Structural Damage To The Brain From High Blood Pressure Demonstrated Among People As Young As 40

Uncontrolled high blood pressure damages the brain's structure and function as early as young middle-age, and even the brains of middle-aged people who clinically would not be considered to have hypertension have evidence of silent structural brain damage, a study led by researchers at UC Davis has found.

The investigation found accelerated brain aging among hypertensive and prehypertensive individuals in their 40s, including damage to the structural integrity of the brain's white matter and the volume of its gray matter, suggesting that vascular brain injury "develops insidiously over the lifetime with discernible effects."

The study is the first to demonstrate that there is structural damage to the brains of adults in young middle age as a result of high blood pressure, the authors said. Structural damage to the brain's white matter caused by high blood pressure previously has been associated with cognitive decline in older individuals.

Published online in the medical journal The Lancet Neurology, the study will appear in print in the December 2012 issue. It emphasizes the need for lifelong attention to vascular risk factors for brain aging, said study senior author Charles DeCarli, professor of neurology and director of the UC Davis Alzheimer's Disease Center.

"The message here is really clear: People can influence their late-life brain health by knowing and treating their blood pressure at a young age, when you wouldn't necessarily be thinking about it," DeCarli said. "The people in our study were cognitively normal, so a lack of symptoms doesn't mean anything."

Normal blood pressure is considered a systolic blood pressure -- the top number -- below 120 and a diastolic pressure -- the bottom number -- below 80. Prehypertensive blood pressure range is a top number between 120 and 139 and a bottom number between 80 and 89. Blood pressures above 140 over 90 are considered high.

Elevated blood pressure affects approximately 50 million Americans and is associated with a 62 percent risk of cerebrovascular disease, such as ischemic stroke, and a 49 percent risk of cardiovascular disease. It is the single-greatest risk factor for mortality in the United States.

Earlier studies have identified associations between elevated blood pressure and a heightened risk of brain injury and atrophy leading to reduced cognitive performance and a greater likelihood of dementia, making hypertension an important, modifiable risk factor for late-life cognitive decline. There is evidence, the study says, that lowering blood pressure among people in middle age and in the young elderly can help prevent late-life cognitive decline and dementia.

Titled "Effects of Systolic Blood Pressure on White Matter Integrity in Young Adults: From the Framingham Heart Study," the research sought to decipher the age of onset, extent and nature of the effects of elevated systolic blood pressure on cognitive decline among participants in the Framingham study, a longitudinal evaluation begun more than 60 years ago of the cardiovascular health of the residents of Framingham, Mass., that is now in its third generation of participants.

The research included 579 Framingham participants who were, on average, 39 years old when recruited for participation in the study, which launched in 2009. Their blood pressure was measured as the average of two physician-recorded blood pressures. The study subjects were organized into groups with normal blood pressure, those who were prehypertensive and those with high blood pressure. Whether they were receiving treatment for high blood pressure and whether they smoked also was noted.

The meticulously conducted study used magnetic resonance imaging (MRI) to determine the participants' brain health using a variety of measurements of white matter injury and gray matter volume. The MRI exams included diffusion tensor imaging, a particular kind of image that reveals microscopic details of tissue architecture within the white matter of the brain. The white matter includes the axons, the biological "wires" of the brain that carry information from one part of the brain to the other. Measurements from diffusion tensor imaging, such as fractional anisotropy, take on larger values if the axons are more intact. White-matter hyperintensities -- white-matter areas that appear intensely white on another kind of MRI scan -- suggest more severe damage than fractional anistropy does, and gray matter density also were examined. The imaging studies then were combined to create a global measurement of brain health that compared normal and hypertensive subjects.

The results were that, in hypertensive individuals, fractional anisotropy in the frontal lobes was reduced by an average of 6.5 percent. The hypertensives also had 9 percent less gray matter, on average, in their brains' frontal and temporal lobes. Hypertensive individuals' brains were significantly less healthy than those of subjects with normal blood pressure. For example, a typical 33-year-old hypertensive's brain health was similar to that of the typical 40-year-old normotensive subject. So, for those 33-year-olds, high blood pressure had prematurely aged the brain by seven or so years.

The authors did not postulate a mechanism for the damage. However, they noted that high blood pressure causes arteries to stiffen, thus making the blood flowing to the brain pulse more strongly. This stresses the blood vessels of the brain, likely making it more difficult for them to nourish brain tissue such as axons.

"This work suggests that recently described white matter microstructural damage associated with high blood pressure in the elderly may be detectable earlier in the life span, further reinforcing the view that vascular brain injury may develop insidiously over several decades," said Pauline Maillard, the study's lead author and a postdoctoral fellow in the UC Davis Department of Neurology. "These results emphasize the need for early and optimum control of blood pressure, which is neither routinely achieved nor subject to testing in randomised controlled clinical trials."


Visit Our Website: www.alwaysbestcaresandiego.com
And like us on Facebook! www.facebook.com/alwaysbestcaresd


Source: http://www.medicalnewstoday.com/

Could Alcohol Be Bad for Your Brain?

VANCOUVER, July 18, 2012 – Light to moderate alcohol consumption has generally been considered to have some health benefits, including possibly reducing risk of cognitive decline. However, two studies reported today at the Alzheimer’s Association International Conference^® 2012 (AAIC^® 2012) in Vancouver suggest that moderate alcohol use in late-life, heavier use earlier in life, and “binge” drinking in late-life increase risk of cognitive decline.

