Elder Care Home Health Blog » Assisted Living Facilities

How to limit Alzheimer’s wandering

admin — Wed, 01 Feb 2012 12:00:53 +0000

By Elizabeth Cohen, Senior Medical Correspondent/updated 11:34 AM EST, Thu November 10, 2011

A hallmark feature for some people with Alzheimer’s Disease is wandering which is scary for the caregiver and potentially very dangerous. Here are some tips and things to look out for should your loved one be a wanderer with dementia.

Tips to prevent or tract people who have Alheimer's Disease and wander.

People with Alzheimer’s and other forms of dementia often leave clues that they’re about to wander.

(CNN) — It was early evening when Lee Ferrero got in his car to make the trip home from a meeting for work. He’d done the trip many times over the years, and he looked forward to the drive.

Several hours later he found himself in open farmland in unfamiliar territory. He pulled over, brought out a book of maps, and realized he’d driven two hours past the turnoff to his home in Los Osos, California.

“It was terrifying,” he remembers now. “I thought, I didn’t mean to come here. How did this happen? I just zoned out.”

But he wasn’t just zoning out. A visit to the Mayo Clinic in Scottsdale, Arizona, showed Ferrero was in the beginning stages of Alzheimer’s disease, a form of dementia.

“That car ride was a real wake-up call,” he says.

After his trip to Mayo, Ferrero’s wife insisted he get a professional driving evaluation to make sure he was safe to drive. His driving was fine — the only problem was that he might wander off again down the road.

It has been five years since that fateful car trip. The disease forced Ferrero, an Air Force veteran, to retire from his position as president and CEO of the Private Industry Council of San Luis Obispo County. Now 64, he doesn’t want to sit home all the time, and still drives and walks around.

To decrease the chance he’ll wander again, Ferrero writes down exactly where he’s going so he can refer to it later, and he wears an ID bracelet with a 24-hour emergency response number. He hasn’t had another wandering incident, but knows he might at some point as his disease progresses.

“I forget things I never used to forget and I know it’s only going to get worse,” he says.

November is National Alzheimer’s Disease Awareness Month and Family Caregiver Month. About 60% of the nation’s 5 million Alzheimer’s patients will wander, according to Beth Kallmyer, senior director of constituent services at the Alzheimer’s Association.

“This is such a big worry for families,” she says. “We tell them their loved ones can wander off at any time, even when you just go into the kitchen for a minute to start dinner.”

Kallmyer advises families that there’s no way to keep an eye on someone 24-7, but that there are some steps they can take to decrease the chances their loved one will wander.

1. Keep wandering top of mind

Sometimes families are surprised when their loved one wanders. Lawrence Schonfeld, an Alzheimer’s expert, has noticed sometimes families forget that wandering is a huge risk because they’re so overwhelmed with other aspects of Alzheimer’s disease.

That can be a fatal mistake.

“Families are worried their loved one will leave the stove on in the kitchen, or they’re annoyed when their loved one asks the same question over and over again,” he says. “Wandering isn’t always their major concern.”

2. Pick up on the red flags of wandering

Wandering can happen at any time, but it’s more likely in certain situations, such as when someone with dementia is in unfamiliar surroundings.

People with Alzheimer’s and other forms of dementia often leave clues that they’re about to wander. If your loved one says, “It’s time to go to work,” she might truly be headed out the door in a few minutes. “I want to go home” might mean he’s about to go in search of his childhood home, and you have to stop him.

3. Distract them

Don’t say “Dad, you haven’t worked in 30 years,” or “Mom, you’re already at home.” Reasoning won’t work. Instead, distract.

“If they say they want to go to work, tell them ‘OK let’s go see if we can find your shoes,’” Schonfeld suggests. “By the time they get their shoes on they’ll have forgotten about going to work.”

4. Block (or disguise) the exits

For safety reasons, you should never lock or trap a person with dementia in a home alone. If someone is there with them you can block the doors. There also are screens you can buy that look like, say, library books, so your loved one won’t realize it’s in front of a door. You can also put a lock toward the bottom of the door; Kallmyer says people with dementia won’t think to look for a lock in such an unusual place.

