Preparing for Changes With a Progressive Disease

During this morning’s Town Hall Forum for caregivers, Dr. Daniel Sewell suggested ways for families to prepare for the various stages of Alzheimer’s and other forms of dementia.


1. Educate yourself and family members, friends and neighbors about the disease. As the most common form of dementia, much is written about Alzheimer’s, but there’s also plenty of information available on Lewy-Body (2nd most common form of dementia), frontal temporal and vascular dementia as well as Huntington’s and Parkinson’s diseases. “It truly takes a village, and we all have to help each other with this terrible disease,” said Sewell, a geriatric psychiatrist at the UCSD Medical Center.

2. Put together a full support team. This should include professionals such as health care providers, pharmacists, eldercare lawyers and close friends and family that you trust and can count on. It also should include a caregiver support group. “The benefits of being in a support group are endless,” the doctor said.

3. Register your loved one in a Safe Return program. This national program – which our Glenner Centers participate in – includes registering someone with dementia into a database and can also include wearing a special ID bracelet or tags in the event they wander from home and get lost. Local authorities will be alerted to start a comprehensive search quickly.

4. Renovate your home. If you plan to keep a spouse or parent in your home, you’ll likely need to make adjustments for safety.

5. Make sure out-of-town family visits. Conflicts often arise when brothers or sisters who live far away question the validity or extent of a parents’ illness because they spend such limited time with them, usually on a telephone. Make sure they visit Mom and Dad for at least a few days so they can observe behaviors and then help make more informed plans for future care.

We had a great turnout for this morning’s session, “A Caregiver’s Road Map for the Alzheimer’s Journey,” held at the Ramada Inn in Kearny Mesa. Come back next week when we’ll tackle Medicare and MediCal options, estate planning and how best to transition from living at home to living at a facility.

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A Springtime Gift from Alpha Chi Chapter of Sorority

Posing for a photo with their handmade and baked goodies



A closer view of the springtime goodies




Marge Galante, Kelly Focht and Tina Rakowski from the Glenner Centers



The women from the Alpha Chi chapter of the Alpha Zeta Beta sorority visited our Hillcrest Center today to present gifts to The George G. Glenner Alzheimer's Family Centers.

A cheerful cake made out of individual cupcakes was surrounded by springtime floral displays made for each of our participants. In addition, the women handed our CEO, Kelly Focht, a check for the proceeds from an annual fundraiser the sorority holds for us.

"We so appreciate everything your organization does to support us," Kelly told the trio on hand to present the check and watch the participants light up as cupcakes were consumed during afternoon snack time.

Thank you, Alpha Chi Ladies!

Free Alzheimer's Caregiver Seminar Next Week

Just a reminder that next week is our free Town Hall Forum for San Diego County caregivers of loved ones with dementia. Our George G. Glenner Alzheimer's Family Centers offers free adult day care while caregivers attend, but you must reserve a spot ahead of time by calling our Hillcrest Center at (619) 543-4704.

Here are some details for the event (which includes breakfast!):

"A Caregiver's Road Map for the Alzheimer's Journey"

Thursday, April 28, 2011
8:30 a.m. to 12:30 p.m.
Ramada Inn & Conference Center
5550 Kearny Mesa Road
San Diego, CA 92111

Join us as we spend the morning with medical experts from the ActivCare® and The George G. Glenner Alzheimer’s Family Centers medical advisory boards. Learn how to empower and protect yourself and your loved one. Topics for discussion include:

•Preparing for changes with a progressive disease

•Financial options for care: private pay, Medicare and Medi-Cal

•Dementia diagnosis and legal decisions

•When it is time to place in a residential facility

Panelists include:

•Dr. Danel Sewell -- Board-certified geriatric psychiatrist

•Todd Shetter -- COO, ActivCare®

•Heidi Klippel -- Attorney, Estate Planning

•Maureen Jones, RN -- ActivCare® Case Manager

To R.S.V.P., please call the Glenner Centers at (619) 543-4700.

