Spring Lawn Care: Or When His (Or Her) Jobs Become Your Jobs

[This is the fifth installment of posts from Faith, AGE’s CaregiverU Coordinator and personal expert on being a family caregiver – you’ll continue hearing from her on a range of topics once a month.]

Lawn care.  Hmmm, not my expertise.  I do enjoy the sight of a well tended lawn, though.  Thick green grass, nicely edged, pretty stones in a ring around each tree, neatly trimmed trees, front flower Green Lawnbed blooming.  All very nice, but I am clueless as to how to create that, and probably not much better on knowing how to maintain it.  You see, I’ve been married close to 45 years and we’ve had a system called ‘his work’ and ‘her work’.  I took care of the inside of the house and he took care of the outside.  The work inside of the house and all my other responsibilities took up all of my time and then some, so I paid little attention to the work in our yard.  Seven years ago when we moved into our current house, I was eager to learn how to do yard work and hoped to work together with my spouse to plan the landscaping and share in the labor.  My dear husband was insulted by those plans—refer back to ‘his work’ and ‘her work’ above.  The yard was definitely his domain and I’d best remember that.  In the name of peace and harmony, I took my rightful place, and simply enjoyed the loveliness.

I enjoyed it until now.  Now my spouse is not so capable of planning and organizing the yard work.  He sometimes forgets how to start the lawn mower and claims it doesn’t work.   Our good neighbor comes over to get it going, and tells him the mower just needed an adjustment.  Helpful friends give him bedding plants for the flower beds, thinking he would enjoy digging in the dirt again.  He enjoys the digging and puttering, but then becomes very anxious because the plants aren’t thriving.  That’s when he asks me what to do, and, I’m –clueless.   He worries about the bald spots in the front lawn and then I worry.  Surely bald spots are not a good thing, but what does one do? Continue reading

Making the Most of the Holidays: Helpful Tips for Caregivers

[This is the third installment of posts from Faith, AGE’s CaregiverU Coordinator and expert on being a family caregiver – you’ll continue hearing from her on a range of topics about once a month.]

We all carry visions of what the holidays should look like and often those visions don’t jibe very well with reality! At this time of year, many of us visualize a Norman Rockwell type scene with everybody gathered happily around a perfectly laid holiday table. Reality is often a bit different!  In addition to that image, I also carry around in my head visions of previous holidays when life was different.   That is, when the kids were younger and my spouse was cognitively able to partner with me in all the holiday preparation.  Today my husband has a cognitive disability and the children are young adults with spouses and responsibilities of their own.  Part of the holiday experience is traveling to their homes for visits and hosting them in our home, all the while helping my spouse cope and have a good time.  As a caregiver, managing the holidays has come to mean managing many different issues—disruptions in schedule and routine, traveling, adapting to new surroundings, decorating the home, shopping for gifts, and preparing food, to name a few. Continue reading

Tips for Traveling: A Caregiver’s Perspective

[This is the second installment of posts from Faith, AGE’s CaregiverU Coordinator and expert on being a family caregiver – you’ll continue hearing from her on a range of topics about once a month.]

Every work day I eat the very same breakfast—oatmeal, juice, soy milk, and green tea.  Is it because this is a favorite meal choice?  No, it’s because I’m not a morning person, so fixing the same breakfast every morning saves me from thinking.  I do it on auto pilot.  Similarly, an individual with a cognitive disability thrives on using auto pilot.  For them, the brain pathways don’t work as well as they formerly did, so thinking requires more effort.  Staying in a routine and doing things the same way every day requires less thinking.   Traveling shakes up the old routine, and takes away the familiarity, requiring more thinking effort, which increases the stress and anxiety that further impedes the thinking process.  Knowing all this, and experiencing all this, may make a caregiver decide to forgo travel—but not this traveler!  I choose to continue traveling with my dear husband because we have three adult children living in other cities, and spending time with them is very important.  To make travel easier on both of us, I’ve adopted new strategies and continue searching for more good ideas from other caregivers. Continue reading

How does Alzheimer’s affect the youngest among us?

My name is Emily, and I am the Development Associate and resident blogger at AGE. And I am a grandchild of Alzheimer’s Disease.

Or rather, I am a grandchild of a woman with dementia, likely caused by Alzheimer’s. It started when I was just 10 years old, and it has been over 15 years since my grandma started disappearing. It is no easier now than it was as a child.

