Alzheimer’s disease

Alzheimer’s: A Cure at Hand?
I have posted before that the currently approved therapies for treating patients with Alzheimer’s disease are not really very...
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January 21, 2020
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Alzheimer’s Disease State of the Nation
It is sadly ironic that it was former president Ronald Reagan who designated November as National Alzheimer’s Awareness Month...
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November 20, 2019
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In the Caregiver's Words

Recent Client Praise

It isn’t always a surprise or a “bolt out of the blue”. It can be a gradual awareness that “things aren’t quite right” or “something is off” with your older loved one. Trust your instincts. Follow the “little voice” that tells you to act. You may not see the unexpected coming, but you can prepare for the unexpected. You can be ready for the life altering events as your loved ones age and their needs and capabilities change.

A Geriatric Care Manager is educated and certified to deal with these life changes. With or without the help of a GCM, you can help identify a problem in the making and develop a strategy and plan to address it. Crises can and will occur. By taking the steps establish a dialogue with your loved one you will lay the groundwork for the more difficult conversations and decisions that will follow in the future.

My experience with elders and my years as a parent, a daughter, and a daughter-in-law, have helped me to understand that the ways you communicate with your loved one will influence how easy it will be to address life’s challenges. It is essential to be patient, loving and receptive to the range of emotions that may be present. Aging and its related changes can be scary and threatening to everyone. Do your best to listen and identify and prioritize your elder’s major (and minor) concerns. If there is resistance from your loved one or a difference of opinion among family members a Geriatric Care Manager is trained to offer an objective perspective and serve as a resource, counselor and mediator.

I had a client who very recently had a stroke that doctors call a transient ischemic attack (TIA). When I arrived on the scene the look a terror on her face told me that she was entirely dependent on me to make good decisions when she couldn’t even form the words to respond. The listening part I already had done in the meetings before a decision was needed, and the empathy part kicked in. I reassured her that I knew whom we were to notify about the stroke and that her pet at home would be attended. It was therefore our collective job to work with the health care providers to get through this first part of the stroke. No one had expected a stroke, but my client and her caregivers were prepared for the unexpected. And she did recover fully.

The role of “caring family member” has a lot of responsibility. Yet this can be managed with the right planning. You can provide a listening ear and a loving heart as you walk alongside your loved one in their journey. Remember that there are services available to assist you and your loved one.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families throughout metropolitan Chicago. Please email your questions to Charlotte Bishop.,geriatric care manager Chicago,geriatric care Chicago
When I say there is no ‘D’ in dementia, it is not that I am Deficient in spelling. Medical research has been accumulating that people with low levels of vitamin D in their bloodstreams are more likely to experience cognitive decline and even develop Alzheimer’s Disease. When I say cognitive issues, it is not all aspects of brain function. The declines associated with vitamin D deficiency are focused on episodic memory loss and deterioration of executive function. Researchers from University of California, Davis and Rutgers University studied 382 adults whose average age was 75.5 years old. These adults received cognitive assessments which categorized them as having dementia (17.5%), having mild cognitive impairment (32.7%) or as cognitively normal (49.5%). Vitamin D levels were lowest for those diagnosed with dementia, but there was only very nominal difference in vitamin D levels for those who were mildly impaired and those who were classified as cognitively normal. All of these adults were studied for nearly five years and then assessed again. During that time the magnitudes of decline in episodic memory and executive function were greater in adults who had been diagnosed as vitamin D deficient or vitamin D-insufficient. The investigators found that regardless of their baseline cognitive assessment, their ethnicity or a range of other risk factors, those who had been vitamin D deficient at the beginning of the five year period were at greater risk of developing Alzheimer’s Disease. Scientists continue to study the association between vitamin D levels and dementia. While there are no studies that suggest taking vitamin D supplements can prevent Alzheimer’s, doctors in practice are not waiting. They are prescribing D for their older patients, especially those who are already at low blood levels of the vitamin. We who live in northern regions should be particularly on top of getting enough sun to activate our natural vitamin D, consuming more dairy products and green leafy vegetables and augmenting our diets with vitamin supplements. Charlotte Bishop is an Aging Life Care Professional and a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.
Nearly 500 Medicare patients die every day from hospital mistakes, accidents or infections acquired while the patient is in a hospital. Short of death, about 25% of all Medicare patients admitted to a hospital will have some sort of preventable incident or harm. Sadly, almost all of these mistakes are preventable. If you are a caregiver to an older loved one, there are a couple of very important precautions you can take to prevent this from happening to your loved one.

