The Symptoms of Early-Onset Alzheimer’s Disease
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The Symptoms of Early-Onset Alzheimer’s Disease

Considerable’s article entitled “7 surprising early signs of Alzheimer’s” provides us with some signs of early-onset Alzheimer’s disease.

Theft or other law-breaking. Any behavioral change as people age is of concern, but this can be a sign of Frontotemporal Dementia (FTD), another progressively damaging, age-related brain disorder. FTD usually hits adults aged 45-65. People’s executive function—their ability to make decisions—can be impacted by FTD, which may explain why they become unable to discern right from wrong.

Frequent falls. A study of 125 older adults asked them to record how frequently in an eight-month period that they fell or tripped. Researchers examined the brain scans of those who fell most frequently and saw a correlation between falls and the early onset of Alzheimer’s Disease.

Forgetting an object’s function. We all forget where we put the keys. However, if you can’t remember what a key is for, or where dirty dishes are supposed to go, then it may be the first signs of Alzheimer’s Disease or dementia.

Inappropriate diet. Prior to the onset of Alzheimer’s, patients typically to eat more (roughly 500 calories more a day) than their aging counterparts but they still tend to lose weight. Doctors think this is a metabolic change. Some elderly actually eat inanimate objects prior to their diagnosis, but researchers don’t know the reason. Because Alzheimer’s and dementia affect the brain’s memory, it may be because their brain receives hunger signals but is unable to discern how to react to them. Some patients eat paper or other inedible objects.

Inability to recognize sarcasm. If you fail to recognize sarcasm or take it very literally and seriously, it may be a sign of atrophy in your brain. A study at the University of California – San Francisco found that Alzheimer’s patients and those with Frontotemporal Disease were among those who couldn’t recognize sarcasm in face-to-face encounters. The brain’s posterior hippocampus is impacted, which is where short-term memory is stored and where a person sorts out such things, like sarcasm.

Depression. If someone has never suffered from clinical depression but develops it after age 50, it could be an early sign of Alzheimer’s. It doesn’t mean if you’re diagnosed with depression in older age that you will develop Alzheimer’s or other cognitive decline. However, you might, so get treatment sooner because some researchers believe that hormones released in the depressed brain may damage certain areas of it, leading to the development of Alzheimer’s or other dementia.

Unfocused Staring. Alzheimer’s Disease is a change in cognitive and executive functioning in the brain. This means that your ability to recall facts, memories and information is compromised, as well as the ability to make decisions. The brain becomes unfocused and staring in a detached way may be an early sign of so-called “tangles” in your brain.

These symptoms may be signs of Alzheimer’s Disease, or they may be the signs of other underlying issues. See your doctor if you have any of these signs. This may be a sign of something else but talk to your doctor to be safe.

Reference: Considerable (December 8, 2020) “7 surprising early signs of Alzheimer’s”

What Should I Ask, If My Mom Is in a Quarantined Facility

Federal guidance for nursing homes state that members of the public and non-essential health care personnel and staff shouldn’t be permitted to visit (with a few exceptions, such as an end-of-life situation — as long as the visitor isn’t showing signs of a respiratory illness), according to guidelines from the Centers for Medicare & Medicaid Services.

AARP’s recent article entitled “6 Questions to Ask if Your Loved One Is in a Quarantined Facility” explains that assisted living communities are a different situation, because they’re governed by the states. As a result, there have been no broad rules covering their management during the outbreak. However, the American Health Care Association/National Center for Assisted Living, an industry trade group, is advocating that its facilities to follow the federal government’s guidance for nursing homes.

To ease the anxiety, many of these residences are making great efforts to communicate with family members, such as emails, phone calls and websites, outlining their policies and instructions for connecting with residents and posting photos of residents’ daily activities.

However, many family members are still worried about how their loved ones are doing, when they can’t confirm their well-being first-hand person. Therefore, if you have questions about their care, you need to be assertive. Be firm, polite and persistent. Here are some questions that you might ask, if your loved one is in a quarantined facility:

  1. Has anyone at the facility tested positive for COVID-19? Nursing homes and long-term care facilities have been hard hit by COVID-19, so ask about testing of all staff members, residents and any vendors who service the facility.
  2. How are you keeping the facility clean and keeping the risk of infection low for residents? Ask about the protocols put into place to protect the patients. This should include screening staff who are caring for your parents, and what are they doing to keep the place sanitized.
  3. Is the facility maintaining regular healthy-living programs? The patients need to have services, like physical therapy and occupational therapy programs designed to keep your loved one from deconditioning.
  4. How are the residents being engaged? Are there activities, like games, presentations and music to keep the residents engaged?
  5. How do I communicate with my parent? Some facilities have set up visits via Skype, WhatsApp and FaceTime between families and their loved ones.
  6. How is the facility working with drop-off deliveries? You may want to deliver something like flowers or baked goods for dad at the care facility, so find out the procedure.

