Alzheimer's and the Great Outdoors

We've been watching Ken Burn's PBS series on America's National Parks and are lucky enough to often visit the nearby Schoodic Section of Acadia National Park.  As the haze of dementia progresses we find that the lessening of outdoor activities decreases our quality of life and wonderment.

On the occassions that get us moving outdoors we realize how beneficial a natural outdoor session can be in promoting positive changes to our physical and emotional well-being.  Exercise, fresh air and the opportunity for informal encounters with the flora and fauna, and other people promote self-esteem and trigger memories.

Whether it's hiking in the Park or working in the garden, the feeling of sun and wind - even fog and rain- is enlivening.

Things to plan for on your outing >>>

• safe walking - paths that are wide, flat, even and slip resisitant
• walking sticks
• choices of sun or shade
• choices of wind or in the lee
• places to sit and rest
• familiar, reassuring companion
• sunscreen
• drinks and snacks
• flexible time frames

So let's get out there and help maintain residual skills.

The Question of Universal Coverage

Here we are now, with Alzheimer's, Medicare and no insurance coverage for needed services - aides and attendants, case managers and social workers , physical therapists and community centers and nursing homes.

To be effective insurance has to include a very large group. Health insurance doesn't work the way other types of insurance do. We know in advance which members are more likely to need care . The young ones and the old ones and those with existing conditions. These groups are often the least able to pay and so an imbalance between needs and resources is created . Since insurance companies know this they tend to exclude or over price their policies in an attempt to cover only that population with a low risk of filing claims. That is their business model.

As Congress wrestles with the appropriate role of government in the protection of it's citizens we hope they will consider home and long term care coverage. With an aging population and increases in dementia and Alzheimer's cases this is a growing problem for sufferers and caregivers who right now have to muddle through on their own.

With thanks to > > > http://www.metaphorcountry.com/dementia_nights/2009/03/healthcare-reform-notes-i-alzheimers-universal-coverage-longterm-care-1.html

World Alzheimer's Day is Today and Everyday

Monday September 21st, 2009 is WORLD ALZHEIMER'S DAY designed to raise awareness of the 35 million ( and growing) people who live within the shadow of this dread disease.

As citizens and caregivers of the world let us strive to provide each day .....

Adequate nutrition
Engagement in activities based on individual ability
Good hygienic practices
Free expression of thoughts and beliefs
Social interaction with family members, peers and others

Read further at > > >
http://www.actionalz.org/about_wad.asp

http://www.alz.org/national/documents/report_summary_2009worldalzheimerreport.pdf

Laundry Day is Every Day

Everyday is laundry day here. We find it easier to manage small daily loads of wash and there is always soiled clothing. You may have to help sort the dirty clothing from the clean as they sometimes get mixed up. The goal is to ensure clean comfortable clothing is worn every day.

• Check all those pockets
• Fasten zippers - you can make them easier to zip with a zipper lubricant or soap
  
• Use your favorite stain remover
• Sew on missing buttons
• If you are washing a small load, use the appropriate water-level setting.
• Don't over-dry your clothes. If your machine has a moisture sensor, use it.
• Clean the lint filter in the dryer after every load to improve air circulation.
• Use the cool-down cycle to allow the clothes to finish drying with the residual heat in the dryer.
• Put tennis balls or dryer balls in the dryer - they help separate clothes and dry them faster.
• Replace clean clothing in the same locations as before. You may want to reduce the number of choices.
  

Today's helpful site >>>
http://www.alzheimersathome.com/support_dressing.html

NEW Television Show on Alzheimer Caregivers

Thursday, September 24 at 8:30 and 10:30 p.m. and Sunday, September 27 at 4:30 p.m.

