Here’s something just released in the Alzheimer’s Disease International World Alzheimer Report 2024:

The latest report, marking five years since the previous edition, highlights persistent misconceptions about dementia. Two striking statistics stand out:

• 80% of the general public* now believe dementia is a normal part of aging, a significant rise from 66% in 2019.
• 65% of health and care professionals* hold this belief as well, up slightly from 62% in 2019.

It’s concerning that so many people continue to view dementia as a natural part of growing older. Could the increased prevalence of dementia be fueling these misconceptions? Clearly, there is still much work to be done in raising awareness.  Believing or even denying the cognitive changes can delay a loved-one’s diagnosis and treatment.

By comparison however, some statistics are very encouraging:

• Over 96% of the general public believe in the value of a medical diagnosis.
• Over 93% of the general public believe there are things we can do to improve the lives of people with dementia.

Sometimes and infection or other medical issue can explain cognitive decline, but if not, talking to an Aging Life Care Manager can provide a holistic path for knowledge and support.  Call us for a free confidential conversation. 571-488-9396. [email protected]  We are compassionate advocates for older adults and their families.

*This is an average of global data.

Unveiling the Assessment Process

At Caring Considerations/ Aging Life Care Managers®, we understand the intricate challenges families face while caring for seniors. Our assessments will create a roadmap for balanced, enriched, healthy living. We confront obstacles, align goals, and ensure documentation of your healthcare.  Assessment can mean different things to you and to us.  Here’s our most common approach.

Through targeted questions and the gathering of information, we uncover your unique situation:

Health Snapshot: Medical history and recent physician visits.
Medication Check: Medication list and reviewing management systems.
Safe Spaces: Home assessment for secure aging.
Wellness: Nutrition and overall health.
Legal Review: Your documentation for incapacity planning.
Emotional Insights: Psychosocial understanding.
Future Readiness: Funeral plans and crisis prevention.
Create a Plan of Care and Informed Steps Ahead…

Our assessment also covers these crucial aspects:

Defining Goals: Your aspirations and their aspirations.
Addressing Concerns: Primary worries and fears.
Visualizing Success: Ideal outcomes for your family.
Effective Strategies: Past successes and failures.
Family Dynamics: Understanding inter-family conversations.
Comprehensive, Electronic Health Documentation…

We finish an assessment by providing a verbal and email report packed with insights and actionable recommendations.

What’s your definition of an assessment? We want to know how we can elevate your family’s quality of life. Contact us at 571-488-9396  [email protected]

Aging in Place vs. Senior Living

Yes, senior living can be the answer for many when it comes to loneliness, but parents have the right to make decisions. We are very independent beings and many of our aging parents are not prepared to live in a senior living community. For them, aging in  place is the best option.

Our response to this need and desire? A Life Enrichment program. Here’s what Caring Considerations will do to help reduce isolation.

We Want To Get To Know You

The in-person, Life Enrichment sessions are customized to meet the specific interests of seniors in ways that are meaningful and relevant. Clients typically receive weekly visits, but we will discuss a schedule to meet a loved-one’s desires.

What Are Life Enrichment Visits?

We provide hourly curated engagement, recreation, and social activities as part of a holistic Aging Life Care® plan.

Physical

• Workout buddy – PT prescribed exercises and seated exercise videos
• Walking Companion

Creative

• Writing
• Craft projects
• Reminiscing & conversation

Brain Fitness

• Math Brain Boost
• Trivia (variety of topics: sports, movies, country specific, holidays)
• Word puzzles

In our Aging Life Care® consulting practice, we witness numerous lingering issues resulting from the COVID lockdown.  Older adults want to remain independent, but often lack the insight and energy to incorporate more social opportunities.  The isolation imposed by the lockdown is perpetual and increasingly a barrier to  seniors returning to the life they enjoyed prior to the pandemic.

An Added Benefit

When your parent doesn’t want to move to assisted living, but you worry about them, Life Enrichment visits can be a non-threatening “check-in.”  Although we don’t provide personal care, we can provide feedback about your loved one’s overall well-being.

