work I had originally filed was sufficient. Within another two weeks, John received his first payment.
Because his care cost exceeded his income, he was awarded the full $1644.00 per month. VA sent another payment from the date that they had first issued his case number. So in the first month, we received two payments. These were sufficient to catch up the debt he owed to his assisted living and to continue with full payments each month.

Applying for the VA Aid and Attendance Pension was detailed, but it was not terribly frustrating because of the general information on the application process I received from my consultant. It did require extra work on my part, but it was well worth the end result of getting the care that John needed and the relief that Bryan and I needed in the end. I am grateful that we had such a wonderful resource in National Care Planning Council to help us find a capable and informative Veteran's Consultant.

Bryan and I now see John twice a week and visit with his assisted living staff often to help him have a comfortable and enjoyable life in his new home. He is able to enjoy activities and meals with other people, have quality personal care and have the peace of mind that someone is always there to help him. I now sleep at ease through the night, knowing that his needs are taken care of and that there won't be any middle of the night calls asking for help.

The National Care Planning Council wishes to thank Melissa for providing her experience. We maintain a list of consultants across the country which can be found at the following address: www.veteranslisting.com. We also provide a book with instructions to help people who want to file an application by themselves. This book can be purchased online at http://www.longtermcarelink.net/a16books.htm.

Little-Known Government Program Pays the Cost of Elder Care

By Anne Pagnoni
WHAT IF 33% OF ALL SENIORS IN THIS COUNTRY could receive up to $1,949 a month in additional income from the government to help cover their elder care costs? THEY CAN!
Under the right circumstances, a little-known federal program will pay additional income to cover long term care costs for at least 1/3 of all US senior households -- that's how many war veterans or their surviving spouses there are in this country. But the provisions of this program are such a well-kept secret that only 4.7% of US seniors are actually receiving the benefit. The great news about this program is the Department of Veterans Affairs will pay you to hire your family, friends or just about anyone to take care of you (Caregiving spouses can't be paid under this program). The program is called "Veterans Pension."
Most people who have heard about Pension know that it will cover the costs of assisted living and, in some cases, cover nursing home costs as well. But the majority of those receiving long term care in this country are in their homes. Estimates are that approximately 70% to 80% of all long term care is being provided in the home. All of the information available about Pension overlooks the fact that this benefit can also be used to pay for home care.
It also comes as a surprise to most people that the Department of Veterans Affairs will allow veterans' households to include the annual cost of paying any person such as family members, friends or hired help for care when calculating the Pension benefit. This annual cost is deducted from household income and used to calculate a lower "countable income" which in turn enables families to receive this disability income from VA. Even though VA claims the benefit is for low income families, because of the special provision in the regulations -- allowing for deduction for care costs -- households earning between $3,000 to $6,000 a month or more can still qualify for Pension under the right conditions.
This extra income can be a welcome benefit for families struggling to provide eldercare for loved ones at home. Under the right circumstances, this annualized medical expense for the cost of family members, friends or any other person providing care, could create an additional household income of up to $1,056 a month for a single surviving spouse of a veteran, up to $1,644 a month for a single veteran or up to $1,949 a month for a couple.
If the disabled care recipient has been rated "housebound" or in need of "aid and attendance" by VA, all fees paid to an in-home attendant will be allowed as long as the attendant provides some medical or nursing services for the disabled person. The attendant does not have to be a licensed health professional. There is also no need to distinguish between medical and nonmedical services -- all are deductible.
For a disabled person who has been rated "in need of aid and attendance" or "housebound", a family member will be considered an in-home attendant, but that family member has to be paid for services duly rendered. There is potential for fraud here where a family member may move into the home and ostensibly receive payment as a caregiver but not actually provide the level of care paid for. Documentation for this care must be provided to VA, and it is reasonable for VA to question whether the services being purchased from a family member living in the household are legitimate. Such arrangements should be extensively documented and completely arm's-length.
The care arrangements and payment for home care must be made prior to application and there must be evidence that this care is needed on an ongoing and regular basis. We recommend a formal care contract and weekly invoice billing for services. Money must exchange hands and federal law requires employment taxes must be withheld and there must be evidence of this. All of this documentation must be provided as proof to VA when making application for the pension benefit. Costs for these services must be unreimbursed; meaning these costs are not paid by insurance, by contributions from the family or from other sources. VA will allow, however, family caregivers being paid by their loved ones, to turn around and pay the household bills for their loved ones to help defray the cost of the care.
Due to the need for a rating, documentation for annualizing care costs and the extensive proof needed to show the caregiver is indeed an employee of the care recipient, most people should not try this on their own. An expert in this area should be sought to help with the application in order to avoid lengthy delays in awarding a benefit or a possible denial of benefits. For a list of individuals or companies in your area who understand how to get this benefit go to http://www.longtermcarelink.net/ref_veterans_consultants.htm