       The first precaution is to be choosy in the hospital where your loved one will be admitted, because not all hospitals do as well at preventing these accidents as others. You now have someone on your side that can help you sort out which hospitals do a better job at making your loved one's hospitalization a positive health experience. If you cannot stop a hospital from making mistakes in the care of your loved one, you certainly can choose a hospital which has a better track record for safety. The Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality (AHRQ) collaborated to come up with a single letter grade scoring system - on the familiar A through F scale - for hospitals. About 30% of hospitals they graded received an "A," and only one percent actually got and "F.” But would you still want to go to a "C" hospital (38% of the total) when you could choose a higher scoring facility? Check out how they scored hospitals as well as a list of those facilities they graded at www.hospitalsafetyscore.org . Those who subscribe to Consumer Reports also can go to www.consumerreports.org/hospitalratings.

       The same people also offered advice on how patients and their caregivers can be vigilant about some of the preventable errors within their control. Most important on that list is being aware of medications administered to the patients while hospitalized. They suggest:

·         Bring a written list of all your medications (prescription and non) with you

·         Watch that hospital staff are checking the patient's wrist ID when administering any medication

·         Be sure the patient speaks up if a med tastes "funny" or looks different

·         If the patient does not feel well after taking a med, let someone know

·         Ask about any medication, what ailment it treats, etc.

·         If it is a new medication, ask what drugs are contraindicated with it

       The bottom line is that when your loved one is admitted to the hospital, the goal is to be safe and to get better. These suggestions are to help you get the best team on your side and make sure everyone is working together for a positive outcome.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
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To answer your first question, Fisetin (pronounced fy-set-in) is a flavonol which is a class of flavonoids found in a number of plants and fruits or vegetables. They are antioxidants, and you may have seen some of the research on the flavonols in chocolate that are thought to help patients with mild cognitive impairment. Some other common sources of flavonols are onions, kale, lettuce, tomato, grapes, berries, tea and red wine. One of the rules of thumb is the greener the leaf, the more of the flavonols the plant will contain. Back to fisetin. Some researchers at the Salk Institute for Biological Studies have published some scientific work based on animal studies that show promise for fisetin's ability to protect the brain's memory from the inexorable degradation of Alzheimer's disease. They have done this in mice, and the scientists think that fisetin has a neuroprotective capability that helps the memories of mice in laboratory tests. The clinical test used three groups of mice. Two groups consisted of what are termed double-transgenic Alzheimer's disease (AD) mice. The third group was the control, and these mice did not have the Alzheimer's transgene. Mice in one of the first two groups were fed fisetin at three months of age until they were nine months old. The other group received no fisetin. Scientists use a water maze as a standard test of mouse learning and memory. The mice without the fisetin did not perform well in the mazes. Those who had been fed the fisetin, however, performed as well as the mice in the control group. Tests were repeated again at 12 months of age, and the results were very much the same with the fisetin mice doing as well as the control mice. Researchers are not prepared to jump immediately into human subject trials, but there is work underway to better understand at the molecular level how fisetin may be working on mouse brains. Ever hopeful, the scientists are also investigating whether fisetin offers any hope of actually reversing the neuro-degradation of AD. What do we take away from this research? Well, animal studies cannot provide a sound rationale for all caregivers to go out and stock up on fisetin rich foods to help an older loved one forestall Alzheimer's progression. But is it a good idea to encourage your older loved one to consume foods rich in antioxidants? probably yes, but as with any dietary, activity or medication change, always consult with your loved one's provider. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@cr eativecaremanagement.com.
It is no secret that we at Creative Care Management are all about what families can do to help older loved ones … as well as help themselves. I often have said that a caregiver can be their best caregiver if they also are taking care of themselves. I came across some research that may be suited to a caregiver’s loved one or to the older caregiver who may be “at retirement age” but still in the work force. A lot of folks are electing to work beyond the traditional retirement age of 65 years…give or take. There is ample evidence that we as Americans are mostly living longer, because we are healthier, and some just find that they need to anticipate a bigger nest egg because we are also, in fact, living longer. Running out of money is considered a “bad retirement plan.” Research published by some Health Economists from The Netherlands suggests that working may be detrimental to one’s longevity…or conversely that retiring earlier could prolong one’s life. These Dutch researchers took advantage of a temporary change in retirement eligibility among male government workers to compare those who had retired early versus those who waited. Five years after the early retirement they compared the mortality rates of the retired men who were at least 55 years old when they quit with those who worked longer before retiring. Those who worked longer showed a 2.6 percent higher mortality five years out than those who retired early. It is not a huge difference, and a person could argue that civil servants have a more stressful work environment…maybe. But studies ion the U.S., Israel, Germany, England and some other European countries had similar findings. Other research even shows that retirees are more socially active than once thought; so much for the social isolation and depression theories. We simply cannot overlook the fact that some jobs…maybe more than we had thought…are just stressful. Long hours get in the way of working out, and high stress can disturb good sleep or even lead to higher alcohol consumption. So, early retirement could be in the cards for us all, but with a few caveats. Work on a nest egg that will be sufficient so that finances do not become a post-retirement stressor. Be active, especially if your career job involved high activity. Stay active so that obesity does not become a challenge with a new sedentary lifestyle. Continue to be socially engaged. Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.

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