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Friday, November 30, 2007

Caregivers' Self-Care During Holidays - Know You Are Special

It is tempting to overlook our own needs in order to take care of others during the holidays. However, if we are not functioning well or our own health gives out we won't be able to continue caregiving. The giving spirit of the holidays seems to spur the impulse sometimes to meet ideals of generosity and caring. As caregivers, we are already putting our heart and soul into helping others and giving our best efforts.

When I worked in medical offices we knew that the holidays are one of the busiest times. The stress and exhaustion that occurs when people try to heroically sacrifice themselves for others is common during the Thanksgiving to New Years weeks.

Guilt is common among caregivers, and so is wishing we could do just a little more. If you feel like this perhaps it will help to know you have plenty of company.

By the end of the holidays caregivers can be collapsing from exhaustion.

We all wish we could do more. But, just being a caregiver means you are a warm, caring person, and a very special person. There is no need to try to prove yourself further.

What can each of us, as caregivers, do to take good care of ourselves? The self-care tips are frequently listed and probably familiar to most of us. Nutrition, vitamins, exercise, social time, activities and hobbies, relaxation and stress reduction are some of the steps. Easy to say, but not always easy to do when time and money cause constraints.

Finding respite care is one of the top priorities and challenges. This can include programs from the Alzheimer's Association, the Area Agency on Aging, Adult Day Care, Shared Care, and paid Agency Caregivers or Independent Caregivers who meet the necessary criteria.

Thursday, November 29, 2007

Fisher Center for Alzheimer's Research - Says "Interact With The Afflicted Person Within His or Her Own Frame of Reference"

The Fisher Center for Alzheimer's Research Foundation, directed by Nobel Laureate Dr. Paul Greengard at The Rockefeller University, says "interact with the afflicted person within his or her own frame of reference for the world, even if it has little to do with reality." Different stages of Alzheimer's or Dementia require different approaches to interaction and communication.

When I was working at a skilled nursing facility that specialized in Alzheimers and Dementia there were three main sections in the building for the residents. Each wing was for residents at a different stage. The style of communicating was according to the stage of their illness.

(1) Early Stage. One wing had residents in the early stages of Alzheimer's or Dementia, who might be forgetful or confused sometimes, but still recognized people and places much of the time. Part of the time they might seem as if there was nothing wrong with the way the brain was functioning, and then part of the time some confusion or forgetfulness would occur.

People in the earliest stages might still be gently cued or prompted to bring them back to our usual reality when they became confused. If this did not seem to work, or it caused agitation, then we would just go with their reality.

(2) Mid-Stage. A second wing had people in the mid-stage of Alzheimer's or Dementia. In a way, this was the most challenging wing for the staff. One moment someone might be completely lucid, and perhaps later in the day, when fatigue or sundowners began, the person might be in another world.

For example, there was one resident who would be fine in the morning, but in the late afternoon she would ask for some dressy clothing, her fancy hat and a dress purse. She would want to get ready to put on her fanciest outfit to get on a plane later for "the trip."

We might say something like "OK, but let's just eat dinner first, before you go, then we'll get ready." Moment by moment the reality changes and after dinner everything would be different again.

The residents in the mid-stage wing were sometimes agitated or combative, and we learned to relate to them in their own reality, not to argue or contradict.

(3) Advanced Stage. The third wing had residents who were in advanced Alzheimer's or Dementia. They usually had severe difficulty with the ability to speak, to perform simple tasks of the activities of daily living, and to walk.

However, some could walk very well, but had severe sundowners and agitation. When they were in a sundowners episode they might walk and walk. Up and down, and all around the halls of the facility they would go, which was locked to protect them from wandering outside and getting lost.

We learned to determine what the person's reality was, and to speak and interact with each unique person by referring to his or her reality.

Wednesday, November 28, 2007

Alzheimer's Association Brain Tour - Pictures of the Brain Make It Easy for the Average Person to Understand

Understanding the effects of Alzheimer's Disease changes in the brain is made easy for everyday people who don't have medical backgrounds by the Brain Tour at the Alzheimer's Association. A series of illustrations that a layperson can understand show the difference between looking at a healthy brain and a brain with Alzheimer's. Illustration #8 shows a brain without nerve cell loss or tissue loss next to the brain with changes from Alzheimer's. A picture of healthy brain cells under a microscope is shown in illustration #10, compared with a picture of damaged, Alzheimer's brain cells.

The abnormal clusters that build up between the cells are easy to see in the Alzheimer's brain. The tangled strands in the photo of the Alzheimer's brain are also easy for a layperson to see, especially compared with the healthy brain in the microscopic picture.

Pictures of early, mild to moderate, and advanced Alzheimer's are illustrated showing the progression through different parts of the brain. The first section of photos shows brain basics, and after understanding the parts of the brain it's easy to understand which parts are affected as Alzheimer's progresses.

In the early stages "learning, memory, thinking and planning" are affected.

The Brain Tour explains that in the mild to moderate stages "speaking and understanding speech, and your sense of where your body is in relationship to objects around you," is affected.

In the mild to moderate stage alzheimer's may cause people to fail to recognize others and to have different behaviors and a changed personality.

The illustration of severe Alzheimer's shows the shrunken brain with much cell damage. At this stage the people with Alzheimer's cannot recognize others, communicate or care for themselves.

You can sign up for a free email newsletter from the Alzheimer's Association at the end of the Brain Tour.

Tuesday, November 27, 2007

Ninety-Six and Ninety-One Year Old Seniors Use Artwork to Stay Mentally Sharp and Active

Senior artists Florence Erb, age 96, and Margaret Haak, age 91, (both pictured below with their paintings), use painting with watercolors and oils to stay mentally sharp. They are both active with a social group of other senior artists, many in their 80's and 90's. Margaret Haak is proof that it is never to late to exercise the mind by learning something new. She began art and painting at the age of 69. Both senior artists said they enjoy the outlet for creative expression, the other senior friends they make at the art groups, and sharing social time with other senior artists.

