All Home Care Matters

If your loved one has been diagnosed with Parkinson’s disease, you might be feeling lost, confused, scared, and overwhelmed with concern. It’s a diagnosis no one wants to hear, but one that far too many families are impacted by year after year. In fact, according to Parkinsons.Org, about 10 million people worldwide are diagnosed with the disease each year.

It’s estimated that about one million Americans have Parkinson’s disease today. That’s more than those who have muscular dystrophy, multiple sclerosis, and amyotrophic lateral sclerosis (or ALS) combined.

Those are staggering numbers. But what exactly is Parkinson’s Disease? How can we provide the care our loved one needs after a diagnosis? How can we care for ourselves? What can we expect in the years ahead? On today’s episode, it’s all about understanding Parkinson’s Disease. By the end of this episode, you should have a much clearer understanding of what your loved one is experiencing – and how you can prepare for what’s to come.

Let’s start with the basics. With numbers as staggering as the ones previously mentioned, it might not be surprising to learn that Parkinson’s disease is the second most common age-related neurodegenerative disease in the world. The most common of these diseases is Alzheimer’s. To learn more about Alzheimer’s Disease, head to our episode page to listen to our many episodes about understanding Alzheimer’s and dementia.

Because Parkinson’s tends to be age related, most people are diagnosed over the age of 50. However, it’s estimated that about 4% of Parkinson’s patients are diagnosed at a younger age. One famous example is Michael J. Fox, who was diagnosed with early onset Parkinson’s at the young age of 29.

The cause of the disease is largely unknown, but the effects are clearer. When a person has Parkinson’s, the brain cells that produce dopamine become impaired or die. Because dopamine controls movement, when these neurons are no longer functioning, movement is drastically impaired. It is unclear what exactly causes these neurons to misfunction or die.

In addition to dopamine, the nerve endings in a Parkinson’s patient’s brain that produce norepinephrine are lost. Norepinephrine sends chemical messages through the sympathetic nervous system, which controls heart rate, blood pressure, and other automatic body functions. Scientists believe that this is why Parkinson’s patients often suffer from irregular blood pressure, slow movement of food through the digestive tract, and fatigue.

Many people with Parkinson’s also have Lewy bodies in their brain cells – which are clumps of abnormal proteins inside neurons. Lewy bodies most often form in the parts of the brain that control memory and movement. This is why many people with Parkinson’s also suffer from Lewy body dementia. To learn more about that condition, listen to our episode on understanding Lewy body dementia.

While it’s unclear what exactly causes Parkinson’s, some cases appear to be hereditary, while others have been linked to genetic mutations. In most cases, though, the diagnosis appears to be random.

Researchers do believe that the disease might be caused by environmental factors – such as exposure to toxins or head injury – but not enough consistent evidence has occurred to pinpoint a straightforward cause. We can only hope that over time scientists will gain a better understanding of why the disease occurs in the first place.

Parkinson’s disease varies widely from person to person. That means that while some symptoms are more frequent or expected, there’s no way to predict what specific symptoms one person might experience or when they might experience them.

Parkinson’s disease is diagnosed clinically – which means that the disease cannot show up on brain scans or through blood tests. Instead, a diagnosis is based on a Doctor’s examination of a person’s medical history and evaluation of symptoms. 

If you’re worried that you or a loved one might have Parkinson’s Disease, but have not yet received an official diagnosis, you might want to see a movement disorder specialist. Movement disorder specialists are neurologists who specialize in Parkinson’s disease among other movement disorders. These doctors will be able to carefully assess the patient and symptoms, and make a diagnosis based off of his or her specialized expertise.

So, what exactly are the symptoms of Parkinson’s disease? Again, the symptoms do vary from person to person, in terms of both the severity and the types of symptoms. Still, there are three movement symptoms that are particularly common, especially in the early stages of the disease.

These three symptoms include stiffness, slowness of movement, and a resting tremor. It is possible for a person to just have one of these symptoms or have all three. Even if you or your loved one is experiencing only one of these symptoms, it’s well worth your time to schedule an appointment with a doctor.

The tremor will look like a slight shaking of the hand, finger, thumb, or chin. Commonly, the tremor will occur during rest in the early stages of the disease. It is sometimes called the “rolling pill” tremor, because if a person rests a pill in their open palm and it rolls, the hand may be experiencing a tremor.

Other common early signs are more subtle. Small handwriting is one of these. If a person’s writing has gotten smaller or the words are crowded together, this could indicate Parkinson’s disease.

Loss of smell is another early symptom. Have your loved one try to smell certain foods – like bananas or licorice and ask them if they are able to smell them clearly. If not, this could mean that they are suffering from Parkinson’s disease, and you should get them to the doctor for examination. 

In addition to smell, voice can be affected early on in the disease. If a person is speaking much more quietly than usual, to the point where they sound hoarse or like they are whispering, this could be a sign of Parkinson’s.

Other common early symptoms include restless sleeping, depression, constipation, stooping over, or dizziness. You might also notice that your loved one has what’s called a “masked face.” If your loved one has a constant angry or serious expression on their face, they might have Parkinson’s disease.

Parkinson’s can be misdiagnosed in the early stages – especially for patients who are not suffering from tremors or muscle stiffness. Some of the other symptoms can be misconstrued as normal parts of ageing. If you feel that your loved one might have Parkinson’s, but they weren’t diagnosed, have them see a specialist for a second opinion.

There are five common stages of Parkinson’s – although, again, not everyone goes through this disease in the same way. The following five stages are the most typical patterns of progression as observed by doctors and scientists.

In the first stage, a person has mild symptoms, such as a tremor or changes in posture or facial expressions. These symptoms won’t usually interfere with daily life. Typically, a person in the first stage will only notice tremors or movement difficulties on one side of the body.

Within three to seven years of diagnosis, most patients will notice moderate changes to these early symptoms. This means that they have officially entered stage two. Stage two of the disease, or the moderate stage, tremors and movement difficulties increase in severity.

While in stage one, zipping a jacket might have been somewhat difficult, it might now take a significant amount of time to do. A person’s posture might start to slump or droop more severely in this stage, and a person might find that their tremors and muscle stiffness have moved to both sides of the body.

A person in the moderate stage of Parkinson’s can usually still care for themselves but will take significantly more time to accomplish simple tasks. Some patients at this stage might request more help with daily activities.

Stage three, the middle stage of Parkinson’s, is the big turning point for most patients. Reflexes will decrease as will balance. A risk of falling is increased, between a patient’s struggles with balance, walking, and posture. Patients at this stage will likely need a wheelchair to get around.

A patient at stage 3 is able to maintain independence – although they will take longer to eat and get dressed and might desire a little extra help to get things done around the house and run errands.

In stage four, a person can no longer be independent. While a person can stand from a chair without extra help, they won’t be able to walk from the chair to their bed or wheelchair on their own. A patient in stage four will need help to eat, dress, bathe, and move around the house.

A person in stage five of Parkinson’s will require around the clock care. Advanced leg stiffness will make it impossible to stand or walk – and a person will require a wheelchair. If a Parkinson’s patient is also suffering from Lewy body dementia, then they might be experiencing increased hallucinations or delusions by this stage. Not everyone with Parkinson’s makes it to stage five of the disease.

While Parkinson’s disease is certainly severe, and complications from the disease are the 14th cause of death in the United States, a person with Parkinson’s can live well with the disease. Michael J. Fox is proof that people can maintain a high quality of life after diagnosis. The disease is a progressive one, but the level of progression varies from person to person – and there are some steps a patient can take to slow the progression.

Have your loved one work with their doctor to establish a treatment plan. A combination of therapies and prescription medications can help a person with Parkinson’s maintain a high quality of life. Doctors will likely prescribe dopaminergic medications, to help with the impaired dopamine neurons in the brain.

While medications cannot cure the disease, they can improve symptoms to make daily living a little easier. In addition to medications, patients should get plenty of exercise. In the early stages, it’s important to get those stiff muscles moving – so activities like biking, running, tai chi, yoga, and dance are all recommended. Exercise will help a person to maintain their balance, mobility, and activities of daily living. Exercise will also improve many symptoms.

According to Parkinson’s.org, “people with PD who start exercising earlier and a minimum of 2.5 hours a week, experience a slowed decline in quality of life compared to those who start later. Establishing early exercise habits is essential to overall disease management.”

Of course, exercise will come with its own set of challenges for Parkinson’s patients. Balance issues, trembles, muscle stiffness, and endurance can all pose challenges to exercising – but there are plenty of ways to exercise safely.

All Parkinson’s patients should consult their doctors before starting a new form of exercise and should ask for a list of recommended exercises based on their symptoms. Physical therapists will help patients with safe, specialized exercises meant to improve symptoms.

Physical therapists will often recommend a routine exercise regimen that includes aerobics and resistance training. There are also community classes in most cities meant for people living with Parkinson’s disease. These classes cover everything from dance to boxing and are catered toward improving symptoms and slowing progression in patients.

There are surgical options for patients with Parkinson’s disease. Deep brain stimulation, or DBS, is one surgical therapy that many patients can benefit from. The surgery works by implanting an electrode into the affected area in the brain. The electrodes are then stimulated with a device located under the skin in the chest. This allows brain to control movement at a “normal” level.

DBS is not a cure for Parkinson’s, and it does not help with non-motor symptoms such as depression, loss of smell, or constipation. Before considering this surgery, be sure to get an evaluation from a movement disorder specialist. DBS is not the best choice for all patients, but a specialist will you’re your loved one determine if it’s the best choice for them.

Patients with Parkinson’s can also assemble a care team of specialists – from home nurses to occupational therapists and neurologists – to help with treatment. The more organized and structured a person’s care plan is, the better.

When considering the type of care a person with Parkinson’s needs, it’s important to think about where they will be living. From assisted living to at home care and everything in between, there are plenty of living options to consider with your loved one. To learn more about the best living options for your loved one, check out our episode on choosing the right type of care for seniors.

Because depression is a common symptom in patients with Parkinson’s, it’s important to make sure your loved one is mentally stimulated. It’s estimated that 50% of patients with Parkinson’s suffer from depression, while 40% face anxiety.

According to Parkinsons.org, “The Parkinson’s Foundation Parkinson’s Outcomes Project found that taken together, mood, depression, and anxiety have the greatest impact on health status, even more than the motor impairments commonly associated with the disease.”

Depression in Parkinson’s is a direct result of changes in brain chemistry, as the parts of the brain that control mood, energy, motivation, and sleep are impacted by Parkinson’s. Social isolation can make the depression even more severe, so make sure your loved one is engaged in social activities – from visits with the grandkids to clubs and organizations.

Make sure that your loved one has something to look forward to – whether trips to the movies or the park, visits, or a nice dinner. Having something to look forward to can help enhance a person’s quality of life and give them something positive to think about.

According to Parkinson’s.org, “the best approach” for treating depression, “is a combination of antidepressant medication, counseling, exercise, and social support.” A counselor can provide essential support and can recommend coping skills to help with positive thinking.

There are therapists and counselors who specialize in Parkinson’s Disease. Additionally, plenty of support groups exist within the Parkinson’s community. Introducing your loved one to people going through similar difficulties can help them to feel less alone in their struggle.

Caring for a person with Parkinson’s also means caring for their home. Make sure that there’s nothing at the home a person can easily trip over – like throw rugs, electric cords, or slippery floors. Clear pathways, place mats in bathtubs and showers, and arrange furniture so it’s not blocking any walkways.

If you want to provide additional support for your loved one, you can help them by volunteering to exercise with them, which will keep them motivated to exercise while allowing them a great opportunity for socialization, and something to look forward to.

Getting your loved one out of the house as often as possible is key to their happiness, also. It’s isolating to be alone in the house all the time – so any excuse to get out will be welcomed, as long as the person is feeling up to it.

While this is more difficult during the pandemic, consider taking your loved one on a walk to the park, or to an outdoor movie. You can also set up a projector in the backyard so your loved one can be outside, engaged in something fun, and comfortable.

Finally, it’s important to be patient with your loved one. Don’t rush your loved one through getting dressed, standing up, or eating dinner. Remember – they are going as fast as they can and rushing them will only make them feel more frustrated. I know that this disease can be endlessly frustrating and disheartening for family members – so make sure you have an outlet to express yourself, that’s not the person suffering. Go to friends, family, a therapist to vent frustrations, so you’re in a better state of mind to be patient with your loved one the next time you see them.

A Parkinson’s diagnosis is never easy – but with the right knowledge, preparation, and treatment plan, you can know what to expect and make the journey as positive as possible for you and your loved one.

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please join us next as we talk about Caring for the Caregiver.

Sources:

https://www.nia.nih.gov/health/parkinsons-disease#:~:text=Parkinson's%20disease%20occurs%20when%20nerve,brain%20chemical%20known%20as%20dopamine.

https://parkinsonsnewstoday.com/parkinsons-disease-statistics/#:~:text=United%20States,Americans%20are%20diagnosed%20with%20Parkinson's.

https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons

https://www.michaeljfox.org/parkinsons-101

https://www.parkinson.org/understanding-parkinsons/10-early-warning-signs

https://www.apdaparkinson.org/what-is-parkinsons/symptoms/

https://www.healthline.com/health/parkinsons-warning-signs#4

https://www.parkinson.org/Understanding-Parkinsons/What-is-Parkinsons/Stages-of-Parkinsons

https://www.healthline.com/health/parkinsons/stages#4

https://www.bannerhealth.com/healthcareblog/teach-me/the-5-stages-of-parkinsons-disease

https://www.parkinson.org/Understanding-Parkinsons/Treatment

https://www.apdaparkinson.org/what-is-parkinsons/treatment-medication/

https://www.apdaparkinson.org/what-is-parkinsons/treatment-medication/deep-brain-stimulation/

https://www.parkinson.org/Living-with-Parkinsons/For-Caregivers/Beginning-Your-Journey-with-Parkinsons/Special-Challenges-of-Caring-for-Someone-with-Parkinsons

https://www.webmd.com/parkinsons-disease/guide/parkinsons#1

https://www.agingcare.com/articles/daily-caregiving-for-someone-with-parkinsons-disease-119724.htm

https://www.healthline.com/health/parkinsons-disease/how-to-support#8.-Be-patient

https://www.webmd.com/parkinsons-disease/guide/parkinsons-disease-progression#2

https://www.parkinson.org/Understanding-Parkinsons/Treatment/Exercise#:~:text=Biking%2C%20running%2C%20Tai%20chi%2C,on%20your%20symptoms%20and%20challenges.

https://www.parkinson.org/Understanding-Parkinsons/Symptoms/Non-Movement-Symptoms/Depression

When our loved one is diagnosed with dementia, we want to do our best to understand exactly what they’re going through. The more we know, the more support we can offer – both emotionally and in regard to long-term care support. We’ll also be better equipped to help ourselves. Knowing what to expect as dementia progresses, and understanding why our parent, spouse, or grandparent is behaving in certain ways can help us manage and care for our own feelings.

