Early Detection and Management of Dementia Cuts Healthcare Costs
With the aging of America, the number of Alzheimer’s cases is growing rapidly.
Early detection, diagnosis and care management for people newly diagnosed with cognitive impairment and dementia reduces outpatient costs by almost 30 percent, according to new research reported at the recent Alzheimer's Association International Conference on Alzheimer's Disease 2010.
According to the Alzheimer's Association, dementia is a common, costly, and often unrecognized problem in older adults. In order to provide better medical care and outcomes for people with Alzheimer's and other dementias, the conditions must first be detected and diagnosed, and needed care management must be provided.
"Research suggests that when the family of someone who is officially diagnosed with Alzheimer's becomes educated about the disease, and they work together with medical professionals on a care plan, it can reduce the patient's difficult behavioral and psychiatric symptoms." said Maria Carrillo, PhD, Senior Director of Medical and Scientific Relations at the Alzheimer's Association. "It can also lower the family caregiver's anxiety, depression and stress."
Alzheimer's care management helps people with the disease and their families to find resources, make decisions, and manage stress. For example, a care manager can help families with decisions about in-home care services, or long-term care whether at home or in a nursing facility.
The study, titled the Dementia Demonstration Project (DDP), was an interdisciplinary effort led by the Geriatric Research, Education and Clinic Center at the Minneapolis Veterans Medical Center. Seven VA Medical Centers took part in the project, which was created to increase detection and diagnosis of dementia in primary care and provide information, support, and care coordination for veterans with newly diagnosed dementia.
In the DDP clinics, once a patient was diagnosed with cognitive impairment, the dementia care team met with the patient and family to review the results, discuss the diagnosis, and outline treatment recommendations.
Interventions were targeted to the severity of dementia and the specific needs of the patient and their caregivers. Informational material, assistance in identifying needed services, and direct support and training from team members was provided, as needed.
"The most important goals of the program were making sure that all family members understood the disease and were on the same page, that patients remained physically active and socially engaged, and that caregivers had the support they needed," said J. Riley McCarten, MD, the project's lead physician.Healthcare costs data showed that veterans diagnosed in the DDP clinics saw their average outpatient healthcare costs decline by about 29 percent (-$1,991) in the year after diagnosis of cognitive impairment compared with the year before diagnosis. "We see in this study's findings that early diagnosis and case management in dementia may also significantly lower healthcare costs. This could have a reverberating positive impact throughout the entire healthcare system," Carrillo said.
Source: The Alzheimer's Association is the leading voluntary health organization in Alzheimer care, support and research. Visit www.alz.org or call 800-272-3900
Right at Home is a national organization dedicated to improving the quality of life for those we serve. We fulfill that mission through a dedicated network of locally owned, franchised providers of in-home care and assistance services.
Tuesday, September 28, 2010
Sunday, September 26, 2010
A Matter of her mind...and my Heart
I have to get busy and write that second edition to my book Matters of the Mind...and the Heart. I was heartened to hear an attendee at one of my talks that my book was like her Bible; she continually referred to it. That sure makes writing it worth my effort.
This week I'm having repair shoulder surgery and won't be able to write for a while. I love writing; about Alzheimer's, about my journey through Alzheimer's, and commenting on other writers and presenters. Last Thursday I heard David Troxel who, along with Virginia Bell, wrote The Best Friends Approach to Alzheimer's. His talk was so encouraging; that caregivers are catching on to treating the person with dementia with dignity. All one has to do to figure out what that means is to examine what makes you feel valued as a person of worth. He talked about elements of KNACK, which is approaching care of the person with an attitude of good will. Some elements of Knack are: being well informed, having empathy, respecting the basic rights of the person, using common sense, communicating skillfully, being optimistic, using humor, developing flexibility, patience, connecting with the spiritual, and something good for everyone, valuing the moment. You've met people with Knack; maybe you are one. I taught homecare aides in the 1990s and there were about 5 of these women who had Knack; a natural love of their clients and a desire to make life better for them. I hope when I need a caregiver, I'll have one with Knack. Don't you?
This week I'm having repair shoulder surgery and won't be able to write for a while. I love writing; about Alzheimer's, about my journey through Alzheimer's, and commenting on other writers and presenters. Last Thursday I heard David Troxel who, along with Virginia Bell, wrote The Best Friends Approach to Alzheimer's. His talk was so encouraging; that caregivers are catching on to treating the person with dementia with dignity. All one has to do to figure out what that means is to examine what makes you feel valued as a person of worth. He talked about elements of KNACK, which is approaching care of the person with an attitude of good will. Some elements of Knack are: being well informed, having empathy, respecting the basic rights of the person, using common sense, communicating skillfully, being optimistic, using humor, developing flexibility, patience, connecting with the spiritual, and something good for everyone, valuing the moment. You've met people with Knack; maybe you are one. I taught homecare aides in the 1990s and there were about 5 of these women who had Knack; a natural love of their clients and a desire to make life better for them. I hope when I need a caregiver, I'll have one with Knack. Don't you?