Florence and Margaret are part of the art group at the Central Coast Seniors Center, San Luis Obispo, California. But, for others outside this area senior centers, clubs, and seniors classes are available everywhere.
Pictured on the left is Florence Erb, 96 with her watercolor painting of a lighthouse.
Below is a photo of Margaret Haak, 91, with her painting of an Arizona landscape.

Monday, November 26, 2007

Reverse Mortgages Explained by Specialist, Sigrid Hurn

Sigrid Hurn, of The Califonia Reverse Mortgage Company, a member of The Generation Morgage Company, recently explained the uses of reverse mortgages and answered questions at a forum. Seniors from the Central Coast Senior Center, San Luis Obispo County, California, learned from Sigrid (1) what types of reverse mortgages are available, (2) what limits there are on the amounts, (3) how to apply and what it costs, and (4) how to choose different plans for reverse mortgage income.

Seniors may use the income to pay for sudden health expenses, prescriptions, in-home caregivers, nursing home care, or for a variety of other choices. If seniors are having financial stress from mortgage payments a reverse mortgage can eliminate the monthly payments.

A reverse mortgage is a Federal Government insured loan program which provides income for senior home owners. Sigrid explained that it is not paid back until a person moves permanently out of the home.

To qualify for a reverse mortgage a senior needs to own the home, be at least 62 years old, and to be living in the home.

Sometimes a sudden illness causes a financial situation that makes getting a reverse mortgage helpful or necessary. If a large mortgage payment is causing financial problems for seniors living on fixed incomes the reverse mortgage can get rid of the mortgage payment, freeing up that money for health expenses.

Other people get reverse mortgages in order to access the cash from home equity while they are alive in order to travel, pay for grandchildren's college, or make other dreams they have come true.

For more details you can visit Sigrid Hurn's website at

Sunday, November 25, 2007

Seniors' Life Story Telling - A Chance to Communicate, Share, Understand

Seniors' life story telling gives later generations insight into what it was like ,on a day to day basis, to live through different eras and cultural changes. Understanding the different conditions of daily life that existed during a senior's childhood, 60 or 70 years ago, helps explain things that might be puzzling to someone today. For example, if you wonder why grandmother never throws anything away, it could be a habit from growing up during the Great Depression.

I know someone like this and here is his story. He is in his mid-70's now, and describes living in a tent in the California Central Valley as a child during the 1930's Great Depression. The family had come to California from the Oklahoma dustbowl. His mother had died of pneumonia and his father worked in the fields.

He remembers his father would drag a long bag for the cotton, that looped over his shoulder while he was picking. As a child he played by riding on the cotton bag as his father dragged it along the ground.

For a Christmas tree there was often a dried cotton stalk with cotton balls for decorations. Toys were blocks of wood and imagination was used to turn them into cars or tractors.

When he was about 6 years old he began working in the fields picking cotton too. School attendance was only possible between field work, and after the eighth grade he stopped attending school and helped the family survive by working in the fields full time.

This senior today has several storage buildings full of personal items that he collected throughout his lifetime. He keeps everything, and explained it's a habit from living during the Depression. Survival was hard, everything was reused, and objects were too difficult to obtain to be able to easily discard them.

I used questions and prompts to encourage him to share his story. He said he hadn't thought about it lately, but he would like a copy of the longer version I made of his story to give to his children, who haven't heard it before. Often people talk in generalities about their life history and the details of daily living don't come up.

It was easy to understand my friend's habit of being a "collector" after I heard his story. His adult children were glad to have it as part of the family history.

Saturday, November 24, 2007

Jacqueline Marcell's Book "Elder Rage, or Take My Father Please" Has Advice and Humor Too

At the website for "ElderRage - Or, Take My Father Please!" eldercare expert Jacqueline Marcell tells about the times she had to intervene when her father, who was mostly blind, and had bad hearing and memory loss, hid the car keys so he could take the car out later. He insisted he did not know where the keys were. After Jacqueline heard a clanking when he walked she found the car keys masking-taped to his leg.

Another story titled, "Midsummer's Nightmare at the Alamo" tells of the time her father came in to wake her and tell her there were two guys in the house, one wearing a coon-skin cap like Davy Crockett, and another who looked like someone from the FBI. He pointed at Jacqueline's mom and said, "There's one of them now." But when they got closer to get a better look he said, "Oh, that's no guy, that's my wife."

By the end of the story Jacqueline's Dad is back in bed. Jacqueline relates, "I went back to my bed and intensely studied the texture of the ceiling as tears streamed down the sides of my face and clogged my ears. I'd have never guessed that I'd have to be my parent's parent..."

Jacqueline has been featured on television shows such as Regis Philbin's show, and on CNN. On the website you'll see over 50 endorsements for Jacqueline and her book, as well as information about her weekly radio show and schedule of speaking engagements.

Jacqueline's site has a wealth of Alzheimer's and eldercare information. She is a caregiver advocate who understands well the situations Alzheimer's caregivers encounter, from having experienced them herself.

Friday, November 23, 2007

Alzheimer's Day Care Center - Participants Feedback Is Enthusiastic

Relief for exhausted caregivers can be obtained when a senior with Alzheimer's is able to attend a Day Care Center. For example, today's post is the story of a local Alzheimer's Day Care Center, The Santa Maria Wisdom Center, part of the Life Steps Foundation.

It is highly recommended by one of my friends whose 82 year old mother participates. Stella Carrasco, 63, is the sole caregiver for her mother, Mary Chaparro, 82, who has Alzheimer's. They are pictured in the photo on this post at a local Craft Fair. They gave me permission to write about them on the internet so that other people could read about their story.

At 9 am a special bus run by the Wisdom Center picks up Mary, in Oceano, California. Between 3:30 and 4 pm the Wisdom Center bus brings her back home.

The Wisdom Center provides breakfast, lunch and an afternoon snack for Mary. Stella said her mother enjoys getting to eat meals with a group. She said it's good for both of them to have some time apart.