“The many dangers of misuse of alcohol, and some of its possible benefits, have been widely reported, and there needs to be further clarification by the scientific community,” said William Thies, PhD, Alzheimer’s Association^® chief medical and scientific officer. “Certainly no one should start drinking in order to reduce Alzheimer’s risk, as these two new reports attest.”
“We need to know more about what factors actually raise and lower risk for cognitive decline and Alzheimer’s disease. To do that, we need longer term studies in larger and more diverse populations, and we need more research funding to make that happen. We have learned incredible amounts about heart disease and stroke risk from long-term research like the Framingham Study – we have solidly proven lifestyle risk factors that people can act on every day. Alzheimer’s now needs its version of that research,” Thies added.

“In 2050, care for people with Alzheimer’s will cost the U.S. more than $1 trillion, creating an enormous strain on the healthcare system, families, and federal and state budgets. Recognizing this growing crisis, the first-ever U.S. National Plan to Address Alzheimer’s was unveiled in May. Now this plan must be swiftly and effectively implemented. We need Congress to support this implementation with an additional $100 million for Alzheimer’s research, education, outreach and community support,” Thies said.

20-year alcohol consumption patterns and cognitive impairment in older women

Whether moderate alcohol consumption has an impact on cognitive impairment in late-life is unsettled with some studies suggesting a protective effect. To date, few studies have examined patterns of alcohol consumption over time in relation to cognitive status, especially in very late-life.
Tina Hoang, MSPH, of NCIRE/The Veterans Health Research Institute, San Francisco and the University of California, San Francisco, and colleagues followed more than 1,300 women aged 65 and older for 20 years. They measured frequency of current and past alcohol use at the beginning, midpoint (years 6 and 8) and late phases (years 10 and 16) of the study. The researchers assessed participants at the end of the study for mild cognitive impairment and dementia. At baseline, 40.6% were nondrinkers, 50.4% were light drinkers (0 to 7 drinks/week), and 9.0% were moderate drinkers (7 to 14 drinks/week). Heavy drinkers (14 drinks/week) were excluded.
The scientists found that:

• Women who reported drinking more in the past than at the beginning of the study were at 30% increased risk of developing cognitive impairment.
• Moderate drinkers at baseline or at midpoint had similar risk of cognitive impairment to non-drinkers; however, moderate drinkers in the late phase of the study were roughly 60% more likely to develop cognitive impairment.
• Women who changed from nondrinking to drinking over the course of the study had a 200% increased risk of cognitive impairment.

“In this group of older women, moderate alcohol consumption was not protective,” Hoang said. “We found that heavier use earlier in life, moderate use in late-life, and transitioning to drinking in late-life were associated with an increased risk of developing cognitive impairment. These findings suggest that alcohol use in late-life may not be beneficial for cognitive function in older women.”
“It may be that the brains of oldest old adults are more vulnerable to the effects of alcohol, but it is also possible that factors associated with changing alcohol use related to coping or loss could be involved. Clinicians should carefully assess their older patients for both how much they drink and any changes in patterns of alcohol use,” Hoang added.

Binge drinking increases risk of cognitive decline in older adults

Little is known about the cognitive effects of heavy episodic (or “binge”) drinking in older people. Binge drinking is a pattern of alcohol consumption in which someone who is not otherwise a heavy drinker consumes several drinks on one occasion.

“We know that binge drinking can be harmful,” said Dr. Iain Lang of Peninsula College of Medicine and Dentistry, University of Exeter, UK. “For example, it can increase the risk of harm to the cardiovascular system, including the chance of developing heart disease, and it is related to increased risk of both intentional and unintentional injuries.”

According to Lang, it is not clear whether binge drinking in older adults has a damaging effect on cognitive health and whether it increases the risk a person will develop dementia.

Lang and colleagues conducted a secondary analysis of data from 5,075 participants aged 65 and older in the Health and Retirement Study (HRS), a biennial, longitudinal, nationally representative survey of U.S. adults age 50 and older, to assess the effects of binge drinking in older people on cognition and mood. Baseline data were collected in 2002 and participants were followed for eight years. Consumption of four or more drinks on one occasion was considered binge drinking. Cognitive function and memory were assessed using the Telephone Interview for Cognitive Status.

Binge drinking once a month or more was reported by 8.3% of men and 1.5% of women; binge drinking twice a month or more was reported by 4.3% of men and 0.5% of women.
The researchers found that:

• Participants who reported heavy episodic drinking once per month were 62% more likely to be in the group experiencing the highest decline in cognitive function, and were 27% more likely to be in the group experiencing the highest amount of memory decline.
• Participants reporting heavy episodic drinking twice per month or more were 147% more likely to be in the group experiencing the highest decline in cognitive function, and were 149% more likely to be in the group experiencing the highest amount of decline in memory.

Outcomes were similar in men and women when analyzed separately.
“In our group of community-dwelling older adults, binge drinking is associated with an increased risk of cognitive decline,” Lang said. “Those who reported binge drinking at least twice a month were more than twice as likely to have the greatest decline in both cognitive function and memory. These differences were present even when we took into account other factors known to be related to cognitive decline such as age and level of education.”

