A Dad Explains Parkinson's Disease to His Children

Earlier this month a freelance writer wrote about talking to children about dementia. Some forms of Parkinson's Disease include dementia, but not all. Our Hillcrest Center program director, Marge Galante, sent us this wonderful short video that won a big prize recently. We think you'll enjoy it too.

Stressed or Depressed?

Caregiving is not for the fainthearted. Becoming a caregiver means enduring an ongoing series of life transitions. These life transitions lead to stress, because change can sometimes be difficult. While sadness, anger and feelings of loss are absolutely normal, there is a fine line between being stressed, and becoming depressed.

It’s not surprising that caregiving is associated with high levels of depression. The Family Caregiver Alliance quips, “What do lack of sleep, dementia and stress have in common? Answer: They all contribute to increased risk of depression.”

Caregiving is correlated with feelings of: yearning for the past; regret and guilt; isolation; restricted freedoms; life stressors; and systemic health issues. However, it’s the level of grief that is the emotion to monitor.

Complicated grief and a depression begin to occur if we become “stuck in the yuck.” It’s that whirlwind feeling when our mind becomes entrapped in the painful emotional turmoil associated with the transition and/or loss. It’s the days when we can’t get out of bed, or have trouble resuming normal life and activities. Web MD has an extensive list of symptoms to determine if you are stressed, or could possibly be depressed. The Mayo Clinic also provides a list of symptoms. If you do have these symptoms, visit your doctor. Get help.

Speaking of getting help – it’s important not be afraid to ask for help, or to explore different options for alleviating sadness. Depression is often left untreated in caregivers. Sometimes because being labeled as "depressed" may be perceived as admitting weakness, or instability. All to often, though, depression in caregivers is left untreated because its symptoms are misconstrued as the “normal aging” process.

The National Institute for Mental Health states that 14.8 million American adults currently are diagnosed with major depressive disorder. They also state that depression is not a normal sign of aging. Being aware of your own feelings, health, and level of functioning is of the utmost importance.

 Just as you need to put your own mask on in an emergency before a child’s mask so you do not suffocate, you must take care of yourself as a caregiver. If you are feeling depressed, find help and do not ignore the symptoms. After all – you’re stronger then you think!

This post was written by Cynthia Koch, the Community Engagement Associate at the Glenner Centers.

Teaching Your Children About Dementia

By Marcela De Vivo, Freelance Writer
Dementia affects every member of the family, whether you choose to care for your aging parent at home, or have them in hospice care. Stressful and confusing for the patient, and the caregiver, the children in the family are also very much affected by an elderly relative’s dementia. The lack of stability in the home environment, increased tension, volatile moods, and decreased awareness and attention coming from both the parents and from the relative with impaired cognitive abilities can be very upsetting to a child. In order to help your child understand the situation, you’ll have to spend time teaching him or her about the disease and how it is affecting the family and the loved one with dementia. A better understanding of the situation can go a long way in making interactions and transitions smoother and less stressful for all parties involved (especially if you plan on moving your elderly relative into your home). When discussing dementia with your children, make sure you talk about the following points:

• Dementia is a disease that affects the brain, and causes the person with the disease to think and behave differently that before. However, this person still loves you.
•  While dementia is an illness, it is not contagious. Nor is it the result of anyone’s actions.
• Talking to the relative with dementia can be confusing, because the disease is creating gaps in the connections in the brain. So sometimes sentences and words get lost—much like a derailed train that can’t get to its destination.
• The relative with dementia may forget a lot of things, for the same reason they may have difficulty communicating. They might forget basic things, like names, faces, or how to tie a shoelace. Don’t get upset if they call you by the wrong name—instead tell them who you are, or play along like you’re role-playing.
• The person with dementia will be happy to have visitors and to see people who love him/her.

Review the points a few times before you visit, or well before the elderly relative moves in with you.
Be honest when answering questions and be available for questions. While the talking points are a solid guideline, they probably will generate more questions. Be open and available to your children when they ask questions before, during and after a visit. Try to answer as simply and honestly as possible—sugarcoating the situation may lead to more stress and confusion for the child than a direct answer.

