Tag Archives: Dementia Live

Hospital Professionals, Senior Care Professionals, The Family Caregiver

Global Dementia Crisis is in our Hands – Are we Prepared?

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No longer is dementia a looming public health threat.  It is a global crisis affecting healthcare systems, delivery of long-term care, worker shortages, community infrastructure, families and most importantly, the quality of life for persons living with dementia.

To put into perspective the scope of this global  health crisis let’s look at these recent statistics from the Global Alzheimer’s and Dementia  Alliance:

1. The world’s economy is set to lose a trillion dollars in 2018, rising to $2 trillion by 2030 unless dementia is tackled.

That’s a cost greater than the GDP of all but the 15 richest economies in the world. If global dementia costs were a country, it would be the 16th largest, in-between Indonesia and Mexico.

Dementia already exceeds the market value of the world largest companies such as Apple (US $742 billion) and Google (US $368 billion). Eighty percent of these costs account for the unpaid and formal care for people living with dementia, two-thirds of which is delivered by women.

2. Dementia affects almost 50 million people worldwide, with a new case of dementia occurring somewhere in the world every 3 seconds.

Worryingly, aging populations – especially in low to middle-income countries (LMICs) – are set to exacerbate prevalence rates. The potential ramifications of this are huge. More than half of people with dementia worldwide (58%) live in LMICs – and the number in some regions is expected to increase fivefold by 2050. The number of people living with dementia in high-income countries is also expected to double by 2050.

Despite this, many countries are unprepared for financing long-term care. As social changes in LMICs mean fewer family members are able to provide care, the urgent need for social care will shift to the formal sector.

3. As few as one in 10 individuals receive a diagnosis for dementia in low and middle-income countries, and less than 50% are diagnosed in high-income countries.

Globally there is a persistent lack of understanding that dementia is a medical condition and not a normal part of aging. People living with dementia all over the world desperately need access to a medical practitioner who can provide a diagnosis and help to plan necessary support.

Risk reduction strategies and earlier diagnosis of dementia could save government expenditure by reducing the high cost of emergency and avoidable health interventions, improving care, and by increasing the effectiveness of social, community and other care services.

4. Two out of every three people globally believe there is little or no understanding of dementia in their countries.

People living with dementia and their families frequently face stigma and discrimination – and in some parts of the world can even face violence. Dementia can also have a negative impact on employability – younger people with dementia have reported being made redundant or unable to find work due to discrimination or lack of understanding. This can have an impact on employment rates and social welfare benefits.

Worryingly, in some countries, there’s not even a word for dementia, with many people affected accused of witchcraft and at risk of threats of violence. A lack of recognition or understanding of the condition permeates from within the community right up to a policy level.

Public policy is critically important,  however, the time it takes for policies to trickle down take a long time.  Progress takes place when people step up to the plate to make positive changes in their own communities.  Change that helps families find resources, support, and education.  Leaders who say we want our towns to be dementia aware and friendly, care communities that embrace person-centered care cultures, and hospitals that step up to the urgent need to do things differently.  The dementia crisis is in our hands and we must all work together to create a better tomorrow for those living with dementia.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who care for them.  She is the creator of the internationally recognized Dementia Live® simulation experience.  

Family Caregiver, Senior Care Professionals, The Faith Community

A tribute to Dad this Father’s Day – Love, Hope and Lessons Learned

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It’s hard to believe that I’ve not had my dad in my life for over 20 years now.  So much of who I am and what I’ve taught to my children came from my dad.  So, it’s appropriate that this blog be a tribute to my dad this Father’s Day.

My dad grew up during the great depression.  He had a difficult childhood filled with chaos and insecurity.  That said, he grew up fast and started working hard at a  young age to help support his family.   I never knew a lot about my father’s life, which told me that it was most likely far more difficult than I ever imagined.

Dad and Mom married and like so many from the greatest generation,  worked hard, saved and wanted more for their children than what they had.  They were partners in life and business and got through the tough times with perseverance and grit.  I grew understanding the value of money and its proper place, frugality and what made life meaningful and important.  Dad treasured his family, valued his many friends, and gave back to his community.  There was never a time in my life when my parents weren’t involved in community organizations that made the world a better place for those around them.

As the youngest of five children, my parents were older than average when I came along, so I journeyed with them in their aging years as a young mother.   At 6’4″, Dad was always larger than life.  A successful entrepreneur,  he was wise in business, a respected leader and certainly a quick-wit with friends and family.  He was from a generation when Dads weren’t overly involved in their children’s lives, nor particularly affectionate, but that was true of my time, so it was pretty normal.

Dad could fix just about anything.  After all, he was the owner of a hardware store.  Rarely if ever did we have the need for plumbers or handyman services.  We had Dad, and if he couldn’t fix it, who could?

