HealthBridge's In-Home Care Blog

It's been an exciting summer for Alzheimer's research. 

The Alzheimer's Association has created an incredible new website to help caregivers track research developments.  A team of scientists developed a new brain scan that can detect the hallmark plaques of the disease. 

Now, here in Texas, a team of researchers has developed a blood test for Alzheimer's Disease. 

The Houston Chronicle interviewed the primary researcher on the project:

"If it's confirmed, this test will offer millions of geriatric patients across the country and the planet the opportunity at least to be screened annually," said Dr. Sid O'Bryant, a professor of neurology at Texas Tech Health Sciences Center and the primary investigator of the study, in Hawaii. "Then, if it's positive they can go to a specialist and get a proper workup and start treatment."

The test, which measures a mix of more than 100 blood proteins, accurately classified those participants who had the disease and those who didn't 95 percent of the time. Blood samples were taken from about 600 people, split between those with and without the disease.

Many research teams are pursuing such a diagnostic tool, but Baylor College of Medicine team member Dr. Rachelle Doody said the Texas research is the most comprehensive and furthest along. The Texas team will publish a paper on the study in an undisclosed journal this fall, only the second ever such journal publication involving an Alzheimer's blood test.

Doody stressed that the study still needs to be replicated.

The team has submitted a grant request to the National Institutes of Health that would not only attempt to replicate the results, but also assess its ability to distinguish different types of Alzheimer's and to predict people's risk of developing the disease.

More than 5 million Americans have the degenerative brain disease, according to the Alzheimer's Association, and experts predict the number will double over the next 15 years as baby boomers age.

Texas has 340,000 people with Alzheimer's or other forms of dementia, an amount projected to grow to at least half a million by 2025.

The study was the product of the Texas Alzheimer's Research Consortium, a Legislature-created collaboration comprised of Baylor, Texas Tech, the University of Texas Southwestern Medical Center in Dallas, the UT Health Science Center at San Antonio and the University of North Texas Health Science Center in Fort Worth.

I'm so proud of the work we're doing here in Texas to fight Alzheimer's Disease.  We're among the first states to have a comprehensive State Plan for Alzheimer's Disease.  The Texas Alzheimer's Research Consortium is a shining example of how collaborating on the hardest problems can yield great results. 

We'll continue to keep you posted as these new Alzheimer's Disease diagnosis tests mature.  Until then, please continue to support the cause and continue to share your success stories with this community!

      One of the upsides to being a senior driver is having years of experience and being able to think critically while on the road.  Also, older drivers can manage their emotions and impulses better than younger adults. Young adults are three times as likely to tailgate as senior citizens and much more likely to run a red light. Unfortunately, as you age, reaction time can slow, vision can be impaired and certain illnesses may affect driving skills. 

If you feel that you may be putting yourself or others at risk on the road then talk to your doctor.  Your primary physician will be able to make a qualified analysis of your driving capabilities and talk to you about alternatives or ways to make yourself safer on the road.

As a nation, we are living longer.  The U.S. Census Bureau predicts that by 2028, drivers over the age of 75 will have grown from 18 million (in 2008) to 31 million.  Between that time over 100,000 senior drivers could lose their lives. With the growth of the mobile web and texting, driving is becoming increasingly more dangerous for everyone.   As a senior citizen, it is important to put into effect some tips to help keep you safe on the road.

