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From Bwtm

This page is about Home support for an Elderly Couple.

Contents

Healthcare

News

Caring for relative and fear you’ll make mistake? Millions do, AARP report says https://www.sacbee.com/news/local/health-and-medicine/article229435059.html

U.S. Federal Court Finds UnitedHealthcare Affiliate Illegally Denied Mental Health and Substance Use Coverage in Nationwide Class Action https://apnews.com/Globe%20Newswire/7ac8e3da7f47c4064e7c49d28b82db4c

Aging

Woman turns 107 and shares her secret to longevity: 'I never got married' http://via.kswbtv.com/U0Twm via @fox5sandiego

Happy ever after: 25 ways to live well into old age https://www.theguardian.com/lifeandstyle/2019/may/26/happy-ever-after-25-ways-to-live-well-into-old-age

Objective

  1. Provide basic hygiene care and grooming for Mom. Bathing and dressing.
  2. help with laundry. organize clothes in closets and tidy laundry area.
  3. Light housekeeping. Change linens and bed making. Collect and dispose of trash and recycling.
  4. Provide healthy breakfast for both. Help with meal prep and cleanup. Keep counters tidy. Check food supply.
  5. Dispence medications from prepared cassettes for both.
  6. Encourage hydration for Mom.
  7. Provide safety for Mom to avoid falls or injuries. Walking assistance.
  8. Provide respite to Dad.
  9. Provide afternoon activity to promote regular sleep patterns.

Services Required

  1. In home Aid service from 8:00am to 11:00am seven days a week.
    1. Primarily covers items 1-7 above.
  2. Daily in home visit to dispense evening medications from cassette, 15 minutes. Encourage hydration for Mom.
  3. Respite for Dad:
    1. Mom should be out of the apartment 3 days per week 2-3hours each time.
    2. Provide companionship. Promote group activities.
    3. Activities could be physical therapy. Combine hair appointment with lunch and walking. Others to be developed.

Desires

  1. Have a writen plan. Provide consistent service day to day. Periodic review and revise if required.
  2. Would like 2-3 Aids to consistently do the daily morning shift. Uniform style of dress. Prominent name tags.
  3. Have a plan to deal with Mom's tantrums. see item 1.
    1. Phone contact to avoid "I will call the Police" threats.

misc

  1. clear out clutter in kitchen cabinets.
  2. note paper crafting with photos of roses.
  3. Mom sometimes likes to cook but use of stove requires supervision.
  4. organize collections and package in display boxes.

Sources

  1. Fox Run Home Support Services
  2. http://seniorshelpingseniors.com for respite care
  3. https://www.homeinstead.com/
  4. http://www.seniorhelpers.com/oaklandmi
  5. http://www.assuredhospicecare.com/Home.html

Kidney Disease

  1. Aranesp® is a prescription medicine used to treat a lower than normal number of red blood cells (anemia) caused by chronic kidney disease in patients on dialysis and not on dialysis. http://www.aranesp.com
  2. Welcome to the ESA APPRISE Oncology Program https://www.esa-apprise.com/ESAAppriseUI/ESAAppriseUI/default.jsp
  3. Blood tests. Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood.
  4. High blood pressure medications. People with kidney disease may experience worsening high blood pressure. Your doctor may recommend medications to lower your blood pressure — commonly angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers — and to preserve kidney function. High blood pressure medications can initially decrease kidney function and change electrolyte levels, so you may need frequent blood tests to monitor your condition. Your doctor will likely also recommend a water pill (diuretic) and a low-salt diet.
  5. Medications to treat anemia. In certain situations, your doctor may recommend supplements of the hormone erythropoietin (uh-rith-roe-POI-uh-tin), sometimes with added iron. Erythropoietin supplements aid in production of more red blood cells, which may relieve fatigue and weakness associated with anemia.
  6. Medications to relieve swelling. People with chronic kidney disease may retain fluids. This can lead to swelling in the legs, as well as high blood pressure. Medications called diuretics can help maintain the balance of fluids in your body.
  7. Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Approximately 2% of the body's creatine is converted to creatinine every day. Creatinine is transported through the bloodstream to the kidneys. The kidneys filter out most of the creatinine and dispose of it in the urine. Because the muscle mass in the body is relatively constant from day to day, the creatinine production normally remains essentially unchanged on a daily basis. http://www.medicinenet.com/creatinine_blood_test/article.htm
  8. Blood urea nitrogen (BUN) level is another indicator of kidney function. Urea is also a metabolic byproduct which can build up if kidney function is impaired. The BUN-to-creatinine ratio generally provides more precise information about kidney function and its possible underlying cause compared with creatinine level alone. BUN also increases with dehydration.
  9. Results of the blood urea nitrogen test are measured in milligrams per deciliter (mg/dL) in the United States and in millimoles per liter (mmol/L) internationally. In general, 7 to 20 mg/dL (2.5 to 7.1 mmol/L) is considered normal. But normal ranges may vary, depending on the reference range used by the lab, and your age. Ask your doctor to explain your results. Urea nitrogen levels tend to increase with age. Infants have lower levels than other people do, and the range in children varies. Generally, a high blood urea nitrogen level means your kidneys aren't working well. http://www.mayoclinic.org/tests-procedures/blood-urea-nitrogen/basics/results/prc-20020239
  10. American Kidney Fund http://www.kidneyfund.org/are-you-at-risk/helpline/

