Alzheimer's Help for San Diego Families

When It's Time to Take Away the Keys

2012-01-24T09:25:00.000-08:00

This morning local news media reported an elderly man with dementia was missing from him home in unincoporated El Cajon. He had been last seen driving a red pickup out of town.

The good news is the man was found near the U.S.-Mexico border and is presumably now safe and secured. But reports like this one are unsettling on a couple of levels.

First, the border patrol officer is quoted as saying Mr. Heil suffers from "early-onset dementia." But he's 86 years old. Early-onset is a more rare form that strikes people under 65. What we suspect is Mr. Heil recently was diagnosed with dementia, which is much different.

But that's not what prompted this post. It's that Mr. Heil (and his family) knew he had dementia and that he frequently was lost and confused and yet allowed him to continue to drive. This made Mr. Heil a danger to others every time he got behind the wheel.

While it may be difficult to do, it is important that families come together to take the keys from a parent, spouse or sibling once they are diagnosed with dementia and especially if they display symptoms that could cause them to become disoriented on the road.

In July 2010, we posted some tips on how to do this. One tip we wish to underscore is calling your Division of Motor Vehicles and requesting an elder driver be retested. You can ask a physician to make the call if you can't. The driver is never told of the tip and instead receives a letter asking him or her to come in to their local branch to be retested.

Mr. Heil's disappearance had a happy ending, and we're grateful for that. But his case also serves as a warning that families - and neighbors if an elder resident lacks nearby relatives - need to be more heavyhanded when it comes to driving.

Free Caregiver Workshop in February

2012-01-18T11:14:00.000-08:00

Alzheimer's Caregiving: The Team Approach

Thursday, February 23, 2012
8:30 a.m. – 12:30 p.m. (Continental Breakfast included.)

Lake San Marcos Resort Conference Center
1025 La Bonita Drive
San Marcos, CA 92078

Memory loss resulting from Alzheimer’s disease and related dementias have a profound impact on the family. Join us for a morning session with Alzheimer’s disease experts and learn how to empower and protect yourself and your loved one. Caring for a loved one with Alzheimer’s disease takes a dedicated team of family members, friends, medical professionals and experts.

Learn how to assemble your team and where to go to pull together the information and resources you need to make yourself a successful and confident leader of that Caregiving Team.

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.

Speakers:

Neil Levine, M.D. - Board Certified Internist
Alan Berkowitz, M.D. - Psychiatrist specializing in Geriatric Medicine
Amy Abrams, MSW/MPH, CMC - Geriatric Care Manager
Family Caregiver

Free adult day care offered during the event at The George G. Glenner Alzheimer’s Family Centers. Reservations required at least one week prior. Call our Encinitas Center at (760) 635-1895.

To RSVP, please log onto Activcareliving.com or call ActivCare at 888-MEM-LOSS.

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

Contest Provides Way to Preserve Memories

2012-01-17T08:55:00.000-08:00

Omaha, NE-based Home Instead Senior Care has launched a contest to help families keep cherished memories alive. The "I Will Remember for You Family Reunion Giveaway" encourages caregivers to submit a story in either written or video format about an experience with a family member who lived or is living with Alzheimer's disease or other dementia. Learn more about entries.

Grand prize is a family reunion that includes activities to help family members create and capture special memories together such as a scrapbooking and shadow box station, a memory booth to capture videos, photos or written thoughts, and assistance from a professional family historian to create a family memory anthology. Depending on the winner's location, in-home care during reunion activities may be included in the package.

Here are some ground rules, based on a news release issued by the company.

Essays and videos need to:

1. Share how Alzheimer's has impacted a family's life.
2. Talk about the role that memories and remembering have played in the family, especially with regard to the member who now has or had Alzheimer's.
3. Share specific stories or examples of how family members cope or coped with challenges of Alzheimer's disease.
4. Tell why this family deserves to win the family reunion.

Entries must be submitted by 11:59 p.m. EST January 31, 2012. The top three finalists will be notified by a judge's panel by Feb. 15, 2012. The judging panel to select the three finalists will include Carole Anderson, Vice President of Education at the American Society on Aging. Online voting to select the grand prize winner will occur from March 28 through June 30, 2012.

The grand prize winner will be publicly revealed in November 2012, following the family reunion event.

Chula Vista Adopts Technology to Track Alzheimer's Patients

2012-01-12T13:45:00.000-08:00

Regular readers will recall one of our staff members "lost" an aunt over the holidays when the woman, 58, failed to return from a quick trip to a South Bay drug store. She suffered from diabetes and mental illness and communities on both sides of the border mounted a search. Fortunately, Yolanda Lopez was found a week later at a Tijuana bus stop by her family. She is much improved now and her family is taking measures to keep her safe.

Now the city of Chula Vista has announced it is the first in San Diego County to start using new tracking technology called EmSeeQ, a wrist device worn by someone with or dementia. It has a mesh band that can't be easily cut or come lose. It also has a lock that only a caregiver is able to open, according to a local news report.

The technology works off cell phone towers, so it is still active should someone enter an enclosed space that GPS satellites may not be able to penetrate. When a loved one wanders, the caregiver can alert authorities who then use the technology to pinpoint their whereabouts. Best of all, Chula Vista is offering the device free to residents who qualify as part of the pilot program.

Many people already are familiar with the Alzheimer's Associations' Safe Return Program, which last year introduced a GPS tool to also help with tracking. Both are part of a growing trend to help families caring at home for members with dementia. Wandering is a major issue that all caregivers must understand and take proactive steps to prevent.

Here are some practical tips to help reduce wandering.

And here is a news report on the Chula Vista initiative.

Could a Nicotine Patch Boost Memory?

2012-01-10T09:22:00.000-08:00

Many longtime smokers who finally kick the habit report that their brain gets a little "fuzzy," and they have trouble remembering even simple things. They attribute it to the withdrawal, and now there's a study that suggests they are correct. It may be the nicotine - or sudden or gradual loss of it - that slows down their thoughts.

A study being reported in various news media today gave dermal patches to 70 individuals, some with nicotine and others with a placebo.

"There were improvements in attention and memory performance in patients who took the nicotine patch compared to those with the placebo patch," lead researcher Dr. Paul Newhouse, a Vanderbilt University psychiatrist, told National Public Radio. "The placebo patients stayed the same or got worse."

Newhouse was quick to point out that the patch worked only on those who might show signs of Mild Cognitive Impairment, which is sometimes a precursor to Alzheimer's Disease. (Not everyone with MCI advance to Alzheimer's.) Those already diagnosed with latter-stage Alzheimer's likely would not see an improvement because the receptors in the brain that nicotine taps are already damaged by the disease.

And the researchers caution that this limited study does not imply people with mild memory impairment should take up smoking, which has long been known to cause cancers and other life-threatening illnesses - including vascular dementia.

As the smoking rate in the U.S. continues to decline - it's currently around 15% of the population; 11.5% in California - the makers of nicotine patches will no doubt welcome the possibility of another use. But much more research is needed to see if introducing nicotine to the pristine system of a non-smoker is really the best way to obtaining a memory boost.

Article: Nicotine Patches Up Early Memory Loss

Study Shows Our Brains Begin Decline in Our 40s

2012-01-06T14:17:00.000-08:00

A new study suggests our brains begin to slip as early as our 40s.

In widely distributed article in today’s USAToday shows mental decline – memory, reasoning and comprehension – begins at 45 to 49, and not in our 60s as we all have long believed.

The study began in 1985 and involved 5,200 male and 2,200 female British civil servants between the ages of 45 and 70. They were periodically tested for memory, vocabulary, hearing and vision. Everyone in the group experienced a drop in cognition over the years. Men 45 to 49 saw a nearly 4 percent drop (compared to 10 percent in those 65-70) and women the same age suffered a 5 percent memory and reasoning loss (7 percent for the older group).

This study also confirms that we’ve probably always had minor memory issues that weren’t as big a deal until Alzheimer’s experts lowered the diagnosis threshold. What should we do? Same thing we do for any other organ: keep the brain healthy. Eat and exercise in healthful ways and engage the brain daily by learning something new and doing mental exercises and cognitive therapy to retain memories and feed your thoughts.

The Glenner Alzheimer’s Family Centers have materials on early memory loss at our corporate office in Hillcrest (3702 Fourth Avenue). Stop by to look in our Reagan Library next time you’re in town.

Article: Mental decline can start at 45, study says

Guest Post: What It's Like to Have Young Onset Alzheimer's

2012-01-04T08:10:00.000-08:00

Editor's Note: We earlier mentioned Michael Ellenbogen, who is trying to spread the word about early-onset Alzheimer's Disease in order for more people to become familiar with the signs and the scope in order to devote more resources to prevention and a cure. Michael wrote today's guest post exclusively for our blog.

My name is Michael Ellenbogen. I am a writer. I am a husband. I am a father. I was a high level manager. In 2008, at age 49, I was diagnosed with Alzheimer’s disease after struggling to get a diagnosis since my first symptoms at age 39. Now I am frustrated, frustrated, and more frustrated. Not because I have Alzheimer’s, but because of the disparity and stigma surrounding this disease.

Everywhere I turn, I hear or see something related to Cancer and HIV. The government contributes 18.7 percent of the NIH research budget to cancer, 9.9% to HIV, and Alzheimer’s receives only 1.45%. This leaves me with one question. Why? There are so many more people living with Alzheimer’s than HIV, yet we receive so much less funding.

Why is it that no one wants to talk about this disease? Why are stars or famous people not proud to stand up and support this cause? I realize there is no pretty outcome, but that is why we all need their help. There are so many of us who are directly impacted by this disease and we choose to do nothing. I know it’s not easy and most are so overwhelmed dealing with the disease. If we do not use our precious time for this cause, who will?

Alzheimer’s disease has impacted so many aspects of my life, like my career, but I was surprised by how it has impacted my hobbies. Not that I had many. I used to love driving a boat and tinkering with electronics, but I can no longer do either of these things. Electronics are not forgiving, and if you make a mistake the projects can go poooofff, when I touch the wrong component. This has happened.

I have tried to take up new hobbies such as golf, but learning new things is difficult. I could not keep track of the ball and had trouble trying to follow the ball. It took me much longer to tee off then others, and I felt too much pressure when I was slowing down the people behind me. I would love to play golf, but at my speed and without all the pressure.

The only good thing about having the disease is that I am able to advocate for the cause, and speak for the many others that can no longer write, speak or have passed on. So please help me with my call for help to help. I need to get the backing of famous people so we can change the perception that exists with Alzheimer’s today. It does not only affect the older generation, but it has an even bigger impact on the younger generation when they are diagnosed. I know it’s very easy to read this article, have a moment of feeling sorry, and then to just move on without doing anything.

Keep in mind this could one day affect you, your spouse, your son or daughter, their grandchildren, or even a close friend. Please do not wait till that day. Do something today. Think of all the lives you can save if you start now, maybe even their lives.

Please help me by joining my cause to make others aware of this debilitating disease and how it also affects young people. The youngest on record is 24 years old. Please reach out to me at my website so we can work together to make Alzheimer’s disease end with me. Someone will develop the disease every 69 seconds. That number will increase to every 33 seconds by 2050.

Don’t wait, our time and lives, are too valuable.

http://www.michaelellenbogenmovement.com/

A Happy Ending to the Year

2012-01-03T09:15:00.000-08:00

We wanted to update everyone on the disappearance of Josephina Yolanda Lopez, who was found a week later (Dec. 31) in Tijuana. Thanks to a massive search by authorities, family, friends and communities, Yolanda was found at a Tijuana bus stop. She had been robbed, beaten and in need of immediate medical attention, but now she is much better and her family is grateful to find her and to everyone who helped in the search.

Here's a local story with more details.

Yolanda, 58, suffers from diabetes and bipolar disorder. She is the aunt of one of our staffers, and we once again wanted to extend our own thanks for those of you who phoned, called and stopped by our offices to see how you could help. The joint effort by everyone paid off!

Yolanda's family now plans to take steps to ensure she does not wander again. At a minimum she is going to be enrolled in the Safe Return Program in Long Beach and will wear a bracelet with GPS to help track her whereabouts in the event she eludes family again.

Happy New Year ... and Thank You!

2011-12-30T12:20:00.000-08:00

As the donations come in daily - even hourly today - for our 2011 Annual Campaign, we are reminded of just how wonderful our supporters are. Thank you all for helping our non-profit start 2012 on a stronger financial foot through your donations. We can't wait for the new year - and a new Glenner - to arrive next month.

