Growing number of seniors caring for other seniors

Growing number of seniors caring for other seniors

January 6, 2014 3:59 AM ET
By MATT SEDENSKY from The Associated Press

NOBLESVILLE, Ind. (AP) - Paul Gregoline lies in bed, awaiting the helper who will get him up, bathed and groomed. He is 92 years old, has Alzheimer's disease and needs a hand with nearly every task the day brings. When the aide arrives, though, he doesn't look so different from the client himself - bald and bespectacled.

"Just a couple of old geezers," jokes Warren Manchess, the 74-year-old caregiver.

As demand for senior services provided by nurses' aides, home health aides and other such workers grows with the aging of baby boomers, so are those professions' employment of other seniors. The new face of America's network of caregivers is increasingly wrinkled.

Among the overall population of direct-care workers, 29 percent are projected to be 55 or older by 2018, up from 22 percent a decade earlier, according to an analysis by the Paraprofessional Healthcare Institute, or PHI, a New York-based nonprofit advocating for workers caring for the country's elderly and disabled. In some segments of the workforce, including personal and home care aides, those 55 and older are the largest single age demographic.

"I think people are surprised that this workforce is as old as it is," said Abby Marquand, a researcher at PHI. "There's often people who have chronic disease themselves who have to muster up the energy to perform these really physically taxing caregiving needs."

Manchess came out of retirement to work for Home Instead Senior Care after caring for his mother-in-law, who, too, had Alzheimer's and whom he regarded as his hero. The experience, though taxing, inspired his new career.

Three days a week, he arrives at Gregoline's house, giving the retired electrician's wife a needed break. He carefully shaves and dresses his client, prepares breakfast and lunch, cleans the house and quickly remedies any accidents. He does the laundry and swaddles Gregoline in a warm towel from the dryer, reads him the sports page to keep him updated on his beloved Bears and sometimes pulls out dominoes or puzzles to pass the time.

Gregoline is rather sedate this afternoon, relaxing in his favorite chair while occasionally offering glimpses of his trademark wit. Asked if he remembered anything about the Army, he says: "It was a bitch!" Offered the chance to go outside, he responds: "No! I'll freeze my ass off out there!" Describing an abrasive personality of long ago, he offers: "He followed me around like a bad conscience."

Manchess has worked for Gregoline for about a year, and the men are at ease around each other. Past aides to Gregoline have been in their 20s, but Manchess says he thinks his age is an asset.

"Age can be an advantage," he said, pointing to the common conversation points and life experience, including his own health troubles and aches and pains that can come with age. "We hit it off pretty well. Maybe I didn't seem to be too much out of the ordinary."

Around the country, senior service agencies are seeing a burgeoning share of older workers. About one-third of Home Instead's 65,000 caregivers are over 60.

Like most occupations, some of the growth in older caregivers is driven by the overall aging of the population and the trend of people working later in life. But with incredibly high rates of turnover and a constant need for more workers, home care agencies have also shown a willingness to hire older people new to the field who have found a tough job market as they try to supplement their retirement income.

The jobs are among the fastest-growing positions in the U.S., but are also notoriously physically demanding, with low pay and high rates of injury. Manchess has had spinal surgery and says he's especially careful when vacuuming. He's not sure how many years he'll be able to continue this work, and he acknowledges it can be tough.

"Halfway through my shift, I'm a little weary myself," he said. "It takes its toll."

Manchess had worked as an Air Force pilot, then in real estate, then as a school bus driver, before becoming a professional caregiver. As Gregoline contentedly nibbles on his ham sandwich, Manchess wraps up his shift, turning reflective when considering his life's careers.

"I think this is about as rewarding, if not more rewarding, than any of them," he said.

Article is C/O:
Associated Press http://www.ap.org/

Matt Sedensky, an AP reporter on leave, is studying aging and workforce issues as part of a one-year fellowship at the AP-NORC Center for Public Affairs Research, which joins NORC's independent research and AP journalism. The fellowship is funded by the Alfred P. Sloan Foundation and supported by APME, an association of AP member newspapers and broadcast stations.
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Follow Matt Sedensky on Twitter at http://twitter.com/sedensky

Can changes in the eyes help diagnose Alzheimer’s Disease?

Diagnosing someone with Alzheimer’s disease can be a long and complicated process.  In addition to reviewing a patient’s full medical history, doctors must also subject individuals to expensive brain scans or invasive surgical procedures in order to be fully certain of the disease’s presence.

But now, there may be an easier way to spot the brain-wasting condition.  Researchers from Georgetown University Medical Center (GUMC) and the University of Hong Kong have found that it may be possible to diagnose Alzheimer's simply by screening for changes in two very important organs: the eyes.

In a new study presented at the Neuroscience 2013 conference, the scientists detailed how the thickness of a particular layer of retinal cells may serve as an indication of Alzheimer’s progression.

“We’re looking for biomarkers for early disease [recognition], partly for our new clinical studies focusing more on prevention of Alzheimer’s… and to test new drugs,” study author Dr. R. Scott Turner, director of the Memory Disorder Program at GUMC, told FoxNews.com.  “We’re hoping to incorporate this as a new biomarker for drug trials and potentially for screening and prognosis.”

Currently, there are two leading biomarkers that physicians can utilize to diagnose Alzheimer’s.  One is the buildup of beta-amyloid plaques in the brain, which can be observed through positron emission tomography (PET) or computed tomography (CT) scans.  The other involves measuring changes in protein levels of the cerebrospinal fluid – the liquid surrounding the brain and spinal cord.

However, brain imaging scans can be expensive for patients, and in order collect samples of the cerebrospinal fluid, doctors must administer a spinal tap, which can be a very invasive procedure.

Hoping to find a simpler biomarker, Turner and his colleagues decided to analyze the relationship between the eyes and dementia.  According to Turner, the retina serves as a direct extension of a person’s brain.

