On July 11, 2014, Dr. David Geldmacher, Director, Division of Memory Disorders and Behavioral Neurology from the University of Alabama at Birmingham will speak at the James P. Nix Center in Fairhope, AL from 8am – 12:00pm.  His major focus is Alzheimer’s patients and their improved treatment.

This is an open access educational offering available to both caregivers and clinicians at no charge to attendees.

CEU credits available for licensed nurses, social workers, NH Administrators and ALF Administrators.

Alzheimer’s Family Services can be reached by calling (850) 478-7790 or at www.alzfamserv.org

Don’t miss the January 22, 2014 at Five Rivers Delta.

Speakers from support groups and dementia services will present information that you want to know.

Meeting begins at 10 am and ends at 11:30 am.

Click Alzheimer and Dementia Coalition meeting for the flyer about the details.

E. A. Roberts Alzheimer’s Center will present Alison Richardson, CPA  of Richardson and Associates at their Educational Dementia Support Group on Thursday, January 9, 2014 at 10am.  The center is located on 169 Mobile Infirmary Boulevard, Mobile, AL  36607.

Complimentary care will be provided during the meeting.  Please call 251-435-6950 for more information.

MOBILE COUNTY SUPPORT GROUPS

Rocking for Alzheimer’s Caregivers Support Group – call in support every third Sunday from 4-5:00 pm. Call 480-297-0773 code 4796634#. Contact Gina Scott at 251-533-6092 for more information.  https://www.dorismariejonesfoundation.org 

The Gulf Coast Dementia Services Support Group

Location: 3263 Demetropolis Road, Ste 9B at the Quadrangle Business Center, Mobile, AL 36693 at Touching Hearts Senior Care Office

The Caregiver Support Groups are held the second and fourth Tuesday from 11:00 – 12:00pm and meets in the Touching Hearts Senior Care office.  This is a free event and completely confidential.

You may call  251-445-4204 or 251-421-4888 for more information:

The Gulf Coast Dementia Services Support Groups provide emotional, educational and social support for caregivers by master certified dementia health coach and dementia practitioner, Janet Rich Pittman, who conducts all sessions.

Click here for a link to Gulf Coast Dementia Services

E. A. Roberts Alzheimer Center offers Dementia Education support once a quarter at 5:00 pm. They are located at 169 Mobile Infirmary Drive.  Please call 251-435-6950 for further information.

We wish you a merry Christmas wherever you are! May God give you the grace to enjoy precious moments by going with the flow presented today.  Smile and be thankful that you are trusted with the gift of loving someone unconditionally in your life.

If you’re having trouble finding evidence of God in your daily life, let me make a suggestion.  Go sit in a parking lot of a nursing home near the entrance.  You will see people coming and going that are busy doing God’s work. People from all walks of life, for a variety of reasons, enter and exit the building all day long.

As I sit in the sunshine, under a large oak tree alongside my wheelchair bound mother, we watch the people go by.  Two women, strangers before they both found themselves on a common mission, pause to speak to one another, each carrying a bagful of items, on their way to serve their moms who reside inside the building.  An x-ray technician arrives, unloads his machine for the hundredth time, and rolls it inside to clarify an awaiting medical situation.

Certified Nursing Assistant’s who arrive for and depart from their 8-hour shift of caring, give us a smile and say hello.  A car pulls in as close to the door as possible, and a frail resident gets out with the help of a friend who assists her inside. It wasn’t that long ago that this particular resident wasn’t able to walk at all.  However, with the regular visits to the physical therapy department and encouragement from her many visitors, she has improved a great deal – even though her prognosis is grim.

The nursing home bus arrives and unloads a group of residents who have been out shopping at the nearby Walmart.  They carry in their purchases with the help of the activity staff.  A stop by the activity room reveals one busy employee wrapping Christmas gifts for resident’s who are able to still collect gifts for their friends and families at Christmastime.

As we make our way into the depths of the building, we pass the gaily decorated halls, see Christmas trees at every wing, observe medicine being given out by nurses, smile at needs being met by compassionate helpers until we finally reach my mom’s room.  The quiet space and familiar setting welcomes and calms us.  The maintenance man enters to clean the heater filter and engages us in conversation.  Before long, Momma’s CNA brings in the afternoon snack.  While there, she informs the maintenance man about my mother’s ability to do handwork as seen hanging in frames on her walls. She points out the intricate work involved. I tell about my mom’s custom to make everyone in the family a special ornament that would represent a major event of the year and that I have 20 years worth of memories to hang on my tree.  As my mother listens intently to us tell about her accomplishments, she has a pleasant smile on her face.  For a lady who has advanced dementia, and is unable to speak, this is a good day.  God’s grace and mercy abound.

Thank you, God, for your loving people.

