How the Glenner Centers Are Different

Last week we visited merchants in Coronado to help build great packages for our silent auction next April. Many shop owners were delighted to help us, recognizing how our organization benefits families (and customers and employees) their community. Some, however, confused us with the Alzheimer’s Association, so we thought we’d clarify how we’re different.

The non-profit George G. Glenner Alzheimer’s Family Centers are 100% local and primarily provide adult day health care services for those with Alzheimer’s, dementia and other memory impairments. We also provide support for caregivers so they can continue to work and/or stay healthy, which then allows their loved one to remain at home. This includes weekly support groups, referrals, case management, family education and, when needed, crisis intervention. Often, the Glenner Alzheimer’s Family Center is the best solution (or transition) between living independently and moving to a skilled nursing facility. Every penny of our fundraisers remains in San Diego County.

The Alzheimer’s Association is a national organization dedicated to finding preventions, treatments, and eventually, a cure for Alzheimer’s disease. Its contributions to our national awareness of this most common form of dementia have helped families worldwide better understand the disease and current treatments. The San Diego/Imperial Chapter assists families locally through research, education and care and support for all affected.

The San Diego/Imperial Alzheimer’s Association chapter is credited with creating the region’s first Alzheimer’s support group after it was established in 1980. Our founders, George G. and Joy Glenner, created the nation’s first dementia-specific adult day care health service right here in San Diego in 1982. Both organizations over the years have helped San Diegans better understand and better cope with the stress of caring for someone who is losing their memory.

As mentioned at the start of this post, we’re currently seeking silent auction items for next year’s signature event in April. If you would like to donate, please contact us at 619-543-4700 or you can email asaita[at]glenner.org.

Using Technology to Keep Better Tabs

Yesterday's "Morning Edition" on National Public Radio featured a piece titled "Wired Homes Keep Tabs on Aging Parents." The seven-minute segment discusses ways adult children are using monitors and cameras to watch parents trying to age in place. It's part of a series on ways to help people stay in their homes as they grow older.

This particular piece features what is called a "tele-caregiver." The featured Georgia couple's long-distance caregiver is named Denise, and she's able to monitor their every move remotely from another state and alert someone when something doesn't seem right, such as someone taking too long in the bathroom or breakfast being undercooked.

Said one ResCare representative in the segment:

"At the same time that we have this huge population of aging folks, we have a shrinking population of caregivers, of younger people who are capable of providing the level of care that these older people are going to need."

Caregivers of parents with dementia have additional challenges, but the series and particularly this technology piece provide some solutions, such as video monitoring services, for those who need to keep a closer eye on Mom and Dad, whether in your home or theirs.

You can listen to the piece here.

Honoring the Angels Among Us

This past weekend we paid tribute to the volunteers within our Guardian Angel Program with a Volunteer Recognition Brunch at the George G. Glenner Alzheimer's Family Centers corporate headquarters.

The program was initiated by San Diego County Supervisors Dianne Jacob and Pam Slater-Price to reduce the isolation of the county's elderly living in long-term care facilities. Since 2001, the Glenner Alzheimer's Family Centers has been privileged to operate the Guardian Angels Program.

Program Coordinator Nya Moses and Program Director Rachel Farias, as well as Glenner CEO Kelly Focht, all noted the impact these volunteers have made.

Forty-three active adult volunteers and 33 active youth volunteers collectively visited more than 55 residents in long-term care facilities and contributed more than 410 hours of servce through 360 visits to some 30 facilities.

Included in Saturday's program was a quote that speaks to the power of volunteerism, for both the recipient and the volunteer. "The best way to find yourself is to lose yourself in the service of others." -- Ghandi.

To learn more about the Guardian Angel program, you can visit its Facebook page. A downloadable volunteer form also is available on our Web site.

Readying the Home for a Family Member

Kathryn Haslanger has an excellent piece on The Huffington Post about why and how best to adapt a home to accommodate a family member with Alzheimer's or other dementia. She interviews Jennifer E. Anderson, who notes that it is best to make modifications early.

Ms. Anderson explained that because dementia patients are very resistant to changes in their environment, and this resistance only increases over time, the earlier modifications can be made, the better. In preparation, she suggests incorporating changes early on that a patient cannot remove down the road. "I tell my caregivers: Because dementia patients are so resistant to change, they will do anything possible to restore their former environment. If an adaptation is removable, I guarantee a dementia patient will try to remove it!"