“The retinas have neurons themselves that send projections straight into the brain,” Turner said. “…Those nerve cells are directly connected to the brain via the optic nerve….So when looking at the retina, it’s the easiest place to see the brain and its neurons.”

Turner also noted that there has been an established association between glaucoma and Alzheimer’s, though the mechanisms behind the relationship remain unclear.  Most studies examining this connection have revolved around the retinal ganglion cell layer, which is responsible for transmitting visual information through the optic nerve.  However, this cell layer relies on information it receives from another layer in the retina called the inner nuclear layer, which had never before been studied in relation to dementia.

With this knowledge in mind, the researchers analyzed a group of mice that had been genetically engineered to develop Alzheimer’s disease, observing the thicknesses of the six layers in their retinas. They found that there was significant loss in thickness to both the inner nuclear layer, which experienced an average 37 percent loss of neurons, and the retinal ganglion cell layer, which experienced an average 49 percent loss.

According to Turner, these two retinal layers may be most vulnerable to neuron loss because they are larger than the other layers.

“The larger the neuron, the more vulnerable it seems to be to injury,” Turner said.  “We looked at some of the other [smaller] neurons, and they didn’t lose much because they were presumably less vulnerable. So we think whatever is killing neurons in the brain is killing the bigger nerve cells in the retina.”

The next step, Turner said, is to see if this biomarker translates to humans with Alzheimer’s.  If similar changes in retinal thickness occur in people, then a simple, noninvasive procedure known as optical coherence tomography (OCT) can be used to measure loss of neurons in these layers.

“If this holds true with humans and seems to be predicative, it could be used for screening, diagnosis, prognosis, but probably more immediately, a research tool to test new drugs,” Turner said. “…But we should probably be looking at the retinal thickness of our Alzheimer’s patients.”

Care of: http://www.foxnews.com/health/2013/11/13/can-changes-in-eyes-help-diagnose-alzheimers-disease/

Alzheimer's blog: Watching The Lights Go Out

We wanted to share with you this blog by David Hilfiker.  He was diagnosed with Alzheimer's in September 2012.

Enlightening journey. http://davidhilfiker.blogspot.com/

Study Seeks Super Agers' Secrets To Brain Health

CHICAGO (AP) — They're called "super agers" — men and women who are in their 80s and 90s, but with brains and memories that seem far younger.

Researchers are looking at this rare group in the hope that they may find ways to help protect others from memory loss. And they've had some tantalizing findings: Imaging tests have found unusually low amounts of age-related plaques along with more brain mass related to attention and memory in these elite seniors.

"We're living long but we're not necessarily living well in our older years and so we hope that the SuperAging study can find factors that are modifiable and that we'll be able to use those to help people live long and live well," said study leader Emily Rogalski, a neuroscientist at Northwestern University's cognitive neurology and Alzheimer's disease center in Chicago.

The study is still seeking volunteers, but chances are you don't qualify: Fewer than 10 percent of would-be participants have met study criteria.

"We've screened over 400 people at this point and only about 35 of them have been eligible for this study, so it really represents a rare portion of the population," Rogalski said.

They include an octogenarian attorney, a 96-year-old retired neuroscientist, a 92-year-old Holocaust survivor and an 81-year-old pack-a-day smoker who drinks a nightly martini.

To qualify, would-be participants have to undergo a battery of mental tests. Once enrolled, they undergo periodic imaging scans and other medical tests. They also must be willing to donate their brains after death.

The memory tests include lists of about 15 words. "Super agers can remember at least nine of them 30 minutes later, which is really impressive because often older adults in their 80s can only remember just a couple," Rogalski said.

Special MRI scans have yielded other remarkable clues, Rogalski said. They show that in super agers, the brain's cortex, or outer layer, responsible for many mental functions including memory, is thicker than in typical 80- and 90-year-olds. And deep within the brain, a small region called the anterior cingulate, important for attention, is bigger than even in many 50- and 60-year-olds.

The super agers aren't just different on the inside; they have more energy than most people their age and share a positive, inquisitive outlook. Rogalski said the researchers are looking into whether those traits contribute to brain health.

Other research has linked a positive attitude with overall health. And some studies have suggested that people who are "cognitively active and socially engaged" have a reduced chance of developing Alzheimer's disease, but which comes first — a healthy brain or a great attitude — isn't known, said Heather Snyder, director of medical and scientific operations for the Alzheimer's Association.

Snyder said the SuperAging study is an important effort that may help provide some answers.

Edith Stern is among the super agers. The petite woman looks far younger than her 92 years, and is a vibrant presence at her Chicago retirement home, where she acts as a sort of room mother, volunteering in the gift shop, helping residents settle in and making sure their needs are met.

Stern lost most of her family in the Holocaust and takes her work seriously.

"What I couldn't do for my parents, I try to do for the residents in the home," she said, her voice still thick with the accent of her native Czechoslovakia.

Stern acknowledges she's different from most people at the home, even many younger residents.

"I am young — inside. And I think that's the difference," she said.

"I grasp fast," she adds. "If people say something, they don't have to tell me twice. I don't forget it."

She's different in other ways, too.

"When you get old, people are mainly interested in themselves. They talk about the doctor, what hurts," she said. "You are not so important that you just concentrate on yourself. You have to think about other people."

Study participant Don Tenbrunsel has a similar mindset. The 85-year-old retired businessman doesn't think of himself as a super ager. "Neither do my children," he says, chuckling.

But Tenbrunsel says his memory has been sharp "from the time I was born. My mother used to say, 'Donald, come sing with me — not because I had a good voice, but because I always knew the words," he said. "I think I'm just lucky, not only with respect to my memory, but I'm able to get around very well; I walk a lot and I have a pretty good attitude toward life itself."

Tenbrunsel volunteers several hours a week at a food pantry run by the Chicago church where he is a parishioner. One recent morning in the sun-filled rectory kitchen, he nimbly packaged ham and cheese sandwiches, set out bags of chips and cans of soda, and cheerfully greeted a steady stream of customers.

