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Sepsis: The Common Cause of Death You’ve Never Heard Of

Charles Summerour was traveling for business when he acquired an everyday infection that almost killed him.

 After initially ignoring the symptoms of what turned out to be a urinary tract infection (UTI), the 54-year-old journalist began to feel markedly worse as the day wore on. He sought medical attention from a doctor, who promptly sent him to the hospital.

Within hours of being admitted, Summerour’s blood pressure had dropped to dangerous levels, his kidneys were failing and his body was slipping into a little-known but very deadly condition called septic shock.

 What Is Sepsis?

Caused by the body’s exaggerated immune response to an infection, sepsis is the most common cause of death in hospitalized patients in the United States. This condition is also referred to as blood poisoning and septicemia. According to the Centers for Disease Control (CDC), the number of people hospitalized with sepsis has more than doubled over an eight-year period.

The human body is constantly bombarded with potentially infectious viruses and bacteria, and people with healthy immune systems are usually able to fight off these microbes with little effort. But, when an infection isn’t subdued quickly enough, the immune system can kick into a dangerous state of overdrive, causing the body to injure itself in an attempt to get rid of invaders. If left too long, sepsis can escalate into a fatal condition called septic shock, which is marked by extensive tissue damage and organ failure.

Anyone can develop sepsis at any age. It can start off as practically anything, including a case of the flu, pneumonia, a sinus infection, a UTI, or an infected bug bite or cut. What is scary is that these seemingly minor ailments can develop into sepsis in a matter of mere hours. According to Martin Doerfler, MD, senior vice president of clinical strategy and development at Northwell Health’s Center for Learning and Innovation in New York, at least 50 percent of people who go into septic shock do not survive.

The Importance of Spreading Awareness

Even though it kills between 150,000 and 300,000 people in the U.S. every year, only about one-third of Americans have ever heard of sepsis. Spreading awareness is crucial because it can develop and become life-threatening in such a short period of time.

In fact, Summerour had no idea what it was that nearly ended his life until he got home from the hospital. “The doctors called it an infection. They said my immune system had become compromised, but they didn’t really put a name to it,” he recalls.

One of the biggest challenges to diagnosis and treatment is the ambiguous nature of the condition. “Sepsis is a very nondescript problem, and it may not jump into a physician’s mind initially,” Dr. Doerfler admits. Some of the more common initial symptoms of sepsis include fever, elevated heart rate and rapid breathing.

Early diagnosis and treatment are paramount, but the preliminary signs of sepsis are also common in many other medical conditions. Therefore, medical professionals can have a difficult time making a definitive diagnosis before a patient begins experiencing severe symptoms, such as confusion, difficulty breathing and a serious drop in blood pressure.

Seniors Are at Greater Risk of Sepsis

Seniors are more vulnerable to the damaging effects of sepsis due to reduced immune function that occurs with age. Older individuals are also more likely to have chronic medical conditions, such as diabetes, cancer, and liver or kidney disease, that can further affect immune responses. For example, diabetics are more susceptible because their condition causes them to develop sores and wounds that heal slowly and are prone to infection.

Furthermore, seniors make more frequent visits to health care settings, where the risk of developing an infection is increased. “The more you encounter the health care system, the more exposure you have to infectious viruses and bacteria,” Dr. Doerfler points out. Any surgery, no matter how minor, increases a person’s risk for becoming septic, as does the insertion of medical devices like catheters, feeding tubes and IVs.

Even if an elder survives a systematic attack, they are likely to live with lasting consequences. Summerour’s brush with sepsis left him with stage 3 kidney failure. Even though he says his experience caused a lot of changes in his life, he knows that many people do not fare as well. It is this knowledge that convinced him to become a speaker and advocate for the Sepsis Alliance, a nationwide charity dedicated to raising awareness of the disease.

Organ failure and amputation are some of the more common effects of sepsis, but older adults may also suffer serious cognitive issues afterwards. A University of Michigan study shows that 60 percent of seniors who were hospitalized for severe sepsis experienced significant declines in physical and/or mental ability even after they recovered from their underlying infections. Study authors estimate that this finding translates into 20,000 new dementia cases in elderly Americans every year.

How to Protect Loved Ones from Sepsis

There are two key ways to protect your loved ones and yourself from sepsis. The first is using consistent preventative measures to avoid contracting and spreading illnesses and infections. This includes receiving all recommended vaccines, including a flu shot each year, adhering to excellent hand-washing and hygiene practices and leading a healthy lifestyle for a strong immune system.

The second component of protection consists of education and advocacy. If you or a loved one falls ill, it is crucial to know what signs of sepsis to look for and not be afraid to speak up and seek immediate medical help. Every hour that a person with sepsis goes without treatment, their risk of death increases by eight percent.

Dr. Doerfler says the symptoms of sepsis can be ambiguous, but if your loved one has signs of an infection and begins acting abnormally confused or tired, the safest bet is to go to the hospital. He stresses that a change in mental state is a clear indicator that a person needs immediate medical attention, whether it is due to sepsis or another medical issue. A confused senior may be more resistant to going to the hospital, but if sepsis is suspected, their objections should be overruled.

The Sepsis Alliance offers the following acronym to help the public easily remember the telltale symptoms of sepsis:

  • Shivering due to a fever over 101° F or a body temperature below 98.6° F
  • Extreme pain or general discomfort
  • Pale or discolored skin
  • Sleepiness, confusion or changes in consciousness
  • I feel like I might die” and other similar remarks from a patient
  • Shortness of breath

If you notice a combination of any of these symptoms in a loved one, call 911 or seek immediate medical treatment at the nearest emergency room. Be sure to tell the triage nurse and other medical professionals that you suspect sepsis. Nurses and doctors aren’t likely to arrive at this conclusion initially, which is why both Dr. Doerfler and Summerour say it’s a good idea for caregivers to give hospital staff a nudge in that direction.