Another idea: Put a mirror or a stop sign on the door, or you can try putting a dark rug in front of the door. People with late-stage dementia might think it’s a hole and won’t go near it.

5. Label your rooms

Sometimes people with dementia will go wandering off in search of the bathroom or a glass of water and get distracted and actually leave the house. The Mayo Clinic suggests putting a picture of a toilet on the door to the bathroom or food on the door to the kitchen, so they can more easily find what they need.

6. Keep them busy

“Sometimes people wander out of boredom, or because no one’s paying attention to them,” Kallmyer says. “Spending a lot of time watching TV isn’t good. Have them wash dishes with you, or fold clothes.”

You can also enroll your loved one in an adult day care program so they’ll have interesting activities. Seniorresource.com and Eldercare Locator have search tools for finding a program near you.

7. Take a walk

“Have them take a walk or exercise with you,” Schonfeld suggests. “They may be so tired afterwards they’ll want to sit for a while.” Even if they’re not tired, the social engagement of the walk might be enough to keep them from wandering in search of company.

8. Provide safe wandering

Create a path through the rooms of your house as a place for your loved one to wander, or a circular trail through a fenced backyard, the Mayo Clinic advises.

GPS shoes track dementia patients

9. Consider technology

Some devices alert you if a door is open in the house. Others tell you if your loved one has wandered beyond a certain area. You can even attach a GPS to your loved one and then go online to find him on a map; the GPS might be on a bracelet or in a shoe.

The Alzheimer’s Association has an overview of electronic devices that can help keep track of Alzheimer’s patients, and the association also has information about the ComfortZone and other safety products it sells. American Health Assistance Fund has a partial listing of companies that sell safety products. These devices can be expensive and some have a monthly service fee.

10. Find the right facility

Many families aren’t sure they can safely keep their loved one with dementia at home. The Alzheimer’s Association has a guide to determining what kind of care you need, and a guide for finding nursing homes and assisted living facilities.

Schonfeld recommends you check out a facility to see whether it has any complaints against it, especially those that involve wandering. The National Long-Term Care Ombudsman Resource Center has a list of state ombudsmans’ offices, which can help you find the complaints.

Be sure to ask the right questions.

“Is the door monitored, either electronically or by staff?” Schonfeld says. “Do they have electronic devices to keep track of people who wander? And ask about their strategy for what they do if someone does wander off.”

Aaron Cooper and John Bonifield contributed to this report.

Read more: http://www.cnn.com/2011/11/10/health/alzheimers-lost-empowered-patient/index.html?hpt=hp_bn10

Navigating Senior Care Services – A Guide to Acronyms:

admin — Mon, 30 Jan 2012 12:00:10 +0000

It is so difficult to understand people when they speak in letters rather than words. The medical profession and governmental organizations in particular seem to have their own language comprised of acronyms. This can be immensely frustrating to us civilians. Here is a guide to acronyms most having to do with Senior Care Services, Home Care, and some medical terms.

Acronyms and Abbreviations:

AAA: Area Agency on Aging

ABT: Arterial Blood Pressure

AC: Before meals

ADA: Americans with Disabilities Act

ADC: Adult Day Care

ADHC: Adult Day Health Care (see ADC)

ADL’S: Activities of Daily Living (& see IADL)

AHCD: Advanced Health Care Directive

APS: Adult Protective Services

B&C: Board & Care Facility

CNA: Certified Nurses Assistant

Cap Dec: Capacity Declaration for Exclusive Informed Medical Consent

CCRC: Continuing Care Retirement Facility

CFAR: Center for Aging Resources

CFP: Certified Financial Planner

CFAR: Center for Aging Resources

CM: Care Manager or Case Manager

CSA: Certified Senior Adviser

COE: Conservator of the Estate

COP: Conservator of the Person

CONS: Conservatorship

C’TOR: Conservator

C’TEE: Conservatee

DAC: Disabled Adult Child Benefits or/ Disabled Adult Child

DD: Developmentally Disabled

DHS: Department of Health Services

DP: Discharge Planner

DPOAHC: Durable Power of Attorney for Health Care

DSM: Diagnostic & Statistical Manual of Mental Disorders

DSS: Department of Social Services

ESC: Eldercare Services Co-ordinator

FC: Family Caregiver

FID: Fiduciary

GAL: Guardian ad Litem

GCM: Geriatric case manager

HHA: Home Health Agency

HICAP: Health Insurance Couseling & Advocacy Program

HIPAA: Health Insurance Portability & Accountability Act

HMO: Health Management Organization

IADL: Independent Activities of Daily Living (& see ADL)

