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Alcohol Consumption and Brain Health

redwineApparently, even one glass of red-wine now is out. For those of us who are caring for or who have cared for someone with dementia, brain health is more than a casual interest. At least, it is for me.

A story in the Health Section of The Washington Post shared the results of a study from BMJ reporting that Even moderate drinking is linked to pathological changes in the brain.  The words they used were atrophy. Now that doesn’t sound good at all. The report tracked 550 adults for 30 years and found that testing showed that people who drank the most during the three decades had a faster and greater decline in cognitive functioning than those who consumed less alcohol.

The only caveat I saw that made me hopeful was that the study only included men (however that still impacts many people I love). The outcome was that the study basically drew the line between someone who drinks and someone that doesn’t. One 12-ounce beer, one five-ounce glass of wine, or one 1.5-ounce drink of 80-proof liquor. One.

This is a topic that interests me as well as many older adults. What are you doing to have better brain health?

I focus on the biggies: Physical exercise, nutrition, sleep, as well as challenging my brain with new activities. I am also now very afraid to ever “retire” and tell myself that I will work in some form until I can no longer contribute. This is a question I repeatedly am asked and will spend a few blogs over the summer sharing the research behind what you can do.

Please reach out if you have found some data to suggest something that has a positive impact on our brain health. Asked. 

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Is Driving a Battle Worth Having? YES!

The choices you are faced with when you are stepping in to help are many and varied. One adult child was telling me how she just got her dad to move into an independent living community and dad was still driving. She shared that he was diagnosed with Alzheimer’s so they wanted to get him somewhere and he seemed to be doing pretty well. I understand the hope to at least get them into a place that is more attuned to help, and that offers other levels of care when needed.

She also mentioned that she worried about him continuing to drive. However, most of us might just accept the move as a win and move on. I know, I was in that situation. For this daughter, just getting him into the community was a victory. The next issue was going to be the driving.

You would hope that the doctor that diagnosed “Alzheimer’s” would help, but in many cases, they don’t discuss how it might impact things like driving and managing the finances.

The daughter was happy that he agreed to move out of his home and into the Life Care Community. When should she bring up the issue of driving?

According to a the National Highway Traffic Safety Administration, the youngest and oldest drivers have much higher rates of highway crashes and deaths than any other age group, according to 2008 government mileage data, the latest available. Drivers ages 16 and 17 are involved in more crashes, and fatality rates rise steeply for those older than 65, with drivers older than 80 being the most vulnerable.

Consumer Reports Dangerous Drivers 10-12

I am not sure if I’m more worried about the issue of causing a fatality, or the risk of losing all of your life savings should an older adult be sued or charged with a crime. In our litigious society, I don’t think it will be long before someone will prove that an individual diagnosed with “Alzheimer’s” or even “cognitive impairment” was reckless by making the choice to drive after a medical diagnosis.

Do you wait for the accident to happen?
As I have reiterated on this blog, when their is cognitive impairment, you often find that you have to wait for a failure. It actually has a medical term. Anosognosia is when someone is unaware of their own mental health condition or that they can’t perceive their condition accurately.  Anosognosia affects up to 81% of people with Alzheimer’s and some studies show up to 77% of patients suffer anosognosia after a stroke. So can your loved one accurately assess their driving ability? How many of us without a diagnosis over-rate some of our abilities?

Some rehab centers offer assessments, but it’s not so easy to find and in reality, who wants to go pay for a test to learn they might not be safe on the road anymore?

As the adult child, my siblings and I discussed it with our parent’s before the doctor submitted the paperwork to revoke their licenses. We were seeing a lot of dents and dings on the car that were multiplying at an alarming rate before this happened. In the end, we had to hide the cars when they continued to drive after their driving privileges were suspended by the state. I had also retrieved them a few times when they got lost driving to familiar locations. To read more about how we managed through this stage, you can read my posts from back in 2012 called Operation Safety Net.