^“7 This is my command: Love each other” John 15:17 NIV.

This purple wreath helped guide the participants to our meeting place today at the Five Rivers Delta Resource Center.  We had a great turnout and heard valuable information from Julie McGee, Director of the Area Agency on Aging. Mrs. McGee gave a brief history of the Coalition and it’s first project – the Helpline – and then introduced her good friend, Gayle Boswell, who is the Area Agency Director in Montgomery, AL.  Mrs. Boswell shared some exciting news about what they are doing with grant money for CNA training in nursing homes.

Della Sanchez, Alabama Cares Coordinator, was making it all happen and handing out information as people arrived.

The next speaker was yours truly, Beth Reinert, who spoke about finding information on the internet to help with dementia care. Caregiversunite.org blog and Facebook page was shown on the screen, a prize was given for making a comment on the Facebook page and there was a question and answer period that followed.  The remaining members of the Coalition were given a chance to tell about themselves and what they are doing:

Laura Harrington of E. A. Roberts Alzheimer Center told of their recent successful open house and stated the center would be open one Saturday a month for Adult Day Care along with their regular weekday schedule.

Gina Germany of Touching Hearts Senior Care told about the Gulf Coast Senior Alliance and the Gulf Coast Dementia Services.  She announced a conference in April that will feature Teepa Snow as the speaker.

Janet Rich Pittman, Director of Marketing at Brookside Retirement Community, told of her passion for teaching about Brain Health and dementia prevention.

Leslie Johnson of Covenant Hospice brought us up to date on the support groups available in Baldwin County.  See the recent post detailing the times and dates of those meetings.

We also heard from a DETA trainer, Martha Allegri, who is available to speak and teach about dementia through Alzbrain.org.

I am excited about the interest shown today and all the people I met who I hope to introduce you to soon via this blog. Thank you all for coming. Long live the Alzheimer and Dementia Coalition of South Alabama!

While there is endless information these days encouraging us caregivers to take care of ourselves, improve our abilities through education, and receive support by connecting with other caregivers, let me remind you of the people we hire to help take care of our loved ones.

When the job of caring became too much for me to do alone, I turned to others for help.  That came in the form of hiring strangers to entrust my mother’s care.  We started by having someone come into my mother’s home to prepare the noonday meal and provide some social interaction.  Although this arrangement only lasted two weeks, I have to say this young lady did what I asked of her even though my mother wasn’t so keen on having her in the house.  Not an easy job when the person you are there to serve doesn’t understand the need or resents your presence.

Very shortly after that, we moved Momma into an assisted living facility, where she had the help of Certified Nursing Assistants (CNA’s) to assist her with dressing and bathing.  I came to appreciate the confidence these (mostly female) workers had as they worked tirelessly all day long, going from one person to the next, to carry out their duties.  Some CNA’s seemed to enjoy their job more than others, some with genuine care and kindness, some just doing their job.  However, they all kept going, regardless of family or health problems or financial needs that was affecting their mood. Do I think that two weeks is a long enough time to be trained as an expert on giving care, especially to someone with dementia? No. Most of the learned care techniques are gained from each other while on the job.  So given the job qualifications required, the tasks to achieve on a daily basis are not easy.  After all, we needed help, too.

I’ve called the CNA’s our “friends” as I’ve explained their involvement to my mother.  We’ve taken their pictures and framed them along with their name underneath to remind us of how important they are to us.  We had to move into a Special Care Unit for a while and benefited from the new CNA’s we met there and their willingness to learn my mom’s habits and behaviors.  I have always tried to find ways to thank and encourage the work they do and report to their supervisor their diligence and good deeds.

Recently, I was considering  broken communication between a CNA and myself.  Instead of complaining, I decided to thank the entire unit for all their help by bringing in lunch for the day shift and dinner for the night shift.   If the pizza didn’t do it, maybe the Mississippi mud cake would bridge any gaps that had developed over the six months we’d been there.  While I have perceived that family members are viewed as potential trouble for the CNA’s, I feel these women need to hear what a good job they are doing and give them opportunity to take pride in their work.  They take the brunt of all complaints and expect to either hear it from the family, or worse, be reprimanded by their supervisor.  While this is appropriate at times, we need to know how to get along without fear of reprisal.

I hope we can change our perception of each other and be willing to work together for the good of the residents.  The care of our loved ones requires a harmonious team.  While we as family members might find that good care is hard to sustain, it’s is all our responsibility to improve communication and learn together.  Let’s start by thanking a CNA today.

“Your Turn To Care”  is a new television series which airs on PBS, Sunday night at 6 p.m.   To see segments of the series along with additional information, go to their website and Facebook page of the same name.