There are over four hundred types of dementia out there – so it’s important not to generalize dementia as one single disorder. Once you know what type of dementia your loved one has, you can look at that variant through a closer lens, so you can focus on providing your loved one with specified care to match their individual needs.

Today, we’re going to talk about one type of dementia that affects over one million people in the United States each year. That’s Lewy body dementia – or LBD. LBD usually sets in around age 50, although it can occur earlier. There are two diagnoses of the disorder – dementia with Lewy bodies, or DLB, and Parkinson’s disease dementia.

By examining LBD in both of its forms, we can have a much clearer understanding of what our loved one is struggling with – and how to help them. After all, LBD is quite different from Alzheimer’s or other forms of dementia, so we want to make sure we’re not grouping these disorders together. We’ll talk about the signs and symptoms of LBD, what to expect as the disease progresses, and possible care and treatment options.

First, it’s important to understand what Lewy bodies are. First discovered by Dr. Friederich Lewy in 1912, Lewy bodies are abnormal protein deposits that form clumps inside neurons, causing neurons to lose function and die. The clumps first form in the parts of the brain that control memory and movement – but as time goes on, the damage spreads to other regions. In all, Lewy bodies can form in the cerebral cortex, the limbic cortex, the hippocampus, the midbrain and basal ganglia, the brain stem, and the olfactory pathways.

The cerebral cortex controls language, thought, and information processing. The limbic cortex dictates emotions and behavior. The hippocampus is where new memories form. The midbrain and basal ganglia control movement. The brain stem regulates sleep. The olfactory pathways control the sense of smell.

To learn more about how exactly LBD affects the brain, listen to our episode that discusses and examines the different types of dementia.

Clearly, LBD is a devastating disorder. It can be extremely hard to watch a loved one fall victim to a progressive brain disease. That’s why it’s so essential to prepare yourself – so that you can minimize unwanted surprises down the road and be there for your loved one every step of the way.

Scientists are unaware of what exactly causes LBD, but they do know that the dying neurons result in a failure of messages to be sent through brain cells. Without these messages, memory, learning, behavior, cognition, mood, and movement are all affected.

LBD is common in patients with Parkinson’s Disease. According to alz.org, 50-80% of Parkinson’s patients experience dementia. The most common form of dementia for these patients is LBD. This is most likely because people with Parkinson’s disease and LBD are both progressive diseases in which brain cells are lost after protein clusters are formed.

Unfortunately, LBD is commonly misdiagnosed or not diagnosed in its earliest stages. That’s because the early symptoms of the disorder can be confused with normal aging or other memory disorders, like Alzheimer’s. Still, there are some key differences to look out for.

Remember, every person responds differently to LBD, so while some people might have every symptom, others may only have some. The severity of these symptoms also varies from person to person. Because of this, whether you notice any or all of these symptoms in your loved one – and regardless of the severity – you should take your loved one to the doctor if you think there’s a chance, she might have LBD.

Among the early symptoms of LBD are physical issues – which is one standout difference between LBD and other forms of dementia. A person with LBD might have a tremor, or struggle with their fine motor skills. Try to notice if your loved one has difficult lifting utensils at dinnertime, or if their arm trembles when they rest. In addition, they could have trouble keeping their balance or lose coordination.

Sometimes the physical symptoms are more subtle. Has your loved one’s facial expressions become less animated and more rigid? Is your loved complaining of muscle stiffness? Has their posture become stooped? You can also look for signs in their handwriting. If their handwriting is smaller, or shakier, than usual – this can be a sign of LBD.

In addition to physical changes, look out for cognitive changes in your loved one. If your loved one is suffering from delusions or hallucinations, that’s an extremely common sign of LBD. She might also seem confused or have trouble interpreting visual information. Her alertness could vary drastically from one day to the next. She could also be experiencing memory loss and have trouble with judgement and planning. Patients with LBD will also have trouble recognizing familiar people earlier on than in other stages of dementia – like Alzheimer’s. 

A doctor will diagnose LBD in a patient who is suffering from both the physical and cognitive symptoms of the disorder. Even if they do not begin at the same time, as long as the physical symptoms begin within a year of the cognitive ones, or vice versa, doctors will likely give a diagnosis of LBD. LBD is a clinical diagnosis, which means that a diagnosis is not determined from a test, but from the doctor’s best judgement based on the information available.

In the early stages, LBD is commonly misdiagnosed as Alzheimer’s – especially if a person is not struggling with the physical symptoms quite yet. There are key differences between the disorders to look out for. In Alzheimer’s disease, memory loss tends to be more prominent earlier on than in LBD. For patients experiencing LBD, changes in judgement, planning, and visual perception usually occur before memory loss.

Movement is a huge difference. While Alzheimer’s does affect walking and balance as time progresses, immediate mobility issues are more prevalent in patients with LBD. If your loved one was diagnosed with Alzheimer’s, but primarily struggles with tremors and balance issues, you might want to consult your doctor about a new diagnosis. 

Hallucinations and delusions are also more common in LBD patients, especially early on. They might see people in the house or misinterpret objects for something else. On MichaelJFox.Org, Ava Butler kept a daily journal of her husband’s, who had LBD, hallucinations. “The plants on the south balcony turned into little children,” she writes, “Today they are musicians and they played for everyone down below. People danced to their music.”

An LBD patient might have trouble recognizing familiar faces right away. Butler writes that her husband sometimes mistook her for his brother, or even forgot his own name. These symptoms occur earlier on in patients with LBD than they do in patients with Alzheimer’s.

Once you understand the key differences between Alzheimer’s and LBD, you can determine if you believe they have been misdiagnosed. If you think they have, take them back to the doctor and re-examine the signs and symptoms together. Receiving the correct diagnosis is important for many reasons – from assuring that your loved one is taking the proper medications to knowing the best type of care for your loved one.

The proper medication is especially important. While antipsychotics might be prescribed to a person with Alzheimer’s to control their behavior, a person with LBD could suffer from severe side-affects from the same medications. Their movement might become even worse, and they could get fevers or even kidney failure. Be sure that your loved one’s doctor has evaluated your loved one for LBD before prescribing any anti-psychotics.

As LBD progresses, many of the symptoms will look similar to middle or late-stage Alzheimer’s disease. You might notice significant mood changes in your loved one – they could become easily agitated or paranoid.

In the early stages of LBD, your loved one will likely struggle with hallucinations or delusions. They could also have tremors and difficulty with basic movements. A person with LBD could get “stuck” in the middle of a movement, as their muscles completely stiffen. While their memory will be mostly intact, they will likely suffer from confusion and difficulty processing information or recognizing familiar faces.

In the middle stages of Lewy body dementia, a patient will suffer from extreme motor impairment, decreased attention, and significant confusion and paranoia. You will notice that your loved one is having more difficulty speaking and swallowing, and that the hallucinations might be becoming more severe. At this stage, it’s essential that your loved one has a caregiver present at all times. This is because the risk of falls is increased and hallucinations and confusion could lead to rash decision making, violent behavior, or wandering from the house.

In the later stages of Lewy body dementia, your loved one might experience extremely stiff muscles that are sensitive to touch. They might not be able to speak at all, or only in whispers. They will need help with all activities of daily living – from eating to bathing to getting dressed.

A person with LBD is likely to live five to seven years after a diagnosis. However, some patients have lived up to 20 years with the disorder.

There are many ways to provide care and support to your loved one with LBD. In addition to determining the best possible care (you can learn about care options in our episode on choosing the right care for your loved one), researching the disorder, and creating a care and medication plan with your loved one’s doctors, you can also act as a support system for them.

Include your loved whenever you can. Take them to the movies, religious services, and out to eat. In the pandemic, this might translate to movie nights at home and Zoom church meetings or picnics in the park. The important thing is to make your loved one feel included and surrounded by people they love. Social interaction with family will brighten your loved one’s mood and keep them from feeling isolated or depressed as they face this new diagnosis. Even as LBD progresses, include your loved one as much as possible. While they might not be able to communicate, they will still enjoy the company.

Be sympathetic to your loved one’s diagnosis. When your loved one hallucinates, don’t shut down his vision outright. Respect what he is seeing and remind him that he is safe, and he is loved. Ava Butler writes, “dismissing his reality is not helpful, and can actually make it appear that I am not trustworthy…remind him that we are safe, and that everyone is on our side…Ask him to look in my eyes. This can help ground him. Remind him that I love him…However if I’m part of the hallucination and am perceived to be involved in some conspiracy, I need to back off and give him space…ask him to describe what he sees. Sometimes this causes him to focus a bit more. What he sees can give me insight into how he is feeling.”

Butler also recommends turning negative into positive – if your loved one thinks they see a bad guy, acknowledge that the person “looked bad” but is actually good and there to help him stay safe. Finally, it’s important to stay calm, cool, and collected. Showing your own frustration or anger will only heighten the situation and make it worse.

Improving the quality of life for an LBD patient might include hiring physical therapists to assist with movement difficulties, speech therapists to help with swallowing and voice problems, occupational therapists to help with everyday activities, and mental health counselors to help with difficult emotions.

Music and art therapy can also help your loved one with their anxiety and give them something to look forward to that will keep them calm and feeling positive.

With over 400 types of dementia, it can be hard to pinpoint exactly what your loved one is suffering from. Once you have a clear diagnosis, though, you can begin individualized treatment and care. If your loved one has been diagnosed with LBD – or if you suspect they might be suffering from it – see your doctor right away and develop a treatment plan together.

It can be devastating to receive this diagnosis – but with the right research and proper care plan, you and your loved one can be as prepared as possible for the road ahead.

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please join us next time as we discuss understanding Parkinson’s disease.

Sources:

https://www.nia.nih.gov/health/what-lewy-body-dementia#:~:text=Lewy%20body%20dementia%20(LBD)%20is,movement%2C%20behavior%2C%20and%20mood.

https://www.healthline.com/health/dementia/lewy-body-dementia#symptoms

https://www.verywellhealth.com/lewy-body-dementia-stages-progression-98735

https://www.lbda.org/10-things-you-should-know-about-lbd/

https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/lewy-body-dementia

https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-progresses/progression-dementia-lewy-bodies

https://www.nia.nih.gov/health/how-care-person-lewy-body-dementia

https://www.thememorycenter.com/how-to-care-for-someone-with-lewy-body-dementia/

https://healthblog.uofmhealth.org/health-management/coping-strategies-for-lewy-body-dementia-caregivers

https://www.nia.nih.gov/health/what-lewy-body-dementia#:~:text=Lewy%20body%20dementia%20affects%20more,slightly%20more%20men%20than%20women.

https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/parkinson-s-disease-dementia

https://www.michaeljfox.org/news/ask-md-what-lewy-body-dementia

https://www.michaeljfox.org/news/what-richard-sees-insight-lewy-body-dementia-hallucinations

If our parents or grandparents have been increasingly struggling with changes in memory or personality, we may be worried that they have Alzheimer’s or dementia. Most people have heard of these diseases and may have had a grandparent or distant family member experience them before.

Still, though, until we are facing these diagnoses head-on, we may not understand exactly what to expect. How can we know the differences between dementia and Alzheimer’s? Do all dementias look the same or are there different types? Could my loved one’s memory problems be related to something else, like simple ageing, or do they have to mean a cognitive disease?

On today’s episode, we’ll examine Alzheimer’s and dementia through a closer lens. We’ll go over the varying types of dementia and what to expect from your loved one before and after a diagnosis. By the end, you should have a much clearer understanding of the world of dementia and Alzheimer’s and feel more prepared to face what’s ahead. While there is no cure for these diseases, the more you can prepare yourself and your loved one, the better you both will feel moving forward.

Dementia affects millions of people every single year. According to alz.org, “an estimated 50 million people worldwide are living with dementia, including 5 million Americans.” It’s an epidemic with no cure, which makes dementia especially devastating for families. Many families choose to care for their loved one at home, and nearly 80% of at-home patients are cared for by family members or unpaid caregivers.

Caring for a dementia patient can be exhausting for anyone – but especially for a family member who has to sacrifice so much to be there for their loved one, and who might find themselves mourning for the way things used to be. With the right knowledge and support, this process can be made easier for all involved.

Dementia and Alzheimer’s are not the same disease, although they are certainly related. Dementia refers to a person’s changes in memory or thinking – and one of the causes of dementia is Alzheimer’s. Neither dementia nor Alzheimer’s are “normal” parts of aging – they are diseases that require extra support, care, and treatment.

Dementia comes in many forms and can have its roots in a number of causes. Alzheimer’s, though, is the most common. According to alz.org, Alzheimer’s accounts for 60-80% of dementia cases. Alzheimer’s is a progressive brain disease that will take over a person’s ability to reason, speak, and care for themselves. To better understand this disease, let’s take a look at the way the brain works.

When a person has Alzheimer’s, their brains are no longer able to function normally. That’s because they are experiencing nerve cell death and tissue loss over a period of time – usually 4 to 8 years, though this fluctuates depending on the person. A person can live up to 20 years with Alzheimer’s disease. While it is not clear what causes this tissue loss, scientists understand that it has something to do with a build-up of plaque and tangles in the brain.

Plaques are protein fragment clusters that crowd between nerve cells. When a nerve cell is dying, or already dead, it contains tangles, or twisted protein strands. The clumps of plaques and tangles can block cell-to-cell signals in the brain. This mixed-up signaling sometimes triggers immune system cells, which consume the dead or dying cells and trigger inflammation.

When a brain is under siege of these tangles and plaques, the brain is unable to process nutrients or other important supplies throughout the cells. With nothing moving through them, the cells die. In the early stages of the disease, the plaques and tangles cluster in the areas of the brain that affect learning and memory, thinking and planning.

This is when you might notice your parent has forgotten where she put her purse, or has trouble planning for the week ahead. The symptoms at this point are subtle enough to be discounted or missed altogether. In the early stages, almost no one is officially diagnosed with Alzheimer’s. After all, momentary lapses in memory could be considered a normal part of aging.

In mild to moderate Alzheimer’s, the plaques and tangles begin to grow and spread. Learning and memory and planning and thinking become overwhelmed with them. You will notice your parent or grandparent struggle with expressing themselves, growing irritated or frustrated more easily, and having increased trouble with their short-term memory.

At this stage, it’s common for a person to confuse dress clothes for casual clothes, and struggle with social interactions. At this stage, their speech will also start to slow, and you might notice your parent forget certain words or speak nonsensically. Your parent also might start to wander, or even have trouble with their spatial awareness.

At this stage, the plaques and tangles have now found their way to the portion of the brain that controls speaking and understanding speech, as well as where your body is compared to your surroundings.

In the severe stages of Alzheimer’s disease, the brain has begun to shrink, due to the death of so many cells. At this point, a person may be unable to communicate at all and cannot care for themselves. They might struggle to recognize important people in their lives.

Alzheimer’s is a devastating disease. If your loved one has been diagnosed, you might find yourself getting frustrated, overwhelmed, or even exhausted when it comes to their care. After all, it’s difficult and heartbreaking to struggle to communicate with your parent, and it’s all too easy to become irritated or even angered with your loved one’s mood swings or forgetfulness.