Contact Us

To learn about this program and more, call 571-488-9396 or email us at [email protected].

Many baby boomers had fewer children or no children.

No other time in the history of our population have there been so many solo-agers. About 17% of those born from 1945-1964 are struggling to get qualified support and a safety net in order to maintain quality of life.

So, what if you had a surrogate daughter who specialized in healthcare advocacy and crisis response for older adults?  What if they had a knowledgeable relationship of your needs so that you could live your best life under your terms? Caring Considerations Aging Life Care Managers® can help.

Our services:

• Be there for you 24/7—just like family
• Discuss options for housing and care. Make a plan.
• Document important information in a secure health care record
• Coordinate resources and help create a team
• Potentially become your legal healthcare agent with medical power of attorney

Our Goals

• Help you remain in control and independent
• Safety and well-being

Call us to learn more!

www.caringconsiderations.com  571-437-9396

So many of us worry about our loved ones being safe, comfortable and treated with kindness when they are living a senior community (i.e. assisted living).

The sad fact is most elder abuse is by a family member. Abuse can come in many forms such as intimidation (emotional), physical or financial, neglect, etc.

But what about in care settings? Most reported abuse doesn’t happen in care settings. But what can you do to make sure your loved one is getting the best care?

1. Come from a place of support to staff. We recommend you are an active, visible advocate in the senior community. Get to know the caregivers, nurse’s and managers and even other family members.
2. Visit often and at different times of the day.
3. Know warning signs of the various types of abuse.

It’s always wise to ask questions of the staff when you are unsure about community procedures and situations.  And it never hurts to bring a treat or something else to the staff. Let them know you respect and care about what they do for your family member.

Questions You Can Ask Your Loved One

Older adults are often grateful for the care they receive and they may not want to complain.  It is true caregiving may never be perfect, but to some extent, we may need to pick the battles.  The other thing you can do is ask the older adult the following questions:

• Who is responsible for caring for you (during the day, in the evening, etc.)?
• Do you feel safe where you are living?
• Does anyone scold you or shout at you?
• Has anyone ever hit or slapped you?
• Has anyone left you alone waiting for food, drink or care?
• Has anyone ever made you do things you don’t want to do?
• Have you ever signed something you do not understand?

When Your Loved-one Has Memory Loss

The important thing to consider in this evaluation is memory loss.  If the resident suffers from Mild Cognitive Impairment (MCI), then you can usually have faith in their answers to these questions.  However, if your loved one has more moderate or severe memory loss or his/her memory is getting worse, be aware that suspicion and confusion is common.  Older adults with memory loss can’t always understand or process what is going on around them, so they will express feelings differently.  In these cases, changes in behavior might be the best indicator of something isn’t quite right.

What To Do If You Suspect Abuse

Get your facts and information together.  Keep an open mind and seek to understand.  Local senior living communities have a grievance process which should be posted in their community in an obvious place.  If you don’t see it, ask for it.  Try to resolve a concern internally with owners and managers.

You may also wish to the local Ombudsman’s Program via the county Area Agency on Aging.  To find your local Area Agency on Aging visit https://www.usaging.org/

A last resort would be to contact the county Adult Protective Services office via the local Area Agency on Aging. https://www.usaging.org/ http://vaaaa.org/

I’m always a little unsure how to provide a meaningful answer when we are asked, “What does an Aging Life™ Care Manager do?”.  To many, our responsibilities seem straight-forward. To others, they may scratch their head and try to imagine how we might be able to help a loved-one better than family.  Families don’t necessarily contact us when the problem is straight-forward, we are contacted as experts who can accomplish so much more in less time.

We are care consultants (RNs, Certified Care Managers, Certified Dementia Practitioners, etc.) with a responsibility for helping the most vulnerable. Care Management can be similarly described as ‘case management’.  However, Care Managers are typically involved in helping adult children help their aging parent(s).  We also support solo agers who may not have enough or any family support.

Listen to the video.  Do you still have questions?  Please contact us at 571-488-9396 or email us [email protected].