“This research has a number of implications. First, older people – and their physicians should be aware that binge drinking may increase their risk of experiencing cognitive decline and encouraged to change their drinking behaviors accordingly. Second, policymakers and public health specialists should know that binge drinking is not just a problem among adolescents and younger adults; we have to start thinking about older people when we are planning interventions to reduce binge drinking,” Lang added.

Visit our website: www.alwaysbestcaresandiego.com
Or like us on Facebook: www.facebook.com/alwaysbestcaresd

Source: By Dr. Edgerly, research expert - http://www.alzheimersblog.org/

Finding In Home Care

In-home care includes a wide range of services provided in the home, rather than in a hospital or care facility. It can allow a person with Alzheimer’s or other dementia to stay in his or her own home. It also can be of great assistance to caregivers.
Not all in-home services are the same. Some in-home services provide non-medical help, such as assistance with daily living. Other in-home services involve medical care given by a licensed health professional, such as a nurse or physical therapist. Common types of in-home services include:

• Companion services: Help with supervision, recreational activities or visiting.
• Personal care services: Help with bathing, dressing, toileting, eating, exercising or other personal care.
• Homemaker services: Help with housekeeping, shopping or meal preparation.

Skilled care: Help with wound care, injections, physical therapy and other medical needs by a licensed health professional. Often times, a home health care agency coordinates these types of skilled care services once they have been ordered by a physician.
Determining who will provide home care is an important decision. For some, using a home health agency is the best choice. And for others, an individual care provider is a better fit.

The following steps can be helpful when trying to find the right care:

• Create a list of care needs and your expectations for how they will be met.
• Call home care providers and find out what help they offer and if it meets your needs.
• Meet with a prospective provider in your home for an interview; prepare questions beforehand.
• Check references; some agencies may conduct criminal background checks. Ask if these have been conducted.

Questions to Ask Potential In-Home Providers:

• Are you trained in first aid and CPR?
• Do you have experience working with someone with dementia?
• Are you trained in dementia care?
• Are you with an agency? (If important to you)
• Are you bonded (protects clients from potential losses caused by the employee)?
• Are you able to provide references?
• Are you available at the times needed?
• Are you able to provide back-up, if sick?
• Are you able to manage our specific health and behavioral care needs?

Costs for home care services vary depending on many factors, including what services are being provided, where you live, and whether the expenses qualify for Medicare or private insurance coverage.

Visit our Website: www.alwaysbestcaresandiego.com
And like us on Facebook! www.facebook.com/alwaysbestcaresandiego
Resource from alzheimersblog.org

How to Respond to "I wanna go home"

“I want to go home.” Many caregivers hear this from their loved one even when their loved one is sitting in the living room of the home they have lived in for many years. It also happens when there’s a change in environment or routine.

It’s upsetting to think your loved one no longer recognizes the environment around them, but this is part of the disease. The person may not believe they are in their home because they truly don’t recognize it. Or that person is likely not speaking literally but searching for the feeling of home – a sense of familiarity, security or comfort. So, what do you do in this situation?

As you so often do, you want to connect to the emotions behind the words instead of reorienting them to their place. In other words, “connect, don’t correct.” Validate their emotions and try to meet the emotional need. A hug or hand holding can soothe. Ask them to tell you about home and they may be able to tell you about the feeling of home.

If it’s not upsetting, you can reminisce about home, possibly using photographs in a photo album. If this upsets the person, distract them with a pleasurable activity – a walk, a favorite snack, or listening to music. You might need to make up an excuse as to why they can’t go home – “the house is being painted; we’ll go later” and distract with an activity.

Reassurance and comfort go a long way; let your loved one know they are safe, taken care of and loved.



Vist our website: http://www.alwaysbestcare.com/us/ca/san-diego/san-diego.aspx
Or like us on Facebook: https://www.facebook.com/alwaysbestcaresd
Source: http://www.alzheimersblog.org/

45 Life Lessons, written by a 90 year old

45 Life Lessons, written by a 90 year old

1. Life isn’t fair, but it’s still good.
2. When in doubt, just take the next small step.
3. Life is too short not to enjoy it.
4. Your job won’t take care of you when you are sick. Your friends and family will.
5. Don’t buy stuff you don’t need.
6. You don’t have to win every argument. Stay true to yourself.
7. Cry with someone. It’s more healing than crying alone.
8. It’s OK to get angry with God. He can take it.
9. Save for things that matter.
10. When it comes to chocolate, resistance is futile.
11. Make peace with your past so it won’t screw up the present.
12. It’s OK to let your children see you cry.
13. Don’t compare your life to others. You have no idea what their journey is all about.
14. If a relationship has to be a secret, you shouldn’t be in it.
15. Everything can change in the blink of an eye… But don’t worry; God never blinks.
16. Take a deep breath. It calms the mind.
17. Get rid of anything that isn’t useful. Clutter weighs you down in many ways.
18. Whatever doesn’t kill you really does make you stronger.
19. It’s never too late to be happy. But it’s all up to you and no one else.
20. When it comes to going after what you love in life, don’t take no for an answer.
21. Burn the candles, use the nice sheets, wear the fancy lingerie. Don’t save it for a special occasion. Today is special.
22. Overprepare, then go with the flow.
23. Be eccentric now. Don’t wait for old age to wear purple.
24. The most important sex organ is the brain.
25. No one is in charge of your happiness but you.
26. Frame every so-called disaster with these words, ‘In five years, will this matter?’
27. Always choose Life.
28. Forgive but don’t forget.
29. What other people think of you is none of your business.
30. Time heals almost everything. Give Time time.
31. However good or bad a situation is, it will change.
32. Don’t take yourself so seriously. No one else does.
33. Believe in miracles.
34. God loves you because of who God is, not because of anything you did or didn’t do.
35. Don’t audit life. Show up and make the most of it now.
36. Growing old beats the alternative — dying young.
37. Your children get only one childhood.
38. All that truly matters in the end is that you loved.
39. Get outside every day. Miracles are waiting everywhere.
40. If we all threw our problems in a pile and saw everyone else’s, we’d
grab ours back.
41. Envy is a waste of time. Accept what you already have, not what you think you need.
42. The best is yet to come…
43. No matter how you feel, get up, dress up and show up.
44. Yield.
45. Life isn’t tied with a bow, but it’s still a gift.