Reference: AARP (April 15, 2020) “6 Questions to Ask if Your Loved One Is in a Quarantined Facility”

Caring for Alzheimer’s and Dementia Patients during Stay-At-Home Orders

The Havre Daily News’ recent article entitled  “Alzheimer’s Association offers tips for keeping people with dementia engaged during stay-at-home orders” reported that, to help caregivers engage their family members suffering from Alzheimer’s and other dementia, the Alzheimer’s Association has provided some ideas to assist.

Alzheimer’s disease is a progressive disorder that causes brain cells to degenerate and die. This disease is the most common cause of dementia, which is defined as a continuous decline in thinking, as well as behavioral and social skills that disrupts a person’s ability to function independently.

When considering how to help a person with dementia stay engaged during the pandemic, the release from the Alzheimer’s Association said, you can start by asking yourself these questions:

  • What do they like to do?
  • What are they able to do?
  • What are they in the mood for today?

The Alzheimer’s Association says that spending time with a family member or loved one with Alzheimer’s and other dementia can still be a meaningful and fun experience, especially if you take your cue from them. Let’s look at some ideas:

Encourage involvement in daily life activities. These types of basic activities can help the person feel like a valued part of the household. This can be things like setting the table and folding laundry. The tasks can give a dementia patient a sense of success and accomplishment.

Be ready to adjust and modify activities. Some activities that the person enjoys may need to be changed or modified, because of the stay-at-home orders in effect in most states. A few ideas are low-impact at-home workout videos; playing games like checkers, cards, or board games; or looking at photo albums.

Concentrate on individual enjoyment. Someone who’s worked in an office might enjoy activities that involve organizing, such as collating papers, putting coins in a holder, or creating a to-do list. A former farmer or gardener may like being in the fresh air and working in the yard.

Don’t be afraid to request help. Ask family members and friends for help with some non-contact chores. This might include help putting the trash out, collecting the mail, or tending to the yard. You should also look into meal and grocery delivery services.

The Alzheimer’s Association now has free expanded educational programs via telephone and online. These programs provide crucial information about Alzheimer’s and related dementias, effective communication techniques, understanding and responding to dementia-related behaviors and more.

There are also additional resources for caregivers on the association’s website at https://www.alz.org.

Reference: Havre Daily News (April 14, 2020) “Alzheimer’s Association offers tips for keeping people with dementia engaged during stay-at-home orders”

Helping Your Elderly Parents during the Pandemic

Considerable’s recent article entitled “4 things you can do for your aging parents during the coronavirus pandemic” reports that 8 out of 10 deaths reported in the U.S. related to COVID-19 have been in adults 65 years old and older, according to the Centers for Disease Control and Prevention (CDC). If your parents are in one of the vulnerable categories, here are four things you can do right now to help them.

  1. Shop or help them place orders online. With many cities experiencing a shopping frenzy in response to the coronavirus, personal care and household items have quickly disappeared from stores. You can help your parents by allowing them to stay home and going to the store for them and dropping off groceries on their door. You can also place online orders that can be delivered to their home.
  2. Contact them regularly. The CDC says the coronavirus is believed to spread primarily from person-to-person contact, particularly between people who are closer than six feet from each other. Therefore, you have likely already been separating yourself from your family members, including your parents. To avoid possibly exposing your parents, use Skype, FaceTime, or call them on the phone. Stay in close communication to keep their spirits up and check on how they’re feeling. This can help you to verify their mental and physical health, as the days of social distancing add up. You can set up a schedule with specific times you’ll call, so they have something to look forward to throughout the day.
  3. Watch for scams. We’re already hearing about the con artists coming out of the woodwork to prey on the elderly—and all of us in this medical and financial crisis. Speak to your parents about these scams, so they can protect themselves. The Federal Trade Commission has issued guidelines for avoiding scams, including the following:
  • Hang up on robocalls and don’t press any numbers.
  • Verify your sellers because many online sellers may say they have in-demand products in stock, when they actually don’t.
  • Don’t click on links from sources you don’t know.
  • Research before making donations, and if asked for donations by cash, gift card, or wiring money, pass!
  1. Keep ‘em busy. Seniors have unique challenges when they stay at home. The inactivity that can be linked to being confined in the home can cause declines in physical health and in physical abilities. The elderly are also at greater risk of developing depression in social isolation, and their elevated risk for bad outcomes from this virus can cause higher levels of anxiety and lead to sleep difficulties and other health issues. Encourage your parents to read, play a board game, do a puzzle, or take a walk, provided that they’re keeping distance from others. Many religious groups have also transitioned their services online, and there are plenty of movies and TV shows on-demand for home viewing.

