I ran across this factsheet on Dementia from the Milton S Hershey Medical Center. The section entitled, What are the Symptoms is particularly interesting.
Source Milton S Hershey Medical Center
Dementia
What is it?
Dementia is the gradual deterioration of mental functioning, such as concentration, memory, and judgment, which affects a person’s ability to perform normal daily activities.
Who gets it?
Dementia occurs primarily in people who are over the age of 65, or in those with an injury or disease that affects brain function. While dementia is most commonly seen in the elderly, it is not a normal consequence of the aging process.
What causes it?
Dementia is caused by the death of brain cells. Brain cells can be destroyed by brain diseases, such as Alzheimer’s disease, or strokes (called vascular or multi-infarct dementia), which decrease blood flow to the brain. Lewy body dementia is another common cause attributed to changes in brain tissue. Other causes can include AIDS, high fever, dehydration, hydrocephalus, systemic lupus erythematosus, Lyme disease, long-term drug or alcohol abuse, vitamin deficiencies/poor nutrition, hypothyroidism or hypercalcemia, multiple sclerosis, brain tumor, or diseases such as Pick’s, Parkinson's, Creutzfeldt-Jakob, or Huntington's. Dementia can also result from a head injury that causes hemorrhaging in the brain or a reaction to a medication.
What are the symptoms?
In most cases, the symptoms of dementia occur gradually, over a period of years. Symptoms of dementia caused by injury or stroke occur more abruptly. Difficulties often begin with memory, progressing from simple forgetfulness to the inability to remember directions, recent events, and familiar faces and names. Other symptoms include difficulty with spoken communication, personality changes, problems with abstract thinking, poor personal hygiene, trouble sleeping, and poor judgment and decision making. Dementia is extremely frustrating for the patient, especially in the early stages when he or she is aware of the deficiencies it causes. People with dementia are likely to lash out at those around them, either out of frustration or because their difficulty with understanding makes them misinterpret the actions of others. They become extremely confused and anxious when in unfamiliar surroundings or with any change in routine. They may begin a task, such as cooking, then wander away aimlessly and completely forget what they had been doing. Dementia is often accompanied by depression and delirium, which is characterized by an inability to pay attention, fluctuating consciousness, hallucinations, paranoia, and delusions. People in advanced stages of dementia lose all control of bodily functions and are completely dependent upon others.
How is it diagnosed?
Dementia is diagnosed through a study of the patient’s medical history and a complete physical and neurological exam. The doctor will speak with those close to the patient to document a pattern of behavior. He or she will also evaluate the patient’s mental functioning with tests of mental status, such as those that require the patient to recall words, lists of objects, names of objects, and recent events. Diagnostic tests, such as blood tests, x-rays, or magnetic resonance imaging (MRI), positron emission tomography (PET), or computed tomography (CT) scans, can help determine the cause of the dementia.
What is the treatment?
In some instances, treating the cause of dementia may successfully reverse some or all of the symptoms. This is the case when the cause is related to a vitamin/nutritional deficiency, tumor, alcohol or drug abuse, reaction to a medication, or hormonal disorder. When dementia is related to an irreversible destruction of brain tissue, such as with Alzheimer’s disease, Lewy body dementia, or multiple strokes, treatment involves improving the patient’s quality of life as much as possible. This includes maintaining a stable, safe, supportive environment and providing constant supervision. While this may be done in the home, people in the advanced stages of dementia may require round-the-clock care in a long-term healthcare facility. It is important to provide the patient with structured activities and avoid disruptions to his or her daily routine. Many patients enjoy therapeutic activities, such as crafts or games, designed specifically for people with dementia. Some medications, such as donepezil and tacrine, have been effective in improving the mental functions of those in the beginning stages of dementia. Patients with hallucinations and delusions may also be treated with antipsychotic drugs, while antidepressant medications are used to treat depression.
Self-care tips
There is currently no known way to prevent dementia associated with Alzheimer's disease. You can decrease your risk of dementia associated with stroke by maintaining a healthy lifestyle, following a heart-healthy diet, and controlling high blood pressure and high cholesterol. Healthy lifestyles, including not smoking and not abusing drugs and alcohol, go a long way in keeping most people in good health. Caring for a person with dementia is stressful. It is important to learn all you can about the disease, seek the help of support groups, and find a responsible caregiver who can give you a break when needed. There are daycare programs specifically designed for patients with dementia that are good for the patient and the family.
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This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.
Tuesday, November 28, 2006
Sunday, November 26, 2006
Americans Fear Alzheimer’s More Than Heart Disease, Diabetes or Stroke
A recent study by the MetLife Foundation found that Americans fear getting Alzheimer's disease more than heart disease, stroke, or diabetes. Alzheimer's ranks second in the minds of American's only to cancer.
MetLife Survey Highlights
The Complete MetLife Survey on Alzheimer's: What America Thinks (36 pages)
The Major Findings of the Study included the following:
Finding 1: Americans fear Alzheimer’s disease.
Finding 2: Americans Know Little or Nothing about Alzheimer’s.
Finding 3: One-third of Americans say they have direct experience with Alzheimer’s disease.
Finding 4: Most Americans are concerned that they will be responsible at some point for someone with Alzheimer’s disease.
Finding 5: Most Americans recognize the need to create a plan to address the possibility of Alzheimer’s disease, but very few have taken steps to do so.
Conclusion
Americans fear Alzheimer’s and the impact that it could have on their lives in the coming years. And although they may recognize the need to look toward the future, the majority hasn’t started making plans.