The Bias of Medical Care Providers towards Aging

Bias Towards Aging Affects the Medical Treatment Seniors Receive

In many cultures in the world, elderly people are revered and their advice is sought and respected. In our culture, the wisdom, the knowledge and the social skills of the elderly are often overlooked and instead we focus on the mental and physical deficits of our older generation.

 

Because of this prevailing attitude, older people in our society are generally regarded as less valuable than younger people. The younger person has responsibilities of raising a family, maintaining a career and supporting the economy. The older person generally has no responsibilities and in addition is a drag on the economy since a great part of the tax base must go towards the support of older Americans.

 

It is inevitable that many medical care providers will unconsciously have this same attitude towards their older patients. As a result, if an older person has a medical complaint and the cause is not readily apparent, a medical practitioner is more likely to accept the condition as a consequence of old age. This attitude causes practitioners to focus treatment on making the elderly more comfortable in their old age as opposed to finding a cure. In younger people, if the medical complaint is interfering with normal daily function, typically a more concerted effort will be made to identify and correct the problem.

 

A 90 year old man meets with his doctor and complains about pain in his right knee. The doctor tells him,

 

"Well Henry, what do you expect? You're 90 years old."

 

Henry replies,

 

"But doctor my left knee is the same age as my right knee, there's no pain and it feels just fine!"

 

Many in the health-care profession consider old age to be a disease itself. Any medical problems are inappropriately attributed to old age as if it were a medical condition. And since there is no cure for old age, appropriate tests and treatment are never performed. Thus, medical problems that may not be related to age and may just as frequently occur in younger people are often not treated. As an example, a recent survey of physicians involved in the health-care of the elderly reported that 35% of the doctors considered hypertension a result of the aging process and that 25% of them felt that treating an 85-year-old for symptoms of hypertension would cause more harm than the benefits it would produce.

 

Consider This Real-Life Example

(courtesy of the National Care Planning Council, www.longtermcarelink.net)

A 71 year old woman has surgery on her shoulder for a bone spur that is causing her considerable pain. The surgery is successful and she goes through several months of physical therapy to help her recover. But she is not recovering as expected. She continues to experience pain that radiates through her entire back. Her physical therapist does not know how to help her and attributes her failure to recover to old age.

 

She visits her family care doctor at least twice over the next six months, complaining of extreme tiredness and lack of energy. He tells her to exercise patience. He tells her that older people generally don't recover as quickly from major surgery as younger people do. She should expect to be tired as surgery can have a major effect on the elderly.

 

Her skin color is gray and she does not look healthy. Finally she visits her doctor once again and insists he check her for some problem since she is not recovering from the surgery and she feels awful.

 

Based on her insistence, he does blood labs and discovers she is severely anemic. He puts her in outpatient care and gives her four units of red blood cells and puts her on iron supplementation. Within two weeks the pain has disappeared and within a month she has recovered fully from the surgery. Numerous tests are done but there is no explanation for the anemia.

 

Six months later she is healthy and active and her cheeks are ruddy. When she asks her doctor why he did not suspect anemia, he tells her that she has never had anemia and based on her history he would never expect her to develop it. He then tells her, in an obvious contradiction of his previous position, that older people sometimes fail to absorb iron.

 

If this had been a young person, the doctor would have likely suspected that something else was wrong and conducted the tests. Because this was an older person, the doctor assumed failure to recover was due to old age.

 

A Holistic Treatment Approach

Most practitioners who specialize in medical care for the elderly are aware of the above-mentioned problems with older patients and they take a holistic approach with the medical treatment of their patients. An attempt is made, not only to treat the specific condition or conditions, but to make sure there is sufficient physical activity, proper nutrition and family support at home. Practitioners work closely with family members to make sure their loved ones are taking medications properly and are reporting their symptoms.

 

Geriatric-oriented practitioners require caregivers to closely monitor health conditions in their loved ones and report any changes before things get worse. These providers also meet with their patients regularly enough to monitor, on their own, their patient's current health.

 

This broad-based approach results in better health, more functionality and fewer visits to the emergency room because intervention for a worsening condition is achieved at an earlier stage.