“You need to advocate and speak up for those who can’t speak for themselves,” says Summerour. “Don’t be afraid to be a little bit pushy.”

Source: AgingCare.com

Can a Caregiver Change a Loved One’s Power of Attorney?

While it may seem like an unusual scenario, there are a few legitimate reasons why family members may want to change an aging loved one’s power of attorney designation. Of course, changes are easy to make if the principal is still mentally competent and wishes to name someone else (known as the agent) to act on their behalf. However, things can get complicated when a loved one is incapacitated and family members believe that a change is in order.

There are a couple of different ways to go about this, but it depends on how a person’s POA document is written and what the desired outcome is. Two of the most common scenarios are when a caregiver no longer wishes to serve as POA for a loved one and when a family member wants to challenge the legality of the current POA’s actions.

 What to Do if You Want to Resign as Power of Attorney

Any caregiver will tell you that this responsibility is not for the faint of heart. There are many reasons why an agent may need or want to step down as POA. Perhaps they have moved out of state and are too far away to effectively manage a loved one’s medical and financial affairs. In some cases, the principal may be abusive and the agent must resign in order to safeguard their own physical and mental health. Acting as a person’s agent is a serious legal responsibility and, regardless of the reason, it is important for an agent to resign if they feel they cannot carry out their duties.

To resign, an agent must compose a formal letter notifying the principal, any co-agents and all parties with which the original POA has been filed, such as banks, elder care providers, etc. While each state has different rules for relinquishing POA, taking formal steps to notify all involved parties offers the most protection from any legal issues. It’s best to sign the resignation letter before a notary and then send copies of it via certified mail with return receipt requested. In this letter, you’ll want to include your full name, the principal’s full name, the date that the original POA document was signed and the date you will terminate your position as an agent. An attorney can help you draft this document easily and at minimal expense if you need help.

Can an Agent Give POA to Someone Else?

The process of resigning as an agent is not particularly difficult, but it can have serious implications for the principal. Who will assume the agent’s responsibilities? If a successor is listed on the original power of attorney document, then he or she will become the new acting agent. It would be wise to cancel the original POA and have a new document drawn up, directly naming the successor as the new agent. However, this is only possible in cases where the principal is still of sound mind. POA can be difficult to “prove” and have accepted by certain entities like banks, so a simple and straightforward document is ideal.

Naming a successor agent (or two) is recommended. It gives the principal a legal back-up plan in case the original agent resigns, becomes incompetent themselves or passes away. If no successor is listed on the original POA document and the principal is already incapacitated, then there are few options left. Unless the document grants the original agent the specific ability to delegate powers to another individual, the general rule is that he/she may not do so. Guardianship is the only other option for passing on this responsibility.

How Guardianship Factors Into Resigning POA

Continuing with the scenario above, an interested family member or friend would have to petition the court for guardianship of the incompetent principal to ensure that their medical and financial affairs continue to be managed responsibly after the original agent resigns. This is a lengthy and expensive process that should only be considered as a last resort, but sometimes there is no other choice.

If no other individuals are interested in or capable of serving in this role, then the principal may wind up as a ward of the state and under public guardianship. A concerned party, such as a physician or Adult Protection Services (APS), may file a referral to a local public guardianship service provider indicating that the indigent and/or incompetent adult requires assistance making medical, financial, and/or daily living decisions. Information is collected about the incapacitated individual and a hearing is conducted to determine if they meet the legal guidelines for public guardianship and rule out the possibility of another suitable person serving as their private guardian. Guardianship in any case is not ideal. It is costly and time consuming and it strips wards of their independence and many personal rights. However, it is sometimes necessary to protect vulnerable adults from neglect and abuse.

Contesting a Power of Attorney

Guardianship can also play a significant role when a person wishes to challenge a current POA. This may be appropriate if you know or suspect that an agent has abused their authority and you wish to take over their duties. Again, going to court to prove that a POA document is invalid or that an agent has mismanaged a principal’s funds or neglected their needs can be a long, expensive and emotional process. These suspicions must be proven in court and, if the agent is removed and the principal is deemed incompetent, then a petition for guardianship will also have to be filed.

It is crucial to understand how power of attorney documents work and carefully consider who to appoint as an agent. Guardianship is an important method of protecting vulnerable seniors, but it should only be used as a last resort. Ultimately, every caregiver’s focus should be on meeting their loved one’s needs and safeguarding their wellbeing. It is imperative to take action if any agent, whether it is yourself or someone else, is unable to handle this responsibility.

Source: AgingCare.com

Skin Care Tips for Seniors

Skin Care Tips for Seniors

Our skin is often the first place we notice signs of aging. Beyond just wrinkles and age spots, our skin is a reflector of our overall health, and yet it is often overlooked.  

Did you know… 

The skin is the largest organ in the body. It has a very important job — protecting our internal organs and systems from bacteria and other foreign matter that can make us sick or otherwise damage us. 

As we age, however, our skin also begins to change. It loses elasticity, becomes thinner and drier, begins to sag, and takes longer to heal. Damage to the skin that occurred in our youth can also start to appear in the form of age spots and dry patches. Medications, diet and exercise can also impact your skin, which is why it is important to check it regularly for changes. 

Among the changes that require attention is the appearance of moles and skin tags, as they can indicate more serious conditions, including diabetes, kidney disease, and several forms of cancer. (link to: https://www.cancer.gov/types/skin) 

 Good Skin Care Is a Must 

  • Drink plenty of water! The human body is 70 percent water. Staying hydrated is essential to overall health as well as keeping your skin soft and supple. Dry skin can create itchy patches, redness and, if you scratch them, sores that can take time to heal and allow bacteria to enter the body. 
  • Eat your veggies! A well-rounded diet that includes lots of vegetables is a must. Beyond our overall health, vegetables contain the ingredients essential for healthy skin. 
  • Moisturize! Use a good body lotion daily in order toto keep skin supple and smooth. Moisturizing also helps with itching and reduces self-imposed scratch marks. Other ways to keep your skin moist is to take fewer baths. Use warm, not hot, water. And, if dry air in your room is a problem, try a humidifier to add a little moisture. 
  • Use Sunscreen! Everyone today knows the dangers of too much sun. While we need sunlight to provide the vitamin D that we absorb through our skin, too much sun is responsible for age spots and several types of cancers. 

