Tag Archives: AGE-u-cate Training Institute

The Depression-Dementia Link and What Caregivers Need to Know

Far too often I talk to family caregivers who are concerned about their loved one’s cognitive decline.  It is not uncommon to hear such explanations go something like this:

Mom just has not been on top of things lately.  She seems scattered.  Her house is messier than normal, and she can’t seem to get things in order.  What concerns me most is that it doesn’t seem to bother her, and that is so unlike her.”

Dad was always such a strong decision maker, and now he can’t decide something simple, like where to go for dinner.  It seems like he’s stuck in limbo with just about everything when it comes to making choices – not just about the big stuff but everyday things”.

My wife has no interest in meeting with friends, going to church, or even going out for a stroll.  This is so unlike her.  I know she is blue, but it seems to be affecting her memory.  The other day she asked me the same questions many times.”

All of these scenarios certainly look like potential dementia-like symptoms.  Being disorganized, not able to make decisions and social isolation are certainly cause for concern, especially with older adults.  What often goes unnoticed is the possibility of depression.

What is Pseudodementia?

There is a link between depression and dementia.  It actually has a name – it’s called pseudodementia. Pseudodementia is a term—not an official diagnosis— that is sometimes used to describe symptoms that resemble dementia but are actually due to other conditions, most commonly depression. Unlike true dementia, depression that is caused by depression is often reversible.

Why is the Depression-Dementia Link often Overlooked?

My non-clinical opinion (but based on years of working with family caregivers and my own caregiving story) is that far too often families and even primary caregivers are not tuned into their loved one’s risks for depression.  Older adults who have at least one chronic health condition and 50% have two or more.  Depression is more common in people who have illnesses that limit their normal daily activities.

Loss and grief are common denominators in the elderly, especially those who are living alone, lost loved ones, especially spouses, and because of illness have lost their independence.  If, for instance, a parent has recently lost a spouse, moved from a life-long home, been diagnosed with a significant illness, can no longer drive or has to have help with everyday tasks – ALL of these are precursors to the possibility of that person’s loss and grief lead to depression.

The domino effects that occur when illness strikes, depression sets in and cognitive decline is recognized are often confusing and shocking for families.

It’s very important that loved ones look at life circumstances, and begin to make notes of lifestyle changes (such as not wanting to go out), lack of ability to make decisions, unkempt dress or cluttered living conditions.  The importance of noting these things will make all the difference when visiting the doctor.  Since we have limited time to spend with busy health care professionals, it is more important than ever that older adults have a health care advocate (preferably a family member) accompany their loved ones’ to doctor visits.

More often than not depression is not going to be diagnosed during a doctor visit unless their advocate is there to share what has been observed.  If it is too uncomfortable to do this with a loved one present, then ask for a consultation visit or at the least leave a note that clearly outlines your concerns so the doctor can read this before visiting with your loved one.

Dementia caused by depression is often reversible by treating the depression.  Before loved ones jump to conclusions that their loved one has Alzheimer’s disease or another form of dementia, they should step back and make comprehensive observations, share this with their healthcare professional and see if treating depression first will reverse what looks like symptoms of dementia.

As the holidays’ approach and families come together, this is an important reminder to observe your loved one’s emotional health just as much, if not more than what is going on physically.  Be willing to talk to others and what they have observed, and even with your loved one should be on your to-do list.

And lastly, keep in mind that the oldest generation did not grow up in the era of “happy pills” so, talking about depression and the possibility of taking a medication to treat depression can often be considered an “off the table” topic.  I’ve found that approaching with empathy and kindness and being prepared to explain that depression is treatable –  just like high blood pressure is helpful.  Above, as the saying goes, use your finest kid gloves.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  A longtime family caregiver herself, Pam has guided thousands of care partners and their loved ones with complex  challenges.

 

 

 

Creating a Sustainable Culture of Compassion

I have to be direct in asking – isn’t this every elder care community’s goal?  After all, we should be in the compassion business, and sustainability is the hot topic today.  Creating a sustainable culture of compassion – makes sense right?

As I write this I can see my readers head shaking.  “It would be ideal, however…….”.  And the list starts adding up quickly of all the barriers to creating a sustainable culture of compassion.

Let’s break this down a bit, starting with Creating.  To create is to bring into existence;  to bring about a course of action or behavior;  to produce through imaginative skill.   Creating should be a blend of many and in elder care, that means everyone from our residents, dining staff, front-line caregivers, housekeeping, clinical staff, administrators and right “up the line” to the CEO.  It’s not a top-down mechanical procedure.  We create things and ideas by listening to each other, churning ideas and then embracing it all with passion.

Sustainability if the ability to be maintained;  In elder care, maintaining a high level of care for each resident is critically important.  High levels of satisfaction from residents, families, and staff are benchmarks upon which our business either succeeds or not.  Sustainability takes a strong commitment from leadership and perseverance to maintain standards even when the going gets tough.