Recognizing Symptoms of Dementia

The Brown family reunion has always been an event everyone looks forward to. Family visits, games, stories and everyone’s favorite foods are always on the agenda. On the top of the menu is Grandmas Lemon Coconut Cake. Grandma always makes the traditional cake from her old family recipe. This year, however, the cake tasted a little on the salty side, perhaps a half cup full of salty.

Though the family was disappointed over the cake, of more concern was Grandma’s confusion with the recipe and her similar confusion about the loved ones around her. Could something be wrong with grandma’s mental state?

One might say that for an elder person a little forgetfulness or confusion is normal, but when do you know if there is a serious problem, such as dementia?

An online article from FamilyDoctor.org outlines some common symptoms in recognizing dementia.
“Dementia causes many problems for the person who has it and for the person’s family. Many of the problems are caused by memory loss. Some common symptoms of dementia are listed below. Not everyone who has dementia will experience all of these symptoms.

• Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you’ve already given them the answer. They won’t even remember that they already asked the question.
• Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it.
• Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want.
• Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.
• Poor judgment. Even a person who
  doesn’t have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather.
• Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them.
• Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can’t find these things later.
• Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.
• Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.
• Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people.”

Dementia is caused by change or destruction of brain cells. Often this change is a result of small strokes or blockage of blood cells, severe hypothyroidism or Alzheimer’s disease. There is a continuous decline in ability to perform normal daily activities. Personal care including dressing, bathing, preparing meals and even eating a meal eventually becomes impossible.

What can family members do if they suspect dementia? An appointment with the doctor or geriatric clinic is the first step to take. Depending on the cause and severity of the problem there are some medications that may help slow the process. Your doctor may recommend a care facility that specializes in dementia and Alzheimer’s. These facilities offer a variety of care options from day care with stimulating activities to part or full-time live-in options. Sometimes if patients tend to wander off, a locked facility is needed.

In the beginning family members find part time caregivers for their loved one. At first, loved ones need only a little help with remembering to do daily activities or prepare meals. As dementia progresses, caregiving demands often progress to 24 hour care. Night and day become confused and normal routines of sleeping, eating and functioning become more difficult for the patient. The demented person feels frustrated and may lash out in anger or fear. It is not uncommon for a child or spouse giving the care to quickly become overwhelmed and discouraged.

Family gatherings provide an excellent opportunity to discuss caregiving plans and whole family support. It is most helpful if everyone in the family is united in supporting a family caregiver in some meaningful way.

“The first step to holding a family meeting, and perhaps the most difficult one, is to get all interested persons together in one place at one time. If it’s a family gathering, perhaps a birthday, an anniversary or another special event could be used as a way to get all to meet. Or maybe even a special dinner might be an incentive.

The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. This might just simply be moral support and agreement to abide by the provisions or it is hoped that those attending will volunteer to do something constructive. This might mean commitments to providing care, transportation, financial support, making legal arrangements or some other tangible support.” The Four Steps of Long Term Care Planning

Professional home care services are an option to help families in the home. These providers are trained and skilled to help with dementia patients. Don’t forget care facilities as well. It may be the best loving care a family member can give is to place their loved one in a facility where that person is safely monitored and cared for.

Dealing with Disabling Chronic Pain

Pain management is the process of bringing pain under control. Pain can be a problem with many people at the end of life. Persistent pain can accelerate the decline in health due to poor nutrition, depression, lack of social stimulation and lack of exercise. Persistent pain becomes a form of disability, interfering in the ability to perform common daily tasks. Here is a list of problems that pain causes to one's self or to others:

·       It is difficult to sleep

·       It is difficult or impossible to pursue hobbies or personal activities

·       Exhaustion can become a constant companion

·       Depression is a very likely outcome

·       There is little desire to eat

·       It is difficult to enjoy the companionship of one's family

·       There is reluctance to move about or exercise

·       The patient and the caregiver become more isolated from the community because of the disability

·       Family and friends who are caregivers become exhausted because of constant worry.

Chronic pain is a problem most often experienced by terminal patients who are dying from cancer.  Non-cancer patients at the end of life may have other pain-causing conditions.  This may be caused by such conditions as neuropathies, chronic back disorders or arthritis.

Chronic or ongoing pain only adds to the suffering of a critically ill person. If the pain can be brought under control, a seriously ill patient can have a better quality of life for the remaining time available to him or her.

Constant pain can also bring on depression, which in turn could lead to suicide. Many people who cannot endure chronic pain take their own lives or seek out assisted suicide. Pain management may be a better alternative than suicide, not so much for the patient but more for the family. If a loved one takes his or her life, that can produce a permanent scar of shame or guilt within the family.

The most common line of treatment in pain management is the use of medications. There are a number of helpful medications and herbal remedies to relieve chronic pain.  Psychologists who specialize in working with clients who have chronic pain are also available.  The human brain has a great deal of power over the pain a person feels and with correct therapy a person may be able to alleviate some of his or her suffering.

Seniors and Adult Children Under One Roof: How to Succeed With This New Trend

Adult children are moving back home with mom and dad in record numbers these days. It’s often not the child’s choice, but rather as a result of circumstances, that parents and grown children find themselves as roommates once again.

The conditions that may force an adult child home include downsizing, divorce, the need to care for an aging parent, or money issues related to student loans or under- or unemployment. In 2010, the country’s college graduates owed an average of $25,250 in loans, according to CNN Money. That is 5 percent more than the class of 2009 owed. The unemployment rate for the 2010 class was 9.1 percent, the largest on record. Compare that to the 20.4 percent unemployment rate for people who didn’t go to college (College Access & Success Project on Student Debt, 2009).

