Dealing with An Aging Parent Who Shows Signs of Cognitive Issues

It is very difficult to realize that your loved one may be losing his or her faculties. In fact, many children who find themselves in this situation as adults will try to do everything in their power to step in and assist with this situation as long as they can. However, after a certain point you may be unable to handle this situation on your own.

This is even more difficult when your loved one is uncomfortable with getting help and may even fight you about it. Relying on your support network of other relatives is extremely important but particularly if there are cognitive issues with your loved one, it is imperative that you discuss these with the family member’s physician and develop a plan for how you and others will assist with this.

Alzheimer’s, plus unclear estate planning, can also generate a great deal of problems down the road when your loved one may no longer be able to make decisions for themselves. Finding advisors that you can trust to help with this situation – including an attorney, accountant, and financial professionals – can give you peace of mind. If something were to happen to your loved one where they were no longer able to make decisions on their own, someone is available to help guide you through the decisions that need to be made.

Unfortunately, elder individuals who are starting to suffer from cognitive issues like Alzheimer’s may be easy picking for scammers who will do everything possible to carry out fraud for people who are unable to make decisions for themselves.

Having the right family and professional people in positions of assistance and who care about your loved ones early on in the process is important. Furthermore, you need a clear plan of what will happen if the condition continues to worsen is crucial for protecting you and your family member.

An estate planning lawyer in Massachusetts is a great resource to turn to during this difficult time.


A Warning for Long-Term Care Patients: Monitor Your B12 Levels

too many meds macroToday’s entry is a little different from my usual blogs, and it’s written especially for my clients who are currently receiving some form of long-term care.

A brand-new study out of Canada, reported in U.S. News & World Report, finds that Vitamin B12 deficiency is surprisingly prevalent among long-term care patients, and it’s a real concern.

Vitamin B12 deficiency is linked with:

  • Amenia
  • Changes in skin pigmentation
  • Depression
  • Difficulty walking
  • Fatigue
  • Gastrointestinal upset
  • Heart palpitations
  • Lightheadedness
  • Nerve problems
  • Respiratory problems
  • Vision loss
  • Weakness

Many of those conditions can exacerbate problems already common among long-term care patients.

Most concerning, though, is the fact that several studies have shown a direct link between vitamin B12 deficiency and memory loss, including dementia. That’s startling when you consider that dementia is emerging as one of the primary factors in the rising need for long-term care in the first place.

While many people assume that the deficiency is caused by a lack of B12 in the diet, it often stems from medications and/or underlying medical conditions that interfere with the body’s ability to absorb the B12 already in your diet.

The good news is that most cases of B12 deficiency can be easily managed. Detection is the key. That’s why we’re sounding the alarm.

If you or someone you love is in long-term care, have a talk with your healthcare provider about vitamin B12 as soon as possible.

A New Year, A New Hope for Dementia

Memory LossStar Wars is all anyone is talking about these days, so I supposed it’s appropriate to be blogging about “a new hope.” (For those who’ve been hiding under an asteroid for the last forty years, A New Hope is the retroactively applied subtitle for the original Star Wars film.)

Over the last year or so, I’ve had the opportunity to tell you about a lot of really encouraging advances in the war on dementia:

…And that’s only scratching the surface.

I’ve frequently commented on how encouraging it is to see so much research springing forth, especially given that dementia was essentially a profound scientific mystery for so many years.

Well it turns out that I’m not the only one to notice the trend. A new report in the Independent says that scientists believe 2016 may be their breakthrough year. They’re confident precisely because 2015 brought them so many advances in their fundamental understanding of this terrible disease.

To be clear, no one is talking about a cure. There may never be one, and if there is, it’s likely a long way off. It’s important that we not conjure up any false hope — the reality is that dementia progress is still in its relative infancy.
But each new morsel of knowledge pertaining to prevention and treatment represents a significant milestone, not only for people already suffering dementia but also for those who might otherwise receive new diagnoses in the decades ahead.