Faecal transplant

Faecal transplant researchers identify 'super-pooper' donors https://www.theguardian.com/science/2019/jan/21/faecal-transplant-researchers-identify-super-pooper-donors

Dementia

General

  1. Rummaging and hiding things
  2. http://www.helpguide.org/articles/alzheimers-dementia/alzheimers-behavior-management.htm
  3. http://www.helpforalzheimersfamilies.com/dementia-support-network/hiding-misplacing-things-rummaging/
  4. Caregiver’s Guide to Understanding Dementia Behaviors https://www.caregiver.org/caregivers-guide-understanding-dementia-behaviors

Use of drugs

New report details misuse of antipsychotics in nursing homes https://apnews.com/2052229826d84280aeb29208f7eb9434

Occupational therapy for dementia

  1. THERAPEUTIC INTERVENTIONS FOR PEOPLE WITH DEMENTIA – COGNITIVE SYMPTOMS AND MAINTENANCE OF FUNCTIONING http://www.ncbi.nlm.nih.gov/books/NBK55462/
  1. Communication is key. Keep the following strategies in mind: http://rehabvisions.com/dementia-occupational-therapy-treatment-techniques/
    1. Present one idea at a time.
    2. Speak slowly and simply.
    3. Avoid asking questions.
    4. If you need to repeat something, repeat the message exactly as you said it the first time.
    5. Approach dementia patients from the front, never from behind.
    6. Use gestures or visual aids.
    7. Remember processing delays (ex: patient may take up to 90 seconds to process a simple verbal command).

links, News

‘Eventually I knew she was no longer safe alone’: how do we care for family with dementia? https://www.theguardian.com/society/2019/sep/28/dementia-how-we-car-for-people-living-with-it-sarah-boseley

Alzheimer’s test predicts onset up to 20 years in advance https://www.theguardian.com/society/2019/aug/02/alzheimers-test-predicts-onset-up-to-20-years-in-advance

Healthy lifestyle may cut risk of dementia regardless of genes. Eight-year study suggests genetic predisposition does not make condition inevitable https://www.theguardian.com/society/2019/jul/14/healthy-lifestyle-may-cut-risk-of-dementia-regardless-of-genes

Researchers have long dreamed of an Alzheimer's vaccine. Now it may finally be within reach. In a new research paper published in NPJ Vaccines, researchers reported they have developed a vaccine using virus-like particles to eliminate the tau tangles in mice who were bred to develop similar symptoms as human Alzheimer’s patients. “We’re excited by these findings, because they seem to suggest that we can use the body’s own immune system to make antibodies against these [tau] tangles .... these antibodies actually bind and clear these tau tangles,” Nicole Maphis, a PhD candidate in UNM’s Biomedical Sciences Graduate Program https://www.salon.com/2019/06/12/researchers-dreamed-of-an-alzheimers-vaccine-now-it-may-finally-be-within-reach/