No matter an adult child’s education level, debt loads are high and income opportunities are increasingly limited. Therefore, many adult children are moving back in with their parents out of necessity.

The movement to migrate back to mom and dad’s has been a few years in the making. Bankrate.com says that three-quarters of 2008 college graduates said they actually planned to move back in with their parents after graduation. In 2006, that figure was two-thirds, which is still a staggering number (Collegegrad.com).

“To a certain extent, it’s a sign of the economy,” says Certified Financial Planner Craig Skeels of Apex Wealth Management Group in Oxnard, Calif. “If it continues to be a prolonged recession with more cuts in jobs, we may see a lot more adult children moving back home than what we’re experiencing today.”

The adjustment for the parents and the adult child can certainly test the relationship. Mom and dad are at a new stage of their lives now compared to when the child was living at home before. If they aren’t already retired, they are perhaps, at the very least, used to the freedom of not having children around. The adult child may have anticipated being out on their own at this point, and it could feel unnatural to be back in mom and dad’s house. The latest census figures reveal that upwards of 80 million “empty nesters” are finding themselves with at least one grown child living at home. These adult children have been referred to as the “boomerang” generation.

Making the new living situation work
Both parties can make it work and even thrive if conversations and agreements occur before or at the beginning of the new living arrangement. Troublewith.com, a website of Focus on the Family, offers these tips for a smooth integration and to minimize conflict.

• Discuss the terms – The sooner that ground rules and expectations can be established from both sides, the better. This can occur even before moving day arrives. Examples include overnight guests, loud stereos, chores, meals and food.
• Don’t be afraid to ask questions – How long will the child be staying in the home? Is rent or a contribution to the household expenses a reasonable request? All relationships are better with good communication.
• Maintain a healthy relationship – Every situation is different, and some are quite complicated. Here are some tips for keeping the relationship intact:
  • Trust adult children to make wise choices. We all learn by making choices. The adult child needs to have the opportunity to make their own choices, even under the parents’ roof.
  • Try not to give advice unless it is solicited from the child. This may be difficult because the parent is aware of much more of the child’s life than it he or she were living outside the home. Again, the child needs the opportunity to grow on their own even though mom and dad are close by.
  • Communication is key. Regularly discuss how the situation is going. Everyone involved should be allowed to bring up issues, clarify expectations or simply clear the air.

Negotiate issues upfront and write them down if necessary. Fox Business News suggests creating a timetable for eventual financial independence. This can begin with fiscal responsibilities in relation to the household including food, utilities and gas for the car. Ultimately, the family needs to be on the same page and working toward a common goal. Fox Business News states in a comment to the parents, “Find the right balance between offering support and taking care of yourselves. You don’t need to fall back into the roles you each played during the years of active parenting –parents giving and the kids receiving. If the parents have been enjoying an empty nest, continue doing just that.”

Generally, the rules for the adult child will be very different than when they were growing up. As long as the grown child acts responsibly, such as holding a job, contributing financially or helping with meal preparation and household chores, he or she deserves the same liberty to come and go as any adult.

Respect for the personal boundaries and preferences of both sides is crucial to the success of this living situation. With predetermined boundaries, good communication and an agreement to revisit and, if necessary, adjust the arrangement along the way, parents and children can create a very comfortable home for all involved.

How to Get the Most Out of Support Groups: Seniors and Caregivers

When faced with life altering issues such as illness, death, and depression, seniors may find themselves in an unfamiliar position of dealing with heavy feelings and how to move forward. Perfectly capable adults who are distraught like never before may suddenly wonder what to do when confronted with overwhelming emotions.

Today’s seniors grew up in a time when people often didn’t share their feelings openly. It was not socially acceptable to disclose secrets of life-threatening illness or feelings of hurt or depression. However, today’s society is not only accepting of a person in a vulnerable state, but it also offers avenues for guiding that person to many types of support groups. Isolation is no longer necessary. Others are experiencing similar issues and are willing to share and provide a safe place to show up and ask for help.

Adult children or caregivers may often be the first line of defense when a senior is struggling. Family can be a good place to start to find support. Even seniors who are reluctant to share their emotions or feelings may seek help from their adult children or caregiver first. While that may be a good option for some people, it may also be a relief to find support outside the immediate circle of contacts.

When the adult child or the caregiver is ill-equipped to counsel the senior, or if they themselves need help, support groups may be the answer. Support groups are available for any ailment or situation. It just takes the willingness to participate and a little research to find the right one.

What is a support group?
The good news is that support groups exist for all kinds of ailments and situations. While many groups hold meetings in hospitals, churches, schools, homes, libraries, or community centers, others are available online. The Daily Strength website offers immediate access to anonymous support groups who meet online. People who are dealing with common types of issues come together and strengthen each other by sharing their feelings, experiences, and suggestions related to those issues and their own situation. Participants can relate to what others in the group are going through and therefore don’t feel alone.

Group leaders may be professional facilitators, such as nurses or psychologists, or peers may lead. It is up to the group members to decide what they are seeking from their leader. Trained facilitators offer a more professional approach to dealing with the issue at hand, while peer groups tend to offer more emotional support and a shared experience approach.