"Good morning, good to see you," he said, standing at the pantry's bright red door. He gave everyone their choice of chips — a small gesture but important, he said, because it gives them some sense of control over their hard-luck lives.

"I enjoy doing it. I probably get more out of it than I give," Tenbrunsel said.

Ken Zwiener, of Deerfield, Ill., is another super ager. He had "more than an inkling" he might qualify for the study, and his kids encouraged him to enroll.

"They said, 'Dad, your brain is the best thing about you,'" the 81-year-old retired businessman recalled.

He's a golfer and Broadway musical "nut" who created a 300-plus-page computer database of shows. Zwiener uses an iPad, recently went hot-air ballooning and is trying to learn Spanish.

He also pours himself a vodka martini every night and is a pack-a-day cigarette smoker, but says he doesn't think his habits have made much difference. His healthy brain, he says, may be due to heredity and genes, but Zwiener said he hopes the study comes up with more "scientific insights".

"My dad lived into his middle 90s and was pretty sharp right up until the day he died," Zwiener said.

Zwiener's motivation for joining the study was simple: The best man at his wedding died of Alzheimer's disease before age 50.

"To lose a mind ... is just a terrible way to go," he said.

Article is care of:

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Online:

SuperAging study: http://tinyurl.com/lo75t7b

Alzheimer's Association: http://www.alz.org

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

Alzheimer's Disease & Other Dementias Course

As schools are letting out for the summer, I want to remind you that we offer online Alzheimer’s and dementia care training classes for family caregivers year-round, 24/7! Each class is self-paced and takes about 5-15 minutes to complete. Check it out and be sure to share this course with a friend or sibling!  Go to: helpforalzheimersfamilies

Dementia-Associated Behaviors

Dementia-Associated Behaviors

Alzheimer's disease or other dementia affects the way a person thinks, feels and behaves. Some of these behaviors may seem uncharacteristic or odd. Because of the dementia, the person cannot prevent or control these actions.Because communication can be difficult, a person with Alzheimer's disease or other dementia may use anger to express him/herself. Triggers for angry bouts can be exhaustion, pain, illness or frustration. Bring up a best-liked subject from the person's life journal, or take a break to change a bad mood into a good one.

Alzheimer's disease and other dementias impact the ability to reason, making questions and tasks difficult to understand. Just like most people, when asked to do something he/she doesn't understand or feel comfortable with, a person with dementia will often respond, "No!" Use a life journal to find a personal appeal to change a no to a "yes."

People with dementia often have difficulty speaking and writing. He or she might not say or come up with the right words. Looking for non-verbal clues can help.

For example, look for a:
Smile - happiness
Frown - discomfort
Grimace - pain

Because communication is difficult, health-related issues that cause discomfort, pain or sadness can lead your loved one to be frustrated, confused and act out. Be sure to monitor for these health issues so that you can work with medical professionals to relieve them and create a better quality of life for your loved one.

Some behaviors can put a person's or caregiver's emotional and physical well-being at risk. Inappropriate physical and/or emotional behaviors are common and include unhealthy eating habits, lack of hygiene and personal care, striking out, wandering, repetition, withdrawing from social situations and false accusations.

Managing behaviors that can put you or your loved one at risk is important. You may have to try several times in order to change a situation. Home Instead recommends choosing from among the five methods we have outlined here. In fact you may have to try "three times in three different ways." This means if a choice doesn't work then try apologizing, and then redirecting or any three combinations of the five options until you successfully change your loved one's behavior.

Give simple choices. This allows your loved one to calm down and feel in control. Assume they will do the task, but give choices/options of how, when and where they will do it.

Apologize or take the blame for the situation, even if it isn't your fault. This takes the attention off of your senior and it may help them calm down.

If the person suffering with dementia is doing or saying something inappropriate, redirect his/her attention to another topic or activity.
If an item or location is causing stress, physically remove the object that is bothering them or take the person to another room.

Use a journal to find memories and best loved activities that you can use to offer choices and redirect your loved one's attention to improve his/her mood and behaviors.

Respond to a negative behavior within the first 30 seconds of noticing it. Doing so can prevent a situation from escalating into a major problem and help keep you and your loved one safe. And don't forget to try "three times in three different ways" until you are able to change the challenging behavior into a good one.

State To Sound Alarm For Straying Seniors

A decade after California launched its Amber Alert program, which enlists citizen help in searching for missing children, the state will add a similar program for another of society's at-risk groups: its elderly.

It's called the Silver Alert program.

Starting Jan. 1, if a person age 65 or older with dementia or Alzheimer's disease is reported missing and believed to be in peril, local police will have the authority to ask the California Highway Patrol to issue an electronic bulletin asking for public, news media and broader law enforcement help to find the person.

California joins an estimated 30 states with Silver Alert programs, acknowledging a growing issue for the nation as the population ages and the number of people suffering from some form of dementia increases.

It's about time, said Joseph Murphy of Tracy, a member of the California Senior Legislature, who has been pushing for years for an alert program.

"California is usually a national leader," Murphy said. "But this time they were dragging their feet."

As the massive wave of baby boomers ages, California's 65-plus population is projected to double from 4.5 million to 9 million in the next 20 years.

An estimated 500,000 seniors now are living with some level of dementia, a number expected to double by 2030, according to former state Sen. Elaine Alquist, the Santa Clara Democrat who authored the Silver Alert law, Senate Bill 1047.

The new law differs from Amber Alerts in several respects. Amber Alerts often are triggered when a child is believed to have been abducted. Silver Alerts are likely to be triggered when older people wander or drive away from their homes or nursing facilities – a practice common among people with moderate to severe dementia.

Advocates for the elderly say it is critical to track down a missing wanderer in the first 24 hours. Many will walk or drive for hours, even if they are feeble. They may fail to eat, may not be dressed for inclement weather, and generally won't ask for help. They may need medications for their health.