The downside of living longer has a high price: Nearly 50 percent of those who are 85 or older are affected, and the rate of Alzheimer’s increases exponentially every five years past the age of 65. And with the aging of America’s population these numbers are sure to become even more dramatic in the future, making it imperative that individuals and institutions plan for the future.
The growing number of people with Alzheimer’s will have an impact on every part of society. The vast majority of people know that this disease may someday affect them, either directly or as a caregiver. In addition, many already know a family member or friend who has Alzheimer’s. They strongly support the concept of planning now to cope with the life-changing impact of the
disease – at least in theory.
Despite widespread agreement, few have taken steps to prepare for the possibility of developing Alzheimer’s. Only a few have a solid understanding of the disease. The overwhelming majorityhas done nothing to plan.
The survey reveals a mismatch between fear of Alzheimer’s and acting on that fear to prepare for the future. The findings from this survey suggest that there is an opportunity to build awareness and help bridge the gaps that were identified in knowledge and behavior. Americans should learn all they can about the disease that will touch so many of us and plan for the future.
Tuesday, November 21, 2006
Benefits Check Up for Seniors
I recently stumbled on to BenefitsCheckUp offered by the National Council on Aging. All you need to do is fill out a short questionairre and the program identifies private and/or government programs that help pay for prescription drugs, health care, utilities, and other needs of seniors. Once you complete the questionairre the computer instantly generates a list of agencies and contact information that fit your profile. I was able to identify a real estate exemption that will save my mother more than $330 annually.
The questionairre is easy to understand and to fill out. It generates the results instantly. Since it check across all kinds of federal, state and local agencies it saves you the time of calling each one or filling out seperate questionairres. In terms of time it will save you many hours and it also provides contact information that was of great value to me.
This program makes it very easy to determine if you are eligible for additional Medicare or Medicaid benefits. It also determines if their are state or local tax exemptions or help with bills such as electricity.
Here is the link to BenefitsCheckUp
If you find this of value please pass on the link or feel free to send others to this blog.
Bobby
The CareGiver Blog
Robert T DeMarco
AllAmerican Senior Care Weblog
Senior Care
Elder Care
CareGiver
Alzheimer’s
The questionairre is easy to understand and to fill out. It generates the results instantly. Since it check across all kinds of federal, state and local agencies it saves you the time of calling each one or filling out seperate questionairres. In terms of time it will save you many hours and it also provides contact information that was of great value to me.
This program makes it very easy to determine if you are eligible for additional Medicare or Medicaid benefits. It also determines if their are state or local tax exemptions or help with bills such as electricity.
Here is the link to BenefitsCheckUp
If you find this of value please pass on the link or feel free to send others to this blog.
Bobby
The CareGiver Blog
Robert T DeMarco
AllAmerican Senior Care Weblog
Senior Care
Elder Care
CareGiver
Alzheimer’s
Saturday, November 18, 2006
Huperzine A Factsheet (Alzheimer's)
I recently read about Huperzine A. The following page contains a fact sheet about the herb. Huperzine A may have cognition-enhancing activity in some.
Source Huperzine A
TRADE NAMES
Huperzine A is available from numerous manufacturers generically. Branded products include Memorall (PharmAssure), Huperzine Rx-Brain (Nature's Plus).
DESCRIPTION
Huperzine A is a plant alkaloid derived from the Chinese club moss plant, Huperzia serrata, which is a member of the Lycopodium species. Huperzia serrata has been used in Chinese folk medicine for the treatment of fevers and inflammation.
Huperzine A has been found to have acetylcholinesterase activity. Huperzine B, also derived from Huperzia serrata, is a much less potent acetylcholinesterase inhibitor. Natural huperzine A is a chiral molecule also called L-huperzine A or (-)-huperzine A. Synthetic huperzine A is a racemic mixture called (±)-huperzine A. Huperzine A is also known as HUP, hup A and selagine. In Chinese medicine, the extract of Huperzia serrata is known as Chien Tseng Ta and shuangyiping. Huperzine A derivatives are being developed for pharmaceutical application.
ACTIONS AND PHARMACOLOGY ACTIONS
Huperzine A may have cognition-enhancing activity in some.
MECHANISM OF ACTION
Alzheimer's disease is a neurodegenerative disorder associated with neuritic plaques that affect the cerebral cortex, amygdala and hippocampus. There is also neurotransmission damage in the brain. One of the major functional deficits in Alzheimer's disease is a hypofunction of cholinergic neurons. This leads to the cholinergic hypothesis of Alzheimer's disease and the rationale for strategies to increase acetylcholine in the brains of Alzheimer's disease patients. Two FDA-approved drugs for the treatment of Alzheimer's disease, tacrine and donepezil, are acetylcholinesterase inhibitors.
Huperzine A is also an acetylcholinesterase inhibitor and has been found to increase acetylcholine levels in the rat brain following its administration. It also increases norepinephrine and dopamine, but not serotonin levels. The natural L or (-)-huperzine A is approximately three times more potent than the racemic or (±)-huperzine A in vitro.
PHARMACOKINETICS
There are limited pharmacokinetic studies with huperzine A. It appears that huperzine A is rapidly absorbed from the gastrointestinal tract and transported to the liver via the portal circulation. Some first-pass metabolism takes place in the liver, and huperzine A and its metabolites are distributed widely in the body, including to the brain. Following ingestion, the time to reach peak blood level is approximately 80 minutes.
INDICATIONS AND USAGE
Huperzine A has potent pharmacological effects and, particularly since long-term safety has not been determined, it should only be used with medical supervision. It may have some effectiveness in Alzheimer's disease and age-related memory impairment. It has been used to treat fever and some inflammatory disorders, but there is no credible scientific evidence to support these uses.