1. Alzheimer’s Association 800.272.3900  24/7

www.alz.org  https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf

2. NIH Clinical Trials

https://www.alzheimers.gov/clinical-trials

3. Good overview videos

What you can do to prevent Alzheimer’s | Lisa Genova

https://www.youtube.com/watch?v=twG4mr6Jov0

Gary Small MD/Successful Aging  https://www.ted.com/talks/gary_small_the_formula_for_successful_aging?utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare

4. More in-depth clinical information

Dale Bredesen, MD A Precision Approach to End ALZ

https://www.ted.com/talks/dale_bredesen_a_precision_approach_to_end_alzheimer_s_disease

5. Reversal of cognitive decline in Alzheimer’s disease – Aging (Albany NY). 2016 Jun

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931830/

6. Reversal of Cognitive Decline: 100 Patients-Journal of Alzheimer’s Disease & Parkinsonism 2018

https://www.omicsonline.org/open-access/reversal-of-cognitive-decline-100-patients-2161-0460-1000450.pdf

7. Practical information about dementia care (Teepa Snow)

https://www.youtube.com/watch?v=t–mkzfHuIE

8. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392084/

9. More Basic Information

https://www.nia.nih.gov/health/what-dementia-symptoms-types-and-diagnosis

 10. Blue Zones bluezones.com

11. Recent Article: Do we have to age?

https://www.theguardian.com/science/2021/jan/03/observer-magazine-do-we-have-to-age-biologist-andrew-steele

 12. Improve brain health with the MIND diet

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/improve-brain-health-with-the-mind-diet/art-20454746

13. Diet: Ketoflex 12/3

https://www.apollohealthco.com/ketoflex-12-3/Keto

14. George Washington Center for Integrative Medicine  www.gwcim.com

202-833-5055

15. Brain Growth Exercises

Elevate – Brain Training Games (phone app)

https://www.dakim.com/  Online and best used on a touch screen/iPad/Tablet

https://enrichvisits.com/  Workbooks for purchase

www.luminosity.com   Online, phone, tablet

https://www.goodwinhouse.org/stronger-memory/  Down loadable, free, worksheets

15. Help for Families

Aging Life Care™ Association  www.aginglifecare.org

National Alliance on Caregiving www.caregiving.org/

Dementia Action Alliance www.daanow.org

Other recent news…

Alzheimer’s Association International Conference 2020  HIGHLIGHTS

Flu and Pneumonia Vaccination Tied to Lower Risk of Alzheimer’s

New research at AAIC 2020 suggests that flu and pneumonia vaccination are associated with a reduced risk of Alzheimer’s. Two studies of older adults found that those who received either a flu or pneumonia vaccination were less likely to develop Alzheimer’s. Those who received the flu vaccine more regularly had an even lower risk. For pneumonia vaccination, the largest risk reduction was observed in people who do not carry one of the known genetic risk factors for Alzheimer’s — a variant of the TOMM40 gene.

• Blood tests that measure abnormal versions of the tau protein may — if verified through further research — diagnose Alzheimer’s dementia without additional confirmation; that is, not requiring autopsy examination, or both an amyloid and tau positron emission tomography (PET) scan.
• Heart health risk factors — such as high blood pressure, diabetes and being overweight — as early as adolescence can influence late-life memory and cognition, especially in African Americans.
• Higher quality early-life education is associated with better language and memory performance and lower risk of late-life dementia. This association can differ between men and women and between Black and white individuals.

If your family has decided that an older adult needs constant care and that living together is probably the best solution, then you may be wondering why any further discussion is necessary. Even if you think it isn’t, consider taking a few minutes to sit down with your loved-one to answer the following questions. Doing this may help prevent misunderstandings in the future.

1.Will home care still be used to care for a loved one? If not, who will take time from their career (family) to care for an aging parent? What will be the trigger to get professional help?

2. How will this affect lost income? Will that person be compensated by the family? Who will relieve the primary care provider when they need a break?

3. Is the home accessible: ramps, railings, stair lifts, spacious bathrooms, etc.? Will there need to be modifications/renovation? How much will the modifications/renovation cost? Who will pay for them?