"If not found within 24 hours, up to half of wandering seniors with dementia suffer serious injury or death," a state legislative analysis said.

Ruth Gay of the Alzheimer's Association of Northern California said wandering happens when a person becomes confused and fails to recognize his surroundings. The person typically will set out looking for familiar surroundings, or "home," even if that home is a childhood residence he hasn't lived in for decades.

The stories have become commonplace:

• A south Sacramento man leaves for a short walk and comes out of his fog hours later, 10 miles from home, completely lost.

• A man driving to Los Angeles forgets he is traveling with his wife and leaves her at a roadside restaurant. He is found three days later, on foot and confused at the Mexican border.

• An elderly Bay Area man drives aimlessly for 36 hours, gets in two crashes and is finally stopped by police and ticketed for driving the wrong way on a street.

Law author Alquist said the state needs to continue to expand its safety net for the elderly.

"When we think of the number of baby boomers out there, it is a train wreck in the making if we don't figure out ways to protect our seniors," Alquist said.

Her law will sunset at the beginning of 2016, but can be extended by legislative vote if officials determine it is useful.

Some other states' Silver Alert systems apply to missing people of all ages, acknowledging the fact that some people in their 50s and even younger suffer from confused thinking and dementia. Alquist said she wrote her bill limiting California's program to people 65 and older, for now, to reduce opposition from state officials who worried about the potential cost and burden of a more expansive program.

Under the new law, the CHP, once contacted by local law enforcement, will determine if the case is dire enough to be posted on electronic bulletins, including messages to news media and neighboring law enforcement agencies.

Unlike Amber Alerts, missing seniors' information won't be posted on freeway signboards. Television and radio stations will have the option of whether to interrupt programming to broadcast the alert.

According to state officials, an alert will be activated if "the person is missing under unexplained or suspicious circumstances," and if law enforcement "believes the person is in danger due to age, health, mental or physical disability, environment or weather conditions."

The alert can be triggered also if the elderly person is "in the company of a potentially dangerous person, or there are other factors indicating that the person may be in peril."

While the system is expected to receive widespread publicity, officials said alerts may not be activated very frequently.

Amber Alerts for missing children have been triggered only 200 times in the decade that system has been in place. The state also has a Blue Alert system, which can be activated when a law enforcement officer has been killed or assaulted by someone who has fled.

Sacramento city police officials said they regularly get calls about missing adults, but most of those are quickly resolved and often are based on miscommunications. City police Detective Chris Bernacchi estimated that about 10 reports of elderly people who disappeared last year would have met the criteria for the new alert.

"It will be helpful to get everybody on the same page," said Bernacchi. "Anything that will get more information to the public to assist us in locating a missing person is great."

Article c/o:  http://www.sacbee.com/2012/12/20/5066553/state-to-sound-alarm-for-straying.html

Read more here: http://www.sacbee.com/2012/12/20/5066553/state-to-sound-alarm-for-straying.html#storylink=cpy

Live Online Chats with Alzheimer's Experts

The next Live Chat for those caring for a loved one with Alzheimer's is scheduled for Friday, Nov. 16th at 12 pm EST. What questions would you like to ask the expert? Do you have any tips you'd like to share for capturing memories? Please share and be sure to register for this informative chat.

Please take time to register today:

https://www.helpforalzheimersfamilies.com

Help For Alzheimer's Families

In conjunction with the Alzheimer's training workshops and network-wide emphasis on Alzheimer's disease and other dementia's during Alzheimer's Awareness Month in November, we will hold a series of four Live Chats led by Alzheimer's and caregiving experts to address questions from family caregivers. Registration will start on October 19. Please register at http://helpforalzheimersfamilies.com

Books to Teach Children About Alzheimer’s

I stopped at a children’s bookshop in Manhattan last week and asked to see books on Alzheimer’s disease. The store stocked at least half a dozen, with titles like “What’s Wrong with Grandma?” and “What’s Happening to Grandpa?”

That was only a small sample. Three doctoral students at Washington University, analyzing the way storybooks describe the disease, found 33 of them published for 4- to 12-year-olds from 1988 to 2009.

It’s a growing market, since the number of people with Alzheimer’s keeps rising along with the number of older Americans. I wonder, given that most of those people are in their 70s and 80s, whether storybook readers are likely to be not grandchildren but great-grandchildren.

Nonetheless, “storybooks about a difficult disease like Alzheimer’s can be a gentle way to introduce it to young children,” said Erin Y. Sakai, lead author of the study, which was just published in the American Journal of Alzheimer’s Disease and Other Dementias. “It’s a recognized technique.” Not only can books give children insight, she added, but also, “they can also guide parents with their discussions.”

Ms. Sakai and her co-authors were disappointed, however, by many of the 33 books they examined. “There are areas that are important to address that some books aren’t capturing,” she told me in an interview.

Like, for example? “The books did a generally good job of portraying the cognitive aspects — memory problems, poor judgment,” Ms. Sakai said. “But other elements were less well-represented.”

They include symptoms like wandering, agitation, sleep disturbances and depression. Only about a third of the books depicted anger or irritability, and very few showed functional limitations — the inability to drive, feed oneself, walk.

The researchers, arguing for more comprehensive portraits, noted that only a quarter of the books discussed the diagnostic process, and only 12 percent reassured kids that Alzheimer’s wasn’t catching and that they wouldn’t come down with it. Acknowledgments that people with the disease will get worse were rare, and references to incurability and eventual death even rarer.

Moreover, few authors pointed out the difference between dementia and normal aging. “I think that’s an important distinction, in terms of reducing stereotypes about aging in general,” Ms. Saka saidi.

Who could disagree? But some books that hit most of those marks — likeMaria Shriver’s “What’s Happening to Grandpa?” — struck me as so earnestly well-intended and so lifeless that I couldn’t imagine reading it the requisite 30 times in a row to a 6-year-old.