RESEARCH SUMMARY
Numerous studies, most of them from China, suggest that huperzine A may be as effective as the drugs tacrine and donepezil in Alzheimer's disease. This is not so surprising since in vitro and animal model tests have demonstrated that huperzine A effectively inhibits acetylcholinesterase, an enzyme that catalyzes acetylcholine breakdown. Tacrine and donepezil work in the same way to conserve acetylcholine in the brain--the mode by which they presumptively improve memory and cognition in those with Alzheimer's and age-related cognitive impairment. Huperzine A may prove superior to tacrine (dose-limited due to its hepatotoxicity) if long-range studies, yet to be conducted, demonstrate its safety.
In one double-blind, randomized study, huperzine A, in injectable form, was tested against a saline control in 56 patients with multi-infarct dementia or senile dementia and in 104 patients with senile and pre-senile simple memory disorders. Huperzine A produced significant positive effects as measured by the Wechsler Memory Scale. Dizziness was experienced by a few of the huperzine A-treated patients.
In another study, this one multicenter, double-blind, placebo-controlled and randomized, 50 subjects with Alzheimer's disease were given huperzine A or placebo for eight weeks. Significant improvement was noted in 58 percent of the patients in terms of memory, cognitive and behavioral functions. Research is ongoing.
CONTRAINDICATIONS, PRECAUTIONS, ADVERSE REACTIONS CONTRAINDICATIONS
None known.
PRECAUTIONS
Huperzine A should be avoided by children, pregnant women and nursing mothers.
Because of possible adverse effects in those with seizure disorders, cardiac arrhythmias and asthma, those with these disorders should avoid huperzine A. Those with irritable bowel disease, inflammatory bowel disease and malabsorption syndromes should avoid huperzine A.
ADVERSE REACTIONS
Adverse effects reported with huperzine A include gastrointestinal effects, such as nausea and diarrhea, sweating, blurred vision, fasciculations and dizziness. Possible adverse effects include vomiting, cramping, bronchospasm, bradycardia, arrhythmias, seizures, urinary incontinence, increased urination and hypersalivation.
INTERACTIONS DRUGS
Acetylcholinesterase Inhibitors: Use of huperzine A along with the acetylcholinesterase inhibitors donepezil or tacrine may produce additive effects, including additive adverse effects. Other acetylcholinesterase inhibitors include neostigmine, physostigmine and pyridostigmine, and use of these agents along with huperzine A may produce additive effects, including additive adverse effects.
Cholinergic Drugs: Use of huperzine A along with cholinergic drugs, such as bethanechol, may produce additive effects, including additive adverse effects.
NUTRITIONAL SUPPLEMENTS
Use of huperzine A with choline, phosphatidylcholine, CDP-choline and L-alpha-glycerylphosphorylcholine hypothetically might produce additive effects, including additive adverse effects.
OVERDOSAGE
There are no reports of overdosage with huperzine A.
DOSAGE AND ADMINISTRATION
There are various forms of huperzine A available, including extracts of Huperzia serrata, natural (-)-huperzine A and synthetic racemic (±)-huperzine A. Natural (-)-huperzine A is approximately three times more potent than the synthetic racemic mixture. The doses of natural (-)-huperzine A used in clinical studies ranged from 60 micrograms to 200 micrograms daily. Huperzine A should only be used with a physician's recommendation and monitoring.
HOW SUPPLIED
Capsules — 50 mcg
Tablets — 50 mcg
LITERATURE
Cheng DH, Tang XC. Comparative studies of huperzine A, E-2020 and tacrine on behavior and cholinesterase activities. Pharmacol Biochem Behav. 1998; 60:377-386.
Cheng DH, Ren H, Tang XC. Huperzine A, a novel promising acetylcholinesterase inhibitor. Neuroreport. 1996; 8:97-101.
Quian BC, Wang M, Zhou ZF, et al. Pharmacokinetics of tablet huperzine A in six volunteers. Chung Kuo Yao Li Hsueh Pao. 1995; 16:396-398.
Tang XC, Kindel GH, Kozikowski AP, Hanin I. Comparison of the effects of natural and synthetic huperzine A on rat brain cholinergic function in vitro and in vivo. J Ethnopharmacol. 1994; 44:147-155.
Xiong ZQ, Tang XC. Effect of huperzine A, a novel acetylcholinesterase inhibitor, on radial maze performance in rats. Pharmacol Biochem Behav. 1995; 51:415-419.
Xu SS, Gao ZX, Weng Z, et al. Efficacy of tablet huperzine-A on memory, cognition and behavior in Alzheimer's disease. Chung Kuo Yao Li Hsueh Pao. 1995; 16:391-395.
Ye JW, Cai JX, Wang LM, Tang XC. Improving effects of huperzine A on spatial working memory in aged monkeys and young adult monkeys with experimental cognitive impairment. J Pharmacol Exp Ther. 1999; 288:814-819.
Zhang RW, Tang XC, Han YY, et al. Drug evaluation of huperzine A in the treatment of senile memory disorders. [Article in Chinese] Chung Kuo Yao Li Hsueh Pao. 1991; 12:250-252.
Senior Care
Elder Care
CareGiver
Alzheimer’s
Source Huperzine A
TRADE NAMES
Huperzine A is available from numerous manufacturers generically. Branded products include Memorall (PharmAssure), Huperzine Rx-Brain (Nature's Plus).
DESCRIPTION
Huperzine A is a plant alkaloid derived from the Chinese club moss plant, Huperzia serrata, which is a member of the Lycopodium species. Huperzia serrata has been used in Chinese folk medicine for the treatment of fevers and inflammation.