Aftercare Tips for Elderly Patients Checking Out of the Hospital

Readmission into the hospital after surgery or another procedure is extremely common, costly and time consuming. Since it is one of our main priorities to keep our clients healthy and living at home rather than in the hospital, I wanted to share this article from The New York Times as it provides great tips for hospital checkout and avoiding readmission.
In 2009,The New England Journal of Medicine reported “one in five Medicare patients returns to the hospital within 30 days of being discharged.” Dr. Mark V. Williams, who worked on this study, suggests that part of the issue is due to the fact that doctors place much of their focus on the admission process, when the patient is most sick. When the patient leaves the hospital, they often have more medications and treatments to worry about than when they first entered. Some doctors suggest that this problem may also occur because it may benefit the hospital financially for patients to be readmitted.
Dr. Eric A. Coleman, professor of medicine at the University of Colorado Denver, has developed a program called Care Transitions Intervention to help seniors take initiative in their care after leaving the hospital. The steps of the program include taking charge of your care, checking the medication list for errors, making a comprehendible discharge plan and contacting your primary physician if you have any questions or concerns. To further help the cause, some medical centers are providing financial incentives for lowering readmission rates and are providing guidance for improving the discharge process.

Recognizing Symptoms of Dementia

By Anne Pagnoni

The Brown family reunion has always been an event everyone looks forward to. Family visits, games, stories and everyone's favorite foods are always on the agenda. On the top of the menu is Grandma's Lemon Coconut Cake. Grandma always makes the traditional cake from her old family recipe. This year, however, the cake tasted a little on the salty side - perhaps a half cupful of salty.

Though the family was disappointed over the cake, of more concern was Grandma's confusion with the recipe and her similar confusion about the loved ones around her. Could something be wrong with grandma's mental state?

One might say that for an older adult a little forgetfulness or confusion is normal, but when do you know if there is a serious problem, such as dementia? An online article from FamilyDoctor.org outlines some common symptoms in recognizing dementia:

"Dementia causes many problems for the person who has it and for the person's family. Many of the problems are caused by memory loss. Some common symptoms of dementia are listed below. Not everyone who has dementia will experience all of these symptoms.

• Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you've already given them the answer. They won't even remember that they already asked the question.
• Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it.
  Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want.
• Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.
• Poor judgment. Even a person who doesn't have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather.
• Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them.
• Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can't find these things later.
• Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.
  Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.
• Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people."

Dementia is caused by change or destruction of brain cells. Often this change is a result of small strokes or blockage of blood cells, severe hypothyroidism or Alzheimer's disease. There is a continuous decline in ability to perform normal daily activities. Personal care including dressing, bathing, preparing meals and even eating a meal eventually becomes impossible.

What can family members do if they suspect dementia? An appointment with the doctor or geriatric clinic is the first step to take. Depending on the cause and severity of the problem there are some medications that may help slow the process. Your doctor may recommend a care facility that specializes in dementia and Alzheimer's. These facilities offer a variety of care options from day care with stimulating activities to part or full-time live-in options. Sometimes if patients tend to wander off, a locked facility is needed.

In the beginning family members find part time caregivers for their loved one. At first, loved ones need only a little help with remembering to do daily activities or prepare meals. As dementia progresses, caregiving demands often progress to 24 hour care. Night and day become confused and normal routines of sleeping, eating and functioning become more difficult for the patient. The demented person feels frustrated and may lash out in anger or fear. It is not uncommon for a child or spouse giving the care to quickly become overwhelmed and discouraged.

Family gatherings provide an excellent opportunity to discuss caregiving plans and whole family support. It is most helpful if everyone in the family is united in supporting a family caregiver in some meaningful way.  "The first step to holding a family meeting, and perhaps the most difficult one, is to get all interested persons together in one place at one time. If it's a family gathering, perhaps a birthday, an anniversary or another special event could be used as a way to get all to meet. Or maybe even a special dinner might be an incentive. The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. This might just simply be moral support and agreement to abide by the provisions or it is hoped that those attending will volunteer to do something constructive. This might mean commitments to providing care, transportation, financial support, making legal arrangements or some other tangible support." The Four Steps of Long Term Care Planning

 Professional home care services are an option to help families in the home. These providers are trained and skilled to help with dementia patients.

The National Care Planning Council supports caregiving services throughout the country. Visit www.longtermcarelink.net for more information.

Why Any and All Activity Matters

By Anne Pagnoni

The health benefits of exercise are extraordinarily well documented. Regular exercise lowers your risk of a stroke by 27%, reduces instances of both high blood pressure and Alzheimer's disease by 40%, cuts your chance of developing diabetes by 50%, and lowers your risk of developing colon cancer by a whopping 60%. As well, it obviously helps maintain a healthy weight. Plus, exercise has been shown to be just as effective at fighting depression as both SSRIs (like Prozac) and therapy.