Be Vigilant 

Skin checks are not often standard in wellness checks at the family doctor. In addition to annual visits to the dermatologist, With months in between visits, however, it is good practice to do a skin check every month or two.  

Even if your loved ones are in an assisted living or other facility, it is a good practice check their skin periodically. The aides that dress or bathe them may not notice or be as adequately trained to spot changes in skin health other than skin breakdown that may indicate a serious health issue.  

Catching problems early is the best prevention.  

The National Institutes of Health has provided  this handy guide for what to look for. 

Check Moles, Birthmarks, or Other Parts of the Skin for the “ABCDE’s” 

A = Asymmetry (one half of the growth looks different from the other half) 

B = Borders that are irregular 

C = Color changes or more than one color 

D = Diameter greater than the size of a pencil eraser 

E = Evolving; this means the growth changes in size, shape, symptoms (itching, tenderness), surface (especially bleeding), or shades of color 

See your doctor right away if you have any of these signs to make sure it is not skin cancer. 

Winter Top Tips: How to Keep Seniors Happy, Healthy and Warm

Winter Top Tips: How to Keep Seniors Happy, Healthy and WarmThe AgingCare.com forum is filled with people coming together to share valuable information. We’ve compiled experienced caregivers’ suggestions for keeping a loved one cozy, content and clean in spite of cold winter weather.

 Winter Skincare Tips

“Although many people use baby oil, it contains mineral oil and artificial fragrances. If your loved one has any chemical sensitivities (and a lot of older people do), it is best to stay away from any artificial fragrances, artificial ingredients and mineral oil. Try organic coconut oil for soothing and moisturizing dry skin. It is simple and very effective. I also recommend visiting a good health food store and asking about lotions that are all natural.” –oceansong

“My primary care physician (whom I hold in very high regard) recommends Eucerin lotion products. They are a little pricey, but they last forever. I think they also make a lotion specifically for diabetics.” –Miasmom1

“Many of us love the bath or shower to be very hot, especially when it is cold outside. However, high temperatures can be very drying for the skin. I know my hands also become super dry in colder weather. I tried just about everything, but my hands felt like I had a dozen paper cuts and I looked like I was attacked by my cats! Then I found O’Keefe’s Working Hands Hand Cream. It’s mainly advertised to men, but I tried it and so far, so good! It can be found in grocery stores and hardware stores.” –freqflyer

“My mom developed dry, irritated skin last winter, and I thought she was having an allergic reaction. When we went to the doctor, he called it ‘winter itch’ (a seasonal type of eczema). It was all over her body and, of course, she has opened some areas on her skin. We are using antibiotic ointment and heavy cream specially forumlated for eczema. This has helped a great deal in just a couple of days!” –Seastar

Staying Warm While Bathing in Winter

“Temperature! Turn up the central heat to keep the bathroom warm during bath time. Seniors are often cold, even when we are wearing short sleeves. If there is cold tile in the bathroom, cover it with a plush bath rug and make sure they don’t fall. If you have an overhead heater, turn that on, too. Wear light clothing so you do not get totally overheated while helping them!” –homeandhearth

“A radiant heater panel can be especially useful for bathrooms. During fall and winter, mine is plugged into a motion sensor timer that you set for automatic shut off. We have it set to go on when motion starts, and it goes off when no motion is detected for five minutes. It makes the bathroom warm (I go and trigger it before Mom goes into the bathroom for a shower), and there’s no risk of it tipping over because it’s anchored to the wall.” –glasshalffull

“I purchased a small fan heater for our bathroom. My loved one gets cold easily, especially since the water is not running on her constantly because she uses a shower seat while bathing.” –Anonymous6636

Ending the Thermostat Wars

“As people age, typically the circulation in their extremities (arms and legs) diminishes, causing them to feel cold. Any time you go to a senior living center, you’ll see older people dressed far more warmly than younger people because the seniors are chilly. They’ll even wear sweaters when it’s hot and humid outside. Low thyroid can be another cause of being cold, so be sure to get that checked. My mom’s thyroid quit working about two years ago. Once we got her on thyroid medications and got the dose regulated, she felt warmer and had more energy.” –blannie

“Last winter (out of desperation), my husband and I installed a programmable thermostat and we put it high enough that Mom can’t reach it to crank the heat up. It has worked so well without having to leave notes or try to remind her not to touch it.” –chrisblair63

“I use a Sunbeam heating pad on the back of my dad’s chair. I just saw that Sunbeam and Sure Fit offer heated slip covers, too. As for me, I have been spared by a tall Dyson fan. It makes very little noise and feels like the air it puts out is cooled even though it isn’t. I set it up pointed directly at my chair. It can also oscillate, but the stationary position is perfect since my dad does not feel it and I do. This setup has kept him warm and me cool—something that many caregivers struggle with.” –pipruby

“If you get an electric blanket, make sure it has a cutoff temperature. My mom hates my electric heating pad for her back because it will only keep a high temperature for so long and then it turns off as a safety feature. I told her it’s better than falling asleep on it and getting burned.” –timbuktu

“Beanbag/microwavable heat packs can be heated and strategically placed at the hip, stomach, back and feet. They also make a slipper version that has helped my mom with the Raynaud’s syndrome in her feet.” –glasshalffull