Allow them to work through their feelings. Ideally, the honest discussions about dementia should help your children understand the situation from a logical standpoint. However, emotions will still come into play, and your children will react differently to seeing a loved one with dementia. Don’t shame them or scold them for feeling uncomfortable, confused, left out, frustrated and fearful after a visit with the relative with dementia. Let them know that their feelings are normal. Be supportive as they try to find solid footing on which to interact with their changed relative.

Seek outside support. There are organizations and resources dedicated to helping young children to young adults understand and cope with dementia in the family. Encourage them to join groups, read the books or sign up for meetings that allows them to talk to peers about their fears, questions, and concerns.



Celebrate the good times. Encourage your children to remember their “happy” times with their loved one and to develop new ones. Celebrate it by taking pictures of particularly happy moments between your elderly relative and child, or going over existing photos and scrapbooks with your children to help them remember how much your relative with dementia loved them. Find ways for the children to spend time with the relative that is fun and playful for all parties involved. Don’t be afraid or hesitant to talk to your children about the realities of dementia. The more they understand, the better they will be able to handle uncomfortable or awkward situations. Constant interaction will also help them build empathy and compassion, while reminding them of care and love this relative once brought—and still brings—into their life.

Marcela De Vivo is a freelance writer from Los Angeles whose writing covers a variety of subjects from health to technology. As a mother of three young children, one of whom has cerebral palsy, she knows how important it is to be open and honest with any question they may have about health. She encourages parents to speak with their own children about common ailments such as dementia.

Adult Financial Planning: Protecting Property

Today’s post is part of a monthly series by Deborah Higgins, president of Higgins Capital Management, Inc., on adult care financial planning.

By Deborah M. Higgins/ President/ Higgins Capital

My mother is 77 years old and discussing her finances, housing, etc. is extremely difficult. I get, “I know Debbie; I am not ready to move out of my house just yet.” She is of sound mind and somewhat sound body, so making decisions on what to do as she ages only becomes more stressful and difficult for all of us.

My husband’s mother was 81 years old when she called and said she was lonely in her condo and wanted to move to assisted living. The transition for her was seamless. My mother is going to be a challenge. Last month’s blog focus was ascertaining the financial aspects of caring for your parent(s). A list of common incapacity documents was provided.

If you are at the stage where you need to protect property against incapacity, I have attached information on how incapacity is determined and how to begin the protection process. It gives insight into the questions you should be asking:
1) What is incapacity?

2) How is incapacity determined?

3) What happens to your property if you don’t plan for incapacity?

4) What can you do to protect your property?

5) How do you decide what you should do?

(Click on the link above to review the questions.)

Adult Financial Planning: Incapacity Documents

Today's post is part of a monthly series by Deborah Higgins, president of Higgins Capital Management, Inc., on adult care financial planning.

By Deborah M. Higgins/ President/ Higgins Capital

Last month you were introduced to my blog post where an extensive checklist of “where to begin” was provided. I am hoping that you had a chance to review. If you missed it, look for the June 12, 2013 blog post, Adult Financial Planning: Caring for an Aging Parent Checklist.

One key element of the checklist is the assessment of your parents’ financial situation. Are you alone in helping your Mom or Dad, or are other people involved? Does the family member you are trying to help have income from a pension, social security, employment, investment accounts, real estate or other sources? Are these assets properly allocated? Are you in a position to re-allocate to optimize income for care? Do you have an idea of their expenses, their assets and liabilities? The more you know, the more you can look for ways to minimize their monthly expenses to offset the costs of care. Are you on the accounts? Do you have the appropriate documents in place to make decisions for your parent(s)?

Common incapacity documents include:

1) Durable Power of Attorney for Health Care
2) Living Will
3) Do Not Resuscitate (DNR) Order
4) Durable Power of Attorney

(Click on the link above to review the advantages and disadvantages to the common incapacity documents listed.)

Yes, You Can Take a Vacation

The other night some friends and I attended one of those wine and canvas events that are popular right now in San Diego County. While we painted our African sunset (mine more resembles Altoona!), one friend talked about how difficult it was to coax an out-of-town cousin to come visit her for a weekend. Her cousin is the primary caregiver for her parents, both of whom have Alzheimer's Disease. And she's convinced she can't leave them to go on a vacation.

Nonesense, I told her. And in today's Huffington Post, someone else agrees with me.

Taking a break from a loved one in your charge does take planning and preparation. But respite is so vital to a caregiver's well-being that it is worth the extra effort. The key is adjusting expectations and managing the emotions that tether us to loved ones in need.

