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This page is about Home support for an Elderly Couple.

Contents

Healthcare

Emergency Treatment

If I ask or tell you to leave me alone your first response should be to do as I ask. Retreat and leave me alone. Observe but allow me to calm down. Do not involve the police or emergency medical services. Woman Detained In Hospital For Weeks Joins Lawsuit Against New Hampshire https://n.pr/31A6lpy

Honey treatment for coughs

Honey better treatment for coughs and colds than antibiotics, study claims. Research suggests honey also more effective than many over-the-counter medicines. https://www.theguardian.com/science/2020/aug/19/honey-better-treatment-for-coughs-and-colds-than-antibiotics-study-clams

Cough. Taking a small amount of honey at bedtime appears to reduce the number of coughing spells in children age 2 years and older. Honey appears to be at least as effective as the cough suppressant dextromethorphan in typical over-the-counter doses. Also, drinking water containing a small amount of a honey/coffee paste seems to reduce the frequency of coughing in adults that have a long-lasting cough after they have been ill. https://www.webmd.com/vitamins/ai/ingredientmono-738/honey

While there are many over-the-counter cough medicines that include honey, you can also mix it with hot lemon yourself at home to obtain a similar effect:

  1. squeeze half a lemon into a mug of boiled water
  2. add 1 to 2 teaspoons of honey
  3. drink while still warm (don't give hot drinks to small children)

https://www.nhs.uk/news/heart-and-lungs/honey-not-antibiotics-recommended-coughs/

Exploding Head Syndrome

Exploding Head Syndrome (EHS) is an actual medical condition in which an individual sometimes experiences an explosive sound inside their head when drifting off to sleep or just waking up. The big boom may also be accompanied by a flash of light. Also called "episodic cranial sensory shock," cases have been reported in the medical literature since the 19th century although the phenomenon is not well studied. In 2017, the BBC's Science Focus magazine and academic collaborators launched a survey about EHS and the results have just been published in the scientific journal Sleep Medicine: https://www.sciencedirect.com/science/article/abs/pii/S1389945720302604

“Exploding Head Syndrome (EHS) is not discussed very much in the media or elsewhere. Consequently, people having this experience may have very little information about what is going on,” said [Goldsmiths psychology professor Alice] Gregory. “In our study, we found that those who had experienced EHS reported poorer sleep quality and less sleep than others. In future, we would like to understand more about these associations. For example, could disturbed sleep trigger this experience, or is it that someone who has experienced EHS finds it more difficult to fall asleep at night?” https://www.sciencefocus.com/news/exploding-head-syndrome-largest-ever-study-of-mysterious-condition/ https://boingboing.net/2020/07/15/do-you-suffer-from-exploding-h.html

Healthcare Insurance cost and billing

The Nation’s Largest Repository of Private Claims Data https://www.fairhealth.org

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

Care Facilities in El Cajon

https://choosewellsandiego.org/facility-search;facilityName=;location=El%20Cajon;capacity=;memberStatus=;specialtyCare=All;pageIndex=0;pageSize=20

Country Hills is an employee owned and operated skilled nursing facility located in the East County of San Diego. We are proud to offer the combined skills of experienced health care professionals to provide a caring home for individuals that need twenty-four hour nursing care. https://www.countryhills.com/services/

Tremor

The Steadi-One | All-in-one Assistive Glove for Essential Hand Tremor Relief https://steadiwear.com/products/steadi-one-glove

Aging

Drug reverses age-related cognitive decline within days. Just a few doses of an experimental drug can reverse age-related declines in memory and mental flexibility in mice, according to a new study by UC San Francisco scientists. The drug, called ISRIB, has already been shown in laboratory studies to restore memory function months after traumatic brain injury (TBI), reverse cognitive impairments in Down Syndrome , prevent noise-related hearing loss, fight certain types of prostate cancer , and even enhance cognition in healthy animals. "ISRIB's extremely rapid effects show for the first time that a significant component of age-related cognitive losses may be caused by a kind of reversible physiological "blockage" rather than more permanent degradation," said Susanna Rosi , Ph.D., Lewis and Ruth Cozen Chair II and professor in the departments of Neurological Surgery and of Physical Therapy and Rehabilitation Science. https://medicalxpress.com/news/2020-12-drug-reverses-age-related-cognitive-decline.html

Watch “Navigating the Long Term Care System” on #Vimeo. Kristin Rigsbee made this presentation at the 4th Annual Convention of the San Diego Chapter of the Huntington's Disease Society of America, San Diego, CA, July 13, 2019. Rigsbee is the Education and Outreach Specialist for the County of San Diego Long Term Care Ombudsman Program. https://vimeo.com/348534839