ICF: Intermediate Care Facility

ICU: Intensive Care Unit

IMCU: Intermediate Medical Care Unit

IPU: Inpatient Unit

LC: Limited Conservatorship

PPN: Licensed Practical Nurse

LPS: Lanterman-Petris Short – Mental Health Conservatorship

LVN: Licensed Vocational Nurse

MICU: Medical Intensive Care Unit

MMMNA: Minimum monthly maintenance need allowance

MMSE: Mini Mental Status Exam

NAPO: National Assn of Professional Organizers

NGA: National Guardians Association

OPG: Office of Public Guardian

PA: Physicians Assistant

PCP: Primary Care Physician

PF: Professional Fiduciary

PFAC: Professional Fiduciaries Assn of California

PDN: Private Duty Nurse

PDR: Physician’s Deck Reference

PHI: Personal Health Information

PICU: Pulmonary Intensive Care Unit

PPF: Professional Private Fiduciary

POA: Power of Attorney

P.O.L.S.T.: Physicians Order for Life-Sustaining Treatment

PT: Physical Therapy

RW: Respite Worker

RCF: Residential Care Facility

RCFE: Residential care facility for the Elderly

RCU: Respiratory Care Unit

RN: Registered Nurse

RNA: Registered nursing assistant or Rehabilitation Nursing Assistant

ROM: Range of motion

SCU: Special Care Unit

SDRC: San Diego Regional Center

SLMB: Special Low-income Medicare beneficiary

SNF: Skilled nursing facility

SNT: Special Needs Trust

SS: Social Security

SSA: Social Security Administration

SSI: Supplemental Security Income

SSDI: Social Security Disability Insurance

SSP: State Supplemental Payment – augments SSI

T’tee: Trustee

USPHA: United States Public Health Admin

VA: Veterans Affairs

W&I: Welfare and Institutions Code

Read more: http://www.elder-care-services.com/blog/2011/11/06/Navigating-Senior-Care-Services-Part-1.aspx

Managing Elderly Depression During The Holidays

admin — Fri, 02 Jul 2010 14:42:39 +0000

Tips For Managing Elderly Depression During The Holidays

According to Mental Health America, more than two million of the 34 million Americans age 65 and older suffer from some form of depression – and during the holidays this number climbs.

Holidays are supposed to be times of joy, celebration, rest (if you can sneak some in) and most importantly family. But for many of our elderly, holidays can mean something totally different.

There are many situations where seniors may not view the holidays as a time of joyous celebration. For the elderly the holidays may serve as reminders of friends who may have passed away, their distance away from loved ones, lack of visitation (if they are in an assisted living facility) and the inability to take part in many holiday events.

What Causes Holiday Depression in the elderly?

We can’t actually call it “holiday depression” because it isn’t the actual holiday that is the cause of this feeling of depression. As we stated earlier there are a host of reasons that may lead to these feelings.

In many cases the symptoms that are characteristic of depression in the elderly can often be overlooked. This is because some people perceive these changes in behavior to be symptomatic of something else… Old Age (as in the stereotype of the old man screaming, “Get Off My Grass!”).

But in fact, depression may be a sign of a host of problems. It could be a result of memory loss, an illness, chronic pain or other medical problems, or even an improper diet.

How Do I Know If My Elder is Depressed?

Signs of depression in your elderly loved one can be difficult to identify and are often times overlooked when they overlap with other medical illnesses or health problems.

Family members and friends are cautioned to be alert to signs of holiday depression among seniors, regardless of whether they live on their own, with family members or in a long-term care facility.

Depression is more apparent in seniors who have limited options for travel, or whose family members are scattered over long distances. Some of the most common symptoms of elderly depression during the holidays may include:

•   Decreased Appetite
•   Change in sleeping patterns or lack of sleep
•   Lack of Personal Care or Hygiene
•   Irresponsible Behavior
•   Decreased interest in socializing
•   Increased Irritability

How Can Elderly Depression Be Treated?