Tiny changes starting happening.

One day, I was talking to Mom and she mentioned that Dad had a hard time installing some new blinds.  She said he had all the parts on the table and just couldn’t figure out what to do first.  At the time it really didn’t occur to me that it was anything more than things taking longer to accomplish because he was older.   For goodness sakes, I was in my twenties.  I really wasn’t tuned in to all this aging stuff!

Like so many spouses, she didn’t want to alarm the children.  Although Mom had seen these same changes with her own mother, there was a sense of denial that she was getting quite used to.  So months turned into years, and with each one passing, Dad became less the person we knew.  They didn’t travel anymore like they had enjoyed for so many years;  mom often would drive, and too often we would note that Dad had a far-away look in his eyes.

When Dad was finally diagnosed with Alzheimer’s disease, Mom, was exhausted, frightened and living life on a roller coaster.  Alzheimer’s had robbed the love of her life, our Dad and was taking its toll on our precious Mom.   Decisions had to be made and with that, family dynamics began to change.   It was a very tough road with many winding turns along the way.

Dad lived his last months in a memory care community.  It was much different than the care communities are now.  I’m pretty sure the culture change had not even been invented.  Quality of care just wasn’t there, but we had little to compare it to.  There just were not that many memory care communities and we chose one that was nice and close, so Mom wouldn’t have to drive that far.   We weren’t particularly happy with the care, but I can’t say that we knew what to expect.  Twenty years ago there just wasn’t a lot of education for families, and memory care was something foreign to us.   Dad was very sad.  So sad, that just a few months later he passed away.  Mom was ridden with guilt, but by this time her own health was declining so rapidly, that there was no possible way for her to care of Dad.  It certainly wasn’t what either of them (or any of us) had envisioned for the latter years of his life, but we got through it and learned many things along the way,

I’ve learned that we have the opportunity to love others in new ways.  We used to call Dad our “hot-headed Italian”.  Not the most patient man on the face of the earth,  he also had a difficult time showing emotions, especially with his daughters.  I found it especially touching that in his latter months, I could sit with him and he would embrace my hands and tell me many times how he loved me.  I never doubted that my whole life, but having us being able to share those moments will always stay with me.  We didn’t have to say much, during those visits.  Just being together was a gift to us both.

While Alzheimer’s robbed him and us in so many ways,  he lived until his 84th year.  He always said his life began when he married my Mom.  It was a good life, and they were very blessed in so many ways, none of which they ever took for granted.   I was blessed to have a Dad that taught me so much about life, and in the end, so much about death,  and accepting that life is far from perfect, but that love is what matters.  That we often can’t choose our path but do the best with what we have.

Happy Father’s Day, Dad and thank you for your love and all you taught me.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who care for them.  Pam has devoted the last 10 years to helping family and professional caregivers.  She is the creator of the Dementia Live® sensitivity awareness program that has helped tens of thousands of caregivers worldwide to better understand life with dementia.  

www.AGEucate.com

 

Senior Care Professionals

Responding to Agitation and Aggression in persons living with Dementia

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Agitation and Aggression- Individuals with dementia frequently become restless, anxious, or upset you may see a resident pacing, moving furniture or objects, talking to themselves, yelling or swearing. These behaviors can escalate to aggressive behaviors like, threatening or causing harm to another by pushing or hitting, cornering another resident or staff, or even throwing objects or food. And unfortunately, aggression among people with dementia can happen suddenly and seemingly without warning.

I am here to let you know if you pay attention you may be able to diffuse the situation or even prevent it.

Things to try to decrease agitation and aggression:  First thing to do is remind yourself to stay calm, it can be very very difficult but by reassuring your resident you are offering them security and creating a safe environment.

Our job is to figure out What they are trying to tell us?? remember all behaviors stem from something. So, we are going to listen to our resident as they verbally and maybe physically express their frustrations. They may not make much sense to you but sometimes a good detective can figure it out and ease the person agitation.

Possible triggers:

So, what are possible triggers:  Pain, discomfort, like being too hot, too cold, hungry, needing to use the bathroom, etc.). Perhaps they may be frustrated or overstimulated.

Environmental triggers: turn down the tv/radio, decrease noises that are loud and startling, move the resident to a smaller dimmer area, play soft music, hold their hand if they will let you and continue to reassure them you want to help.

Do Not: scold them or tell them things like “you know better”  “stop that” “ don’t touch that” that’s not yours” “ this is not acceptable. Because it is not going to help, in fact, it may make things worse.  Get yourself into their reality they are only trying to meet their needs.