Let’s hope 2016 is every bit as momentous as dementia experts expect it to be (and then some). If these are the Dementia Wars, may 2016 be the year that Science Strikes Back.

For Dementia Patients, Increased Awareness Brings New Dignity

Things are changing on the dementia front, and we might say they’re changing for both the better and the worst. On the one hand, the overall rate of dementia is (according to most projections) rising rather rapidly. On the other, though, scientists are finally starting to make some real headway in their understanding of this terrible disease.

With the growing diagnoses and the more frequent dementia-related headlines in the news, we’re seeing more widespread awareness about dementia than ever before.

Statistical models show that if you don’t already know someone affected by dementia, you probably will within the next few decades (or sooner), unless things change. In other words, the disease is really hitting home for many Americans.Group Of Senior Couples Enjoying Meal Together With Home Help

In a sense, that is encouraging news — history shows us that medical advances often follow a rising tide of cultural awareness.

For today’s dementia patients, this newfound awareness also heralds a more immediate benefit — dignity. New nursing homes are popping up with dementia-specific care programs. Seniors have a growing number of alternative care options, too, like “Dementia Villages,” which are designed to provide a neighborhood-like living environment for those with advanced care needs.

Recently, I came across a story about a pub in Mill Creek, Washington that offers a 90-minute dementia “supper club” every week, designed to offer a good meal and a respectful network of support for dementia patients and their caregivers. “Mac ‘n’ cheese with a side of dignity,” they call it.

Dignity is crucial to the dementia patient’s experience, and it ought to be a paramount objective in every service we seek out for them. It’s always a chief goal in my efforts as a Middlesex County elder law attorney, and I’m pleased to see that people in other lines of business are getting on board with that notion as well.

Even for Dementia Patients, There’s No Place Like Home

The yellow brick roadNBC paved yet another yellow brick road to ruby-red-hot ratings with their latest live musical event this month, The Wiz LIVE!

The Wizard of Oz holds a special place in our cultural consciousness, with the 1939 MGM version standing out as perhaps the most-watched movie in the whole history of cinema. Nearly every American has seen it, and for decades now, scholars have pondered how that original novel and its two most famous adaptations (the 1939 film and Broadway’s The Wiz) have molded our collective notion of home.

Indeed, the banner song in The Wiz is a beautiful ballad entitled “Home,” in which Dorothy wrestles what it really means to “go home.” (By all accounts, actress Shanice Williams knocked it out of the park on NBC.)

Incidentally, I recently ran across a U.S. News & World Report piece that grapples with that very same question for dementia patients. What does “home” mean for someone who might struggle to remember where that is?

“Caregivers are initially caught off guard when people in the middle to late-middle stage of dementia plead, ‘I want to go home!’” the article explains. Often, the home they’re referencing is the one they knew long ago in their childhood, as those earliest memories tend to last the longest.

Of course, childhood homes are often inaccessible for the elderly, so World Report offers these tips for helping dementia patients feel “at home” in a place they don’t recognize:

  • Talk to them about the “home” they remember. Describe it to them. Show pictures if you have them. Recount stories they might have shared with you about the place they grew up in.
  • Have a conversation. Some patients hang on to more communication skills and/or stronger memories than others, but a few simple questions about their past — or about whichever “home” they’re referring to — can help them to feel centered and engaged.
  • Offer to take them home. Simply going on a journey can be encouraging to them. You may or may not actually make it there. For that matter, that “home” may not even exist anymore! But just like the rest of us, for dementia patients, the journey can mean more than the destination.

Truly, there’s no place like home, and that’s a notion that can stick with us long after memories fade.

A Change in Your Sense of Humor Could Mean Dementia

Doctor and patientThe things that make you laugh may have caused plenty of arguments about which movie to see at the theater over the years, but they’ve never been of much clinical interest to doctors… until now.