Monday, September 20, 2010
An article on Frontotemporal Dementia
This is an article from Alzheimer's Weekly. You can log on to www.alzheimersweekly.com/RESEARCH
Frontotemporal dementia (FTD), sometimes called frontal lobe dementia, describes a group of diseases characterized by degeneration of nerve cells - especially those in the frontal and temporal lobes of the brain. Unlike AD, FTD usually does not include formation of amyloid plaques. In many people with FTD, there is an abnormal form of tau protein in the brain, which accumulates into neurofibrillary tangles. This disrupts normal cell activities and may cause the cells to die.
Experts believe FTD accounts for 2 to 10 percent of all cases of dementia. Symptoms of FTD usually appear between the ages of 40 and 65. In many cases, people with FTD have a family history of dementia, suggesting that there is a strong genetic factor in the disease. The duration of FTD varies, with some patients declining rapidly over 2 to 3 years and others showing only minimal changes for many years. People with FTD live with the disease for an average of 5 to 10 years after diagnosis.
Because structures found in the frontal and temporal lobes of the brain control judgment and social behavior, people with FTD often have problems maintaining normal interactions and following social conventions. They may steal or exhibit impolite and socially inappropriate behavior, and they may neglect their normal responsibilities. Other common symptoms include loss of speech and language, compulsive or repetitive behavior, increased appetite, and motor problems such as stiffness and balance problems. Memory loss also may occur, although it typically appears late in the disease.
Frontotemporal dementia (FTD), sometimes called frontal lobe dementia, describes a group of diseases characterized by degeneration of nerve cells - especially those in the frontal and temporal lobes of the brain. Unlike AD, FTD usually does not include formation of amyloid plaques. In many people with FTD, there is an abnormal form of tau protein in the brain, which accumulates into neurofibrillary tangles. This disrupts normal cell activities and may cause the cells to die.
Experts believe FTD accounts for 2 to 10 percent of all cases of dementia. Symptoms of FTD usually appear between the ages of 40 and 65. In many cases, people with FTD have a family history of dementia, suggesting that there is a strong genetic factor in the disease. The duration of FTD varies, with some patients declining rapidly over 2 to 3 years and others showing only minimal changes for many years. People with FTD live with the disease for an average of 5 to 10 years after diagnosis.
Because structures found in the frontal and temporal lobes of the brain control judgment and social behavior, people with FTD often have problems maintaining normal interactions and following social conventions. They may steal or exhibit impolite and socially inappropriate behavior, and they may neglect their normal responsibilities. Other common symptoms include loss of speech and language, compulsive or repetitive behavior, increased appetite, and motor problems such as stiffness and balance problems. Memory loss also may occur, although it typically appears late in the disease.
Wednesday, September 8, 2010
Vacation Lessons
My husband and I took a week's vacation which turned out very different from what was planned. The plan was to sail for 6 days in our 30 foot Nonesuch named So Far So Good (appropriate name for 2 people who make one whole sailor). Then business had to be attended to. Then Hurrican Earl was predicted and then fizzled out, making us unhappy we hadn't sailed anyway. We have friends who need a time, a destination and their expectations met every step of the way. They are not sailors; sailors cannot control the wind direction, the current, wave height or the weather. Sailors get up, find out if the wind will take them to their planned destination, and if not, they change direction.
A colleague has a training business in Alzheimer care. Her motto is: You can't change the wind, but you can adjust your sails. So true. Often the change brings unexpected joys. It made me think how often plans get changed when you are a caregiver for someone with Alzheimer's. Often you can't plan easily, as so much can interrupt well laid plans when you're a caregiver. Many unexpected 'happenings' can alter plans. How do you handle the uncertainty? I think the successful caregiver is flexible and kind of loosey-goosey, not rattled by change, able to switch gears easily.
Our vacation took a new twist. We were not on the water. We took day trips;one to Norman Rockwell's Museum in Stockbridge (a delightful trip), one to Maine to LL Bean and favorite haunts for good seafood (clam cakes), and on the last day we toured our own city Quincy in a trolley to visit the Adams Mansion and John and John Quincy's birthplaces. It was reminiscent of our dating days, driving, easily chatting and having good meals together. It turned out to be a restful vacation after all; not what we'd planned, but delightful nontheless. Can you approach your caregiving experience like that? It would help to learn to.