Update on Yolanda Lopez

2011-12-29T08:48:00.000-08:00

It's now Thursday, almost a week since 58-year-old Yolanda Lopez disappeared while on her way to a National City drugstore to buy hair dye. She is the aunt of one of our staff members -- Marketing Coordinator Liz Reinhofer -- and has an extended family that is very worried about her whereabouts, especially since she relies on medication for diabetes and dementia.

Yolanda's family continues to canvass the area and yesterday spent all day and most of the evening in Tijuana, in case Yolanda crossed the border. They had new fliers created that are more visible to draw new attention to the missing woman.

We wanted to thank everyone who has helped in the search by passing along our pleas through social media and for all of the emails and phone calls Liz and other family members have received to lend moral support.

We'll keep you updated as more information is available.

Help Us Find This Woman

2011-12-27T08:27:00.000-08:00

We sometimes write in general about people with memory impairment who wander. Today's post hits much closer to home.

A 58-year-old Long Beach woman with diabetes and mental illness left to buy hair dye at a drug store in Otay Mesa on Thursday and never made it back. She is the aunt of our marketing coordinator, Liz Reinhofer.

Yolanda Lopez has brown hair and eyes, is 5 feet, 4 inches tall and weighs 150 pounds. She was last seen wearing a beige thermal sweater, bluejeans, white shoes, three gold rings and gold bracelets on both wrists. According to news accounts, Yolanda has wandered from home before, but always returned later. She was recently diagnosed with type 2 diabetes and bipolar disorder.

If you have seen her, or anyone who seemed to be walking in South Bay that may fit her description. She was last seen at sister's home at 523 Doolittle Avenue, Otay Mesa Thursday.

Anyone with information about her whereabouts was urged to contact San Diego police at (619) 531-2000.

From Our Home to Yours

2011-12-23T12:39:00.001-08:00

We're Rockin' the Holidays in Encinitas

2011-12-22T13:37:00.001-08:00

Should Margaret Thatcher's Dementia Make the Movie?

2011-12-22T11:13:00.000-08:00

We're taking a break from all of the holiday photos and videos to bring attention to an upcoming movie that features Meryl Street [shown in photo] as Margaret Thatcher, the controversial former prime minister of England. "The Iron Lady" shows many facets of the world leader, including her mental decline as the result of Alzheimer's Disease. She is still living with the disease today.

And that's drawn criticism from both ends of the political spectrum. Thatcher's daughter disclosed in 2008 that her mother had dementia, so the movie provides no new revelations. But some close friends take issue with the inclusion of her latest years in the biopic.

“I was strongly against the film depicting a living person with dementia. That was very upsetting for her friends and family,” Charles Moore, the authorized biographer of Thatcher who will publish his book upon her death, said in a telephone interview with the Wall Street Journal. “It’s an extremely unkind thing to do.”

Other prominent world leaders, such as the late President Ronald Reagan, also had the fatal disease. Unless the family chooses otherwise, the mass media generally respects their wishes to keep the matter private.

In doing so, however, it also may leave the impression that people with Alzheimer's or another form of dementia no longer "exist" in our society - which is far from the case. At present, the Alzheimer's Association estimates half of all adults 85 and older have dementia, most likely Alzheimer's. And people more frequently live well into their 80s and 90s if they manage their health well in earlier years.

Such extended longevity does and will continue to put enormous stress on existing resources, from health care and housing to families charged with caring for a member with memory impairment. This movie also reminds us that Alzheimer's is an equal opportunity disease, striking all segments of society.

And yet, each journey through the disease is a highly personal one. Put yourself in the Thatcher family's position, and you must wonder if this is how they want their matriarch to be remembered.

Season's Greetings from South Bay!

2011-12-19T08:46:00.001-08:00

Congratulations to Uriel Perez

2011-12-15T14:51:00.000-08:00

Encinitas Program Director Sheila Argeanton, BSW poses with Uriel Perez after he receives the Glenner Ridenour Award from his peers. Uriel is a program assistant who was praised for his work with our participants and for his respect for fellow employees. We salute Uriel for doing such a great job at Glenner!

Congratulations to Laura Aribuabo

2011-12-14T15:49:00.000-08:00

Laura Aribuabo today received this year's peer-voted Glenner Ridenour Award for outstanding service. Laura is a program assistant who commutes to Chula Vista from Temecula each day. She's been with Glenner for 11 years. Here she is with Bernice Molina, MSW, the center program director. Congratulations, Laura!!

Congratulations to Mariana Garcia

2011-12-13T15:49:00.000-08:00

Mariana Garcia was given this year's Glenner Ridenour Award by employees at our Hillcrest Center. Mariana is a program assistant known for her dedication to our participants and to always being cheerful and encouraging. Here she is with Marge Galante, RN, the Program Director and Director of Nursing.

Total Lunar Eclipse

2011-12-12T09:13:00.000-08:00

We had a rare celestial treat in San Diego this weekend with a total lunar eclipse at daybreak. This photograph was shot with a simple digital camera, but it shows the marvel that so many people were able to witness as the sun, earth and moon were all in alignment for several minutes early Saturday. Enjoy.

Making Music Really Helps the Brain

2011-12-09T09:21:00.000-08:00

So often we think of residential homes, particularly skilled nursing facilities, as a place where dreams die. But, of course, those familiar with such places know that isn’t true and that many people learn to make the most of their time there.

That’s why we wanted to share this story in today’s New York Times about an aging musician who came to a Buffalo nursing home after a struggling career as a pianist and discovered a new audience eager to hear and watch him perform.

Music therapy is an important part of our Glenner Alzheimer’s Family Centers. Not only does it provide a source of entertainment, but it also has been known to improve the quality of life for everyone in the family. It promotes social engagement and often leads to fewer visits to the doctor and less medication.

“Creative expression actually builds capacity in our brains,” says Gay Hanna, Ph.D., the executive director of the National Center for Creative Aging, said during a Webinar yesterday.

Anne Hastings, Ph.D., is director of the University of Wisconsin-Madison’s Center on Age and Community. She noted that storytelling in all its forms improves cortisol levels in both caregivers and loved ones. Moods improve and challenging behaviors decline.

“Having a sense of meaning and purpose is a protection against dementia,” she notes.

Engaging in artistic expression – be it the visual or performing arts – can improve brain cell activity and provide an outlet when others appear to be closing in due to dementia. She notes singer Glen Campbell, who this summer publicly announced he had Alzheimer’s. He now has difficulty with daily tasks but can continue to perform on stage.

“The power of the arts is integral to our being as humans,” Dr. Hanna says.

The story of Boyd Lee Dunlop in today’s newspaper demonstrates these principles. It also shows that people can have enriched, satisfying lives well beyond their working years and even after they are unable to age at home anymore. Thank you, Mr. Dunlop, for that note of hope.

Article: Rhythms Flow as Aging Pianist Finds New Audience

Who Is Eligible for New Community-Based Adult Services in 2012

2011-12-05T14:36:00.000-08:00

As already mentioned here, Adult Day Health Care programs will remain in place until March 1, when state-funded ADHC will be replaced with a new program called Community-Based Adult Services.

CBAS will be funded through a 1115 Medi-Cal waiver and include different eligibility requirements. Here are some such requirements to participate, as outlined in a memorandum from Disability Rights California.

1. An individual must meet current ADHC eligibility and medical necessary criteria.

2. In addition, the individual must fall into one or more of the following categories:

Individual who meets or exceed Nursing Facility-A (NF-A) level of care (including those who live in non-medical residential care facilities or at home)
Individual who has an organic, acquired or traumatic brain injury and/or chronic mental illness (must be diagnosed by a physician and require supervision for such life skills as bathing, dressing, medication management, hygiene OR money management, meal preparation or transportation
Individual with moderate to severe Alzheimer’s Disease or other dementia (Stages 5-7 of Alzheimer’s Disease)
Individual with MCI to moderate Alzheimer’ Disease or other dementia (Stage 4 of Alzheimer’s Disease) and needing assistance with two of the following: bathing, dressing, self-feeding, toileting, ambulation, transferring, medication management and hygiene
Individual with developmental disabilities.

Assessments will take place Dec. 19 through January 2012 the ADHC center by a nurse.

Read more details here.

Fish: It's Good for the Brain

2011-12-01T14:06:00.000-08:00

Today's widely publicized announcement that eating fish may dramatically reduced the risk of Alzheimer's is giving everyone more food for thought. According to a new study of 260 healthy adults shows those who eat fish weekly are less likely to develop Alzheimer's disease, including the related condition known as mild cognitive impairment (MCI).

The benefits of fish on the brain stem from high levels of omega-3 fatty acids and selenium, both of which are known for their anti-inflammatory benefits.

“This is the first study to establish a direct relationship between fish consumption, brain structure and Alzheimer’s risk,” said Cyrus Raji, M.D., Ph.D., from the University of Pittsburgh School of Medicine. “The results showed that people who consumed baked or broiled fish at least one time per week had better preservation of gray matter volume on MRI in brain areas at risk for Alzheimer’s disease.”

“Consuming baked or broiled fish promotes stronger neurons in the brain’s gray matter by making them larger and healthier,” noted Dr. Raji. “This simple lifestyle choice increases the brain’s resistance to Alzheimer’s disease and lowers risk for the disorder.”

Image of brains from the University of Pittsburgh
Article: Eating Fish Tied to Dramatic Drop in Alzheimer's Risk

The Caregiver's Health Is Impacted

2011-11-28T14:01:00.000-08:00

Whenever a caregiver comes up to our booth, we like to give them a laminated “bookmark” that lists ways for caregivers to take care of themselves. Often, and especially if the caregiver is an adult child, they will wave dismissively and say they don’t need it.

Now there’s proof they do.

The National Alliance for Caregiving has published an 18-month research study that shows caregivers of a family member with Alzheimer’s Disease require 25% more health care services than non-caregivers in their same age brackets. In fact, during the study time, hospital emergency visits and hospital-based services were double those who were not caring for a loved one with Alzheimer’s.

The study was based on more than 1,200 families living in Birmingham, Boston, Miami, Philadelphia and Palo Alto, Calif. To qualify, the caregiver had to be at least 22 and caring for someone with Alzheimer’s for at least the past six months and at least four hours daily. Broken down, the group was comprised of mostly women (83%) averaging 61 years old and caring for someone with a mean age of 78.

Those who self-reported initially to be in fair or poor health were most likely to experience a decline. During the same period, the Alzheimer’s care recipients, in general, saw a drop in cognitive abilities based on the Mini Mental State Exam.

“The findings suggest that the strain of caring for someone with AD can cause family caregivers to use health care services at higher rates than non-caregivers of the same age, including rates for emergency room visits, hospital use and doctor visits,” the study said.

That increase translated to $4,766 more annually in health care costs for caregivers, many of whom are below the age for Medicare to kick in.

The researchers suggest primary care doctors be sensitive to middle-aged and older adults who may be someone’s primary caregiver and make sure they are aware of the physical and mental stress of the job they are undertaking. Here is also where a caregiver support group, such as those offered for free at each of our Glenner Alzheimer’s Family Centers, can be invaluable.

Our support groups meet Wednesdays and provide free adult day care during the sessions.

3-4:30 p.m.
Hillcrest
3702 Fourth Avenue
619-543-4704

3-4:30 p.m.
Chula Vista
280 Saylor Drive
(next to Fredericka Manor)
619-420-1703

10-11:30 a.m.
Encinitas
335 Saxony Road
(inside Silverado Senior Living)
760-635-1895

An 'Amazing' Celebration in Hillcrest

2011-11-23T14:44:00.000-08:00

We tried to capture the true flavor of our annual holiday dinner at our Hillcrest Center.

Chula Vista Celebrates Thanksgiving

2011-11-23T10:55:00.000-08:00

Special thanks to everyone at Collwood Stellar Care for donating all of the food for our festivities.

Let's Talk Turkey

2011-11-22T09:30:00.000-08:00

Special thanks to the women in the Del Norte Chapter of The National Charity League for cooking and serving such a great meal and providing each of our caregiver families with wonderful gift baskets.

ADHC to Remain in California Beyond Dec. 1

2011-11-18T09:03:00.000-08:00

Good - no, great! -- news arrived yesterday: The state of California reached a settlement with disability and eldercare advocates to keep adult day health care services for the growing number of Californians who currently and will in the future need ADHC services. ADHC as we know it will now be in place through Feb. 29, 2012, when many participants will move to new Community-Based Adult Services programs. That should include our George G. Glenner Alzheimer's Family Centers.

Here is a news release that was issued by CAADS:

(Sacramento, CA) – “Immense relief” and “joy” are the words that California Association for Adult Day Services Executive Director Lydia Missaelides uses to describe the sentiments of tens of thousands of elder, chronically ill and disabled patients after a major settlement was reached today in a lawsuit against the state brought on their behalf by Disabilities Rights California. Missaelides said:

“Throughout this entire year, 35,000 low-income, medically needy patients and their families have endured incredible stress and lived in fear that they would no longer be able to access care at their local Adult Day Health Care (ADHC) center.