Huperzine A has been found to have acetylcholinesterase activity. Huperzine B, also derived from Huperzia serrata, is a much less potent acetylcholinesterase inhibitor. Natural huperzine A is a chiral molecule also called L-huperzine A or (-)-huperzine A. Synthetic huperzine A is a racemic mixture called (±)-huperzine A. Huperzine A is also known as HUP, hup A and selagine. In Chinese medicine, the extract of Huperzia serrata is known as Chien Tseng Ta and shuangyiping. Huperzine A derivatives are being developed for pharmaceutical application.
ACTIONS AND PHARMACOLOGY ACTIONS
Huperzine A may have cognition-enhancing activity in some.
MECHANISM OF ACTION
Alzheimer's disease is a neurodegenerative disorder associated with neuritic plaques that affect the cerebral cortex, amygdala and hippocampus. There is also neurotransmission damage in the brain. One of the major functional deficits in Alzheimer's disease is a hypofunction of cholinergic neurons. This leads to the cholinergic hypothesis of Alzheimer's disease and the rationale for strategies to increase acetylcholine in the brains of Alzheimer's disease patients. Two FDA-approved drugs for the treatment of Alzheimer's disease, tacrine and donepezil, are acetylcholinesterase inhibitors.
Huperzine A is also an acetylcholinesterase inhibitor and has been found to increase acetylcholine levels in the rat brain following its administration. It also increases norepinephrine and dopamine, but not serotonin levels. The natural L or (-)-huperzine A is approximately three times more potent than the racemic or (±)-huperzine A in vitro.
PHARMACOKINETICS
There are limited pharmacokinetic studies with huperzine A. It appears that huperzine A is rapidly absorbed from the gastrointestinal tract and transported to the liver via the portal circulation. Some first-pass metabolism takes place in the liver, and huperzine A and its metabolites are distributed widely in the body, including to the brain. Following ingestion, the time to reach peak blood level is approximately 80 minutes.
INDICATIONS AND USAGE
Huperzine A has potent pharmacological effects and, particularly since long-term safety has not been determined, it should only be used with medical supervision. It may have some effectiveness in Alzheimer's disease and age-related memory impairment. It has been used to treat fever and some inflammatory disorders, but there is no credible scientific evidence to support these uses.
RESEARCH SUMMARY
Numerous studies, most of them from China, suggest that huperzine A may be as effective as the drugs tacrine and donepezil in Alzheimer's disease. This is not so surprising since in vitro and animal model tests have demonstrated that huperzine A effectively inhibits acetylcholinesterase, an enzyme that catalyzes acetylcholine breakdown. Tacrine and donepezil work in the same way to conserve acetylcholine in the brain--the mode by which they presumptively improve memory and cognition in those with Alzheimer's and age-related cognitive impairment. Huperzine A may prove superior to tacrine (dose-limited due to its hepatotoxicity) if long-range studies, yet to be conducted, demonstrate its safety.
In one double-blind, randomized study, huperzine A, in injectable form, was tested against a saline control in 56 patients with multi-infarct dementia or senile dementia and in 104 patients with senile and pre-senile simple memory disorders. Huperzine A produced significant positive effects as measured by the Wechsler Memory Scale. Dizziness was experienced by a few of the huperzine A-treated patients.
In another study, this one multicenter, double-blind, placebo-controlled and randomized, 50 subjects with Alzheimer's disease were given huperzine A or placebo for eight weeks. Significant improvement was noted in 58 percent of the patients in terms of memory, cognitive and behavioral functions. Research is ongoing.
CONTRAINDICATIONS, PRECAUTIONS, ADVERSE REACTIONS CONTRAINDICATIONS
None known.
PRECAUTIONS
Huperzine A should be avoided by children, pregnant women and nursing mothers.
Because of possible adverse effects in those with seizure disorders, cardiac arrhythmias and asthma, those with these disorders should avoid huperzine A. Those with irritable bowel disease, inflammatory bowel disease and malabsorption syndromes should avoid huperzine A.
ADVERSE REACTIONS
Adverse effects reported with huperzine A include gastrointestinal effects, such as nausea and diarrhea, sweating, blurred vision, fasciculations and dizziness. Possible adverse effects include vomiting, cramping, bronchospasm, bradycardia, arrhythmias, seizures, urinary incontinence, increased urination and hypersalivation.
INTERACTIONS DRUGS
Acetylcholinesterase Inhibitors: Use of huperzine A along with the acetylcholinesterase inhibitors donepezil or tacrine may produce additive effects, including additive adverse effects. Other acetylcholinesterase inhibitors include neostigmine, physostigmine and pyridostigmine, and use of these agents along with huperzine A may produce additive effects, including additive adverse effects.
Cholinergic Drugs: Use of huperzine A along with cholinergic drugs, such as bethanechol, may produce additive effects, including additive adverse effects.
NUTRITIONAL SUPPLEMENTS
Use of huperzine A with choline, phosphatidylcholine, CDP-choline and L-alpha-glycerylphosphorylcholine hypothetically might produce additive effects, including additive adverse effects.
OVERDOSAGE
There are no reports of overdosage with huperzine A.
DOSAGE AND ADMINISTRATION
There are various forms of huperzine A available, including extracts of Huperzia serrata, natural (-)-huperzine A and synthetic racemic (±)-huperzine A. Natural (-)-huperzine A is approximately three times more potent than the synthetic racemic mixture. The doses of natural (-)-huperzine A used in clinical studies ranged from 60 micrograms to 200 micrograms daily. Huperzine A should only be used with a physician's recommendation and monitoring.
HOW SUPPLIED
Capsules — 50 mcg
Tablets — 50 mcg
LITERATURE
Cheng DH, Tang XC. Comparative studies of huperzine A, E-2020 and tacrine on behavior and cholinesterase activities. Pharmacol Biochem Behav. 1998; 60:377-386.