4. What is the budget for caregiving, room and board, etc.? Will you need to learn about Medicaid Community Based Services? What other services are needed?

5.What training will the primary caregiver need? Who will pay for the training?

6. If there is dementia, wandering, or severe behavior issues that become unmanageable, how will they be handled?

7. How and who will be educated about dementia? Everyone in the family or only the primary care provider?

8. Will there always be joint (family) meals? How much time will be spent together daily, weekly, etc.?

9. What household space is available (or can be designated) for private, more secluded time for everyone in the family?

10. How will grandparents interact with grandchildren or participate in discipline?

11. Do family members living together agree on the division of duties? Are there conflicts over tasks, duties & expectations?

12. Will the family be willing to or need to hire a professional counselor or mediator to resolve issues?

13. What will the older adult (e.g. grandparent) be able to contribute to the household activities?

14. Do the grandparents have local opportunities to engage with peers (e.g. senior center)?

15. What if an adult child needs to move? Is there a back-up plan?

We all have expectations and boundaries when living together. Communication early on may help set the stage for future conversations and negotiations.

If you find it difficult to come to a consensus, or you need help in exploring living and care options, contact us at 571-488-9396 [email protected]

“Do you want to be resuscitated if your heart stops—meaning if it happened at this moment, would you?”

Depending on the stage of a person’s life, many reply, “No, I don’t want to be resuscitated and those wishes are documented in my Living Will (aka Advance Directives).”

The difference between a Living Will and a Do Not Resuscitate (DNR) order and how they are used is a common misunderstanding among older adults and their adult children.

The Problem

If your heart stops and you are unconscious (aka cardiac arrest), someone will call 911.

Paramedics will arrive and attempt to resuscitate you by default. They will not ask to see a copy of your Living Will or Advance Directives while fighting to save your life.

How will you communicate your wishes outside of your legal advance directives?

Unlike most Americans, you have been conscientious about legally preparing for the future. You have been thoughtful and diligent about getting your ducks in a row.

Our Observation

We estimate at least 90% of older adults and families we serve do not recognize the difference between the legal documents designed to carry out your end-of-life wishes and a Physician-signed Do Not Resuscitate (DNR) order.

The reason may be that when we are younger, our Advance Directive may indicate the desire to prohibit life-sustaining interventions in the event of a lengthy coma with no reasonable expectation to survive. (Do you recall the case of Terri Schiavo?) When medical professionals have determined your body cannot function without artificial means (i.e. a ventilator) our Living Will reveals our wishes to family.  However, outside of traumatic permanent injuries, most of us want to be resuscitated when we are young.

Older adults often feel differently. By their advanced years, many adults have dealt with cancers, several chronic conditions such as COPD, diabetes, heart disease, arthritis, dementia, etc. By the time they reach a certain age, they may feel fulfilled and are comfortable with letting nature take its course.

The Solution

If you do not want to be resuscitated, then it is time to talk to your doctor. Debbie Aggen RN, CMC, CDP tells her clients, “A DNR is not a document written up by an attorney. It is a medical order from the doctor. Medical professionals have to follow a doctor’s order, that includes Paramedics, EMT, hospitals, nurses and home care aides or others who may be in your home.“

Ask your doctor if it is time to consider a DNR.

Questions to Ask

Discuss medical interventions and how they may affect you with your doctor. Medicare will cover the doctor conversation.

Here are questions to start the dialogue:

• What are the chances that CPR will save your life?
• What happens to my body when CPR is administered?
• When would artificial nutrition be appropriate?
• What if I just want to be kept comfortable? When would respiratory therapy be considered?
• DNR: Where should the DNR go and who should have it?

The two most important places a DNR should be kept:

• The Refrigerator
• In Your Wallet.

Make several copies and make sure your family and doctor also have a copy.

Consider how a Living Will and a DNR affects your life.

Your life is your choice.

Still Have Questions?

Do you need additional information about a DNR? Contact Us. We look forward to answering your questions.