Your Behaviors: It is also very important to reflect on your behavior in response to the person. If you are not already doing so, reassure the person that you are there to provide assistance and comfort. If it seems like the person needs something to do, try redirection to an enjoyable activity. Refer to a social history if there isn’t one accessible talk to your manager.

Behavior charting:  when charting on a behavioral incident or when filling out a behavior flow sheet, it is helpful to use specific, concrete words that clearly describe what a resident is doing so you can truly track whether the interventions/changes the environment work to decrease the behavior

Remember: no person is the same so not every intervention will be successful and what works for one may not work for the other. When you do find something that works, share it with your coworkers and manager.

Emmy Kaczmarksi, RN is a Master Trainer for AGE-u-cate® Training Institute, Dementia Educator, Behavioral Specialist and lives in Hudson, WI. 

http://www.AGEucate.com

Family Caregiver, Hospital Professionals, Senior Care Professionals

Noise Pollution and Older Adults – A Real Health Hazard

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When was the last time you walked into a restaurant hoping for a relaxing dinner only to feel like you were in the middle of a rock concert, and a bad one at that?  You’re not alone.  Noise pollution is a real health hazard, especially for older adults.  Yes, I’m in the AARP club myself, but don’t consider myself “old” (and not sure when that starts)  but I’ve noticed how noise has affected me as I’ve aged.

The EPA (Environmental Protection Agency) defines noise pollution as “unwanted or disturbing sound,” explaining that “sound becomes unwanted when it either interferes with normal activities such as sleeping or conversation or disrupts or diminishes one’s quality of life.  The annoyance can have major consequences, primarily to one’s overall health.”

Studies show that noise can have a direct and immediate effect on a person’s health.  Older adults are especially at risk simply because as human’s we often react with a “fight or flight” response.  With prolonged or obtrusive noise, physiological changes actually are taking place in the nervous, hormonal and vascular systems, resulting in potentially long-lasting consequences.

What can exposure to the constant and excessive level of noises cause to our health?  Stress-related illnesses, high blood pressure, speech interference, sleep disruption, depression and lost productivity, to name just a few.  Noise pollution is serious business.

The World Health Organization (WHO) identified the following categories of  adverse health effect of noise pollution on humans:

  1.  Hearing Impairment due to noise-induced hearing loss is the most common and often-discussed health effect.  This may be accompanied by abnormal loudness perception, distortion or tinnitus, which is inflammation of the ear.  Tinnitus may be temporary or may become permanent after prolonged exposure.
  2. Interference with spoken communication;  Noise pollution interferes with the ability to comprehend speech and may lead to a number of personal disabilities, handicaps and behavioral changes.  These might include problems with concentration, fatigue, uncertainty, lack of self-confidence, irritation, misunderstandings, decreased working capacity, disturbed interpersonal relationships and stress reactions.
  3. Sleep disturbances:  Uninterrupted sleep is known to be a prerequisite for good physiologic and mental functioning in healthy individuals.  Environmental noise is one of the major causes of disturbed sleep.  When sleep disruption becomes chronic, the results are mood changes, fatigue, depression, a decrease in quality of performance and other long-term effects on well-being.
  4. Cardiovascular disturbances: The nervous system can be temporarily, and even permanently affected by noise, acting as a biologic stressor, triggering a negative response to the cardiovascular system and increasing the risk of cardiovascular disease.
  5. Disturbances in mental health;  Noice can accelerate and even intensify the development of mental disorders;  however, it is not a direct cause of mental illness.  The elderly and those with underlying depression may be particularly vulnerable to these effects because they may lack adequate coping mechanisms.
  6. Impaired task performance: Noise pollution impairs task performance at school and at work, increases errors, and decreases motivation.  Reading attention, problem solving and memory are most strongly affected by noise.  Two types of memory deficits have been identified under experimental conditions; recall of subject content and recall of incidental details.

Older Adults are often at risk for increased vulnerability to noise pollution due to slower mental processing and sensory changes that take place in the aging process.  Persons living with dementia are at an even great risk as they often struggle with processing what is going on in their environment, decreasing stimuli can decrease certain behaviors.  Turning off the TV or radio in the evenings and reducing chatter or at any time you want them to wind down may help decrease agitation.

For care communities, shift change if often met with noise and chatter of oncoming and off going employees.  Even shuffling of papers during this busy time can add to agitated behavior, especially with persons living with dementia.

Not all noise is detrimental.  In fact, calming background music and can have a positive effect on mood, relaxation, reduced anxiety, and agitation.  This is especially true for meal times or helping to induce sleep before naps or bedtime.

Understanding sensory change in older adults, especially those living with dementia is critically important for care partners working in elder care communities, home care providers, families and for businesses who serve older adults.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and creator of the Dementia Live® simulation and awareness training being implemented by providers across the US and internationally.  

http://www.AGEucate.com