Most significantly, make certain that your parents are taking the pandemic seriously and emphasize the importance of social distancing.

Reference:  Considerable (April 8, 2020) “4 things you can do for your aging parents during the coronavirus pandemic”

How Can I Be a Good Caregiver?

If you find yourself suddenly in a caregiving role, you may not know where to begin. CaringBridge’s recent article entitled “5 Tips to Be a Good Caregiver” provides some great advice.

Communicate. This is the most important factor, when trying to be a good caregiver. Caregivers should strive to communicate with patience, understanding and empathy.  A person being taken care of can sometimes feel like they’re a burden or a nuisance. Good communication and reassurance can help prevent that. You should also have communication between you and your other family and friends. Asking for help isn’t always easy, but those who care about you will want to support you.

Take Care of Yourself.  When you’re constantly on call caring for a person who is ill, it’s not hard to forget about your own needs. Caregivers can be so overwhelmed, that they’re unable to take time for their other family or interests. They can feel guilty being away from the person in need. However, you can’t be a good caregiver, if you aren’t also in good shape. Prioritize your own health, physical and mental—it’s vital for both you and your loved one. First, take care of yourself because you can’t take care of a loved one, if you are not taking care of yourself.

Have a Lot of Patience. This is important because it’s helpful to be patient with yourself. You’ll make mistakes, but remember that you’re trying your best, and no one’s perfect. You should also be aware that communication can sometimes be difficult, when you’re caregiving. Your loved one might say or do something that hurts your feelings. However, do your best to be patient and empathetic. Don’t take it personally. Try to look at the situation with understanding and acceptance to battle discouragement.

Create Boundaries. When spending so much time with one person, and sharing their most intimate moments, it’s still important to have some boundaries. These can include you knowing your own limitations and what you’re comfortable doing for that person. Boundaries also apply to the person receiving the care and things, such as the way in which that want to be cared for and their likes and dislikes. Boundaries allow both people to be happier.

Remind Yourself of Your Mission. Sometimes, you can become a caregiver out of necessity or a sudden crisis. Nonetheless, at the center of the situation is love and empathy. Caregivers love and want the best for the person they’re helping. You should try to harness that compassion to keep you motivated through hard times.

Remember that a good caregiver is one who cares. You’re not expected to be perfect, so make certain that you give yourself just as much love and patience as you offer your patient.

Reference: CaringBridge (Feb. 13, 2020) “5 Tips to Be a Good Caregiver”

What I Need to Know about Caring for a Loved One with Dementia

Family caregivers of dementia patients must be more prepared for immediate changes in temperament. They need more support and respite care, and they need a better idea of what to expect in the days and months ahead.

Forbes’s recent article entitled “When Your Loved One Has Dementia: 3 Questions For Family Caregivers” provided three important questions to ask if your aging parent or family member has been diagnosed with a form of dementia.

What training must I have? When a parent, friend, or other loved one in your care is has dementia, you should look to local healthcare resources for education and training.

The temperament of people suffering from a form of dementia can change swiftly. It can rapidly turn hurtful or even violent. However, there are things a caregiver can do to interact with them to help keep them calm. Ask their healthcare provider for suggestions or referrals.

As a caregiver, do I have the legal standing to take care of this person? You should determine if your loved one has a will or living will in place, along with a healthcare power of attorney. These are documents that must be drafted and signed, before their dementia progresses to the point where it totally distorts your loved one’s thought process.

The documents provide instructions as how to care for them, according to their original wishes and avoid stress in the family, if disagreements arise. Contact an elder law attorney as soon as possible to create these documents.

How do I get help when I need it? Caring for an aging loved one can be a very tiring task. Tending to the needs of an aging loved one with a form of dementia is an even greater challenge. Begin planning now for self-care.

You can’t take care of a loved one with dementia, if your physical and mental health is wiped out and you are exhausted. Look at respite care options to give yourself the rest you’re going to need.

Getting these measures ready now can ensure that you are prepared for the tough future.

Reference:  Forbes (March 23, 2020) “When Your Loved One Has Dementia: 3 Questions For Family Caregivers”

What are the Restrictions on Visiting the Elderly in a Care Facility?