A recent study from the Appalachian State University's Human Performance Lab even showed that people who took a brisk walk five days a week had fewer and less severe colds and flus than sedentary control subjects. So it's not just long-term chronic and fatal conditions that being fit staves off – regular exercise actually helps you battle the common cold, too!

Beyond full-on exercise, however, a recent study out of Australia also shows the health risk of being inactive. The study from the physical activity lab at the Baker IDI Heart and Diabetes Institute in Victoria, Australia found that the more television its subjects watched, the greater risk they had of dying at a younger age, particularly from heart disease.

Subjects in the study who watched four hours or more of television per day were 80% more likely to die from heart disease and 46% more likely to die from all causes, even when factors such as: education levels, overall health, age, past smoking, waist circumference, cholesterol levels, and blood pressure of the subjects was taken into account.

The study concluded that the real problem with television watching is that it is done while sitting, and sitting with extraordinarily little muscle movement. Such "extreme" inactivity affects metabolism overall, not just during the time spent inactive. A study from July 2008 showed that standing engages muscles and promotes the distribution of lipase, a fat-absorbing enzyme that triggers the body to process fat and cholesterol. Most important, the benefits of this regular, unremarkable movement are independent from the amount of time subjects spent exercising.

That same study found that the health consequences that develop from too much sitting are very different and independent from those that result from too little exercise. Along with the recent Australian study, it found that the negative health consequences of prolonged periods of sitting – larger waistlines, higher bad cholesterol levels, lower good cholesterol levels, heart disease risks – were not fully counteracted by regular exercise.

In other words, regular exercise – beneficial as it is – doesn't counteract the negative effects of long periods of inactivity.

Part of the issue is that television watching is fundamentally inactive. Harvard Health Publications estimates that, when it comes to calories burned, watching television (56 calories per hour) is closer to sleeping (46 calories per hour) than it is to sitting and reading (84 calories per hour), which itself is more akin to standing in line (94 calories per hour) than it is to watching television. (Note: calorie counts are for a 155-pound person.) In other words, watching television is an inactive as a person can get without sleeping.

Along with limiting television watching, these studies point to the importance of remaining active throughout the day. The good news is that it ends up that the simple physical movements of standing and moving between rooms has significant health benefits. When watching television, standing up during commercial breaks, going to get a glass of water, or even putting down the remote control and getting up to change channels and adjust volume the old-fashioned way can help people from staying in one extremely inactive position for extended periods of time.

Light household tasks and self-care – activities encouraged by the Balanced Care Method™ whenever clients are physically able – can help keep people moving. Not only does such daily activity help keep people physically active longer, we now know it also can help fight heart disease and other health risks.

 

