Women and Alzheimer's Disease: The Caregiver's Crisis | workingmother.com

This is how Alzheimer's Disease is impacting today's working mothers.

Women and Alzheimer's Disease: The Caregiver's Crisis | workingmother.com

Take It. Share It.

In 2011, the American Diabetes Association encouraged Americans to “Join the Million Challenge” and more than 600,000 people took the Diabetes Risk Test. On March, 27, 2012, the Association will aim to top that number, inspiring people to take the all-new Diabetes Risk Test, as well as to share the test with everyone they care about - friends, family members and colleagues. With each person that takes the test and knows their risk, the Association is that much closer to stopping diabetes.

American Diabetes Association Alert Day®, which is held every fourth Tuesday in March, is a one-day, “wake-up call” asking the American public to take the Diabetes Risk Test to find out if they are at risk for developing type 2 diabetes.

The new Diabetes Risk Test asks users to answer simple questions about weight, age, family history and other potential risks for prediabetes or type 2 diabetes.  Preventative tips are provided for everyone who takes the test, including encouraging those at high risk to talk with their health care provider.

Diabetes by the Numbers

Diabetes is a serious disease that strikes nearly 26 million children and adults in the United States, and a quarter of them—7 million—do not even know they have it. An additional 79 million, or one in three American adults, have prediabetes, which puts them at high risk for developing type 2 diabetes. Recent estimates project that as many as one in three American adults will have diabetes in 2050 unless we take the steps to Stop Diabetes®.
 

Are You at Risk?

Everyone should be aware of the risk factors for type 2 diabetes.  People who are overweight, under active (living a sedentary lifestyle) and over the age of 45 should consider themselves at risk for the disease.  African Americans, Hispanics/Latinos, Native Americans, Asian Americans, Pacific Islanders and people who have a family history of the disease also are at an increased risk for type 2 diabetes.

Unfortunately, diagnosis often comes 7 to 10 years after the onset of the disease, after disabling and even deadly complications have had time to develop.  Therefore, early diagnosis is critical to successful treatment and delaying or preventing some of its complications such as heart disease, blindness, kidney disease, stroke, amputation and death. 

The American Diabetes Association has made a strong commitment to primary prevention of type 2 diabetes by increasing awareness of prediabetes and actively engaging individuals in preventative behaviors like weight loss, physical activity and healthful eating.  Alert Day is a singular moment in time in which we can raise awareness and prompt action among the general public – particularly those at risk.

Take Charge of Your Health

Studies have shown that type 2 diabetes can often be prevented or delayed by losing just 7% of body weight (such as 15 pounds if you weigh 200) through regular physical activity (30 minutes a day, five days a week) and healthy eating.  By understanding your risk, you can take the necessary steps to help prevent the onset of type 2 diabetes.
 

You can be part of the movement to Stop Diabetes® and get your free Diabetes Risk Test (English or Spanish) by visiting the Association on Facebook, stopdiabetes.com or by calling 1-800-DIABETES (1-800-342-2383). Although Alert Day is a one-day event, the Diabetes Risk Test is available year-round.

About the American Diabetes Association

The American Diabetes Association is leading the fight to Stop Diabetes and its deadly consequences and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, our mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. For more information please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit www.diabetes.org. Information from both these sources is available in English and Spanish.

Happy St. Patrick's Day!

Some might be surprised to learn that St. Patrick's Day is actually a religious holiday celebrated yearly on March 17th.  St. Patrick's Day commemorates the arrival of Christianity in Ireland as well as the life of St. Patrick, who is the patron saint of Ireland.  It became an official Feast day in the 17th century but has gradually become a secular festival, which celebrates Irish culture in general. 

St. Patrick is said to have been born into a wealthy Roman Britain family sometime in the 4th century.  Both his father and grandfather were deacons in the church.  When he was 16 years old, he was taken captive by Irish raiders and was taken to Ireland where he was imprisoned as a slave.  Eventually Patrick was able to flee captivity and return to Britain.  Upon his return, he joined the church and studied to become a priest. 