Some other suggestions for modifying a home, according to the article:

-Replace bathroom towel racks with sturdier grab bars.
-Reduce kitchen clutter and always keep standard equipment and dishware in the same spot.
-Remove stove knobs to prevent stove use (and misuse); instead, encourage microwave use to heat food.
-Set up a personal emergency response system that requires just a button press to sound an alarm.
-In latter stages of dementia, consider removing mirros since patients sometimes are frightened when they no longer recognize the face staring back at them.

Article: Adapting Your Home for Families Members with Alzheimer's or Dementia

'Adult Day Care a Vital Family Service'

Bingo Day at the Glenner Center in Encinitas

North County Times columnist Agnes Herman last week featured the Glenner Alzheimer's Family Centers in an article about the importance of adult day health care for families in San Diego County. Ms. Herman interviewed three adult day care professionals, including Glenner's Sheila Meyer, who manages our Encinitas Center located within the Silverado campus on Saxony Road.

The column does a great job of explaining the role of adult day care centers for those trying to support families while also caring for the elderly ill in their home. These centers allow caregivers to continue to work while knowing their loved one is in good hands.

The all-encompassing care that these centers and others like them offer cannot always be duplicated at home. The [non-profit] Glenner Centers provide meals from Meals-on-Wheels; that is possible at home. But they have much more: consistent care, oversight and activities by professionals, to keep the elder generation active, interested, entertained as well as challenged within each one's abilities.

The piece also stresses the funding threat facing all adult day health care centers throughout California due to state budget cuts. The columnist notes that if the budget ax falls, federal funding also is jeapordized since California may then violate the Americans with Disabilities Act. "The loss of adult day health care will affect more than the individuals and families who enjoy the security the service provides. The economy will change again for those families where one bread-winner now has to stay home."

Article: Adult Day Care is a Vital Family Service

Dementia Caregivers: Free Seminar Series

Scripps Memorial Hospital in Encinitas is hosting a free series of forums in September and October for those caring for loved ones with dementia. Led by Debra Lobatz, MA, MFT, the series covers neurological and psychiatrict perspectives, financial issues, community resources and stress management for the caregiver.

Included among the speakers are members of the George G. Glenner Alzheimer's Family Centers' board of directors: Amy Abrams, Joan Kallin and Scott Stewart.

Here's the schedule:

Sept. 16 (6-8 p.m.): Jack Schim, MC, Scripps Encinitas neurologist
Sept. 23 (6-8 p.m.): Kathleen Erwin, MD, Scripps Encinitas psychiatrist
Sept. 30 (6-8 p.m.): Julie Chippendale, RN, stress management; Elizabeth Wagner, RD CCN, dietician/nutrition
Oct. 2 (9 a.m.-noon): Amy Abrams, MSW/MPH, and Joan Kallin, RN, community resources. Keynote speakers include the Glenner Center, Alzheimer's Association, Southern Caregivers Resource Center, Aging and Independence Services and Elder Care Resource Team.
Oct. 7 (6-8 p.m.): Scott Stewart, Esq., elder law attorney; Irv Eisenberg, CPA, wealth management advisor; Julai Fagin, insurance specialist.

To register for these free seminars, call 1-800-SCRIPPS.

Do You Really Want to Know?

Since the recent burst of news about new PET scans and spinal-fluid tests to help determine a person's propensity to develop Alzheimer's disease, many have been asking themselves: Do I really want to know?

Caregivers of Alzheimer's patients are uniquely aware of the challenges that come with the disease as it advances. Knowing well ahead of time can help you prepare, if not prevent, the disease. But it also will reshape the way you live and interact during your healthy years. Plus, what if the tests are wrong?

One such woman wrote about her own quandry on The Huffington Post. She relates the journey she's traveled with her mother, whose dementia was initially masked by both alcoholism and denial. Her grandmother also is now believed to have had Alzheimer's, which has her wondering about how high the heredity stakes in her case.

Read what she eventually concludes.

[Photo originally appears on cndstudio.com]

Summer Travel with Dementia Patients

During a recent Town Hall Forum co-sponsored by The George G. Glenner Alzheimer's Family Centers, a caregiver asked our medical experts about traveling with a loved one who has dementia. The ability to travel as a family or a couple depends on numerous factors, including how well they currently handle a change in routine. Are they easily agitated? Do they become highly irritable with the slightest change in their environment or routine?

If a person with dementia doesn't seem agitated, then they may be a candidate for traveling.

"Be prepared to stop a lot. Be prepared to take them to the bathroom a lot. And be prepared for them to become restless," said Dr. Alan Berkowitz, a geriatric psychiatrist who specializes in the management of acutely agitated long-term care patients.