• Avoid left turns- this is the most important thing a senior can do to keep themselves and other people on the road safe.  28% of accidents involving seniors happen when the senior is attempting a left turn.  It may take you a little longer to get to the grocery store, but it is a small price to pay for your safety.
• Leave the left lane to the speeders- I do not condone speeding for anyone, but unfortunately, it is one of those permanent evils (like cockroaches).  Staying in the right lane not only helps you make a quick exit, but keeps you away from some of the most dangerous drivers on the road.
• Try to avoid the highway- If you can, just steer clear of the highway all together.  In Dallas, I still get a little panicked whenever I merge onto 635 and often find ways to avoid it.  On Mapquest you can find routes to your destination and choose an option that lets you avoid highways.  It's incredibly handy.
• Avoid night driving- This rule is one that a lot of seniors follow for their own reasons.  Street signs are harder to read at night and the headlights from other cars can be disorienting.  On top of that, night time can bring out more dangerous driving from other people on the road.
• It's okay, just valet- I realize that valet parking is not provided everywhere, but in the Dallas metroplex it certainly is growing in popularity. It's even at some of the local malls.  On skinny side streets and busy traffic areas if you have the choice between parallel parking and valet, choose valet. Not only does it save you time from circling the parking lots and waiting for cars to move, but usually it's free of charge.  Sometimes there is a small fee and tipping your valet is encouraged when you pick up your car, but I think the small price is worth the big pay-off of your safety.
• Use public transportation- Do your part for our earth and keep yourself safe at the same time.  Also, it will keep you from spending money on gas.  Walking to the bus stop can be beneficial to your health as well. Dallas offers a Dart Rail service that discounts for senior citizens.
• Don't be Superman (or woman)- If you've recently been injured, are healing from an injury or have an illness such as athritis that affects your joints or driving ability; just don't drive.  Period. Your family and friends would be more than happy to give you rides to places you need to go.  Don't be afraid to ask for help.

Keep in mind that you need to be honest with yourself or your loved one when it comes to the decision to stop driving.  It seems tough to give up such a regular part of your life, but the bottom line is keeping everyone safe on the road.  Please feel free to leave your driving suggestions/tips in the comments.

When did you begin to suspect your loved one might have a memory issue?

Twenty years ago, I started to suspect my grandma’s memory was slipping when she began retelling the same stories.  I know we're all a little guilty of repeating our favorite stories, but this was, well, different.

Was this a normal part of aging or something else?  

I didn't know it then, but my grandma had Alzheimer's Disease.

As I began to research how my grandma’s mind was changing, I was startled to discovery how difficult it was to find current, reliable information.  I knew there was research happening, but I didn’t know where to find it.  

To consolidate that information and make it accessible to busy caregivers, the Alzheimer’s Association has created a new website called the Alzheimer’s Association Research Center.  

The site acts as a filter, pulling in news and research and presenting it in a way that’s useful to the busy caregiver.  Here’s a little bit from the Association on how and why it developed the site:

"As I travel the country and talk to people whose families are affected by Alzheimer's disease, and as I read my daily e-mails, it is strikingly apparent that a wide range of people are genuinely interested in learning about what's happening in Alzheimer's science and when the next breakthroughs are going to come," said Angela Geiger, Chief Strategy Officer at the Alzheimer's Association. "The Alzheimer's Association is exploring innovative ways to advance research and also to engage and educate all kinds of people. This new website is an extension of this ever-expanding effort."

The innovative website seamlessly combines rich visuals with easy-to-understand content on a broad array of topics including:

• What Alzheimer's is, and how the disease progresses.
• Advances in treatments, diagnosis and prevention.
• How to volunteer for Alzheimer's clinical trials.
• Updates on key local, national and global research initiatives.

Important concepts about Alzheimer's the disease are explained and illustrated. Leading scientists are profiled. All of this and more is found at the "Research Center" in an easy-to-navigate presentation that enables users to quickly discover and connect with the information that matters most to them. Regular updates will include new information, interviews, graphics, and videos.

"Research is the most critical aspect of solving the Alzheimer crisis. This is why it is vital to have a place where people can go to find out about the latest Alzheimer research," Geiger said. "We listened to our constituents who said they wanted to know, learn and understand more. We hope this site serves as a catalyst for deeper understanding about Alzheimer research and a long-term dialogue with the public that encourages hope and engages them in the Alzheimer's cause."

Thanks to the Alzheimer's Association for creating this resource.  I know my family and our clients will use it often. 

Long before our Founding Fathers declared independence from Great Britain, independence itself was a sacred American virtue.  We cherish our autonomy.  We boldly defend our freedom. 

Our pursuit of independence is our personal Manifest Destiny. 

Should we be surprised when our loved ones resist senior care because it infringes on their independence? 