Caregiver Stress: Hazardous to Your Health

By Anne Pagnoni
UNDERSTANDING CAREGIVER STRESS
A 2003 study of caregivers by a research team at Ohio State University has proven the off-repeated adage "stress can kill you" is true. The focus of the investigation was the effect the stress of caregiving had on caregivers. The team, led by Dr. Janice Kiecolt-Glaser, reports on a 6-year study of elderly people caring for spouses with Alzheimer's Disease. The study not only found a significant deterioration in the health of caregivers when compared to a similar group of non-caregivers but also found the caregivers had a 63% higher death rate than the control group.
The demands on a caregiver result in a great deal of stress. It is often observed in aging publications that stress can induce illness and depression. The resulting poor health can further decrease the effectiveness of the caregiver and in some cases, as proven by the study mentioned above, even cause premature death.
Stress can be defined as a physiological reaction to a threat. The greater the threat -- the greater the level of stress. A threat is a real or perceived action against our person. Threats may include the anticipated possibility of death or injury but may also include challenges to our self-esteem, social standing or relationships to others or a threat may simply be a potential or real disruption of our established routines. What is stressful to one person may not be to another. For example, bumper-to-bumper traffic might be stressful to the woman executive who is late for an important meeting but to the delivery man who has no deadline and is being paid by the hour, it may be a welcome respite to relax and listen to the radio.
Stress produces real physical changes. In some unknown way the fears in our mind, both conscious and unconscious, cause the hypothalamus and pituitary glands, deep in our brain, to initiate a cascade of hormones and immune system proteins that temporarily alter our physical body. This is a normal human physiological response inherent to the human body when a threat is perceived--real or not. It is often called the "fight-or-flight response" or the "stress response". The purpose is to give us clearer thought and increased strength as well as to activate the immune system to deal with potential injury and to repair potential wounds. When the perceived threat is removed, assuming no damage is done, the body returns to normal.
A team of researchers at Ohio State University Medical Center has found a chemical marker in the blood that shows a significant increase under chronic stress and is linked to an impaired immune system response in aging adults. The team, led by Dr. Janice Kiecolt-Glaser, reports in the June 30, 2003 issue of Proceedings of the National Academy of Sciences on a 6-year study of elderly people caring for spouses with Alzheimer's Disease. With the caregivers, the team found a four-fold increase in an immune system protein -- interleukin 6 (IL-6) -- as compared to an identically matched control group of non-caregivers. Only the stress of caregiving correlated to the marked increase of IL-6 in the caregiver group. All other factors, including age, were not significant to the outcome. Even the younger caregivers saw an increase in IL-6.
The study also found that the caregivers had a 63% higher death rate than the control group. About 70% of the caregivers died before the end of the study and had to be replaced by new subjects. Another surprising result was that high levels of IL-6 continued even three years after the caregiving stopped. Dr. Glaser proposes the prolonged stress may have triggered a permanent abnormality of the immune system.
IL-6 is only one cytokine--an immune system mediator protein--in a cascade of endocrine hormones and cytokines that are released when the brain signals a person is threatened with harm, injury, undue mental or physical stress or death. The hormones prepare the body to react quickly by increasing heart rate, making muscles more reactive, stimulating thought, altering sugar metabolism and producing many more changes that result in the "rush" people experience when they think they may be harmed.
The cytokine release is mediated by IL-6, which takes the role of directing the immune system to gear up to prevent infection, promote wound healing and repair organs and muscles from any injury that may result from the imminent danger. The release of cytokines such as IL-1, IL-6, IL-8, TNF and other proteins such as CRP (C reactive protein) also promote development of inflammation, which is essential for blood cells to home in on injury or infection. In addition, these chemicals promote development of various types of immune system blood cells in bone marrow. This response to harm -- either real or perceived -- is an important and beneficial life-saving activity of a normally functioning body.
The problem is if this response is initiated over and over again, frequently, and over a long period; it can have a dangerous effect on the body. This constant initiation of the stress response is common among caregivers -- especially those caring for loved ones with dementia. Providing supervision or physical assistance many hours a week and over a period of years turns out to be extremely stressful. This type of stress is often unrelenting, occurring day after day and week after week. And the long-term effects of this stress are more pronounced in middle-aged and older people who are precisely the group most likely offering long term care to loved ones.

In most younger people, when the threat lessens or disappears, the body reacts fairly quickly to shut down the stress response and return things to normal. But numerous studies have shown, as people age, the chemical cascade from stress lingers. Over a period of time, this constant chemical stimulus impairs the immune system and results in early aging, development of debilitating disease and early death. In this altered state, the body maintains high, potentially harmful levels of IL-6. The body does not return to normal without intervention.
Prolonged high levels of IL-6 and the accompanying hormones and cytokines have been linked to: cardiovascular disease, type II diabetes, frequent viral infections, intestinal, stomach and colon disorders, osteoporosis, periodontal disease, various cancers and auto immune disorders such as lupus, rheumatoid arthritis and multiple sclerosis. Alzheimer's, dementia, nerve damage and mental problems are also linked to high IL-6. Wounds heal slower, vaccinations are less likely to take and recovery from infectious disease is impaired. People who have depression also have high levels of IL-6. Depression in caregivers is about 8 times higher than the non-cargiving population.
This debilitating response to chronic stress is not unique to humans. Animals are affected as well. A 2004 PBS Scientific American Frontiers Special entitled "Worried Sick", explored the effect of chronic stress on animals. Observations in the field and experiments on animals exposed to chronic stress, uncovered the same phenomenon of debilitating disease and early death found in humans. Blood tests on the affected animals confirmed high levels of IL-6. The work of Dr. Janice Kiecolt-Glaser's team was also followed in the Special.

STRATEGIES TO REDUCE CAREGIVER STRESS
Ask for help.
Most caregivers are reluctantly thrust into their role without preparation because the need for care usually comes with little warning. Caregivers end up operating in a "crisis" mode--arranging medical care and living arrangements, scheduling care time, providing meals and household chores and so forth. Because they are so stressed and burdened, they rarely take time to find out what resources are available to help them. Ironically, caregivers often sever ties with family, friends and support groups about this time just when help from these people is most needed.
As a caregiver you must ask for help. The stress of going it alone is dangerous to your health. If it's difficult to ask for yourself, use an advocate--a sibling, friend or professional care manager --to arrange a meeting and get formal, written commitments from those people who are willing to help you. The extra help will give you breathing room to find all those resources that are there to help you.
Seek care management advice.
A number of organizations and private companies will give you advice and guidance -- many for free. If your care recipient has a very low income, you might get free help from your local Area Agency on Aging. A lot depends on available funds. Go to http://www.longtermcarelink.net/eldercare/ref_state_aging_services.htm for statewide lists of agencies.
A good source of free professional advice is the rapidly growing business of non-medical home care companies. Most will offer free consultations and these companies will also provide paid aides to help you with your loved-one…such things as bathing, dressing, shopping, household chores, transportation, companionship and much more. These people may also help you coordinate adult daycare or other community services. Go to http://www.longtermcarelink.net/a7homecare.htm for a nationwide list.