First, find someone who can take care of your loved one[s] while you're gone. This requires some homework. It could be a trusted relative or a professional service provider. Relatives can be more convenient and less costly, but they may also be less reliable. If a parent or spouse is used to staying home, consider hiring in-home care for the duration of your trip; if they still have a little adventure in them, try a residential facility that provides overnight respite. Will they provide the same level of care you do? Probably not. But your loved one will still be safe and may even enjoy the break in routine. Just be sure you chose the right person or place.

Next, stay near a phone but don't overuse it. Checking in every hour is no way to relax. It's also highly annoying to your host or traveling friends. It's okay to periodically wonder how things are going, and to worry something may go wrong. But having an emergency plan in place and ample instructions for others should hedge any difficulties taking place while you're gone.

Work up to a longer break. Start with an overnight trip, even if its from your home to a nearby hotel. And if that's successful for both parties, make it a weekend trip the next time. Eventually, you might be able to stay away for longer. But in any event, you'll have taken some time to recharge. And that should be of benefit to everyone in the family.

Teaching the Brain to Be More Kind...It Can Happen

Could you or someone you know stand to be a little more compassionate?

Now there’s a new study that suggests compassion can be developed through training. The study published in the journal Psychological Science focused on training young adults in an ancient Buddhist technique known as “compassion meditation.” People focused on visualizing someone suffering and helping them to alleviate that hurt through repeated phrases focused on ease and joy.

The study group first focused on loved ones and then themselves before moving on to strangers. The last exercise was to apply the practice to someone they considered difficult, such as a coworker or troublesome relative.

“It’s kind of like weight training,” reported Helen Weng, a psychological graduate student at the University of Wisconsin-Madison, where the study was conducted. “Using this systematic approach, we found that people can actually build up their compassion ‘muscle’ and respond to others’ suffering with care and a desire to help.”

Next, the same group was trained to become more altruistic, giving more to others instead of themselves. Participants played an Internet-based game with two anonymous players, one a “victim” and the other a “dictator.” Each of the three was given money to spend at will and watched as the dictator player shared very little money with the victim.

“We found that people trained in compassion were more likely to spend their own money altruistically to help someone who was treated unfairly than those who were trained in cognitive reappraisal,” Weng said in a UW-Madison online article.

Other exercises are explained in the article, all of which point to promising results. Weng said she'd like to expand both the experimental and control groups and provided a link to audio downloads and scripts on the Center for Investigating Health Minds Web site.

So if you or someone you know are lacking an appropriate level of compassion in general or in a specific situation, such as siblings sharing in the care of a loved one with a memory impairment, do know that it’s possible to change the way they think and respond and to become a little less selfish and a little more kind. It just takes training the brain to think differently about others around them.

Utah Study Shows Caregivers' Attitudes Make All the Difference

A new study by Utah-based researchers shows caregivers' attitudes make all the difference in how someone with Alzheimer's progresses through the disease.

"The caregiver has a huge influence on the person with dementia," JoAnn Tschanz, psychology professor at Utah Stae University and lead author on the study, said in an article.

"She said data suggest community support agencies are not utilized as much as they could be, and that getting people in touch with such options would be beneficial, as the organizations can help with some of the problem-solving," according to the piece in the Deseret News.

The ongoing study is trying to what those who fare better with Alzheimer's Disease have in common. And Utah is perhaps a good state to conduct such research since it has one of the highest per capita cases of Alzheimer's Disease. This is in part because it's an attractive state to retire and because many Utah residents remain relatively healthy later in life. Age is the biggest risk factor in Alzheimer's.

Researchers have been tracking 5,000 residents for 10 years to study their aging process. Tschanz's study focuses on 223 of those people who developed dementia. She wanted to see what role the primary caregiver played in how the disease advanced.

Overall health conditions, diet and nutrition, and basic demographics are environmental factors that can play a part in the outcomes of Alzheimer's disease, but so do a caregiver's coping mechanisms.

Positive coping strategies, Tschanz said, include problem-focused coping, seeking greater social support and counting blessings. Each helps to slow patient decline.

On the other hand, research found that caregivers who focused on negative coping strategies — such as avoidance, blaming themselves or others, and wishful thinking — resulted in more rapid decline in a patient's cognitive and functional measures, she said.