Ms. Sakai declined to offer opinions on specific titles, so I called my highly opinionated friend Marjorie Ingall, a Tablet columnist who reviews children’s books for The New York Times. “The kid’s not going to want to hear it 30 times,” she pointed out. “The kid will run from the room.”

We both sympathized, as authors ourselves, with the difficulties of trying to convey information about a terrible disease while simultaneously telling an absorbing story, all without inducing nightmares. But, Ms. Ingall insisted, “Picture books are not school. Picture books are not medicine. You can be a very little kid and understand good literature.”

The book we both liked — I felt so validated — was “The Memory Box,” published 20 years ago by a small Illinois press, written by Mary Bahr and beautifully illustrated by David Cunningham. I imagine the Washington University team would find it insufficiently comprehensive — it doesn’t mention diagnostics or communicability, and uses the term “Alzheimer’s disease” precisely once — but it’s a lovely tale of a boy already feeling the loss of his grandfather.

“It works as a story,” Ms. Ingall said. “I believe in the concept of bibliotherapy. Reading about stuff can enrich your life. But you have to start with, ‘Is this book successful as a book?’”

I don’t imagine children’s authors will resolve this tension between comprehensiveness and literary merit any time soon, but meanwhile, I thought I’d pass along a couple of Ms. Ingall’s other picks for parents and grandparents hoping to introduce children to a subject we would all rather not face.

She likes “Still My Grandma,” by Veronique Van Den Abeele, with illustrations by Claude K. Dubois, because “it’s got lot of kid appeal.”

And for older readers past the picturebook stage, she gives props to Gordon Korman’s “Pop,” the rare book in which a character has early-onset Alzheimer’s. And to Jordan Sonnenblick’s “Curveball: The Year I Lost My Grip,” because “it’s fabulous.”

For more information: http://newoldage.blogs.nytimes.com

Is Long-Term Use of Ginkgo Biloba Effective for Alzheimer’s Disease?

An estimated 5.1 million adults in the United States have Alzheimer’s disease, according to the National Institute on Aging. A common form of dementia, Alzheimer’s disease affects cognitive and behavioral function.

In the later stages of the disease, Alzheimer’s disease significantly affects memory and cognition, resulting in patients being unable to recognize their family members and understand language.

Because of the serious effects of the disease, research has investigated new treatment possibilities. Currently, there is no cure for Alzheimer’s disease.

The U.S. Food and Drug Administration have approved four medications for Alzheimer’s disease: donepezil, rivastigmine, galantamine and memantine.

Rivastigmine and galantamine are for mild to moderate Alzheimer’s disease, while memantine is for moderate to severe Alzheimer’s. Donepezil is used for mild to moderate as well as severe Alzheimer’s.

Some patients have looked into alternative treatments to help with the symptoms of Alzheimer’s disease. One such alternative treatment is ginkgo biloba. The herb contains two components thought to have medicinal effects: flavonoids and terpenoids.

The University of Maryland Medical Center noted that in Europe, ginkgo biloba is used for the treatment of dementia, with the original rationale being that the herbal medicine improved flow of blood to the brain. Currently, it is thought that it protects cells in the brain that are damaged by Alzheimer’s disease.

Possible benefits of ginkgo biloba include improvements in cognitive function, social behavior and activities of daily living, according to the University of Maryland Medical Center.

However, long-term use of ginkgo biloba may not protect users’ Alzheimer’s disease from progressing. A randomized double-blind study investigated the effects of gingko biloba on Alzheimer’s disease progression over five years.

The study included 2,854 participants, who were divided into two groups: a group that received at least one ginkgo biloba extract dose (1,406 individuals), and a group that received at least one placebo dose (1,414 participants).

Article care of:  http://www.empowher.com/alzheimer039s-disease/content/long-term-use-ginkgo-biloba-effective-alzheimer-s-disease

September is World Alzheimer's Month!

World Alzheimer’s Month 2012 - Dementia: Living together

September is World Alzheimer's Month!

September 2012 marks the first global World Alzheimer’s Month, an international campaign to raise awareness and challenge stigma.

The theme for World Alzheimer's Month 2012 is Dementia: Living together.

Alzheimer associations across the world will focus their activities on reducing the stigma associated with dementia and making communities more dementia-friendly by offering a range of programmes and events. Activities will include educational seminars, workshops and enjoyable social events for people with dementia and their carers. Memory Walks will take place in numerous countries with communities gathering to show their commitment to remembering those who they have lost and creating a society where people with dementia and their families can live without the fear of discrimination.

For More info visit:  http://www.alz.co.uk/world-alzheimers-month

GO PURPLE TO END ALZHEIMER'S

GO PURPLE TO END ALZHEIMER'S






September is World Alzheimer's Month. Worldwide, 35 million people and their families are affected by dementia. Join us by raising awareness, reducing stigma and sharing your story. Together, we can help end Alzheimer's.

GO PURPLE!

Wear purple on Sept. 21, Alzheimer's Action Day; then turn Facebook and Twitter purple by changing your profile picture to our END ALZ icon & telling your friends to do the same.
Go purple!

SHARE YOUR STORY!

Whether it's by sharing a diagnosis — or taking action to honor a family member — read how these brave individuals are overcoming stigma & facing Alzheimer's head on.
Be inspired!


BE INSPIRED!

Whether you are a caregiver, family member, person with the disease or friend – tell us how you are fighting stigma and taking action to end Alzheimer's.
Share your story.

Go to:  http://www.alz.org for more info

What Is Your Risk Of Developing Alzheimer's?

Despite fears of Alzheimer’s, many would like to know their risk for the disease

Alzheimer’s disease can’t be prevented or cured, and it ranks second only to cancer among diseases that people fear. Still, in an international study last year from the Harvard School of Public Health, about two-thirds of respondents from the United States said they would want to know if they were destined to get the disease. Although there are no definitive tests that predict whether most people will get the disease, people sometimes want such information for legal and financial planning purposes or to help weigh the need for long-term-care insurance.