First, she stopped cooking. It was how she showed her love and doted on us. I knew something was really wrong when my Grandpa, who had never really cooked, took over what had once been Grandma’s domain.

Then the more bizarre behaviors began- things that really mortified the kid I was at the time. Grandma would take out her dentures at the most inappropriate places to clean them, or she’d ask for ketchup at a Mexican restaurant because she couldn’t differentiate that from salsa, or she started to lose her ability to know when she should whisper in church or the movie theater instead of loudly observe things that you don’t say aloud in public.

And, of course, in crept the tell-tale sign of asking the same exact questions over and over and over again.

Grandma had an ‘angry’ period where she was occasionally physically and verbally violent, mostly towards my Grandpa. Then after a while, she became more and more juvenile- in the most joyful way. She became so affectionate, always reaching for a hand to hold.  And then, she became too affectionate, even with strangers. She has been known to sneak a kiss when a friend would try to just give her a hug, and since she’s in a wheelchair it’s quite easy for her hands to wrap around and give someone a little squeeze on the behind- it’s even happened to our pastor.

Mood swings and personality changes are common for those with dementia, but that was difficult to understand as child and even as a teenager. I sometimes felt annoyed at her behavior, angry at her outbursts, indifferent, confused, sometimes amused, and so very often deeply sad. Most of all, I felt beyond guilty for feeling anything but pure love and gratefulness for this woman.

As for the rest of the family, there have been stages of grief, denial, and bargaining for my parents and my aunt as they transitioned from being this woman’s children to being her caregivers. It has been an incredible journey of highs and lows, questions and transformations that have all fundamentally altered what my family looks like. Dementia changed my Grandmother, but it also changed us.

The irony is that she’s almost as fit physically now as she was five years ago. There’s no indication that she’s giving up yet, even if her mind has. The grandma I once knew has been almost completely devastated by whatever has taken residence in her brain. It has been a long progression. She hasn’t been able to walk for a few years now. She doesn’t really recognize any of us anymore. I don’t think I’ve heard a purposeful sentence from her in over a year. And these things can be hard for a child to witness and accept. “She looks fine, why won’t she talk to me? Why doesn’t she know you, Mom? How can she forget that she’s married?

I know my experience is not special or unique:  1 in 8 older Americans have Alzheimer’s disease. And there are over 15 million Americans providing unpaid care for a person with Alzheimer’s or other form of dementia (Alzheimer’s Association). That is a massive amount of individuals, spouses, children, and grandchildren being dragged through the mud of this disease. You are not alone. We can learn from our shared experiences. It’s important to tell your story. And it’s important  to include the children of your family in discussions about what’s going on with your loved one with dementia.

For those of you who have a child facing the immediate reality of dementia in either a parent or grandparent, there are some lots of resources out there to help you talk about dementia or Alzheimer’s. This disease is a bit different from others in that Grandma, or your uncle, or your Mom may look perfectly healthy on the outside. Kids need some help understanding the mechanics of this disease and that you can’t always see that something is wrong when someone is sick in this way. The two resources listed below have great information ranging from how to make the conversation developmentally appropriate to concrete tips and talking points:

Ultimately, I do not want to detract from unbelievably heartbreaking experience of those, like my Grandma, who are dealing with dementia themselves. Because it isn’t really about the pain of the rest of the family at all, it’s about allowing your loved one to experience the rest of their life with as much dignity and vitality as possible. Helping the children in your life understand what Alzheimer’s is doing to their loved one will make it easier for them to continue to see the person instead of the disease.

Reflecting back on the beginning years, Grandma never once talked about being aware of her diagnosis or what it was like for her. She sort of just slipped from the beginning stage where she was just ‘mildly’ forgetful to a place where she could no longer contemplate a question about her state of mind if she tried. I wish I knew what it was like for her. This journey has shown me that there many things I don’t know, and that there’s no ‘right’ way to be a supporter for someone with dementia. What I do know, Grandma, is that I will continue to love you wherever else this road takes us.

For those in the greater Austin area, AGE of Central Texas has a number of resources for caregivers and for those experiencing dementia. Click here to visit our website for more information.