A colleague has a training business in Alzheimer care. Her motto is: You can't change the wind, but you can adjust your sails. So true. Often the change brings unexpected joys. It made me think how often plans get changed when you are a caregiver for someone with Alzheimer's. Often you can't plan easily, as so much can interrupt well laid plans when you're a caregiver. Many unexpected 'happenings' can alter plans. How do you handle the uncertainty? I think the successful caregiver is flexible and kind of loosey-goosey, not rattled by change, able to switch gears easily.
Our vacation took a new twist. We were not on the water. We took day trips;one to Norman Rockwell's Museum in Stockbridge (a delightful trip), one to Maine to LL Bean and favorite haunts for good seafood (clam cakes), and on the last day we toured our own city Quincy in a trolley to visit the Adams Mansion and John and John Quincy's birthplaces. It was reminiscent of our dating days, driving, easily chatting and having good meals together. It turned out to be a restful vacation after all; not what we'd planned, but delightful nontheless. Can you approach your caregiving experience like that? It would help to learn to.
Wednesday, August 25, 2010
New article from Right at Home Newsletter: Dressing
Alzheimer's Caregiver Tips: Helping Your Loved One Dress
_______________________
Throughout our lives, most of us put a fair amount of care and attention into choosing and caring for the clothes we wear. But for people with Alzheimer's disease and other dementia, dressing can be a challenge. And for family, seeing the difference in their loved one, who once took great pride in how they looked, is a reminder of how their loved one has changed.
_______________________
Family caregivers may be confused about whether to step in when Dad selects a plaid shirt and clashing plaid trousers, or Mom puts her blouse on inside out. And their loved one may be resistant to assistance. The National Institute on Aging offers these suggestions on assisted independence, to make the process go more smoothly.
People with Alzheimer's disease often need more time to dress. It can be hard for them to choose their clothes. They might wear the wrong clothing for the season. They also might wear colors that don't go together or forget to put on a piece of clothing. Allow the person to dress on his or her own for as long as possible.
Here are some tips that can help:
Lay out clothes in the order the person should put them on, such as underwear first, then pants, then a shirt, and then a sweater.
Hand the person one thing at a time or give step-by-step dressing instructions.
Put away some clothes in another room to reduce the number of choices. Keep only one or two outfits in the closet or dresser.
Keep the closet locked if needed. This prevents some of the problems people may have while getting dressed.
Buy three or four sets of the same clothes, if the person wants to wear the same clothing every day.
Buy loose-fitting, comfortable clothing. Avoid girdles, control-top pantyhose, knee-high nylons, garters, high heels, tight socks, and bras for women. Sports bras are comfortable and provide good support. Short cotton socks and loose cotton underwear are best. Sweat pants and shorts with elastic waistbands are helpful.
Use Velcro or large zipper pulls for clothing, instead of shoelaces, buttons, or buckles. Try slip-on shoes that won't slide off or shoes with Velcro straps.
This information provided by the National Institute on Aging's Alzheimer’s Disease Education and Referral Center (ADEAR). Visit the ADEAR website for more information on effective dementia caregiving.
_______________________
Throughout our lives, most of us put a fair amount of care and attention into choosing and caring for the clothes we wear. But for people with Alzheimer's disease and other dementia, dressing can be a challenge. And for family, seeing the difference in their loved one, who once took great pride in how they looked, is a reminder of how their loved one has changed.
_______________________
Family caregivers may be confused about whether to step in when Dad selects a plaid shirt and clashing plaid trousers, or Mom puts her blouse on inside out. And their loved one may be resistant to assistance. The National Institute on Aging offers these suggestions on assisted independence, to make the process go more smoothly.
People with Alzheimer's disease often need more time to dress. It can be hard for them to choose their clothes. They might wear the wrong clothing for the season. They also might wear colors that don't go together or forget to put on a piece of clothing. Allow the person to dress on his or her own for as long as possible.
Here are some tips that can help:
Lay out clothes in the order the person should put them on, such as underwear first, then pants, then a shirt, and then a sweater.
Hand the person one thing at a time or give step-by-step dressing instructions.
Put away some clothes in another room to reduce the number of choices. Keep only one or two outfits in the closet or dresser.
Keep the closet locked if needed. This prevents some of the problems people may have while getting dressed.
Buy three or four sets of the same clothes, if the person wants to wear the same clothing every day.
