Identifying mild cognitive impairment

Alzheimer's Association Medical and Scientific Advisory Council Chair Ronald Petersen, M.D., Ph.D., explains mild cognitive impairment (MCI) and highlights the importance of distinguishing among the various dementias that can occur with aging.

This video is part of the "THE ALZHEIMER'S PROJECT," a presentation of HBO Documentary Films and the National Institute on Aging at the National Institutes of Health in association with the Alzheimer's Association, The Fidelity® Charitable Gift Fund and Geoffrey Beene Gives Back® Alzheimer's Initiative.

A Fresh Approach to Living with Alzheimer’s

A recent article on Alzheimer's from the New York Times presented a unique perspective on living with and treating the disease. It talks about a nursing home called Beatitudes that offers a different approach for their residents. They are allowed to sleep, be bathed and dine whenever they want. They can eat whatever they want, even if would be considered unhealthy—even unlimited chocolate or an alcoholic nip at night! They provide pretty much anything that gives the patients comfort.

This seems counterintuitive with much of the information available on Alzheimer's where structure and consistency are considered a necessary part of living with the disease. However, Beatitudes is actually following some of the latest science that suggests that creating positive emotional experiences diminishes distress and behavior problems. They encourage their patients to eat their favorite foods regardless of its health benefits, or lack thereof. They have found that comforting foods improve behavior and mood because they send messages they can still understand: "it feels good, therefore I must be in a place where I am loved." They also go beyond food to create the positive emotional experiences by integrating other pleasurable activities, such as art, music, and exercise. In many cases the cumulative effect was a discontinuation of antipsychotic medications, which come with many side effects for the patients, and focused on medicines that relieve pain and depression.

As a professional caregiver, I found these techniques very interesting and valid, but perhaps somewhat impractical in a home setting. People function around schedules – its part of life. It would be very difficult, without a full staff, to cooperate with the whims of the Alzheimer's patient completely. Food, dressing, bathing in the middle of the night would be hard on the caregivers. That being said, there is plenty of room for compromise. "Do you want your shower before you go to bed or first thing in the morning?" A change of menu to include the patient's favorite foods(let them choose), flexibility on meal times, favorite clothes (patient's choice), familiar activities from their past, favorite scents such as colognes and perfumes, cuddly stuffed animals –whatever brings them comfort, even if it seems insignificant or strange to you. Making them feel it's their idea, even though you limit the choices to those that work with your lifestyle, could probably have the same comforting effect.

It seems that some of Beatitudes' techniques could be integrated into the home setting. It takes creativity, imagination, flexibility and a different way of looking at Alzheimer's care to make these a part of the day. But, I believe well worth the effort. A happy, less agitated and combative (perhaps less medicated) Alzheimer patient would make life easier and be good for everyone!

By Linda Christensen

What Should You Know About Home Care Agencies?

Written by Zoltan Gaspar

Home care providers differ in many ways: types of services provided, fees for services, policies and procedures, and administrative structure. They are large and small, non-profit and for-profit, Medicare-certified and non-Medicare certified.

The types of home care agencies listed below are not all all-inclusive. Home care service providers offer a range of services including short-term medical care, long-term personal care, and housekeeping. It is helpful to clarify the type of reimbursement an agency accepts as well as the level of care it provides.

Social Service Agencies

In some communities, home care services are available through social service agencies. Most of these organizations are non-profit; many have a religious affiliation. These agencies often furnish other services in addition to home care. For example, an agency may conduct a preliminary assessment by a nurse or social worker, and/or involve a social worker to help with decision making, counseling, coordination and adjusting to a care plan.

Homemaker/Home Care Agencies

These agencies provide a variety of non-medical home support services. They can provide homemakers, home health aides, chore housekeepers and other workers. The workforce is generally not under the direct supervision of a medical professional and services are not usually Medicare reimbursable.

Home Health Care Agencies

These agencies, some of which are hospital affiliated, focus on the medical aspects of care. Their professionally trained personnel (e.g., registered nurses, licensed practical nurses, physical therapist, etc.)  can do dressing changes, monitor vital signs, and perform other tasks as required by the physician or nurse. Most also offer the services of certified nurse assistants who are supervised by licensed professional nurses. Some agencies do provide non-medical home care services.

Nurse Agencies

These agencies may be, but are not always, Medicare-certified. In addition to private duty registered nurses, licensed practical nurses, and/or skilled therapists (for physical therapy, occupational therapy, or speech theraphy), these agencies often provide certified nurse aides and homemakers.

FINDING THE RIGHT AGENCY

Social Services Departments at hospitals are a good place to locate information on in-home help agencies. In addition, there is an extensive national network of State and Area Agencies on Aging that links seniors with services in their communities. For information about these services anywhere in the country, call ELDERCARE LOCATOR AT 800-677-1116. If you are eligible for government-sponsored services, your Area Agency on Aging can select the home care provider for you.

You may reply to Zoltan in the "Leave a Comment" section below or send an email tozoltang@OptimumSeniorCare.com and be sure to visit the website at http://www.optimumseniorcare.com/.

Senior Pets for Seniors

Although life changes as we age, people who enjoy the company of pets rarely outgrow that trait. Most feel as they become senior citizens they don't have the patience and energy to care for a young pet. Housebreaking dogs and keeping kittens out of trouble can be exhausting. But, adopting an older pet could be a great solution. In this scenario everyone wins! The human gets a companion and the senior pet gets a new home and a chance to live the remainder of their lives out of the shelter. They are housebroken, trained and calmer than the younger pets. Families with younger members typically desire younger pets, leaving the older ones behind – sometimes destined to live the rest of their lives in a cage or small run.

Studies have shown that not only do pet owners have a constant companion, but they are less lonely, more likely to exercise, derive satisfaction from owning the pet and have lower blood pressures. It also seems to stave off depression. Senior pet owners tend to feel self-sufficient and dependable when it comes to caring for their pet. Not to mention the unconditional love and attention bestowed upon them by the pets, regardless of the owner's age or amount of gray hair they possess.

It appears that pet ownership among seniors also has some health benefits. Pets allow the individual to escape stress and concentrate on something other than their own health issues. A 1990 UCLA study showed that pet ownership could actually improve overall health and reduce the time seniors spend in a doctor's office.

Pet ownership can serve as a conversation icebreaker for the senior, especially since pet owners are attracted to one another. Everyone loves to talk about their pets!

There is also the sad realization that younger pets could outlive their owners. Shelters are full of animals that find themselves in this predicament. Matching a senior pet with a senior human could minimize this problem. All the challenges of aging, aches and pains, lack of mobility, memory, hearing and sight loss, make the senior citizens sharply aware of what it is like to get older and makes them uniquely qualified to care for an aging pet. They can sympathize with their pet and go through the challenges together.

Several members of my family had dogs well into their senior years. In these cases, their spouses had passed and they were alone. They would tell me on more than one occasion that if it wasn't for the pet needing something, they wouldn't even get out of bed in the morning. The pet's needs drove them to remain able-bodied and healthy and gave them something to care for. They enjoyed being needed during a time when their own families had moved on and were living their own lives.

Who would benefit from these relationships? In my opinion, both pet and owner would reap the rewards. It is definitely something to consider for the senior in your life.