“To know that these patients’ legal rights have been preserved is a huge comfort to us and to tens of thousands of Californians throughout the state. This decision means those in the care of our centers will be able to stay at home and in their communities and receive necessary medical and therapeutic services without interruption. We are grateful that the nearly 300 ADHC centers statewide have been given a reprieve to stay open past the planned December 1 closure, resulting in 7,000 jobs being saved and vendors being spared further cuts to their local businesses.

“This settlement makes it clear that the services provided by center-based adult day health programs are irreplaceable in preventing or reducing use of higher-cost institutional services such as nursing homes and hospital emergency rooms, and honors patient dignity and the Americans with Disabilities Act.

“We are looking forward to collaborating with the State as we move forward in this transition. We see many challenges ahead as the details of implementation of the settlement are finalized and put in place. We are committed to working in partnership with the state and DRC to make this settlement agreement a success for all parties.

“We wish to express our deep appreciation to Disability Rights California and their co-counsel National Senior Citizens Law Center, National Health Law Program, AARP Foundation Litigation, and Morrison & Foerster, LLP for defending the rights of Adult Day Health Care patients and their working families, and to preserve the model of Adult Day Health Care and the valuable safety net it provides.”

NOTE: Under the terms of the settlement, CBAS will be offered through Medi-Cal managed care plans in most parts of the State. CBAS will be part of the State’s 1115 Medicaid waiver, and will not cap enrollment, ensuring that all eligible beneficiaries are able to receive these vital services. Current ADHC recipients who are not eligible for CBAS will receive enhanced case management to assist them to transition smoothly to other long-term care services in the community. Many of the current ADHC providers will be able to provide CBAS services, thus ensuring continuity of care.

For more information:
State Reaches Settlement to Establish New Version of ADHC
California Adult Day Health Care Gets a Reprieve

Young Onset Alzheimer's Disease

2011-11-15T09:00:00.000-08:00

Yesterday we received a message from a Phildelphia man trying to raise awareness of what he calls Young Onset Alzheimer's Disease. This is where people begin to show symptoms of permanent memory loss well before their 70s and even 50s and 60s. If Alzheimer's is diagnosed before 65, we call it Early Onset Alzheimer's Disease. In the case of Michael Ellenbogen, 53, he says he first displayed signs when he was only 39. When he first mentioned to friends and family his difficulties remembering names, dates, and other common information, they told him it was just the stress of daily life as a data analyst and father. But it turned out to be a more serious cause.

Michael's story sounds unique because of his young age, but as more health care professionals become familiar with the signs of early-onset dementia, we will see more people like Michael being diagnosed with memory impairment in their prime, rather than later in life. This will have serous consequences for families and companies who will struggle with how best to handle the disease as it grabs hold of parents with young children and breadwinners, not just grandparents and retirees.

Here is a video (one of several) Michael's produced that explains his journey and why he is starting a "movement."

Nutrition Tips to Get Through Tough Times

2011-11-11T15:57:00.000-08:00

Diet and exercise are a common theme on our blog because they are the foundation of wellness not just for someone with dementia but those who take on responsibility for their care. Sometimes the effects of a physical illness impact our mental well-being, and vica versa.

Today we wanted to share some advice we received during a panel on how to take better care of ourselves. It was led by Wendy Hileman, Ph.D. Candidate, MPH, MSW, MS, who is CEO and Principle Researcher for the non-profit Healthy Adventures Foundation. Eating well allows your body to better withstand the stress and viruses that seem to grow exponentially this time of year.

Not All Carbs Are Bad
Actually, many of them are quite good for us. Our daily diet should consist of 50-65% carbohydrates, most of which are the complex variety (whole fruits and vegetables, beans and whole grains). We also need fats and proteins. When it comes to fats, plant-based oils are fine; animal-based fats are not. By the way, our bodies are "engineered" to watch carbs because that's what we all need for sustenance. But those carbs should be in their truest form -- raw; not blended into smoothies. Each time our food is treated - baked, fried, steamed, etc. - it loses some nutritional value.

Someday You Will Stop Aging. Until then...
We all start to age when we turn 30. From that point forward, we will gain a pound a year if nothing else in our lifestyle changes. Therefore, to maintain or lose weight, you must exercise to consume more than you take in. Here's some good news: for an unknown reason, we stop aging in our late 90s. So if you make it to 100, you technically won't look a day over 98.

Vitamin D Deficiencies Can Influence Mood
Most of us are familiar with SAD - Seasonal Affectiveness Disorder -- but fortunately for us in San Diego, we don't go weeks or month without sunshine. But if we are homebound, we can start to see changes in our moods, and not for the better. Vitamin D is even known to play a role in depression. The best source is sunlight, and the best way to get your daily dose is to go for a walk outdoors 15 to 20 minutes without sunscreen. Doing so will reduce your risk of some cancers by as much as 30%.

Some Foods That Are Good for You
Did you know broccoli can erace cancer cells? That blackberries pack the most antioxidant punch, followed by walnuts, strawberries, artichokes and coffee? To ease or eliminate the common menapausal symptom known as "hot flashes," eat a teaspoon of freshly ground flaxseed each day. And ever wonder why love eating popcorn? It is not only high in fiber, but it contains the same "feel good" chemical triptophan found in turkey. Finally, one more bit of food trivia: 2 Brazil nuts have enough selenium to fight inflammation as a dose of Motrin. But eat more than 6 at a time and they become toxic in our bodies. Now you know why there are so few in that can of mixed nuts!

Announcing Our Interim CEO

2011-11-07T11:35:00.000-08:00

Julie A. Sugita, who has experience both professionally and personally with dementia care, has been named the interim CEO at The George G. Glenner Alzheimer’s Family Centers.

Julie replaces Kelly Focht, who left the organization in September to become a center manager for St. Paul’s PACE program.

Julie is a former periodontist with many elderly patients at her dental practice before health issues led her to a new career as a California Licensed Professional Fiduciary and a National Certified Guardian.

It was during her own experience caring full time for her mother-in-law with Alzheimer’s Disease that she came to fully understand and appreciate the critical role programs such as our adult day programs and support groups provide to families dealing with complex healthcare issues.

“I have a passion for the caregivers’ journey because that’s where I came from,” she said. “To me, it’s an honor to be able to ensure the future of providing these services to caregivers and to help carry The Glenner Centers into the next 30 years.”

A graduate of San Diego State University, where she earned an M.S. in gerontology, Julie has extensive experience in marketing and business management as well as healthcare and the non-profit sector, where she provided startup development for a 501(c)3 foundation. She received both a B.S. in business administration and Doctor of Dental Surgery from Loma Linda University.

As interim CEO, Julie will oversee daily operations of the organization, provide leadership where needed, meet all fundraising and activities deadlines, and carry out responsibilities determined by the Search Committee.

Julie is a member of the Glenner Centers’ board of directors and LightBridge Hospice Community Foundation. She lives in Alpine with her husband, three children and many four-legged friends.

No, It's Not Old Age for 60% of People

2011-11-07T10:14:00.000-08:00

Just read a startling statistic in a UK publication. "Six out of ten people with Alzheimer's and other forms of dementia go undiagnosed, figures revealed yesterday. Almost 400,000 individuals and their families are failing to get vital help from the NHS, according to campaigners. But up to two thirds of adults don't understand the differences between normal signs of ageing and symptoms of dementia, says a survey."

So often we fail to recognize symptoms in ourselves or our loved ones, simply because we don't want to face the consequences - maybe either way. Even with normal aging, most of us reach a point when we need assistance and with it, some loss of independence. Earlier this year members of The George G. Glenner Medical Advisory Board gave a great presentation on signs of normal aging versus dementia. In light of this survey, we thought it might be a good idea to resurrect that slide show. It's easy to follow and full of useful information as you try to decide the best solution.

Is It Normal or Is It Dementia?

View more presentations from GlennerCenters

Daily Mail Article: 2/3 of Adults Don't Recognize Dementia Symptoms

Alzheimer's Hits the Workplace in a Big Way

2011-11-02T16:43:00.000-07:00

The other day a group of social workers gathered informally and the discussion turned to Alzheimer's. More people are being diagnosed at an earlier age when they are still working. Today's Chicago Tribune illustrates the struggles of those diagnosed with early-onset Alzheimer's Disease in an article about the tough choices that must be made by both employees and their employers and co-workers.

The article also taps into an even larger concern: caregivers trying to hold it all together at work while their loved one is mentally and maybe physically deteriorating at home. Consider this passage:

At Harris, Rothenberg International, a provider of employee-assistance programs for corporate clients, there has been a 100 percent increase since 2009 in the number of calls for help dealing with employees who have Alzheimer's or with employees who are saddled with demanding caretaking responsibilities for a loved one.

"The recession is keeping some people at work long after they intended to retire because they have to work," said Randy Martin, director of clinical services at Harris, Rothenberg. "A lot of people also want to keep working simply because of desire. Whatever the reason, employers are encountering more people with dementia in the workplace."

And this:

"Sixty percent of caregivers for people with dementia are employed full- or part-time," Martin said. "It's a major drain on their ability to focus at work. They need all kinds of support to help care for their parent or spouse or relative."

Many caregivers do not realize there's an option between in-home care and assisted living or a skilled nursing facility. Adult day care programs can bridge the gap in care while a spouse or adult child is at work. If you or someone you know is in this situation where the cost of caregiving is seriously impacting their ability to work, consider contacting one of our adult day care centers to determine if one of our programs is an ideal solution. You can contact us at 619-543-4700.

Article: Alzheimer's Forces Workers to Make Tough Choices

Happy Halloween

2011-10-31T11:12:00.000-07:00

The triplets paid our Hillcrest Center a visit for Halloween. We do a lot of multigenerational activities, and the participants love when babies come for a visit.

Clothing That Keeps Alzheimer's Patients from Wandering

2011-10-25T09:02:00.000-07:00

I remember years ago hearing about research being done at M.I.T. to embed technology into our clothing. It sounded far-fetched at the time but toda, we're seeing such an application with the announcement of $300 shoes containing GPS technology to track Alzheimer's patients who may wander.

Though the price point may be an issue for some cash-strapped families, this is a great example of "functional clothing" that does double duty as both garment and device. And wandering is an issue with many families who have a loved one at home requiring constant monitoring.

Article: GPS Shoes for Alzheimer's Patients

2011 Memory Walk in San Diego

2011-10-24T09:15:00.000-07:00

These are several of many photos taken by staff member Claudia Gonzalez during Saturday's Memory Walk through Balboa Park. Once again the crowds did not disappoint, and this year the Alzheimer's Association added flowers for caregivers and surviving family members to hold during the walk. It made for an even more spectacular event.

We have plenty of other photos that you can view on our Glenner Centers' Facebook Page. Check it out, and if you aren't already a Fan, be sure to 'Like' our page. Thanks!

Our Dawn DeStefani Answers Your Alzheimer's Questions

2011-10-20T13:39:00.000-07:00

Tomorrow at 10 a.m., Dawn DeStefani, our director of programs and services here at The George G. Glenner Alzheimer's Family Centers, will be the guest on Alzheimer's Speaks, a Web-based talk radio program hosted by Lori La Bey.

You can access the online interview live here.

There's also a call-in number to ask Dawn questions about ways to improve the quality of life for everyone in the family when dealing with a loved one with memory loss. We look forward to listening in and even hearing from you tomorrow morning.

It Takes a Village

2011-10-18T15:48:00.000-07:00

The George G. Glenner Alzheimer's Family Centers provide a valuable service to families in San Diego County: a safe, structured and social environment for those with memory impairment. Among our beneficiaries are the primary caregivers who can work, rest, volunteer or run errands knowing their loved one is in a great place.

Caregiving is a 24-hour job, and the advent of Web 3.0 has moved the World Wide Web from merely informational to interactive. As a result, caregivers with access to the Internet, whether using a PC or smartphone, now more resources than ever at their fingertips. They also have more access to each other.

One online Web site we wanted to bring to everyone's attention is Caregiver Village, which uses avatars and games to provide useful information and connections to those dealing with the stress of caring for someone with special needs. Alzheimer's and dementia is one such subset of the Caregiver Village. There's even a book club for those who not only want to read but share what they've learned. There's good data, displayed in a unique manner, that makes Caregiver Village worth a look.

Emma's Gut Bucket Band

2011-10-11T13:17:00.000-07:00

Thought we'd share our latest video on our YouTube Channel, featuring a popular bluegrass band in San Diego that performs every few months at our Hillcrest Center. As you will see, they get our participants up on their feet. A great way to exercise and socialize.