If you understand what is happening inside their brains – that it is quite literally shrinking – it might help you to better understand what your parent is dealing with. In any case, it will give you a better idea of why your parent’s disease is progressing, and what you can expect as time goes on.

To learn more about how to care for a loved one with Alzheimer’s, and what to specifically expect from the disease, check out our previous episodes on the stages of Alzheimer’s and supporting a loved one with dementia. There, you’ll find insight into how to best care for your loved one, what to expect int their behavior and cognitive ability as time goes on, and tips for how to keep their lives as full as possible.

While Alzheimer’s is the most common cause of dementia, there are many other types of dementia that your parent or grandparent might be diagnosed with. Having an understanding not just of dementia alone, but of the specific types, will better prepare you for what to expect on an individual basis, and the types of care you should consider. It will also help you understand what type of support your loved one requires.

Before we get into the other types of dementia, let’s look at dementia in broader terms. While dementia looks different in every case, most people will face memory loss, difficulties with problem-solving, language struggles, and thinking struggles. In some cases, a person might experience mood swings or changes in personality. Like Alzheimer’s, dementia will progress over time. 

A human brain looks different depending on the type of dementia a person has. Just like a brain suffering with Alzheimer’s has a very specific trajectory, the varying types of dementia impact the brain in different, but similar, ways.

The second most common type of dementia is Vascular dementia. This disease accounts for about 5 to 10% of all dementia cases. Vascular dementia occurs when the brain receives a reduced blood supply, due to diseased blood vessels. Without a ready supply of blood, brain cells are deprived of necessary oxygen and nutrients. The cells therefore die.

Vascular dementia causes problems in thinking, reasoning, and memory. It does not always affect all three, however, because it depends on where the blood supply is being blocked within the brain. Because of this, Vascular dementia is believed to be underdiagnosed. You might find that your parent struggles with mobility, like balance or walking, and may even experience numbness on one side of the face or body. They might not have a single issue with memory, though.

At the same time, your parent could be struggling deeply with memory issues, but be walking and moving around just fine. That’s why vascular dementia can be especially difficult to diagnose.

A person with vascular dementia might suffer from multiple small strokes that impact blood vessels and nerve fibers inside the brain. This could lead to changes in thinking, planning, and judgement. You might notice that your parent has been laughing or crying uncontrollably or is unable to function in social situations.

Because vascular dementia is so commonly undiagnosed, it is recommended that your loved one undergo cognitive testing – especially if they have suffered a stroke in the past. If your loved one has suffered a stroke, or is vulnerable to heart or blood vessel disease, there are ways to reduce the risk of developing vascular dementia.

Avoid anything that raises blood pressure or cholesterol, don’t smoke, and limit your drinking. Exercise and healthy eating also do wonders for reducing the risk of vascular dementia, along with a myriad of other health issues.

Treatment for vascular dementia is all about stopping the condition from worsening. This can be accomplished through eating a healthy, low-salt diet to manage high blood pressure, losing weight if necessary, quitting smoking, and cutting down on or cutting out alcohol. Therapies like physiotherapy and occupational therapy can help your loved one to get through daily tasks. Music and dance therapy, massages, and meditation have also proved helpful in patients with vascular dementia.

Another type of dementia is known as Dementia with Lewy Bodies – or DLB. DLB is sort of a hybrid of Alzheimer’s and Parkinson’s, a disease that heavily affects mental and physical abilities in a diagnosed person. About 10-15% of dementia cases are DLB.

DLB is so similar to Alzheimer’s, that it is often misdiagnosed for the latter – but there are key differences that are worth looking out for. The right diagnosis means the right care for your loved one. Of course, DLB and Alzheimer’s require much the same care, so a misdiagnosis likely won’t make a great impact on your loved one’s treatment. Still, understanding the difference between DLB and Alzheimer’s can mean little changes in treatment and care that go a long way.

Lewy bodies refer to deposits of protein that emerge in nerve cells within the brain. While it is unknown why these deposits show up, their impact on the brain is clearer. Lewy bodies lead to low levels of chemicals that are important for brain function – especially acetylcholine and dopamine, which are essential for carrying messages through the nerve cells. A lack of connections in the cells leads to nerve cell death.

Lewy bodies also affect the areas of the brain that control movement and mental disease. Because of this, many people with DLB are also diagnosed with Parkinson’s disease.

Treatment for DLB is used to keep a patient’s quality of life as high as possible, for as long as possible. As with other forms of dementia, a healthy diet will help to keep your loved one feeling strong and energized. A psychotherapist can help your loved one to feel supported and learn how to manage emotional and behavioral difficulties.

Talk to your loved one about joining a support group or taking on one on one therapy. Even in the age of COVID-19, therapies and support groups are taking place over Zoom. You might even find that your loved one is more willing to share their experiences through a camera than in person, which might make them feel overwhelmed.

Another form of dementia is Frontotemporal Dementia – or FTD. This is a rarer form of the disease, but it does affect about 50,000 to 60,000 people in the United States each year. FTB takes place when the nerve cells in the frontal and temporal lobes of the brain are damaged or dying. This causes connections to break down and chemical messengers to decrease significantly.

For a person with FTD, behavioral and personality changes are common. Because the frontal lobe plays a huge role in personality, this can mean drastic changes in the people we love. Their emotions, behaviors, and focus will be greatly impacted, to the point where they may not be recognizable to us.

At the same time, the temporal lobes are involved with language. Someone with FTD might struggle with the meanings of words or using the correct words to describe an object. If you notice that your parent is having trouble with language and their personality and behavior have significantly changed, they might be suffering from FTD. Unlike other forms of dementia, where the first symptoms are typically memory loss, personality changes and language problems occur early on in a patient with FTD.

Establishing a care plan for a loved one with FTD is important. Choosing a type of care that can help them to stay as independent as possible, for as long as possible, can make the transition to long term care helps a little bit easier.

Therapies like physiotherapy, occupational therapy, and speech and language therapy can be enormously helpful for anyone with FTD. Physiotherapy will assist your loved one with mobility problems, while occupational therapy will help them with other problems – like dressing and problem solving. Speech and language therapy will help with communication, memory, and even issues swallowing.

The more stimulating, active assistance your loved one can receive, the longer they can hopefully remain relatively independent. Of course, nothing is guaranteed, but therapies have been proven to make every day living easier for patients with FTD.

Your loved one may also be struggling with mixed dementia. Mixed dementia is when a person has more than one type of dementia. Most commonly, a person will have Alzheimer’s disease and vascular dementia at the same time. Another common combination is Alzheimer’s disease and LBD.

About one in ten people with dementia has more than one type – this is especially common for people over the age of 75. Even though that’s a high number, it is not commonly diagnosed. According to Alzheimers.org.uk, doctors usually only diagnose mixed dementia when a person struggles deeply with more than one type that are both contributing equally to their symptoms.

Unsurprisingly, symptoms of mixed dementia vary greatly, depending on the combination of diseases. In most cases, one type of dementia is considered the “predominant” disease in a person and impacts more of the brain than the other. If a person has Alzheimer’s and Vascular Dementia, for instance, they will probably have more symptoms of Alzheimer’s if the blood supply blockage is only in one part of the brain.

Dementia is not reserved for the elderly. Early onset dementia in younger people, a common form of young-onset dementia affects about 200,000 Americans every year, according to Alzheimers.org. This is usually difficult to diagnose, just because doctors don’t tend to think of dementia when meeting with younger patients.

If you are under the age of 65 and have been experiencing symptoms related to memory loss or personality changes, it might be smart to meet with a doctor who specializes in Dementia, rather than your regular physician.

Early onset dementia is often hereditary, but it can also be caused by over consumption of alcohol. In that case, it’s known as alcohol related dementia, or ARBD. 

Alcohol-related dementia affects about one in eight people with dementia under the age of 65. Usually, a person with ARBD is about 40-50 years old. This occurs when a person drinks or binge drinks regularly, leading alcohol to damage the brain’s nerve cells, blood vessels, or ability to process VitaminB1. A person with ARBD might struggle with day-to-day tasks and memory loss, balance, and mood swings.

There are many other types of dementia, that can affect people of all ages. These include Huntington’s Disease, Parkinson’s Disease Dementia, Creutzfeldt-Jakob Disease, and more.  

Regardless of the type of dementia your loved one is struggling with, they will need constant care and support from their family, friends, and caregivers. This includes constant care as the disease progresses, brain stimulating activities, and a whole lot of patience, gentleness, and love.

Remember that these diseases are greatly impacting your loved one’s brains, so your loved one is not at all in control of her behavior, mood, or thinking. Because of that, it’s essential not to blame your loved one for their behavior, no matter how frustrated you might feel. Always keep in mind that this is as hard for your loved one, if not harder, than it is for you.

If you are worried that your parent might be suffering from dementia or Alzheimer’s, but aren’t entirely sure, make sure to schedule a doctor appointment where all of their symptoms can be addressed.

The earlier you can pin down a diagnosis, the sooner you can provide your parent with the treatment and support they need. While there is no cure for dementia, treatment plans can help delay the progression of the disease. To learn more about that, listen to our episode on supporting a loved one with dementia.

We know how devastating it can be when a loved one is struggling with a cognitive disease. We hope that through a better understanding of these diseases, you can better prepare yourself to understand what your loved one is going through. 

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please join us next time as we answer the question, what is Lewy Body dementia?

Sources:

https://www.alzheimers.org.uk/about-dementia/types-dementia

https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-answers/alzheimers-and-dementia-whats-the-difference/faq-20396861

https://www.healthline.com/health/types-dementia

https://www.healthline.com/health/alzheimers-disease/difference-dementia-alzheimers

https://www.seniorlifestyle.com/resources/blog/understanding-different-types-dementia/

https://www.tuftsmedicarepreferred.org/members/caring-loved-one/understanding-dementia-and-alzheimer%E2%80%99s-disease

https://thebristal.com/where-to-begin/understanding-alzheimers-and-other-types-of-dementia/

https://www.alz.org/alzheimers-dementia/what-is-alzheimers/brain_tour_part_2

https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/vascular-dementia#:~:text=Vascular%20dementia%20is%20widely%20considered,%25%20to%2010%25%20of%20cases.

https://www.alz.org/alzheimers-dementia/difference-between-dementia-and-alzheimer-s#:~:text=Dementia%20is%20a%20general%20term,Dementia%20is%20not.

https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia

https://www.alz.org/media/documents/understanding-alzheimers-dementia-b.pdf

As your parents or grandparents age and become more dependent, there may come a time when your role transitions into that of a caregiver. For family members, this can be a difficult adjustment. As well as we know and as much as we love our parents, we’re probably used to them supporting us, more than the other way around. Still, being a family caregiver is a wonderful way to bond with our loved ones and truly appreciate the time we have left with them.

While being a caregiver for a loved one can be immensely rewarding, it’s also emotionally taxing, with a huge learning curve. If you’re just starting this new role, you probably feel a bit daunted. You’ve had to take on a long list of new responsibilities – and learn to balance them with your own personal lives.

Being a family caregiver isn’t an easy task, but with the right preparation, you can make the experience more positive for you and your loved one. That’s why today, we’re diving into the family caregiver’s checklist – so you can know what to expect for the years ahead and be as prepared as possible.

First on the checklist? Gathering and recording important information. You might feel like you know everything about your parent – after all, you’ve known them your whole life, and had lived with them for years growing up. Even still, it’s essential that all the information you know is written and recorded in one easy-to-access, organized place.

Important information includes all those basics you have floating around in your head. Your loved one’s social security number, driver’s license number, and blood type, and any possible allergies. If your loved one is a veteran, record their service serial number. Even though it might feel redundant to write down something you know by heart, it’s important to prepare for possible emergency situations, when someone else needs access to these files, or you simply have a mental blank.

Once you’ve gathered and organized basic details, you can turn your attention to medical history. Write down everything you know about your loved one’s medical history – including family history. Record the phone numbers of anyone who handles their medical care – including their physician, physical therapist, and anyone else who seems relevant.

You’ll also want to keep a list of their medications – including any supplements, vitamins, over the counter drugs or even creams that they use. To learn more about organizing your parents’ medications, check out our episode on medication safety.

After you’ve organized personal and medical information, you can look toward important people in your loved one’s life. Create a list of your parent’s most important contacts – including addresses and phone numbers – so you can easily contact them in the event of an emergency. Even if you think you know this information from the top of your head, it can easily be forgotten in the moment.

After all, if your loved one has an emergency, you will be entirely focused on them – and not want to rack your brain for who to call. If you accidentally forget someone, that could lead to hurt feelings and unnecessary stress. It’s a good idea to have a list handy, no matter what.

Once all this information is noted, you can shift your focus to the deeper things you know about your parent. Their likes and dislikes, values, talents, goals, favorite meals and activities, least favorite meals and activities.

Having a clear understanding of who your parent is – beyond the informational basics – will help to ensure that you’re giving them the best possible care. As your parent becomes more dependent, it might be harder for them to express themselves to you – so you’ll want to know these things like the back of your hand. That way, your parent will never have to eat a food they dislike, and they can participate in games and activities that hone their interests.

Next, you’ll want to make an assessment of your parents’ capabilities. How much care does your parent need? At the beginning, you might just be helping with the basics, like shopping or cleaning. There’s a chance, though, that your parent might require more heavy-duty care – maybe they have trouble eating on their own or keeping up with personal hygiene. Maybe they need help keeping track of medications.

By making a list of what your parents’ abilities are, you’ll have a better idea of how much they really need from you. Too often, family caregivers are thrown into the ocean without a life raft. They might not be prepared for just how much help their parent needs and be overwhelmed when it’s more than they expected. To avoid this type of situation, start assessing right away.

If your parent is moving in with you from out of town, or if you’re moving in with them, you might not know their present situation as well as you need to. Contact the people closest to them – doctors, friends, other family members – and ask questions. Has your parent had trouble walking lately? Do they ever seem confused or forgetful? What’s the condition of their living space – are they keeping up with house care?

Gather all the information you can and make a checklist of activities your parent can do by himself, and the ones he needs more help with. AARP suggests assessing the following activities of daily living: feeding, toileting, selecting proper attire, grooming, maintaining continence, putting on clothes, bathing, walking and transferring from a chair or a bed to a wheelchair.

In addition, they suggest you look at the following IADLs, or instrumental activities of daily living: managing finances, handling transportation (driving or navigating public transit), shopping, preparing meals, using the telephone and other communication devices, managing medications, performing housework and basic home maintenance.

In addition to assessing these needs yourself, take your parent to a doctor or a geriatric social worker. There, they will conduct an official assessment of activity that will give you a much better idea of the level of care they need.

If your parent requires around the clock care, you’ll need to consider how you plan to meet their needs. Can you handle this level of care by yourself, or do you need to consider other options? If keeping your loved one at home is important to your loved one and to you, then consider speaking with a professional home care provider about options that can help you manage their needs and yours. If your loved one requires medical care, then you can discuss home health care options with their doctor. To learn more about the varying types of care available, check out our episode on how to choose the best care for your loved one.