A new program from MPBN, Caring for the Caregiver focuses on issues facing families caring for loved ones with Alzheimer’s disease and dementia. The scourge of these illnesses is an acute source of concern not just for patients, but also those suddenly thrust into the role of primary caregiver for an aging spouse, parent or grandparent. The program, which was developed in partnership with the Maine Alzheimer’s Association, is hosted by MPBN radio’s Suzanne Nance. Weaving interviews with health experts caring for Alzheimer’s patients with the personal experiences of Mainers who have suddenly found themselves dealing with the gradual, painful loss of a loved one, the program is designed for anyone who is now or who may one day need to confront this difficult reality. It airs Thursday, September 24 at 8:30 and 10:30 p.m. and Sunday, September 27 at 4:30 p.m. and will have components on the Web at www.mpbn.net.

Also, please visit MPBN's new web page for Alzheimer caregivers at: http://www.mpbn.net/Television/LocalTelevisionPrograms/CaringfortheCaregiverDementiaandAlzheimers/tabid/1065/Default.aspx

Good Planning ... I. C. E.

Place On Your Refrigerator > > >

In case of emergency

Save time and eliminate confusion in an emergency situation -

direct paramedics to critical information.

• List of all medications, dosages and allergies
• Doctors phone numbers
• Emergency contact numbers
• Notation that there is a person with Alzheimer's in the household who should not be left alone ....and whom to call for their assistance
• Number of pets and whom to call for their care
• Attach your red envelope with a magnet and mark it

IN CASE OF EMERGENCY

Red, White or Blue Tableware???

Studies have shown that Alzheimer patients increase food intake by 24% and liquid by 84% due to good color contrasts between their foods and tableware. Red or dark blue seem to work the best. The ability to distinguish contrast between colors is sometimes lessened in people with AD. Using tableware that offers a high contrast to the food and drink will make mealtimes go more smoothly and increase food and liquid intake. Visual impairment certainly plays a role in nutrition. Colorful table settings will make for an easier mealtime.

• set just one utensil, one plate and one cup
• avoid white place settings
  
• limit the number of foods served
  
• try a place mat or tray to define space
  
• cut up foods into bite size pieces - finger foods are good
• keep your dining table well lit
• reduce noise in the room
  
• limit conversation
• avoid extreme food temperatures - very hot or very cold
• allow plenty of uninterrupted time
• give limited verbal instructions and use physical cues
• eat together and enjoy each others company ~~~ Bon Appetit !
  

Visual contrast enhances food and liquid intake in advanced Alzheimer"s disease
Clinical Nutrition, Volume 23, Issue 4, Pages 533-538
T.Dunne, S.Neargarder, P.Cipolloni, A.Cronin-Golomb

Alzheimer's Shopping Tips

Shopping can be tiresome or fun for most people, but for those with AD it can become a worrisome situation full of fear and confusion.
Stores can be noisy, crowded and filled with audio and visual over stimulation. Tiredness can develop and have a negative impact on memory.

Schedule wisely. Determine the time of day when your loved one is most calm and agreeable. Established routines help make the day more predictable and less confusing.
Take more time. Expect things to take longer than they used to. Schedule more time to complete even simple tasks so that you don't need to hurry your loved one. Provide instructions one step at a time.

• Shop on off times days and hours when stores are not so busy

• Have your companion push the shopping cart - gives him something to hold on to and reduces separation anxiety.

• Wear bright, distinctive clothing to help track both your movements.

• Find a visible bench for him to rest on while you wait in the check out line.

• Involve him in decision making - "would you like apples or bananas".

• Try to make shopping trips something to look forward too - perhaps include a "lunch date"?

• The smaller the store, the better !

• Plan the trip to include stops at a very limited number of shops.

• Stay together - no more "I'll meet you in Aisle 4 near the coffee grinder".

• Do not leave your companion alone in the car to wait for you.

"Often I ask myself, What's the better of two evils? To stay at home alone and suffer the worry as to why my wife is so long shopping or to go with her and suffer all the added confusion and anxiety of the day?'
My family think they are being kind because they always get my shopping for me, but I would love to go out sometimes. I get very lonely at home on my own."

