Tag: Philadelphia caregiver

The role of depression and diabetes in the development of dementias in older adults

Posted on by Peter R. Abraldes

What are the symptoms of depression for older adults?  Does depression increase the risk of developing a dementia?  What is the impact of other chronic conditions such as diabetes?

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We mitigate the risk and continuation of depression. It is important to engage older adults in meaningful activities, not only to fight  depression, but also the development of other more serious conditions.

It is important for us to recognize these signs of depression in our older relatives and friends (“Depression in Older Adults”).   

  • Loose of interest socializing or in hobbies
  • Worries about being a burden, feelings of worthlessness
  • Slowed movement or speech
  • Neglect of personal care such as skipping meals, forgetting meds, neglecting hygiene
  • Lack of motivation and energy
  • Weight loss or general loss of appetite
  • Sadness or feelings of despair
  • Sleep disturbances, issues falling asleep, staying asleep, or beginning to sleep at different times

It is important to incorporate meaningful activities and interactions into the lives of older adults.  NursePartners has two company divisions dedicated to offering individualized companion and care services to older adults living in Philadelphia, Montgomery, Chester, and Delaware counties.  By involving your loved ones in meaningful activities early, you may stave off a development of a dementia, especially if the older adults are already dealing with chronic conditions such as diabetes.

In a population-based study of 2.4 million adults in Denmark, depression and diabetes were independently associated with greater dementia risk.  The combined association of the two disorders had a higher association with the risk of developing a dementia than the aggregate effects of the two dependent variables individually.

Covariates included martial status and its possible effect on depression and general health.

According to the study, “during the first year after depression, the associated hazard of all-cause dementia was elevated by nearly seven-fold”.  Additional periods of depression decreased the risk of developing a dementia in comparison to the first year but left the overall hazard ratio dementia risk rate about twice as high as those without depression (See Figure 1).  

This is a link to the full study, “Impact of Depression and Diabetes on Risk of Dementia In a National Population-Based Cohort”.

Other studies have focused on the singular impact of depression on dementia.  To learn more, consult the authors’ reference list in the study cited above.

 

Overview of the GEM levels

Posted on by NursePartners

NursePartners practices the GEMTM level approach to connect with our clients living with dementia.  One of the first things we teach carepartners is to find new ways to say hello.  Depending on a client’s GEMTM stage, we need to communicate through engaging other senses.

Each of our clients receives an activity basket and customized plan of care.  Carepartners help engage older adults in meaningful projects and activities of daily living.  A nurse visits clients biweekly to ensure the success of our approaches and address signs of progression.

NursePartners admin have all completed the GEMTM training and include dementia coaches and practitioners.  We are committed to honoring our clients and assisting their families.

 

The 10 Warning Signs of Alzheimer’s Disease

Posted on by Peter R. Abraldes

The Alzheimer’s Association presents the following as warnings signs of Alzheimer’s disease:

  1. Memory loss that disrupts daily life
  2. Challenges in planning or solving problems
  3. Difficulty completing familiar tasks at home, work, or leisure
  4. Confusion with time or place
  5. Trouble understanding visual images and spatial relationships
  6. New problems with words in speaking or writing
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased or poor judgment
  9. Withdrawal from work or social activities
  10. Changes in mood and personality

memory loss, dementia care, Philadelphia dementia care, Montgomery County dementia care, Rosemont dementia care

As we age, our organs do not perform as before.  The brain is no exception.  Some natural cognitive decline is natural.  When presenting the early warning signs, it is important that we put each warning sign in its proper context.

It is also important to remember that each person has their own baseline.  We do not all have the same skills or personalities.  Life experiences and family relationships also impact how we develop as individuals.  In order to receive a proper diagnosis, a physician must take the time to fully understand the personality and life experiences.  Other factors such as  stress, depression, and vitamin deficiencies might be to blame.

  1. Memory loss that disrupts daily life
    • Forgetting the names of new classroom of students is normal.  This is different from being unable to remember the name of your spouse or children (if you have a few!).  Typically we forget names, but are able to remember them on our own later.
  2. Challenges in planning or solving problems
    • This is relative to your problem solving skills when you were younger.  If these skills were never strong, they will also be weak as an older adult.
  3. Difficulty completing familiar tasks at home, work, or leisure.
    • The key word is “familiar”.  If you have never been good at folding clothes, this is not a familiar task, and therefore there is no cause for concern that you still cannot do it well.
  4. Confusion with time or place
    • It is normal to write the year wrong in January or to think it is Tuesday when it is in fact Wednesday.  Life stresses causing us to loose track of the passage of small periods of time.  However, it is not normal to perceive yourself as being in the opposite season or many years in the past.
  5. Trouble understanding visual images and spatial relationships
    • Vision generally worsens as we age.  Older adults aged 75+ typically have peripheral vision of about 45 degrees in each direction.  Older adults living with dementia will develop tunnel vision.  Eventually this vision becomes binocular and then monocular.  They will also have issues gauging distance while driving or recognizing the depth perception of items in a room.
  6. New problems with words in speaking or writing
    • Some older adults may have a stutter or become timid in large group settings.  Their energy level or stress can also impact their ability to speak well.  We also all forget the names of items, especially words that we use infrequently.  It is not normal to forget words that are common to our every day life.  If we forget them, we may remember them by mentioning other related words.  If we think of the common word after this activity, this may be a sign of a developing cognitive impairment.
  7. Misplacing things and losing the ability to retrace steps
    • We all loose our keys, unless we are very disciplined!  We may leave them in our pockets, put them on the counter, or periodically forget to even bring them out of the car.  These are all normal acts.  What is abnormal is putting keys in the fruit bowl, refrigerator, or give them to a friendly stranger.
  8. Decreased or poor judgment
    • Related to the above, poor judgment might be falling victim to a sweepstakes scam or donating more than you can afford.  We all have different levels of judgment, but typically this decline is hard to uncover in family and friends.
  9. Withdrawal from work or social activities
    • This is especially relevant for extroverts.  If a person finds themselves suddenly lost in a conversation this could be an issue.  However, we should consider other issues such as depression or exhaustion.  Introverts may avoid social activities, but enjoy gatherings among family and a few friends.  If these behaviors change over the course of months or years, this might be cause for concern.
  10. Changes in mood and personality
    • These are differences that arise over the course of the medium and long term.  Keep in mind that life experiences can also permanently impact one’s personality.  It is important to take the time to understand if traumatic incidents are to blame.