Once you’ve gathered all this information about your loved one – from their social security number to their ability levels – it’s time to take a look at the living environment. It might be necessary to install extra safety precautions at home. From extra handrails in the shower and by the toilet, to possibly installing a stairlift, you’ll need to make sure that the house is as safe as possible for your loved one.

The main reason to check home safety is to prevent unnecessary falls. Start with the bathroom. You can add non-skid strips to the tub or shower, to make the floor less slippery, in addition to adding safety rails in the bathroom. Make sure to wipe the floor whenever it’s wet, and to put bathmats beside the shower and tub. Finally, add a shower or bath seat.

Now, take a look at the rest of the house. Make sure there is a clear path from one room to another, so that your parent can easily move around the house. Are there cords or wires that your parent could trip over? Uneven steps on the staircase? Rooms with poor lighting? Evaluate any risks and see what you can do to minimize them.

Things like removing throw rugs from the house and installing thinner carpet can help prevent falls. You can also install handrails by the stairs (if not a stairlift) and make sure your parent is wearing shoes and slippers with non-skid soles. Make sure chairs have arm rests to help your parent get in and out of them more easily.

Next, make your way to the kitchen. Open the drawers, cabinets, oven, and refrigerator. Are any doors jammed or stuck? Do they feel heavy and difficult to open? Are there items on high shelves that your parent will need regular access to?

Once you’ve examined your loved one’s living space, it’s time to examine yourself. This isn’t an easy job – so you need to make sure you’re in the best possible shape to perform it. That means making time for yourself, too. Schedule in time for yourself every day – even if it’s just for an hour. Go for walks, read, engage in hobbies that you love.

If you can, try to make room for a day out at least one day a week. You might need to find respite care for this time – see if any friends or family might be able to help or speaking with a professional home care provider. Caregiving is emotionally and physically taxing – so while it might seem selfish to put in the time for yourself, it’s actually one of the most selfless things you can do.

If you feel like you’re having a hard time, ask yourself the following questions: are you eating healthily? Are you sleeping enough? Are you taking breaks? Do you have a support system? Have you considered or looked into a caregiver support group? Do you ask for help when you need it? Does your employer know that you’ve taken on these extra responsibilities?

Remember – when you’re taking care of yourself, you’re taking care of your loved one, too. You might find that caregiving is too overwhelming, and if it’s just not working, it’s okay to be honest with yourself. You will need to accept help from time to time, as this is an enormous task for any one person to take on. Be patient and gentle with yourself as you begin this journey.

Making the transition to a family caregiver is never easy. We hope that this check list will help you to get started – so you can feel a little bit less daunted and a lot more prepared as you begin. Caregiving can be one of the most rewarding experiences in the world – and the more prepared you are, the better the experience will be for both you and your loved one.

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Next time on All Home Care Matters we will be discussing and explaining the different types of dementia, you won’t want to miss it.

Sources:

https://www.aarp.org/content/dam/aarp/entertainment/books/2015-04/Caregivers_Excerpt.pdf

https://www.caregivingmetrowest.org/InfoCenter/Home-Health-and-Safety/Home-Safety-and-Modification

http://www.agis.com/Document/5/caregiver-self-assessment.aspx

http://www.agis.com/Document/26/tips-for-preventing-falls.aspx

https://www.homecareassistanceftlauderdale.com/caregiving-rewards/#:~:text=Surveys%20indicate%20that%2083%20percent,member%20also%20provides%20many%20benefits.

http://www.caregiverslibrary.org/Caregivers-Resources/GRP-Checklists-Forms

If you’ve been diagnosed with arthritis, you might find that life has been harder to navigate. Experiencing chronic pain can feel impossible to manage – and it might even be keeping you from engaging in some of the activities you love. No one should have to make sacrifices because they’re in pain, which is why today, we’re going to delve into tips for managing arthritis. While there’s no cure for arthritis, practicing certain treatments can help significantly.

Arthritis is a strikingly common condition in the United States. In fact, according to the CDC, over 54 million Americans are diagnosed with it. Of those, about 24 million suffer from severe joint pain that limits their ability to fully function.

Arthritis occurs when a person experiences joint disease or swelling around the joints. It can be extremely debilitating – according to the CDC, it’s actually the leading cause of work disability, costing about $303.5 billion a year in health care costs and lost income.

Arthritis is not a singular condition. In fact, there are over 100 types of arthritis or related conditions, with varying levels of pain and different plans for treatment. In some cases, Arthritis occurs as a degenerative condition, in which symptoms worsen over time. In others, it’s an autoimmune disease, in which a person will experience frequent ups and downs, pain that flares up and goes away at random. If you have arthritis, it’s important to understand the type you’re experiencing, so you know how to provide yourself with the best possible care.

The most common type of arthritis is osteoarthritis, or OA. For a long time, doctors believed Arthritis to be caused by wearing down joints over time. In fact, it’s actually a joint disease.

The Arthritis Foundation reports that over 27 million Americans are affected by OA. OA is a degenerative Arthritis, so it worsens over time. It can be caused by injuries, age, joint injury, or obesity. It can also be inherited, so check your family’s history to find out if OA runs in your bloodline. OA most commonly occurs in a person’s 50’s, and women are more susceptible to the condition than men.

Not everyone with OA experiences the same symptoms, but common symptoms include sore joints, poor coordination, and stiffness (especially in the morning). Because OA is degenerative, these symptoms will worsen as time goes on. You might find that your joints are aching when you’re active – and you don’t have to be running on the treadmill. It’s possible that your joints will be in pain after a day spent on your feet at work or even playing the piano. Your muscles might feel weaker than usual, and you may even experience joint instability or buckling, like your knees giving out. If you notice the sound of a “crack” every time your joint is bent, you might have OA.

OA can be felt in the hips, fingers, feet, or knees. In the hips, the pain is usually felt in the groin or rear, or inside knees and thighs. If you have OA in your knees, you might feel a scraping feeling whenever you move them. In your fingers, bone spurs will cause swelling, redness, and tenderness. You might also experience particularly bad pain around your thumb. In your feet, your big toes will feel tender, and your ankles and feet might swell.

The effects of this pain can be debilitating. According to Arthritis.org, “as OA gets worse, cartilage may get uneven edges and cracks. Bones may harden, change shape, and get bumpy. Once the cartilage breaks down, it doesn’t grow back on its own.” Over time, you might find it more difficult to move and you could even experience falls. Arthritis.org reports that people with OA experience 30 percent more falls than people without it. This is because of weakened muscles, side effects from medications, and poor fine motor skills. Falls mean an increased chance of fractures, breaks, or even head injuries. 

If you are worried that you might have OA, make sure you see a doctor right away. That way, you can rule out any other problems, and begin treatment as soon as possible. The doctor will numb the area of pain and take fluid through a needle, which she will test for infection or crystals. This will help the doctor to identify the exact type of arthritis you might have. You’ll also receive an x-ray to look for joint damage, and possibly an MRI.

If you go to the doctor and receive a positive diagnosis for OA, there are ways to treat the pain. In addition to taking any prescribed medications, it will be essential to engage in movement and exercise. That way, your muscles and joints will be strengthened to fight the condition. At the same time, exercise will help to fight the stiffness in your joints. The doctor will likely recommend range-of-motion exercises, in which you keep your joints moving through stretches. You might also try balance exercises to strengthen your knees and ankles or strengthening exercises to build muscle around your joints.

People with OA have an increased likelihood of experiencing obesity, due to a lack of movement or exercise. Excess weight can greatly exacerbate OA. Obesity, of course, also leads to a myriad of other health issues, such as diabetes and heart disease. This is why it’s so important to exercise as much as possible – just make sure to consult your doctor about the best types of exercise for you.

You never want to overwork your sore muscles or feel like you’re torturing yourself. Your doctor should have an idea of exercises that you can handle, that will help you to fight off weight and lessen your pain. According to the US Department of Health and Human Services, a person with OA should exercise at least 150 minutes a week. 

For help with exercising, you can always consider physical therapy. A physical therapist will help you perfect a series of helpful exercises designed to fight against Arthritis. He can also provide handy assistive devices like shoe inserts, that will make walking much more comfortable. Finally, a PT will help you to stay on track with that 150-minute work-out goal. You can get much of your exercising done at the PT’s office, and not have to worry about it too much when you’re back at home.

In addition to exercise, it’s important to watch what you’re eating. It’s common for a person with OA to suffer from diabetes – so do what you can to control your blood sugar levels and avoid foods with high glucose. This will keep your cartilage from breaking down, weakening, or stiffening.

You can also make sure to practice gentle stretching – like raising and lowering arms and legs or going on daily walks. Make sure not to push past the pain – you don’t want to cause more damage to your joints or over-do it. Simple, light movements can work alongside carefully planned exercise to strengthen your joints and keep your muscles from stiffening.

Believe it or not, stress can make OA worse. Be sure to practice self-care, so you can avoid unnecessary or debilitating stress that will put your body at risk. Whether you’re listening to podcasts or music, taking hot baths, or engaging in a hobby like reading or drawing, find something that helps you to feel relaxed. The more relaxed you feel, the more relaxed your joints will feel, too.

Worst comes to worst, you might turn to surgery to fight the pain. Replacing damage joints can drastically improve mobility and decrease pain. Hip and knee replacements are the most common surgeries performed on OA patients. Speak with your doctor about whether surgery is the best answer for you.  

The second most common type of Arthritis is Rheumatoid Arthritis, or RA. About 1.3 million Americans suffer from RA, usually between the ages of thirty and sixty. Unlike OA, RA is an autoimmune disease – so the immune system is actually attacking the joints and causing them to swell. While it’s unclear what causes RA, some doctors believe it has to do with an immune system confused by an infection or virus – attacking healthy joints instead of sick ones, leading to inflammation. With RA, the immune system specifically attacks the joints, causing swelling and tissue damage.

According to Healthline, a person with RA has a 60% increased chance of heart attack or stroke after a diagnosis. That’s because RA can actually attack a person’s heart lining, and cause swelling throughout the entire body. At the same time, similarly to OA, people with RA might be reluctant to exercise, and experience excessive weight gain.

There are treatment plans for RA, that can help you to achieve a state of remission, so you can feel more like yourself again. In addition to taking prescribed medication, it’s important to implement diet and exercise changes.

Like with OA, it will be important to consult a physical therapist to help you create an exercise plan that works for you. Exercises like water aerobics, water therapy, and strength training are especially common. Water exercises can work wonders on relaxing stiffened muscles and reducing swelling around joints. Just make sure you follow careful exercise instructions from your doctor or PT, so you don’t accidentally worsen the pain.

When it comes to diet, decreasing sugar and gluten intake and increasing fiber and omega-3’s can be extremely beneficial. Foods that are high in omega-3 include fatty fish like salmon and tuna, and walnuts, almonds, or chia seeds. Consider taking fish oil supplements and even antioxidants, like Vitamin A, C, or E. A change of diet can actually reduce inflammation of your joints, which will provide a great sense of relief to your body.

Another common type of Arthritis is Psoriatic Arthritis. It affects people who suffer from Psoriasis, a disease that causes swollen and inflamed skin. The skin might look patchy, scaly, and reddened – especially around the elbows, knees, scalp, groin, and rear. They might also experience swollen toes and fingers, and discolored fingernails. Joint swelling can occur in many joints or be isolated to just one or two – such as a joint in just one knee. The pain can become quite severe, so treatment to manage symptoms is crucial. This condition is equally prominent in men and women, and usually occurs between the ages of 30 and 50.

Other symptoms include back pain, caused by an inflammation of joints in the spine, foot pain caused by swelling in the ligaments attached to the bone, and deformities in hands and feet. You might even notice the deformities before you are suffering from joint pain.

A person with this disease might also experience eye inflammation, inflamed bowels, obesity, diabetes, high cholesterol, or heart disease. It’s essential to maintain a healthy diet and exercise, in order to avoid worsening symptoms.

Psoriatic arthritis is caused by the immune system attacking healthy cells and the body overproducing skin cells. This disease often runs in families – so a person whose parents have suffered from psoriatic arthritis are more likely to be diagnosed themselves. 

Make sure to engage in a treatment plan to avoid eventual disability, even if your pain isn’t too severe. Start by meeting with a rheumatologist for an evaluation of symptoms, and to begin a treat-to-target treatment plan.

No matter what type of arthritis you have, it’s important to engage in a treatment plan right away. That way, you’ll reach a point of remission where your pain feels manageable, and you can hopefully go back to doing the activities you love. Remember to follow your PT’s exercise plan and eat a healthy, low sugar, diet.  With the right treatment, you should feel like you have your life back on track.

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com where there is a private secure fillable form where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

Remember, you can listen to the show anywhere that podcasts are played and you can watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please join us on the next episode of All Home Care Matters as we discuss the Caregiver Checklist. If you are currently or transitioning into being a family caregiver then you know it can be overwhelming and daunting at times. We will be providing the tips and resources to make your role as caregiver hopefully a little easier.

Sources:

https://www.arthritis.org/diseases/more-about/how-to-achieve-remission-in-psoriatic-arthritis

https://www.arthritis.org/diseases/more-about/how-to-achieve-remission-in-psoriatic-arthritis

https://www.healthline.com/health/anti-inflammatory-ra-diet

https://www.healthline.com/health/anti-inflammatory-ra-diet

https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html

https://www.arthritis.org/diseases/osteoarthritis

https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/what-is-arthritis#:~:text=Actually%2C%20%E2%80%9Carthritis%E2%80%9D%20is%20not,cause%20of%20disability%20in%20America.

https://www.cdc.gov/chronicdisease/resources/publications/factsheets/arthritis.htm#:~:text=In%20the%20United%20States%2C%2023,arthritis%20report%20severe%20joint%20pain.

https://www.healthline.com/health/arthritis-types#osteoarthritis

https://www.webmd.com/rheumatoid-arthritis/guide/most-common-arthritis-types

https://www.cdc.gov/arthritis/basics/types.html

https://www.medicalnewstoday.com/articles/7621

https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/what-is-arthritis

https://www.gethealthystayhealthy.com/articles/tips-for-managing-arthritis-pain

https://www.medicalnewstoday.com/articles/324446

https://www.versusarthritis.org/about-arthritis/conditions/arthritis/

https://www.arthritis.org/health-wellness/healthy-living/managing-pain/pain-relief-solutions/4-tips-for-managing-chronic-pain

https://www.mayoclinic.org/diseases-conditions/arthritis/in-depth/arthritis/art-20046440

When a loved one is diagnosed with Alzheimer’s disease, it can feel devastating. This disease will be life changing for your loved one and, likely, for you. The senior in your life will require a special amount of support, love, and devotion – so you can make sure she is safe and cared for.

Alzheimer’s is a slowly progressing neurological disorder, which means that your loved one will become increasingly dependent as time goes on. While there is no cure for the disease, there are ways to slow the progression. Everyone experiences Alzheimer’s differently, but there are seven stages that you can expect your loved one to go through after a diagnosis.

It’s important to know what to expect as you face this new diagnosis. That way, you can be better prepared to be there for your loved one – and, hopefully, won’t be taken by any painful surprises.