Today's web tip > > >
http://www.alzheimersforum.org/site/index.php

The Healthcare Debate

As we go into this Labor Day weekend we're all thinking about the seemingly insurmountable problem that universal access to healthcare seems to be. The rights of the individual versus what's best for the herd. Many are already covered by some form of Federal Insurance (VA, Medicare, Medicaid, and the Military and Federal Employees and Congressional Plans. Why not combine all of these options into a pool and allow some form of subsidized buy in for those without health insurance. Compliments to Senators Snowe and Collins from Maine for their attempts to reach some working compromise to move a solution closer for all of us. Meanwhile we can all do our best to stay healthy and treat problems early on.

http://www.theatlantic.com/doc/200909/health-care

Brain Fitness Ideas for Caregivers

Dr. Howard's Day-by-Day Brain Workout
from Pierce J. Howard, PhD at the Center for Applied Cognitive Studies

Try this brain-fitness regimen...

• Sunday: Create something in an artistic medium that you’ve never tried (such as painting with watercolors or sculpting clay)... repair or clean something that you have neglected (such as reorganizing messy files).
• Monday: Switch left-pocket contents to the right pocket... contact a high school or college friend with whom you haven’t communicated since then (or for years).
• Tuesday: Write a love poem or note to your partner, child or friend... plant something (such as orchids) that you’ve never tried to grow before.
• Wednesday: Tackle a word or number game that you do not usually do... write a thank-you note to someone who has meant a great deal to you.
• Thursday: Listen closely to music by a composer whose work you’ve never listened to and identify what you like and don’t like about the piece... or begin learning a new language.
• Friday: Write a letter to an editor or blogger about an issue that you feel strongly about... begin constructing a model of an airplane, a house or another object that you’ve never built.
• Saturday: Learn the words to a poem or song and recite and/or perform the piece at least three times for yourself and/or others... learn to do something new in a computer software program you use regularly (such as organizing messages into folders in your e-mail program).

Wednesday Burger Night for Two

Gordon still enjoys mealtimes and so I like to put out some degree of effort to make them special.

Take some 85% ground beef, season with salt and pepper and Worcestershire sauce and gently form 2 thick patties. Now take 2 chunks of a good blue cheese and bury them in the middle of the burgers. Fry them up to your desired doneness.

We served them with shredded Romaine lettuce, poppy seed dressing, and blue cheese chunks and macaroni salad from the deli. Added a side dish of maple baked beans. Beverage was a glass of red wine and for dessert – German chocolate cup cakes with vanilla frosting.

It was a delicious, quick and easy meal for two.

Buttons and Bows

I encourage Gordon to select his own clothes, but make it easier by simplifying the number of choices. For example, offer two outfits to choose between, asking if he wants to wear a short sleeve shirt or a long sleeve. Some days he'll manage to get his pants on backwards and inside out - don't think I could manage that !
Choose washable, no ironing, comfortably loose clothing with solid colors or simple patterns. Gordon loves to wear cowboy shirts. Buttons, snaps, belt buckles and hooks are very difficult for him to manage. Pullover shirts (even if sometimes worn backwards) are easier. Elastic waistbands are great as are slip on or velcroed footwear.
Be sure to give out a compliment from time to time - "You look very handsome this morning".
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Medicare coverage for Alzheimer's disease

In the past, Medicare automatically denied coverage for certain medical services for people with Alzheimer's on the grounds that treatment wouldn't yield any improvement. Typically, these services were covered for other Medicare beneficiaries, but not those with Alzheimer's or another dementia. This situation changed in 2001. Now, people with Alzheimer's disease who are eligible for Medicare can be reimbursed for many services, including mental health care, occupational or physical therapy, speech therapy, and some home health care.

The policy change underscores that individuals with Alzheimer's disease can benefit significantly from these therapies. Many advocates believe that the coverage may enable people to live at home longer. For example, occupational therapy may improve a person's ability to dress or bathe himself, while physical therapy may steady a wobbly gait. Now, families who are interested in pursuing these services for a patient might not have to shoulder all the costs.

To find out more about Medicare coverage, call the Centers for Medicare & Medicaid Services at 877-267-2323 (toll free) or go online.
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