You may wish to pay for a formal assessment and care plan from a professional geriatric care manager. Go to http://www.longtermcarelink.net/a2bfindmanager.htm for a nationwide list of these valuable care specialists. Even though it may cost you a little money to hire a care manager, this could be the best money you will ever spend. Care managers are valuable in helping find supporting resources, providing respite, saving money from care providers, finding money to pay for care, making arrangements with family or government providers and providing advice on issues that you may be struggling with.
Take time off--find temporary substitutes.
Taking a break from caregiving is just as important as taking a break at work or taking that long-awaited vacation. A care manager may be of help in selecting the best temporary help to give you a break. Or you may make arrangements with family or friends to give you a break from caregiving.
Make plans for funding future care arrangements for you or for a healthy parent.
The analysis of data from three national surveys (Mature Market Institute, National Alliance for Caregiving and LifePlans, Inc) points out that employees caring for disabled elders who have long term care insurance (LTCI) are nearly two times more likely to be able to continue working than those caring for non-insured relatives. In addition, working caregivers of those with long term care insurance said that they were less likely to experience some type of stress, such as having to give constant attention to the care recipient or having to provide care while not feeling well themselves. Also, the group with insurance devoted more "quality time"--more companionship and less hands-on assistance--than the group without.
See if your healthy parent can still buy insurance. If he or she can't afford it, see if other family members might contribute to premiums. There are also useful strategies using a reverse mortgage to buy long-term care insurance and life insurance for your loved ones. You should also consider insurance for yourself so when you need care someday, it won't be so stressful on your caregivers. To learn all about long term care insurance and reverse mortgages go to www.longtermcarelink.net.
Use assistive technology.
There are a number of technologies to make sure your loved-ones are safe while you're away. Such things as emergency alert bracelets and pendants, GPS tracking for wandering, remote video surveillance, telehomecare, sensory augmentation and all sorts of assistive devices to help disabled people cope on their own. Go to www.longtermcarelink.net for more information.
FINDING RESOURCES FOR CAREGIVERS
The free resources of www.longtermcarelink.net are designed to provide you with government provider lists, free care assessments, information and care provider lists for reducing your eldercare burden and the attending stress. The site is a non-commercial source of help. It is the largest and most comprehensive free source of long term care information on the Internet. There are no ads or solicitations or pop-ups. A related site for the veterans aid and attendance benefit is found at www.veteransaidbenefit.org. This is a benefit that could be available to up to one third of all US residents over the age of 65 under certain conditions. It could provide an additional monthly income of up to $1,843 a month for qualifying veterans households.
Stay tuned for additional options that are available to managing caregiver stress!

Happy Holidays?

By Anne Pagnoni

Getting together and celebrating a special occasion with the family can be a wonderful time. It can also be a time when you begin noticing changes in your aging loved one. Perhaps as you celebrated the recent holidays, you noticed that your mother's hygiene isn't what it used to be. You may have noticed that her short term memory is declining or that she has been losing weight. Perhaps she mentioned being lonely during the day but being unable to get out of the house on her own due to physical ailments. You are working and taking care of your own busy family and can't imagine taking on additional caregiving responsibilities even though you want to. So what do you do? Now is the time to call Home Care Assistance.

Home Care Assistance is a full service home care agency offering hourly services but with a specialty in live-in caregivers. Our caregivers are specifically trained in our exclusive Balanced Care Method^TM . Focusing on lifestyle and dietary choices, the Balanced Care Method^TM promotes healthy activity, stress reduction, and social interaction to help seniors live their best possible lives – in the comfort of home. But, what exactly does this mean for your mother?

1. When it comes to physical hygiene, our caregivers are able to provide assistance with bathing, dressing, and grooming. A little help here can go a long way in improving your mom's willingness to interact with others and her own self-image.
   
2. From planning the menu to preparing the meal, the caregiver will ensure that your mother is eating three, well balanced meals per day. If your mother has food preferences or enjoys cooking, then she and her caregiver will enjoy doing this together.
   
3. Exercise. Not a word that most of us like to think about, but it's a necessity nonetheless. Your mom isn't going to be training for a marathon by any stretch, but the caregiver will work to improve her physical stamina. From simply doing stretches and chair exercises to walking to the mailbox or around the block, she won't be sitting in her favorite chair all day long anymore!
   
4. You know the old saying, use it or lose it. It applies to short term memory, too! While our caregivers can't reverse memory loss associated with dementia and Alzheimer's Disease, they can provide social interaction, which has been shown to improve cognitive function. A game of cards, anyone?
   