"If we could slow the progression of Alzheimer's and other dementias, there could be a huge cost savings, but there are also beneficial effects for loved ones," Tschanz said. "Caregiving in itself can be very stressful. It can take a toll on the caregiver's health. Being able to promote higher level of functioning over time would allow individuals to stay in their homes at lower costs to the family and the community."

Free Upcoming Workshops for Alzheimer's Family Caregivers

Spanish-Only Caregiver Forum on Alzheimer's and Dementia Care
A caregiver forum specifically for Spanish-speaking families will be held from 9:30 a.m. to 1 p.m. on Saturday, December 15, at the San Ysidro Adut Day Health Center (3364 Beyer Blvd., San Diego 92173). Learn the neurological explanations for Alzheimer's and dementia and how to manage both a loved one's behaviors and caregiver's stress. Food, entertainment and raffles also will be available. Free day care also is available at the center during this time. To register, call (877) 303-7037.

Living with Alzheimer's for Caregivers: Middle Stage
This two-part series will be held 10 a.m. to 12 noon on Tuesday, Jan. 15 and 22, 2013 at Lantern Crest Senior Living (11010 Sunset Trail, Santee, CA). Learn practical answers to the questions that arise in the middle stage of Alzheimer's Disease. To register, contact the Alzheimer's Association at (800) 272-3900.

Legal & Financial Program for Those with Alzheimer's
The Alzheimer's Association of San Diego and Imperial Counties will hold a program to help those in the early stage of dementia, their care partners and their families members from 10 to 11:30 .m. on Wednesday, Jan. 16, 2013 at the Alzheimer's Association (6632 Convoy Court, San Diego, CA 92111). Attendees will learn the legal and financial issues that may impact them and how to make important decisions and put legal and financial plans in place. To register, call (800) 272-3900.

Know the 10 Signs
This family education seminar will help attendees distinguish between normal aging and Alzheimer's disease. The session will be held from 9:30 to 10: 30 a.m. on Tuesday, January 29, 2013 at Neighborhood House (795 Boundary Street, San Diego, CA 92113). To register, contact the Alzheimer's Association at (800) 272-3900.

Teenaged Caregivers to Alzheimer's Parents

When Diane Darby Beach, Ed.D., was working on her dissertation in the 1990s, she had trouble finding enough subjects: adolescent children living with a family member that had Alzheimer's Disease.


Today, there are more children to choose from for studies, but instead of living with a grandparent, these young men and women are helping a parent who has early onset Alzheimer's or another form of dementia.

These often are children born to older parents in their 40s or who were adopted by an older parent. Also, 1 in 8 children in the U.S. are being raised by grandparents.

There has been much said and written about adult children sandwiched between taking care of their own children and their parents. But less known are children having the manage an older parent through diseases of aging. There is no doubt the experience impacts such a child in ways both small and profound.

Two years ago one such Missouri teenager was featured on CNN. "The most recent data available from the association, released in 2003, estimated that 250,000 U.S. kids under 18 are unpaid caregivers for people with Alzheimer's," according to the report. "'It's not at an age to care for a parent with Alzheimer's."

No doubt that number has grown just as the number of people diagnosed daily with Alzheimer's has ballooned.

One resource for children that might be useful is from the Alzheimer's Association called Kids & Teens. It too seems to recognize the growing phenomenon.

As professional and family caregivers, we need to mindful of younger members of society who may be struggling with aging parents and with far more limited emotional and financial resources. And we need to pay more attention since they are our future.

The Caregiver's Health Is Impacted

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

When Is Poor Caregiving Criminal?

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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Preparing for Changes With a Progressive Disease

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


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

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

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

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

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

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

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Are You Mom's Favorite?

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

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

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

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

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

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

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


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Planning for the Future . . . and Now

This week the Alzheimer's Association released a report showing there are roughly 15 million U.S. unpaid caregivers of dementia patients, which amounts to about $202 billion in savings by taking care of Mom and Dad (or a grandparent, a husband or wife, aunt or uncle, sister or brother, . . .) at home, rather than placing them directly into a facility. The report also shows the heavy toll caring for a loved one with memory impairment is taking on these men and women. A third of them report suffering from depression, and stress is running near 100%.