Alzheimer’s is not a normal part of aging – but it does affect a large number of seniors every year. It’s the most common form of dementia. The disease is the 6th leading cause of death in the United States, affecting 1 in 10 Americans over the age of 65. Far too many cases go undiagnosed. These statistics can be hard to come to terms with. If you sense

that your loved one might have Alzheimer’s, but aren’t sure, it’s important to understand how common the disease is, and what signs and symptoms to look out for. 

Because Alzheimer’s is a cognitive disease, it impacts memory, thinking, and language. It can also impact movement, problem-solving and even personality. Eventually, daily tasks will be nearly impossible to accomplish – but with the right treatment, it can be possible to delay worsening symptoms.

Before we get into the stages, it’s important to remember that everyone is different. Alzheimer’s might not look the same for your parent as it did for your grandparent, for instance. Still, these stages give us a pretty good idea of what we can expect moving forward, before and after a diagnosis.

The period before a diagnosis is known as “preclinical Alzheimer’s disease.” This stage is considered a normal part of aging, because symptoms are too subtle to isolate. A person might be in the preclinical stage for years before their disease develops. Over time, scientists hope to develop advanced imaging technology that will indicate when a person is in this stage. That way, they can get an early start preparing for what’s next.

Slowly, a person will start to experience very mild forgetfulness. This is considered the second stage of the disease. It’s common at this stage for a person to forget a word or misplace something. Your loved one’s daily life will not yet be affected by the disease – they can still live independently.

Often, family, friends, and even doctors won’t notice that anything is wrong. Your loved one might confuse names or places, take longer than usual to express herself, and have a hard time with complicated tasks like paying the bills. Again, these symptoms are usually subtle – and they can be mistaken for normal ageing. If you notice that your loved one is experiencing forgetfulness, you can have her engage in mental activities, exercise, and eat healthy. While the progression of the disease is inevitable, activities like these will help your parent to have a stronger cognitive performance.

The third stage of Alzheimer’s is known as the mild dementia stage. It can go on for as long as seven years, and the symptoms will appear slowly. During this time, memory problems might become severe enough for doctors and family members to take notice. A person in the mild dementia stage might have trouble completing tasks or solving problems. If they had been planning an event, for instance, they might struggle greatly with that task, and become overwhelmed or exhausted.

During this stage, they could also start sleeping more frequently during the day and staying up longer at night. They might get lost driving or walking along familiar routes, or struggle to remember new information.

In this stage, their personality might start to slowly change. You might notice that your loved one is withdrawn or irritable during socially challenging situations – like parties, group events, or meetings. She might become overwhelmed by a lengthy visit with grandchildren, for instance, or following a meeting with a financial advisor.

Continue to work with your parent on mental exercises and making sure they are eating right and exercising. It is also recommended that your parent engage in counseling, especially if he or she is in denial or experiencing anxiety.

The fourth stage of Alzheimer’s usually lasts two years. It’s known as moderate dementia due to Alzheimer’s disease. This is the stage when most people receive an official diagnosis. You might notice that your mother or father is struggling to complete everyday tasks, like getting dressed or changing their clothes. They might not know the proper clothes to wear for specific events, such as weddings or funerals. Occasionally, they could lose control of their bladder.

Memory loss will be even greater during this time. They might start to forget important details about themselves – such as their address or their first job. They could make up stories in an attempt to fill disorienting gaps in their memory.

At this stage, they might also begin to wander. Oftentimes, especially when away from home, a person with Alzheimer’s wanders in an attempt to find something familiar. At this stage, it’s important not to leave your loved one alone. They could even wander from their own home if it momentarily seems strange or unsafe to them. Still, home is often the best place for a person with Alzheimer’s to be, because it is where they will feel safest most of the time.

The fourth stage of Alzheimer’s disease is also when most people experience major changes in their personality. This can be extremely difficult to witness. You might feel that you are losing part of your Mom, Dad, or grandparent, or find yourself offended or hurt when they lash out. Remember that these mood swings are your parents’ disease, not your parent. Try to remain calm, patient, and gentle. If you are angry or frustrated with your parent, this will only exacerbate the situation. 

These personality changes can be severe. They could become irritable and agitated and even lash out in anger. You might notice they are hearing or seeing things that simply are not there.

Again, these personality changes are heartbreaking for any family to experience. It will take an enormous amount of patience and love to get through. It’s essential to keep in mind that these mood swings are simply not personal. They are the product of a cruel disease.

The fifth stage is referred to as severe dementia due to Alzheimer’s. At this stage, your loved one will need a significant amount of support. It lasts about one to one and a half years. Without care, your parent might feel unsafe, insecure, and increasingly angry. During this time, you might notice that your mother or father is increasingly paranoid. They might become convinced that a caregiver is stealing, that their children are lying to them, or that their spouse is having an affair. With the help of an experienced caregiver, who provides your parent with a steady routine and daily mental exercises, this paranoia can be calmed.

They might not remember what the weather is outside, if their granddaughter just got married, or what their phone number is. Often, they’ll struggle with mental exercises like counting backwards.

They will recognize names and faces of those close to them but might struggle to speak with them in ways that make sense. They will require help with everyday care such as bathing, eating, and using the bathroom.

In some cases, your mother or father might have a hard time walking, sitting, or even holding up their head without support. They could start struggling with swallowing – and will eventually lose their ability to swallow altogether.

Memory care and professional home care are the most common types of care for a person in this stage of the disease. If you are able to keep your parent at home, with constant care, this is usually the best choice – because they will feel safer in familiar surroundings. When a person with Alzheimer’s finds themselves in a strange place, their cognitive abilities can decline at an even faster rate. For more on choosing the right type of care for your loved one, you can listen to our episode on choosing the right type of care.

Stage six is moderately severe Alzheimer’s. This typically lasts around two or three years and you will notice that your parent is struggling very severely. There are five main characteristics for someone in this stage.

They will no longer be able to dress on their own. They will need help brushing their teeth and keeping up with hygiene. They will need help using the bathroom and with toilet cleanliness. They will struggle to count backwards from 10. They might start stuttering or struggling to speak.

At this stage, your parent might also confuse family members and forget significant life events. This can be heartbreaking to experience for any family, but it’s knowing what to expect can help to prepare you.

Ensuring that your parent has 24-hour care is essential – especially because they might leave the house at night and get lost or lose their balance when attempting to dress or bathe themselves. They will also need help to eat.

The seventh and final stage of the disease is severe Alzheimer’s. During this stage, your loved one will feel completely lost. They might become fully immobile and lose their ability to speak.

Forty percent of people in the seventh stage of Alzheimer’s form hardening of muscles, tissues, and contractures, so they may feel constantly uncomfortable. This can result in behavior like thumb sucking, in order to feel more secure. 

This stage is especially difficult for family members, because the reality is that you may no longer recognize your parent and feel frustrated that you can’t do more to help. It hurts to see our loved ones in pain and unable to move or speak. You can provide support for your parent by being present with them, speaking gently to them, and making sure they are not alone. Even though your parent cannot engage in conversation, she still benefits greatly from your companionship.

If your loved one has been diagnosed with Alzheimer’s disease, make sure that you are getting all the help you need, too. Find local support groups for families facing the disease and turn to friends and family when you need them. The better you care for yourself, the better you can care for your loved one.

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please join us next time as we talk about tips for dealing with Arthritis.

Sources:

https://www.alzheimers.net/stages-of-alzheimers-disease/

https://www.webmd.com/alzheimers/guide/alzheimers-disease-stages#1

https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-stages/art-20048448

https://www.healthline.com/health/stages-progression-alzheimers#takeaway

https://www.alz.org/help-support/caregiving/stages-behaviors/accepting_the_diagnosis

https://www.seniorlivingspecialists.com/alzheimers-dementia-care/guide-caring-loved-one-alzheimers-disease/

https://www.healthline.com/health/alzheimers-disease#stages

https://www.alz.org/alzheimers-dementia/what-is-alzheimers

https://www.alz.org/alzheimers-dementia/facts-figures

https://www.alzheimers.net/resources/alzheimers-statistics

https://my.clevelandclinic.org/health/articles/11825-stages-of-alzheimers-disease

https://www.dementiacarecentral.com/aboutdementia/facts/risk/

https://www.alz.org/alzheimers-dementia/stages

A Dementia diagnosis is a hard truth for any family to face. Caring for a loved one with dementia can be a stressful, exhausting, and profoundly emotional experience – but with the right tools and preparation, care can be a little easier.  

Too often, the emotional needs of a person with dementia are overlooked or unmet. It makes sense – the physical care can be quite taxing, between feeding, bathing, clothing, and everything else. Not to mention, it’s difficult to be emotionally present for a person with dementia – especially when it reaches the more severe stages. Emotional outbursts, difficulty speaking, and changes in personality can all be barriers in helping a person to emotionally connect. Still, these very difficulties are the reason that our loved ones need our emotional support more than ever.

According to The British Psychological Society, up to a third of people with advanced dementia suffer from depression. Cognitive diseases impact every bit of life, and they can be absolutely devastating to the diagnosed individual. Between increased dependence, a reduced quality of life, and facing higher morality, depression is all too common.

In addition, because of communication struggles, people with dementia can be powerless to make decisions on their own and end up in positions that they are not happy or comfortable with – but they are unable to speak up or defend themselves. Dementia patients are also often excluded from events or activities that family members assume they would not be interested in.

It’s difficult to know how to support a loved one with dementia.  That’s why today, we’re going to discuss the best ways to care for your loved one – not just physically, but emotionally. When we are providing our parents or grandparents with the connection and love they need, the entire family benefits.

It is common for a dementia patient to experience mood swings. You might notice that your mother is quicker to anger, or your father gets frustrated constantly. It can be a battle to get your parent to bathe or even eat – and you might find yourself walking on eggshells. Changes in personality are heartbreaking for the family, and they can feel confusing or overwhelming. You might not know how to respond to your mother, or might take her outburst personally – even when you know that it’s a result of the disease.

Unfortunately, depression is harder to diagnose in dementia patients – because much of the symptoms, like apathy, lethargy, isolation and withdrawal, are also symptoms of dementia. Further, a person with dementia will have difficulty articulating their feelings.

If you are worried that your parent might be suffering from dementia, it’s a good idea to meet with a geriatric psychiatrist. These are mental health professionals who specialize in recognizing symptoms in seniors – and they might be able to detect symptoms that you are not able to.

In addition, the National Institute of Mental Health has a set of guidelines for recognizing and diagnosing depression in Alzheimer’s and dementia patients. The institute recommends that a caregiver examines whether the patient is tearful, hopeless, suicidal, or irritable. If your parent is experiencing these symptoms, whether as a result of the dementia or depression (or both), it’s essential that they are provided with feelings of safety, love, and unconditional support. 

A study by the British Psychological Society found that the more emotional care your parent is given, the less frequent her outbursts will be. Outbursts are a result of internalized fears, frustrations, and confusion.

It can be difficult, or even feel impossible, to understand exactly what your parent is going through. When you feel distanced from your parents’ experience, you might struggle when things become uncomfortable. That’s understandable. It’s heartbreaking to watch a parent’s personality slowly transform into something unfamiliar.

When our parent is often frustrated or angry, it can be hard not to take their words personally. You might feel an urge to fight back, to defend yourself, to argue. The more patience and understanding you show, however, the better you and your parent will feel.

According to Alzheimers.net, as the disease progresses, “it becomes easier to forget that your loved one is still present. Many caregivers are frustrated by their loved one’s inability to communicate their thoughts or remember faces and names. The disease eventually takes away independence so that caregivers become the feet, hands, and minds of people struggling with dementia.” 

Try to keep in mind just how difficult this is for your mom or dad. Imagine waking up and not knowing where you are or having enormous gaps in memory that you simply can’t account for. Imagine struggling with basic needs, like dressing or bathing. Imagine being stripped of your independence and not understanding why.

When your parent feels safe, secure, and loved, she is less likely to grow frustrated or irritable. Of course, that will still happen from time to time, but the outbursts should become less frequent and intense. Why? Because when your parent feels safe and supported, she is in a better position to be strong, calm, and comfortable.

For most dementia and Alzheimer’s patients suffering from depression, treatment includes medicine, counseling, and engagement in activities and socialization. A person with dementia cannot merely “snap out of it” and will not be able to recover on their own. They will require a significant amount of encouragement, support, and medical and professional help.

In addition to providing help for depression, it’s important to ensure your parent has the best possible quality of life. There are plenty of ways to care for your parent and make them feel safe and loved. Understanding the disease and knowing what to expect, as well as how to respond to varying situations, can help to make the experience easier for you and your loved one. 

The type of support you provide will depend on the stage of dementia your parent is facing. Being supportive, loving, and communicative, though, is key regardless of the severity. In the early days, you can begin by educating yourself about the disease and creating a plan for the future.

Be sure to include your parent in the planning. This is their life, after all, so they should have a say in the type of care they will receive and where they will live. Try to respect their choices, when possible, with an understanding that this is already such a difficult transition for your parent.

The more supported they are, the safer they will feel. If your parent wants to remain at home, for example, you may want to explore speaking with a professional home care provider about their memory care services. This is one of the more common choices for dementia patients and their families. For a person with dementia, familiar surroundings mean reduced stress and strengthened memory.

To learn more about home care for dementia patients, listen to our episode on choosing the right type of care for your loved one. There, you will also find insight about other types of care and living situations that might be best for your loved one and your family.

I understand that including your loved one in the conversation might be difficult. If your parent is struggling to express themselves or has difficulty asking or answering questions, that doesn’t mean they don’t have feelings or opinions on the matter. In fact, it can feel embarrassing, degrading, or even heartbreaking to be excluded from these conversations.  

To improve communication, it’s important to be clear, positive, gentle, and to acknowledge your loved one’s feelings. When speaking about challenging topics, keep a calm tone of voice and gentle body language. Avoid using harsh language or sounding frustrated or angry. Even if you feel frustrated, try your best not show it. If your parent believes they are an inconvenience to you, they will struggle even more to communicate with you. Remember, we want our parents to feel loved and supported.

Speak calmly and slowly, using simple words – and be prepared to have to repeat yourself. Only ask yes or no questions, and only provide choices that are realistic. In other words, don’t promise something that can’t be delivered. Provide the truthful information in a calm and reassuring voice and repeat it as many times as your parent needs you to. They are trying to understand, even if that doesn’t seem apparent.

It’s also important to make eye contact. That way, you’re respecting your parent while also helping them stay engaged in the communication. You can also use body language, like holding their hand or leaning toward them, to help them stay focused on the discussion.

Being purposeful with your words and word placement is essential, as well. Avoid pronouns like “he,” “she,” or “they,” can be confusing. Instead, use the full names of people and places. You can also use positive words, like “I enjoyed this,” or “I am so glad we spent this time together.” Finally, choose your last words carefully. The last word is the easiest to remember, so this is the part of the sentence your loved ones will cling to.