When it comes to caring for your aging loved one, accept help from the professionals. While this is new to you, it isn't new to us. For more information about Home Care Assistance, please visit our website at www.homecareassistance.com. To be directed to your local Home Care Assistance office, please call 1-866-4-LIVEIN.

Difficulties Facing Stressed & Overwhelmed Family Caregivers

by Anne Pagnoni

Many family caregivers find themselves unprepared for the physical and emotional demands of caring for a loved one and quickly become stressed and overloaded. When this occurs many caregivers find themselves unable to provide the level of care necessary to nurture their loved one at home.

Situation One: The care receiver lives with the care provider

If the caregiver is working outside of the home or has a very active social calendar, then the care receiver often finds him or herself at home alone for the greater part of the day. As a result the care receiver quite often becomes imprisoned by the home environment due to functional limitation. Receiving little or no social stimulus, the care recipient spends day after day sleeping and watching television. Physical exercise consists of moving to or from the bathroom. The care receiver typically will not prepare a meal. Many times drinking and eating are deliberately avoided to lessen trips to the bathroom. When the care receiver lacks adequate food and fluid intake the result is malnutrition and dehydration both of which result in poor mental reasoning and stupor; hence, the cycle of sleeping and television watching continues.

Solution: A home health aide is a great option if you wish to have your loved one remain in your home while being properly care for during your daily absences. In addition to a home health aide, consider having your loved one attend an adult day care center either daily or several times per week. An assisted living community is another viable option if you feel that your home is no longer an appropriate setting for your loved one.

Situation Two: The care receiver lives alone

Care recipients who live alone can be guilty of self-neglect. Self-neglect is when the care recipient is not interested or is incapable of taking care of his or her own needs. Examples of self-neglect include not eating or drinking enough; not tending to personal hygiene including bathing and grooming; allowing garbage to accumulate within the home; having unattended pets, which urinate and defecate in living spaces; and refusing assistance. When a caregiver is providing care to a care recipient who lives alone, it is imperative that the caregiver work to provide a stimulating environment for the care receiver. Self-neglect with or without a caregiver is a form of elder abuse and in some states it is required by law that its existence be reported. A caregiver allowing self-neglect to happen could be criminally charged.

Solution: A home health aide can assist your loved one with meal preparation, bathing, dressing, grooming, and housekeeping. Many live-in caregivers will tend to family pets. For social interaction have your loved one attend an adult day care center or senior center. Seek out the services of a Geriatric Care Manager for guidance on how to make your loved one safe at home.

Situation Three: Failure to bring in outside help

The biggest mistake made by caregivers is not asking for help. The reasons for this vary. Sometimes the caregiver is a child, who is a long distance caregiver, and doesn't fully appreciate the severity of the situation. Other times money can be the big motivator. Stressed and overwhelmed caregivers become so involved with their loved one that they isolate themselves from others. This isolation makes them reluctant to contact those who can help. Regardless of the cause, failure to ask for help or to hire help can have dire consequences on the welfare of the care recipient and the caregiver.

Solution: Ask for help!! Talk to a local home care agency about available options. While you may think that home care services aren't affordable, you may find yourself pleasantly surprised. Contact your local area agency on aging. If you are a long distance caregiver, then enlist the services of a Geriatric Care Manager so that there is someone locally managing your loved one's care.

If you are the primary caregiver for another individual, then please do not allow yourself and your loved one to fall into one of the situations described above. Ask for help. Be involved. Know your options.

Please direct comments or questions on this post to apagnoni@homecareassistance.com. For more information on Home Care Assistance, please visit us at http://www.homecareassistance.com/ or call 1-866-4-LIVEIN.

Travel Tips for Seniors on the Go!

by Dr. Kathy Johnson, PhD, CMC

Going on a trip? Are you traveling by plane, train or bus and you want to pack light? Here are some great travel suggestions for Seniors Citizens who plan to travel for a one week stay to almost anywhere for two:

» If you have to take shampoos, lotions, tooth paste, mouth wash, etc. either buy the small traveler sizes or, if small bottles are available, transfer liquids to these.
» Pack only cotton underwear (3) and cotton socks (men 3 pr.- women one pr. panty-hose, one pr. knee-highs one pr. cotton socks), and roll these to save space (they can be placed into shoes). Note: you can wash these items while there.
» Pack items of clothing to ‘layer’, i.e. one light-weight cotton knit cardigan to wear over two or three different cotton knit shirts or blouses (NO bulky sweaters).
» No more than TWO pairs of shoes (one pr. comfortable walking and one pr. dress), the comfortable clothes will probably be worn in travel.
» Two pairs slacks (you'll be wearing the third pair) or skirts (if preferred). Choose items that can mix/match with everything packed.
» Pack medicines, book/magazine, snack, flat slippers (in case the feet swell) and only other necessary items in the carry-on tote. If there is a necessity for dress clothes, pack these in the fold-up hanging bag; shoes can fit in these, also, along with odd/end items.
» Don’t carry on board anything but the tote and a jacket/coat (when necessary-but don’t pack them); leave the ‘handling’ to others. If going to visit friends/family, and want to take gifts, box them and mail ahead of time; let the postal dept. help! Pack your needs, but pack them wisely! Happy traveling!