The car keys represent freedom and independence. Most people don’t want to let that go. However, it’s a battle that is worth fighting for everyone’s safety. Believed. 

Options:

  1. Check out your local community to see if you have a Village that can provide a ride.
  2. Contact your county Agency for Aging that can refer you to discounted coupon packages or other discounted local ride services.
  3. Contact a home care agency to set up permanent rides to the grocery, mall, or drugstore.
  4. Check with neighbors or church members who might be interested and available to help out.
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How to Screen Out Crooked Callers

crankcallsI often get asked how to stop the pesky telemarketing calls in my job as a daily money manager. Most of us have all put our names on the National Do Not Call Registry, but the people calling aren’t typically playing by the rules. After you register, other types of organizations may still call you, such as charities, political groups, debt collectors and surveys. If you continue to get calls after being on the list for 31 days, you can report them to the FTC here.

Unfortunately, for seniors, the biggest complaint is about the number of charities that are calling. They are exempted from the National Do Not Call Registry. If you have asked that they remove you from their call list, and they continue to call, here are a few things you can do to help stop nuisance calls:

  1. Sign up for a automated service for your landline to block calls. Nomorobo is free service I can get from my local carrier, Verizon. The Nomorobo website can help you find out if you can get their free service in your area. I implemented it at home and it has made a big difference. When we moved in 17 years ago, we opted for the unlisted number–that USED to work at keeping callers at bay. 
  2. If you can’t get a service like Nomorobo, you can purchase a call blocking device like Sentry 2 that lets you blacklist numbers. It does require that you tag calls to the “blacklist” to block, and you can also add numbers and only get calls from those on your “whitelist”. It can fill the need but does require assistance to be effective.
  3. Don’t answer the phone if you don’t recognize the number. When you answer, they know they have a valid number. Asking to be removed, or selecting the dial option they offer typically won’t yield a positive results.
  4. Sign up for “Anonymous Call Rejection” with your local carrier. It will reject calls from anyone that has blocked their caller ID information. It is usually something you can enable using *77 but varies by provider.

The DEFCON 5 OPTION

When I was in elementary school, we were getting calls at home that were personally threatening. This was in the 70’s before all the other technology options and rules existed. My parent’s put whistles by the phones, and I was told to blow it in the phone should I answer and find the person on the other end of phone is threatening me. I haven’t instituted this in my own home, but wonder if the calls would stop more quickly if we all choose the whistle option. Mischievously Wondered. 

 ** I will follow-up on what you can do if you are being pestered on your cell-phone. 

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Three Common Senior Scams

checkbookI found that my parent’s were writing checks to charities on a regular basis, which was a new habit. When I realized that I didn’t recognize many of them, and then saw the amount of mail coming in doubling, the alarm bells went off.

I work with a variety of seniors. Most still live at home, have children who don’t live in the area, and need some simple help keeping track of cash flow and their bill payments. I was recently interviewed for a story on the three common senior scams and hope that you will find some tips on help to help your loved ones avoid becoming a victim to the hideous people hoping to separate them from their savings. Referred.

 

Related Stories:
– “Be on Guard: 3 Common Senior Scams” by Amy Fontinelle

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Strokes and Dementia

strokeI recall the many visits to the neurologist with my mom after her stroke. We learned this was her second stroke. The doctor guessed the first one happened over a decade before but went un-reported or un-diagnosed. The second stroke began with dizziness and after watching my mom try to walk, my dad drove her right to the emergency room. The second stroke left no physical reminders, but there was a noticeable difference to my mom’s memory and how she processed information. They told me she had an ischemic stroke.

Over the six-months of visits, we really focused on understanding the cause and how to prevent a future stroke. The doctor never explained how the stroke might impact her ability to drive, manage her finances, or retain information. She also never mentioned that based on my mom’s behavior, that she probably had Vascular Dementia.