The Wisdom Center is very multi-cultural, and people there represent a variety of ethnic groups. There are bilingual speakers on the staff.

Stella has had many years of being the sole caregiver for her mother. The exhaustion and isolation were serious problems, and now that her mother attends Day Care Stella has time to rest, go for walks, play the radio, and other activities that we usually take for granted.

Stella said that before her mother started the Day Care Center she was warned about facilities, but in this case there are no worries. Her mother, Mary, enjoys the Day Care people and activities and loves to go there.

Stella said everyone there is kind and respectful, and Mary enjoys the people, arts and crafts, and other group activities. The Wisdom Center is supplying some colored pencils and drawing paper for Mary, who likes colored pencils better than other mediums for drawing.Stella looks forward to getting together with friends and attending activities now that she has some relief in her caregiving schedule.

Alzheimer's Day Care is available in many areas, and you can check your phone book or the internet to local Day Care in your area.

Thursday, November 22, 2007

Caregivers Can Read Medical Weblogs - Doctors Blog About What's Really Going On

Caregivers and seniors who want to understand the issues doctors face today and what really goes on can read medblogs, short for medical blogs. At internal medicine physician and blogger Kevin Pho says "people not involved in healthcare have no idea what goes on "behind the curtain." Some of the posts have covered subjects such as "the death of primary care," "defensive medicine,""malpractice," "reimbursement," and "health care reform."

KevinMD has been featured in publications including The Wall Street Journal, British Medical Journal, and American Medical News.

He's also been interviewed on CBS News by Katie Couric.

The KevinMD Med Blog Power 8 Lists the medical blogs that were exceptional during the past week.

Many of the subjects in the Power 8 included information that would be helpful in saving money on prescriptions, understanding how emergency rooms work, and other topics useful for caregivers.

Wednesday, November 21, 2007

Caregivers and Seniors Can Find Healthy Holiday Recipes at Mayo

If you are a caregiver preparing holiday meals for seniors who have special needs, you can visit The Mayo Clinic website. Recipes in the Healthy Living section include heart healthy diets, diabetic diets, high fiber diets, low sodium diets, and more. Traditional Thanksgiving recipes that are high in carbohydrates can be redesigned to be healthier.

The Cooking Clinic section has topics such as "Recipe Makeovers: 5 Ways to Create Healthy Recipes, " "Ingredient Substitutions," and "Adjusting the Servings."

For example, instead of traditional gravy there is a recipe for "Roasted Turkey With Balsamic Vinegar Sauce."

Olive oil, rosemary and garlic are used to season the turkey while it's cooking. Instead of the usual gravy recipe you use 1 cup of balsamic vinegar, 1 cup of defatted turkey drippings, and 3 tablespoons of brown sugar.

A 5 ounce serving has 247 calories, 34 grams of protein, only 10 grams of carbohydrates, and 6 grams of fat.

The featured Healthy Living Recipes included such variety as corn tamales with avocado-tomatillo salsa, spicy red lentils, and baked apples with cherries and almonds.

With recipes from the Mayo Clinic caregivers can prepare healthy Thanksgiving and Christmas dinners.

Tuesday, November 20, 2007

Alzheimer's Sundowning - Things That Can Help

For many years I worked with caregiver agencies, and many of the clients had Alzheimer's Sundowning. I found that the things that helped were unique in each person's case. Below are descriptions of some typical situations and what worked to make things better.

One lady who had sundowning had previously wandered outside, while her husband was napping in the late afternoon. She walked downtown in a tourist area. Passing travelers saw she looked like she needed help and picked her up in their car.

She couldn't remember her name or where she lived, and they drove around for hours trying to see if anything looked familiar to her. Although she had lived in the town for decades, she did not recognize anything. Eventually someone recognized her and was able to guide them to her home.

When her husband became ill and was hospitalized, I arrived as a 24 hour stand-by-assist caregiver for a long row of days. The first afternoon I was there she became more and more agitated. Suddenly she went out the door and walked rapidly toward town, saying she had to catch a train to go home.

I caught up with her and used my cell phone to call someone with a car to come and pick us up. She accepted that I was a friend. She believed she was staying with me for awhile for company. She didn't recognize her own home.

During the next days I got a system going. We spent afternoons playing dominoes, coloring pictures, eating healthy snacks, looking at magazine pictures, doing easy jigsaw puzzles, playing easy card games, doing crossword puzzles and looking at photo albums. I might be doing most of the picture coloring but she picked out the colors. Visual activities worked well, but conversation was difficult because she could not follow it.

For the crosswords I would read the question and we'd make guesses together on the answers. For cards I would lay them out and play both sides but she watched while I explained it. Even if I was doing most of the activity she was still enjoying participating by watching.

When she lost interest I switched to another activity and so on. We put the pictures we colored up with tape. She enjoyed making more pictures with me each day.

If she was participating in an activity it kept her attention busy, so she didn't hop up and start out the door to go wandering when sundowners started in the late afternoon. Watching TV didn't work well because she didn't get involved enough with it.

I also found that having lots of lights on helped. I'm not sure if it made her feel it was earlier in the day, or if she could see better, or if it helped avoid shadows and hallucinations. But, having the house well lit helped.

Being active during the day helped her sleep better at night. We tried going out in the car for scenic drives, going for walks, and going downtown to sit and watch people and activities.

All these things helped pass the time, keep her attention, and provide enough activity, without overdoing it. By night time she was ready to rest.

Too much activity though and exhaustion or stress could make sundowners worse. It had to be a balance that was just right, but since each day is different all I could do was try my best.

Soothing music also helped. Some people liked to listen to soft spiritual music and old favorite hymns, such as "Shall We Gather At the River." Others just seemed more content and calm with any smooth, easy going music that was popular with their age group.

I would try to keep my voice and actions calm and quiet, and just go with the flow. One lady with Alzheimer's Sundowners frequently thought we were in an airport. When I was assisting her as she used her walker to head for the bathroom she would say she hoped we didn't lose her husband in the airport.