*This course meets the qualifications for three hours of continuing education credits for MFTs and LCSWs as required by the California Board of Behavioral Sciences (#PCE 646) and three hours of continuing education credits as required by the Board of Registered Nursing (CEP 9035).

New Guidelines Show Alzheimer's Hits Earlier Than We See

Today the National Institute on Aging and the Alzheimer's Association released new diagnostic guidelines for Alzheimer's disease that outline how the disease progresses in distinct phases, the earliest of which is undetectable without a brain scan.

The guidelines, the first to be released since shortly after our Glenner Centers opened in the early 1980s, now include a precursor phase in which the amyloid protein begins to lump together in the brain. Our founder, the late Dr. George G. Glenner, was a UCSD researcher who helped discover the beta amyloid protein's link to Alzheimer's disease.

The newly recognized "preclinical stage" develops into mild cognitive impairment, which we've discussed on this blog before (and no doubt will again ... and again because it's highly important to those trying to stay mentally fit and to recognize symptoms in others). This stage of the disease shows mild memory loss, and some with MCI never advance to full-blown dementia.

Earlier guidelines released in 1984 only recognized the dementia stage of Alzheimer's, in which severe memory impairment eventually impedes a person's ability to care for themselves. By now including two earlier stages, it not only will help researchers move drug research and treatments in a new direction, but it also means many people develop the disease earlier in life than first realized, when they typically are at the peak of their careers and still raising families.

There's much to ponder with today's news. And much to be hopeful for since new drug treatments focused on brain activity earlier in the disease may prove more successful than those that have been developed for full-blown dementia.

Here's just some of the media outlets writing about today's release:
ABC News: Criteria for Early Alzheimer's Diagnosis Expanded
U.S. News & World Report: Alzheimer's Cases Could Double With New Guidelines
Washington Post: Guidelines Call for Diagnosing Early Alzheimer's

Showing Appreciation for Our Volunteers

Our Encinitas facility in North County yesterday held a Volunteer Appreciation Day. Our participants made chocolate chip cookies and then presented each volunteer with a hand-decorated vase of tissue paper that appeared as stained glass and filled with fresh flowers. The participants were the artisans on the vases too.

Our Alzheimer's Family Centers has a wonderful group of people who volunteer their time and talent to help with various types of therapies -- particularly music, dance, art and pets -- that are always a highlight of the centers' week for both our participants and for our volunteers.

The George G. Glenner Alzheimer's Family Centers also is the administrator for San Diego County's Guardian Angel Volunteer Program, which matches people with isolated seniors.

Find Out More About Our Volunteer Programs

Are You Mom's Favorite?

The subject of birth order and elder caregiving comes up often, so we thought now might be a good time to resurrect some research showing Mom really does have a preference for who will care for her in old age.

Cornell University researchers in 2009 talked to mothers aged 65 to 75 in the Boston area about who was the favorite among their children. Perhaps surprising to those who'd always been told Mom and Dad don't play favorites, these women freely admitted to being emotionally closer to one child over another.  "Parental favoritism is a fundamental part of the family landscape throughout life,” gerontologist and lead researcher Karl Pillemer told reporters when the study was released.

Part of that closeness may be the parent believing a particular child better reflects his or her values and way of thinking, which can be important when the time comes to depend on that person to help take care of them. And that child, according to other research, most frequently is a daughter and/or the youngest child in the family.

“If you expect you may be losing your autonomy, you want a child who shares your values,” Dr. Pillemer told a New York Times blogger. “If someone’s going to be making decisions for you and you know you’re going to be dependent on her, you want someone you feel close to.”

The problem, though, may be that the chosen caregiver is not in the best position to assume that role. Again, research suggests Mom doesn't care if her favorite is raising her own children, unemployed or even battling substance abuse.

But other siblings might care, which is why it is so important for brothers and sisters to have conversations about long-term care for their parents, particularly before a crisis hits and duty-bound adult children are caught ill-prepared.