Fortunately, depression is a treatable disease. Aside from medication, family and friends can offer their support and comfort to ease their loved ones’ feelings of despair. In some cases, treatment may be as simple as relieving loneliness through visitations, outings and involvement in family activities. In more severe cases professional help may be needed.

So although holidays can be very stressful for everyone, take this time to make sure your elderly loved one is a part of all of the festivities and feels that special feeling that we all seek during these occasions. It can go a long way towards bolstering their sense of self worth.

If you have any Elder Care information or resources that you believe can help our readers, we’d love to share them. Become a Guest Blogger. For more information, contact us.

Explaining The Veterans Aid & Attendance Pension Benefit

admin — Thu, 10 Jun 2010 15:22:16 +0000

How The Government Can Help With Your Home Care Costs

Understanding the Veterans Aid & Attendance Pension Benefit Program

With the rising costs of assisted living and home health care, it’s extremely difficult for many of our elders to receive the care they need. It also places an unusual burden on the spouses of the elderly or other caregivers, but if the senior is a veteran, there may be help.

What many don’t know is that if your elder is an honorably discharged veteran who is over 65, he or she may be eligible for the VA’s benefit program.

Unknown to many, the Veterans Administration offers Aid & Attendance as part of an “Improved Pension” Benefit. Now you may be asking, “okay, what is this “improved pension benefit”? The Veteran Aid Website explains the benefit as:

”This Improved Pension allows for Veterans and surviving spouses who require the regular attendance of another person to assist in eating, bathing, dressing, undressing, medication dosing, or taking care of the needs of nature to receive additional monetary benefits. It also includes individuals who are blind or a patient in a nursing home because of mental or physical incapacity. Assisted care in an Assisted Living facility also qualifies.”

This may be welcome news for families trying to find creative ways to cover home care related expenses, especially in these tough times. But, keep in mind, that there are eligibility requirements. So it is extremely important to research this program to find out if your elder qualifies.

Some things you need to know about the program:

• This Pension Benefit is not dependent upon service-related injuries for compensation.
• Single surviving spouses of these veterans are also eligible.
• If younger than 65, the veteran must be totally disabled.
• There is no disability requirement for a single surviving spouse.
• The pension is a tax-free benefit paid directly to the qualified applicant.

According to Veteran Aid, a Veteran is eligible for up to $1,632 per month, while a surviving spouse is eligible for up to $1,055 per month. A couple is eligible for up to $1,949 per month (it is still recommended that you contact the VA to verify current Aid and Attendance monthly payments).

It is little known programs like these that can help families that are caring for senior members breath a little easier; and after the commitment our veterans have made for us, isn’t this the least we can do?

For more information about the Aid & Assistance Program, please visit: VA.Gov.

If you have any Elder Care information or resources that you believe can help our readers, we’d love to share them. Become a Guest Blogger. For more information, contact us.

Home Health Care vs. Assisted Living Facilities

admin — Fri, 21 May 2010 19:30:12 +0000

Studies show seniors prefer living at home, as opposed to ALF's

Home Care allows your aging parent or elderly relative to remain safely in their home. As Dorothy said; “there’s no place like home”. A home health aide will help with personal care such as bathing, dressing and getting around their home without falling.

The aide will also do the laundry, shopping, cooking and provide transportation to doctor appointments and other outings. This caregiver will also provide companionship to your mother or father.

Aging parents or their adult children may decide that staying at home is not the best decision. Although home care agencies and services can provide live in round the clock care, the stimulation of daily entertainment, communal meals and no longer managing the household can point caregivers and older adults to Assisted Living Facilities. There, they will have greater socialization, help with medications and be free of caring for a home.

Seniors tend to go to ALFs (assisted living facilities) when they either can no longer manage at home or no longer want to live independently on their own.

They may seek the security of having a staff available as well all of the social aspects of group living. It is a big move and often family caregivers will have the home care aide continue with their parents for a couple of weeks to ease their elderly parent’s transition into facility life.

If you have any Elder Care information or resources that you believe can help our readers, we’d love to share them. Become a Guest Blogger. For more information, contact us.