In 432, Patrick said that God called him to return to Ireland so that he could bring Christianity to them.  After spending 30 years in Ireland, Patrick passed away on March 17, 461, and was buried in Downpatrick.  Patrick is held in esteem in the Irish church and is heralded for bringing Christianity to Ireland.  According to Irish folklore, Patrick taught the pagan Irish about the holy trinity by using the example of the three leaf shamrock. 

In the early days, the original color associated with St. Patrick's Day was blue.  Over time, however, green began to grow in popularity.  In the 1798 rebellion, Irish soldiers hoping to make a political statement and gather public attention, wore green on March 17th. 

In the mid 1990s, the Irish government began an initiative to globally showcase Ireland and its culture on St. Patrick's Day.  In doing so, the government hoped to make a day whereby all Irish descendents could join in on festivities celebrating their heritage and to have a celebration that was amongst the largest and greatest in the world.  March 17, 1996 marked the first St. Patrick's Day festival in Ireland.  By 2006, the festival had become five days long with almost 1 million people in attendance. 

In the United States, every year since 1991 March has been proclaimed Irish-American Heritage month.  Today St. Patrick's Day is celebrated by both the Irish and non-Irish alike.  For most Irish Americans, St. Patrick's Day is both a religious and festive day.  Many Irish-Americans start the day off with church services followed by parades, parties, Irish music and food, and dances.  Alcohol consumption on St. Patrick's Day has soared over the past several years as individuals are allowed to break their Lenten sacrifices in order to celebrate the day. 

One would think that the largest St. Patrick's Day parade would take place in Ireland; however, this isn't true.  The largest St. Patrick's Day parade takes place in New York City.  It has close to 15,000 people marching in the parade with almost 2 million in spectators lining the NYC streets. 

It needs to be mentioned that there are more Irish-Americans than there are Irish!  There are 36.5 million Americans claiming an Irish heritage.  Ireland, on the other hand, only has a population of about 6 million. 

Erin go braugh! 

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. 

Get Your Plate in Shape!

by Anne Pagnoni


During March we observe National Nutrition Month^®.  For 2012 the Academy of Nutrition and Dietetics encourages everyone to think about what goes on his or her plate or in his bowl through this year's theme: "Get Your Plate in Shape."

It’s important to focus our thoughts on foods like fruits, vegetables, low-fat dairy products, lean proteins, and whole grains as they contain necessary nutrients without too many extra calories.  Make sure that you eat foods from all of the food groups during the day. 

The food and nutrition experts at the Academy of Nutrition and Dietetics make the following recommendations on how to “Get Your Plate in Shape”: 

·         Make half of your plate fruits and vegetables: Eat a variety of vegetables, especially dark-green, red and orange varieties. Add fresh, dried, frozen or canned fruits to meals and snacks.

·         Make at least half your grains whole: Choose 100 percent whole-grain breads, cereals, crackers, pasta and brown rice. Check the ingredients list on food packages to find whole-grain foods.

·         Switch to fat-free or low-fat milk: Fat-free and low-fat milk have the same amount of calcium and other essential nutrients as whole milk, but less fat and calories. For those who are lactose intolerant, try lactose-free milk or a calcium-fortified soy beverage.

·         Vary your protein choices: Eat a variety of foods from the protein food group each week, such as seafood, nuts and beans, as well as lean meat, poultry and eggs. Keep meat and poultry portions small and lean. And be sure to choose seafood as the protein at least twice a week.

·         Cut back on sodium and empty calories from solid fats and added sugars: Compare sodium in foods and choose those with lower numbers, and season your foods with herbs and spices instead of salt. Switch from solid fats to healthy oils like olive and canola oil. Replace sugary drinks with water and choose fruit for dessert.