The Harvard Health Review explains, “if you ask, ‘would you like to wear the green shirt or the blue shirt,’ only the word ‘shirt’ might stick in the person’s mind, and you won’t get an answer…ask ‘would you like to wear this green shirt today or the one that’s blue?’ and the person will say ‘blue.’ She feels as though she has decided for herself rather than being told what to wear, but the choice has been made so easy that she feels little anxiety about it.’”

Acknowledge your parents’ feelings by letting him know that you see him, and you understand. For example, if your parent is growing irritable or frustrated, don’t ignore that. Say things like, “I understand that you are frustrated and I’m sorry this is something you are facing.” Offer to take a break from the conversation if your parent feels exhausted or overwhelmed.

Communication is not only important for the hard conversations. It’s a way to provide support and friendship to a loved one, on a consistent and routine basis. In the early stages, you can remind them of things like doctor appointments, events, or anything else by writing notes on Post-Its and placing them around the house where your parent will see them. These notes can also be notes of friendship, that remind them of how loved they are and that they are not alone.

Communicating may be a lengthy and tedious process, but its importance cannot be emphasized enough. If you show up one day and take your parent into a long-term care facility or residence without warning, her condition will likely worsen – and she could face feelings of betrayal, shock, depression, or even heartbreak. Never forget that at the end of the day, this is your mother’s life. Your father’s life. Not yours. If possible, include them in the conversation.

Of course, if your parents’ dementia has increased in severity, this simply may not be possible. In this case, your parent might no longer be speaking or they might not understand their surroundings at all. If you have to make important decisions without their input, remember to be patient and gentle with them – and don’t leave them alone to experience these difficult times. For example, if there is no choice but to move them into a memory care facility without communicating with them, do what you can to be present through the move and in the days or weeks following.

In addition to communication, there are ways to help your loved one build their self-esteem and sense of dignity. Offer praise and encouragement whenever you can – especially if your parent has achieved a small victory, like remembering an appointment or even putting on a shirt by herself. At the same time, don’t berate them or criticize mistakes or forgetfulness. It is common for a person with dementia to forget what clothing is appropriate for certain occasions, for example. If your parent puts on a t-shirt before a wedding, don’t be critical or accuse her of making a mistake. Be patient, warm, and gentle as you help her pick another blouse to wear.

A dementia patient’s self-esteem can also be increased by engagement in social activities. While your parent is still able, attending support groups, classes, or activities can help them to feel more dignified and happier. If your parent is past the point of being able to participate in socially challenging events, help them with memory games, books, hobbies or other stimulating activities that can keep them busy and engaged.

If your parent is experiencing delusions, be patient and supportive. Rather than challenging their perception of reality, acknowledge it and try to redirect their thinking. For example, if your parent is paranoid that their caregiver has stolen a piece of jewelry from them, don’t jump to say, “how dare you accuse her of something like that!” or “that’s ridiculous.” Instead, tell them that you’re sorry their jewelry is missing and offer to help them find it.

Similarly, if your parent believes a lost loved one is still alive, ask her questions about the person instead of shutting her down.

In Learning to Speak Alzheimer’s, author Joanne Koenig Coste tells a story in which her husband is scrubbing the Teflon off a frying pan. She congratulates him for doing a good job, instead of telling him that he’s ruining the pan. To tell him that he ruined the pan, would lead nowhere except for frustration and upset feelings. By congratulating him, she redirected his feelings in that moment and turned a situation positive, ensuring his feelings of safety.

The frying pan story is also a great example of letting your loved one do something for himself. If your father wants to help with the dishes, let him. Don’t say that you can do it faster or more efficiently. Even if it means you have to do the dishes all over again when he’s no longer present, letting him feel helpful is enormously important for his feelings of self-esteem and independence.

When it comes to helping your parent with her mood swings, you can take preventative measures to ensure that she isn’t put in uncomfortable or exhausting situations. Dementia patients can become impatient quickly, due to their shortened attention spans. So, don’t put them in situations where they need to be patient. If you’re going to bathe them, for instance, don’t tell them it’s time for a bath until their bath is drawn and ready to go. Don’t tell them it’s time to go to the doctor until it really is time to go to the doctor.

Of course, this doesn’t mean you shouldn’t prepare them for what to expect each day. You can let your parent know they have a doctor appointment that day, and you should, to avoid any unnecessary stress or surprise. It simply means that when it’s time to go, don’t make them wait to get into the car and get to the appointment.

You can also help your parent feel calmer by avoiding over stimulation. While it’s important to include family members in events so they don’t feel left out or forgotten, avoid loud or crowded gatherings that might be overwhelming. During the holidays, for example, you could aim for small gatherings or provide a quiet room for your parent to escape to. Avoid turning on the TV while your parent is trying to have a conversation.

A 2003 study by researchers at the Karolinska Institute found that music positively effects dementia patients, even in later stages of the disease. The study is explained in The Harvard Health Letter, which says that when listening to music, patients “sat up straighter, their movements became stronger and more regular, and their awareness improved.” Amazingly, even more effective than playing music was singing songs. When caregivers sang to their patients, their mobile and cognitive abilities actually improved. Singing brings a sense of calm and positivity to the patient, and therefore improves their overall move and cognitions.

Finally, try your best not to treat your loved one differently. I know this can be tough, especially on the days when your parent feels unfamiliar or incredibly difficult to communicate with. Of course, you will have to treat your parent a little bit differently no matter what, since you can’t engage in conversation like you once could and will need to be extra patient with them. But in this sense, not treating them differently simply means to treat them with respect and kindness.

If there’s another person present on a visit, don’t talk about your parent in front of them, as though they’re not there. Include them in your conversation. In addition, try not to speak down to them like they are a child. This is a person who has lived a full life, not a toddler who is learning to speak. Finally, allow them to make their own choices whenever possible.

It can be devastating to learn that your loved one has dementia, but when you know what to expect, you can prepare yourself to be more patient, kinder, and more understanding. Always lead with empathy first and never make your parent feel alone in his or her struggle.

We have seen countless families that have been touched by this disease and what may work for one family may not work for another. But, there is one common thread for every family and loved one that is facing dementia and that is everyone deserves to be treated with respect, dignity, and love.

When you help your loved one to feel safe, loved, and supported, you are giving her the strength to face what’s ahead.

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please join us next time where we will be explaining the different stages of Alzheimer’s disease. This is a topic that we are always getting questions about and what the different stages are and what to expect with each stage – you won’t want to miss that episode.

Sources:

https://www.bps.org.uk/sites/www.bps.org.uk/files/Policy/Policy%20-%20Files/Evidence%20Briefing%20-%20Emotional%20and%20Psychological%20Needs%20in%20Advanced%20Dementia.pdf

https://edisonhhc.com/coping-with-emotional-aspects-of-dementia/

https://www.health.harvard.edu/newsletter_article/the-emotional-side-of-alzheimers-disease

https://www.weatherlyinn.com/blog/how-to-support-a-loved-one-with-early-dementia

https://www.alzheimers.org.uk/get-support/help-dementia-care/understanding-supporting-person-dementia

https://autumnleaves.com/5-simple-ways-help-someone-dementia-short-long-term/

https://www.alz.org/media/documents/alzheimers-dementia-care-10-ways-to-help-a-family-c.pdf

https://www.alzheimers.net/caring-for-someone-with-dementia/

https://www.helpguide.org/articles/alzheimers-dementia-aging/tips-for-alzheimers-caregivers.htm

https://www.caregiver.org/caregivers-guide-understanding-dementia-behaviors

https://www.alz.org/help-support/caregiving/stages-behaviors/depression

As your loved one has gotten older, you might have noticed a steadily growing number of medications building up in their medicine cabinet. While it might be a bit of a shock to see just how many pill bottles your parents are collecting, it’s important to remember that this is a normal part of getting older. According to The Journal of Patient Safety, “people over the age of 65 use more medications, both over-the-counter and prescription, than any other age group.”

Still, as important as these medications are to our parents’ health, they can also be dangerous, if not taken correctly. It’s essential for anyone to practice medicine safety – but especially for seniors, who might have trouble keeping up with their growing number of medications.

From medicine storage to ensuring that no incompatible drugs are being taken together, there are many ways to ensure your parent is taking her medications safely. Today, we’ll let you know exactly how you can help prevent medication-related problems for your parent.

There are many reasons that your parent might struggle with his or her medications. For one thing, age-related changes such as weight loss or decreased body fluid can alter how drugs perform in a body. Similarly, weakened kidneys and livers may not process drugs as easily, so medication could stay in the body for longer periods of time. In addition, issues like memory loss or hearing and vision difficulties make it hard to remember when to take medications or understand how to take them properly.

Finally, if your parent suffers from a condition like arthritis, high blood pressure, or diabetes, he will likely follow a complex medicine regimen that can be difficult to keep up with.

According to the FDA, “as you age, body changes can affect the way medicines are absorbed and used. For example, changes in the digestive system can affect how fast medicines enter the bloodstream. Changes in body weight can influence the amount of medicine you need to take and how long it stays in your body. The circulation system may slow down, which can affect how fast drugs get to the liver and kidneys. The liver and kidneys also may work more slowly affecting the way a drug breaks down and is removed from the body.”

Regardless of the reason, at its worst, practicing medicine safety can mean the difference between life and death for seniors. Be sure that you, your parent, and your parents’ caregiver are doing all that they can to prevent any problems.

First, it’s important to make a note of what we consider medications. Believe it or not, medicine covers more than just the pills inside an orange bottle. In addition to prescription pills, there are prescription creams, asthma inhalers, epi-pens, and more. Medicine also refers to over-the-counter meds, like pills, creams, liquids, or chew tablets. Additionally, things like vitamins, ear and eye drops, and dietary supplements are all considered medications.

This is an exhaustive list – and it’s essential that you keep track of everything your parent is taking. You never know if a vitamin can’t mix with a certain prescription, or if a cream will cause an allergic reaction.

On that note, be sure to coordinate your parents’ care. If your mother has more than one provider, it can be more difficult to stay on top of all of her medications. It’s not impossible, though. You just need to get everyone on the same page. You can use something called medication reconciliation to get everyone on your mother’s health team coordinated. Medication reconciliation means creating a thorough list of all possible medications that your parent might be taking and comparing it to her patient record and medication orders.

When creating this list, make sure it’s as detailed as possible. Try to include the drug name, the frequency of use, and the dosage. Again, don’t forget to add the seemingly little stuff here – like eye creams or vitamins. The more information you can provide, the better for creating a clear understanding of your mother’s medicinal needs. After comparing the list with your mother’s medical records, ensure that everything is updated and correct. Be sure to take the list to all doctor appointments or care appointments of any kind.

In addition to coordinating care through medication reconciliation, you can also ensure that all of your mother’s medicine is coming through the same pharmacy. That way, you’ll have a clear, organized record of your mother’s medications and you will have an easier time keeping track of everything. Not only that, but the pharmacist will keep an updated list of all the medicines your parent is taking – and will know if any two medicines should not be taken together.

If your mother has prescriptions sent to multiple pharmacies, mix ups can happen very quickly. This could mean forgotten meds, double dosages, or a lost record of prescriptions – all of which can be extremely dangerous or even deadly.

Pharmacists are also a great resource for answering any questions you might have about a medication. Having one pharmacist is even better, because she will be somewhat familiar with your parents’ medications and history.

In addition to keeping an organized record of your parents’ medication, you’ll want to make sure the medicine is organized within the household. If your dad is keeping one pill bottle in the kitchen, another in the living room, and another in the bathroom – he’s more likely to forget a dose or two. Make sure that all of his medications are stored in one place, like the bathroom cabinet. If your dad does not have a caregiver, help him to organize the cabinet as efficiently as possible – in the order of when he takes each dose, for instance.

Of course, certain medications need to be stored in the refrigerator or in another specific environment. Consult your parents’ doctor to ensure that the medications are being stored properly. 

While you’re going through the cabinet with him, make sure that nothing is expired or out of date. Check over each bottle with your own list to ensure that there’s nothing missing, or nothing present that shouldn’t be. If your dad has any over-the-counter drugs, check with his doctor to make sure they can mix with his prescriptions. If they can’t, get rid of them right away.

Every week, you should also pre-sort a week’s worth of medication or they also have monthly pill organizers now if that is easier. Use a pill organizer to best manage your parents’ medication, dose by dose. Choose an organizer that has the correct number of compartments per day for your parents’ individual needs. If any drugs need to be split or crushed, do so ahead of time, so your parent doesn’t need to struggle trying or accidentally forget and take too much.

Once you have an organized record of your parents’ medications – and you’ve gathered everything into one place – take your parent to the doctor. Bring your list, so that the doctor can go over every medication carefully and ensure that it all looks good. While you’re there, get the facts about each drug.

For every medication, you should know: the name, the reason it’s being taken, and the possible side effects. While you might not pay attention to side effects for yourself, it’s essential that you know what they are for your parents. As we age, our kidneys and livers can weaken, making medications stay in our bodies longer. This means that seniors are more susceptible to feeling side effects than younger people. If you notice that your parent is suffering from side effects, consult their doctor right away.

Make sure that your parents’ doctor also has an updated list of your parents’ allergies – so that he can make sure there’s no risk of a reaction with new types of medications.

In addition to asking about side effects, be sure to check in about possible drug interactions. Drug interactions occur when one drug affects how the other works, a specific medical condition reacts poorly to a certain type of drug, a food or drink reacts with a drug, alcohol reacts with a drug, or supplements react with a drug.

Learn about interactions by speaking with your parents’ doctor, carefully reading labels, and reviewing special instructions with your parents’ pharmacist. It’s possible that drug interactions will cause side effects that seem similar to natural health problems in the elderly. Most commonly, memory problems or light headedness. If you notice that your parent is suffering from a sudden health issue, don’t write it off as a normal part of ageing before speaking to your parents’ physician. 

Watch out, especially, for dizzying side effects. If you notice that your father’s medication is making him dizzy, be sure to tell the doctor right away. Dizziness could affect your father’s balance and cause him to fall – which could lead to a plethora of health problems.

Pay careful attention to how drugs might interact with food or alcohol. Drug-alcohol interactions can be incredibly dangerous – so know which of your parents’ drugs do not mix well with alcohol. If you notice that your parent is dizzy, irritable, or imbalanced after drinking – it may be the result of a bad interaction.

When it comes to food, a food/drug interaction occurs when the digestive tract cannot absorb the drug properly because of a certain type of food being digested. In addition, it’s possible for medication to affect how nutrients are absorbed in the body. Ask your doctor if there are any foods your parent should avoid with his medication.

In addition to getting the facts, make sure you ask questions. According to The Journal for Patient Safety, “up to half of prescription medications are not taken properly.” That’s a scary statistic. Be sure your parent (or your parent’s caregiver) knows exactly how to take her medication. Examples of questions to ask your parents’ doctor might include:

• Should this medication be taken with food or water?
• Can this medication be taken safely with my other medications?
• How should I store the medication?
• How do I know if it’s working?
• What side effects can I expect?
• What do I do if I miss a dose?
• How does this affect over-the-counter medications?
• How will traveling to a different time zone affect this medication?