Cheng DH, Ren H, Tang XC. Huperzine A, a novel promising acetylcholinesterase inhibitor. Neuroreport. 1996; 8:97-101.
Quian BC, Wang M, Zhou ZF, et al. Pharmacokinetics of tablet huperzine A in six volunteers. Chung Kuo Yao Li Hsueh Pao. 1995; 16:396-398.
Tang XC, Kindel GH, Kozikowski AP, Hanin I. Comparison of the effects of natural and synthetic huperzine A on rat brain cholinergic function in vitro and in vivo. J Ethnopharmacol. 1994; 44:147-155.
Xiong ZQ, Tang XC. Effect of huperzine A, a novel acetylcholinesterase inhibitor, on radial maze performance in rats. Pharmacol Biochem Behav. 1995; 51:415-419.
Xu SS, Gao ZX, Weng Z, et al. Efficacy of tablet huperzine-A on memory, cognition and behavior in Alzheimer's disease. Chung Kuo Yao Li Hsueh Pao. 1995; 16:391-395.
Ye JW, Cai JX, Wang LM, Tang XC. Improving effects of huperzine A on spatial working memory in aged monkeys and young adult monkeys with experimental cognitive impairment. J Pharmacol Exp Ther. 1999; 288:814-819.
Zhang RW, Tang XC, Han YY, et al. Drug evaluation of huperzine A in the treatment of senile memory disorders. [Article in Chinese] Chung Kuo Yao Li Hsueh Pao. 1991; 12:250-252.
Senior Care
Elder Care
CareGiver
Alzheimer’s
Friday, November 17, 2006
All American Senior Care: Huperzine A in Alzheimer's Disease
I just finished reading an interesting article about Huperzine A. You can get an excerpt, the link to the article and the link to the clinical trial on the next page.
Follow this link to get the information about the clinical trial, Huperzine A in Alzheimer's Disease
Alzheimer's herb
Here is an excerpt from the article:
Karen says when it comes to her mom, "It made her want to get up out of the chair, it made her want to go out to the pool and swim laps, it made her want to go out and prune her flowers."
Another benefit Betty's family has seen: she has lost 50 pounds because she has been more active. Dr. DeCarli said this is just one example of clinical trials in action.
Follow this link to the complete article, Herb
All American Senior Care
The CareGiver
Senior Care
Elder Care
CareGiver
Alzheimer’s
Follow this link to get the information about the clinical trial, Huperzine A in Alzheimer's Disease
Alzheimer's herb
Here is an excerpt from the article:
Karen says when it comes to her mom, "It made her want to get up out of the chair, it made her want to go out to the pool and swim laps, it made her want to go out and prune her flowers."
Another benefit Betty's family has seen: she has lost 50 pounds because she has been more active. Dr. DeCarli said this is just one example of clinical trials in action.
Follow this link to the complete article, Herb
All American Senior Care
The CareGiver
Senior Care
Elder Care
CareGiver
Alzheimer’s
Tuesday, November 14, 2006
With Alzheimer's, the Caregiver Is a Patient, Too
This is an interesting and thought provoking article that highlights the problems often effecting Alzheimer's care giver's.
With Alzheimer's, the Caregiver Is a Patient, Too
Alzheimer's Disease and other forms of dementia do not affect just the patient. These diseases gradually rob patients of memory and other intellectual abilities, leaving them unable to perform routine tasks. As the disease continues to destroy brain cells, patients increasingly depend on family members or others to carry out simple tasks like shopping and getting dressed. Ultimately, most patients will need complete care, adding to the caregiver's burden.
Alzheimer's disease is the most common form of dementia, affecting up to 4 million Americans - and untold millions of family members and others who care for them. Physicians now recognize that Alzheimer's caregivers themselves often require care and attention, says Diana R. Kerwin, MD, Medical College of Wisconsin Assistant Professor of Medicine in the Division of Geriatrics and Gerontology.
"What we're seeing is that Alzheimer's is not a typical disease model," she says, "precisely because the health and well-being of the caretaker is affected as well as the patient. I know when I assume the care of an Alzheimer's patient, I am also caring for the caregiver."
Caregivers who accompany patients to the Froedtert Senior Health Program's Geriatric Evaluation Clinic, where Dr. Kerwin practices, are screened for "caregiver stress" and see a gerontologic nurse and social worker who will answer their questions, provide information and help create a plan for care of the patient. Caregivers are given a kit with information about support groups and community services, including adult day care, home care agencies, assisted living, skilled nursing facilities and respite care.
Stress, Depression Are Common
According to the Alzheimer's Association, more than 80% of Alzheimer caregivers report that they frequently experience high levels of stress, and nearly half say they suffer from depression. It's not difficult to see why.
The national Family Caregiver Alliance terms caregiver depression "one of today's all-too-silent health crises." The alliance estimates that caregiving spouses between the ages of 66 and 96 who are experiencing mental or emotional strain have a 63% higher risk of dying than people the same age who are not caregivers.
"Alzheimer's causes progressive memory loss, and in the later stages patients can develop behavior problems," Dr. Kerwin says. "It's distressing for the caregiver to suddenly have to cope with their loved one's anger, hallucinations, paranoia, aggression or inappropriate conduct in public. It's upsetting when, as the disease progresses, the patient no longer recognizes the spouse or loved one."
