Validating the Older Person with Memory Loss

Thursday, May 17th 2012 from 8:00AM-10:00AM
Presented at San Clemente Villas by the Sea
660 Camino de Los Mares, San Clemente
AGING MATTERS INC President/Founder, Dr. Jane Mahakian talks about validating the older person with dementia.

• Learn ways to validate and empower
• Best Practices for those with memory loss
• Understanding the meaning behind behavioral challanges
• Was to develop person centered care

To RSVP telephone: 949 212-4105 or Aileen Brazeau at 949 289-1534

Professionals may be eligible for 2 CEU credits.

This seminar has been approved by the state of California’ State Board of Registered Nurses for RN’s, LVN’s and CNA’s (#13719) as well as for RCFE Administrators (1000920-740-2) Lic#385600368

Go to  http://www.nia.nih.gov/alzheimers/publication/2010-alzheimers-disease-progress-report-deeper-understanding

The National Institute on Aging (NIA), part of the Federal Government’s National Institutes of Health (NIH) at the U.S. Department of Health and Human Services, has primary responsibility for basic, clinical, behavioral, and social research in Alzheimer’s disease, aimed at finding ways to treat and, ultimately, prevent this disease. The Institute’s Alzheimer’s disease research program is integral to its mission, which is to enhance the health and well-being of older people. This 2010 Progress Report on Alzheimer’s Disease summarizes Alzheimer’s research conducted or supported by the NIA and other components of NIH, including:

• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
• National Cancer Institute (NCI)
• National Center for Complementary and Alternative Medicine (NCCAM)
• National Center for Research Resources (NCRR)
• National Eye Institute (NEI)
• National Heart, Lung, and Blood Institute (NHLBI)
• National Human Genome Research Institute (NHGRI)
• National Institute of Allergy and Infectious Diseases (NIAID)
• National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
• National Institute of Biomedical Imaging and Bioengineering (NIBIB)
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
• National Institute of Environmental Health Sciences (NIEHS)
• National Institute of General Medical Sciences (NIGMS)
• National Institute of Mental Health (NIMH)
• National Institute of Neurological Disorders and Stroke (NINDS)
• National Institute of Nursing Research (NINR)
• National Institute on Alcohol Abuse and Alcoholism (NIAAA)
• National Institute on Deafness and Other Communication Disorders (NIDCD)
• National Institute on Drug Abuse (NIDA)
• National Library of Medicine (NLM)

Related articles

• NIH Scrambling to Shift $50 Million Into Alzheimer’s Research (news.sciencemag.org)

Step into my Shoes..Validating the Older Person with Memory Loss

Thursday, May 17th 2012 from 8:00AM-10:00AM
Presented at San Clemente Villas by the Sea
660 Camino de Los Mares, San Clemente

Aging Matters Inc. President/Founder, Dr. Jane Mahakian talks about validating the older person with dementia.

• Learn ways to validate and empower
• Best Practices for those with memory loss
• Understanding the meaning behind behavioral challanges
• Was to develop person centered care

To RSVP telephone: 949 212-4105 or Aileen Brazeau at 949 289-1534

Professionals may be eligible for 2 CEU credits. This seminar has been approved by the state of California’ State Board of Registered Nurses for RN’s, LVN’s and CNA’s (#13719) as well as for RCFE Administrators (1000920-740-2) Lic#385600368

CT Scanner, Crash Cart (Photo credit: Civilian Scrabble)

The blog piece, How Doctors Die, It’s Not Like the Rest of Us, But It Should Be by Ken Murray, MD, has come up repeatedly in more than one of my San Francisco support groups .. and around the internet .. and newspapers, and blogs, ..

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little.

An interesting read, and something to think about when planning for yourself and your loved ones.  Just a bit of the ripple effect created by this article can be explored in the related article section below, but the Time article by Shannon Brownlee nicely expands on the themes begun in Ken Murray’s article.