As The Wall Street Journal reports, a new study conducted by University College London and published in the Journal of Alzheimer’s Disease has found that changes in a person’s sense of humor can signal oncoming dementia by as much as ten years.

The Journal cites stories of people with dignified senses of humor who suddenly became snide, or those who’ve always adored satire but then took an unexpected interest in slapstick. For some, it could be a simple shift in personality, but many of those people go on to develop dementia.

Why is that? Dr. Jason Warren, one of the neurologists responsible for the study, puts it like this: “Humor is like a stress test. The same way you’re on a treadmill to test the cardiovascular system, complex jokes are stressing the brain more than usual.”

Until now, scientists have looked primarily to memory as a marker of cognitive change. But the patient’s sense of humor may hold more diagnostic value because friends and family are more likely to pick up on changes in humor than to notice subtle memory problems.

I rather like the way that the Journal sizes up our brain’s relationship with the comedy we enjoy:

“…Most forms of humor require some form of cognitive sleight-of-hand. ‘Getting’ satire hinges on the ability to shift perspective in a nanosecond. Absurdist jokes play fast and loose with our grasp of logic and social norms; black humor lampoons taboos. All are a rich source of data about the brain.”

Data about the brain is exactly what makes this study so encouraging — we are getting more and more of that data all the time. The ability to recognize new warning signs of dementia as much as a decade in advance could be game changing for people we know and love — maybe even for ourselves. It’s no laughing matter, but I know I’ll appreciate the things that do make me laugh all the more now.

Cancer Medication May Improve Parkinson’s, Dementia

Home careParkinson’s disease, Alzheimer’s disease, and other forms of dementia all share certain key traits. Now, it seems, we might add leukemia to that list too.

NPR reports that nilotinib, a medication long used to treat leukemia, may confer significant health benefits for seniors diagnosed with Parkinson’s disease or Lewy body dementia as well.

Lewy body is one of the most common kinds of dementia, second only to Alzheimer’s, and in fact, the two are often confused in their early stages. It isn’t uncommon for doctors to misdiagnose Lewy body, given that the symptoms may mirror that of other neural disorders like Parkinson’s.

But in patients treated with nilotinib, those symptoms show remarkable improvement.

“After 25 years in Parkinson’s disease research, this is the most excited I’ve ever been,” Fernando Pagan told NPR. Pagan directs the Movement Disorders Program at Georgetown University Medical Center.

For Parkinson’s patients, this is a rare breath of fresh air. Good news has been much more common on the dementia front.

Indeed, every week seems to bring a significant new advancement in our understanding of — and treatment for — dementia, a condition that not long ago was considered entirely untreatable.

Of course, we still haven’t managed to turn the tide on dementia altogether, and those who are diagnosed with the crippling disorder continue to face real medical and financial hardship. But good news is always welcome, and there seems to be plenty of it lately.

Assisted Living Facility Offers “Virtual Dementia Tour”

A senior living community in Texas is giving visitors and family members a chance to experience dementia first hand. They call it the “virtual dementia tour.”

By way of newfangled “virtual reality goggles,” the Silverado Memory Care Community in Plano, TX is able to offer a simulated disorientation for its visitors. The experience is similar to the loss of motor function observed in numerous dementia patients.

Donning special glasses, gloves, headphones, and shoe insoles, tour takers are assigned four simple, everyday tasks:

  • Make the bed
  • Find a black jacket and zip it up
  • Feed the dog
  • Take medication (a placebo pill)

Sound easy? For those with dementia or other diseases or disorders, it isn’t. The tour takers had a tough time, too.

“I felt disoriented,” one visitor told The Dallas Morning News. “If I had been by myself, I think I would’ve sat down and waited until someone told me what to do next.”

Indeed, one guest after another failed to grab the jacket, forgot to feed the dog, or fumbled in finding the pillbox. Some of them couldn’t even walk without holding onto the wall.