Caregivers often experience feelings of guilt, believing they are not doing enough to help, she adds. Spouses and adult children feel grief and loss, not unlike a death in the family - except that instead of being sudden, it's spread out over years. Alzheimer's is a progressively worsening disease, but the rate of progression from mild to advanced can vary widely, from three to 20 years. As Alzheimer's progresses, the loss of brain function itself will cause death unless the patient has one or more other serious illness.
When the Child Becomes the Parent
For an adult child who cares for a parent with dementia, taking on the role of caregiver is a role reversal and takes some adjustment. "It can be a difficult transition for a child to take on the role of 'parent' and decision-maker," Dr. Kerwin says. "The child often needs to be empowered to step in and begin caring for their ailing parent - making sure their parent takes his or her medication, for instance, or telling their parent they should not drive, and making difficult decisions about when the parent is no longer able to safely live alone."
Those caregivers are often already juggling multiple responsibilities with their own spouses, children and careers. In some cases, adult-child caregivers with siblings feel resentful if they must bear the brunt of their parent's care, Dr. Kerwin says. If the adult-child caregiver is the only sibling living in the same city as the parent he or she often feels isolated, overwhelmed and underappreciated.
And sometimes, whether the caregiver is a spouse or an adult sibling, out-of-town siblings or other family members who see the parent infrequently may think the caregiver is exaggerating the extent of the Alzheimer's patient's decline. The out-of-town family members may feel guilty about not being able to help from a distance, and when they do visit, they may criticize or ask to change the care their parent is receiving.
Caregivers are often fatigued from carrying out their new responsibilities, Dr. Kerwin says. "I see them neglecting their own health. It's not unusual for caregivers to suffer not only depression but also higher levels of hypertension. We recommend they have annual physicals, during which they should be sure to tell their primary care physician that they are caregivers. We also recommend they participate in support groups and learn about the community resources available."
Other concerns caregivers regularly express are loss of concentration due to their caregiving responsibilities and fear that they themselves might eventually get the disease.
Warning Signs for Caregivers What are some warning signs of caregiver stress? According to the Alzheimer's Association, they include:
Anger
Anxiety
Denial
Depression
Exhaustion
Health problems
Irritability
Lack of concentration
Sleeplessness
Social withdrawal
Caregivers who regularly experience these conditions should seek help from their physician, says the Alzheimer's Association.
Financial Strain Heightens Burden
In some families, the presence of Alzheimer's disease also brings financial problems that can add to stress and depression. Caregivers sometimes give up paying jobs for the unpaid one of caring for a loved one. They often find additional responsibilities are thrust on them, such as overseeing medications for their patient, knowing if or when the patient's care should be transferred to a nursing home, and taking on power of attorney duties along with living wills and advanced directives that specify whether terminal patients should undergo extreme measures to keep them alive.
The national Family Caregiver Alliance estimates that approximately 80% of the long-term care in the United States is provided without compensation, sometimes around the clock.
"The responsibilities are vast," Dr. Kerwin notes. "It's important for caregivers to regularly take some time for themselves, away from their caring responsibilities."
Barbara Abel
HealthLink Contributing Writer
The Medical College's Center for Healthy Communities, along with the local non-profit organization Community Care for the Elderly Partnership, has developed a Caring for Caregivers Program to support Medicaid- and Medicare-eligible residents in the community who care for frail relatives, often those with dementia. For more information, contact Tovah H. Bates, PhD, Assistant Professor, Family & Community Medicine, at 414-456-4305, or Community Care for the Elderly at 414-385-6600.
For more information on this topic, see the HealthLink articles End-Stage Alzheimer's - the Long Goodbye and Current Research on Alzheimer's, Memory Loss, and Aging.
Article Created: 2003-11-14
Article Reviewed: 2003-11-14
All American Senior Care
AllAmerican Senior Care Weblog
With Alzheimer's, the Caregiver Is a Patient, Too
Alzheimer's Disease and other forms of dementia do not affect just the patient. These diseases gradually rob patients of memory and other intellectual abilities, leaving them unable to perform routine tasks. As the disease continues to destroy brain cells, patients increasingly depend on family members or others to carry out simple tasks like shopping and getting dressed. Ultimately, most patients will need complete care, adding to the caregiver's burden.
Alzheimer's disease is the most common form of dementia, affecting up to 4 million Americans - and untold millions of family members and others who care for them. Physicians now recognize that Alzheimer's caregivers themselves often require care and attention, says Diana R. Kerwin, MD, Medical College of Wisconsin Assistant Professor of Medicine in the Division of Geriatrics and Gerontology.
"What we're seeing is that Alzheimer's is not a typical disease model," she says, "precisely because the health and well-being of the caretaker is affected as well as the patient. I know when I assume the care of an Alzheimer's patient, I am also caring for the caregiver."
Caregivers who accompany patients to the Froedtert Senior Health Program's Geriatric Evaluation Clinic, where Dr. Kerwin practices, are screened for "caregiver stress" and see a gerontologic nurse and social worker who will answer their questions, provide information and help create a plan for care of the patient. Caregivers are given a kit with information about support groups and community services, including adult day care, home care agencies, assisted living, skilled nursing facilities and respite care.
Stress, Depression Are Common
According to the Alzheimer's Association, more than 80% of Alzheimer caregivers report that they frequently experience high levels of stress, and nearly half say they suffer from depression. It's not difficult to see why.
The national Family Caregiver Alliance terms caregiver depression "one of today's all-too-silent health crises." The alliance estimates that caregiving spouses between the ages of 66 and 96 who are experiencing mental or emotional strain have a 63% higher risk of dying than people the same age who are not caregivers.
"Alzheimer's causes progressive memory loss, and in the later stages patients can develop behavior problems," Dr. Kerwin says. "It's distressing for the caregiver to suddenly have to cope with their loved one's anger, hallucinations, paranoia, aggression or inappropriate conduct in public. It's upsetting when, as the disease progresses, the patient no longer recognizes the spouse or loved one."