These kinds of figures have gained the news media's attention and in many cases, news organizations have drilled down to state and local levels to explore the economic and emotional impact. One syndicated article on California cites the following:

Alzheimer's is the sixth leading cause of death in California. If trends continue, it will become an even more significant factor in mortality. The number of deaths attributed to the disease increased by 58 percent in the period from 2000 to 2004, the last year for which data are available, the Alzheimer's Association reports.

Current projections are that those who reach age 65 will have a 1 in 8 chance of developing Alzheimer's. Once individuals reach 85, they will have a 50-50 chance of developing the disease.

Article: California planning for increase in Alzheimer's cases

Here in San Diego, our ABC affiliate, HGTV, came to our George G. Glenner Alzheimer's Family Center in Hillcrest yesterday to interview our center manager, Marge Galante, about how Alzheimer's is affecting families throughout our county. She did a wonderful job, and we hope you'll tune into channel 10 this weekend to see their report. (We're waiting to find out when exactly it will run.)

The Alzheimer's Association report urges lawmakers to prepare for the increase in families needing support in the coming decade -- advice that arrived just after the key legislative committee voted to ax state support for adult day health care centers (one of the most cost-effective programs) and create a new agency responsible for a much smaller budget.

We're at a unique period in our society in which the population is pressing into retirement ill prepared for a debilitating disease such as Alzheimer's. Many of these individuals lost from a little to a lot of their nest eggs in the Great Recession and will be relying on family members to help them through the tough journey ahead. These caregivers frequently will have jobs and financial responsibilities related to raising families of their own. They too will quickly be overwhelmed by the additional time, money, patience and empathy required for their new role.

Each generation learns something from its elders, and one lesson will be to take action while healthy for a time when they are not. Long-term health care insurance will become more popular in the coming decades, but in the meantime, we each need to do our part to help our neighbor make the most of the challenging years ahead.

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To Prevent Falls: Declutter Your House

Nothing affects someone's care more than a serious fall, whether it involves the caregiver or the loved one they are responsible for. Such a fall can land someone in the hospital and require weeks or months of convalescence.

There are things you can do to minimize the chances of a fall, at least within your home.

Modify Your Environment
First and foremost, declutter. Remove ottomans that someone can trip over. Take away tables with sharp edges that someone's cane or clothing can catch on. Make sure dining chairs are tucked in when not in use. Also, remove loose rugs and, if you must, replace them with coverings that have a stronger floor grip. Make sure there are no cables, furniture, plants or other obstacles in hallways and high-traffic areas.

Worried about stairs? Put up "toddler gates" to keep someone from wandering up or down them.

Watch the Medications
"Family and caregivers need to understand every medication has side effects," internist Neil Levine told caregivers during last week's Town Hall Forum in San Marcos. Some medications could impact a person's balance. This includes anti-depressants. Others, such as sleep aids, may induce sleepwalking. Ambien, for instance, has been known to cause psychomotor cognition problems that can make someone fall. Dr. Levine recommends if a person cannot sleep with up to 10 mgs, get rid of the medication. Blood pressure medication also can cause dizzy spells with changes in dosages. Talk to your physician to see if there's a way to reduce side effects.

Get Some Sun
Lack of vitamin D has been linked to falls due to weak muscles and bones. We each should get 1000 units daily, preferably from different sources and not just supplements. In addition to milk and dairy products -- particularly eggs -- exposure to sunlight is a great way to soak up this important nutrient.

Eat a Balanced Diet
Along the same lines, make sure an elderly person's diet includes protein. Most people have no problem eating enough carbohydrates, but protein is another story. Some continue to bypass daily products because of cholesterol concerns. One way to make sure 40% to 50% of their diet is from protein is to introduce protein shakes, such as Muscle Milk, into their meal plan. The chocolate-flavored Viactiv chews and even peanut-filled Reese's Pieces will work too. And who doesn't like chocolate, right?!

Changing the Public's Perception

By now most of you know that yesterday R. Sargeant Shriver, 95, died of Alzheimer's Disease. He was best known for launching The Peace Corps, a public service organization founded by his brother-in-law by marriage, President John F. Kennedy.

So often public figures recede from the limelight once illness steps in, but the Shrivers allowed people to see a bit of their family's battle with Alzheimer's after their patriarch was diagnosed in 2003. In doing so, they helped remove the stigma attached to the memory-impairment disease and created greater awareness of its symptoms and prevalence. Maria Shriver in particular, because of her role as a media celebrity and former California First Lady, has been a strong advocate.