Inheriting Alzheimer's Disease

2011-10-04T16:38:00.000-07:00

The top story in today's online version of The New York Times involves a Columbian family with strong genetic links to Alzheimer's Disease, which tends to grab hold of their brains by their 40s and leave them seriously impaired by their 50s. From tests being conducted on members, scientists hope to find new treatments to counter the terminal disease well before symptoms start to show. It's a fascinating tale worth reading. Some family members have made serious choices for fear of "spreading" the disease. One father voluntarily was sterilized once he realized he could pass on the fatal illness.

Consider this passage from another family member being treated at an Arizona facility:

“Psychologically it’s very tough,” said their daughter Natalia Agudelo, 24, who also traveled to Phoenix.
“After they lose memory, what remains are their instincts like animals,” she said, adding that her father can still chew and make other instinctive movements. “Until his last moment, we’ll be there seeing what more we can do to help, what more we can do to love.”

Natalia and her younger brother and sister may have inherited the mutation from their father or, if their mother is a carrier, from her as well. As a result, Natalia has decided not to have children.

“I love babies, and I’d be so happy with children, but having a child isn’t just ‘Oh, how cute,’ ” she said. “You have to be realistic and be clear that the disease is very tough. They say in Medellin, ‘Don’t go spreading the Alzheimer’s around.’ ”

Article: Hoping to Crack Alzheimer's, Together As a Family

Photo of Natalia courtesy of NYTimes.com

Wise Use of Prescription Medications

2011-09-29T14:52:00.000-07:00

Did you know that inappropriate use of medications is among the top 10 causes of death in the United States? We didn’t either until we heard yesterday’s presentation on “Wise Use of Medication” at the Meet the Pharmacist & Senior Health Fair in National City.

Done is quiz form, Maxine Fischer, manager for state operations for AARP, delivered a strong “dose of prescription drug reality” by asking how well seniors in attendance know their prescription drugs. We thought we’d pose some of the questions to you too.

1. How many prescription drugs does the average person age 45 and older take every day?

a) One

b) Four

c) Six

2. What percent of adults 65+ skip does or do not fill prescriptions because of cost?

a) 10%

b) 25%

c) 50%

3. What should you do if you forget to take a medication dose?

a) Consult your doctor or pharmacist

b) Take your medication as soon as you remember

c) Wait for your next scheduled dose

d) Double your next scheduled dose

4. Which is not a safe way to dispose of old medication?

a) Take it back to the pharmacist

b) Toss it in the garbage or flush it in the toilet

c) Crush the drugs, mix them with used coffee grounds or kitty litter and put in a can or sealable bag before tossing

d) Bring meds to community drug disposal, solid waste or pharmaceutical take-back program

5. Where should you store your medicine?

a) In the medicine cabinet, of course

b) In your safety deposit box

c) In a cool, dark, dry, safe place

d) In the refrigerator

Answers: 1.) B 2.) B 3.) A 4.) B, you don’t want old medications getting into the water system. 5.) C, medications actually disintegrate from the moisture produced in bathrooms so medicine cabinets are a poor storage choice.

'Oh, My Aching Back!'

2011-09-26T10:35:00.000-07:00

One of the most common physical complaints among adult caregivers is a back ache, especially if a disabled loved one requires assistance moving from one spot to another. Today’s health tips focus on tips for back care so you can stay strong, for you and for those who depend on you.

Know Your Limits. Do not lift objects – including people – without help if that thing or person is too heavy.

Lift with Care. Keep feet apart for balance, bend your knees to lower yourself and life close to your body. Do not use your back to do the lifting. It’s all in the legs. Also, never pivot – face forward at all times when you are lifting and carrying.

Stay Balanced. A strong back starts with strong stomach muscles. Incorporate core-strengthening exercises, such as Pilates, into your daily routine. If your stomach and back are really weak, consider a back brace until you can strengthen both.

Sleep Firmly. Makes sure you sleep on a firm mattress, and that you do not sleep on your stomach.

Sit Down. Your knees should be higher than your hips when you sit in a car. For additional support, you can use a small pillow or rolled towel.

Stretch Regularly. Stretching key muscle groups helps increase your flexibility and reduce your risk of injury.

Wear Proper Shoes. No high heels. No shoes with flimsy soles (like some flip flops). Focus on comfort and support, even if the pair cost a few more pennies.

Control Your Weight. Goes without saying that being overweight puts additional stress on the lower back.

Maintain Good Posture. As we age, it becomes harder to maintain good posture. Make a point to suck in that stomach and sit or stand tall with properly alighted shoulders and hips.

Why Active Aging is a Bit of a Stretch

2011-09-22T15:45:00.000-07:00

We participated in the annual Active Aging Health Fair today at the Balboa Naval Medical Center in San Diego and are excited to share some of the information we learned from other vendors and experts.

Several booths focused on yoga, tai chi and other non-aerobic exercises that help with weight and stress management. As we age, if we don't ply our muscles, they will contract and result in poor posture and tightness that can make even easy moves -- like tying your shoe or putting on a pair of pants -- become difficult. Even if you have limited mobility, you and a loved one with dementia should be sure to incorporate stretching into your daily regimen. Here are some tips courtesy of the National Institute of Health:

Wear comfortable clothing and thick socks.
As you stretch, you shoulf feel a gentle pull or tug, not pain - which means you've stretched too far. Wait a day or two for the pain to subside before you try that stretch again.
You may feel some soreness following initial stretching sessions. It's normal.
Be sure to warm up, with something easy such as walking in place, before starting the stretches.
Stretch two or three times weekly and rest between workouts.
When you start, do each stretch once or twice and hold for a count of 5. Then work up to a count of 30.
After a few weeks, increase to each stretch to three or four times for a count of 30.
Finally, make your goal to do each stretch five times for a 30-count.

Changes will happen gradually, but you should notice results in 6 to 8 weeks. Be sure to also incoporate other activities such as walks and weights into your weekly workout plan.

Diabetes and Dementia: Stronger Link Than You Think

2011-09-20T11:49:00.000-07:00

Anyone who has helped care for a loved one with diabetes, particularly Type 2 diabetes, know how important it is to monitor their diets and blood-sugar level. Type 2 diabetes has been on the rise for at least a couple of decades and is now the most common form, affected 26 million people in the United States. It's not unusual for someone to have it (sometimes for years) and not know it. Symptoms include:

Increased thirst
Frequent urination
Weight loss
Fatigue
Blurred vision

A new study now says there's a stronger link between those with diabetes and all forms of dementia. In that group, 27 pecent of diabetes developed dementia compared to 20 percent with normal blood sugar levels. That's significant, especially given Type 2 diabetes is preventable and once it develops, manageable through diet and exercise and insulin injections as needed. Other studies have shown similar links, but these particular research project was conducted over more than a decade and involved 1,000 patients, so the results are drawing the medical world's attention.

"Diabetes is a major risk factor for vascular disease," said Dr. Spyros Mezitis, a clinical endocrinologist at Lenox Hill Hospital in New York City. "If the blood vessels are not allowing enough oxygen to get to the brain, you can get dementia."

The study will "change the way we practice medicine" and could lead to quicker referral of diabetics to neurologists when they show signs of memory loss or other cognitive problems, he said.

The goal for patients is to avoid the progression of vascular disease and to maintain proper blood sugar levels, he noted.

Article: Diabetes tied to increased risk for Alzheimer's

16 de Septiembre

2011-09-16T13:08:00.000-07:00

It's a big holiday if you happen to live south of the border. Or if you happen to attend our George G. Glenner Alzheimer's Family Center in Chula Vista.

The Power to Heal

2011-09-14T10:02:00.000-07:00

With our focus the past week on how to handle a major power outage, we thought it might be nice to shift into lighter gears and focus on the power to heal, or at least help someone, through small gestures.

One of our most prolific volunteers that we've mentioned here before is Mary Moore, who is 93 years young and continues to fill a room with sunshine as she delivers "The Good News" daily to our Hillcrest participants. Mary selects feel-good pieces from newspapers and magazines for discussion. She also spends a lot of her free time handstiching bookmarks that we can then donate in our "healing baskets" given to area hospital patients of all ages.

We'll have more on our baskets in another blog post. For now, we wanted to share some of Mary's latest work and to publicly thank her for all she does for our center and for our community. Never underestimate the power of creative energy!

How to Handle Power Outages with Dementia Patients

2011-09-12T13:32:00.000-07:00

Last week’s major power outage gave our Glenner Alzheimer Family Centers an opportunity to test their emergency management systems. We asked each of our center managers what they did and what advice they might have for caregivers of dementia patients should they find themselves without any electricity for an extended period of time.

Dawn DeStefani, Center Manager for our Chula Vista Center:

What We Did: Since we practice emergency drills once per month, the staff felt very prepared when the power went out. We do have emergency procedures and a disaster plan that we follow. We ensured that the building was safe and contacted our landlord and security. Our staff did a great job resuming activities and the participants didn’t seem to notice that there was a power outage.

What We Advise: The best thing to do is to remain calm and continue to keep the routine as normal as possible. It is very important to have emergency supplies available, in your car and in your home. This event has reminded us of how important it is to have basics like water, shelf stable food, flashlights, batteries, a radio and gas in your car!

When It’s Unusually Hot: The best thing to do is to find a cool, shady place, if possible. It is also vital to stay hydrated with plenty of water. As long as the water is safe, moist towels can provide comfort to the head and neck.

Sheila Meyer, Center Manager for our Encinitas Center:

What We Did: Our staff did exactly what they should do: put flashlights into use, moved to naturally lighted rooms and remain calm and cheerful. We just continued with the activities that were already in place, a word search.

Most of our participants were raised in an age where TV, computers, and cell phones didn't exist. Radios were listened to in the evening as entertainment. Word search games, balloon toss games, and just plain conversation got us through the end of the day, plus serving plenty of water. In fact, it was kind of fun talking to the participants about the 'good old days' and bringing up old words like 'icebox' 'divan' 'davenport' and 'water closet.'

What We Advise: Remain calm and cheerful. Have a flashlight always ready to go and, if possible, a radio that runs on batteries.

What If It’s Unusually Hot: Stay indoors, wear loose clothing, drink lots of water but cut back on the iced tea/ iced coffee. Those can cause you to lose water.

What To Do During a Power Outage

2011-09-09T12:08:00.000-07:00

Sometimes we "young folks" forget how strong our elders are.

Yesterday San Diego County (and beyond) experienced the largest power outage in its history, with 1.4 million locally enduring hot temperatures and hot tempers due to a power line failure in Arizona that created a cascade effect and knocked out electricity everywhere. My grandmother, 97, lives with us and I worried that she might not be well as I inched toward home in rush hour traffic on steriods. Our cell phones didn't work, so I couldn't call to check in on her.

When I did finally make it home, I found Grandma just chillin' on our coach, staying cool and staying calm. I explained that the power was out everywhere, and her response was, "Really? What's for dinner?"

As I whined on about all of the inconveniences we had to endure, she reminded me that she grew up without electric power on a farm and that our peanut butter and jelly sandwiches (with chips!) would be plenty during the Great Depression. She was miffed that I didn't risk a house fire to make her a cup of tea, but otherwise, she seemed grateful to witness yet another historic moment in a life that has seen many.

Later, sitting in our pajamas on the porch, she joked that the only thing missing from the still and dark night were air raid sirens. Then she seriously asked what we would do if terrorists did strike, gently reminded me that life now was much preferrable to life during wartime.

There are some things the CDC recommends we all do during an extended power outage:

Throw away food in the fridge if the temperature gets about 45 degrees, which happens after about two hours without power.
Be careful of carbon monoxide poisoning when using backup devices beyond a generator or grill
Check with local authorities to make sure the tap water is safe. Boil it for at least 2 minutes (once power's restored) if it's not.
Drink plenty of liquids if it's hot and try not to move around too much to conserve energy.
Turn off all appliances and lights and A/C or fans so there isn't a power surge when electricity is restored.

My grandmother and I talked for a couple of hours before she said it was time for bed and headed off, promising to keep a battery-powered night light by her bedside. I checked on her about an hour later and found her sleeping soundly, her head illuminated by a hallow of light from accidentally turning on the night light beneath her pillow.

I mention this personal tale because sometimes we need to be reminded that though our parents and grandparents become more fragile with age, they remain hardy souls. They also can provide levity in serious situations and put our own problems in proper perspective. Thanks, Grandma. The next cup of tea is on me.

Housework Helps Ward Off Dementia

2011-09-06T10:39:00.000-07:00

We've written before about the value of housework as a way to keep a loved one with dementia engaged and feel like they are contributing to the household. This is particularly true of mothers and grandmothers who were full-time homemakers earlier in life and derived a lot of their personal identity from a job well done. Fathers and grandfathers also took great pride in maintaining a showcase yard.