Indoor and Outdoor Safety Tips

“My dad has two walkers. There is one that he leaves in the garage after going all over the yard and through the snow/dirt. Mom won’t let him in the house with it unless he cleans it off, so Dad just bought another walker for indoor use only.” –freqflyer

“Your loved one’s favorite holiday decoration may be a fifty-year-old menorah or Nativity scene with incandescent bulbs. On all décor, check thoroughly for dried and cracking wires and loose connections on the plug. It may have been perfectly safe for many years, but old wiring causes many fires this time of year.” –pamstegma

“A word of caution: canes are terrible on ice. If your loved one needs someone or something to help them walk, it is better that they stay indoors until the weather improves. If they need to get out and about, have someone meet them at home to help them on snowy, icy walkways.” –freqflyer

“I worry when my mother-in-law runs the temperature up higher in her home due to her tendency to get dehydrated. Each and every time she has been hospitalized, it has been because of dehydration. It is common knowledge that it is easier for seniors to get dehydrated when it is hot outside, but it is also a serious issue during winter, especially for those who have trouble getting enough liquids. Help them hydrate any way you can!” –oldcodger2

Source: AgingCare.com

Early Diagnosis of Alzheimer’s Is Crucial for Effective Planning and Treatment

November is National Alzheimer’s Disease Awareness Month—an important opportunity to shed light on a condition that is often misperceived as untreatable. Alzheimer’s disease (AD) is the sixth leading cause of death in the United States, but dementia from Alzheimer’s continues to be underdiagnosed and underreported. In fact, according to a U.S. survey conducted by the Alzheimer’s Association, almost half of patients with AD are already in the moderate to severe stages by the time they are diagnosed. This lack of attention to the early stages of Alzheimer’s is unfortunate, because there are things we can do to help those who are starting to experience memory loss and support the people who are caring for them. Although a cure does not yet exist, available treatment options can help to slow down the progression of symptoms, especially if diagnosed early.

Caring for Someone with Alzheimer’s Disease

AD poses real challenges not only for the people diagnosed with the disease but also for the 15 million Americans who assume caregiving responsibilities. The multitude of obligations can have a huge impact on caregivers, with one out of every two of them developing major depression. The economic burden of providing care is huge as well. In 2016, the annual cost of care was $230 billion in the U.S. alone.

Many of my patients and their caregivers are hoping and waiting for a cure to become available. Even though there are novel drugs and other interventions in various phases of research and development, patients’ mental states continue to deteriorate with each passing day as their families wait for a disease-modifying treatment. The road to development and approval of a new drug is long and rigorous, and only a small percentage of medicines ever make it to market. This is time that Alzheimer’s patients simply cannot afford to waste.

A diagnosis will spur family members to start a conversation about planning for the future—a difficult, yet necessary discussion that they may have shied away from without a clear understanding of their loved one’s health. Timing is crucial because this planning phase must be done while the patient is still capable of sharing their wishes and competent to execute all the necessary legal documents, such as medical and financial powers of attorney, a will, advance health care directives, trusts, etc. These preparations enable the family to understand their loved one’s preferences for long-term and end-of-life care and give them the legal authority to see them through once their loved one has lost the ability to handle their own affairs.

The Treatment Journey

While there are no treatments available that can prevent, cure or change the underlying progression of Alzheimer’s disease, there are medications that can help minimize symptoms for a while. Once again, early diagnosis is key since each prescription is approved for different stages of the disease. These medicines can help people living with AD maintain their cognitive abilities and continue functioning at higher levels longer.

In addition to pharmaceutical treatments, there are also lifestyle choices that can help lower the risk of developing the disease and stabilize the symptoms of AD for those who already have it. These activities include regular physical exercise, stress management, proper diet, and prompt treatment of medical conditions like hypertension and high cholesterol. These lifestyle modifications can have a huge impact on a person’s brain health.

If you are concerned about a loved one’s memory, encourage them to go see a doctor. The good news might be that there is nothing to worry about, but if a problem is detected, ask about available treatment options. Early diagnosis and proactive treatment could help some of the 5.5 million Americans who are currently living with Alzheimer’s disease and their loved ones.

Source: AgingCare.com

Capgras Syndrome: How to Cope with a Loved One’s Delusions

Capgras Syndrome: How to Cope with a Loved One’s Delusions

Capgras is a type of delusional misidentification syndrome (DMS) that may present due to any number of neurological diseases or psychiatric disorders. Although the exact prevalence of this disorder is unknown, a 1999 study estimates that it is present in between two and 30 percent of individuals with Alzheimer’s disease. This disorder can seriously complicate a dementia patient’s quality of life and their caregivers’ efforts, so it is crucial to spread awareness of this little-known condition.

What is Capgras Syndrome?

“Capgras is a misidentification syn­drome characterized by the transient, recurrent, or permanent belief that someone known to a patient has been replaced by an impostor with a strong physical resemblance,” explains Erin Shvetzoff Hennessey, MA, NHA, CPG, and Vice President of Health Dimensions Group. “These delusions are suggested to stem from impairment of the brain’s facial recognition system and are also associated with brain lesions.” There is limited research available on this condition, but it affects those with a variety of neurological and psychological diagnoses, including schizophrenia, Alzheimer’s and other forms of dementia.

Capgras can be extremely stressful for the person with the syndrome, but it is also very disturbing for those around them. “While dementia caregivers usually anticipate a loved one’s forgetfulness and inability to remember close family members and friends, it can be very painful and confusing when this syndrome causes a different kind of loss of recognition,” laments Shvetzoff Hennessey. A loved one may remember their caregiver, spouse, or other relative—and may even ask for them by name—but they believe that this person is an impostor. Such delusions can make caregiving, family time, and other social experiences extremely painful and confusing.

Reality Orientation Techniques

When interacting with a person who is experiencing Capgras, it is common for caregivers and family members to attempt to correct or explain their delusions. A research article in the Frontiers in Human Neuroscience journal states that, “A defining characteristic of delusions also present in Capgras syndrome is that patients will firmly hold on to their delusional beliefs [even] in the presence of mounting contradictory evidence.”