Additionally, support group participants often benefit from information shared during meetings. Genetic Health says that oftentimes people in support groups easily share information about medical treatments, research, and strategies for dealing with an ailment. Other helpful information can also include public policy, legal resources, privacy laws, protection from discrimination, and connections to financial assistance and scholarships. Uncovering this information on one’s own could take months with a concerted effort, but in a support group, that information is shared readily.

Tips for finding a support group

• Talk to your doctor or the hospital
• Ask friends who have gone through the same experience
• Search online for local meetings
• Check online for resources such as online support groups , blogs, or chat rooms that are focused on your issue
• Contact focused associations such as the American Cancer Society or Alzheimer’s Association.
• Another great resource for discovering the appropriate type of support is the Mental Health America website, which guides visitors to support groups. One may also visit the Mental Health America affiliate website, which is an excellent resource for support groups by state.

Characteristics of a good support group
While each person will seek something different from support groups, participants must ultimately feel comfortable attending meetings and sharing their thoughts, feelings, and experiences. The common characteristics that generally create a well-functioning group are:

• Prompt response to inquiries about the group
• Up-to-date and reliable information
• Strong leadership
• Access to professional advisors who align with the group’s interest
• A clearly stated and practiced “confidentiality policy”

The Mayo Clinic says that the benefits offered by support groups are unmatched and unlimited for a person struggling with an issue. People get something different out of the same meeting, depending on where they are in their experience and how willing they are to accept help. Benefits from joining and participating in a support group are:

·  Feeling less lonely, isolated, or judged

·  Gaining a sense of empowerment and control

·  Improving coping skills and adjustment

·  Engaging in an opportunity to talk openly and honestly about personal feelings

·  Reducing distress, depression, or anxiety

·  Gaining a clearer understanding of what to expect with one’s situation

·  Learning about new medical research

·  Getting practical advice or information about treatment options

·  Comparing notes about resources such as doctors and alternative options

Seniors who are dealing with new issues or issues that continue to plague their daily lives and hinder them from enjoying a productive life should investigate support groups. An adult child, caregiver, friend, or doctor can help find the right place for the senior to engage in getting help through the unique opportunity of support groups.

Adult children and caregivers also have access to support groups. Being responsible for a senior’s care can be frustrating, emotionally and physically draining, and overwhelming. People often need help, and sometimes that help is just a support group away from changing a life.

Combating the Pain from Shingles

Shingles is a serious infection for anyone, but especially for seniors. An estimated one million people in the United States get shingles each year, and most of those are age 50 and above (National Institute of Allergy and Infectious Diseases). About one-third of the people who get shingles will develop serious complications, and the complications caused by shingles are increasingly more common after age 60 (Centers for Disease Control and Prevention). One in five of those inflicted with shingles will have pain that lingers long after the shingles episode is over (AfterShingles.com).

Your doctor can discuss the necessary steps to help prevent a shingles outbreak or minimize its severity. Because seniors are more at risk for acquiring shingles and are most acutely affected by a shingles episode, they should be aware of the signs and symptoms and the actions to take in case of an outbreak.

Shingles comes on very quickly and manifests itself as a painful rash of blisters, usually concentrated around either the left or right side of the torso. A person who has had chickenpox is more likely to develop shingles later in life because shingles is caused by the same varicella-zoster virus that evokes chickenpox. The virus lays dormant in the body after chickenpox has come and gone, but it can flare up at any time, returning as shingles. Shingles is more common in people with immune systems weakened by chemotherapy, radiation treatment, transplant operations, stress, and HIV infection.
Early detection and immediate treatment with medication are key to combating shingles. For best treatment results, a person should see a doctor at the first sign of shingles. The doctor can determine if blisters are shingles just by looking at them and will administer treatment right away. The initial symptoms of shingles are typically felt on only one side of the body or face. These signs are tingling, itching, and burning or shooting pain. A person may also experience achiness, headaches, fever and chills, and fatigue. A rash and fluid-filled blisters soon follow and remain for up to 14 days.

The condition of pain following a shingles episode is called postherpetic neuralgia (PHN) and can last for months or even years. In fact, a person has an increased chance of getting PHN as they age. A 50 year old has a 50 percent chance of developing PHN. An 80 year old has an 80 percent chance of developing PHN (Aftershingles.com).

The most common symptom of PHN is the acute sensitivity of the skin where the shingles rash occurred. The skin is hyper-sensitive to the lightest touch from clothing, a gentle breeze, or even a change in temperature. The affected area may also remain an abnormal temperature, appear discolored, sweat more, or lose muscle tone. Medications are effective in dealing with the pain associated with PHN.

To help a person keep track of the pain experienced after having shingles, Aftershingles.com offers this Pain Checklist and Discussion Guide. This is helpful information for a doctor to have when he or she begins treating the condition.

Complications can also occur when shingles appear on the face, which can lead to problems with hearing and vision. If the shingles infection gets into the eye through the eye’s ophthalmic nerve, damage can occur to the cornea, leading to temporary or permanent blindness.

No cure exists for shingles. It is not life threatening, but it is painful. Shingles must be treated with medication such as acyclovir, valacyclovir and famcyclovir. The sooner a person begins treatment, the better the chance that the severity and the length of the outbreak will be reduced and subsequently, that long-term pain associated with a shingles episode will be less as well.