The restrictions in Virginia started after the American Health Care Association, the largest national trade organization representing long-term care centers, and the Centers for Disease Control and Prevention issued guidance recommending extreme measures to prevent a scenario that has played out in a Washington state nursing home, where the virus spread rapidly and took many lives.

The Richmond Times-Dispatch’s recent article entitled “Virginia nursing homes restrict visitors over coronavirus fears, families worry about separation” says, however, that some family members and advocates worry that — without loved ones allowed to visit — residents will be even more vulnerable to neglect in nursing homes that already struggle to give them basic care.

“What we have found is that experts believe that this is the most prudent step that we can take to protect the residents,” said Keith Hare, CEO of the Virginia Health Care Association, the state chapter of the AHCA. “We have to put the health and well-being of these residents first. … It really is unprecedented action.”

However, some family members who are told that they can drop off supplies for the residents at the nursing home, cannot stay for a visit. Some are worried that parents with Alzheimer’s who need help eating, won’t be fed without their regular visitors because nursing homes are understaffed.

Nursing homes in the state say it was a hard decision to cease visitation, but it was necessary to prevent any exposure in the care facilities. They’re going to do whatever we can to keep it out, official say.

Innovative Healthcare Management, a company that runs five nursing homes in Virginia with a total of 750 residents, said that it has been educating its staff and preparing for a potential outbreak, since first learning of the coronavirus outbreak in China. IHM recently began screening visitors for possible coronavirus infection before they entered the facilities. The company decided to restrict all nonessential visitors, except when a resident is believed to be dying.

Nursing homes are trying other ways for family members to connect with residents, like phone calls and video chats.

While nursing homes around the country are doing the same thing and are restricting group gatherings within the centers, they are trying to make sure residents are being entertained with in-room activities, such as movies, card games, and puzzles. The focus at the facilities is on communication and keeping residents entertained.

Reference:  Richmond Times-Dispatch (March 15, 2020) “Virginia nursing homes restrict visitors over coronavirus fears, families worry about separation”

Coronavirus Scams are Surfacing

Maryland U.S. Attorney Robert K. Hur is “encouraging all Marylanders to be aware of individuals attempting to profit from the coronavirus pandemic,” reported Marcia Murphy, a USAO spokeswoman.

The Cecil Whig’s recent article entitled “Maryland U.S. attorney warns of COVID-19 scams; Cecil County remains vigilant” cautions that coronavirus scams are being uncovered around the country.

Scammers have been sending e-mails to people claiming to be from local hospitals offering coronavirus vaccines for a fee. However, no vaccine is currently available for the coronavirus. Some of these criminals are using websites that appear to be legitimate but are actually fake websites that infect the users’ computers with harmful malware or seek personal information that can be later used to commit fraud. Many of these scams prey on the most vulnerable, especially the elderly.

Seniors need to contact the police, if they think someone has targeted them for a scam and to educate themselves on the COVID-19-related scams by checking official government websites, like the CDC.gov for information.

Seniors need to scrutinize anyone who makes a contact with them about a COVID-19 vaccine—which does not exist—and to report any such interaction to law enforcement.

Late last week, U.S. Attorney General William P. Barr sent a memo to all U.S. Attorneys, in which he made the investigation of these scams and the individuals perpetrating them a priority. Therefore, federal, state and local law enforcement agencies are prepared to investigate these frauds.

The Federal Trade Commission has consumer information about coronavirus scams on its website, including a complaint form to report scammers. Elderly victims can also call the newly launched Elder Fraud Hotline at 833-FRAUD-11 (833-372-8311), if they believe they are victims of a coronavirus scam—or any other type of fraud.

In addition to selling bogus cures and infecting computers by using COVID-19-related communications, other examples of coronavirus schemes include:

  • Phishing emails from entities posing as the World Health Organization or the Centers for Disease Control and Prevention
  • Those asking for donations for fraudulently, illegitimate, or non-existent charitable organizations; and
  • Scammers posing as doctors, who ask for patient information for COVID-19 testing and then use that information to fraudulently bill for other tests and procedures.

Barr asked the public to report suspected fraud schemes related to COVID-19, by calling the National Center for Disaster Fraud (NCDF) hotline (1-866-720-5721) or by e-mailing the NCDF at disaster@leo.gov.

Reference:  Cecil Whig (March 23, 2020) “Maryland U.S. attorney warns of COVID-19 scams; Cecil County remains vigilant”

How Risky Is the Coronavirus for Seniors?