While some caregivers may continue to correct sufferers and try to convince them that they are merely experiencing delusions, the use of reality orientation techniques for sufferers of memory loss has declined in recent years. “This strategy includes frequent reminders of present time, location and facts based in reality, including deaths, moves or other major life events,” Shvetzoff Hennessey explains. Reality orientation may be logical and appealing for those without Capgras but is often frustrating and upsetting for individuals who are experiencing delusions.

Validation Therapy

Shvetzoff Hennessey says that reality orientation has largely been replaced by validation therapy, which supports the patient’s delusions rather than correcting or contradicting these very real ideas, thoughts and feelings. Validation techniques have been found to reduce stress and anxiety in both dementia patients and their loved ones.

For some sufferers, neither reality orientation nor validation techniques are successful, leaving both the patient and their loved ones frustrated, lonely and anxious. For these situations, a mixture of several techniques may be needed in order for both parties to enjoy spending time together. “By working with the patient’s care team, including direct care providers, physicians, social work professionals, pharmacists and therapists, techniques and strategies can be developed to relieve the symptoms in the patient, as well as reduce the stress and frustration of loved ones,” advises Shvetzoff Hennessey. “This can include communication techniques, medications, and creative problem-solving methods.”

Interactions and Caregiving

Research shows that time and interactions with loved ones who have Alzheimer’s or other types of dementia is valuable for both the patients and their caregivers. However, this delusional condition can make it difficult, if not impossible, for the patient and the believed impostor to interact. Some patients may blatantly refuse to speak or cooperate with the “impostor.” Changing the format, timing and length of visits may help in some cases.

“If the patient does not live with those they do not recognize, these loved ones may have to visit during certain times of the day when the patient is more relaxed,” Shvetzoff Hennessey recommends. “Impostors” may need to visit along with other people that the patient recognizes, or even visit as a stranger, but these options may still allow for interaction.

Shvetzoff Hennessy emphasizes that safety and wellbeing are paramount. “If the patient’s delusions make caregiving, living together and safety challenging, housing changes may be needed to ensure the emotional and physical health of everyone involved.” In such cases, placement in a specialized memory care unit might be the best option.

Care for Yourself, Too

Alzheimer’s and dementia caregivers already experience serious emotional and physical strain, and this is only compounded by the development of Capgras syndrome. “It is important for family members and caregivers of sufferers to care for themselves in order to better care for their loved ones,” Shvetzoff Hennessey urges. This self-care can include increased time away from the patient, self-acceptance of limitations and reliance on other support systems including friends, family, and community and healthcare resources.

Interacting with Someone Who Is Suffering from Delusions

Shvetzoff Hennessey offers family caregivers the following tips for interacting with a person who is experiencing Capgras syndrome.

  • Validate their feelings and concerns. Rather than challenging their perspective, make it clear that you understand how they are feeling and that it is perfectly acceptable for them to feel this way. Try to identify with their reality rather than correct it.
  • Make a safe, emotional connection. Dementia alone can be extremely confusing and disorienting for a patient. Adding delusions that someone they trust has been replaced with an identical fraud can be very frightening for them. Remind the patient of how much you love them and how much the “impostor” loves them. If the patient has additional misconceptions that this fake is trying to harm them or steal from them, gently reassure them that they are safe and you will not allow anything of the sort to happen.
  • Rely on auditory interactions. Since this disorder makes it difficult or impossible for sufferers to visually connect with loved ones, sound is the next best way to communicate. Rather than visiting face-to-face, try conversing over the telephone or just outside of their line of sight. If a patient has difficulty interacting in person, it can help for the impostor to announce themselves while still out of sight. This helps to establish an emotional connection and begin a conversation that continues while they come into sight. This may assist the patient in positively identifying their loved one.

Source: AgingCare.com

Hallucinations, Delusions and Paranoia Related to Dementia

Hallucinations, Delusions and Paranoia Related to DementiaHallucinations, Delusions and Paranoia Related to Dementia

According to the Alzheimer’s Foundation of America, the major psychiatric symptoms of middle stage Alzheimer’s disease and other forms of dementia include hallucinations, delusions and paranoia. About 40 percent of dementia patients experience delusions, while hallucinations occur in about 25 percent of cases. When a senior is experiencing hallucinations and delusions, their caregiver often wants to help them understand that these beliefs and experiences are not real.

 “It is not helpful to argue or rationally explain why something happened,” says Lisa P. Gwyther, associate professor in the Department of Psychiatry and Behavioral Sciences at Duke University and director of the Duke Aging Center Family Support Program. “It just frustrates the person. They somehow know that you are not taking their thoughts and feelings seriously.”

While reinforcing reality seems like the logical and kind thing to do, this natural instinct can be wrong. Family caregivers can ensure they’re prepared to handle these challenging behaviors by learning the differences between them and proper coping techniques for each one.

 Understanding the Differences

Hallucinations, delusions and paranoia are symptoms of disease and not a normal part of aging. While they may seem similar, they are actually very different.

Hallucinations are false sensory experiences that can be visual, auditory and/or tactile. These perceptions cannot be corrected by telling a patient that they’re not real. Examples include a dementia patient hearing music when none is playing or seeing bugs on a surface where there aren’t any.

Delusions are fixed false beliefs that are not supported by reality. They are often caused by a faulty memory. Examples include accusing caregivers of theft and infidelity.

Paranoia is centered around suspiciousness. Elderly individuals often project hostility and frustration onto caregivers through paranoid behaviors.