What’s the Difference: A Look at Dementia and Alzheimer’s

Dementia: The presence of multiple cognitive deficits by both memory impairment and one or more of the following:

  • Executive functioning (planning, organization, sequencing, abstraction)
  • Aphasia, Apraxia, Agnosia
  • No delirium
  • Interferes with social or occupational functioning

Alzheimer’s Disease: A slowly progressing brain disease, which is the most common form of dementia. It affects recent memories first, then begins to affect emotions, decision making, personality, eventually destroying long-term memory and ability to interact with the world. In the moderate stages you might notice mood and communication changes, delirium, and wandering.

It is not easy to distinguish between dementia (and its other causes) and Alzheimer’s.   They are often confused because they share a similar set of symptoms, but Alzheimer’s is just one of many possible causes of dementia.

Some causes of dementia may sometimes be treatable, so it is important to talk with your doctor to try and figure out exactly what is going on. A diagnosis of dementia does not necessarily mean the person has Alzheimer’s. Unfortunately, Alzheimer’s cannot technically be diagnosed while someone is alive, because the only definite way to identify Alzheimer’s is to examine brain tissue upon a person’s death. It can be very challenging to deal with not being able to find an absolutely definitive diagnosis.

Information care of Kim Butrum, RN, Gerontological Nurse Practitioner from The Memory Center at the Seton Brain and Spine Institute

Below is a video from aboutalz.org which explains the process that occurs within the brain with Alzheimer’s:

AGE serves an average of 40 older adults every day who need daytime supervision and assistance due to a memory impairment. AGE’s Adult Day Centers provide a community where older adults can engage with their peers in therapeutic and stimulating activities under the supervision of a full-time nurse and trained staff. This program helps these vulnerable older adults avoid early nursing home placement and instead keeps them at home with their families. This gives family caregivers the respite they need to continue to work and balance taking care of their families and themselves.

If you would like to join the AGE of Central Texas family by giving towards the direct services that benefit clients and family caregivers who are dealing with dementia and Alzheimer’s, please click here or send a check to AGE at 3710 Cedar St # 2 Austin, TX 78705. Feel free to reach us at www.ageofaustin.org or 512.451.4611.

 We are ever grateful for those who support us in deed and word in our mission to serve older adults and those who care for them. With your support, we hope to continue to meet the needs of this community.

How many of us get enough sleep?

Did you know that during sleep our brains consolidate and store our memory and learning? Sleep also helps us function more efficiently and effectively. Sleep helps us stay healthy and prevent additional health problems.

An adult needs 7 to 9 hours of sleep per night. How often do you meet that?

Sometimes we deprive ourselves of sleep by the lifestyle we have (or choose to have). Work, poor sleep habits, and other factors contribute to volitional sleep deprivation. This shows that many of us don’t take sleep as seriously as we should. But other things beyond your control also affect how we sleep: environmental disruptions and untreated sleep disorders fall into this category.

Being tired can interfere with your daily activities, such as being sleepy at work- which can causes errors or injuries. It also affects your driving. We may not like to admit it, but how many people have felt drowsy while driving? Or even more dangerous, dozed off while at the wheel? It’s more common than you may think.

Sleep Apnea is one serious sleep disorder, and it is when airflow stops during sleep. This causes frequent awakenings so the person can adjust and open their airway. In severe Apnea, some people stop breathing over 30 times each hour during their sleep. That does not sound very restful! If you think you might have an issue similar to this, you should contact your doctor, or look up the Central Texas Neurology Consultants of St. David’s Round Rock Medical Center, who provided this information.

Those with Alzheimer’s disease (or those who care for them) know that as the disease progresses, sleep patterns often change. They might experience confusion between night and day, causing them to sleep long periods at off hours. Often, it can causes restlessness or sleeplessness, which can lead to wandering. And, of course, for caregivers all of this can prevent or interfere from being able to get any real rest of their own.

There are a couple of things that caregivers can do to alleviate sleep issues:

  • Check with your physician about medications that might be causing sleeplessness.
  • Avoid caffeine or stimulants.
  • Encourage your loved one to be active during the day, even exercise, but be wary of too much activity close to bed time.
  • If they struggle sleeping at night, minimize daytime naps especially later in the day.
  • And try exposing them to sunlight in the morning and earlier in the day.
  • And of course, maintain consistency when possible in rising for the day and going to bed at night.

Moral of the story: take care of yourself, get enough sleep. The consequences can echo through every aspect of your life. And if you think you or your loved one need medical help with getting real, restful sleep, don’t hesitate to contact your doctor. And if there are other things in your life (such as issues with aging or getting older, or caregiver challenges) that are interfering with your ability to rest and take care of yourself, please contact AGE of Central Texas and let us figure out how to help you find what you need.