Paula Span addressed this question in her New Old Age Blog, which I've quoted here at length:

When we do talk or think about aging, not a favorite activity among the general public, we applaud the astonishing outliers, the silver-haired marathoner, the 90-year-old senator, the 78-year-old Betty White — the ones who don’t have to stop doing what they’ve always done.

Yet most older Americans — two-thirds of them, by one commonly used projection — will reach a point of dependency, a time when they will need to rely on others for such everyday needs as taking a shower or getting dressed.

In some cultures, where the multigenerational family remains normative, perhaps this phase feels more natural. Here, the ideal is Clint Eastwood. He’s not only doing great work at 80; he’s the self-sufficient loner, the outlaw, the Man With No Name.

Dependence generates anger, shame, defiance. It’s acceptable only for the very young; among adults, it’s not merely an uncomfortable personal reality, it’s un-American. We are all supposed to be able to take care of ourselves, apparently forever.

I might argue that this is nonsense, that we’re all dependent on a global web of other people every day of our lives, but that’s not much help to a family member who wishes her father would start using the senior bus instead of driving, or hopes her mother will allow an aide to help with laundry and cooking.

Tough and painful negotiations often ensue, and our own cultural and political history contributes to the tensions. We’ve all grown up with independence as a primary value. So we shouldn’t be so startled when our elders say, Don’t Tread on Me.

Span closes her article by quoting the Gadsden Flag, which pictures a coiled rattlesnake above the motto, "Don't Tread on Me." 

Perhaps nothing better symbolizes American independence. 

But, that's not the only American virtue we hold dear. Our Founding Fathers knew that, unless the American Colonies banded together, we would never succeed. 

As Americans, we build great cities, companies and communities.  We hold teamwork in high regard.

As caregivers, we can draw inspiration from this virtue.  When we care for our loved ones, united we stand and divided we fall.  We cannot care for ourselves forever.  When the time comes, we must embrace the American value of teamwork. 

The consequences of not joining together for care can be dire. 

We may not agree with his melancholy tone, but we can't disagree with Benjamin Franklin's urgency when he implores us to "Join, or Die."

How do you help your loved ones while preserving their independence? 

It is no secret that being the sole caregiver for an aging loved one can often feel overwhelming. Of course, you want to give the love and attention you felt as a child back to your parents as they age, but this can sometimes lead to strife among family members, lack of sleep, immune-system deficiency, and a myriad of other health problems. Sometimes it seems never ending. How can we cope with these stressors?

Flying home from a family reunion this past weekend, I read an interesting article in Newsweek titled The Caregiving Boomerang. It is written by Gail Sheehy, the author of 'Passages.'  It pointed out a lot of the negative aspects of being a caregiver, but also how to combat them. Here are a few of the ideas that Gail has used in her own life to ward off the negative and focus on the positive.

• Be on the same team with your siblings.  Some studies have shown that siblings are the number one cause of interpersonal stress when dealing with the care of a parent.  If your parents are still independent, meet with your siblings and come up with a team plan now.  If your parents are dependent, see your siblings in person with a mediator (i.e. a social worker or your parents primary physician). Have your siblings share what they think they can bring to the table, whether it be money or time. Just because you live the closest does not mean that the responsibility should be yours alone.

• Start a care calendar online that can be accessed by all involved in your loved ones care.  It will help keep you organized and off the phone.  You can search for them on google or check out this one.

• Join a local support group where you can hear stories and ideas from veteran caregivers.  As silly as it sounds, sometimes it's just nice to know you aren't the only one dealing with this. Here are a couple Dallas based support groups.

• Since lack of sleep is often a symptom of caregiving, excercise regularly. Excercise is beneficial in many ways.  That jog around the neighborhood is a little time to yourself, it will make you feel good, and help you sleep more restfully at night. Admit it, you know you're a pro at multi-tasking by now!

• Gail insists that the caregiver take an hour a day for themselves.  Whether it's to get a pedicure or just have coffee with a friend, this is an essential rule.  I'm sure the reasoning behind it is pretty obvious.  Instead of racking yourself with guilt over leaving your loved one for an hour, look at it as a reward for a job well done. If you can't take the time away from them without worrying, then it's okay to hire a caregiver.
  