Coping with Hallucinations

When it comes to handling a senior’s hallucinations, Dr. Marion Somers, author of “Elder Care Made Easier: Doctor Marion’s 10 Steps to Help You Care for an Aging Loved One,” suggests joining them in their version of reality. Ask them about what they are experiencing as if it is real so that you can more effectively defuse the situation. Refrain from trying to explain that what they are seeing or hearing is all in their head. “Otherwise, you’re going to aggravate them, and you don’t want to increase the level of agitation,” says Dr. Somers.

Reassure them by validating their feelings. Say something like, “I see that you’re upset. I would be upset if I saw those things, too.” Tell them that they are safe with you and you will do whatever you can to help them feel secure.

A comforting touch, such as gently patting their back, may help the person turn their attention to you and reduce the hallucination, according to the Alzheimer’s Association. You also can suggest that they move to a different room or take a walk to get away from whatever may have triggered the experience.

Realize that some hallucinations, such as seeing children or hearing music, can be comforting. If the individual is reassured by a hallucination, caregivers don’t need to do anything to stop it, Gwyther says. “You only need to respond to things that are scary or disruptive or keep the person from getting adequate care,” she says.

In addition to dementia, poor eyesight, hearing loss, certain medications, and physical problems like dehydration and urinary tract infections (UTIs) can contribute to hallucinations. If all other factors are ruled out and a loved one’s hallucinations are disturbing and persistent, then antipsychotic medication may be prescribed to reduce them. However, Gwyther says these medications can present a risk for dementia patients. She recommends first changing the way you communicate during these episodes and changing the activity and environment to remove or reduce triggers.

The Alzheimer’s Association offers these tips to change the environment:

  • See if any lighting or lack of lighting casts shadows, distortions or reflections on walls, floors and even furniture that could contribute to visual hallucinations.
  • Listen for any sounds, such as TV or air conditioning noise, which could be misinterpreted.
  • Remove or cover mirrors if they could cause someone to think they are seeing a stranger.

Dealing with Delusions

Delusions among dementia patients typically result from their cognitive impairment. They occur when a senior tries to make sense of a situation, but their confusion and memory problems make it impossible. “They end up filling a hole in a faulty memory with a delusion that makes sense to them,” Gwyther says. For example, if a loved one cannot find their purse, they may decide that it is missing because someone stole it.

Delusions can be frightening for the person living with dementia, but they can also be very hurtful for caregivers when they are the accused. Recognize that the elderly individual is living in a world that doesn’t make sense to them and is likely scared. Do not take any accusations personally or respond with logical explanations. Instead, reassure the person and avoid asking questions that may cause more confusion. If they are looking for an item, tell them you will help them find it. In cases where a loved one regularly misplaces an item and becomes agitated over the loss, the Alzheimer’s Association recommends purchasing a duplicate of the item to quickly resolve the issue until the original is found.

Distraction is another strategy that dementia caregivers use in response to delusional thinking, but it may not work for every patient or every delusion. If a loved one is experiencing a mild delusion, offering a favorite snack or activity or asking them to tell you about an important experience in their life may be sufficient to redirect their attention. In cases where the person is very upset, reassurance may be the only viable option. Again, it is crucial to avoid rationalizing the situation and stress your commitment to their security and happiness.

Responding to Paranoia

Paranoia is less common than delusions and hallucinations but can still be very troubling. According to the Alzheimer’s Association, when paranoia occurs, caregivers can assess the problem by considering these questions:

  • What happened right before the person became suspicious?
  • Has something like this happened before?
  • Was it in the same room or at the same time of day?
  • Can this trigger be removed or altered to avoid eliciting suspicion?

If someone is experiencing paranoia, it is important to discuss their medications (prescription and over the counter drugs as well as vitamins) with their doctor. “Sometimes medications interact with one another or the dosages are too large,” notes Somers. “That can bring on paranoia, but a doctor can address problems and adjust the senior’s regimen to minimize issues.”

Recognizing the causes for all three behaviors and understanding what a loved one goes through while enduring hallucinations, delusions and paranoia can help you both keep calm and find solutions.

Source: AgingCare.com

Ask your doctor the right questions about your Alzheimer’s diagnosis

Just Diagnosed

Receiving a diagnosis of Alzheimer’s is never easy — it’s life changing. It is normal to experience a range of emotions. Acknowledging your feelings can be an empowering first step in coping with the challenges ahead.

Emotions you may have

You noticed symptoms. You made a doctor’s appointment. You took tests. And you felt a roller coaster of emotions — fear, hope, despair, denial. Then you received a diagnosis. You may have felt numb, unsure of how to respond or where to turn.

You also may be grieving over the present losses you are experiencing, or the expectation of future changes as the disease progresses. It can be helpful to identify and understand some of the emotions you may experience after receiving your diagnosis.

These emotions may include:

  • Anger. Your life is taking a different course than the one you and your family had planned. You cannot control the course of the disease.
  • Relief. The changes you were experiencing were cause for concern. A diagnosis validated these concerns by assigning a name to your symptoms.
  • Denial. The diagnosis seems impossible to believe. You may feel overwhelmed by how your life will change as a result of Alzheimer’s.
  • Depression. You may feel sad or hopeless about the way your life is changing.
  • Resentment. You may be asking yourself what you did to deserve your diagnosis or why this is happening to you and not someone else.
  • Fear. You may be fearful of the future and how your family will be affected.
  • Isolation. You may feel as if no one understands what you’re going through or lose interest in maintaining relationships with others.
  • Sense of loss. It may be difficult to accept changes in your abilities.

If these feelings linger week after week, you may be dealing with depression or anxiety. Feeling depressed or anxious about your diagnosis is common, but both can be successfully treated.

Taking care of your emotional needs

Coming to terms with your diagnosis and the emotions you are feeling will help you accept your diagnosis, move forward, and discover new ways to live a positive and fulfilling life.