Today's U.S. News & World Report has an article about another benefit of housework -- besides staying on top of chores and maintaining a clean and orderly place. It's good for your heart and circulation system, which helps keep blood pumping to the brain and may help keep dementia at bay.

New research finds that seniors who expended the most energy doing chores, running errands, taking care of loved ones and simply going about their business were less likely to experience mental declines as they aged.

"All those things that you would never think of as exercise, they get our heart rate up and make our blood vessels pump blood," said study co-author Todd Manini, an assistant professor of aging and geriatric research at the University of Florida, Gainesville. "But we kind of ignored them in the past and thought mainly about volitional exercise, such as jogging. What this study is telling us is those other activities might also count for health benefits."

So grab that mop and lend a helping hand -- or accept one from a senior relative or friend -- and know you are providing an even bigger benefit to your health and to those you love. This is especially true if jogging is not for you!

Article: Routine Chores Might Help Keep Dementia at Bay

Smart Goals for Retirement

2011-09-02T10:40:00.000-07:00

Caregivers need to plan for the future too. One of the talks during yesterday's Senior of Today Conference sponsored by the San Diego County Council on Aging focused on 10 principles of retirement planning. David Lam of Edward Jones offered the following tips that we wanted to repeat here.

This holiday weekend may be a good time to do some "pre-fall planning" and spend some time seriously considering what you want to do once your "retire" and how best to make sure you're financially prepared for a long life. We wanted to focus particularly on No. 5 since all it takes is one crisis to drain someone's personal savings.

1. Map Out Your Goals

2. Plan for a Long and Fulfilling Retirement

3. Start Smart with Your Spending

4. Inflation Doesn’t Retire

5. Prepare for the Unexpected

6. Don’t Reach for Yield

7. Maintain a Healthy Portfolio

8. Keep Retirement from Being Taxing

9. Define Your Legacy

10. Remember Your Annual Checkup

Signs There May Be Trouble at Home

2011-08-29T15:00:00.000-07:00

Some tough decisions are required when it comes to adult children of a parent with Alzheimer's or another form of dementia. One of the toughest is admitting when there is a problem. Spouses may try to hide the other's shortcomings for fear of losing independence. Families may have difficulty charting a course of action. But sometimes the most difficult part is coming to terms it's time to intervene.

Here are some signs someone may need help, courtesy of the latest San Diego Eldercare Directory. Thanks to Ginny Wallis for passing these along.

Mail piles up
Bills go unpaid
A previously well tended house falls into disrepair
Trash cans no longer get put out or picked up on the proper days
More clutter than usual
Appliances are misused or ignored
Driving and judgement are impaired (inattention, forgetting to get gas)
Sudden shift to poor personal hygiene
Incontenance
Walking or balance problems
Difficulty locating familiar places, even at home

Be aware parents may be reluctant to discuss issues happening within the home. But it's important if there are strong enough signs to take action, beginning with a talk, to help them before a situation becomes dangerous.

'Make It Work'

2011-08-26T10:37:00.000-07:00

Anyone who's a fan of the reality TV competition Project Runway is familiar with mentor Tim Gunn's trademark expression, "Make it work." It's advice for designers to do the best they can with what resources and time is left.

That expression was underscored this week when University of Tennesse women's basketball coach Pat Summitt announced she had early onset Alzheimer's Disease and intended to continue working as long as she could.

Alzheimer's is a terminal illness, something we sometimes forget because the disease can take up to 20 years before it claims a life. The average, though, is 8 to 10 years and typically 5 or less for those diagnosed before 65. A lot has to do with any other health factors which could undermine or extend life spans.

At 59, Summitt is one of the most successful coaches in college history and said she wants to continue working as long as possible. Many of us derive at least part of our personal worth from our occupations, and it's one reason that it is important to making loved ones continue to feel valued. If they were a lawyer, you might send them into a home office to do "research." If they worked retail, they may enjoy folding laundry and displaying it on a dining room table. If they were a homemaker, a simple meal they can prepare would make their day.

Consider ways that you can help your loved one with dementia continue to feel productive in the early stages, when they still have the cognitive ability to perform simple and maybe even complex tasks. It will go a long way in making their day - and yours.

Aloha from Hillcrest

2011-08-22T10:35:00.000-07:00

Here's our latest video from last week's Luau at our Hillcrest Center:

'Is it Normal Aging or Dementia'

2011-08-17T14:01:00.000-07:00

Is It Normal or Is It Dementia?

View more presentations from GlennerCenters.

We recently posted about this subject, but not in as much detail as this slide show. This is definitely worth a look if you not only want to know the differences but how to maintain a healthy brain as long as possible.

When Is Enough Enough?

2011-08-16T10:50:00.000-07:00

This morning a report is out showing moderate amount of alcoholic beverages might stave off Alzheimer’s and dementia. This is potentially good news to those who like a glass of wine with dinner or to have a beer with friends on the weekend.

Others studies have proven that those who drink too much are at greater risk of Alzheimer’s and dementia. Here we’re referring to alcoholics who drink (now or at an earlier stage of life) to excess on a regular basis.

What can be confusing is determining what amount of alcohol may carry benefits and what amount may carry risks.

The new Loyola Study suggests heavy drinkers consume 3-5 drinks per day, implying that those in the “safe zone” to actually improve their cognitive longevity imbibe 1-2 drinks per day at most. Though no solid rationale is given for why a little helps, the study suggests smaller amounts of alcohol have health benefits, including opening up blood vessels that allow more blood to flow to the brain.

The opposite effect from heavy drinkers is the result of the alcohol damaging brain cells and therefore raising the stakes for the person to develop dementia.

The Loyola University researchers also do not recommend non-drinkers take up alcohol to help stay mentally active. Instead, they should focus on a sound exercise and diet regime that also keeps the blood flowing and brain in good shape.

Options for Hiring an In-Home Caregiver

2011-08-12T14:49:00.000-07:00

Yesterday we mentioned some of the risks of hiring an in-home caregiver, particularly if you opt to privately hire from public sources without doing a proper background check. Today we’re following up that post with one outlining options for the main types of caregivers. As with the last entry, the information is from a Health Care Reform Expo held last week in La Jolla and sponsored by local members of CAHSAH. This information comes from a presentation titled “A Pivotal Year for Health Care” given by Brittnei Salerno, president and CEO of La Jolla Nurses Homecare.

Option 1: Hiring a Caregiver Directly

This includes finding someone using online or newspaper ads or church and community bulletins. The cost to hire is low but risk is high.

• You are responsible for checking references and doing a complete background check. (By law in California, you can request one from the Department of Justice.)

• The patient, as the employer, is responsible for deducting payroll taxes and obtaining Workers’ Compensation Insurance.

• The patient does the hiring and the firing, which can be both awkward and difficult depending on circumstances.

• Be sure to tell the caregiver exactly what you expect of them and how they should be carried out.

Option 2: Hiring Through a Direct Referral Agency

The cost for using an agency is moderate and the risk is high.

• There typically is a fee to help the patient hire a caregiver

• The patient is the employer and responsible for supervision, payroll taxes and Workers’ Compensation Insurance

• If it doesn’t work out, the patient does the firing and must start the process to find a replacement

Option 3: Hiring Through a Full-Service Agency

The cost is moderate to high and the risk is low.

• The agency is the employer and takes care of the screening, hiring, firing and payroll

• The agency is liable for the caregivers’ actions while employed with them

• The agency finds a replacement if needed

• Caregivers may be eligible for employee benefits, such as health insurance and 401(k) retirement accounts

The Risks of Hiring a Caregiver

2011-08-11T15:55:00.000-07:00

Last week in San Diego, a caregiver was charged with the murder of an 89-year-old Rancho Bernardo man who disappeared last fall. The case once again highlights how important it is to carefully screen and monitor in-home caregivers.

The percentage of seniors in need of ongoing assistance with daily living activities is expected to double by 2025, according to Brittnei Salerno, who spoke at a Health Care Reform Expo sponsored by local members of CAHSAH.

When a parent in particular requires more care than the family can manage on its own, a common course of action is to find an in-home caregiver so Mom and Dad can age in place. More than 50% find family members to help, while others privately hire someone through classified ads, church bulletins, word of mouth and other informal avenues. Still others use referral or employer-model agencies.

Most states, including California, have no licensing requirements for aide-level care.

The California Senate Office of Oversight and Outcomes examined private duty home care and found few Californians who hire caregivers on their own know they have a legal right to request a criminal background check through the Department of Justice.

During the state Senate committee examination they determined:

• More than 25% of caregivers from Craigslist and newspaper ads had previous criminal histories

• Crimes ranged from shoplifting and burglary to assaulting a patient and impersonating a registered nurse.

• Using 7 years’ worth of newspaper ads for caregivers, 64 had legal trouble from transgression on the job

• In 27% of those 64 cases, the caregiver had been previously convicted of a crime

• In 13 of those 17 cases, the old crimes mirrored the new crimes

Something else to consider is if the caregiving situation doesn’t work out. Hiring is easy; firing is not. Some are reluctant because they do not have a backup plan and others are fearful of retaliation.

Next Up: What to consider with various caregiver options

'The Unkindest Cut'

2011-08-09T10:44:00.000-07:00

Last night we listened online with others as guests on KALW’s “City Visions” discussed what will happen to the 34,000 to 37,000 families impacted by the elimination of Adult Day Health Care in California. From the experts and those who called in to the segment titled "The Unkindest Cut," it’s apparent there’s already some movement.

One hospital ER worker has seen an increase in elderly patients since a nearby adult day health care center closed due to budget cuts. Another noted that there’s now a 4 to 6 months waiting list for skilled nursing homes in her area since the local ADHC closure created sudden demand for a limited number of beds.

To those locally who are wondering about our Glenner Centers: We intend to remain open!

The first half of the live broadcast focused on how we reached this point, with the legislature first voting to eliminate ADHC and then the governor vetoing it’s replacement, Keeping Adults Free from Institutions (KAFI).

Assembly member Mariko Yamada (D-Davis), who chairs Chair of the Assembly Committee on Aging and Long-Term Care, told the audience she never would have voted as she did had she suspected Gov. Jerry Brown would veto KAFI.

“It is a vote that I will regret for the remainder of my career,” she said.

During the show, Yamada noted the “silver tsunami” that’s arrived -- referring to the vast number of Baby Boomers turning into senior citizens and requiring more long-term care options. Even with the large number of ADHC recipients today, she said, “we do not have the capacity to place everyone that would need to be institutionalized.”

Someone who operates an ADHC within the Chinese community of San Francisco called to say 43 percent of residents in his area live alone, do not speak English and do not want to give up their family doctor, let alone move to a facility. “We provide medication management and we remind them to take medicine at hime. If we’re eliminated, I worry they will become confused with medications.”

Michelle Pope, who operates Alzheimer’s Services of East Bay, was more blunt in her predictions.

“I think it’s going to be catastrophic,” she said. Ninety percent of those served at her ADHC have caregivers who work. “It’s short-sighted to throw our seniors and their communities under the bus when they need us most,” she said.

Yamada agreed. “People will have to make a choice between their jobs and taking care of their loved ones, and that is a choice no one should have to make, especially in this economy.”

You can listen to the broadcast later this week when it is posted on at www.kalw.org.

'Planet of the Apes' Stars James Franco ... and Alzheimer's

2011-08-08T09:47:00.000-07:00

The new science fiction thriller Rise of the Planet of the Apes opened to great reviews this weekend. While we typically don't endorse movies on our blog, we did want to point to something in this one that might be of interest. A key element of the plot is Alzheimer's.

We won't delve too much into the plot, but do know that the disease and search for a cure plays a vital role in the film. James Franco plays a scientist with both personal and professional reasons for wanting to eradicate Alzheimer's: his father has the disease. Someone did their research because in many ways Franco's caregiver role seems realistic, as does how the disease plays out in his father, played with aplomb by John Lithgow.

We could go on and on, but we hate spoilers. So we'll leave with just one other interesting tidbit that may or may not have influenced the story line: The wildly popular 1968 original of the Planet of the Apes starred Charleton Heston, who died of Alzheimer's Disease in 2008.

Upcoming Radio Program on ADHC Elimination

2011-08-05T11:46:00.000-07:00

We wanted to pass along information on an upcoming program that is of interest to all of us in California, whether your loved one is currently enrolled in Adult Day Health Care or not.

This is from the California Association of Adult Day Services:

Tune in Monday August 8th from 7:00 to 8:00 PM for a live radio program on KALW in the Bay Area on City Visions hosted by Joseph Pace on ADHC elimination.