Researchers say they've made progress toward preventing Alzheimer's https://thehill.com/homenews/news/447857-researchers-say-theyve-made-progress-toward-preventing-alzheimers

Pfizer had clues its blockbuster drug could prevent Alzheimer’s. Why didn’t it tell the world? Sometimes doctors prescribe drugs for uses that have not been approved by the Food and Drug Administration. But none of the experts interviewed for this story said such “off-label’’ use of Enbrel would be appropriate for Alzheimer’s, because of the very limited nature of the data thus far. Nor, they said, do they believe such prescribing is happening to any significant extent. The role of brain inflammation in Alzheimer’s recently has been getting closer attention among academics after the failure of multiple experimental drugs that targeted the buildup of plaques on brain tissue. In 2016, researchers from Dartmouth and Harvard universities published a study of insurance claims data — similar to Pfizer’s internal findings — that showed a potential benefit of Enbrel. Enbrel “shows promise as a potential treatment’’ for Alzheimer’s, the study found. https://wapo.st/2HTW4xX

The World Health Organization (WHO) has launched its first ever guidelines on how people can help avoid getting dementia. It looked at the evidence of what works and what doesn't for lowering risk. Things to avoid include smoking and drinking too much alcohol. While eating a healthy diet is beneficial, popping vitamin pills makes no difference to dementia risk, it advises. There is no good evidence that brain training works but some studies suggest it may be worthwhile, says the WHO. https://www.bbc.com/news/articles/clldg965yzjo

He has dementia, but cartoonist Gahan Wilson still sees humor in the world. Paul recently took Gahan out for coffee. "This fresh air smells so good," Wilson had said, and then he asked, "How did you break me out of jail?" https://www.azcentral.com/story/news/local/karinabland/2019/04/11/gahan-wilson-cartoonist-still-sees-humor-world/3432875002/ via @azcentral

Is It Alzheimer's Or Another Dementia? The Right Answer Matters https://n.pr/2CmMNeu

Does our immune system hold the key to beating Alzheimer’s disease? https://www.theguardian.com/society/2019/mar/03/alzheimers-disease-immune-system-immunotherapy-vaccine

Words of reassurance left for an elderly lady with dementia by her daughter. A simple white board left… https://old.reddit.com/r/pics/comments/akbxho/words_of_reassurance_left_for_an_elderly_lady/

Blood test could detect Alzheimer's years before symptoms begin. By measuring changes in the levels of a protein in the blood, called neurofilament light chain (NfL), researchers believe any rise in levels of the protein could be an early sign of the disease, according to the study published Monday in the journal Nature Medicine. NfL is a "marker in the blood which gives an indication of nerve cell loss in the brain," explained lead researcher Mathias Jucker, professor of cell biology of neurological diseases at the German Center for Neurodegenerative Diseases. The more neurofilament you have in the blood, the more brain damage you have," he said. @CNN https://cnn.it/2AWr4JM

Virtual reality to help detect early risk of Alzheimer’s https://www.theguardian.com/society/2018/dec/16/alzheimers-dementia-cure-virtual-reality-navigation-skills

A professional geriatric care manager has been educated in various fields of human services — social work, psychology, nursing, gerontology — and trained to assess, plan, coordinate, monitor and provide services for the elderly and their families. Advocacy for older adults is a primary function of the care manager. http://newoldage.blogs.nytimes.com/2008/10/06/why-hire-a-geriatric-care-manager/

Dementia Care Resource and Training Center The Resource center is open to the public Monday through Friday from 10:00am – 2:00 pm or by appointment – call 615-283-4512, Senior Helpers, 109 Holiday Court Suite D1, Franklin, TN 37067 http://www.seniorhelpers.com/franklin-tn/services/alzheimers

Alzheimer’s San Diego is dedicated to supporting families and caregivers. For many, one of the the best sources of support is through regular support group meetings. Not only is it an opportunity to understand you are not alone in the daily struggles of caring for someone with Alzheimer’s disease or another dementia, but you will build relationships and learn from other caregivers who understand what you are going through, develop new coping strategies and find comfort, strength and hope in a compassionate and safe environment. Groups are free, led by a trained group leaders and located throughout San Diego County. http://www.alzsd.org/services/support-discussion-groups/

https://www.caring.com

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