Related articles

• Time: What Doctors Know – And We Can Learn – About Dying
  (ideas.time.com)
• The Washington Post: How Doctors Die, cont’d
  (washingtonpost.com)
• The New Old Age Blog: When Doctors Face Death
  (newoldage.blogs.nytimes.com)

Related articles

• Use it or Lose it: A Graphic Illustration (bettermovement.org)

Antibody Rendering (Credit: Image courtesy of Rensselaer Polytechnic Institute)

Sciencedaily.com recently post this article about the development of an Alzheimer’s antibody. According to Assistant Professor of Chemical and Biological Engineering Peter Tessier and his colleagues at Rensselaer Polytechnic Institute and with funding from the Alzheimer’s Association, the National Science Foundation (NSF), and the Pew Charitable Trust, a new method for designing antibodies in a “surprisingly simple” way has produced some promising results.

Using antibodies to attack and eliminate offending proteins, like APoE4, is nothing new and the buzz around this type of treatment did not appear without promising initial results. However, upon further trials, some of the early attempts have resulted in only “okay” results often due to dangerous side effects like brain swelling.

So whats the big deal? Well, it seems that the ability to easily design antibodies is the breakthrough here. Easier methods for designing antibodies may mean more designs, and more deigns may mean that researchers will be able to eventually create more targeted antibodies. In the case of the “Rensselaer” study, the most promising antibody developed using the new method only attacks the toxic, sticky “Alzheimer’s protein” rather than the building blocks of the Alzheimer’s protein.

Read the original Sciencedaily.com article by clicking below and check out the other links below for a bit of background on antibody treatment for Alzheimer’s:

Researchers design Alzheimer’s antibodies: Surprisingly simple method to target harmful proteins.

Related articles

• NPR Radio Broadcast – All Things Considered
  April 12, 2005 — A small study being presented at the American Academy of Neurology meeting in Miami suggests that treating Alzheimer’s patients with a type of antibody may halt or even reverse progress of the degenerative disease.
•  Wall Street Journal Health Blog – Shirley S. Wang
  June 17, 2008 — Mixed Results for Experimental Alzheimer’s Antibody
• Alzheimer’s Vaccine Triggers Brain Inflammation When Brain Amyloid Burden Is High
  November 15, 2011 — (medicalnewstoday.com)
• Researchers look to immune therapy to treat Alzheimer’s
  

  December. 11, 2011 — (theglobeandmail.com)

From Huffington Post: http://www.huffingtonpost.com/marguerite-manteaurao/alzheimers_b_833644.html

Some surprising points covered in the CDC’s fact sheet on falls:

• Falls are the leading cause of death among adults 65 and older.
• Over the past 10 years, fall related deaths have risen sharply among older men and women.
• Moderate to severe injuries (ie. lacerations, hip fractures and head trauma) occur in 20 to 30% of the falls reported. Many falls aren’t reported at all.
• Almost 20,000 fall related deaths were reported in 2008
• In 2009 2.2 million non-fatal falls were treated in U.S. Emergency rooms.
• Falls can be a downward spiral. Injuries and the fear that result  from falling can limit individuals’ activities. This can lead to reduced mobility and reduced physical fitness which then increases the risks of further falls.
• Men fall more than women but women experience fractures more often then men.

For people at home with mobility issues, identifying fall hazards could stave off the potential for serious injury, hospitalization and even early death.  Any care management professional worth their salt should do a fall prevention “sweep” of the home as part of their original assessment. Below are many of the things I look for in a client’s home; it should be handy in your own home or the home of a loved one at risk for taking an unwanted trip.

But First, Talk to a Doctor …
… especially if abrupt changes occur to one’s balance, strength, and/or a general change to the way someone normally walks (aka: gait changes). An abrupt change could be the result of a serious medical condition. What we are talking about here is a gradual decline in mobility that has probably been noticeable for some time, perhaps there is a history of falling or a recent fall. Even in the case of a gradual change, doctors may want to rule out new or undiagnosed medical conditions.

Review Medications & Supplements 
Make sure that doctors understand how side-effects and drug interactions (including over-the-counter medicines) may express within an elderly patient. Consult with or switch to an trusted doctor is a Geriatric Specialist. Consider an osteoporosis screening and consult with doctors on making sure that vitamin D and calcium levels are appropriate.  Also, talk to the pharmacist, explain mobility and balance issues and to ask for advice when introducing a new prescription or over-ther-counter medication.