In today's Los Angeles Times (originally posted in The Baltimore Sun), University of Maryland Professor William Thomas notes that it was the family's approach to Alzheimer's that impacted our perception of people dying of the disease.

"Instead, he was a person living with Alzheimer's, and that's an absolutely crucial distinction," Thomas said. "What the Shrivers were about were sort of normalizing this disease. It is important for people of stature, like the Shrivers, to step into the light and to be seen and to tell their story, because so many other people feel like they can't do that."

Thomas calls Alzheimer's a "silent epidemic." The number of people with the disease is growing, but they are often an invisible group, living many times in nursing homes, away from society at large.

You can read the full article here.

Dawn's Story

Many of you who read our blog are caregivers, so we thought today we'd share a story that appears on the cover of our newest George G. Glenner Alzheimer's newsletter.

It's by one of our caregivers and it's a story that everyone can relate to. She talks about the symptoms that announced her father's mental decline and her resistance to becoming his caregiver. Shifting roles between parent and child is extremely stressful, but it's also necessary. Dawn deftly describes her anguish with feeling trapped in the house and finding our adult day health care center, which allowed her to get back parts of her day while knowing her father was safe and engaged.

You can read Dawn's story here.

Meaningful Activities for People with Alzheimer's Disease

Structure is important for both the caregiver and their loved ones. And scheduling purposeful and meaningful activities benefits both when the right activities are planned ahead and involve family and friends when possible. Here are some activities that caregivers may consider while caring for someone with Alzheimer's Disease, according to the National Institute on Aging. Some of these work best in the early stages of Alzheimer's, and some can be accomplished in later stages as well.

Around the House
Help cook or bake
Provide company during mealtime preparation
Wash or sort dishes
Set the table
Clip coupons
Sort recycling material
Water the plants

Family and Pets
Play simple board games
Read stories or books aloud
Take a walk in the park
Look through photo albums
Visit the zoo
Play with a pet
String food chains for kids, pets or holiday decorations


Art and Music
Play CDs of music that evokes memories
Talk about their favorite music or artists
Sing or dance to their favorite songs
Attend a free concert in the park
Draw, paint or sculpt

Make sure everyone gets some "fresh air" by going for daily walks outside or, during inclement weather, in a mall, museum or other walker- and wheelchair-friendly place.

Taking Care of the Caregiver

Earlier this week Dr. Marc Ringel appeared on a Colorado public radio station in a piece called “The Hardest Job There Is.” It was about the physical, mental and emotional toll of caring at home for someone with Alzheimer’s disease. It’s a piece that every primary caregiver – and right now there are 10 million of them across the U.S.A. – can relate to.

Consider this passage:

Out of love, and sometimes for financial reasons too, people make the most amazing efforts to keep demented elderly out of institutions. In early stages of disease, there may be no more challenge than to keep an eye on a forgetful housemate some of the time. The need for supervision will inevitably progress as confusion and wandering come into play, to the point that a competent person needs to be present 100% of the time.

Caring for the Caregiver also was the theme of last week’s Town Hall Forum in San Diego. Among the speakers was Alejandra Ceja-Aguilar, director of education and outreach for the Southern Caregiver Resource Center. This week we’re going to feature some of her tips to help caregivers stay well themselves so that they can be of benefit to those who depend on them.

Four Steps to Help Reduce Caregiver Stress

1. Recognize the Warning Signs of Stress
Trouble focusing
Difficulty making decisions
Change in sleep habits
Feel overwhelmed
Feeling edgy and irritable
Becoming isolated
Consuming sleeping pills, alcohol or caffeine
Feeling hopeless or helpless

2. Identify the Stressors Individually
Do you feel angry when you can’t go for a walk because there’s no one to look after your father? Do you feel tired in the mornings because you couldn’t sleep the night before?

3. Explore Potential Solutions to Each Stressor
Ask for help and accept help. People want to do it and you must recognize you need the help. Be specific and clear with your requests, such as asking a neighbor to stay with your mom while you run to the grocery store.

4. Implement a Solution That Will Work for Each Stressor
Remember to focus on each stressor individually; the entire picture can be quite scary.

Always remember that you cannot change the condition, only the way you respond to it.

KUNC Audio/Transcript: The Hardest Job There Is