Caregivers often experience feelings of guilt, believing they are not doing enough to help, she adds. Spouses and adult children feel grief and loss, not unlike a death in the family - except that instead of being sudden, it's spread out over years. Alzheimer's is a progressively worsening disease, but the rate of progression from mild to advanced can vary widely, from three to 20 years. As Alzheimer's progresses, the loss of brain function itself will cause death unless the patient has one or more other serious illness.
When the Child Becomes the Parent
For an adult child who cares for a parent with dementia, taking on the role of caregiver is a role reversal and takes some adjustment. "It can be a difficult transition for a child to take on the role of 'parent' and decision-maker," Dr. Kerwin says. "The child often needs to be empowered to step in and begin caring for their ailing parent - making sure their parent takes his or her medication, for instance, or telling their parent they should not drive, and making difficult decisions about when the parent is no longer able to safely live alone."
Those caregivers are often already juggling multiple responsibilities with their own spouses, children and careers. In some cases, adult-child caregivers with siblings feel resentful if they must bear the brunt of their parent's care, Dr. Kerwin says. If the adult-child caregiver is the only sibling living in the same city as the parent he or she often feels isolated, overwhelmed and underappreciated.
And sometimes, whether the caregiver is a spouse or an adult sibling, out-of-town siblings or other family members who see the parent infrequently may think the caregiver is exaggerating the extent of the Alzheimer's patient's decline. The out-of-town family members may feel guilty about not being able to help from a distance, and when they do visit, they may criticize or ask to change the care their parent is receiving.
Caregivers are often fatigued from carrying out their new responsibilities, Dr. Kerwin says. "I see them neglecting their own health. It's not unusual for caregivers to suffer not only depression but also higher levels of hypertension. We recommend they have annual physicals, during which they should be sure to tell their primary care physician that they are caregivers. We also recommend they participate in support groups and learn about the community resources available."
Other concerns caregivers regularly express are loss of concentration due to their caregiving responsibilities and fear that they themselves might eventually get the disease.
Warning Signs for Caregivers What are some warning signs of caregiver stress? According to the Alzheimer's Association, they include:
Anger
Anxiety
Denial
Depression
Exhaustion
Health problems
Irritability
Lack of concentration
Sleeplessness
Social withdrawal
Caregivers who regularly experience these conditions should seek help from their physician, says the Alzheimer's Association.
Financial Strain Heightens Burden
In some families, the presence of Alzheimer's disease also brings financial problems that can add to stress and depression. Caregivers sometimes give up paying jobs for the unpaid one of caring for a loved one. They often find additional responsibilities are thrust on them, such as overseeing medications for their patient, knowing if or when the patient's care should be transferred to a nursing home, and taking on power of attorney duties along with living wills and advanced directives that specify whether terminal patients should undergo extreme measures to keep them alive.
The national Family Caregiver Alliance estimates that approximately 80% of the long-term care in the United States is provided without compensation, sometimes around the clock.
"The responsibilities are vast," Dr. Kerwin notes. "It's important for caregivers to regularly take some time for themselves, away from their caring responsibilities."
Barbara Abel
HealthLink Contributing Writer
The Medical College's Center for Healthy Communities, along with the local non-profit organization Community Care for the Elderly Partnership, has developed a Caring for Caregivers Program to support Medicaid- and Medicare-eligible residents in the community who care for frail relatives, often those with dementia. For more information, contact Tovah H. Bates, PhD, Assistant Professor, Family & Community Medicine, at 414-456-4305, or Community Care for the Elderly at 414-385-6600.
For more information on this topic, see the HealthLink articles End-Stage Alzheimer's - the Long Goodbye and Current Research on Alzheimer's, Memory Loss, and Aging.
Article Created: 2003-11-14
Article Reviewed: 2003-11-14
All American Senior Care
AllAmerican Senior Care Weblog
Tuesday, November 07, 2006
Why Didn't I Get It?
The signs were there but no one could see them--not even me.
Why Didn't I Get It?
Tuesday, November 07, 2006
I was talking to my sister one evening and she said to me, “You better call Mom she says she hasn’t talked to you in months.” I laughed and said I talked to her two days ago and for more than an hour. Later in the evening, I decided to call my mother. After she recognized my voice she said, “Well its about time you called.” When I said I just talked to you two days ago she just shrugged it off and we began our usual conversation.
I really don’t know why I wasn’t more concerned at the time but to be honest I wasn’t. And neither was anyone else. The typical comment, “she sounds good to me.” I guess like most people I just accepted the fact that she was getting old. Nobody saw a problem not even her friends who saw her on a daily basis.
Looking back there were plenty of signs. For one thing, she was developing a very negative attitude. But, it seemed when I spent time with her, a few days, she would turn back into her normal self and start to have a more positive outlook on things. Another sign occurred when she began to scrape her feet as she walked. I suppose I should have concluded something but I didn’t. We thought she was finally slowing down. I could go on and on.
Then Christmas came and I decided to take her shopping. To my surprise she could barely walk for five minutes without stopping. In fact, she was almost slumping over. Out of the clear blue sky, or so it seemed, she just couldn’t walk any distance and it was struggle just getting her back to the car. Clearly something was a-muck.
I went to talk to her doctor. Other than her high blood pressure, her heart was fine and her overall blood work was pretty good—more than pretty good for a woman her age. Keep in mind we are talking about an 87 year old woman at the time, a woman who had never had a major illness or operation her entire life. The closest she had come to any of that was when she had an operation on a bunion on her foot.