You are the only person who can change how you feel about your diagnosis. So it’s important to find healthy ways to deal with your emotions. This can be difficult at the beginning. But once you make the commitment to take care of your emotional needs, you may find that you can rise to the challenge and face your diagnosis. This is a new phase of your life, and you can choose to experience it with sense of connection to your emotional health.

When working through your feelings, try a combination of approaches. The following tips may be helpful:

    • Write down your thoughts and feelings about your diagnosis in a journal.
    • You may find your friends and family struggling with your diagnosis and their feelings. Learn more about how you can help family and friends.
    • Share your feelings with close family and friends. Speak open and honestly about your feelings.
    • Surround yourself with a good support system that includes individuals who are also living in the early stage of the disease and understand what you’re going through. Join our ALZConnected message boards or learn more about support programs.
    • Join an early-stage support group. It can provide you with a safe and supportive environment of peers. To find a support group in your area, check with your local Alzheimer’s Association chapter.
    • Talk to your doctor if you or others are concerned about your emotional well-being. Your doctor can determine the most appropriate treatment plan to address your concerns.
    • Seek help from a counselor or clergy member. He or she can help you to see things in a new way and help you understand more fully what you are feeling.
    • If you are feeling misunderstood or stereotyped because of your diagnosis, learn what you can do to overcome stigma.
    • Stay engaged. Continue to do the activities you enjoy for as long as you are able.
    • Take the time you need to feel sad, mourn and grieve.
    • No two people deal with their diagnosis in exactly the same way. There is no right approach. Some days may be more difficult than others, but don’t be discouraged. Learn coping tips to help you manage challenges.

You are not alone

A diagnosis of Alzheimer’s disease can leave you feeling disconnected, isolated or abandoned from others. You may feel unsure of where to turn and that no one can possibly understand what you’re going through. People living with early-stage Alzheimer’s have stated that one of the most important lessons they learned early on in their diagnosis is this: they could not just wait for others to help them – they had to go out and help themselves to the best of their ability.

Whenever facing difficult times, having a good support network you can turn to for advice and encouragement may help you feel socially connected and give you a sense of belonging and purpose. Make sure your network includes other people who are living in the early stage of the disease. Connecting with others like you may help put your own experiences living with the disease in perspective, and provide you with the support and encouragement necessary to move beyond your diagnosis.

Questions for your doctor

After receiving your diagnosis, it’s normal to leave your doctor’s office unsure of what questions to ask. You just received life-changing news, and you need time to absorb this information and understand what it means for you and your family.

Your doctor is an important member of your care team. Use the opportunity to ask your doctor questions about your diagnosis, all the available options, and the benefits and risks of each choice you make.

You may be asking: “How do I know what to ask my doctor?”

Members of our Alzheimer’s Association National Early-Stage Advisory Group have shared their own experiences and questions they wish they had asked their doctors. You may find this information helpful as you develop your own list of questions.

Download these questions and others as a PDF

Example questions:

The diagnosis of Alzheimer’s disease

  1. What test(s) or tools did you use to determine my diagnosis?
  2. What are you measuring with the tests you performed?

Alzheimer’s disease

  1. How will the disease progress?
  2. What can I expect in the future?

Treatments

  1. What treatment options are available?
  2. Which symptoms are being targeting by each medication?

Clinical trials

  1. What clinical trials are available?
  2. Where can I find published information about clinical treatment studies?

Care team

  1. How familiar are you with Alzheimer’s disease? Will you be managing my care going forward?
  2. If I need to be hospitalized, will you be able to provide care in this setting?

Care and support

  1. What resources are available to help me learn more about my diagnosis? My family?
  2. What support services are available to help me live well with the disease, for as long as possible?

Source: alz.org

Satisfy a Senior’s Sweet Tooth in a Healthy Way

Satisfy a Senior’s Sweet Tooth in a Healthy WayAlthough providing an elder with a balanced, nourishing diet is not too difficult, getting your loved one to actually eat the healthy foods you serve can be a real challenge. As people age, their appetites often diminish. Problems with teeth or swallowing, medications, pain, and the inability to taste and enjoy certain flavors are only a few of the many causes of eating problems in the elderly.

Understandably, caregivers who strive to provide good nutrition to their loved ones can become frustrated when the only foods their elders want are sugary and low in key nutrients. However, it’s important to remember that seniors have different dietary requirements than younger individuals. Fortunately, there are ways to strike a healthy and delicious compromise.
 Aging Loved Ones Have Different Nutritional Requirements

Most sweets are high in calories and fat. While this combination is generally discouraged, it may be okay for a senior, since fat reserves in the body tend to shrink as we age. When it comes to your loved one’s diet, share your concerns with their doctor and ask for some guidance. If the doctor doesn’t see their sweet tooth as a serious issue (it would be for a diabetic), then let them eat what they like. Don’t expect to put a lot of weight on a frail elder. You can try to improve their nutrition, but that may be the best you can realistically do.

The Reasons Behind a Senior’s Sweet Tooth

While a diet high in sugary foods may not necessarily be detrimental to their health, it can indicate other underlying issues that can be remedied. For example, if your elder has problems chewing, swallowing or digesting foods, it’s natural for them to choose a soft sweet, such as a cupcake, over tougher, more nutritious foods, like meat. Ill-fitting dentures and tooth pain are both common reasons for dietary changes in seniors. Make an appointment with the dentist to rule out oral health issues as a contributing factor. For problems with swallowing (called dysphagia) and digestion, see their doctor. These complications can be caused by a host of health conditions, such as advancing dementia or constipation.

Hiding Nutritious Ingredients in Food

Regardless of the reasons why they gravitate toward sweets, convincing a loved one to consume healthy foods can be challenging. It’s often best to start by introducing nutritious ingredients into their diet gradually. Keep in mind that it’s okay to be sneaky when it comes to nutrition. There are cookbooks on the market that can teach you how to “hide” healthy ingredients in meals, including desserts. Examples include creamy banana ice cream, black bean brownies and chocolate chip sweet potato cookies. Make a list of foods that your elder has enjoyed throughout their life and do some research on how you can adapt the recipes to make them healthier.