Buy loose-fitting, comfortable clothing. Avoid girdles, control-top pantyhose, knee-high nylons, garters, high heels, tight socks, and bras for women. Sports bras are comfortable and provide good support. Short cotton socks and loose cotton underwear are best. Sweat pants and shorts with elastic waistbands are helpful.
Use Velcro or large zipper pulls for clothing, instead of shoelaces, buttons, or buckles. Try slip-on shoes that won't slide off or shoes with Velcro straps.
This information provided by the National Institute on Aging's Alzheimer’s Disease Education and Referral Center (ADEAR). Visit the ADEAR website for more information on effective dementia caregiving.
Monday, August 23, 2010
Namenda news from Alzheimersweekly.com
Namenda & Side-Effects
A team of investigators unraveled exactly how Namenda helps Alzheimer's patients without causing serious side effects.
Alzheimer's disease destroys brain cells and their connections (called synapses), causing memory loss and other cognitive problems that disrupt work, hobbies and daily life. Symptoms can be alleviated, in part, by the drug Namenda (marketed in some countries as Ebixa, generically known as memantine).
New research shows a unique advantage of Namenda. Researchers revealed a signaling process that normally helps a healthy brain to communicate. This process can destroy brain cells when it sends the wrong signal. It seems that Namenda can tell the difference between the two, allowing the process to do its job when signals work properly, while blocking it whenever signals will be destructive.
Namenda is currently FDA-approved to treat moderate-to-severe Alzheimer's disease. It was, in part, developed by Stuart A. Lipton, M.D., Ph.D., Director of the Del E. Web Center for Neuroscience, Aging and Stem Cell Research at Sanford-Burnham Medical Research Institute (Sanford-Burnham).
Namenda improves symptoms by blocking abnormal activity of glutamate, a chemical that transmits messages between nerve cells.
In a study appearing August 18 in The Journal of Neuroscience, a team of investigators at Sanford-Burnham led by Dr. Lipton unravel exactly how Namenda helps Alzheimer's patients without causing serious side effects.
"While Namenda is partially effective in treating Alzheimer's disease, one of its major advantages is how safe and well-tolerated it is clinically," said Dr. Lipton
In treating any disease, one of the most difficult parts of designing a new drug is finding ways to maximize its beneficial effect while minimizing harmful side effects. Namenda is a particularly safe treatment for Alzheimer's disease because it dampens excessive glutamate signaling that occurs away from synapses without blocking glutamate activity at the synapses. This is important because interfering with synaptic glutamate signaling would disrupt normal brain activity.
"We showed definitively for the first time that Namenda, the drug our group developed for Alzheimer's disease, works in a unique way," Dr. Lipton said.
"It inhibits a protein that binds glutamate called the NMDA receptor, but predominantly blocks NMDA receptors that signal molecularly to cause neuronal injury and death. It spares the synaptic receptors that mediate normal communication between nerve cells in the brain."
This finding helps explain why the drug is so well tolerated by Alzheimer's patients and might provide hints for the development of future therapies targeting the NMDA receptor and similar cellular machinery in other diseases.
Namenda is now available in an XR and a generic to save money and take fewer doses a day. Go to www.alzheimersweekly.com/treatment/namenda-&-side-effects-a804.html
A team of investigators unraveled exactly how Namenda helps Alzheimer's patients without causing serious side effects.
Alzheimer's disease destroys brain cells and their connections (called synapses), causing memory loss and other cognitive problems that disrupt work, hobbies and daily life. Symptoms can be alleviated, in part, by the drug Namenda (marketed in some countries as Ebixa, generically known as memantine).
New research shows a unique advantage of Namenda. Researchers revealed a signaling process that normally helps a healthy brain to communicate. This process can destroy brain cells when it sends the wrong signal. It seems that Namenda can tell the difference between the two, allowing the process to do its job when signals work properly, while blocking it whenever signals will be destructive.
Namenda is currently FDA-approved to treat moderate-to-severe Alzheimer's disease. It was, in part, developed by Stuart A. Lipton, M.D., Ph.D., Director of the Del E. Web Center for Neuroscience, Aging and Stem Cell Research at Sanford-Burnham Medical Research Institute (Sanford-Burnham).
Namenda improves symptoms by blocking abnormal activity of glutamate, a chemical that transmits messages between nerve cells.
In a study appearing August 18 in The Journal of Neuroscience, a team of investigators at Sanford-Burnham led by Dr. Lipton unravel exactly how Namenda helps Alzheimer's patients without causing serious side effects.