In Helsinki about 4,000 frail people are equipped with various safety gadgets to help them stay living at home for longer https://t.co/pRtbNE635R — The Economist (@TheEconomist) https://twitter.com/TheEconomist/status/1215649530856775681 January 10, 2020

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. Dad must be left alone undisturbed for 2-3hours.
    2. Mom should be out of the apartment 3 days per week 2-3hours each time.
    3. Provide companionship to Mom. Promote group activities.
    4. If Mom wants to be left alone walk her to one of the loobies or the library, withdraw but stay within sight of her and let her sit alone.
    5. Activities for Mom could be physical therapy. Combine hair appointment with lunch and walking. Others to be developed.
    6. Dad must be left alone undisturbed by Mom or Aid for 2-3hours.

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

Delirium

manifestation

Delirium Isn't 'Just Part of Getting Older'. Delirium refers to a change in the brain’s neurochemistry that causes a person to become highly confused and unable to think clearly. People with delirium often can’t remember recent events or where they are. The condition usually comes on quickly, but the symptoms can come and go. https://nexav.org/2HD0j0y via @nextavenue

Delirium manifests in two primary ways: high agitation (which is called hyperactive delirium) or, more commonly, as inactivity (which is called hypoactive delirium). It’s possible to experience both hyperactive and hypoactive delirium throughout the course of an illness.

It’s more difficult to catch hypoactive delirium because this type of delirium is much less obvious. When patients have hyperactive delirium, they’re doing things like shouting at family members or hospital staff, trying to pull out intravenous tubes or even striking out at people.

“But more often, people just become really withdrawn and they stop eating, stop moving around,” Takahashi says. “When I’m talking to patients or their families, I say: ‘If you notice mom has become less interactive, her mood and behavior changes, she’s less alert and she’s not really responding to you, that’s as serious as the overactive type.’”

Delirium’s mortality rate is high — the same in-hospital mortality rate as having a heart attack, says Dr. Stephanie Rogers, a geriatrician and physician lead for the University of California San Francisco’s (UCSF) Delirium Reduction program.

“It causes a lot of patient and family distress. There’s been reported cases of post-traumatic stress disorder after hospitalization,” Rogers says. “It increases the likelihood that you’re going to have to go into a nursing home after discharge rather than going home.” Delirium is also associated with patient falls in hospitals.

links

It's Time to Take Delirium Seriously. Fortunately, basic steps can be taken to prevent delirium or shorten its course, such as making sure the patient is well hydrated, has access to eyeglasses and hearing aids if he or she uses them, gets out of bed and walks as soon as possible, has adequate sleep, and is socially engaged by hospital staff and loved ones. https://www.scientificamerican.com/article/its-time-to-take-delirium-seriously/?amp via @sciam

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).

New drugs, treatments

An experimental Alzheimer's drug from Eli Lilly showed significant slowing of decline in patients with early symptoms of the disease, the company said Monday. An experimental Alzheimer's drug from Eli Lilly showed significant slowing of decline in patients with early symptoms of the disease, the company said Monday. https://thehill.com/policy/healthcare/533712-experimental-alzheimers-drug-shows-promise-in-small-trial

links, News

The coronavirus jab's most tantalising side effects? It may help fight cancer, chronic pain... and even Alzheimer's. Scientists have documented the unexpected benefits of vaccines for decades. Some experts suggest vaccines can 'train' the immune system, strengthening it. Others say increased stress hormones affect cells' ability to target infections. https://www.dailymail.co.uk/health/article-9307203/Coronavirus-jab-help-fight-cancer-chronic-pain-Alzheimers.html

As humanity ages the numbers of people with dementia will surge. The world is ill-prepared for the frightening human, economic and social implications. https://www.economist.com/special-report/2020/08/27/as-humanity-ages-the-numbers-of-people-with-dementia-will-surge

21 ways to reduce your Alzheimer's risk, backed by research. https://www.cnn.com/2020/07/20/health/alzheimers-disease-prevention-wellness/index.html

For men and women over 50, the dementia risk is 28% when taking body mass index and waist circumference into account together, the study said. Researchers measured participants' height, weight and waist circumference and followed up with them an average of 11 years later to see whether they'd been diagnosed with dementia. "As belly size gets larger, the memory center in the brain gets smaller, based on prior studies," said Dr. Richard Isaacson, who heads the Alzheimer's Prevention Clinic at Weill Cornell Medicine and New York-Presbyterian Hospital. https://www.cnn.com/2020/06/23/health/belly-fat-dementia-link-wellness/index.html

Watch “Complaints of a Dutiful Daughter” on #Vimeo On Demand https://vimeo.com/ondemand/138538

‘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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