For a picky eater who loves sweets, smoothies are the perfect vehicles for hidden nutrition. A healthy smoothie can include far more than fruit, and it doesn’t require a formal recipe. Homemade smoothies can be full of nutrients, taste like a delicious dessert and deliver much-needed calories. They can also be adjusted to appeal to a senior’s sweet tooth (see this recipe for a senior-friendly Shamrock Shake) and meet specific dietary restrictions.

Begin by using mostly fruit for flavoring. Strawberries, blueberries, pineapple and mango are popular, and a banana can provide some much-needed potassium and a creamy texture. Try hiding a tablespoon of flax seeds, a spoonful of nut butter or a dollop of Greek yogurt in your next creation for added protein and healthy fat. Liquid multivitamins and protein powders can be included for an extra boost of nutrients. Leafy greens like kale and spinach are easy to hide in a smoothie as well, but they can be bitter. Be sure to balance these ingredients out with a sweeter fruit blend or a drizzle of honey. You can adjust the smoothie’s thickness by adding ice cubes, water, milk or orange juice. There are many smoothie books on the market and recipes available on the Internet that can provide inspiration.

Let Them Indulge

Unless their physician has banned a particular food because of diabetes or another disease, it’s perfectly fine to allow your loved one to enjoy desserts often. Even though you’re trying to improve their nutrition, you want to offer enjoyment as well as calories. Our loved ones have likely suffered many losses as they’ve gotten older. Letting them indulge in the foods they love can help improve their quality of life.

If I make it to 80, I hope that I can have the foods I like, even if they aren’t “good for me.” In my opinion, unless the food is a direct health threat, our elders have earned the right to eat what they enjoy.

Source: AgingCare.com

4 Tricks for a Happy Halloween with an Elderly Loved One

Halloween is a holiday that people of all ages look forward to each year. Costumes, candy, haunted houses and festive parties set this occasion apart from all the others, but how do you help an elder celebrate All Hallows’ Eve in a safe, fun and healthy way? Use these tricks and treats to include your loved ones in the festivities this Halloween.

  1. Choose healthy treats to haunt your home and candy bowl. Whether you plan to hand out candy to trick-or-treaters, have a small get together or simply spend a low-key evening at home with your loved one, make sure you have healthy treats on hand. Help yourselves avoid binging on fattening and sugary candies by having better options available at home and for children who are trick-or-treating.
    As a special treat, you and your elder can indulge in a few pieces of dark chocolate, which is lower in sugar and fat than milk varieties and even packs some immune-boosting antioxidants. A celebratory dessert made with natural and/or sugar free ice cream is another special treat that will delight your loved one. Provide healthy topping options like nuts, berries and other kinds of fruit, and oats or granola that they can choose from to make their own tasty creation. This will boost their intake of nutrients like potassium, vitamin C, dietary fiber, and protein.
    There are countless healthy options for snacks and desserts available. However, keep in mind that some elders may have difficulty eating certain foods. A loved one who has trouble chewing and/or swallowing may fare better with a healthy smoothie or bowl of pudding instead of a hard granola bar or dense fruit like apples.
  2. Plan your “paranormal” activities appropriately. Your loved one may enjoy the excitement of handing out goodies to trick-or-treaters and seeing neighborhood children in their costumes. This is a fun and easy way for elders to interact with other generations and feel that they are a part of the celebration without even leaving their front porch or driveway. Encouraging them to participate is a great way to improve their mood and get them into the spirit of Halloween.
    However, some elders may not interact well with children or be able to handle the hubbub of trick-or-treating. In this case, post an easily visible note in your driveway or on your front door that says, “Sorry, no more candy,” or “No trick-or-treaters, please.” This can be especially important for loved ones who have dementia and may be agitated or confused by repeated knocking or ringing of the doorbell.
    Most trick-or-treaters make their rounds at dusk or just after dark, which may coincide with the onset of Sundowner’s syndrome. For an individual with Alzheimer’s or dementia, confusion and agitation can be heightened at this time of day. Excessive noise, the coming and going of strangers, and costumes can be extremely disorienting and even frightening. Making treats together, watching a not-too-scary movie, or engaging in simple holiday crafts can be great low-key distractions. If you both choose to participate in Halloween festivities, be sure that you remain attentive and aware of your loved one’s mood and comfort level throughout the evening.
  3. Keep seasonal décor spooky but safe. Houses can be decorated to celebrate the height of the fall season with pumpkins, wreaths of fall foliage and cinnamon brooms, or they can be made into sinister dwellings full of cobwebs, spooky figurines, bats and spiders. Regardless of how you wish to decorate, make sure that none of these items present a tripping or fire hazard. One of the best ways to do this is to place larger decorations outside on the lawn, and keep indoor embellishments to small accents.
    Décor may be out of the question for a loved one who has dementia, especially if they are prone to hallucinations, delusions or paranoia. Decorative touches that we think are tame may be extremely unsettling or bothersome for an elder with cognitive impairment. Their brain processes sensory stimulation in ways that can be scary or overwhelming. You know your loved one best, so decorate in a safe and considerate way.
  4. Make costumes creative and comfortable. For some, the ability to dress up is the best part of celebrating Halloween. If your loved one wants and is able to, assist them in making a costume, and let them show it off to trick-or-treaters on Halloween night.
    Keep in mind that complicated or elaborate outfits may make it difficult to walk and/or make trips to the restroom. Simpler costumes will keep your loved one comfortable and make your caregiving duties much easier so you both can enjoy the festivities.
 Holidays like Halloween can be enjoyed by people of all ages. Help your loved one celebrate in a fun and healthy way, and remember that there’s nothing wrong with a little bit of indulgence and kookiness every so often!
Source: AgingCare.com