• Remember that you're a fallible human being. No one is perfect and you cannot hold yourself to a standard that cannot be upheld.  You cannot control the aging or illness of your loved one. And you need to remember that you are doing the best you can, even if the care recipient says otherwise.  Sometimes it is nice to have a daily affirmation.  I would choose one that incorporates your love for the care recipient, yourself, and your peace of mind.

Try to keep in touch with old friends, family members, and your church or temple.  When the day comes that your loved one leaves you, staying in contact with these people will be one of the easiest ways to transition back to "yourself."  Hopefully, utilizing these steps will keep you from becoming too overwhelmed by caregiving and keep you young at heart.

How do you know if your loved one has Alzheimer's Disease?

Right now, you don't.  At least not definitively.  

You can have a pretty good idea based on a battery of clinical tests that allow you to eliminate other alternatives. But, even the smartest doctors at the best medical centers are often wrong. 

Twenty percent of people with dementia who received a diagnosis of Alzheimer's Disease did not have it.  Half of people with mild cognitive impairment were misdiagnosed with Alzheimer's.  

The only definitive way to diagnose Alzheimer's Disease is through an autopsy.  

Why is Alzheimer's Disease so hard to diagnose? 

A person with memory loss doesn't necessarily have Alzheimer's Disease.

Alzheimer's Disease is plaque in the brain plus memory loss and mental decline.  Doctors can't see the plaque in the brain without an autopsy.  They have to rely on other tests to make their best guess at the diagnosis.  

Not being able to see the plaque in living patients presents two big problems: 

1. It means doctors can't tell if the disease is progressing in your loved one.
2. Doctors can't tell if people with plaque, but normal memories, are developing Alzheimer's Disease. 
   

An accurate diagnosis, at last.  

Finding a trustworthy diagnosis for Alzheimer's Disease is the mission of Dr. Daniel Skovronsky and his team at Avid Radiopharmaceuticals.  

Avid discovered a dye that, combined with a brain scan, shows the hallmark plaque collecting in the brains of people with Alzheimer's Disease.  

The dye and scan are still being tested, but the preliminary findings are astounding, according to the New York Times.

A man diagnosed with Alzheimer's and cancer had a scan showing no plaque.  His autopsy did not show it either.  The diagnosis was wrong.  Another man with Parkinson's disease and dementia had been diagnosed as having dementia solely due to Parkinson's.  His scan showed amyloid.  So did the autopsy.  He had Alzheimer's.  A woman with mild memory loss had a scan showing no amyloid.  Her autopsy also found none.  Three others had clinical diagnoses of Alzheimer's, confirmed by scans and autopsies.  

This means doctors will, for the first time, have a reliable way to diagnose the presence of Alzheimer's Disease in patients with memory problems.  And people with a small build up of plaque, but no memory impairment, can immediately begin treatment to stave off the disease. 

The findings must still be approved by the Food and Drug Administration.  But, if they hold up, we will finally have a trustworthy way to diagnose Alzheimer's Disease.  

How will your life as an Alzheimer's caregiver change, if this accurate diagnosis method comes to pass?  

Trina Ennamany is our caregiver of the week!

 Here are just some of the reasons Trina deserves this title.

• She's been known to swing by her clients house just to make sure they're doing okay.
• She makes her clients laugh and feel at ease.
• She'll go out of her way to help others.
• She lights up our day just by stopping into the office.
• You can tell that she loves her clients just by talking to her about her week. 
• She's willing to be flexible with her schedule in order to give help to her clients who need it most.

This is Trina's second time to receive this honor. She has proven time and again just how important her clients are to her while giving them peace of mind and topnotch care.

You can read Trina's original interview here.

Thank you Trina for being such a great caregiver!

Caregiving may feed the soul, but the families we serve are starving for knowledge about it. 

It's a job without a job description.  It's a task that we're duty bound to do, but ill prepared to do well.  