Alzheimer’s disease (AD) is the most common form of dementia – a disease that affects adults older than 65 and causes the death of nerve cells in the brain. A person with AD loses memory and the ability to complete everyday tasks. As the number of older American grows, so does the prevalence of the disease. Currently, there are 5 million people living with AD in the United States. By 2050, that number is expected to triple.

People caring for AD patients may have several challenges, including:

• Communicating and coping with changes in the patient’s personality
• Other conditions that affect the elderly such as slip-and-fall injuries that may require hip replacement surgery
• Heart troubles
• Diabetes

On top of this, these are several medications for treating AD that have varying levels of effectiveness and safety. Symptoms like depression, psychosis and apathy may be treated with additional drugs that also carry a host of side effects and may interact with AD medications.

Caregivers should know what to look out for when it comes to these medications because some can cause serious harm.

Types of Medications Used to Treat Alzheimer’s

In the United States, there are two classes of U.S. Food and Drug Administration (FDA)-approved drugs for the treatment of AD: cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists. These drugs are fairly expensive and have not been found to be very effective.

Cholinesterase inhibitors work by preventing the breakdown of a chemical responsible for thought, learning and memory called acetylcholine. These drugs are recommended for mild to moderate cases of AD.

Some drugs in this category are:

• Aricept
• Exelon
• Razadyne

Aricept in particular has come under fire from consumer advocate groups like Public Citizen because of its lack of effectiveness and severe side effects at higher doses, including dizziness, agitation and gastrointestinal problems. Vomiting is also a severe side effect and can lead to pneumonia, bleeding and even death.

The only N-methyl-D-aspartate (NDMA) receptor antagonist that is FDA approved is Namenda, which treats moderate to severe AD. This drug works by blocking NDMA receptors, preventing the release of amino acids that kill nerve cells. It can also be prescribed in combination with Aricept.

Common side effects of these drugs are dizziness, drowsiness and fainting – conditions that may heighten the risk of injuries from falls. If more than one of these drugs is prescribed, side effects could be worse.

Other Drugs Prescribed to AD Patients

There are a number of other symptoms AD patients may suffer from, such as depression, apathy and psychosis. These symptoms may be treated with additional drugs, including:

• SSRIs. For depression, doctors typically prescribe antidepressants known as selective serotonin reuptake inhibitors (SSRIs). While SSRIs like Zoloft are linked to birth defects when taken during pregnancy, older patients with AD may experience nausea, weight loss or gain, dizziness or agitation.
• Stimulants. Apathy is another common symptom of AD. To treat this, doctors may prescribe a stimulant such as Ritalin. This drug can cause high blood pressure, severe insomnia and psychotic symptoms. It is also addictive. This medication is especially risky for adults older than 65, and a caregiver may wish to inquire about an alternative.
• Antipsychotics. Some AD patients suffer from hallucinations or aggressive behavior, and antipsychotics are used to treat these symptoms. A study published in the May 2009 issue of Lancet Neurology revealed that these drugs are not much more effective at controlling these episodes than placebo, however. Also, they may double the risk of death, and serious side effects such as Parkinsonian-like symptoms can also develop. Before prescribing antipsychotic medications, many doctors recommend behavioral treatments such as controlling the patient’s environment and routine.

Non-Pharmaceutical Options

There is no cure for AD, but there are a few alternatives to medications for easing some symptoms:

• Keep a routine and avoid unfamiliar places.
• Always be aware of tone and body language when communicating with an AD patient, and try to use gentle touch to communicate if verbal communication is not working.
• Use distractions such as music, dancing or singing to stop disruptive behaviors.
• Take time out for yourself if you are getting frustrated.
• Always let the patient know he or she is safe.
• Keep extra sets of things patients may lose, such as glasses or keys.
• Try not to argue with the patient.

As always, when making any decision about a patient’s care or medications, work hand-in-hand with the patient’s physician.

Bio: Michelle Y. Llamas is a writer and researcher for Drugwatch.com and the host of Drugwatch Radio. She has written for medical journals and been a guest on podcasts focused on health

Sources:

National Institutes of Health. (2013). Methylphenidate. Retrieved from www.nlm.nih.gov/medlineplus/druginfo/meds/a682188.html

New York Times. (2012). Alzheimer’s disease medications. New York Times. Retrieved from http://health.nytimes.com/health/guides/disease/alzheimers-disease/medications.html

Consumers Union of United States. (2013, January 7). Alzheimer’s drugs are expensive, and they don’t work very well for most people. Washington Post. Retrieved from http://articles.washingtonpost.com/2013-01-07/national/36188995_1_drugs-generics-seroquel

National Institute on Aging. (2012). Caring for a person with Alzheimer’s disease. Retrieved from http://www.nia.nih.gov/alzheimers/publication/caring-person-ad/understanding-how-ad-changes-people-challenges-and-coping