Yet now for some reason she was no longer able to walk comfortably. I began to notice how she was somewhat unsteady, how she began to reach out and hold on to things as she walked, and how she no longer had an interest in doing anything that required her to walk. Two years earlier this woman, my mother, walked more than a mile round trip with me in New York to eat breakfast.
All American Senior Care
Why Didn't I Get It?
Tuesday, November 07, 2006
I was talking to my sister one evening and she said to me, “You better call Mom she says she hasn’t talked to you in months.” I laughed and said I talked to her two days ago and for more than an hour. Later in the evening, I decided to call my mother. After she recognized my voice she said, “Well its about time you called.” When I said I just talked to you two days ago she just shrugged it off and we began our usual conversation.
I really don’t know why I wasn’t more concerned at the time but to be honest I wasn’t. And neither was anyone else. The typical comment, “she sounds good to me.” I guess like most people I just accepted the fact that she was getting old. Nobody saw a problem not even her friends who saw her on a daily basis.
Looking back there were plenty of signs. For one thing, she was developing a very negative attitude. But, it seemed when I spent time with her, a few days, she would turn back into her normal self and start to have a more positive outlook on things. Another sign occurred when she began to scrape her feet as she walked. I suppose I should have concluded something but I didn’t. We thought she was finally slowing down. I could go on and on.
Then Christmas came and I decided to take her shopping. To my surprise she could barely walk for five minutes without stopping. In fact, she was almost slumping over. Out of the clear blue sky, or so it seemed, she just couldn’t walk any distance and it was struggle just getting her back to the car. Clearly something was a-muck.
I went to talk to her doctor. Other than her high blood pressure, her heart was fine and her overall blood work was pretty good—more than pretty good for a woman her age. Keep in mind we are talking about an 87 year old woman at the time, a woman who had never had a major illness or operation her entire life. The closest she had come to any of that was when she had an operation on a bunion on her foot.
Yet now for some reason she was no longer able to walk comfortably. I began to notice how she was somewhat unsteady, how she began to reach out and hold on to things as she walked, and how she no longer had an interest in doing anything that required her to walk. Two years earlier this woman, my mother, walked more than a mile round trip with me in New York to eat breakfast.
All American Senior Care
Thursday, November 02, 2006
My Mother the Dynamo
My mother at the age of 85 was a dynamo. She lived on her own, paid her own bills, and took care of herself.......
My mother at the age of 85 was a dynamo. She lived on her own, paid her own bills, and took care of herself. She had been doing this for more than ten years since the death of my father. She was on her own.
My mother was often spotted walking to the pool in her community. A tiny women the senior citizens all around her marveled. It seemed as if father time had forgotten about her. There was no limit to what she could do. Walk 20 blocks, no problem, you name it. Up at dawn and awake at midnight she was a real dynamo.
My mother was very funny, a real character. She made people laugh and smile. She read the paper and watched CNN, she had opinion on everything and wanted to know your opinion. She was a wonderful person: always welcoming people into her home. She was noted for all of my 50 years for her great Italian cooking. I remember as a kid that all of my friends really looked forward to staying over our house. Donuts, spaghetti and meatballs you name it. Ravioli anyone?
Me? I was there with my mother when my fathered "passed away'; this was when I really started about her longevity, her health. I was thinking about her for years knowing that someday she had to live with one of us (I have a brother and sister). As the years flew by I started to think about it more and more. But she just kept going ang going without a health problem of any kind. Rarely a minor illness. She was the real energizer bunny.
At times, my brother, sister and I had discussions about putting my mother into some kind of "facility". But to be honest, to be honest now, I knew I would never be able to do it. While I had only mentioned it to a few people, I had made a promise to my father not long before he died. I promised him no matter what, I would take care of his wife of 55 years, my mother, our love. Dot. It was not a promise I made haphazardly. I made up my mind about this while we were taking care of my dying father. It seemed as natural to me as breathing. I already knew in my mind and my heart, I was the one.
I knew the day would come. I just didn't know when. Or how.
All American Senior Care
My mother at the age of 85 was a dynamo. She lived on her own, paid her own bills, and took care of herself. She had been doing this for more than ten years since the death of my father. She was on her own.
My mother was often spotted walking to the pool in her community. A tiny women the senior citizens all around her marveled. It seemed as if father time had forgotten about her. There was no limit to what she could do. Walk 20 blocks, no problem, you name it. Up at dawn and awake at midnight she was a real dynamo.
My mother was very funny, a real character. She made people laugh and smile. She read the paper and watched CNN, she had opinion on everything and wanted to know your opinion. She was a wonderful person: always welcoming people into her home. She was noted for all of my 50 years for her great Italian cooking. I remember as a kid that all of my friends really looked forward to staying over our house. Donuts, spaghetti and meatballs you name it. Ravioli anyone?
Me? I was there with my mother when my fathered "passed away'; this was when I really started about her longevity, her health. I was thinking about her for years knowing that someday she had to live with one of us (I have a brother and sister). As the years flew by I started to think about it more and more. But she just kept going ang going without a health problem of any kind. Rarely a minor illness. She was the real energizer bunny.
At times, my brother, sister and I had discussions about putting my mother into some kind of "facility". But to be honest, to be honest now, I knew I would never be able to do it. While I had only mentioned it to a few people, I had made a promise to my father not long before he died. I promised him no matter what, I would take care of his wife of 55 years, my mother, our love. Dot. It was not a promise I made haphazardly. I made up my mind about this while we were taking care of my dying father. It seemed as natural to me as breathing. I already knew in my mind and my heart, I was the one.
I knew the day would come. I just didn't know when. Or how.
All American Senior Care
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