So, I'm always on the hunt for useful guides about caregiving.

I like the new guide from the National Institute on Aging about caring for a loved one with Alzheimer's Disease.  

It dives into the deep and complex issues of caregiving, without being overwhelming.  It's not a pamphlet.  It's a venerable guide that will improve the care you provide your loved one.   

Read the whole guide online here.  

For more Dallas Alzheimer's Care resources, visit the website of the Greater Dallas Chapter of the Alzheimer's Association.  You'll find literature, events, seminars and classes you can use to support your caregiving mission.  

General well-being (characterized by how people currently felt about their life) fell sharply through the age of 25 and tapered more gradually overall until the ages of 50 to 53. And by the early 70s, that wellbeing was back up to late-teen levels. 

"As people age, they are less troubled by stress and anger," the researchers noted in their study, which was led by Arthur Stone, of the Department of Psychiatry and Behavioral Science at Stony Brook University, and published online May 17 in the Proceedings of the National Academy of Sciences. "And although worry persists, without increasing, until middle age, " they continued, "it too fades after the age of 50."

The data come from a 2008 phone survey performed by the Gallup Organization of 340,847 randomly selected adults aged 18 to 85. The respondents represented a fairly average slice of the U.S. population, with about 29 percent holding a college degree and a median monthly average household income between $3,000 and $3,999. During the call, participants were asked to rate how they currently felt their life stood on a scale of 0 ("the worst possible life for you") to 10 ("the best possible life for you"). They were then asked if they had felt different affective states (happiness, enjoyment, stress, sadness, anger and worry) "a lot of the day yesterday." Keeping questions to relatively current periods in time by asking about yesterday as opposed to the previous week, month or year helped the researchers avoid some of the retrospective bias that might have played a role in similar past studies. 

We're all frightened of losing ourselves to Alzheimer's Disease.  Watching our mind slip away while our body still has vigor is a terrifying idea.  

Now, the disease has a new wrinkle that, if you can imagine, makes it even scarier.  

The $20,000,000,000,000 cost.  

While we struggle through the worst financial crisis since the Great Depression, we're forced to acknowledge that caring for our loved ones with Alzheimer's Disease will completely disrupt our economy.  

We knew this impending neurological epidemic was huge, but until this new study by the Alzheimer's Association, we didn't know it was thirteen-zeros-huge.  Click here to download the full report. 

What, exactly, does this mean?

• By the year 2050, 13.5 million people will have Alzheimer's Disease.  That's compared to roughly 5.1 million who have it today.  
• The annual costs of care would also increase from $172 billion to more than $1 trillion.
• Medicare costs will rise by more than 600% and Medicaid costs will soar to $178 billion, up from the current $34 billion. 

What can we do about it?

There is not a cure for Alzheimer's Disease.  Wonderful and worthwhile organizations like the Alzheimer's Association are working for a cure.  They focus on two avenues:

1. Delaying onset of the disease.  A lot of encouraging research shows that we can personally help prevent the disease.  Living a healthy life, exercising and eating a Mediterranean diet can all help.  A breakthrough that delayed the onset of Alzheimer's Disease would reduce the number of people with the disease.  Needless to say, we want this.  
2. Slowing the progression of the disease.  Living with the early stages of the disease is life changing, but can be bearable.  Bill Bridgwater showed us a few weeks ago that "Alzheimer's Disease is something people have, not who they are."  Slowing the progression of the disease would increase the number of people with Alzheimer's Disease, but would improve the life of everyone afflicted.  

Here at HealthBridge, our purpose is simple:  to help people care for each other.  We believe finding a cure for Alzheimer's Disease is consistent with our purpose.  

In a couple of weeks, we'll announce the details of our plan to support the search for a cure for Alzheimer's Disease.  Until then, would you send me your ideas?  Please leave a comment below or send me an email to matt (at) myhealthbridge dot com (spelled out to avoid the spam-bots).  

P.S:  The costs above don't include the unpaid care provided by family members and friends.  In 2009, that cost was estimated to be $144 billion.  Whoa.