Never be afraid to ask questions. According to medical officer at the US FDA, Sandra L. Kweder, MD, FACP, “as a society, we have become reliant on pharmaceuticals to help us attain a longer and higher-quality life. It’s a wonderful success of Western medicine. The goal should be for each of us to access that benefit from respect that medicines are serious business. To get the most out of them, you should take them with great care and according to directions.” There isn’t such thing as stupid questions when it comes to medicinal care. This is, after all, “serious business.”

Here’s the thing – medicine won’t help if you aren’t taking it properly. In fact, it could make things worse. Make sure your parent is not choosing a dose for herself but is following the directions to a tee. Kweder reminds us that, “medication can’t work unless you take it. For instance, medications that treat chronic conditions such as high blood pressure and diabetes typically only work when taken regularly as directed. You have to take them continuously to maintain control over your condition.”

When it comes to taking medicine correctly, don’t forget to account for any drugs taken in the middle of the night. If you have to wake up at night to take a dose, keep that medicine beside your bed, with a glass of water, in its proper dosage.   

Try to go over your parents’ medication list at every doctor appointment – to ensure that all medications are still necessary, and any over-the-counter drugs are safe to take. At the very least, schedule a medicine “check in” appointment at least once a year for your parent.

If your parent travels, make sure they bring their doctor’s contact information with them in case there are any problems with their medications while out of town. Ensure that they know how to adjust their routine to the new time zone. Additionally, have your parent carry their meds with them at all times – and never pack them in a checked bag. You also want to make sure your parent keeps the medication away from direct sunlight or heat while on a trip. If medication is lost or tampered with on a trip, have your parent call their doctor and set up a refill at a local pharmacy.

In addition to scrutinizing every detail with your parents’ physician and pharmacist, you need to make sure that your parent is not struggling with the logistical aspects of the drugs. For instance, does your dad have a hard time opening the container? If he does, the pharmacist can provide containers that are easier to open. Does your mom struggle with swallowing pills? See if there’s a liquid form of her medication available. The drug may not work if you crush it, break it, or chew it – so make sure you know if the drug will still work if its tampered with.

If your parent has trouble reading the label, ask the pharmacist to print a label in larger font. If she still can’t read the label, you will want to make sure that you or a caregiver are helping her to take her medicine properly.

In addition to ensuring that your parent can open her medicine and read its label, you want to make sure she doesn’t forget to take it. It can be hard for caregivers and seniors alike to keep track of all the dosages – even when they’re kept in a pill organizer. Set up a medication reminder system so you can make sure all drugs are accounted for and that the right dose is taken at the right time.

One method is to create a chart on poster board, a white board, or a wall calendar. Carefully list the medications, along with their dosages, within the proper day and time. After taking each dose, mark the poster with a check mark so you know it was taken. That way, you’ll never have to wonder if a dose was missed.

You can also set alarms on your parents’ phone and their caregiver’s phone. A little notification will “ding” at the time of the medication, and you can even write down the proper dosage there. If your parent is good with technology (or if their caregiver is) you can also use a medication management app, like Medisafe, Pillboxie, or CareZone to keep track of your medications.

Medisafe is the number one app recommended by pharmacists for medication management. It sends reminders that automatically adhere to changing time zones – so if your parent is travelling, her medication reminder will go off at the proper time, regardless of what time zone she’s in. You can also manage an entire family’s medicines into the app – so if your mom and dad are taking medications, this is a way to organize both of their meds at once. The Medisafe app is completely free to use.

Pillboxie is all about visually managing your medications. By dropping an animated pill into a pillbox within the app, the app will tell you the name, color, and shape of your medication, to ensure that you’re taking the correct pill. The app also allows you set daily medication schedules with a checklist that you can mark as you go. Pillboxie is $1.99 in the App Store.

With CareZone, you upload pictures of your medication bottles and the app makes a list for you. This is a great app to use for making a list of medications and dosages. You can set reminders not just for when you need to take a pill, but also for when you need refills from the pharmacy. The app is also printable – so you can print off a pre-formatted schedule to provide your parent or her doctor with. CareZone is free in the App Store.

Speaking of technology, there might be times when your parent needs to purchase medicine on the internet. This is rare, but it does happen. Maybe they’re abroad or unable to see their doctor in person. Never order medication online without consulting a doctor first, even if remotely. If you must order your parents’ medication online, check the Verified Internet Pharmacy Practice Sites program for a seal of approval on each drug.

As your parents’ medication needs get more complicated, so do their daily routines and schedules. The more organized and efficient you can help them be, the better. After all, medicine safety is no joking matter. When it comes to medicine, responsibility means safety. 

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please join us next time as we talk about effective ways for communicating with a loved one who has dementia.

 Sources:

https://www.fda.gov/consumers/consumer-updates/4-medication-safety-tips-older-adults#:~:text=Take%20your%20medicine%20regularly%20and,first%20consulting%20with%20your%20provider.

https://www.nia.nih.gov/health/safe-use-medicines-older-adults

https://dailycaring.com/medication-management-for-seniors-10-safety-tips/

https://www.bemedwise.org/medication-management-for-older-adults/

https://www.fda.gov/drugs/resources-you-drugs/medicines-and-you-guide-older-adults

https://eldercare.acl.gov/public/resources/brochures/docs/Older_Adults_and_Medication_Safety.pdf

https://journals.lww.com/journalpatientsafety/Citation/2009/03000/Medication_Safety_for_Seniors.10.aspx

https://www.healthinaging.org/medications-older-adults

https://www.drugs.com/cg/medication-safety-for-older-adults.html

https://betterhealthwhileaging.net/6-medication-problems-aging/

http://www.ihi.org/Topics/ADEsMedicationReconciliation/Pages/default.aspx

https://senioradvocacyservices.org/technology-for-aging-in-place-apps-for-managing-medications/

Episode 51 -

Choosing the best senior living option for your mom or dad can feel overwhelming. Many of us expect the answer will be obvious – if our Mother is suffering from Dementia, for instance, the time will come when she needs to engage in Memory Care. Or, if our Dad has been diagnosed with Parkinson’s, we know he might need assisted living or maybe he prefers home care instead?

The truth is, though, that the right choice isn’t usually in front of our eyes. More often than not, it’s the little things – like that time Dad complained about the single stair in his shower, or the time Mom forgot to feed the dog – that indicate it’s time to look into care options.

In those less obvious cases, choosing between so many different types of care might feel daunting. What’s the difference between assisted living and a nursing home? Are there ways my parent can continue to live independently? Do I have to hire a full-time caregiver? Does my mom really need that extra help?

In today’s episode, we’ll break down the options for you – so that this new and treacherous landscape can transform into something simple and comprehensible. When you understand your options, you can make a much more informed decision – without worrying that you might be missing something. We’ll discuss assisted living, nursing homes, memory care, home care, and even whether moving Mom or Dad in with you is an ideal option. We’ll also talk about independent living – and ways to stretch that period out for your parents, while still giving them the help they need.

Before we get into all that, though, let’s get into the signs that it might be time for more help in the first place.

You can begin by analyzing your parents’ overall physical health. If your parent is in great physical shape, then their options might be a lot more open. If you notice changes or problems in their health, though, you don’t want to wait to consult a doctor and start planning your next steps. Physical health is nothing to mess around with and must be a priority.

If you can visit with your parent, take the time on your next trip to absorb their behavior and look for any signs of health changes. Observe details like weight, sleep patterns, and possible injuries.

Has your mom lost a surprising amount of weight lately? If she looks thinner than usual, this could indicate that she’s been forgetting to eat. It could also be a sign of something more serious – like cancer, dementia, or depression. If you notice dramatic weight changes, you shouldn’t wait to get your parent to a doctor. When the reason for the weight loss is determined, not only can your mother begin treatment – but together, you can decide the best care option. If this is an early sign of dementia, for instance, you can think about Memory Care. If it’s a medical condition like cancer, your doctor will help you find the most suitable care.

If your parent’s weight is about the same – that’s a great sign. It’s possible that your mother can continue to live independently. Still, there are other – equally important - factors to consider. Once you’ve analyzed your parents’ weight, find out how they’ve been sleeping.

Have you noticed that your dad has been falling asleep at the couch more often, or taking a long time to get out of bed morning? In a non-confrontational, conversational manner, ask him if he’s had any trouble sleeping lately. Has he missed early morning appointments or been consistently late due to sleeping in? This could be a sign that he’s struggling to fall asleep at night. Has he been taking “naps” during the day that tend to last for hours? Does he seem lethargic or is he alert? Changes in sleep patterns are a sign that physical health might be declining. Dad could be losing sleep because of new aches or pains in his body, or because he is just generally slowing down.

If you notice that your mom or dad’s sleep is being affected, be sure to take them to the doctor. Once you understand why this is happening, and treatment begins, you can start looking into the best options for care.

Finally, try to notice if there are any signs of injury on your parent’s body. Your parent might not always tell you when he’s suffered a fall – so you’ll need to look out for these signs yourself. If you notice new bruises, possible limping, or broken skin – this is a sign that your parent has been facing mobility struggles. Now, depending on the severity of these struggles, you might not need to jump to assisted living or a nursing home. Depending on your finances, there are plenty of options to making the home a safer place for your loved one. However, if the falls are a sign of something bigger – like Parkinson’s disease – you will have to look into more serious care.

Of course, not everyone can observe their parents’ physical health. Maybe you live out of town or you aren’t able to see your loved one in person due to the COVID-19 pandemic. If this is the case, ask yourself if there is anyone who is able to stop by Mom’s house for you and report back. Do you have a sibling in town or a family friend? Try to find a neutral party who will report their findings in an honest way. If your sibling is adamantly against long-term care, for example, he might not be the best person to ask – because he’ll go out of his way to only look for signs that help his cause.

You can also ask your parent about their health on the phone. Just keep in mind that they might not be entirely honest with you – or they might not even know the answers. If your dad has suffered weight loss, for example, he probably hasn’t noticed. Still, it’s worth speaking directly to your parents so that they have a chance to voice their own concerns about their health.

Once you’ve analyzed your parents’ physical health, it’s time to address their mental health. Mental health is equally important to consider when it comes to knowing if it’s time for extra help. If your parent is suffering from memory loss, depression, anxiety, or anything else concerning – you’ll want to get them help right away.

Signs of faltering mental health might not be as obvious, but there are certain signs you can look for. Have you noticed if your parents’ house is being neglected, for example? If your mother or father is no longer caring for their home – this could indicate that they are no longer managing their lives well. Look for dirty dishes, messy floors, cluttered corners – anything that indicates that domestic needs are being forgotten. If your parent is not able to keep up with housework, it’s safe to assume he’s struggling to keep up with his own care. Not to mention, no one wants their parent to be living in filth. It might be time to enlist extra help around the house.

Does your parent seem confused? Has mom been leaving the oven on or has dad forgotten to put groceries away? Did you find the TV remote in a kitchen cabinet? Is your mom calling her cat by the wrong name? Sure a simple mistake might happen from time to time and not be cause for alarm, but if you’re noticing frequent signs of confusion, it’s a sign that something more serious might be happening. If this is the case, it’s time to take your parent to a doctor and discuss care options.

Finally, take note of your parents’ physical appearance. If it looks like they are failing to shower, brush their teeth, or keep up with basic grooming, this might mean they are suffering from depression or that a change in their health has impacted their ability to care for themselves. When your parent is unable to care for themselves, it’s time to enlist extra help. Bring your parent to the doctor for further assessment.

Once you have assessed the situation and determined that your mom or dad does need help, it’s time to decide the best type of care for them. Remember to include your parent in this conversation – after all, this is their life, and they should have a say in any major changes they are facing whenever possible. To learn more about how to begin this conversation with your mom or dad, check out our episode “When is it Time to Move?”

If you know that your parent needs some extra help, but believe she still has a great bill of health overall, you might want to make some simple adjustments to her independent living style. This can be the best option for many families – especially when the parent is hesitant to make a more drastic move. Independent living adjustments can also act as a transitionary period to get your parent used to accepting more help.

There are many instances in which independent living is still the best option. If your mom is physically and mentally healthy, for example, but she is struggling to move around the house, consider hiring an occupational therapist or speak with her doctor to see if she qualifies for home health care – that would provide an occupational therapist through her Medicare.

Occupational therapists will evaluate the home and recommend safety changes – like installing grab bars or chairlifts for the stairs. They will also help your parent to improve their physical strength and balance, by teaching them new exercises and techniques. According to AARP, “studies show that visits from an OT help older people stay in their homes longer.” If your relatively healthy parent is adamantly against moving into a facility, an OT just might be the perfect answer for both of you.

In addition to installing grab bars and other safety measures, you can also look into purchasing assistive technology. There are a number of products available meant to help with your parent’s at-home safety. AARP reports that, “SimplyHome offers monitoring equipment such as motion sensors and GPS watches, and QuietCare has a motion-sensor system that can learn a person’s daily patterns and send alerts when there is a significant change.”

If your parent is resisting help, but you can’t be around to track their health and keep up with their living situation, assistive technology might provide just the help you need – temporarily, at least.

You can also enroll in your mom or dad into an Adult Day Care program. If you don’t want your parent to be alone or unsupervised throughout the day, this could be a good solution. Adult Day Care programs provide meals, activities, and companionship – so if your mom is forgetting to eat or your dad is staring at the TV all day, this could be extremely helpful. It can also provide your parents with a new community of friends who can relate to them – which is especially important if they are living alone and don’t spend much time socializing.

The most popular of these services is the Program of All-Inclusive Care for the Elderly or, PACE. If your loved one qualifies for Medicaid, this service is completely free. Otherwise, it’s about $3,000 a month.

If your mom or dad seems perfectly healthy, but they are suffering from loneliness, service programs like Senior Corps could be a great help. Senior Corps sends volunteers to visit with the elderly right in their own home – and the volunteers are 55 and up, to ensure that your mom or dad will feel comfortable.

There are also support networks known as “Villages” available in certain areas around the country. These are nonprofit networks that are intended to help seniors stay at home and get the care they need. Villages volunteers will help your parent with everyday tasks. Your parent will also qualify for discounted services – including everything from household maintenance to at-home nursing care. Villages cost around $300 to $500 a month.

Finally, if your parent wants to stay home but has major health problems that require constant medical care, you can look into hiring a registered nurse. Whether you need a registered nurse for 24-hour healthcare, or only in certain durations, this is something to consider if your parent’s health is failing, but they are adamantly against leaving their home. 

While independent living is a wonderful option for many seniors, it is not always possible. If your parent has been diagnosed with a chronic illness, is feeling depressed, has severe mobility struggles, or is simply not in a place to care for their home at all anymore – it might be time to consider other options.

Now, that doesn’t necessarily mean your parent needs to leave their beloved home. In fact, the most common type of care option is Home Care. It’s the largest and fastest growing sector of long term care out there – and it’s easy to understand why.

With home care, your Mom or Dad doesn’t need to make the move to assisted living or a nursing home – which means that in addition to saving on the stress and transitionary position that moving comes with, you’ll also be saving quite a bit financially.