Current tests to identify the risk of developing Alzheimer’s disease when no symptoms are present provide only limited information, and health insurance generally doesn’t cover them. But that’s not stopping some people from trying to learn more.

Most of the 5 million people who have Alzheimer’s developed it after age 60. In these cases, the disease is likely caused by a combination of genetic, lifestyle and environmental factors. About 5 percent of Alzheimer’s patients have inherited an early-onset form that is generally linked to a mutation on one of three chromosomes.


Research suggests that the brain may show signs of Alzheimer’s decades before obvious symptoms appear. Scans can identify the presence of beta-amyloid, a protein that is often deposited in the brains of people with the disease, for example. Changes in proteins in the blood or cerebrospinal fluid may also be associated with Alzheimer’s disease.

But tests to measure these changes are available only in a research setting, and insurance typically doesn’t cover them. James Cross, head of national medical policy and operations for Aetna, says his company “does not consider blood tests or brain scans medically necessary for diagnosing or assessing Alzheimer’s disease in symptomatic or asymptomatic people because the clinical value of these remains unproven.”

Genetic testing is somewhat easier to arrange, but insurers generally won’t pay for it, either.

In addition, genetic counselors caution that long-term-care insurers may use genetic testing results when evaluating whether to issue a policy. The Genetic Information Nondiscrimination Act prohibits health insurers and employers from discriminating against people based on their genetic information. However, life and long-term-care insurers are not covered by the law.

“Before anyone has genetic testing, they should get life insurance and long-term-care insurance,” says Jill Goldman, a certified genetic counselor at the Taub Institute at Columbia University Medical Center.

Genetic testing for late-onset Alzheimer’s involves one gene, the apolipoprotein E (APOE) gene on the 19th chromosome. The gene comes in three different forms — E2, E3 and E4. Everyone inherits one form, or allele, from each parent. Having one or two of the E4 variants can increase a person’s risk of developing Alzheimer’s disease three to 15 times.

About half of those who develop late-onset Alzheimer’s, however, don’t have any E4 alleles at all. Genetic testing in asymptomatic people therefore isn’t definitive or even all that informative, say experts. For late-onset Alzheimer’s, “the predictive value of genetic testing is low,” says Mary Sano, director of the Mount Sinai Alzheimer’s Disease Research Center.

But sometimes people want information, even if it’s inconclusive.

Brian Moore, whose father died of Alzheimer’s at age 89, wanted to know more about his genetic risk for the disease. Moore, 48, was better equipped than most to understand the testing: A neuropathologist who co-chairs the department of pathology at Southern Illinois University’s School of Medicine, he has performed hundreds of autopsies on the brains of people who died of Alzheimer’s disease.

Moore contacted 23andMe, a company that for $299 offers a genetic analysis of a person’s risk for more than 100 diseases and conditions, including Alzheimer’s, based on the APOE gene. The company sent him a specimen kit with a container for saliva collection that he then sent to a lab for analysis. About six weeks later, he logged on to the company’s Web site and learned that he has two E3 alleles, the most common variants, which means that his Alzheimer’s risk is average, at least as it relates to the APOE gene.

“It was reassuring,” he says. “I know it’s not determinant, and environment and lifestyle also play a role. But at least I have that base covered.”

The National Society of Genetic Counselors and the American College of Medical Genetics practice guidelines recommend against direct-to-consumer APOE testing for late-onset Alzheimer’s, in part because of the difficulty of interpreting the results.

Ashley Gould, 23andMe’s vice president of corporate development and chief legal officer, says that if people want help understanding their results, there are genetic counselors they can speak with. This service is available by phone for a fee based on the level of service.

But in the case of the APOE gene, some experts say, the information isn’t all that helpful.

“The things we know that really impact the disease are related to lifestyle,” says George Perry, dean and professor of biology at the University of Texas at San Antonio, who is the editor-in-chief of the Journal of Alzheimer’s Disease. “Be mentally and physically active, eat a diet rich in fruit and vegetables. These reduce the risk of developing the disease by at least half.”

This column is produced through a collaboration between The Post and Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health-care-policy organization that is not affiliated with Kaiser Permanente. E-mail: questions@kaiserhealthnews.org.

Article c/o:  http://www.washingtonpost.com

Home Instead CAREGivers Receive Alzheimer's Training

In mid 2009, the U.S Census Bureau released a report titled An Aging World: 2008. Highlights included the prediction that by 2040 more than 1.3 billion people around the world will be over the age of 65. In many countries, those over age 80 make up the fastest growing segment of the population, one that's predicted to increase 233% between 2008 and 2040. And it's expected that of those over 85, one of every two people will have Alzheimer's disease.

A Global Crisis

Every year, 4.6 million new cases of dementia are reported worldwide -- one new case every seven seconds. The 2009 World Alzheimer's Report estimates 35 million people around the globe are living with Alzheimer's and other forms of dementia. By 2050, the incidence will quadruple, meaning 115 million, or 1 in 85 persons, worldwide will be living with some form of dementia. The number of people with dementia is anticipated to increase by 40% in Europe and 89% in the developed Asia-Pacific countries.

Individual Needs 

To us, these statistics are not just numbers. They are individuals who require special care. They are families trying their best to care for an aging loved one. We know that the best place for a person with memory loss is in familiar surroundings. The services provided by the Home Instead Senior Care^® network of locally involved franchise offices is a valuable, trusted solution to help those struggling with the challenges of dementia to maintain a regular routine, enhancing quality of life. With more than 900 independently owned and operated offices internationally, Home Instead Senior Care is uniquely positioned to provide reliable, one-on-one senior care through more than 65,000 compassionate CAREGivers^SM. Because we've been caring for seniors with Alzheimer's since 1994, we have the experience and knowledge to help millions of families make what can be a most difficult time much less stressful.