CAADS member Micheal Pope, Executive Director of Alzheimer's Services of the East Bay, and Elizabeth Zirker, Staff Attorney with Disability Rights California will be interviewed along with Assembly Member Mariko Yamada, Chair of the Assembly Aging and Long Term Care Committee.

The tentative title of the show is "Unkindest Cuts: The Threatened Closure of California's Adult Day Health Centers."

I encourage you to tell friends, colleagues, and interested constituencies about the show and that they are invited to call in or e-mail questions. I am aiming to send you a more detailed description of the show by tomorrow that you may forward.

For your information, the studio call-in line is (415) 841-4134, and comments and questions can be emailed in advance or during the show to feedback@cityvisionsradio.com.

You can listen live on www.kalw.org (click listen live, then click either windows streaming or mp3). You can also listen live at the time
the show airs on cityvisionsradio.com. A day or two after the show there will be a link to listen to the program which in turn you can link to
any other website.

Normal Aging vs. Alzheimer's

2011-08-05T11:39:00.000-07:00

A hot topic at yesterday's Caregivers Town Hall Forum in Carlsbad was how to distinguish a normally aging brain from one with dementia, particularly Alzheimer's. Dr. Daniel Sewell, a UCSD geriatric psychiastrist and member of the George G. Glenner Alzheimer's Family Centers Medical Advisory Board, offered these examples to help you tell the difference:

Normal Aging: Being more outspoken.
As we accumulate more life experiences, we can feel more compelled to share those experiences and particularly lessons learned from them with others. We can at least appear more opinionated because, again, we have many years of keen observations upon which to draw conclusions.
Dementia: Being inappropriate when speaking.
Those with brain cell damage say things that violate rules of etiquette and/or are deemed socially inappropriate. They do not filter their thoughts before speaking them, regardless of the need for sensitivity.

Normal Aging: Being less concerned about what others think.
As we age, we become more competent -- and confident -- in our decisions and less dependent on approval or validation from others.
Dementia: Being disrespectful of others' rights and boundaries.
Someone with dementia may use another's property or possessions without permission and be confused and hostile when confronted.

Normal Aging: Becoming hypochondriacal.
The more aware of our bodies, the more we consider suggestive symptoms of illnesses we hear or read about.
Dementia: Becoming preoccupied or delusional about non-existent illnesses.
These people become so convinced of an illness despite medical evidence to the contrary that it becomes a major preoccupation or they become delusional.

Normal Aging: Becoming more vigilent.
As we age, we become more aware of the need to adapt our lifestyles or environment to avoid hazards that can produce, say, falls that can have dire consequences. An example is taking more time going down steps and always using a handrail.
Dementia: Developing disabling anxiety.
While normally aging people will take steps to reduce risks, those with dementia begin to altogether avoid people and places for fear of something that may not ever happen. For example, rather than taking more precautions going down stairs, this person refuses to use stairs out of an abnormal fear.

Normal Aging: Worrying about becoming a victim of fraud.
We constantly hear of criminals who exploit the elderly, and it makes seniors more aware of such situations.
Dementia: Becoming excessively paranoid of people.
Someone with dementia is not just wary but suffers from paranoid delusions that limit their quality of life.

Normal Aging: Coping with loss.
As we age, we start to outlive people important to us. Healthy-brained seniors acknowledge the loss and over time replace lost members of their social network.
Dementia: Becoming socially withdrawn.
Those with an abnormal brain isolate and withdraw from their social networks many months following a loss.

Free Event: The Aging Brain & Maintaining Wellness

2011-08-02T09:27:00.000-07:00

The George G. Glenner Alzheimer's Family Centers and ActivCare at Bressi Ranch is holding a Town Hall Forum for caregivers on Thursday in Carlsbad.

Join us for a morning sesion with Alzheimer's disease experts and learn more about the impact of memory loss on the family. Here are more details:

"The Aging Brain & Maintaining Wellness"

10 a.m. to Noon
Thursday, Aug. 4
Boys & Girls Clubs at Bressi Ranch (Courtyard)
2730 Bressi Ranch Way
Carlsbad CA 92009

Topics include:
Normal memory loss vs. dementia
Defining dementia and the various types
Environmental factors related to behaviors
Nutrition's affect on brain health and general wellness
Helpful tips for family caregivers on daily routines

Speakers:
Daniel Sewell, M.D. - Board-Certified Geriatric Psychiastrist
Neil Levine, M.D. - Board-Certified Internist

To RSVP, call 760-603-9999.

Who Needs the County Fair . . .

2011-07-28T13:22:00.000-07:00

. . . when we have the Encinitas Center Carnival!

Here's a video we created that captures some of the fun and excitement. Be sure to turn up the volume!

How to Communicate with Your Loved One

2011-07-27T09:15:00.000-07:00

This is part two of a conversation in sharing best practices for improving communications with someone with dementia, as recommended by Dawn DeStefani. Dawn manages The George G. Glenner Alzheimer’s Family Center in Chula Vista and recently presented these tips to caregivers at a forum sponsored by Partners in Caring of San Diego County.

Earlier we discussed how to be a great listener. Today we’ll discuss how to be a better communicator using words.

Set yourself up for success. Approach your loved one from the front to avoid startling her and starting off on the wrong foot.

Be aware of tone and body language. Although you are focused on what you say, your loved one will notice friendly gestures. Speak clearly in a relaxed tone of voice to put him at ease.

Keep it simple. Difficult words or long sentences may overwhelmed someone with Alzheimer’s.

Wait for a response. Remember the last post, when we recommended patience? Here’s where it can be displayed. Give your loved one more time to absorb what you’ve said and to respond.

Be clear. Avoid expressions that can be taken literally, like “have a seat,” which can be confusing.

Focus on the keyword or idea. Emphasize the most important word in your message either verbally or nonverbally (pointing).

Account for hearing or vision problems. Make sure your loved one is wearing a working hearing aid and clean glasses, if either or both are prescribed.

Don’t reason or argue. Resist the urge.

Avoid quizzing. Don’t test their memory with expressions like, “Don’t you remember ----“ It’s not helpful and increases their frustration.

How to Help Your Loved One Communicate

2011-07-25T13:09:00.000-07:00

Last week we had the pleasure of attending a caregiver forum sponsored by Partners in Caring. One of the presenters was our very own Dawn DeStefani, who runs the George G. Glenner Alzheimer’s Family Center in Chula Vista. Dawn spoke about ways to best communicate with someone who has dementia. This week we’re going to share her tips, including today’s on how to help a loved one “talk” to you.

The key is to be an excellent listener. Consider employing the following practices:

Show patience. Your loved one can sense when you’re impatient or agitated, which just increases their own frustration. Schedule “cushions” to accommodate minor setbacks and that will help you be patient.

Provide reassurance. If your loved one is having trouble communicating, tell him it’s fine and encourage him to keep trying to put his thoughts into words.

Focus on the positive. Instead of correcting, focus on what your loved one has said and try to find meaning in her message. Smile and be positive…it really does help.

Agree instead of argue. This one is especially difficult because it goes against our norm. If they say the sky is green, do your best to let it go rather than argue it’s blue.

Offer alternatives. If your loved one can’t find the right words, offer a guess as long as he appears to want the help.

Concentrate on feelings. Even if you can’t comprehend the content of a message, often you can uncover the feelings behind it by observing tone of voice, facial expressions, gestures and body language.

Reduce distractions. Try to talk in a quiet, calm place.

Scenes from Our Senior Prom

2011-07-21T15:57:00.000-07:00

Click on the image for a larger version of this collage.

Senior Prom for high schoolers is a special occasion and this prom for our seniors was too. The staff at our Chula Vista adult day health care center thought of everything reminiscent of prom -- from special hats and corsages for the ladies (made during a special arts and crafts project) and paper vests for the men. We even had some caregivers in a support group join us to partner up on the dance floor. There was a special photo area and, of course, the crowning of the king and queen. Thanks to signer Ian Campbell for the entertainment and to everyone that attended for an afternoon full of dancing. Almost everyone was on the dance floor cutting a rug at one point or another.

Hat's off to our South Bay staff! We can't wait for next year's prom.

For more photos, become a fan of our Facebook page by "liking" us.

More News on the Alzheimer's Front

2011-07-19T13:39:00.000-07:00

Here’s today’s rundown of recent news from the international conference in Paris and research publications.

Lifestyle changes can help reduce Alzheimer’s. A new, theoretical analysis finds that about half of the risk factors for Alzheimer's disease are potentially changeable, and that reducing them could substantially decrease the number of new cases of disease worldwide. The study, presented at the International Alzheimer’s Association conference and published today in a medical journal, is the first known analysis that tries to quantify and compare how risk factors are associated with Alzheimer's.

For Alzheimer’s patients, antidepressants no better than placebos. Two antidepressants commonly prescribed to people with dementia appear to be no better than a sugar pill at easing the symptoms of depression in Alzheimer’s patients, according to a new study published today in the Lancet. Zoloft (sertraline) and Remeron (mirtazapine), which are both available as generics, also generated more—and more severe—side effects than placebo, leading the researchers to suggest that these and other antidepressants should be reserved for dementia patients whose depression fails to respond to more conservative treatments, such as psychotherapy.

Predicting Alzheimer’s: Would you want to know? This is a topic we’ve tackled on this blog before, but it was a major area of discussion in Paris. Nice Q&A on whether it’s good to know you have an incurable disease years before it hits its stride.

What's New[s] in Alzheimer's

2011-07-18T15:19:00.000-07:00

There’s a lot of news about Alzheimer’s research coming out of an international conference taking place in Paris. We thought today we’d highlight some of the findings here, just in case you don't have much time to sift through the wealth of news yourself.

1. Brain swelling may be common with Alzheimer’s drugs. An experimental drug that may reduce the beta amyloid protein in Alzheimer’s patients also causes brain swelling in some beta testers.
2. Eye test for Alzheimer’s could revolutionize diagnosis. Researchers find the blood vessels in the retina are different for those with Alzheimer’s.
3. More evidence that football is bad for your brain. NFL players are much more likely to develop MCI, an early stage of Alzheimer’s, based on a voluntary study. In fact, 35% of former players showed signs of dementia by the average age of 61; in the general population, only 13% have Alzheimer’s.
4. Aspirin may have improve memory-thinking skills. Though the anti-inflammatory may reduce the risks, much more research is needed.

Remembering The Car Show

2011-07-14T09:14:00.000-07:00

We just posted a cute video from the South Bay Cruisers' Car Show at The George G. Glenner Alzheimer's Family Centers in Chula Vista. The ending still makes us smile.

Alzheimer's Brought Dad and Daughter Together

2011-07-08T11:44:00.000-07:00

So often when we hear of relationships being strained by dementia that we fail to realize sometimes they actually are strengthened.

This week's selection for National Public Radio's Story Corps that aired today is about a daughter who never got along well with her straight-as-a-pin father until he developed Alzheimer's Disease. Dad was a former Marine who ran a very tight ship, and daughter wanted life on somewhat looser terms. So she left home at 18 but later in life became close to her father, maybe because now his life was a bit more messy too.

Charles Brooks was 78 when he was diagnosed with Alzheimer's. And his condition brought a change to his relationship with his daughter.

"All of a sudden, he turned to me — because he knew that if he had every single drawer out from the dresser on the floor, I really couldn't care less," Betsy says. "So he didn't really hide from me."

In fact, the pair spent more time together, Betsy recalls.

"We would sit on the back porch and eat pistachio nuts and share a beer," she says. And I could tell him my secrets. And I got to enjoy all the good that was in him."

It's a beautiful story. Give it a listen.

Great Dental Tips for Alzheimer's Patients

2011-07-05T09:25:00.000-07:00

To get an idea of how easy it is for someone with dementia to develop dental health problems, try this experiment: chew a cracker and then do nothing. Don’t try to dislodge the mushy mess with your tongue and saliva. Hard to do, isn’t it? We instinctively want to clean our mouths to remove embedded food. However, those with advanced dementia often lose the ability to self-cleanse. That is why the elderly need to visit a dentist, and usually more frequently, to ensure they maintain good dental health.

The cracker experiment was related by Rose Hall, a registered dental hygienist in San Diego, who works with elderly patients at Dr. Jon Peterson’s office. In an interview and subsequent email exchange, she offered great insights and tips to caregivers to help keep their loved one’s teeth and gums from decay and disease, which can lead to tooth (and weight) loss and infections that compromise already fragile health.