She had me tear up pieces of paper and drop them on the floor, so that her husband could follow them to find her. She was so afraid of losing him in the airport. In the morning she knew she was in her own home and recognized us. But by late afternoon Sundowners time she thought she was in an airport.

The people with Alzheimer's Sundowners will not believe you if they don't recognize their own home, but you insist that they are indeed in their home. Just going with the reality they are experiencing instead of arguing is important. Wherever they say they believe they are, that is the location and reality you go along with.

If they don't recognize their home, I've asked them to stay in the house for the night, before returning to their own home tomorrow. Usually in the morning they recognize it as their own, but when late afternoon Sundowners starts then once again they may want "to go home."

At any moment people with Alzheimer's may be completely cognizant. But you cannot make assumptions, because in the next moment that can change. Clear thinking one minute, with good memory recall, can switch to confusion with lack of memory the next minute.

Exhausted Caregivers During the Holidays Are Hidden Heroes

Caregivers often put their heart and soul into taking care of people whom they assist. During the holidays exhaustion and stress, "caregivers' syndrome," may be worse due to the extra rushing around. Preparing for festivities is fun, but it can be tiring. Recently I have had several caregivers speak to me about the added exhaustion and stress they feel at this time of the year.

I wish there was a special award to give to all the caregivers who do so much to make others lives better, and who often go without thanks and praise for all they do. Being a caregiver is very special. It's not a high status or high paying role, but in the world of nonmaterial things and goodness of heart it's at the top.

During the holidays it would be nice to go out of our way to tell caregivers they are special and wonderful. Caregivers who are on "stand by assist," meaning they cannot leave the person they assist alone, give up their own dreams, time for friends, and hobbies, because they care about others.

Isolated and sometimes forgotten, caregivers are the hidden heroes of the world today.

Monday, November 19, 2007

Seniors Can Find Mental Fitness Programs at "Sharp Brains"

Mental Fitness Programs are the specialty of "Sharp Brains." A recent post titled "Mental Fitness: 10 Myths Debunked" starts with the myth that it's "in our genes." The article says there is a 35% to 40% reduced risk of developing Alzheimer's for people who "lead mentally stimulating lives, through education, occupation and liesure activities."

Another myth is that it is costly to improve our cognitive ability. Every time we learn something new we change the structure of the brain. The article explains there is a "modification, growth or pruning of our neurons, connections called synapses." The physical characteristics of the brain change when we learn new skills, concepts or facts.

The article also says another myth is that crossword puzzles are the best way to improve our cognitive skills as we age. Dr. Daniel Gopher, Professor of Human Factors Engineering at Techion Institute of Science says, "Computer based cognitive trainers are the most effective."

Today the number of seniors using computers continues to grow, and the mental stimulation provides a good workout for the brain. I always encourage seniors who are hesitant about using computers to get involved in a learning program as one way to provide fitness training for the brain.

Sunday, November 18, 2007

American Diabetes Association Says Plan Ahead to Keep Blood Glucose Levels Down During Holiday Feasting

The American Diabetes Association offers tips for diabetics during the holiday feasting. It is a time when it's easy to stray from the special diet that a diabetic needs. The stress can also contribute to exhaustion, overeating, and changes in blood glucose levels. To prepare for the holidays the American Diabetes Association advises checking your schedules and menus in order to plan ahead.

Just yesterday a friend of mine, who is a 70 year old diabetic, mentioned she had begun celebrating the holidays and her blood suger was way up. When everyone else is partying and eating high carb foods, such as cookies, bread, pizza, cake and pies, it is easy to lose track of what you eat.

The website explains it's important to keep the fat, suger and carbohydrate counts under control in the foods that you prepare for the holidays. Traditional recipes may need to be altered or to use substitutions.

The website for the American Diabetes Association suggests getting plenty of exercise. It is tempting to spend a lot of time sitting and eating when there is so much feasting going on. The site recommends using exercise to help control blood glucose levels.

An article on the site titled "Eat Your Veggies" recommended avoiding potatoes, corn and starchy vegetables as the high carb vegetables can raise blood glucose levels. Tomatoes, carrots, squash, and green vegetables were recommended.

If you are a caregiver for a diabetic you will be preparing holiday foods. By using substitutions in the recipes you can keep the food healthy for a diabetic to consume and enjoy. There is a wealth of information on menu planning at the American Diabetes Association website to help you plan ahead.

Saturday, November 17, 2007

Senior Centers Provide Thanksgiving Gatherings - No One Needs to Be Alone During the Holidays

Senior Center gatherings provide holiday social time for people who might otherwise be alone. Holidays can be difficult for seniors who feel isolated. Those who live far away from families or who have lost touch with friends may feel the holiday blues. Senior Centers provide a place for active or frail seniors to gather and share holiday dinners.

An example of the benefits of participating in activities at a senior center is the one where I volunteer, The Central Coast Seniors Center, San Luis Obispo, California.

Close to 100 Thanksgiving Dinners were provided today by the Center, and we shared a time of friendship and family style togetherness. Seniors who live alone, senior couples whose family lives far away, or seniors who live with caregivers were all part of the group, so no one had to be alone or isolated.

Great music was provided by The Music Man, Paul Lassonde, pictured above, who croons classic favorites including country western, cool soft rock, swing, and oldies but goodies.

People who had not attended a senior center gathering before said they didn't realize we were having so much fun there.

The table where I sat had some great humorists, and I spent the dinner laughing as they tried to outdo each other with jokes. People of all ages participated, including one of my 94 year old friends.

If you, or someone whom you assist, would like to join a fun social group you can check your local phone book or the internet listings for senior centers in your area.

Friday, November 16, 2007

Hospital Impact Blog RE: 25% of People in Study Misread Prescription and Appointment Info

Dr. Marc C. Rothman writes at the Hospital Impact blog in a post titled "Healthcare Complexity: The Elephant in the Room" that an article in the Archive of Internal Medicine had details about a study of healthcare literacy. Over a period of 6 years, the authors of the article included 3500 people over the age of 65 in the study. The results were "A quarter of the folks had inadequate healthcare literacy, meaning they misread prescription bottles and appointment slips."

