How do you know when it’s time to transition from Home Care to full time skilled nursing care?

Some families make this decision based on their ability to manage the needs of their loved one in the following three areas:

Safety – considering wandering, fall risk, leaving items on the stove (fire hazard), leaving water running (creating flooding), inability to consistently use assistive devices (cane, walker, wheel chair) without supervision


Incontinence – family isn’t willing/able to keep the loved one clean/dry due to urine/bowel incontinence and results in rapid skin breakdown/bed sores/wounds


Disease Symptom Management – Family is often unable to keep loved ones’ symptoms controlled outside of a controlled environment with a strict regimen of medication administration and care management, thus the need for placement.

If you’re caring for a loved one with Alzheimer’s disease or another form of dementia, Halloween can be exceptionally scary.

The constantly ringing doorbell and children in costumes can be disturbing, confusing and even frightening for someone with any type of dementia including Alzheimer’s. Here are some tips to keep your loved one with safe on Halloween.

Make sure your loved one has company on Halloween

Unfortunately, this is a time that masks are acceptable and a burglary could possibly occur.

Choose fun Halloween decorations—not scary ones

Pumpkins are good. Scary things or items that make noise...not so much.

Eliminate candles and glowing lights

Due to vision changes, avoid shadow casting.

Monitor television viewing closely

There are a lot of disturbing programs on this time of year. The wrong show could leave a lasting impression.

Build your own traditions

Consider doing seasonal crafts, watching a fun (not scary) movie, or looking through old photographs and remembering holidays past. Focus on fun activities and pay close attention to see which Halloween festivities your loved one enjoys.

90% of people who live in nursing homes suffer from apathy, which has a negative effect on their well being.  This "magic table" was created to help. See video here. 

 

“In order to empathize with old-old people, we need to understand the complex interweaving of physical deterioration and developmental needs,” writes Naomi Feil in The Validation Breakthrough.

Like Feil, who has more than 30 years experience working with the elderly, I’ve found that “old disoriented people have an intuitive wisdom, a basic humanity that we all share. Behind their disorientation lies a human knowing. I have witnessed this “human knowing” in people with dementia, even when they find it difficult to articulate their thoughts. I call it “intuitive clairvoyance.”

It shouldn’t come as a surprise that old people have the same needs all of us do. But somehow we lose sight of their humanity and their right to dignity. We treat them like children. We talk about them like they are invisible even when they’re right beside us. We tell them what to do. We restrain them physically and chemically. We ignore and isolate them. We fail to provide them the things they need to live full and productive lives to the end. What a shame!

We must use our failures (as Feil herself has) to develop a deeper understanding as well as better tools, techniques, and ways of caring for the elderly and people with dementia. I believe we must change the way we see and support the elderly, in particular people who have dementia. As they become less able to do so themselves, it’s our responsibility to help them get their needs met in the final part of their journey.

Fell suggests “old-old” people and people with dementia have psychological and social needs just like the rest of us. I would go further and say these are rights, not just needs. Everyone has the right to the needs Feil’s describes:

Resolve unfinished issues, in order to die in peace.
Live in peace.
Restore a sense of equilibrium when aspects of self fail (e.g. sight, hearing, mobility, and memory).
Make sense out of unbearable reality: find a place that feels comfortable, where one feels in order or in harmony and where relationships are familiar.
Be recognized and have status identity and self-worth.
Be useful and productive.
Be listened to and respected.
Express feelings and be heard
Be loved and feel a sense of belonging; have human contact.
Be nurtured, feel safe and secure, rather than immobilized and restrained.
Have all five senses stimulated touch, sight, sound, smell, taste, and be allowed to express one’s sexuality.
Reduce pain and discomfort.

BY SUSAN MACAULAY

People with Alzheimer's have better cognition skills in the late summer and early fall, than in the winter and spring, according to a new study.

Adults both with and without Alzheimer's disease have better cognition skills in the late summer and early fall than in the winter and spring, according to a new study. (The study was published in PLOS Medicine by Andrew Lim of Sunnybrook Health Sciences Centre and the University of Toronto, Canada, and colleagues.)

There have been few previous studies concerning the association between season and cognition in older adults. In the new work, researchers analyzed data on 3,353 people enrolled in three different cohort studies in the U.S., Canada, and France, with fascinating results.
Participants had undergone neuropsychological testing and, for some participants, levels of proteins and genes associated with Alzheimer's disease were available.

The authors found that average cognitive functioning was higher in the summer and fall than the winter and spring, equivalent in cognitive effect to 4.8 years difference in age-related decline. In addition, the odds of meeting the diagnostic criteria for mild cognitive impairment or dementia were higher in the winter and spring (odds ratio 1.31, 95% CI: 1.10-1.57) than summer or fall.

The association between season and cognitive function remained significant even when the data was controlled for potential confounders, including depression, sleep, physical activity, and thyroid status.

Finally, an association with seasonality was also seen in levels of Alzheimer's-related proteins and genes in cerebrospinal fluid and the brain. However, the study was limited by the fact that each participant was only assessed once per annual cycle, and only included data on individuals from temperate northern-hemisphere regions, not from southern-hemisphere or equatorial regions.

"There may be value in increasing dementia-related clinical resources in the winter and early spring when symptoms are likely to be most pronounced," the authors say. "By shedding light on the mechanisms underlying the seasonal improvement in cognition in the summer and early fall, these findings also open the door to new avenues of treatment for Alzheimer's disease."

Source:Seasonal plasticity of cognition and related biological measures in adults with and without Alzheimer disease: Analysis of multiple cohorts. PLOS Medicine