“Geriatric patients often have dry mouths because of medications that cause less saliva. Saliva is cleansing and has minerals to help prevent cavities. Older patients have gum recession, which exposes the root of the tooth. Since the roots are not as strong as enamel, the patient is at risk for more cavities. “Most older patients leave plaque along the lower third of the tooth at the gumline. Caregivers should angle a soft bristle brush 45 degrees at the gumline and brush gently with

The type of toothbrush used can also help. Consider an electric toothbrush or one with a bigger handle for easier maneuvering. There can be resistance to brushing, especially in the latter stages of Alzheimer’s, so brush the teeth where the loved one is comfortable, be it in bed or another room besides the bathroom. Also, consider brushing from behind to minimize getting sprayed, and use gloves to keep fingers from infection and from contaminating clean areas.

“For Alzheimer’s patients, it is good to Tell, Show and Do,” Rose Hall continued. “Tell them what you are going to do, show them the brush, and then do the steps in the same way that you explained them. Also, they may need to hold a favorite item for comfort. Interdental cleaning (spaces between the teeth) also is needed which includes flossing and other tools if possible.”

Some people dislike dental visits, and that includes elderly patients. However, Hall says, it’s important that caregivers continue to take their loved ones for regularly check-ups and cleanings to prevent cavities.

When It's Time to Transition: Staff

2011-07-01T09:44:00.000-07:00

This is the third and final post in a series

Earlier we discussed questions to ask about a facility's environment and services specific to dementia care. Today we're suggesting areas to consider asking -- yourself or residential home officials -- about staff. Once again, we thank CAHR for providing this checklist.

Do people, particularly the direct care staff, have special training in dementia care? How many hours? And at what frequency?
What role does the staff have in the care planning process?
What role does the resident and family or legal representative have in the care planning process?
Does someone with special training with dementia patients coordinate the activity program? Are they full time? Do they have assistants?
Is staff assigned to work with the same residents?
What is the ratio of direct care staff to residents at each shift?
Who supervises staff? What are their qualifications?
What special training does the administrator and supervisors receive in dementia care?

When It's Time to Transition: Examining Services

2011-06-29T09:48:00.000-07:00

Second in a series

Earlier we discussed environmental issues to consider when it is time for a loved one with dementia to transition to a long-term care residential facility. Today we tackle services.

As with our other list of questions, these come from the California Advocates for Nursing Home Reform.

Are there activities especially designed for those with dementia?
Do activity programs operate exclusively during the day or are some provided on evenings and weekend?
Are activities individualized for each resident?
Does the facility operate a "Safe Return" program?
Are nutritious finger foods served?
Are water and decaf drinks available through the day?
Do they conduct night checks?
How many staff members are awake during the night?

Up next: Staff

When It's Time to Transition to a Residential Facility

2011-06-27T11:18:00.000-07:00

First in a series

The George G. Glenner Alzheimer’s Family Centers provide a secured environment for those with dementia and other memory impairments. It’s an adult day health care center, which means it’s only open during the day. Many people mistakenly believe we’re a 24-hour residential facility.

While our participants can be with us for many years, sometimes they must move on to a skilled nursing facility that includes or specializes in dementia care. There are many wonderful facilities within San Diego County that provide these services.

This week, we thought we’d outline some questions for caregivers to consider if and when the time comes to make that transition. (And, if the state as now planned eliminates funding adult day health care and in-home health services, many more dementia patients will need to be placed.)

These checklists come from the California Advocates for Nursing Home Reform.

First up, the environment:

Is the facility calm and quiet?
Does it use soft music or natural scents to create a soothing atmosphere?
Is the place well lighted?
Are there complex patterns on carpets or walls?
Can staff easily observe from common and outside areas?
Does the facility have a wander system alert?
Do doors come equipped with a system to delay exit?
Is there a locked and secured outdoor area for walking?

An interesting note: California law requires a resident’s or court-appointed conservator’s consent before he or she may be placed in a locked or secured perimeter facility – the type often utilized for dementia care residential facilities. No one else – including family members or an agent listed in an advance director – may give consent.

Alzheimer's Claims Another Icon

2011-06-24T14:35:00.000-07:00

Today the world lost another icon when actor Peter Falk passed away. He'd had Alzheimer's disease for several years, according to his daughter.

Some of us who are old enough, welcomed Falk into our living rooms as we watched him solve murder mysteries in his own unique way on the long-running television series "Columbo." He also played a role in the iconic 1980s film The Princess Bride.

Some news reports mentioned a 2008 legal battle that began when Falk's daughter went to court seeking conservatorship once her father's dementia had progressed to a certain point. He apparently had named his wife legal guardian after he was first diagnosed with Alzheimer's disease.

The Falks' situation underscores the need for all families to decide on a course of action well before a parent or spouse is in need of a higher level of care. This includes legal preparations such as assigning power of attorney and preparing advanced health directives in the event they are needed. This is good advice for any family but especially so for those whose parents have begun to display signs of dementia.

Glen Campbell Has Alzheimer's Disease

2011-06-23T10:36:00.000-07:00

Yesterday's announcement that country music legend Glen Campbell has Alzheimer's Disease has everyone abuzz. With a new album and tour, Campbell and his wife wanted everyone to understand if he lost track of a song's lyrics or song order while on stage. They made the announcement after a concert review noted his disorientation and accused the performer of being unprepared.

We're guessing that at least initially, the memory slips the Rhinestone Cowboy singer experienced were chalked up to normal aging. This is quite common. But there are some differences between the occasional lapse and the onset of Alzheimer's - a stage of the illness known as Mild Cognitive Impairment. We thought we'd take this opportunity to outline some of the differences.

Click on the image for a larger view

Can Coffee Keep Away Alzheimer's?

2011-06-21T15:47:00.000-07:00

A new research study on mice shows that drinking ample amounts of drip-brewed coffee -- what we might call the hard stuff -- held Alzheimer's at bay.

Though the study still has a ways to go before everyone starts chugging java 'round the clock (and we really mean it since you'll be up for days drinking so much caffeine!), it does appear that caffeine and a mystery ingredient in coffee prevented mice bred to develop Alzheimer's from displaying signs of the disease. It might also help with other health issues.

From an article in a Florida newspaper:

"We found that caffeinated coffee has some rather astounding additions to caffeine that provide protection" against cognitive impairment, said Arendash. The result, he said, was a sharper increase in blood levels of growth factor called GCSF. This protein — granulocyte colony stimulating factor — is known to bolster the human immune system and has shown promise in animal studies for repairing damage from a stroke.
Scientists don't know what other chemical compound is produced when coffee is brewed, but they do know that it is stripped from beverages that are decaffeinated.

Mullan said the large human studies correlating "moderate" coffee consumption — four to five cups a day — with Alzheimer's prevention need to be better understood. The studies showed that people who drank that much coffee in their 40s and 50s had lower incidences of the disease later on.

Applauding the Volunteers Among Us

2011-06-20T10:37:00.000-07:00

This Saturday we feted the men and women who donate time each week to visiting isolated seniors in facilities around San Diego County. They are part of the Guardian Angels program that is funded by the county's Aging and Independence Services agency and coordinated through our George G. Glenner Alzheimer's Family Centers.

In addition to sharing a few snapshots, we also wanted to share some encouraging statistics that Program Coordinator and Event Hostess Nya Moses pulled from the United Way:

• In 2008, 61.8 million Americans (26.4% of the population) contributed 8 billion hours of volunteer service worth an estimated $162 billion, based on $20.25 hourly value on volunteer time.

• Neighborhood engagement levels have risen sharply since 2007, with a 31% increase in the number of people who worked with their neighbors to fix a community problem and a 17 % increase in the number of
people who attended community meetings.

• Between September 2008 and March 2009, more than a third (37%) of nonprofit organizations report increasing the number of volunteers they use, and almost half (48%) foresee increasing their usage of volunteers in the coming year.

• Volunteers were much more likely than non-volunteers to donate to a charitable cause in 2008, with 78.2 percent contributing $25 or more compared to 38.5 percent of non-volunteers.

• About 8.24 million young people ages 16-24 volunteered in 2008, over 441,000 more than in 2007.This increase in young adult volunteers makes up almost half of the overall increase in the number of volunteers nationally.

• Adults who began volunteering as youth are twice as likely to volunteer as those who did not volunteer when they were younger.

Calling All Angels

2011-06-17T09:41:00.000-07:00

Looking forward to tomorrow's "bruncheon" to honor all of our Guardian Angels who've donated time to visit an isolated senior.

A Massive Grassroots Movement Is Underfoot

2011-06-15T11:19:00.000-07:00

Many of you may not be on the San Diego Alzheimer's Association mailing list. But we want to be sure everyone is aware of a movement underway to save adult day health care in California.

Here, in its entirety, is the message that was released. Please, if you know of someone in need or already using these services, consider contributing to the effort to keep many of these 35,000 individuals (not all of whom are elderly or suffering from dementia, by the way) from being placed in more expensive, long-term care facilities or forced into home isolation.

A MASSIVE GRASSROOTS OUTPOURING OF SUPPORT IS NEEDED STARTING TODAY IF WE ARE TO SAVE ADULT DAY HEALTH CARE (ADHC)

Contact Governor Brown's office at (916) 445-2841 and ask him to:

1. Sign AB 96

AB 96 authorizes the state to proceed with submission of a waiver application to Center for Medicaid and Medi-Cal Services (CMS) for a reconfigured ADHC program "Keeping Adults Free from Institutions" (KAFI). The only way to obtain a dollar for dollar federal match of state funding is to get ADHC authorized under a federal waiver.

2. Retain the $85 million appropriation in the budget

This was part of the March compromise to implement KAFI and keep some ADHC infrastructure in place to avoid the greater cost of nursing home admission, emergency room visits and hospital stays for our current ADHC population.

Contact your legislator at (click here to find the phone number for your local legislator) and ask them to:

1. Contact the Governor to:

A. Sign AB 96; and

B. Retain the $85 million appropriation in the budget

Background Information:

The State Senate voted on June 11, 2011 to approve the state budget bill and AB 96 (Blumenfield), which directs the state to apply for a federal waiver for ADHC. The Assembly will vote on AB 96 in the days ahead and is expected to pass. The Legislature must pass a balanced budget bill to the Governor by June 15 or begin forfeiting pay and expenses. It is not balanced until there are enough votes to approve extending the temporary tax measures passed in 2009. Four Republican votes are still needed for any revenue measure. For more information, check out this editorial from the Sacramento Bee outlining the importance of Adult Day Health Centers.

FACTS:

• ADHC is the only community AND medically-based long term support and service.

• The Lewin Group estimated that elimination of ADHC would cost the state $53 million more than it saves.

• In-Home Supportive Services cannot replace the skilled medical services, therapies and social work provided in ADHC.

• The strain on the health care system to absorb 35,000 chronically-ill patients will result in higher medical costs across the system.

Why ADHC Is So Important to Californians

2011-06-13T10:02:00.000-07:00

The other week we met a lot of aging Baby Boomers at the Vital Aging Conference in Point Loma. Most thought The George G. Glenner Alzheimer's Family Centers were residential facilities, and when they learned we operated adult day health care centers, they were intrigued. Despite being around for almost 30 years, a lot of people still confuse our services with those of skilled nursing or assisted living facilities.

But we are very different -- and for many families -- very vital to the entire family's well-being. As a day care center, we allow families to continue to all live under one roof. And as a health care center, we continue to monitor and medicate loved ones as needed during daytime hours they are at our centers. This gives caregivers additional peace of mind, knowing their spouse or parent's medical needs are met as well as their emotional, psychological and physical needs while they work or run errands.

As many of our readers know, the state has had to cut back on its support in the past couple of years, and now it is weighing whether to eliminate funding entirely, then restructure ADHC. There's an interesting piece in an online publication produced by The Pew Center for The States on the impact if the state of California pulls funding for Adult Day Health Care Centers. Consider this passage:

Without Medicaid funding — $170 million from the state, plus an equal amount from the federal government — most of the centers will find it difficult to stay open. The 39,000 elders and adults with disabilities who spend their days at the centers — receiving medical treatment for chronic diseases, as well as mental health counseling and physical therapy — will have to find somewhere else to go.

The state says it will find other Medicaid services for the patients, but elder advocates say there are no other facilities that provide the same kind of care. Many patients will end up calling emergency medical services, going to emergency rooms and getting admitted and re-admitted to hospitals. Some will go directly to nursing homes. Instead of paying $76 per day for adult health care, the state will have to reimburse nursing homes at a rate of $200 per day.

‘The Single Most Important Step’ for Family Caregivers

2011-06-07T11:39:00.000-07:00

During a webinar yesterday on making the most of respite care, the speaker proclaimed that taking time off from caring for a loved one is “the single most important step family caregivers can take.” And yet, so many caregivers – particularly spouses and parents of disabled children – do not take time off to do something they enjoy.