Alzheimer's Training for CAREGivers Worldwide

Home Instead Senior Care's Alzheimer's care training programs are an important part of the training we provide. They give CAREGivers the latest in Alzheimer's education and dementia care techniques, so all franchises in your master territory can offer the care of a trusted professional, skilled in dealing with dementia-related issues.

CAREGivers are trained to:

• Maintain a safe environment
• Manage changing behaviors
• Provide nutritious meals
• Provide mind-stimulating activities
• Create social interaction
• Supervise daily activities
• Provide personal care and continence care

In addition, CAREGivers can provide assistance with enhancing and restoring the simple pleasures of life, such as a walk in the park, a ride in the car to get ice cream or spending time in the garden. These elder care activities are proven to maximize abilities and independence, and they remain one of the best treatments for this disease. Home Instead Senior Care's approach of encouragement and assistance helps family members cope with the challenges of dementia. As a Home Instead Senior Care Master Franchisee, you can offer an effective solution for this ever-growing worldwide need.

Visit the National Alzheimer's Association at alz.org or log onto the Alzheimer's Foundation web site at alzfdn.orgfor more information and resources.

Scientists See Progress In Alzheimer's Despite Growing List of Drug Failures

Another once-promising Alzheimer's drug has just been tossed on the pharmaceutical scrap heap.

This time it's a drug called bapineuzumab. Like several previous experimental drugs, it was designed to attack the plaques that build up in the brains of people with Alzheimer's.

And like those earlier drugs, it failed.

The drug company Pfizer issued astatement yesterday saying a study of about 1,300 patients with mild-to-moderate Alzheimer's disease found that bapineuzumab didn't help. Pfizer also announced it was discontinuing all studies of the intravenous form of the drug.

The failure of bapineuzumab is the latest evidence that treating Alzheimer's may not be as simple as going after plaques in the brain.

But scientists remain confident that treatments will need to target the major component of those plaques, a protein called amyloid beta or "A-beta."

"It all begins with A-beta," Robert Vassar, an Alzheimer's researcher at Northwestern University, tells Shots. "If we could limit the production of A-beta in the brain or enhance its clearance out of the brain then I think we could really make some headway in terms of preventing Alzheimer's disease and perhaps curing it."

The question is whether it makes sense to attack the A-beta in plaques that have already formed.

Recently, some scientists have suggested that the sticky plaques actually protect the brain by trapping bits of A-beta. These scientists suspect that it's free-floating particles of A-beta that actually damage brain cells.

If that's the case, drugs would have to eliminate free floating bits of A-beta, not just the A-beta in plaques.

One way to accomplish this may be to interrupt the process that forms A-beta in the first place, researchers say.

Several drugs designed to do this are in the pipeline. And their prospects are looking bright after a study found that people with a gene mutation that reduces A-beta production were much less likely to develop Alzheimer's.

The failure of plaque-attacking drugs may also be a sign that treatments need to begin well before people begin showing symptoms of Alzheimer's.

"My opinion and the opinion of many colleagues is that once the A-Beta begins to accumulate in the brain and a person actually has memory symptoms it may actually be too late," Vassar says.

And ultimately, treating Alzheimer's may require going after A-beta in several different ways, says William Mobley, chairman of the department of neurosciences at the University of California, San Diego. That could mean finding a way to both reduce production of A-beta and remove it from the brain, he says.

"Several shots on goal may be needed," Mobley says.

Article care of : http://www.npr.org 

The Caregiver's Silent Burden

My healthy and energetic husband, business partner and best friend had a heart attack at 52. We were still reeling from the affects of 9/11 on our psyches and our business, which needed our undivided attention six days a week. Our two sons were still at home, one homeschooled and one in high school, and our lives were packed full. Life has a way of throwing us curves when we least expect it and true to form, our world was quite suddenly thrown into chaos.

I operated on adrenaline for the first few days and weeks as I took on the full responsibility of our business and livelihood, the care of our children and the care of my husband. We do what we have to do, but churning relentlessly beneath the surface was the heartbreak, the shock, the fear, the loneliness of loss. The emotional ramifications were profound and lasting. He is alive and well, but on so many levels this experienced rocked my world.

Every day women and men across generations and the socio-economic landscape are faced with the difficult decisions and responsibilities inherent in the daily care of a sick or aging loved one. Caring for aging parents is a much talked about concern among adult children, but whether one is caring for a parent, a spouse, or a seriously ill or disabled child, the silent burden of the caregiver is the same. It is profound and constant.

In the midst of the extreme stress and myriad responsibilities of caring for a loved one, family caregivers are coping with one of life's most difficult emotions, that of grief and loss. A woman caring for her husband after a stroke or a heart attack, is not only picking up the slack around the house, shouldering financial responsibilities, and the day-to-day care of her spouse, she is doing so in the midst of a very real and very personal life crisis. She has suddenly lost the emotional and practical support of perhaps her most significant relationship, even if only temporarily. Every morning she looks death in the face and consciously or unconsciously wrestles with the ramifications of losing her loved one, her dreams, and her life as she knew it.

The events leading up to a caregiving situation often occur unexpectedly and without warning. There is no time for preparation. Everything is fine until one day it isn't. The change is immediate and lasting. How is one to keep his/her head above water at such a time?

So often we talk about the role of "caregiver" as if it were a hat we put on, a "temporary" upheaval in our schedules, but it is so much more than that. The grief, the loss of normalcy, not only to our life but to our relationships, lies buried beneath the surface of daily demands. The painful emotions are squelched and shoved aside by necessity and perhaps more likely, by guilt. After all, we reason, we are alive and well. Our needs are not as important as our loved ones. It's not his fault he can't be there for me. There is no time to fall apart, to grieve, or to adjust. It must wait.

When we talk about caregiver burnout, compassion fatigue or the stress of caretaking in general, perhaps the most important dimension to address is that of the emotional upheaval, the undertaking of the grieving process that often begins in earnest and lies buried in silence far too long. The caregiver needs support, compassion and guidance with the silent pain as much, if not more, than they need assistance with practical matters. By the time we move into the caregiving role, most of us are adept at problem solving and decision-making. Our real difficulty more likely rests in making sense of and coming to terms with loss.