·         Enjoy your foods but eat less: Avoid oversized portions. Use a smaller plate, bowl and glass. Cook more often at home where you are in control of what’s in your food. When eating out, choose lower calorie menu options.

·         Be physically active your way: Adults need at least 2 hours and 30 minutes of physical activity every week. Choose activities that you enjoy, and start by doing as much as you can. 

For more information on how you can “Get Your Plate in Shape”, please visit the Academy of Nutrition and Dietetics’ National Nutrition Month.  

African Americans and Alzheimer's Disease

Currently, as many as 5.4 million Americans have Alzheimer’s disease. This devastating, deteriorating and debilitating disease is the ultimate thief — a thief of memories, thief of independence, thief of control, and ultimately, a thief of life.

Many Americans dismiss the warning signs of Alzheimer’s, believing that these symptoms are a part of normal aging. They are diagnosed too late and miss the opportunity to get the best care possible. This issue is of even greater concern for African-Americans, who are about two times more likely to have Alzheimer’s and other dementias than whites.

African-Americans have a higher rate of vascular disease (diseases involving blood vessels, including heart attack and stroke) – one of the suspected risk factors of Alzheimer’s disease. Often caused in part by poor nutritional habits and low physical activity levels, vascular disease may trigger cognitive decline.

To help reduce these risk factors and reverse the growing trend of Alzheimer’s disease among African-Americans, visit alz.org/africanamerican. This Web portal from the Alzheimer’s Association offers tips on brain and heart health, summarizes the 10 warning signs of Alzheimer’s and suggests methods of stress relief for the African-American caregiver.

Raising Alzheimer’s Awareness Worldwide

Alzheimer’s disease affects more than 35 million individuals worldwide and costs the global economy more than $600 billion. Alzheimer’s is an international health epidemic that impacts people from all racial and ethnic backgrounds.

September is World Alzheimer’s Month and an opportunity to raise awareness of this devastating disease on a global level. If you know an individual who is in need of information on Alzheimer’s, you can direct them to the following resources in multiple languages from the Alzheimer’s Association:

• Brain Tour – A virtual tour of the brain that helps to explain how the brain works and how Alzheimer’s disease affects it. It is currently available in 14 languages including German, Polish, French and Spanish at alz.org.

• Know the 10 Signs – An easy-to-read list describing the warning signs of Alzheimer’s disease. Available at alz.org in Spanish, Korean, Vietnamese and Chinese.

• 24/7 Helpline – A round-the-clock information and support helpline provided by education specialists and masters level counselors. Services include bilingual Spanish-speaking consultants and interpretation for more than 170 languages. Call 1.800.272.3900.

• Online portals – Fully translated microsites with an overview of Alzheimer's disease, signs and symptoms, caregiving tips and more. These sites are currently available in Chinese, Korean, Spanish and Japanese and can be accessed by visiting alz.org.

For those seeking information on Alzheimer’s in other languages, a local chapter of the Alzheimer’s Association may also be a good resource. To find the chapter nearest you, visit alz.org.

Maintaining Mental Health as We Age

by Anne Pagnoni

Oh, to be young again!  How many times have you heard yourself or someone else say this?  As Home Care Assistance of New Jersey celebrates Health Aging Month, it's important to keep in mind that healthy aging encompasses more than just physical health.  Mental health plays a big part in how well we age. 

Many people are of the impression that memory loss is a product of normal aging.  This is not true!  However, as the saying goes, use it or lose it.  Therefore, in order to maintain your mental and cognitive health, you have to make sure you're exercising your cognitive abilities.  Here are some great brain exercises that you can do on a daily basis:

• Play games that involve strategies, such as chess or bridge
• Read newspapers, books, magazines and anything else that you find challenging 
• Try to learn new things such as games, driving routes, musical instruments, a foreign language, or a topic of interest
• Do crossword and other word puzzles
• Spend time regularly with others either by phone or in person
• Volunteer your time at an organization that you believe in

While many people live in fear of losing their memory, the greatest enemy of mental health is depression.  According to the National Institute of Mental Health, older adults are disproportionately likely to die as a result of suicide.  Depression is one of the conditions most commonly associated with suicide.  The risk of depression increases when someone begins to lose his or her physical function and when other illnesses are present.  While feelings of sadness, grief, and blue mood are normal, persistent depression that interferes with someone's ability to function is not.