"While Namenda is partially effective in treating Alzheimer's disease, one of its major advantages is how safe and well-tolerated it is clinically," said Dr. Lipton
In treating any disease, one of the most difficult parts of designing a new drug is finding ways to maximize its beneficial effect while minimizing harmful side effects. Namenda is a particularly safe treatment for Alzheimer's disease because it dampens excessive glutamate signaling that occurs away from synapses without blocking glutamate activity at the synapses. This is important because interfering with synaptic glutamate signaling would disrupt normal brain activity.
"We showed definitively for the first time that Namenda, the drug our group developed for Alzheimer's disease, works in a unique way," Dr. Lipton said.
"It inhibits a protein that binds glutamate called the NMDA receptor, but predominantly blocks NMDA receptors that signal molecularly to cause neuronal injury and death. It spares the synaptic receptors that mediate normal communication between nerve cells in the brain."
This finding helps explain why the drug is so well tolerated by Alzheimer's patients and might provide hints for the development of future therapies targeting the NMDA receptor and similar cellular machinery in other diseases.
Namenda is now available in an XR and a generic to save money and take fewer doses a day. Go to www.alzheimersweekly.com/treatment/namenda-&-side-effects-a804.html
Friday, August 20, 2010
Make Happiness Happen
I am on WATD tomorrow morning talking about how to bring happiness to someone with dementia. My column in the SS Senior News www.southshoresenior.com has the same ideas. I'm including it here for those of you who don't get the paper (you should; log on and read some good articles)
Make Happiness Happen
Believe it or not, August is Happiness Happens Month. Where do they come up with these titles for months anyway? How does one make happiness happen? One of my coaches, Susan, gave me a plaque that reads: ‘We don’t remember days; we only remember moments.’ That is true for all of us. We remember the joy in seeing our first born for the first time. We remember a moment on a vacation that brings a smile or a tear.
We hear a song and the feeling it evokes brings to remembrance who we were with and what we were doing. We are capable of pulling those special memories out of our head and enjoy them again.
Happiness for the person with Alzheimer’s however doesn’t just happen. Since often all the person with memory loss is aware of is this moment, caregivers need to find how to create as many happy moments throughout the day as possible. For each person this can be different. Does music bring a smile? One wife, unable to make her aphasic husband understand her invitation to come to the table to eat, recalled his happiness while ballroom dancing in years past. They had gone dancing weekly then. She decided to put on dance music each meal and invite him to dance which he willingly did. Then she danced him to the table with a smile. When he saw the visual cues of a meal on the table he was ready to sit and eat. She felt joy seeing the happiness on his face so she continued this dance routine three times a day.
A daughter taped the Judge Judy Show, seeing the enjoyment her mother got whenever she watched it. When her mother became restless or irritable, she popped in a Judge Judy tape. Voila; instant smiles and contentment!
So what makes your family member with Alzheimer’s smile? Is it old photos? Is it plants? Does he love the beach, sunsets, baseball games? Try offering those activities and see what feelings of happiness you can make happen for both of you.
Coach Beverly
Make Happiness Happen
Believe it or not, August is Happiness Happens Month. Where do they come up with these titles for months anyway? How does one make happiness happen? One of my coaches, Susan, gave me a plaque that reads: ‘We don’t remember days; we only remember moments.’ That is true for all of us. We remember the joy in seeing our first born for the first time. We remember a moment on a vacation that brings a smile or a tear.
We hear a song and the feeling it evokes brings to remembrance who we were with and what we were doing. We are capable of pulling those special memories out of our head and enjoy them again.
Happiness for the person with Alzheimer’s however doesn’t just happen. Since often all the person with memory loss is aware of is this moment, caregivers need to find how to create as many happy moments throughout the day as possible. For each person this can be different. Does music bring a smile? One wife, unable to make her aphasic husband understand her invitation to come to the table to eat, recalled his happiness while ballroom dancing in years past. They had gone dancing weekly then. She decided to put on dance music each meal and invite him to dance which he willingly did. Then she danced him to the table with a smile. When he saw the visual cues of a meal on the table he was ready to sit and eat. She felt joy seeing the happiness on his face so she continued this dance routine three times a day.
A daughter taped the Judge Judy Show, seeing the enjoyment her mother got whenever she watched it. When her mother became restless or irritable, she popped in a Judge Judy tape. Voila; instant smiles and contentment!
So what makes your family member with Alzheimer’s smile? Is it old photos? Is it plants? Does he love the beach, sunsets, baseball games? Try offering those activities and see what feelings of happiness you can make happen for both of you.
Coach Beverly
Subscribe to:
Posts (Atom)