After so many studies on birth order, a few generalizations have emerged that can help a family sort out responsibilities for elder caregiving. Oldest children tend to be the most responsible and therefore may be best as handling legal and financial issues; middle children are the best peacemakers and can mediate conflicts over care; and the youngest are typically the closest to their parents and should be ready to make room for Mom or Dad if need be.


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An Alzheimer's Breakthrough, Pt 3.

Could your diet cause Alzheimer’s? Learn the revolutionary new breakthrough that may help you prevent or even reverse this disease. Click here...

An Alzheimer's Breakthrough, Pt 2.

Could your diet cause Alzheimer’s? Learn the revolutionary new breakthrough that may help you prevent or even reverse this disease. Click here...

An Alzheimer's Breakthrough, Pt 1.

Could your diet cause Alzheimer’s? Learn the revolutionary new breakthrough that may help you prevent or even reverse this disease. Click here...

Can You Afford to Be a Caregiver?

We often focus on the emotional and physical toll of elder caregivers, but a newspaper column this week serves as a good reminder of the financial hit adult children face when they must care for an elderly loved one.

Dallas Morning News business columnist Pamela Yip warns that the costs add up quickly, particularly if the caregiver does not plan ahead. According to a director of the MetLife Mature Market Institute quoted in the article, caregivers on average spend more than $5,500 annually in out-of-pocket expenses. If they live far away, it's about $8,700 because of additional transportation and food.

As the loved one's health declines, some employed caregivers drop to part-time or retire early. This could have lasting ramifications.

"People have to think about it because it cuts back their own lifetime wealth," Sandra Timmerman, the MetLife MMI director said.

The article offers the following expert advice to avoid such a situation.

Get a Good Read on Your Parents Financial Situation
This can be tough, particularly if your mother and father have always kept their finances close to the vest. You might start by discussing your own finances and then explain that you want to be sure your parents are prepared if something were to happen to them. Get details on how much they own and how much they owe and if they have adequate medical coverage that will pay for long-term care.

Obtain a Power of Attorney
It's important that you or a trusted relative or friend of the family have a parent sign a financial power of attorney that allows you to be part of their financial decision-making initially and then assume their finances when either or both are incapacitated.

Know What Insurance Will and Will Not Cover
It's particularly important that you understand what Medicare and Medicaid, as well as Medi-Cal here in The Golden State, pays for and what it doesn't. You'll need to know this to determine what type of long-term care you and your parents can afford.

Here also is where adult day health care can be a lifesaver for caregivers still working or unable to afford quality long-term care for their loved one. Centers such as our George G. Glenner Alzheimer's Family Centers provide a safe, engaging environment in which those with dementia can stay for up to a full day while the caregiver continues to work. Rates vary, but financial assistance can come from a variety of sources, including Medicare and Medi-Cal and the Veterans Administration if the dementia patient served in the armed forces. To learn more, go to http://www.alzheimerhelp.org/.

Article: The Cost of Care

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Where's a Camera When You Need It?

Your intrepid blogger arrived Saturday at the site of our annual gala with a car stuffed with gowns, suits, dress shoes, auction items, bid sheets, decorations, and much much more. Alas, she forgot the camera. So, here are some others' snapshots from Saturday's gala, "Old Hollywood Glam: Memories of Good Times Past," to benefit our organization.

Turnout was terrific (we sold out!). Venue spot on (the historic El Cortez). The food and service excellent (thanks Ranch Events!). Entertainment pitch perfect (kudos to jazz duo Brisa Nova and the featured band, Kicks). And the guests were all smiles as we gathered to honor Philip Forgione and help raise money for our family care services.

Our sponsors were all wonderful, receiving Academy Awards or their own Hollywood Star along the Walk of Fame. Our auction donors were quite generous and helped us surpass our financial expectations. One of our caregivers donated her photography services, and we anxiously await the results. In the meantime, here are some candid photos of volunteers and staff to share.

Sondra F. and Mark C.

Patrick W. and Liz R.

Sara F., Alex F., and Nya M.

Happy and Art S.

Dawn and Lauren E.

Briana R. and Teresa R. with Miss California Arianna Afsar

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