If you're depressed, you very well may want to lock the door to your home and not allow anyone in or venture out.  You may allow yourself to sleep or watch television all day.  These things will only make the depression worse.  Instead, you need to make yourself more active and more socially involved.  Research suggests that physical activity may be just as effective as antidepressants in treating depression.  You don't need to hit the gym for two hours per day to reap the benefits of exercise.  Instead, park a little farther from the store, do some light housework, or take a short walk.  If you're physically disabled or frail, you can always participate in chair exercises to help boost your spirits and your muscle tone.  Make sure you're enjoying the company of others.  You need support to get through a depressive episode.  Limit the time you spend alone.  Keep in touch over the phone or email if you're unable to get out of the house regularly. Participate in activities that you enjoy.  Get a pet to keep you company.  Laugh!  If you don't feel like you have anything to laugh about, then watch a comedy or read a funny book. 

If you have made some lifestyle changes but are still experiencing depression, then seek help.  Talk to your family physician about how you're feeling.  Therapy, support groups, and medications are all effective treatments for depression.  Don't go it alone. 

The key to maintaining mental health as we age is to continue to find meaning in our lives.  While we may no longer be working and our children may live further away, we can find other things that will give us a sense of purpose in our lives.  Keep moving forward instead of focusing on the past. 

As Mark Twain said, "Age is an issue of mind over matter. If you don't mind, it doesn't matter."  Make sure you're giving your mental health as much attention as your physical health!

MyCareCommunity Hosts a Free Webinar for New Jersey Caregivers

by Anne Pagnoni

According to the National Alliance for Caregiving, there are more than 65 million Americans spending an average of 20 hours per week providing care for a loved one. The value of these caregiving services is estimated to be $375 billion a year. This is almost double the amount spent on home care and nursing home services combined. As a service to these caregivers, MyCareCommunity of New Jersey is hosting an educational web conference entitled, "For Those in Transition…A Community Behind You". The program will address which community support services are available, should you or your loved one choose to remain at home. Also discussed in the program will be variety of senior healthcare and housing options that are available should you or your loved one choose to move from your home.

Kevin McClarren, president and care manager of Home Care Assistance in Warren Township, has partnered with MyCareCommunity both to promote the resources that it offers to caregivers and to pull together a local panel of experts, who will be present on the webinar. “This webinar is an excellent one-stop shop for caregivers to gain insight into the variety of care options that are available to their loved ones both in the home and in other care settings. Caregivers will have the ability to ask questions and interact directly with the panel, which includes experts in the field of home care, independent living, and assisted living.”

This live and interactive consumer-oriented event will be offered April 28, 2011, at 12:00 PM EST. The hour long program will explore options regarding utilizing the services of a Senior Real Estate Specialist; Assisted Living; Independent Living; Home Care; and Geriatric Care Management.

Preregistration for the event is required. Sign up today by visiting http://www.mycarecommunitynj.org/ and clicking on the registration link. Caregivers who are unable to attend the live webinar will be able to view a playback of the presentation provided that they are preregistered for the event.

About MyCareCommunity

MyCareCommunity is a free, online caregiver support program providing caregivers and their families the support and information they need to manage their many caregiving responsibilities. For more information, please visit http://www.mycarecommunitynj.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 http://www.longtermcarelink.net/.