Airport Security Measures
Before you go on that senior travel tour make sure to check security measures and what you can and cannot take on board with you. Go to www.tsa.gov and click on “travel and consumers.” You will find a list of prohibited and permitted items for checked and carry-on luggage.

Invest in Portable Luggage
How many of us are still dragging around those heavy pieces of luggage? Well, it’s time for some new pieces! You know the kind that has the expandable tote-handle and wheels! Ah, what relief for our backs! I found these sizes to be so handy: 21″/22″ Carry-on (but don’t carry on :o) 27″ Upright, then add the 15″ Tote (to carry with you containing your medications and other absolute senior travel necessities), and the hang-up/zip-close ’suitor’ that has great extra compartments. These latter two MUST have handles, so you can lap these over either the Upright or Carry-on extended handles, and shuffle along your way! Don’t throw out the old luggage, however; use to store old keepsakes, clothing, books, whatever, and place in the attic to one day give to your grandchildren!

Traveling Off Season, The Senior Way!
Remember when we were younger and took the kids on vacation? And how crowded places of interest were? We had to make reservations far in advance to get a motel room. I’ve enjoyed a much slower pace of senior citizen travel and find it not hard to get reservation when traveling in the ‘off-season’; that is, when kids are back in school! We’ll also be giving families a break by not competing with their ‘time’. So try to plan your trips around this time of year (school summer vacations); you’ll find your trips more relaxing and easier to make plans.

How to Improve Senior Sleep Patterns

How to improve senior sleep patterns.
-Dr. Kathy Johnson, PhD CMC

Naps and medication are two of the most frequently cited ways seniors and their caregivers try to solve their sleep problems. Either (or both) may be appropriate, but each carries its own ability to disrupt sleep further. Each must be used carefully and purposefully, and in conjunction with healthy sleep habits (a.k.a. “sleep hygiene”) as outlined below.

Naps can be either the cause or the cure, depending on how and when they happen. For seniors who struggle to stay alert all day, a short nap may be the bridge they need to get them from a convenient waking time to a reasonable bedtime. Good, healthy, restorative naps are short – just 15 to 30 minutes – since longer naps can lead to drowiness and an inability to fall asleep at bedtime, relatively early in the afternoon so they don’t conflict with bedtime, and physically comfortable in a quiet and dimly lit place.

Many seniors turn to the ever-growing numbers of sleep aids – both prescription and over-the-counter – that are available. One of the potential problems with this route is that sleep aids can interact negatively with a range of medications the senior may already be taking and/or they can cause drowsiness that itself leads to accidents and falls. Worse, many sleep aids can cause confusion and disorientation even in younger, healthier people. For seniors with any level of dementia, this potential side effect must be closely monitored and avoided since it can lead to night fears, heightened anxiety, and even worse: sleep problems.

For seniors having trouble getting to sleep and staying asleep long enough to feel rested and refreshed in the morning, these “sleep hygiene” tips and habits are the first steps to take:

Gradually eliminate caffeine from your diet, or at least limit caffeine intake to one caffeinated beverage in the morning. Avoid all caffeine after lunch.

1.Eat a big meal at lunchtime, and have a lighter dinner.
2.Avoid alcohol, or at least limit alcohol consumption to one drink, preferably with a meal and not right before bedtime.
3.Do some sort of physical activity every day, preferably outside where you can get direct daylight. Exercise early in the day since physical exertion too close to bedtime can be stimulating.
4.Establish and maintain a set bedtime and waking time. If you choose to take a nap (see guidelines above), do so at a regular, set time.
5.Establish a pre-bedtime calming routine. This may include a warm bath, reading, or listening to restful music.
6.Avoid television right before bed.
7.Write down or simply state aloud any fears, worries, or concerns that are on your mind as part of your bedtime routine – giving voice to such concerns can help reduce their ability to negatively impact sleep.
8.Use your bed (and preferably the whole bedroom) only for sleeping, do not read or watch television in bed.

If you don’t fall asleep after 15 – 20 minutes, get out of bed and do something quiet and calm, read or listen to restful music or a book on tape. Serious or long-term sleep disorders should always, of course, be brought to the attention of a health care provider.

The Need for Outside Help in Family Caregiving

by Anne Pagnoni

Being a family caregiver for a loved one makes for a very stressful situation especially in the long-term. After a prolonged period of time, caregiving can become too difficult to endure any longer, and the caregiver reaches a crisis point. At this point outside help is typically needed.