Not so super: NFL players lose cognitive function in their senior years

This Sunday, Superbowl XLV will feature the Packers v the Stealers in our favorite American tradition. While I may personally be more excited about the special episode of Glee that will follow the game, I know I will keep an eye out for any major head injuries by both team’s players. Why? Because these star athletes have an exponentially increased risk of developing cognitive problems as they age, as a result of multiple head injuries during their career. Sadly, the bright young stars of today’s football may be just as legendary as former greats like Earl Campbell, Ted Johnson, or Ralph Wenzel. Also like them, they may face the same health related problems that they do. -SP

Ralph Wenzel was a lineman for the Pittsburgh Steelers from 1966 to 1970 and for the San Diego Chargers in 1972 and 1973. Like many other former NFL players, today he suffers from Alzheimer's-type dementia, forcing him to live in an assisted living facility. His neurologist attributes his condition to the concussions and other brain trauma he experienced as a player. Photo and text from http://www.ralphwenzeltrust.org
NFL’s dirty little secret: Players suffer
By Jeff Pearlman, SI.com.

(CNN) — The business leaders of the National Football League used to have a secret.

It was a deep, dark secret, one they kept written on a microscopic piece of gold-plated paper, locked behind a door, behind a vault, behind a 20-foot-long man-eating anaconda in the basement of its New York offices.

The majority of the world’s secrets are easily uncovered. This one, however, stood as a modern-day equivalent of the inner workings of the Bavarian Illuminati. Nobody was ever supposed to suspect. It was passed down from generation to generation; only the most trusted and knowledgeable of NFL officials were ever genuinely aware of the truth.

Now, however, in Year of Our Lord 2011, the secret has somehow escaped professional football’s clutches, only to land in the midst of mainstream society.

The world is doomed! The empire is conquered!

Playing football is (gasp!) bad for you.

Yes, it is true. Playing football is bad for you. Bad for the neck and shoulders, bad for the arms and legs, really bad for the brain. See how NFL players look like muscular human-stallion hybrids, what with their fire hydrant forearms and refrigerator-sized calves and 4.3-40 times? Check back in a decade, when a shockingly large number will have trouble limping from the couch to the refrigerator without stumbling to the ground in agony. In the worst cases, some will struggle to remember their own names.

The stories of past NFL players-turned-walking (or not walking) wounded are heartbreaking and endless. The great Earl Campbell can barely stand up. Neither can the great Wilber Marshall. Or the great Dave Pear. Or the great Wally Chambers. John Mackey, the legendary Colts tight end, suffers from frontotemporal dementia and lives in full-time assisted living. Ralph Wenzel, an NFL guard from 1966-73, also suffers from dementia and can no longer dress, bathe or feed himself. Ted Johnson, a former Patriots linebacker and only 38 years old, shows early signs of Alzheimer’s disease.

Yet even though we are all now relatively well-versed in the risks that come with America’s most cherished sport, the NFL — the ultimate corporate monolith — doesn’t want you to think about it. Or worry about it. Or, ahem, be aware of it. Just kick back and drink your Budweiser.

As reported in The New York Times, the league recently demanded that Toyota significantly alter a 30-second advertisement that cites the danger of football (Pathetically, Toyota gave in). The spot, which most sports fans have seen by now, focuses on the automobile company having contributed crash research to those scientists looking into football concussions. In the ad, a mother worries “about my son playing football.”

Brian McCarthy, an NFL talking head, told the Times that “we felt it was unfair to single out a particular sport. Concussions aren’t just a football issue.”

Read more at CNN.com.

What if America Waged a War on Dementia?

Its an interesting concept that the government of South Korea is implementing now, through a series of costly and innovative programs, including adult day care, national long-term care insurance, and hundreds of local clinics on the frontlines. As one of the fastest AGING nations in the world, losing such a large part of their populations to dementia, and the other part being burdened with the heavy costs of care, perhaps this is a war after all. Please share your thoughts in the comments section! -SP

High school students in Seoul assisted a woman with dementia at the Cheongam nursing home, part of a broader “War on Dementia” by the South Korean government.

SEONGNAM, South Korea — They were stooped, hobbled, disoriented, fumbling around the house. They got confused in the bathtub and struggled up stairs that seemed to swim before them.