Somebody's Sweetheart

by Anne Pagnoni

The month of February and Valentine’s Day brings a celebration of love and stirs couples to rekindle feelings of romance and devotion. Not so different from young couples are aging seniors, celebrating memories of sweethearts and romance in days gone by. Sit a while with a senior couple and they will soon be telling you their romance story or listen to a widow or widower as they sing their favorite love song from their youth.

Dementia and Alzheimer’s can rob senior minds of many of these treasured memories, changing their personality and life style. Because of these and other illnesses, many seniors end up in nursing homes or care facilities where only their basic physical needs are cared for by the facility staff. To these seniors, Valentine’s Day becomes no different from every other day. They often find it difficult to relive memories of the past. In one care facility a sign placed lovingly over a patient’s bed reads, “I Am Somebody’s Sweetheart,” as if to say I once dreamed, lived and loved, please treat me kindly.

When asked how she relates to those she cares for, nurse assistant Karen W. replies that most of the time it's those patients who are causing a disturbance or may be in danger of harming themselves who are the ones that get her attention. Even then she can only take care of the immediate problem. Very seldom has she time to personally get to know well all the elderly people she cares for.

Although this is true with many facilities, the need for more personalized care is, in some cases, being recognized. Assisted living facilities with specialized memory care programs -- some using art, music and dance or physical activities -- are finding great success with increasing the quality of life for those suffering from dementia and Alzheimer’s. Many care facilities across the nation are adding these programs to better serve their residents.

If you cannot find a facility in your area that provides this special attention, home care may be a better option. Consider this real experience. When Nora would visit her father in the nursing home she would find him sitting, slumped over and disinterested in his surroundings. By the time she and her young children finished their visit, he was alert and talking to them. Feeling he would do better in her home environment, Nora enlisted the services of a Geriatric Care Manager to evaluate her father and determine what would be needed for his care at home so that he could get the social stimulation that he needed.

A Geriatric Care Manager can be a valuable asset to family members when it becomes necessary to look at alternatives for their loved one's long term care. They work with all members of the family in educating about resources and making decisions. Some services provided are:

•  Make an assessment about the type of care need
•  Develop a care plan for care both current and future care 
•  Work with physicians in getting medical support
•  Find home care services that work with the families’ needs
•  Provide assistance with legal and financial issues

Home care services vary, depending on what is needed, and may change as caregiving requirements change in regards to the physical or mental health of the elderly person. Types of Home Care are:

• Home health care companies: provide nurses, physical therapists, social workers and aides that assist with basic health care such as changing bandages, taking vital signs and helping with medication as well as a host of other skilled needs. 
• Non-medical home providers: help with bathing, dressing, meals, ambulating, chores, errands, housekeeping and much, much more.

Home care personnel are skilled in working with the spouse and extended family members of their ailing loved one to provide needed services and support in the home. They add consistency in the care and are available in time of crisis or need to add additional services.

With help from her Geriatric Care Manager, Nora brought her father to her home for his care. The care manager worked with her father’s doctor, prescribing a physical therapist and nurse's aide to come to the home. A non-medical home care company was employed to help with daily bathing and dressing.

Another resource available to families, which is not used as often as it should be, is hospice. Hospice care is provided in the home or in a hospice facility, hospital or nursing home. When illness is terminal, hospice service is provided by a team which includes doctors, nurses, grief counselors, aides and social workers as needed. These services can be provided at no out-of-pocket cost by Medicare.

In her internet article Naomi Naierman, President and CEO of the American Hospice Foundation states: “As a Medicare beneficiary, you are entitled to the Medicare Hospice Benefit without additional premiums. If you are enrolled in a managed care organization (MCO) you have access to this benefit, even if the MCO does not cover hospice services. The Medicare Hospice Benefit covers the following hospice services in full:

• Skilled nursing services
• Volunteer Services
• Physician visits
• Skilled therapy
• Home health aide visits
• Medical social services
• Spiritual counseling
• Nutrition counseling
• Bereavement support for the family”

There is a growing market for care providers throughout the nation to fill the need of senior care services. Assisted living, home care and hospice care, geriatric care managers and geriatric clinics are all just part of these services. The National Care Planning Council supports family caregivers with information and resources of all types of long term care services on its website: http://www.longtermcarelink.net/.