Chances are, your loved one isn’t ready to leave their home – and might not ever be. Home care allows them to stay where they are most comfortable, without making many adjustments. They’ll be able to eat what they love, engage in household activities that they are familiar with, and feel safe in their own familiar surroundings.

If your parent is suffering from dementia, home care is often the best option. It’s highly recommended that a person with dementia remains within familiar surroundings – in order to reduce stress and strengthen memory. Depending on the degree of the disease, you might need to consider memory care – but often, dementia patients are able to stay at home for the remainder of their lives.

Home care also allows you to be in control of when your parent receives help. If your mother needs help maintaining her home or cooking her meals, for example, you can schedule assistance for just a few hours each day. This is a great alternative to paying for a full-time lease with assisted living, especially when your mom or dad may require more hands-on care and assistance.

Finally, home care is customized to your loved one. That makes it pretty indispensable. Your loved one will be the number one priority to his caregivers and his care will be fully customized to fit his individual needs. Unfortunately, that’s not as possible at move-in facilities, just because the staff has so many residents to keep track of. With all the focus on your Mom or Dad, you’ll never have to worry that their individual needs are not being met to their liking.

Home care can provide your loved one with everything they need, up to needing a licensed registered nurse (if you are looking for 24-hour nurse care, we’ll dig into that later on).

Of course, if you and your loved one decide that leaving the home is the right option for them, there are plenty of live-in facilities to consider.

Assisted living is a fantastic option for any person who needs extra help, but is still able to function on their own to a significant degree. The reason a person might choose assisted living over home care is if they are interested in residing in a community of other seniors – where they can build friendships and connections. Assisted living also provides a safe place to live with regular visits from nurses, as well as a nice community and daily activities. 

Assisted living doesn’t strip your parent of her independence – it just provides a space in which daily living is easier. Not to mention, the community of other seniors establishes a foundation for friendships and companionship that simply would not be available to your mom or dad at home.

Many seniors report that assisted living communities feel like college again – because they are surrounded by new friends and have so much to do. From community theatre to art classes to book clubs, the activities really are endless. Plus, if you are not able to be with your parent most of the time, you can rest assured that your parent is being well taken care of in an assisted living community.

Depending on the facility and the state – as well as the insurance, assisted living costs can vary greatly. On average, though, the cost can range fairly significantly from $2000 to $4000 up to $8000 to $10,000 a month depending on the facility and the amenities that are offered. If you believe that this is the best option for your parent, look into long-term care insurance or the living benefits of your parents’ life insurance.

Now, if your parent is unable to live independently at all, a skilled nursing facility might be the best option. At a skilled nursing facility, your parent will receive round-the-clock care for everything from their illness to their daily needs. Much of their care will be monitored by doctors and they will receive physical, speech, and occupational therapy to help strengthen their minds and bodies.

If your parent is unable to feed, bathe, dress, or move on her own – this is likely the best option. These facilities don’t have to be permanent residences, though. If your parent has suffered a bad fall or is recovering from surgery, they may need to stay here temporarily while they recover.

Much like assisted living facilities, the cost of skilled nursing facilities depends on the state and the location itself. A private room in a nursing home can be quite costly – averaging about $7000 a month. If your parent is a veteran, though, they might qualify for discounted care. Otherwise, again, look into insurance options – either from Medicare, long-term care insurance, or life insurance and Medicaid.

If your parent is suffering from Alzheimer’s or Dementia, Memory Care living might be their only option. Memory Care provides specialized care for patients suffering memory problems. Specific routines are structured to decrease stress, and staff is trained to deal with the unique difficulties that coincide with Alzheimer’s and Dementia.

There are more frequent check-ins than at Assisted Living Facilities and everything from meal to basic care is highly organized, so there are never any breaks from routine or surprises.

Daily activities are meant to improve cognitive function – so that residents are mentally engaged and strengthening their memory. There are different activities offered depending on the stage of your parents’ disease.

According to registered nurse and memory care consultant Megan Carnarius, “in regular assisted living, residents are expected to manage their own time; menus and mealtimes are posted, but staff is not checking in on them. In memory care, the staff ensures residents are getting to meals, coming to activities, and moving onto the next thing.”

At the same time, these facilities also offer heightened security – so that patients with a tendency to wander cannot leave the premises or risk getting lost. Elevators need codes, doors are alarmed, and in some instances, patients wear tracking bracelets.

If your parent has recently suffered a stroke and is suffering from temporary cognitive and memory problems as a result, Memory Care is probably not the best option. This type of care is intended to be permanent or long-term, not temporary. Instead, you might consider at-home care specialists that are memory specialists or a temporary stay in a skilled nursing facility while your parent recovers.

Memory care costs around $5000 a month on average – but, again, this pricing varies depending on the state and the level of care. Unfortunately, insurance does not always cover the cost of this type of intensive care. According to elder law attorney Richard Newman, “most families that utilize memory care have to pay out of their own pockets.” Long-term care insurance is an exception, though – so, if it’s not too late, be sure to look into purchasing a plan if you haven’t already.

After assessing the different options for long-term care, you might have decided that you want your parent to move in with you. If this is something you are considering, it’s essential that you analyze the situation closely and ask yourself some serious questions before you take that leap. Having a parent move in might not be as cost-efficient as you are hoping or might entail a great deal more work than you’re anticipating.

You also need to make sure this is in the best interest of your parent. Have your parent analyze the situation just as much as you do, because oftentimes, she may simply not want to move in with her adult child. This could make her feel a loss of dignity or she may simply want her space.

Before you move your parent home with you, ask yourself these questions:

• Will I need to quit work to care for my loved one?
• Can I afford to implement the proper safety measures – like grab rails – into my home?
• Can I afford the extra expense of another household member?
• Do I have a good relationship with my parent – or do we fight a lot? Is there any unresolved issues between us?
• How will this move affect the rest of my family members?
• How will I establish boundaries?
• Do I have the resources to provide my loved one with the care they need? Do I want to take on this responsibility?

At the same time, have your parent answer these questions for themselves:

• Do I feel comfortable living in my child’s space and respecting their household rules?
• Do I feel comfortable confronting my child if they are doing something I do not like?
• Do I have unresolved issues with my child?
• Will I still be able to participate in activities I love?
• Do I need to help pay for my care in their house?
• Will this move make me feel less independent?

After both parties have answered these questions, if you determine that moving in together is still the best fit, make sure to implement the necessary safety measures and set up local community resources to help your parent feel at home in the community. These might include church memberships, classes, and counseling services. Then, make sure you speak with your parent openly and honestly about how they can continue to feel independent when living with you.

Finding the best care solution for your parent is never easy. There are so many factors to consider – from your parents’ abilities and desires, to cost of care. Once you have carefully assessed all of your options, however, you should be in a better place to make the best decision for you and your parent. Just be sure to include them in the conversation, too, since this decision will be impacting the rest of their lives.

With the right care, you and your parent can set your worries aside and focus on what’s most important: spending time together and reclaiming happiness.

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please join us next time as we discuss an important issue that all families need to hear and that’s medication and prescription safety.

Sources:

https://www.aarp.org/caregiving/basics/info-2017/your-loved-ones-next-move.html

https://www.caring.com/caregivers/elder-care-options-for-senior-living-arrangements/

https://caringadvisor.com/level-of-senior-care/

https://www.senioradvisor.com/blog/2018/12/types-of-senior-care/

https://www.payingforseniorcare.com/types

https://www.kiplinger.com/article/retirement/t066-c000-s001-how-to-choose-a-long-term-care-facility-for-a-love.html

https://www.elderly-homecare.com/types-of-senior-care-how-to-choose-the-best-elder-care-option/

https://www.familyassets.com/senior-care-options

https://www.visitingangels.com/knowledge-center/care-options/understanding-the-different-kinds-of-senior-care-available/282

https://www.aarp.org/caregiving/basics/info-2019/memory-care-alzheimers-dementia.html

https://www.aplaceformom.com/caregiver-resources/articles/moving-parents-into-your-home

https://www.aarp.org/caregiving/home-care/info-2018/living-with-aging-parents.html

https://www.care.com/c/stories/5412/9-signs-your-parent-needs-help/

https://www.caregiver.org/selected-long-term-care-statistics

https://www.whereyoulivematters.org/how-much-does-assisted-living-cost/

https://www.seniorliving.org/nursing-homes/costs/

Episode 50 – Coping with Cognitive Issues

Hello, and welcome back to All Home Care Matters. If this is your first time visiting us here at the show. Thank you for taking time out to be with us today. We appreciate how valuable everyone’s time is and that is why we try and make each episode here at All Home Care Matters something that will hopefully matter to you.

Before we get started, we would like to take a quick moment and say thank to everyone for their support and encouragement. This is our 50th episode of All Home Care Matters and we would not be here if it weren’t for all of you. We have received countless emails, comments, and feedback from you sharing what the show has meant to you and from some of you how it has helped you in even the smallest of ways. That is why we do this show, to help families and individuals who are going through these issues with their loved ones.

When a loved one’s diagnosed with a cognitive problem, it can be devastating. In a lot of ways, watching a parent or grandparent suffer from memory loss or a change in personality feels like a devastating loss. Your parent or grandparent just isn’t the same. Still, there are ways to cope with this difficult news – and ways to maintain a meaningful relationship with your parent even once they have lost their memory or are suffering from other cognitive difficulties. Today, we’re going to talk about how to cope with a loved one’s diagnosis – so you can have the tools you need to get through this period together.

First of all, keep in mind that you and your parent are not alone. According to the CDC, 1 in 9 adults suffer from subjective cognitive decline in their older years. This most commonly occurs in the form of Alzheimer’s, dementia, Parkinson’s Disease, or a brain tumor. Stroke victims also often face cognitive difficulties.

With a diagnosis, often comes a major lifestyle change. Dementia patients, for instance, will usually require constant care and may need professional assistance in the home or have to move into a long-term care facility or nursing home depending on their circumstances. It can be devastating to watch a parent go from living independently to needing full-time care fairly quickly, while you are still trying to make sense of their diagnosis.

Along with major lifestyle changes, cognitive difficulties might lead to behavioral changes that can be frustrating or disheartening to witness. You might find that your parent is easily irritable, paranoid, or even aggressive. Try to remember that while it hurts to see a parent behave this way, nothing that they say or do is a personal attack. It’s a rage that stems from their disease and they have little to no control over it. If you feel like you don’t recognize your mom, or find yourself thinking, ‘Dad would never say something like that,’ remind yourself that it’s the disease talking, not your parent.

To protect your parent and yourself during this time, it’s essential that you practice patience, compassion, and good humor. Getting angry with your parent isn’t productive – they don’t understand what they’re saying or why, and at the end of the day, all they need is your support and love. Your anger or frustration could only make them more confused. With that in mind, begin your visits with the expectation that not all days are good and that there is a chance Mom or Dad won’t be in the brightest mood today.

It’s important that you savor the good days for when your loved one has their more difficult days. If you go into the visit with this in mind, you are better preparing yourself to remain calm and rational in case of an emotional outbreak.

Now, maintaining control over your emotions might feel impossible, right? Cognitive difficulties lead to an overload of mixed feelings. You might find that you’re both heartbroken and angry when your mom lashes out. Or that you want to hug your mom as much as, in that moment, you want to get away from her. This is normal. I promise. There’ll be days where you feel frustrated, hurt, and overwhelmed – where you just want a break, even though you love your parents more than anything.

It’s so important that you allow yourself to feel whatever you’re feeling – without guilt. Don’t show these emotions to your parents but make room for them in the rest of your life. Make sure that while you’re caring for your parent, you are caring for yourself too. Confide in a friend or a spouse, write in a journal, go on long walks, take hot baths. The more you practice self-care, the better prepared you will be to care for your loved one. I can’t emphasize that enough. You’re much more likely to lose patience or get outwardly frustrated with your mom or dad if you are exhausted and neglecting your own needs. Self-care might sound cliché, but it’s a necessary step to caring for others.

While you’re caring for yourself, you also want to educate yourself on your parents’ new diagnosis. The more you know about what’s happening inside of their brains, the more you can be there for them – and the more you’ll know what to expect. You also might find that the information is comforting – after all, the unknown can be really scary. When you have an idea of what you are facing, less is left up in the air.

Learning about the disease is also a great way to stay in-the-know when it comes to possible new treatments or medications. Talk to your doctor about the best resources to look into and listen to their advice when it comes to how to best care for your parent.

You’ll also want to help your parent be as comfortable as possible in their new life. If they had to move into a long-term care facility, help them decorate their new surroundings with sentimental furniture or art. Make sure that their living space is kept clean and their things are properly organized.   Making their new place feel like home will help them to get comfortable faster – and they might feel calmer and more relaxed as a result.

You can also help your parent to improve their mental difficulties by playing mind games with them – and no, I don’t mean manipulating them – I mean playing games that help to strengthen their memory function. A mind game can be any game that keeps a person’s brain stimulated and engaged. Board games, card games, or puzzles are a great place to start. Puzzles have actually been proven to help strengthen seniors’ mental health – and they’re a lot of fun, too.

You can also read with your parent, write with them, or even help them learn a new instrument, depending on their current abilities. The Washington Post reported that learning an instrument helps a person to process memory speed and enhance verbal fluency. Reading and writing help to reduce stress and get better sleep.

Helping your loved one to keep up with friends can also make a big difference. The more a person is stimulated, the more their brain is engaged and building strength – and what’s more stimulating than a fun hang out with friends? Arrange weekly or bi-weekly engagements with your parents’ friends – even if it’s over Zoom. Not only can socialization help their minds, but it can also keep them from feeling lonely or even depressed.

If you want to make sure you’re on top of your parents’ progress, but can’t be around as often as you’d like to be, make sure to stay in close contact with their caregivers. Stay informed not only about their treatment and progress, but also about their socialization and how often they have access to games and hobbies. If you get the impression that your parent isn’t doing enough to engage their minds, mail a care package of puzzles and other games to them and ask the caregiver to challenge your parent to a friendly competition.

When you focus on your own needs while allowing yourself to feel what you need to while you face these difficult circumstances, you are equipping yourself with the energy and strength you need to care for your parent with patience and compassion – no matter what. It can be devastating to watch a parent suffer from a cognitive impairment, but with the right tools you can make the process easier and more meaningful for everyone.

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please join us next time as we discuss the different long-term care options available and what might be the right choice for you.

Sources:

https://www.nia.nih.gov/health/talking-older-patients-about-cognitive-problems

https://www.nia.nih.gov/health/cognitive-health-and-older-adults

https://caregiver.com/articles/coping-cognitive-impairment/

https://www.caregiver.org/caring-adults-cognitive-and-memory-impairment

https://health.usnews.com/health-news/patient-advice/slideshows/5-ways-to-cope-with-mild-cognitive-impairment?slide=2

https://www.salmonhealth.com/blog/senior-mental-health/

https://www.cdc.gov/aging/aginginfo/subjective-cognitive-decline-brief.html#:~:text=The%20prevalence%20of%20subjective%20cognitive,compared%20to%2010.6%25%20among%20women.