Article c/o Dorothy Sanders
http://www.huffingtonpost.com/dorothy-sander/the-caregivers-silent-bur_b_1570584.html

A PETITION FOR A STRONG NATIONAL ALZHEIMER'S PLAN

A PETITION FOR A STRONG NATIONAL ALZHEIMER'S PLAN

Families Facing Alzheimer's Disease Can't Wait

We, the undersigned, call on the President to issue a strong National Alzheimer's Plan to help the millions of Americans now affected by Alzheimer's disease, and the many millions more at risk.

Alzheimer's won't wait.

Today, more than 5 million Americans are facing the challenges of Alzheimer's. This number could rise to 16 million by 2050 if we do not act.

Right now, nearly 15 million Americans serve as caregivers, and this is projected to soar to 45 million in that same timeframe.

The cost of inaction is too high. Alzheimer's will cost the nation $200 billion this year. This will rise to $1 trillion by 2050, bankrupting families and our health care system.

Alzheimer's is the sixth-leading cause of death in the United States and the only one among the top 10 without a way to cure, prevent or even slow its progression.

We urge the President to take the next bold step forward in the fight against Alzheimer's, fulfilling the promise of the National Alzheimer's Project Act passed unanimously by Congress more than a year ago. Now is the time to create a world without Alzheimer's.

Families won't forget.

To sign the petition please go to: http://www.alz.org/petition/

7 Signs Santa Has Alzheimer's

Doctors know well that the holidays bring an upturn in families noticing worrisome signs of memory loss in older adults. No disrespect to Santa intended, but Jolly Old St. Nick also shows a worrisome number of not-so-jolly potential symptoms of dementia.

Only a doctor, of course, can diagnose Alzheimer's disease. But Mrs. Claus would do well to take a closer look at the following warning signs, which warrant a cognitive evaluation and medical exam in order to rule out other possible causes of dementia or -- though it seems impossible to imagine in                                                                                                 s                                                                 someone known for his ho, ho, ho -- depression.

1. Santa keeps making that list and checking it twice.

People with early memory loss are often aware that they're slipping, and they struggle to employ strategies to help them keep track. Writing notes to themselves is one way they do this. Eventually, though, the person with cognitive trouble forgets ever having written a list in the first place and then never consults it later.

Why does Santa check his list twice? Maybe he's just careful -- after all, it's a long list. But obsessively checking and rechecking a note or the clock -- often because you literally can't remember just having done so -- is a common sign of memory loss. The ability to record these new memories is impaired.

2. He wears the same clothes over and over.

Have you ever seen Santa wearing anything besides that fur-trimmed red suit? Wearing the same clothes repeatedly is another hallmark of advancing cognitive difficulty.

It's possible, of course, that the red suit is just Santa's chosen uniform, a la Steve Jobs -- but even Jobs ditched his signature black turtleneck and jeans for sleeping or sports. If Mrs. Claus has to sneak the suit out of the room at night in order to wash it every now and again, or if there are blue and yellow suits hanging in the closet that never get selected, she might consider this a red flag.

3. He needs a red-nosed reindeer to direct him on the same route he's driven for years.

You'd think Santa would know his worldwide sky routes like the back of his hand by now, instead of having to seek out a bright-nosed reindeer to lead the way.

But getting lost on familiar routes is often one of the earliest memory symptoms families notice. One classic clue: driving the same way for years but suddenly having moments of confusion during which he or she isn't certain of the location or destination. Both memory loss and "motion blindness" -- the ability to perceive motion well and navigate the environment -- are to blame.

If kids in Tokyo or Toledo wake up without any toys this Christmas, it just might be because Santa got lost in Tibet.

4. He's getting up there in years.

Alzheimer's disease isn't an inevitable side effect of aging. But the odds of developing it doincrease with age. As many as one in two people over age 85 have signs of dementia. And Santa is how old? Multiple centuries?

5. He asks the same questions over and over. ("What do you want for Christmas?" "Have you been a good little girl?")

Spend a few minutes with someone with mild dementia, and repetition -- of questions, comments, and even word-for-word long anecdotes -- is often apparent. The person may seem to get stuck on just a few phrases with certain people or in certain situations. Always asking a grandchild, "How's school?" or an adult child, "How's the family?" for example, are helpful crutches that the person with mild dementia may use to mask an underlying uncertainty.

Makes you wonder what Santa has ever said to a child around the globe besides, "What do you want for Christmas?" and "Have you been good?" You'd think he'd have plenty of stories and advice to share, but we just don't hear it.

6. He's obese.

The exact cause of Alzheimer's is unknown. But scientists have uncovered plenty of risk factors. High on the list: obesity. Santa's exact weight is unknown, but nobody looking at that bowl full of shaking jelly would place him inside the "normal" columns of the body-mass-index chart.

Belly fat (weight centered in the midsection) is clearly associated with an increased risk of Alzheimer's disease, especially when it accumulates in midlife. People who are obese also tend to develop diabetes and heart disease, which are themselves linked to a higher risk of dementia.

7. He's prone to mistaking the chimney for a door, and to calling musical instruments "rooty-toot-toots and rummy-tum-tums."

It's hard to understand why Santa chooses to use the chimney over the door, given that everyone's supposed to be asleep anyway and given how often he flops into fires and ashes. But cognitive difficulties often cause confusion in behavior and language.

Misusing words, a part of a general condition of language problems called aphasia, is another common development with dementia. Some people with dementia call a toothbrush a "mouth scraper" or a "thingamajig," for example. Songs about Santa refer to "rooty-toot-toots" and rummy-tum-tums" for musical instruments. Hmmm. . . .

Here's hoping those hardworking toymaker elves are also good at caregiving, since -- as far as we know -- Mr. and Mrs. Claus have no children of their own up at the Pole to step up to the demands of the job.


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