"Somebody’s Sweetheart" may be in need of your loving care someday and help is available to reduce your burden and ease the journey.

 

How to Choose Homecare

By Kathryn Zakskorn

One of most difficult decisions adult children make when caring for aging parents is where to turn for in-home care. The myriad of choices can be overwhelming. Essentially, there are three choices: private hire, Domestic Referral Agencies and full service companies.

With a private hire caregiver, the family or older adult becomes responsible for all steps of the hiring process. They must advertise, interview, and conduct background checks. Once a caregiver is selected, the older adult or family member must negotiate schedule, salary and benefits. A written contract, signed by both parties, clearly outlining all of the duties and expectations, is imperative. Liability normally falls on the client’s lap when it comes to payroll taxes, social security, unemployment taxes and workers compensation cost. It is imperative to get a rider on your homeowners insurance policy to protect your assets if anything should happen to the private hire in your home. Even though a private hire may be cost effective, the safety risk is the greatest especially when the older adult lives alone without supportive family available or there is impaired judgment on the part of the older adult. The risk is greatly reduced when a family member is able to supervise the caregiver. Professional geriatric care managers are also excellent supervisors when family is not available (more on that next issue).

Domestic referral agencies are essentially registries. A client calls for service and a caregiver is placed in a home for a placement fee and sometimes an ongoing management fee. The referral agencies do not employ the caregiver. The client becomes the employer, and similar to a private hire is responsible for payroll taxes, social security, and unemployment insurance and workers compensation. Some referral agencies have trust accounts where the client pays the agency and the agency then pays the caregiver, and sometimes sets up a tax service for the client, but the client is still considered the employer. Since referral agencies are not employers, they do not supervise the caregiver. This increases the safety risk. Like a private hire, it is important that a family members or geriatric care manager supervise and oversee the care.

Full service agencies employ the caregivers. They hire, screen, train and supervise the employees and place them in the older adult’s home. As the employer, the full service agency is responsible for all payroll taxes, social security, worker compensation, and unemployment insurance. A good full service agency should be able to produce a copy of their liability insurance and carry some sort of bond. Supervision is done by the agency, with some agencies providing care managers who directly oversee client cases, thereby lowering the risk to the consumer. The cost of a full service agency is normally higher than a private duty hire or a domestic referral agency due to these factors, however the risk is essentially lower.

When choosing homecare for yourself or an older adult, remember to take into consideration the risk level of the older adult and the familial involvement. Educate yourself on what service is best for your situation and then interview several potential individuals or agencies. Finally, think ahead. Don’t wait for a crisis to begin searching for the best care for you or your loved one.

Using the Holidays to Your Advantage

The holidays are the time of year when even far away family members travel in order to gather together. This makes the holidays the perfect time to do some planning for the future. With parents aging and their health and lifestyles changing, children need to discuss some changes and decisions that will be needed in the near future. Parents should take the time to tell their children where important documents are kept and what their wishes are in the event of needing health care directives or experiencing long term care needs.

For those children who live away, the change they see in their parent's health and mental capacity may be alarming -- whereas siblings that have daily contact are working with these issues constantly. Here is the chance to compare notes and work together as a complete family in the long term care planning process.

For you parents who are well and active, this is a good time to hold a family meeting and share with your children your plan for long term care. Tell them where financial and legal documents are located. Review health care directives, living wills and long term care alternatives.

Experience has shown that even families that are close can quickly grow angry, jealous and hostile towards each other when an aging parent begins to need long term care. If a sibling moves into the parent's home, others can easily be suspicious of ulterior motives and fear losing their inheritance. On the other hand, the child who assumes the role of caregiver becomes bitter and feels there is no support or help from siblings. Meetings for the purpose of making a plan, before eldercare becomes imminent, avoids these types of conflicts.