 

 

 

 

Understanding Fall Risks

Posted on by Peter R. Abraldes

Falls are a common and serious problem affecting many older adults. Individuals suffering with Alzheimer’s disease or another form of dementia however, are twice as likely to experience annual falls and fractures. This varies from a range of factors including medication, night waking, shuffling, weakening musculature and balance. The first step in protecting your loved one from a serious injury associated with a fall is understanding the risk factors.

 

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The following are common causes of falls:

Health Conditions

While everyone is at risk for falls, older adults are at the greatest risk due to chronic health conditions such as heart disease, arthritis, low blood pressure, Parkinson’s disease, dementia and other cognitive impairments. While some individuals in the early stages of Alzheimer’s are in excellent physical condition, many others seem to develop difficulties before cognitive impairment even begins. As Alzheimer’s progresses, it can cause lack of coordination, muscle weakness and diminished joint flexibility.

Reaction Time

As we get older, the nerves that carry information to and from the brain deteriorate. This slows reaction time and the ability to navigate around obstacles. This can be hazardous as seniors do not react as quickly in dangerous situations.

Medication

Many medicines also have side effects, causing dizziness, drowsiness and impaired vision.

Environmental Hazards

Many times, falls can happen because of environmental factors and hazards found throughout the home. These include everything from wet or slippery floors, poor lighting, to tripping hazards such as loose rugs, uneven floors, and trailing wires.

Visual-Spatial Problems

Because Alzheimer’s disease can affect the visual-spatial abilities, an individual can misinterpret and misjudge steps, uneven terrain, shiny areas on the floor or changes in floor color.

What you can do:

  1. Identify the risk factors for your loved one. Many people with Alzheimer’s and dementia suffer from poor eyesight, shuffling gait, muscle weakness and generalized frailty.
  2. Minimize or avoid medications that have been linked to falls. People with dementia are also more likely to fall when taking sedatives, tranquilizers, and antipsychotics.
  3. Exercise is important in preventing people from falling, especially if it includes balance and strength exercises. Ask the doctor about leg strength, gait, and balance evaluations. These tests help can determine physical risk factors.
  4. Consider a physical therapist or occupational therapist. These experts can work with your loved one to develop exercises strengthen joints.
  5. Make sure your loved one has eye tests regularly. Low vision is a huge risk factor for falls, and many vision problems come on gradually but steadily.  NursePartners’ use of theGEMTM methodology will also alert us towards changes in vision.
  6. Finally, get a home-safety assessment. Carepartners routinely perform these and can target danger spots and suggest easy improvements. This assessment can focus specifically on the needs of your loved one.

If you or a loved one is thinking about home care assistance, our team would love to help. Contact us today.

 

Sources:
Heerema, Esther. “Common Causes of Falls in People with Dementia.” Verywell.com. N.p., 31 Dec. 2015. Web. 30 May 2016.
 Perkins, Chris. “Dementia and Falling.” Continuing Medical Education 35.1 (2008): n. pag. Web. 31 May 2016.

Effective Communication Strategies

Posted on by Peter R. Abraldes

Tomorrow Angela Geiger will present on behalf of the Alzheimer’s Association. Angela is a certified dementia practitioner, registered nurse, and founder of NursePartners, Inc. We have been servicing older adults living with a diagnosis of dementia since 2002.

Effective communication is crucial for establishing a good relationship between the carepartner and the care recipient. You will learn new ways to “say hello” and connect as the disease progresses. Angela will show us how to incorporate the Positive Physical ApproachTM into daily interactions to make them more meaningful and successful.

She will also explain how we can connect through each of the senses. As the disease progresses, some senses are heightened. We will also learn how to use visual cuing over verbal cuing. Often those living with dementia invent words to communicate. We should anticipate these changes and react accordingly. By knowing the care recipient’s history, we will increase the odds of our success.

It is also important to ensure that the care recipient still feel competent and involved in their own care. We can make this possible by simplifying the decision process. This is done by minimizing distractions and communicating directly with the care recipient.

We look forward to seeing you tomorrow at the Delaware Valley Veteran Home at 2pm.

The address is 2701 Southampton Road, Philadelphia, PA 19154.