When I was talking with a client last week, he stopped me to ask why I used the term “vascular dementia” to describe his partner. She had a stroke and when I spoke with her, she had trouble getting out her words and he admitted that she had had trouble with her short-term memory. I’m not a doctor, but I shared that she seemed to present like my mom did after her stroke.

The interaction reminded me just how difficult it was to get my mom and dad diagnosed. The first neurologist for both of them never even used the term “mild cognitive impairment”, although to me and my siblings, we all recognized something was different in their behavior and thinking. Had we had an earlier diagnosis, maybe we could have developed a better plan of care to have them live with purpose and meaning for the rest of their lives.

I hope if your loved one has had a stroke, you might have more information to understand the impact and how it might shape the coming years. Every one is different, but I worry that the move to shorter medical appointments will make it even harder for the next wave of caregivers to come. Wondered.

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My Ten Big Dementia Don’ts

BestBlogs2017I started this blog to help me deal with all of the changes I was seeing in my parent’s and feeling helpless. Over five years I learned quite a bit, and have poured it into Dealing with Dementia in hopes of making this journey a little easier on the next family.

I’m honored to again be name one of the Best Blogs of the Year. To celebrate, I’m recapping my Top Ten Dementia Don’ts.

I wrote these when my mom was living in an assisted living community dedicated to memory care. Some really only come into play in the later stages, but could really just be general life rules if you ask me!

10. Don’t assume because they can’t tell you, that your words or actions don’t hurt their feelings.

9. Don’t assume they can’t answer for themselves.

8. Don’t blame them for the changes in their behavior.

7. Don’t remind them of a death of a loved one or pet.

6. Don’t talk about someone with dementia in front of them like they don’t exist.

5. Don’t think they can’t communicate just because they don’t speak.

4. Don’t assume they can’t understand you because they are silent.

3. Don’t correct or challenge trivial things.

2. Don’t say “Remember when … “

1. Don’t tell someone diagnosed with dementia they are wrong.

What are some of yours?

Revisited. 

 

 

 

 

 

 

 

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Be Mindful of Remaining a Spouse/Daughter/Son

transportchairI was asked to participate in a panel discussion called “Help Mom & Dad Make All the Right Moves” with a doctor who serves the senior community, and a life care manager. In the closing segment, we were asked to share one piece of advice for a fellow son or daughter about our caregiving journey. The doctor, Steven Simmons shared that you need to remember to be the son or daughter. He went on to share how difficult it is for him to not be the doctor and how he just faced a crisis with his mom and worked really hard to be the son not the M.D. He said he worked quickly to bring in another doctor so he could be the son.

I was shaking my head in agreement as he spoke. I have shared this with the professionals that did come in to help me through pivotal moments. I have confessed to them that looking back, I wished I used them more. I wanted to help and so many of the things seemed simple, but one of my biggest regrets is not having a life care manager manage all of my mom’s medical needs.

The last year of my mom’s life she was in and out of hospice care … the palliative kind … which is now very common to help older adults live comfortably for issues that medical interventions can’t cure. So we had a hospice doctor that would visit her in the community. However, there was also a community doctor, and some minor issues, seemed to keep getting lost between the two doctors. Every month, I was spending several hours trying to chase down these minor health care issues which took away time from visiting my mom. I was at her community, but not even in the presence of my mom. Over the course of the year, maybe it would have cost a few thousand to have someone else take her out for the medical follow-ups, chase down and get answers to the minor issues that needed resolution. Mom had the means to pay for it, and I should have used it so I could have been the daughter.

Yes, a son or daughter should be counted on to do those things. However, I am still raising kids, running a business, and was trying to lead a life too. Now that mom is gone, I wish I had a do-over and instead spent the time with her, not on managing her care needs.

While an aging life care manager does have an hourly rate between $135 – $185, they can resolve issues quickly. There were so many things I learned on my journey, but, at the end of the day, I might have better served me and my mom if I brought in someone to handle certain aspects of her care.

At the time, I made the best decision I could with the information I had. Reviewed. 

 

 

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