In its book, The 4 Steps of Long Term Care Planning, the National Care Planning Council provides guidelines and checklists for family planning meetings. Here are some suggestions as taken from the book:

• Get all interested persons together in one place at one time. Taking advantage of the holidays or another special event can be a great way to get everyone together. If this isn't conducive, then perhaps a special dinner might be an incentive.
• Depending on the circumstances surrounding the meeting, the facilitator can be the parent, caregiver, family friend, or a professional advisor. 
• The agenda can be formal or informal. If you want a formal agenda, then a care plan should be prepared prior to the meeting and presented to all attendees. The facilitator should work to encourage input from everyone involved through active discussion.  
• After a thorough discussion of the issues and the presentation of the solutions to the problems that will be encountered, there should be a consensus of all attending to support the plan. It is not always possible to please everyone so there must sometimes be compromise.  
• The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. GET IT IN WRITING! All good intentions seem to be forgotten with time. It may be years after this meeting before the long term care plan begins.

The U.S Department of Health and Human Services states: "No one wants to think about a time when they might need long-term care. So planning ahead for this possibility often gets put off. Most people first learn about long-term care when they or a loved one need care. Then their options are often limited by lack of information, the immediate need for services, and insufficient resources to pay for preferred services. Planning ahead allows you to have more control over your future."

Whether you plan a formal meeting with an agenda or informally gather for a discussion, when the family is together make it a point to start the long term care planning process. There is a lot to learn and many decisions to make concerning finances, health issues and legal work. It may take research and a lot of time to put a plan together, but if everyone is involved it will work, and be worth it.

For more information, please visit Home Care Assistance or the National Care Planning Council. 

 

The Perfect Holiday Caregiver: It’s All a State of Mind

by Anne Pagnoni

The holidays are always a wonderful time of year for family gatherings, reflection on what we have and the spirit of giving. The television is packed with specials showing relationships and families coming together for the holidays. But the holidays can also be a time of stress and sadness for those who are caring for family members that are struggling with health problems, frailty, dementia and loss. Those who care for these individuals may feel overwhelmed, frustrated, depressed or resentful as they watch “perfect” families enjoying the holidays. There are many surveys and documents that show that caregivers are highly susceptible to these feelings. If you are a caregiver, there are measures you can take to avoid this.

First: you are not alone.

If you are new to caregiving or have been caring for someone for a very long time, remember that the perfect family on television is not reality for many Americans. You are not the only one with these challenges. A recent study by the National Alliance for Caregiving and AARP found that 44.4 million Americans age 18 or older are providing unpaid care to an adult. In fact according to the survey provided by the National Family Caregivers Association:

• The typical caregiver is a 46-year-old Baby Boomer woman with some college education who works and spends more than 20 hours per week caring for her mother who lives nearby.

• Female caregivers provide more hours of care and provide a higher level of care than male caregivers.

• Almost seven in ten 69%) caregivers say they help one person.

• The average length of caregiving is 4.3 years.

• Many caregivers fulfill multiple roles. Most caregivers are married or living with a partner (62%), and most have worked and managed caregiving responsibilities at the same time (74%).

Second:  find help.

There are many resources available to a caregiver. Some of these include family members, friends, a local religious group, elder care agencies and homecare providers. The internet provides many great resources and help. The National Care Planning Council offers many articles, brochures and local referrals to help caregivers find the help that they need.