The best line of defense against shingles is a vaccine injection, usually given in the upper arm.
The Centers for Disease Control and Prevention recommends the shingles vaccine for people over age 60. It prevents the reactivation of the virus in the body, and while not 100 percent effective, the vaccine may reduce the intensity and length of a shingles outbreak. Medicare or other health insurance policies may not cover the vaccination, so check your policy for coverage.

According to the Mayo Clinic, the shingles vaccine is not recommended for people who:

 Have ever had a life threatening allergic reaction to gelatin, the antibiotic neomycin, or any other component of the shingles vaccine.
 Have a weakened immune system due to HIV/AIDS, lymphoma, or leukemia
 Are receiving immune-system-suppressing drugs such as steroids, adalimumab (Humira), infliximab (Remicade), etanercept (Enbrel), radiation, or chemotherapy
 Have active, untreated tuberculosis
 Are pregnant or trying to become pregnant

Medical experts estimate that the vaccine could prevent 250,000 cases of shingles annually, and another 250,000 cases would not be as severe (NIH: National Institute of Allergy and Infectious Diseases).

A quick response to symptoms of shingles will make a big difference in how the infection progresses, the resulting pain and any complications. Ask your doctor about the shingles vaccination, and take control of preventing shingles.


Reprinted by Always Best Care Senior Services with permission from the Society of Certified Senior Advisors.

The Certified Senior Advisor (CSA) program provides the advanced knowledge and practical tools to serve seniors at the highest level possible while providing recipients a powerful credential that increases their competitive advantage over other professionals. The CSA works closely with Always Best Care Senior Services to help ABC business owners understand how to build effective relationships with seniors based on a broad-based knowledge of the health, social and financial issues that are important to seniors, and the dynamics of how these factors work together in seniors’ lives. To be a Certified Senior Advisor (CSA) means one willingly accepts and vigilantly upholds the standards in the CSA Code of Professional Responsibility. These standards define the behavior that we owe to seniors, to ourselves, and to our fellow CSAs. The reputation built over the years by the hard work and high standards of CSAs flows to everyone who adds the designation to their name. For more information, visit www.society-csa.com.

Always Best Care Senior Services

Always Best Care Senior Services (http://www.alwaysbestcare.com/us/ca/san-diego/san-diego.aspx) is based on the belief that having the right people for the right level of care means peace of mind for the client and family. Always Best Care Senior Services has assisted over 25,000 seniors, representing a wide range of illnesses and personal needs. This has established the company as one of the premier providers of in-home care, assisted living placement assistance, and skilled home health care.

Get Your Act Together -- Plan for Long Term Care

Here is a brief outline of the process of creating a long term care plan:

Providing Planning Documents and Instructions

Include sample planning documents to be given to family members or trusted advisers. This includes instructions regarding wishes pertaining to care preferences, wishes pertaining to end-of-life, wishes concerning preferred medical treatments, desires for disposition of property and instructions to the Care Advocate or Personal Care Representative. These instructions do not replace formal legal documents designed for the same purpose but will provide in one place the preferences further outlined in legal documents. Family should be referred to legal documents if they exist.

Determining a Care Advocate in Advance

 The Care Advocate or Personal Care Representative represents the interests of a loved one receiving care. This person could also be the caregiver, a child, a friend or a trusted adviser. This Care Advocate plays an important role in making caregiving decisions, in arranging funding for services, in arranging services and in coordinating care. The person could also be given responsibility with a power of attorney or as a representative.

Planning for End-Of-Life

Issues considered are preplanning of final arrangements, expressing wishes for a place to die and information and instructions for advance planning documents. Forms are provided for instructions on providing these services.

Preparing Legal Documents and End-Of-Life Arrangements

Detailed instructions on arranging estate planning documents and establishing various powers of attorney. We recommend using an attorney.

Providing Financial Information for Future Care Costs

This form is provided to the family with a listing of assets, income and insurance plans. Particular funding strategies for long-term care services are detailed.

Providing Copies of Checklists for All Involved in Care

 Each checklist provides specific instructions in a particular area of long-term care services or provider settings. These instructions allow the caregiver and/or the Care Advocate to make informed choices in choosing settings and services. The intent is to save these people a great deal of time, heartache, stress and money in choosing services and settings for the loved ones.

Making Your Wishes Known

This final step is the most important. No plan has value unless those involved in making the decisions are aware of it.

Always in Touch

Introducing Always in Touch - a free telephone reassurance program that provides a friendly voice each weekday for seniors and disabled adults. Always in Touch provides daily socialization and the reassurance that the senior "is not alone."

http://ping.fm/RU0M3

Always In Touch

Introducing Always in Touch....Anyone can fall or become ill during the night. If someone lives alone, a fall or illness during the night can be disastrous. Who will know? When will help come?

Introducing Always in Touch - an absolutely free telephone reassurance service sponsored by Always Best Care Senior Services.

We provide a daily "safety check" phone call and peace of mind to seniors who live alone.If you or a loved one would like to receive a free phone call every day, Monday thru Friday, contact us today!

http://www.always-in-touch.com/

For an interesting article:

Dementia Bingo: Easier to play, and it may help patients

http://ping.fm/Pfast