As one can guess this group had a higher chance of dying in the next six years. The difference between the chances of dying were 40% for the group with healthcare literacy difficulty (reading prescriptions and appointments), and ony 18% for those with good healthcare literacy.

Dr. Rothman reports in the blog that the difference was greater in those who had cardiovascular difficulties because these conditions need many "prescriptions, appointments and tests."

This highlights the importance for caregivers to keep a medication log, a daily caregiver notes diary, and a calendar to record test dates, appointments and so on.

Caregivers are non-medical. But if something seems to be puzzling, or you think an elderly person is misreading a prescription or appointment slip, you can contact the appropriate source for help.

A call or appointment with the doctor, nurse, pharmacist, therapist or other healthcare professional can provide information to clarify or explain prescriptions and what they are for. Calling to verify appoinments, and keeping a calendar listing treatments and tests is important.

If, as a caregiver, you have a question, don't hesitate to phone for information to the appropriate source, or point out the situation to a family member and/or healthcare professional who can help.

Thursday, November 15, 2007

Hospital Overbilled You? Errors? Medical Claims Advocates Review Hospital Bills

At Medical Claims Advocates you can get ideas for action when there is an error on a medical bill. At CNN Money an article titled "Five Ways to Cut Your Medical Costs" by Cybele Weisser said that errors occur in 80% of medical bills. One of the suggestions the article made is to use a Medical Claims Advocate who can review your medical bills for a percentage of the money saved. A website at the Health Rights Hotline provides Independent Assistance for Health Care Consumers, and has suggestions for when medical billing problems occur or are suspected.

An acquaintance in his mid-seventies told me today about receiving a $600 bill from a hospital this week, for three procedures, with three different dates. He had been given treatments at a hospital after he fell while fishing in a river and cracked his knee. He said he understood the treatments involved an IV drip that lasted for about an hour, and were for the purpose of delivering antibiotics to the knee.

Here are the problems. He only had one of these types of treatments. He understood that his Secure Horizons would be paying for it. He was never near the hospital on two out of the three dates.

Luckily he did not automatically write out a check for $600 to pay the bill and mail it. This morning he went to the hospital business office. After spending the morning there, it was determined that he was correct. He was really only there for the treatments once. There were no other treatments scheduled or expected.

The amounts on the bill for two more treatments could have been a typing error, if someone hit a three instead of a one, but there are two more dates with treatments listed, so a typing error does not seem likely.

The hospital determined that Secure Horizons would now be billed and that he does not personally owe anything.

If he had not scrutinized his bill and gone to the hospital billing office to wait in line, and be an advocate for himself, he would have simply written out a check for $600.

How many other people out there are paying bills that have errors like this? If the hospital actually typed in two more dates and treatments, so this is not just a typing error, what is going on? What can be done to protect seniors from paying bills with errors, or something worse (were the two extra dates typed on purpose?), like this?

I searched on the internet and found the Medical Claims Advocate site. In addition to scrutinizing all of your bills carefully, keeping dates of your treatments to compare to the bills, and going back to ask for explanations, a Medical Claims Advocate can help "screen" the bills for errors.

It's another lesson to be careful before paying medical bills.

Wednesday, November 14, 2007

Foundation for Alzheimer's and Cultural Memory Has a "Bridge"

A new approach to Alzheimer's quality of life is presented by a documentary titled "There Is a Bridge."The Foundation for Alzheimer's and Cultural Memory says "Everyone, regardless of their degree of mental sharpness, needs companionship, not only to physically survive but also to live emotionally." You can check your local listings for public television to see when it's being shown in your area.

The Chicago Memory Bridge is a project that educates junior high and high school students about Alzheimer's and Dementia and pairs them with seniors who have dementia.

The website at includes useful and interesting resources that provide insight for understanding how to cope with someone who has Alzheimer's. For example, below are a few of the articles there.

"The Human Face of Alzheimer's" is an article there by Colleen Campbell that tells the story of Ronald Reagon's experiences with Alzheimer's.

"Touch, A Fundamental Aspect of Communication with Older People Experiencing Dementia" by Madeline Gleeson and Fiona Timmons explains why touch is so important.

"Celebrating Senior Storytelling" by Gene Mitchell explains using storytelling to use imagination and build relationships.

Tuesday, November 13, 2007

Alzheimer's Society - More New Evidence Fish and Vegetables Prevent Dementia

Today the BBC News has an article titled "Healthy Diet Cuts Dementia Risk," subtitled "More evidence that a diet rich in oily fish and vegetables can reduce the chances of dementia later in life has been uncovered by scientists."

The Mediterranean Diet has long been known to help protect against dementia. Several new studies showed beta-carotene, which contains anti-oxidents, helps the brain avoid damage.

The article explains a study with 8,000 participants. The ones who ate a diet high in omega-3, an oil found in fish, had a higher percentage of avoiding dementia. People who ate fish once per week had a 40% less chance of dementia during the four years of the study. Eating fruit and vegetables reduced dementia risk by 35%.

Another study followed 4,000 participants for 18 years. Half of the participants who took beta-carotene, the chemical that gives carrots their color. The participants who took beta-carotene scored much higher on mental tests.

Monday, November 12, 2007

National Memory Screening Day Is November 13, 2007 - The First Step Towards Getting Help

National Memory Screening Day is tomorrow, November 13, 2007. Spearheaded by the Alzheimer's Foundation of America, and it is now presented as a shared effort by a group of organizations. If someone you know has any of the warning signs of memory issues this is the chance to get more information. Below are some of the signs listed at the Alzheimer's Foundation of America that it is time for a memory screening.