He recommends flying first-class if that is an option. If other modes of transportation are planned, be prepared.

Here are several resources to guide your travel plans, should they include a loved one with memory impairment from Alzheimer's, Lewy Body, Parkinson's or any other disease.

University of Iowa: Traveling Guidelines for People with Dementing Illnesses

University of Florida: Traveling with Dementia PowerPoint Presentation

Fisher Center for Alzheimer's Research: 10 Tips for Traveling with an Alzheimer's Patient

Early Screening for Alzheimer's Under Review

In an earlier post, we discussed signs that someone may be experiencing the early stages of dementia. The earlier dementia is detected, the more opportunities to take steps to improve the patient's (and the caregiver's) quality of life going forward. Dementia is the umbrella term for those with memory impairment, whereas Alzheimer's is the leading type of dementia.

Today's Boston Globe features one such family of caregivers as the narrative around the important subject of screenings. There remains much debate about how best to screen for Alzheimer's and what, if anything, can be done to prevent it. Just what organically signals Alzheimer's or another type of dementia remains a major focus for researchers.

Scientists think Alzheimer’s begins to damage the brain years before memory lapses and other symptoms appear, and they are developing screening tests to detect victims in these silent early stages. A reliable test would not only give people like Bernice an answer, but might enable physicians to prevent or delay the dementia with drugs or other therapies — much the same way patients with high cholesterol readings are treated with statins to stave off heart disease.

The agony for families like the Osbornes is that researchers say these technologies are years away from being ready for routine use, and there is not yet any medication that could alter the course of the disease.

The good news is that there's a great deal of research being devoted to Alzheimer's, which currently affects 5 million Americans. That number is expected to triple in the next 40 years as the population's primary demographic - baby boomers - continue to age. This will put increasing pressure on facilities to come up with better screenings for the disease as well as more preemptive steps we can take while we're in good health to help stave off dementia.

Article: Do I Have It? Tests for Alzheimer's are in the works, but their routine use is still far off.

Photo courtesy of Boston.com

Common Dementia Issue: Agitation

Agitation takes on many forms in those with dementia, and it's important for caregivers to recognize symptoms and possible causes to find solutions that benefit both the patient and their families.

At a recent Town Hall Forum co-sponsored by The Glenner Alzheimer's Family Centers, Dr. Alan Berkowitz explained that the vast majority of dementia patients experience some type of behavioral change when their routines or settings are disrupted. "Transitioning from home to whereever it may be is a huge step," said Dr. Berkowitz, a geriatric psychiatrist with Sharp Healthcare. He discussed how best to manage acutely agitated long-term care patients.

"Early identification is important," he said, noting a Newsweek article a couple of years ago that spoke of "pleasant dementia." "Most people with dementia don't have 'pleasant dementia.'"

"Agitation" is any inappropriate verbal, vocal or motor activity that is not an obvious expression of need. Physical, non-agressive signs of agitation include:

--Pacing
--Inappropriate dressing or underdressing
--Inappropriate handling of objects
--Complaining

Physical, aggressive signs of agitation include:

--Hitting
--Kicking
--Biting
--Scratching
--Threatening

Some common reasons for agitation are:

--Caregiver-related
--Environment-related
--Confusion
--Psychiatric
--Manifestation of a medical disorder
--Medication side effects
--Urinary tract infection

UTIs, in fact, are the biggest cause of agitation in long-term care facilities, Dr. Berkowitz said. Once the cause can be found, modifications may bring an end to the behaviors or at least mitigate them.

Mild Cognitive Impairment

Dementia takes on many stages, and among the earliest is what is known as Mild Cognitive Impairment, or MCI. This is the stage where someone shows signs of memory impairment but can still function in all other ways.

MCI also distinguishes dementia from normal signs of aging and occurs in those age 55 years and older. Factors such as family history, education, work experience and life experiences can influence its onset.

According to medical experts at last week's caregiver Town Hall Forum in San Marcos, sign common signs that you or a loved one may be experiencing MCI include:

--Forgetting recent events and conversations
--Difficulty performing more than one task at a time
--Difficulty solving problems
--Taking longer to perform more difficult mental activities

One way to determine if MCI is present is to consult a physician who may also recommend testing with a neurologist, psychiatrist, geriatrician or other specialist. PET scans have been found to be 90% accurate and often are covered by Medicare if the doctor is trying to test for an exact type of dementia.