“When my husband’s stepfather was released from the hospital in December of 2009, he called us to give him a ride home. Once he was home, we quickly realized that he was not able to care for himself at all. He lived alone and we found ourselves driving back and forth three or four times a day to assist all of his needs. It was overwhelming and frightening to suddenly become a caregiver to a man we weren’t even that close to. With my husband working full time days, I became his primary caregiver. I would pack up my two little girls every day to come with me to take him to the doctor, do his laundry and feed him his meals, do his grocery shopping and help him with his bills. I had no idea what his finances were like or how to pay his medical bills. He was too sick to care or even understand what I was saying to him. I quickly realized I was going to have to find help. First I called his children. They were sympathetic, but gave all kinds of excuses as to why they could not help. Next, I went to the internet. I went to the website for National Care Planning Council www.longtermcarelink.net and found and contacted a Care planner in my area. The Care Planner came to my stepfather’s house and met with the two of us. They helped me get organized and set up time to meet with someone to explain his Medicare services and what my next steps would be. It was such a relief to have a plan and to know what to do.” MH- Salt Lake City, Utah

Most family members are willing to help, but just don’t know what to do. Many caregivers feel that they are the only one who can give the best care. It is important to communicate with other family members about what kind of help you need and let them know specifically what they can do.

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. Click here for a nationwide list of agencies.

A good source for professional advice is the rapidly growing business of non-medical home care companies. Most will offer free consultations and will provide paid aides to help you with your loved-one with such things as bathing, dressing, shopping, household chores, transportation, companionship and much more. These people may also help you coordinate adult day care or other community services.

You may wish to pay for a formal assessment and care plan from a professional geriatric care manager. 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.

Lastly: it is important to take care of yourself first in order to give effective and loving care.

Stephen Covey tells a story in his book The Seven Habits of Highly Effective People about a man who is sawing a tree. A woman approaches and asks the obviously exhausted man how long he has been sawing the tree. He tells her that he has been there for hours.

She says “Well, I see that your saw is dull, if you would just sharpen your saw you would be able to saw it much faster and with less effort.”

He replies, “I don’t have time to stop and sharpen my saw, I need to chop this tree down now!”

It seems pretty silly that the man just doesn’t stop for a few minutes to make the work easier. It is common for caregivers to do the same thing. They focus on caring for their loved one and run themselves down instead of stopping to “sharpen their saw”.

Covey states that “sharpening the saw” is to take care of yourself by keeping your physical, mental, emotional and spiritual self balanced. There is joy and respite in balancing all of these areas in our life. This is what makes us efficient and happy. Here are some ways for you as a caregiver to sharpen your own saw:

• Maintain a positive attitude. Take time to be grateful for everything that is good in your life. There is always something. Adjust your expectations for the holiday season. If you aren’t expecting that perfect holiday family picture, then you won’t be angry and frustrated that it isn’t something you have right now. It is always possible to change your attitude and perceptions, but it is not always possible to change your circumstances.

• Eat healthy food and be sure to get some exercise. Do this in small increments if it is too overwhelming to plan menus. Drink more water, cut down on sugary snacks, pick up some vegetables and fruit to grab. Walk or do marching in place. Run or walk up and down stairs if that is all the time you have right now.

• Forgive and let go of frustrations, anger, resentment and guilt. These are common feelings for caregivers. The best thing a caregiver can do for their own emotional health is to clear out these negative thoughts and feelings. Get counseling, talk to a friend or family member or simply write down the negative feelings to get them out of your system. Never take your anger and frustrations out on those you care for.

• Take time to do something you enjoy and give yourself a little bit of rejuvenation everyday. Laughter is a great stress reliever. Find something funny to read or get on the internet and find a funny video to watch.

• During the holidays, be easy on yourself. If you enjoy holiday activities, then get out there and do them. Ask someone to help with your caregiving duties even if it is just for an hour or two to shop or to see a concert or movie. There are day care facilities or home care services available for short term care. See www.longtermcarelink.net for a service in your area.

Being a “perfect” caregiver during the holidays does not have to look like the perfect on-screen holiday family. How you handle your circumstance will be the key to creating your own peace, happiness and cheer during the holiday season. The holidays can be a time of reflection on good things. Your attitude and a little care for yourself can make a big difference in the care that you give in the coming year.

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.