  • Forgetfulness
  • Difficulty concentrating
  • Difficulty performing tasks
  • Difficulty remembering words or names
  • Forgetting where you are
  • Misplacing things
  • Getting lost in a familiar place
  • Mood or personality changes

If someone you know has been avoiding getting a memory screening then Nov. 13 provides a good opportunity to get one without actually having to go to the doctor's office. Screenings are held in a variety of locations and health professionals from a number of related careers provide the memory screening.

You can go to the to look for the locations of memory screening sites. You can also call your local Seniors' Center as they often have this type of information and may well be participating in the screening.

The screening is held in a private setting. Questions or tasks test memory, language, thinking, and other mental skills. The results are confidential.

According to the Alzheimer's Foundation other warning signs of dementia can include the following.

Relying on memory helpers

Depression or irritability

Seeing or hearing things

The site explains that depression, vitamin deficiencies or thyroid problems can also cause memory issues and that after a screening the next step is to see a doctor for further tests.

Sunday, November 11, 2007

National Home Care and National Hospice Month is November

November is National Home Care and National Hospice Month, and an article at Medical News Today says that over "7.5 million American's receive daily assistance from nearly one million caregivers." Val Halamandaris, president of the National Association for Home Care and Hospice, says , "Dedicated people spend their days taking care of those who can no longer care for themselves, making them silent heroes who should be recognized and thanked all year round."

The article, dated November 9, 2007, provides tips to help family members know when it's time to get help from Home Care or Hospice.

It also provides questions to ask when choosing a home care provider.

At the home page for the National Association for Home Care and Hospice you will find information on legislation, caregiving, education, and other consumer information.

The opening page has a quote from Mother Theresa, "Yesterday has gone, Tomorrow has not yet come, We have only today, Let us begin."

There are suggestions for ways to celebrate Home Care and Hospice this month, including recognizing the physical and emotional support that dedicated home care workers provide for those who can no longer take care of themselves alone.

Saturday, November 10, 2007

Alzheimer's Association "Redefining the Quality of Life"

"Alzheimer's Awareness - Redefining the Quality of Life," November 2007, has a series of articles including "Chemistry in Our Daily Life," "Life Enrichment," "Music Therapy," "Early Stage Support Groups," "Would Care Management Help?," and "Getting What You Need."

Sara Bartlett, Caregiver Consultant, Alzheimer's Association, San Luis Obispo Office, writes "There is hope on the horizon, with nine drugs for Alzheimer's currently in clinical trials and advances in diagnostic tools." Her article, "Who We Are, What We Do," provides an overview of the Alzheimer's Association.

Below is a list of services available through the Association.

(1) Client and Family consultations in the office or home
(2) Assessment to ascertain the needs of family
(3) Long term care planning
(4) Information and referral to resources in the community
(5) Education and training tailored to the family's individual needs
(6) Practical tools for care-giving
(7) Current information on the disease
(8) Suggestions for caregiver's self-care
(9) Outreach to the community
(10)Support groups for family members, caregivers, and those with Alzheimer's
(11) Safe Return Program for identifying those with dementias that become lost
(12) Respite care Funds to help caregivers take care of themselves
(13) Services available in Spanish or English
(14) Resource library of books, videos and journals

The supplement "Alzheimer's Awareness - Redefining the Quality of Life," appeared as a supplement in "The Tribune" of San Luis Obispo County, California.

For more information you can locate your nearest Alzheimer's Association office by going to the website at

Thursday, November 8, 2007

Candles of Care for Alzheimer's - Photos, A Day of Caring

The National Commemorative Candle of Care Lighting Ceremony for Alzheimer's, sponsored by the Alzheimer's Foundation of America was celebrated today. Shining a light on Alzheimer's, and related illnesses, from coast to coast, people everywhere shared a day of caring.

At the local Central Coast Senior's Center, San Luis Obispo, California, there were 27 candles lit, people gathered in a circle, shared prayers and memories, and Kristi Gott provided a speech with information about Alzheimer's and research. For the speech Kristi used quotations for emphasis from Eric Hall, CEO and founder of the Alzheimer's Foundation of America, and from Carol Bradley Bursack, author of Minding Our Elders, both of whom write blogs at

After Kristi's prayer of thanks and hope for a cure, many people offered their prayers and memories also.

Nearby, a local seniors' "Expo 55" was held, sponsored by the Arroyo Grande Community Hospital, Arroyo Grande Chamber of Commerce, and Community Health Centers. The Central Coast Seniors had a Candle Lighting Ceremony at the beginning of the day at their exhibit and kept a Candle of Care lit all day.

At both ceremonies resources were provided where people can get information about Alzheimer's, dementia, and related diseases.

Pictured on the left is Central Coast Seniors Center manager Betty Milne at the "Expo 55+", with brochures about Alzheimer's and a Candle of Care burning brightly.

Candles of Care for Alzheimer's Today - Hopes, Prayers and Memories

The Alzheimer's Foundation of America sponsors the National Commemorative Candle Lighting that will be held today. People will be united with inspirational thoughts, hopes for a cure, prayers, and memories of loved ones whose lives have been affected by Alzheimer's.

Our local site for the ceremony is The Central Coast Seniors Center, Oceano, California. During the lighting of candles we are going to join hands and think of the Candles of Care being lit everywhere for Alzheimer's. Our thoughts, words and prayers will be with all those whose lives have been touched by Alzheimer’s or related illnesses, and we will join together with our hopes for a cure.

Locally we will also have a Candle of Care for Alzheimer's burning at an Expo for Seniors that is being held today, and there will be a gathering at the South County Regional Center, Arroyo Grande as well.

Writer Carol Bursack, author of Minding Our Elders, said it well in her blog at titled "Speak Out About Alzheimer's During November!" She says "Whether you as a caregiver have been dealing with this heartbreaking disease for one day or 20 years, I encourage you to share your story. Speak to friends, neighbors, colleagues, strangers."

Eric Hall, founder and CEO of the Alzheimer's Foundation of America writes this week at and says "A lot of awareness-raising goes on during these next few weeks. The media, thankfully, jumps on the issues more. Legislators become more cognizant of the extent and enormity of Alzheimer's disease and caregiving. Those in the throes of the disease and/or caregiving gain recognition. Others become educated. Many are drawn into the cause and become dedicated advocates.