The whole experience is part of a national effort to educate the public about the challenges posed by aging. The nonprofit creatives behind the project, Second Wind Dreams, are taking their initiative to various sites around the country. The idea is to remind people that aging isn’t just a matter of cognitive impairment. Dementia is very much a physical condition, too.

It’s encouraging to see the kind of revelations that come out of these simulated experiences. I think one of the most difficult aspects of the senior experience is the frustration the elderly sometimes feel when trying to aptly describe their day-to-day challenges. By all accounts, the “virtual dementia tour” helps to overcome that barrier and lend real understanding to these patients’ loved ones.

Naturally, understanding yields both compassion and progress. Let’s hope the “virtual dementia tour” generates plenty of both once it makes it’s way around America.

How An Adam Sandler Movie Is Changing Dementia Care

Well, nobody saw this one coming.

An Adam Sandler movie, of all things, has inspired an effective new trend in healthcare and therapy for dementia patients. And it only took 11 years for it to catch onNoreenMurphyBlogPic

50 First Dates made its way to theaters in 2004 and has aired ad infinitum on cable ever since then, so many of you may already be familiar with its premise. Sandler plays a bachelor living the wild life in Hawaii, but when he meets a lovely young lady named Lucy (Drew Barrymore), he sees fit to change his ways. The only problem? Lucy suffers from short-term memory loss and starts each morning with no memories from the previous day.

It’s a silly romantic comedy, but according to TIME, one plot point in particular caught the attention of dementia care providers. In the film, Sandler’s character records videos to help comfort Lucy and remind her of who he is — and who she is.

One nursing home, the Hebrew Home at Riverdale in New York City, decided to give that ideal a whirl for their own patients suffering from Alzheimer’s or dementia.

“[The film] was fluff, but it made me think, ‘How could that translate to our residents with memory loss?’” says Charlotte Dell, the home’s director of social services.

It’s working, Hebrew Home tells NBC New York. The video program helps to set a positive tone each morning, establish routine, and trigger residents’ memories.

Of course, every patient is unique. Alzheimer’s and dementia present differently in different people. Experts expect the therapy to be more effective in some people than in others.

Still, isn’t it nice to know that life-changing inspiration can come from the most unexpected places?

Daily Exercise Promotes Mobility and Wards Off Dementia

Confirming what experts have suspected for a while now, a new scientific study by the Rush University Medical Center in Chicago finds that daily exercise has a profound limiting effect on dementia and Alzheimer’s disease. As an added bonus, daily movements also prevent the kind of brain damage that could impair mental and motor function as you get older.

The study adds to our growing understanding about how non-medicinal lifestyle changes may largely ward off the worst parts of growing old. Its findings are reported in greater detail at WebMD.

Most interestingly, the researchers reveal that you can claim these protective health benefits for yourself with only a moderate amount of pleasurable physical activity. In other words, you don’t have to run a marathon.

That’s very important because the biggest reason that people avoid an active lifestyle is that extreme exercise simply isn’t fun. Given the prospect of working up a daily sweat on a miles-long hike, many choose to settle in on the couch instead.

But that’s a false dichotomy. Seniors needn’t choose between extreme sports and couch potato-dom. Researchers found that even more moderate amounts of enjoyable movement could be equally effective, so long as it’s safe and daily.

Their advice isn’t only for the elderly, either. The earlier in life you adopt daily physicality, the more fully you can protect against future brain damage (and the sooner you can start reversing any damage already done).

Given the fact that dementia is on the rise all around the world, I’m thrilled to see so many new reports about simple lifestyle changes that we all can make to meaningfully reduce our risk of disease.

Of course, it’s important to remember that exercise isn’t a guaranteed cure-all, and even the most active senior is likely to experience an increase in healthcare costs as they age. Even in a future that could see substantially fewer cases of dementia, long-term care planning remains important. The good news, though, is that it’s a future we can really be excited to plan for.