MarketWatch’s recent article entitled “America’s growing elderly population is at risk — here’s what we can learn from Italy” says that we need to keep as many people at home to avoid spreading the disease, especially considering not everyone shows signs of the coronavirus but could still be carriers, and protect all citizens, especially the most vulnerable, including the elderly and those with heart and lung diseases.

“What you’re now hearing repeatedly, is that people over 60 and people who have chronic conditions are most at risk of coronavirus,” said Paul Irving, chairman of the Milken Institute Center for the Future of Aging. “That does create serious concerns for older Americans.”

The United States has more than 4,000 confirmed cases of the coronavirus, and 69 deaths.

Italy is to date the hardest hit country in Europe and has the second highest number of confirmed cases and deaths from the coronavirus. China started spreading the infectious disease in December. Italy experienced its highest number of cases within a 24-hour period last weekend — an increase of 3,590 cases and 398 deaths, officials said.

The State of Washington has had the most deaths in the U.S.—many of which were linked to an outbreak at a nursing home in Kirkland in February. There were 26 patients at the Life Care Center of Kirkland who have died between February 19 and March 13, the center said. More than 50% of its residents had been moved to hospitals. New York City, which just shut the nation’s largest public school system for a month, has had five cases as of Sunday night, including two people in their 50s, two people in their late 70s and one woman in her 80s.

The average age of those who passed away in Italy was 81, and many suffered from pre-existing health issues, the BBC said. In China, the death rate among those 80 and older was about 15%, according to a Chinese CCDC report last updated in the middle of February, when there were approximately 72,000 confirmed cases. Those between 70 and 79 years old had a death rate of 8%. By comparison, those in their 20s and 30s each had a death rate of 0.2%, according to Worldometers, which aggregated global reports related to coronavirus.

“There’s also a risk to the broader population, but we really need to focus on protecting our elders,” Irving said. “The older a disease-sufferer, the higher the risk.”

Although just 14.50% of the United States’ population is 65 and older, that number is anticipated to increase in the next decade. Since the start of 2011, about 10,000 people have turned 65 years old each day, and they will continue to do so until 2030, according to nonprofit think tank Pew Research Center. At that point, roughly 18% of the country will be 65 or older.

Government responses to the coronavirus include closing large gatherings of people. like sporting events, universities, and restaurants, which may be important in slowing down the spread of the virus. The CDC recommends all Americans, especially older people, to stay indoors, stock up on necessary food and medications, and reduce contact with others. The CDC also strongly urges everyone to wash their hands with soap and water for 20 seconds, avoid touching their faces and use hand sanitizer with at least 60% alcohol when soap is not available.

Reference: MarketWatch (March 16, 2020) “America’s growing elderly population is at risk — here’s what we can learn from Italy”

How to Plan for Nursing Home Care for Parents

The median annual cost of care in a skilled nursing facility in South Carolina is $42,000, according to a cost of care survey by long-term care insurance company Genworth. You can’t expect Medicare to cover it. Medicaid coverage doesn’t start in, until the value of your assets is reduced to $2,000, says The Columbia Regional Business Report’s recent article entitled “Nursing home care requires advance planning.”

Many people don’t know that to qualify for Medicaid, your assets have to be spent down to almost nothing. Planning for long-term care includes both insurance and financial planning. However, the long-term care insurance options are limited. There are only a few providers remaining in the industry, but it’s worth the effort to see what they have.

Long-term care insurance is a plan that lets you pay a premium in exchange for coverage for a stay in an assisted care facility, full-scale care facility, or even at home. Without a policy, those financial costs can be catastrophic.

Because the cost of long-term care is so high, begin planning for your later years as soon as possible. It’s likely that in the next few decades, when the baby boomer generation starts requiring long-term or assisted living care, paying for it could become a crisis.

For people who are starting to save for future care needs, financial planners earmark 10% to 15% of your income. If you’re older and see that you don’t have enough money saved, put away at least 20% of your income. IRS guidelines include catch-up provisions for people older than 50 for IRAs and 401(k)s.

Some group insurance plans offer long-term care options. There are some additions for life insurance policies that could extend living benefits for elder care. You should plan on paying for three years of long-term care.

How to pay for skilled care is just one of the issues a family may face in later years. You also should have a will, advance directives, medical or health care power of attorney and durable power of attorney in place to help your family with difficult decisions. Remember to make sure the beneficiaries on your insurance plans are up-to-date.

Talk to an attorney about late-life concerns.

It’s never too soon to develop some kind of plan that can ease the financial burden for you and your family.

Reference:  Columbia Regional Business Report (March 10, 2020) “Nursing home care requires advance planning