Today's blog will end with a prayer for Alzheimer's, "Dear God, we hold the memories of those whose lives have been effected by Alzheimer's close to our hearts. We thank you for the joy they brought to us, and for the progress that has been made in Alzheimer's research. We join as one to pray for a cure today."

Wednesday, November 7, 2007

Caregivers Who Are Grieving Can Turn to Hospice for Grief Support

  • In 1996 when my husband died from cancer, I was not aware of the many types of bereavement groups, educational activities, and counseling that are available from Hospice. Today, I'm very familiar with our local Hospice in San Luis Obispo , California, both from my own experience and from my work.

    Family members, caregivers and friends who are grieving can go to the website for the Hospice Foundation to locate a Hospice nearby for grief support. Hospice of San Luis Obispo County is located at 1304 Pacific Street, San Luis Obispo, CA 93401, and the phone number is (805) 544-2266 or (805) 434-1164. The website is at

    The variety of grief support programs range from special events to prepare for getting through the holidays without a loved one, to multi-cultural events such as Dia De Los Muertos, which is Mexico's Day of the Dead, and is a little bit similar to a different version of All Saints Day.

    The Hospice of San Luis Obispo County is in a beautiful, large, old, craftsman style house, almost a mansion, and the warmth and friendliness of bygone days seems to provide an uplift when you go in the door. A variety of poetry books sit on an antique table as you walk over to the receptionist. A wide range of original art representing different ethnic backgrounds decorates the walls, and it's the kind of place where everyone feels comfortable.

    There is no charge for attending Grief Groups or for individual counseling, but a donation to show gratitude is always welcome.

    The grief groups include general grief groups for walk-ins, widow and widower groups, pet grief groups, and other specialized groups. Counselors are available to provide individual grief counseling as well.

    A notebook full of helpful leaflets about grieving is provided and across from the receptionist is a library full of related books that you can check out.

    One of the leaflets is titled "The After Loss Credo" and starts with the following.

    "I need to talk about my loss.
    I may often need to tell you what happened or to ask you why it happened.
    Each time I discuss my loss I am helping myself...
    I need to know that you care about me.
    I need to feel your touch, your hugs,
    I need you just to be with me."

    Another leaflet is titled "Please, See Me Through My Tears" and begins like this.

    "You asked, "How are you doing?" As I told you, tears came to my eyes. You immediately began to talk again, your eyes looked away from me, your speech picked up, and all the attention you had given me went away."

    Features and expressions of grief are described elsewhere, including physical symptoms/sensations, emotional responses, cognitive responses, and behaviors.

    Steps of grieving, grief rituals, and coping with grief are titles of other topics covered in the notebook packet. One page is titled, "There is no timetable for recovering from grief." It's important to understand that each person's grief is different. No two people will grieve alike.

    Hospice Grief Programs provide a place where it is safe for bereaved people to talk and express their feelings with others who are grieving. It's a safe haven, and a place to share. Hearing how others are coping can help each individual navigate the grief process.

Monday, November 5, 2007

Alzheimer's Consultant and Caregiver's Guide Provide Resources

"What Now? Caregiver's Quick Guide and Resource Manual" from the Alzheimer's Association enables caregivers to attend "Caregiver University." I learned more about it when I met with Alzheimer's Consultant Jacque Murray (pictured) of the California Central Coast Chapter. Jacque provides consultations in a variety of settings and makes appointments for in-home consultations as well.

The guide is just one of the many resources you can find at the Alzheimer's Association.

A look at Section 1 of the book shows that among many topics the following are covered.

"(1) What is Alzheimer's Disease (2) The Dementia Umbrella (3) Medical and Scientific Basics (4) Get a Complete Diagnosis (5) Is It Alzheimer's Disease or...(6) Are All Person's With Alzheimer's Disease Alike (7) What Can I Expect From My Loved One (8) EarlyOnset Alzheimer's Disease (9) A Reminder About the Symptoms and Stages (10) The Three Stages."

Other Sections cover such topics as "Putting Legal and Financial Affairs in Order", "Learning to Manage Challenging Behaviors," and "Hiring and Managing In-Home Caregivers."

The book is available to Alzheimer's caregivers, along with an extensive group of other helpful material about Alzheimer's and caregiving.

Contact your local Alzheimer's Association for information about having a consultant come to your home and about obtaining Alzheimer's information.

Sunday, November 4, 2007

Arts and Crafts Fair at Senior Center - Friends, Fun and Creativity

Arts and Crafts Fairs provide seniors, their families, and their caregivers with a chance to mingle, socialize and set up a booth or table for selling their creative handmade items. I visited the Central Coast Seniors Center Craft Fair and Bake Sale on Saturday, November 3, 2007.

The details and imagination that went into the decorated trinket boxes, handpainted mirror frames, elaborate woodcarving and other items were beautiful. It was a reminder that store bought items just don't have the same vintage quality that handcrafted items do. A handmade heirloom is always so special.

Pictured at the Craft Fair is Twila Witt, wearing a hand-decorated sweatshirt, and holding several of her "wearable art" hand-painted tops. Twila's display was an example of the huge variety that some people create. Some of her crafts include sand-painting, crocheting baskets, embroidering pillows, and crocheting trim on handmade dishtowels. She also exhibits are many small and large craft shows throughout the central coast.

Woodcarving, handmade jewelry, scented sachets, bumpy boucle' knit scarves, hand-crafted Christmas ornaments, and homemade candles were some of the other crafts.

The seniors enjoy creating these beautiful items at home and many attend arts and crafts classes at the Central Coast Senior Center. The opportunity to join up with others who have a shared interest provides for a way to meet friends. Family members and caregivers often participate also, and the crafts provide a fun group activity.