When someone initially takes on the role of caregiver, he or she is confident and has everything under control. The caregiver is coping well with the situation. However, as time continues and the care recipient begins needing more help, the caregiver may begin to isolate from family and friends. The caregiver starts to feel alone and helpless. If the caregiver doesn’t look for outside help at this point, then the caregiver may begin to find his or her physical health deteriorating. Once the physical health of the caregiver is compromised, the caregiver loses focus and extreme fatigue will cloud judgment resulting in the caregiver being unable to make rational decisions or ask for help. Without intervention, the caregiver may find him or herself requiring care.

When assuming the responsibility of a family caregiver, it is important to enlist the help of outside professionals. A financial planner or reverse mortgage specialist may find funds to pay for professional in-home care services. An elder law attorney can help stave off future legal issues. A geriatric care manager can be a guide through the maze of long-term care issues. A home care agency can provide care services to allow the primary caregiver to take a much-needed break. Having a strong support system in place at the beginning will often make the difference between allowing a loved one to remain at home and needing to relocate to a nursing facility.

Family caregivers need the support of family, friends, and professionals. Doing it alone almost never works. If you find yourself in the position of being a family caregiver for a loved one, take the necessary steps at the beginning to get a support system in place. In the long run you’ll be happy that you did!

The Benefits of Elderly Home Care

The Benefits of Elderly Home Care
by Suzan Love

As your parents and grandparents grow older, you may become concerned about their safety at home. Placing them in an assisted living facility is often considered as an option. However, homecare is an alternative that has many benefits.

1. Seniors who live at home are able to maintain a level of freedom that would not be possible at an assisted living residence. For many, this freedom is synonymous with maintaining dignity, which is something many individuals fear loosing as they age. Similarly, those who receive homecare can come and go as they please-for whatever reason. They can also choose their own meal times.
2. Elderly individuals do not have to part with any of their beloved possessions if they continue to live at home. Having the things they love physically close at hand can help keep stress levels to a minimum, as those possessions are tied to invaluable memories. Seniors can also keep their pets when living at home, and caring for an animal has been scientifically proven to have positive health benefits.

3. Those who live at home can have visitors whenever they please and are not restricted by visiting hours. This can lead to more fulfilling relationships with friends and family, as they are able to visit more frequently.

4. Living at home has physical health benefits, as it is easier to avoid those who are sick. When living in a place with many people, such as an assisted living facility, one person’s illness spreads like wildfire. At home it is also possible to request that sick people visit only after they are fully recovered.

5. Home care allows the elderly to avoid the emotional stress of moving to a new place with new people and a new routine. Maintaining continuity leads to psychological wellbeing.

6. Assisted living facilities can be very expensive and, in some cases, far away from other family members’ homes, especially in less populated areas. In many cases, seniors have already completely paid off their off mortgage, which can substantially reduce the costs of caregiving at home. The stressors related to the actual moving process are also eliminated.

7. As a final point, those who live at home are often happier than they would be living at a retirement home. The familiarity and comforts of home are irreplaceable.

There are now many products and services that make living at home both feasible and affordable. Enhanced security systems, emergency panic buttons, and home delivered meals are just a few of the options to choose from. If your elderly family member wants to live at home, honoring that wish is now easier than ever before.

Elderly Home Care Service Can Help Your Loved One Maintain Independence

Elderly Home Care Service Can Help Your Loved One Maintain Independence
by: Thao Nguyan

Elderly home care services are growing at an accelerated rate, and this particular industry is only poised to continue to grow as the population of the United States ages. The number of people of retirement age and older is expected to double by the year 2030, and by the middle of this century, there will be more elderly people in this country than any other age group.

While a few people are lucky and stay healthy enough to be able to take care of themselves without help for their entire lives, others are not so fortunate. With advances in preventive medicine and anti-aging technologies, the number of elderly who live alone will rise, but there will always be a need for help for those who have difficulties maintaining their independence. Family members are not always able to attend to every need of the aging parent or grandparent, especially if that person needs frequent assistance. No one wants to go the nursing home route if other alternatives are available, and that is the reason why elderly home care companies provide such an essential service.

The elderly home care agency you choose can usually help with a variety of personal care services and chores around the house. Depending on the needs and wants of your elderly relative, you can find elderly home care services that can send people out to check on him or her once a day, once a week, round the clock or however often is required. These elderly care assistants can do minor household chores, help with bathing and dressing, and administer medications. Having such a service available and on call can make the difference between your relative remaining in his or her own home and having to go into an assisted living or nursing facility.

If you decide to use elderly home care services, help your loved one interview and select the paid caregiver. Have the agency send someone over to spend some time with your relative, so they can see if the match is a good one. Not every match is right and you might have to through many different elderly care assistants before finding the right person. The whole experience of using an elderly home care service will be much more successful for everyone if you determine the needs and wants of your loved one and involve him or her in the process of finding the most suitable elderly care assistant.

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