“Oh, it hurts,” said Noh Hyun-ho, sinking to the ground.

“I thought I was going to die,” said Yook Seo-hyun.

There was surprisingly little giggling, considering that Hyun-ho, Seo-hyun and the others were actually perfectly healthy 11- to 13-year-old children. But they had strapped on splints, weighted harnesses and fogged-up glasses, and were given tasks like “Doorknob Experience” and “Bathroom Experience,” all to help them feel what it was like to be old, frail or demented.

“Even though they are smiling for us, every day, 24 hours, is difficult for them,” Jeong Jae-hee, 12, said she learned. “They lose their memory and go back to childhood.”

It is part of a remarkable South Korean campaign to cope with an exploding problem: Alzheimer’s disease and other dementias. As one of the world’s fastest-aging countries, with nearly 9 percent of its population over 65 already afflicted, South Korea has opened a “War on Dementia,” spending money and shining floodlights on a disease that is, here as in many places, riddled with shame and fear.

South Korea is training thousands of people, including children, as “dementia supporters,” to recognize symptoms and care for patients. The 11- to 13-year-olds, for instance, were in the government’s “Aging-Friendly Comprehensive Experience Hall” outside Seoul. Besides the aging simulation exercise, they viewed a PowerPoint presentation defining dementia and were trained, in the hall’s Dementia Experience Center, to perform hand massage in nursing homes.

“ ‘What did I do with my phone? It’s in the refrigerator,’ ” said one instructor, explaining memory loss. “Have you seen someone like that? They may go missing and die on the street.”

Read more here at The New York Times, and see the video too!

Study: Patients Who Survive Sepsis Infections Are More Than Three Times as Likely to Develop Cognitive Problems

First large-scale study shows that most older patients hospitalized with severe sepsis face years of cognitive, physical decline, according to U-M research

ANN ARBOR, Mich., Oct. 26 /PRNewswire-USNewswire/ — Older adults who survive severe sepsis are at higher risk for long-term cognitive impairment and physical limitations than those hospitalized for other reasons, according to researchers from the University of Michigan Health System.

Research to be published Oct. 27 today in the Journal of the American Medical Association showed that 60 percent of hospitalizations for severe sepsis were associated with worsened cognitive and physical function among surviving older adults. The odds of acquiring moderate to severe cognitive impairment were 3.3 times higher following an episode of sepsis than for other hospitalizations.

Severe sepsis also was associated with greater risk for the development of new functional limitations following hospitalization, says lead author, Theodore (Jack) Iwashyna, M.D., Ph.D., assistant professor of internal medicine at U-M.

Among patients who had no limitations before sepsis, more than 40% developed trouble with walking. Nearly 1 in 5 developed new problems with shopping or preparing a meal. Patients often developed new problems with such basic things as bathing and toileting themselves.

“We used to think of sepsis as just a medical emergency, an infection that you get sick with and then recover,” said Iwashyna, “But we discovered a significant number of people face years of problems afterwards.

“Those problems are bigger and more common than we expected. Most older Americans suffer real brain and body problems. We need new treatments, not just for the sepsis infection, but to prevent these new disabilities afterwards.”

Sepsis is an overwhelming infection that can result in failure of multiple organ systems. The initial infections are often common problems, such as pneumonia or a urinary tract infection. About 40 percent of those with severe sepsis die from the infection.

Read the whole article here at PR Newswire.

Study: Alzheimer’s risk spikes 157% with heavy smoking

If you needed another reason to quite smoking, well, here you go…-SP

By Mary Brophy Marcus, USA TODAY
Heavy smoking in midlife more than doubles your odds of developing Alzheimer’s disease, a Kaiser Permanente study said Monday.
The study is the first to examine the long-term consequences of heavy smoking on Alzheimer’s and vascular dementia, says the study’s principal investigator, Rachel Whitmer, a research scientist with Kaiser Permanente in Oakland.

From 1994 to 2008, researchers evaluated the records of 21,123 men and women in midlife and continued following them, on average, for 23 years. Compared with non-smokers, those who had smoked two packs of cigarettes a day increased their risk of developing Alzheimer’s by more than 157% and had a 172% higher risk of developing vascular dementia — the second most common form of dementia after Alzheimer’s. The research is published in the Archives of Internal Medicine.

Read the full article at USA Today’s website.