Saturday, November 3, 2007

An Alzheimer's Family Caregiver Speaks on Isolation, Exhaustion and Stress

In honor of National Family Caregivers Month and National Alzheimer's Disease Awareness Month today's blog post is dedicated to family caregivers and people whose lives have been touched by Alzheimer's.

In the picture are two ladies whose story highlights this month's messages, and who represent so many others who are in similar circumstances.

Stella Carrasco, on the left in the picture, is a 63 year old family caregiver who is going through tests for a liver transplant. For the last four years she has been the sole caregiver for her mother, Mary Chaparro, 82, who has Alzheimer's. Stella gave permission for her story to be part of this blog, and she hopes it will help others to understand what a situation like hers is like. In the photo Stella and Mary are at a local Craft Fair, held today, displaying some of the beautiful items they create by hand at home.

There is no caregiver relief or support because Mary, due to the Alzheimer's symptoms, rejects the relief caregivers they've tried. "Mom has been so against it," Stella said. "She doesn't trust anybody, she's always thinking they are taking her money, then she hides, it, and accuses me of taking the money."

Stella is with her mom 24 hours a day because Mary cannot be left alone due to the Alzheimer's Disease. They tried having some outside help, but Stella explained the caregivers who came in were young and inexperienced, and did not understand Alzheimer's Disease or communication with someone who has it.

Stella explained, "What hurts me to no end is when she accuses me of taking her money. It brings me to tears." She said that when exhaustion and stress get to be too much she sleeps all day, but keeps the door to her room open in order to hear her mom and wake up if she is needed.

She said, "Being at the craft fair at the Central Coast Seniors Center today is the first real outing since 2003. On Sundays someone takes Mom to Mass and I can rest for awhile. Otherwise we are at home working on crafts. I don't have anybody I can really talk to. I don't have a social life. I am isolated."

Stella and I met when I was taking digitial photos of a Craft Fair and Bake Sale for the Central Coast Seniors Center site. She explained about her mother, and we sat down for a visit. Stella donated a beautiful handmade afghan for the raffle today. The exquisite heirloom quality handmade crafts that she and her mother make use many vintage items as decoration.

What can be done? The manager of the Central Coast Seniors Center, and a local church pastor, and I gave Stella our phone numbers and took her number. She won't be alone because we will call her, she can call us, and we will get together to visit. We are working on some ideas for some relief and support for Stella.

Betty Milne, the manager at the Central Coast Seniors Center, is checking the schedule to see when we can schedule a caregivers day out with lunch and a video on the large screen at the center. Stella said a humorous movie would help reduce stress. She will bring her mother to enjoy the movie too. We exchanged hugs, and I am so happy to have met such a dedicated caregiver and friend.

Additionally, we are getting into contact with the local Area Agency on Aging and the local Alzheimer's Association, as well as resources at San Luis Seniors. As we progress with support more updates will be available.

Friday, November 2, 2007

National Alzheimer's Disease Awareness Month - Light a Candle of Care

This month is National Alzheimer's Awareness Month and the Alzheimer's Foundation of America has some special events planned. On November 8, 2007 there will be The National Commemorative Candle Lighting, for lighting a "Candle of Care." The following week, on November 13, 2007 is National Memory Screening Day.

At the website for the Alzheimer's Foundation of America you can find information about joining the Dementia Care Professionals of America, educational tools, and a wealth of information.

The Alzheimer's Foundation of American Quilt to Remember is a project that includes quilt panels made by contributors. Each panel tells a special story about someone whose life was touched in some way by Alzheimer's.

At The National Alzheimer's Association you can find steps to take to increase Alzheimer's Awareness this month, including donating, joining a memory walk, fundraising, and becoming an Alzheimer's Champion. You can sign up to be part of the National Alzheimer's Advocate Network to help create a world without Alzheimer's.

For a group of expert's blogs, resources, news, and shareposts you can go to Our Alzheimer's , which is part of Health Central. The daily updates from a variety of experts will keep you informed. Nationally known Caregiver Expert and author of Minding Our Elders, Carol Bradley Bursack provides insight gained from experience.

Along with Carol Bursack, you'll find the panel of experts who write at the Our Alzheimer's site includes the following.

(1) Dorian Martin, an Alzheimer's Caregiver for her mother and an expert in communications and education

(2) Leah, a former schoolteacher who has Vascular Dementia

(3) Jacqueline Marcell, nationally known expert, speaker and author of the book Elder Rage,

(4) Craig Stoltz, Health Journalist, who spent six years as editor of The Washington Post Health Section,

(5) Eric J. Hall, founder and CEO of the Alzheimer's Foundation of America

(6) David Roeltgen, M.D. , Neurologist and Professor with 20 years of experience

(7) Alzheimer's Foundation of America Social Services Team, which is available for counseling and referrals

There are so many excellent sites you can visit, and more of them will be covered in later posts. On the left side of this blog is a list of caregivers blogs, and reading these first person accounts is a way to share and learn along with the Alzheimer's community online.

Thursday, November 1, 2007

National Family Caregivers Month - A Time to Speak Up for Caregiver Rights

It is Day One of National Family Caregivers Month, November, 2007. At The National Family Caregivers Association you can find ten steps to take to celebrate and speak up for caregivers. The organization encourages "caregivers to take action to improve their own health and well being by speaking up for their rights." Ten ways to celebrate and participate are listed, beginning with an invitation to sign up for free to join the National Family Caregivers Association.

The benefits of membership include receiving free information and support, lessening the isolation, and providing skills for finding community help or acting in healthcare settings.

Other steps you can take include identifying yourself as caregiver when speaking to others, protecting your health, going to a support group, and asking for help when you need it. Striving for flexibility with balancing work and time that you need is another step caregivers can take.

You can also wear a personal medical ID tag identifying yourself as a caregiver so that if something happens to you, others will know that the person you care for needs help.

The site recommends reading the book "A Family Caregiver Speaks Up - It Doesn't Have to Be This Hard" by cofounder Susan Mintz. Additionally, caregivers can let their elected officials know your opinions and contact media to advocate for caregivers.