Physical Therapy & Exercise
Explain the mobility and balance changes to a Doctor, once other medical conditions are ruled out s/he may offer a referral to a Physical Therapist for a balance assessment – if the doctor doesn’t offer physical therapy (PT) go ahead and ask for a referral.  A Physical Therapist can assess balance, recommend a cane or walker and devise a training and exercise plan. The plan usually consists of about three to six sessions. PT sessions are usually covered by Medicare or insurance, and Physical Therapists will often make house calls since mobility is the issue at hand.

Treatment for Balance and mobility issues generally involve a good amount of strength building in the legs; cane or walker training if applicable; techniques for getting in and out of chairs, beds and vehicles. The therapist may also recommend ongoing exercises to maintain and increase strength and balance – ask them to if they don’t.

When Jack LaLanne yelled, “use it or lose it” he was talking about balance too. Weight bearing exercise strengthens muscles and bones. Stronger legs help us recover from a misstep or stumble and, of course, strong bones protects us from fractures when a fall takes place.

Eye Glasses
Keep that eye glass prescription up to date. The CDC recommends considering a dedicated pair of single vision distance glasses used when walking outside. Check with an Optometrist about current glasses and whether they are appropriate for someone with mobility issues.

Fall Prevention Sweep in the Home
Tidy up, Rearrange & Lighting
Remove clutter! Clear walk ways and hallways. It is natural for newspapers, mail, and other items to accumulate near that favorite chair, get a magazine rack or a waste can to keep things tidy.  Rearrange and remove furniture to accommodate canes and walkers.

Make sure furniture is conducive to mobility needs – will that side table collapse if it has to be used for support in an unbalanced moment? Get rid of it or replace it with a sturdier table.  Identify potential low lying hazards in case a fall does happen. That beautiful marble fireplace hearth and that cute, crocheted brick door-stop can be lethal. Make sure rugs, mats and floor runners don’t ripple or slide easily, it is probably safest to just remove most of them.

Finally, make sure the lighting is adequate around the home. Brighter bulbs don’t have to mean new lamps and fixtures – compact fluorescent light bulbs burn brighter and cooler than incandescent predecessors.

Fall Hotspots
Bathrooms, hallways, bedrooms and of course stairways are especially tricky areas. To increases independence and decrease falls install permanent grab bars in showers, tubs and near the toilette. Banisters in hallways are very useful and don’t forget to double check the strength of that thirty year old banister in the stairway. It is often a good idea to install a second banister on the other side of the stairway too.

If falling out of bed is a problem take a trip to the medical supply store. Half bed rails are easy to install and help people move, stand and stabilize themselves when getting in and out of bed. Special high impact bedside mats can be used to soften landings. Low rise beds are available, but beds can also be lowered by removing the box spring if the bed frame cannot be adjusted.

Clothing & Shoes
While polyester is virtually indestructible, we are not.  Those rose colored, poly-knit, bell-bottoms still look fresh off the rack .. but tripping over that hem just isn’t worth the fashion statement. Check all pant hems, house coats and robes to make sure they are not too long.  A trip to the tailor could save a trip to floor.

Well fitted comfortable shoes are very important in preventing falls.  I suggest you burn loose fitting slip-0ns and flip-flops (or at least passionately slam-dunk them into the nearest trash can), slippers and sandals are safer with heel straps. Go to a shoe store that knows how to measure feet and fit shoes (probably not Payless or DSW). Ask a podiatrist for referrals to good shoe stores.

Finally, reducing fall risk takes plain old observation. Watching how someone moves around their space may reveal unforeseen obstacles. Try to take a look around with fresh eyes, it is natural to miss hazards in an environment that we are accustomed to.

In part two of this post (coming soon), we’ll look at a few more statistics and what fall prevention looks like in managed care communities and nursing homes.

The Arts Health Institute is part of The Dementia Collaborative Research Centers funded by the National Health and Medical Research Council of Australia.