Part of that is cultural. According to speaker Dale Lund, a professor of sociology at Cal State University San Bernardino who’s conducted caregiver research since 1983, research shows we as a society accept that widowhood is among the most demanding experiences in life, while caregiving is not. And yet the two share a lot of traits in common, including depression, isolation, financial stress and sense of loss.

As such, caregivers of the disabled often feel guilty if they take time for themselves or try activities that do not involve everyone in the family. And those who do seek respite care often do not otpimally use the time off, generating even more stress!

According to Dr. Lund, here are some ways caregivers can effectively use respite care, whether it’s being relieved for a couple of hours at home or by enrolling their loved on in adult day care programs such as those offered by our organization. (We were founded by George and Joy Glenner to specifically provide respite care for caregivers of dementia patients.)

1. Begin using respite care early in the “caregiving career.” Caregivers with jobs outside the home are more likely to be satisifed with respite care because they use it to work. However, those who stay at home to be full-time caregivers do not see their roles as "work" and therefore are more resistant to outside help. The earlier respite care is arranged, the better it is for everyone in the family.

2. Use respite care regularly. Research indicates scheduling outside care twice weekly is a good starting point. It can be for just a couple of hours or a couple of days. What’s important is that it’s consistently used.

3. Use respite care in sufficient amounts. Start with two-hour blocks to acclimate and plan activities that can be done during that amount of time. It’s important these be activities that bring the caregiver enjoyment – whether it’s leisurely grocery shopping or taking a much-needed nap. Increase the “dosage” as caregiving responsibilities evolve.

4. Use respite care alongside other services. Consider using some of that spare time to become better educated in caregiving through classes, support groups and counseling. Or, visit the gym or a park or museum. Don't just sit in front of the television, worrying about your loved one.

5. Be careful about volunteering. Caregivers by nature are giving people, and some friends and family members may take advantage of that generosity by requesting help when they know the caregiver is free. For some, volunteering provides a great deal of satisfaction; however, if helping out feels burdensome, let someone else with a different lifestyle and more free time take on those tasks.

Dr. Lund recommends caregivers set weekly goals for how they will spend their respite time and then check at the end of the week to see if those goals were accomplished. Do you feel more rested? Did you catch up on all of your errands that had been weighing on you? Did you get to read a good book or take in a movie you’ve wanted to see? If your respite time was done well, the answer to all of these questions will be a big, “YES!”

When Is Poor Caregiving Criminal?

2011-06-02T10:21:00.000-07:00

Photo courtesy of The Los Angeles Times Web site

As a family service, our organization not only provides adult day health care for those with memory impairment, but we also are an expert resource for those trying to manage the often overwhelming responsibilities that come with caring for someone with dementia.

Family members often are at odds with options for how best to handle Mom or Dad's growing physical and medical needs (as we use Mom or Dad because increasingly -- and ultimately -- it's the adult children, nieces, nephews and grandchildren who bear the responsibilility). Some deny a situation has progressed to the point of intervention; others are desperate for help.

That combination appears to have been at play in the case of a young woman who was caring for an elderly great-aunt with dementia that refused to see doctors or be placed in a facility. They lived in a rural community in California where presumably fewer resources exist, but at some point the elderly aunt's body began to fail her, much as her mind had. When she died, she weighed a mere 35 pounds and was riddled with painful bedsores. First responders said the tiny home reeked of urine and feces from improperly disposed diapers.

The caregiver, now 26, was charged with murder for failing to take the necessary steps to keep her aunt alive. She was jailed and her 4-year-old daughter taken. Her attorneys claimed the elderly aunt, 91, died of natural causes and that the bedsores was the skin organ failing after the woman's weight had dropped to an unsustainable state.

So often the stories of criminal charges brought against caregivers involve more obvious signs of elder abuse, but this stands out as different. The young woman, who apparently lacked much family support up to and including her trial, tried to honor her aunt's wishes, even if they killed her.

The article notes that cases such as these are likely to rise as more adult children try to honor parents' wishes to stay at home as their mental and physical health declines. We at The George G. Glenner Alzheimer's Family Centers work with caregivers to help them make the best choices for everyone in the family. We provide a plethora of possible resources and peer support as they work through difficult decisions.

If you are a caregiver in San Diego and feel overwhelmed by the duties now demanded of you, adult day health care may be a great option. And if it isn't what you're seeking, our staff is available to help you find a solution that is.

Los Angeles Times: Death of 91-Year-Old Spotlights Lines Between Caring and Killing

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Racing for Alzheimer's

2011-05-31T09:19:00.000-07:00

Admittedly, some of us aren't as big an auto racing fan as others, but we can certainly appreciate the dramatic finish at this weekend's Indianapolis 500 that was a win for an "unemployed" British driver and for Alzheimer's.

If you haven't heard already, rookie J.R. Hildrebrand crashed his formula car going into the final stretch, opening the way for Dan Wheldon's second Indy trophy. Among the logos Wheldon wore was one for the Alzheimer's Association. His mother, Sue, was diagnosed at age 55 with Alzheimer's in 2009.

Wheldon choked up when mentioning his mom in a post-race interview and later described the impact the disease had on the entire family. Given there were 250,000 in attendance and millions more who watched the televised event and celebration, the race car champ may have helped a few take note of the disease's prominence in our communities. That makes him a big winner to us too.

Technorati: Dan Wheldon Wins Indy 500 - and Alzheimer's Awareness Wins Too

Come On, Get Moving!

2011-05-25T09:30:00.000-07:00

Today is National Senior Health & Fitness Day, and the perfect day to start making a lifestyle shift if you happen to be sedentary. Even if you are wheelchair-bound, there are ways to tone muscles, strengthen bones and improve cardiovascular systems to help stave off illness and injuries -- both of which become more common as we advance in years. Age is no boundary!

Exercise is a key part of each day at our Glenner Alzheimer's Family Centers, whether it's conducting chair aerobics, walking outdoors or dancing to music. Our participants raise their heart rates tossing beach balls around a room and de-stress with a dose of yoga. We keep it simple, and we keep it interesting.

Daily exercise not only helps keep our weight and blood pressure down, but it's been shown to help slow the development of Alzheimer's and reduce the tension accompanying caregiving. And, in San Diego, the weather is rarely an excuse. Right now the jacaranda are in bloom throughout the county, so make it a point to take a stroll today ... and tomorrow ... and the next day ....

Your body and your mind will thank you.

Glenner Center participants in Chula Vista work out with Therabands
and instructor Kay Bodge.

Depression Hurts Everyone in the Family

2011-05-17T09:54:00.000-07:00

Caregivers of dementia patients have a high rate of depression. One survey by Caring.com puts the number at 25 percent, while the Alzheimer’s Association’s most recent report puts that figure at 33 percent.

At some point in the journey, caregivers become overwhelmed with their current circumstances. Sometimes that continuous worry leads to stress, and that unabated stress can become depression. This, of course, has an impact on the level of care they can provide to their memory-impaired spouse or parent. But what isn’t typically talked about in this context is the toll untreated depression can have on the caregivers’ children. This is particularly true of adult children who are caring for a parent while being a parent to younger children.

According to an article in The Wall Street Journal, untreated depression in mothers and fathers can lead to a similar condition in their children.

"These findings should alert us. If you have the disease, get into treatment, because it can have a big impact on your family," says psychiatrist Madhukar Trivedi from the University of Texas Southwestern Medical Center in Dallas, a co-author of the study. Only about half of people who fit the criteria for major depression get treatment, he says.

The George G. Glenner Alzheimer’s Family Centers began in 1982 to help caregivers cope with their daily stress by offering a place for their loved one to socialize and be supervised for a few hours or a full day. And while the WSJ piece focuses on post-partum depression, a similar condition can develop with those caring for memory-impaired elders. If some of the following symptoms last more than two weeks, you should seek professional help – if not for your own good, then for your family’s.

• Feelings of guilt or worthlessness
• Irritation and agitation
• Inability to sleep well
• Constant fatigue
• Loss of interest in normally fun activities
• Decrease or increase in appetite or weight
• Suicidal thoughts or actions

Sources:
Alzheimer's Caregivers Biggest Health Risk
Alzheimer's Caregivers' Heavy Toll

'Cowboy Bob' Mosies Into South Bay

2011-05-13T10:57:00.000-07:00

If you haven't been to our YouTube channel lately -- and, let's face it, we know you haven't -- then you missed our most recent posting of video from a special appearance by Cowboy Bob, a fixture in the South Bay. The entertainer really connected with our participants and sang songs in both English and Spanish, to everyone's delight.

He was good natured when one of the instruments broke (playing on with a faulty banjo) and when, well, he didn't have enough wind for one of this wind instruments. Watch it and see for yourself.

San Diego State Students In Full 'Swing'

2011-05-10T13:08:00.001-07:00

What a treat for our Hillcrest participants when students from San Diego State University's Music Outreach program came to play for us! The group of talented instrumentalists and singers travel the county each Friday to perform for different groups. We're so glad our central San Diego Center made it onto their schedule. Great times! Great tunes!

How to Hold On To Your Property

2011-05-05T13:34:00.000-07:00

The woman wanted to add her daughter to her bank accounts so she could pay her bills and have access to mom’s money in case of an emergency. So, against her attorney’s advice, she added the daughter to the accounts.

Then one day she discovered $67,000 was missing.

No, the daughter didn’t take it. The IRS did.

It turns out the daughter owed taxes to the federal government and once she became a co-signer, she also became a co-owner of those assets. The bank account was deemed community property and the elderly woman learned a valuable lesson on a common mistake senior citizens make as they advance in years and are reduced in health.

This was just one example La Jolla attorney Heidi Klippel told caregivers during last week’s Town Hall Forum. The topic was estate planning, and Klippel had plenty to say about the best ways to establish a legal decision maker and the documents needed for them to handle a parent’s finances once they can no longer do so.

“There’s a risk any time you put someone else on your asset,” she said.

That includes adding children to the title of your house.

The attorney related a client who put her daughter on the title to her house. The daughter was under insured when she was involved in a drunken driving crash and, as co-owner of the house by title, had the property seized to help pay a settlement, rendering both her and her mother homeless.

Instead of adding adult children to assets, Klippel suggests parents establish living trusts to “house” property and other assets as a way to avoid probate after they die. Trusts are established for specific reasons and provide the following benefits:

Allow a designee (or “trustee”) to manage your assets should you become unable to do so yourself
Avoid probate and transfer your assets immediately to your beneficiaries
Reduce or at least provide for payment of estate taxes

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Medicare Made Simple

2011-05-03T09:49:00.000-07:00

One of the most important yet also most perplexing elements of eldercare is handling health care insurance.

During last week’s Town Hall Forum, Todd Shetter, the COO of Health Care Group, helped Alzheimer's caregivers better understand options under Medicare and how they differ from Medi-Cal. Here is a summary of Medicare benefits Part A, B, C and D. Keep in mind premiums for each varies, depending on annual income.

Medicare Part A: Helps primarily with the cost of hospital stays and “medically necessary” skilled nursing services following a hospital stay. It’s important to note that A requires three admission days (three overnights that include midnight). It does not cover long-term custodial care; you need private insurance for that.

Medicare Part B: Helps with doctor’s visits and other medical services, such as ambulances, lab tests, supplies and outpatient surgery. It also can help provide in-home health services. It does not cover dental, vision, hearing or long-term care.

Medicare Part C: This plan combines A & B so that you are covered for hospital costs, doctor’s visits and other medical services. There is also optional prescription drug coverage. This plan operates as an HMO in that you are assigned select health care providers and requires you have A & B coverage. It also includes dental, vision and hearing exams.

Medicare Part D: Pays for your prescription drugs. You sign up for this benefit during the open enrollment period. If you are on expensive medications, it likely will be reflected in your premium.

Medi-Cal is called Medicaid everywhere except California. This program that helps pay medical costs for low-income residents, including the elderly, the disabled and those with high health care costs who’ve run out of money. It has eligibility requirements, and if you meet them, Medi-Cal will help pay for doctor visits, hospital stays, prescription drugs, rehabilitation, and other medical services.

Preparing for Changes With a Progressive Disease

2011-04-28T14:31:00.000-07:00

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

2011-04-21T15:02:00.000-07:00

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

2011-04-21T09:52:00.000-07:00

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

2011-04-19T10:02:00.000-07:00

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

2011-04-15T13:27:00.000-07:00

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?

2011-04-12T10:05:00.000-07:00

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.

2011-04-08T14:55:00.001-07:00

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.

2011-04-08T14:54:00.001-07:00

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.

2011-04-08T14:53:00.001-07:00

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?

2011-04-07T14:26:00.000-07:00

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?

2011-04-05T11:41:00.000-07:00

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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