 Now we look at a Culture of Compassion.  Wow, now we’re getting to the real meat here.  Compassion is simply empathy and concern for others.  Culture is the characteristics and knowledge of a group of people.  It’s a collective whole that creates a certain environment.
Aren’t we in the compassion business?  
Most certainly we are in the compassion business and I believe most of us found our way to senior or elder care because somewhere in our life experiences we found that this caring business is pretty dog-gone important to others and ourselves.
Why, then do we struggle with creating a sustainable culture of compassion?  Are we not looking at the vision we must create as leaders?  Are we not listening enough to those who are really doing the work that makes our business?  And, goodness knows, are we forgetting to listen to the very people who live in our communities?
I believe that creating a sustainable culture of compassion is not only doable but essential.  So many good things will happen when compassion cultures are created and maintained.  It is a domino effect of great leadership, teambuilding, happy residents, staff and families.  It’s getting down to the basics of why we do what we do every single day.
To coin a phrase, Just Do It!
Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  She led the development of the Compassionate Touch® program.  She may be contacted at pam@AGEucate.com.

Can we Age Well through the Challenges of Aging?

Until a miracle cure is found to stop, reverse or drastically slow down the aging process,  the news flash of the day is that we will all leave this earth someday.  In our anti-aging driven society of wrinkle reducers and body re-shaping, the fact is that all of us are, shall I say it – AGING!  The question is not that we are aging, but can we age well through the challenges of aging?

Unlike what many marketers would have us believe, aging is not a disease.  Normal aging is associated with changes, some of these being:

  • Vision – decreased depth perception and ability to distinguish dark colors.  Often this includes decreased night vision.
  • Hearing – loss is gradual;  in the 65 – 74 age group 25% hearing loss is average, with men experiencing more than women.
  • Smell – by age 80, 40% of older adults may experience changes in ability to smell.
  • Touch – the number of nerve receptors in skin decrease and difficulty in the ability to discriminate temperature increases with age.
  • Psychosocial – memory and reaction time typically being to decline at about the age of 70, leading to slower response time, decreased reflexes in the feet and learning time takes longer.

These age-related changes can be challenging, especially if we don’t accept these as a reality of normal aging.  For instance, vision changes require that we see our eye doctor on a regular basis so that symptoms such as cataracts can be corrected.  Hearing loss can be treated with hearing aids.

Other changes are more complex which can be related to a number of chronic illnesses, such as diabetes, medications, and dementia.  The “snowball” effect of age-related changes such as falling, depression, memory loss, loss of peripheral vision, weight loss, for example, is not a normal part of aging and needs to be addressed in order to age well.

To age well we:

  1. Must accept the normal changes taking place as we age
  2. Address these changes with regular health care visits
  3. Understand that an unhealthy lifestyle such as lack of physical exercise, unhealthy eating, over-consumption of alcohol, drug or medication misuse,  and lack of social interactions will have a domino effect on normal aging.

Age is the greatest factor in developing Alzheimer’s, Parkinson’s disease and other neurological symptoms, heart disease and other chronic illness.  For the 78 million boomers marching toward old age who want to age well, the best first step is to realize that you have the ability to choose if this will be your course of action.  To age well, we must take on the aging challenges intentionally.  Not by ignoring that we are aging, or allowing ourselves to wallow in the woes of aching joints.

“Know that you are a perfect age.  Each year is special and precious, for you shall only live it once.  Be comfortable with growing older.”                              ….Louise Hay

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  She is the creator of the internationally acclaimed Dementia Live Simulation program.  She may be contacted at pam@ageucate.com

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Personhood and it’s Value in Dementia Care

Quite simply, the definition of personhood is the quality or condition of being an individual person.  At the core of personhood is the self- who we are are, our values and beliefs.  It’s who makes us who we are.  Being able to recognize the “self” of personhood is key to understanding and practicing person-centered care for persons living with dementia.

Professor Thomas Kitwood was a pioneer in the philosophy of person-centered care from the University of Bradford in England and in the 1990s, connected the beliefs and values of person-centered care specifically to dementia care. His work and research gave voice and credence to the need to realign dementia care practices to a model oriented to the “personhood” of the individual living with dementia.  Although he passed away before his research was complete, his valuable work, and has been built upon throughout the world as the basis and model for providers of dementia care services, advocates and certainly the continued research on this topic.

Personhood doesn’t go away as dementia progresses.  The individual within is what makes up who we are.  In many ways, dementia does change one’s judgment, memory, sensory abilities, language, mood, and behaviors.  But what makes them who they are doesn’t change – it’s their personhood.  Unfortunately, too often our society, families and even professional caregivers treat someone living with dementia as if they have lost who they are.  When we ‘discount’ that person’s selfhood (or personhood), it alters how they think of themselves in the world, their relationships, security, and purpose.

Humans are born to relate, connect and bond.  These needs remain for a lifetime, yet far too often when someone has even mild dementia, others treat them as if those inner needs that keep them whole, are simply not important.  Sadly, those who are often the most vulnerable to this reaction are families.  The root cause of not respecting one’s personhood is often fear,  denial or the need to suddenly take control.  Losing one’s personhood robs them of the ability to hang on those basic human needs – to related, connect and bond.

Respecting one’s personhood in dementia care means that we must move into their world.  Join them where they are, in the moment, with no expectations other than to connect with the individual within.  When doing so, we are practicing person-centered care and their personhood.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and their caregivers.  Pam is the creator of the internationally acclaimed Dementia Live awareness and training program and worked with recognized expert, Ann Catlin in developing the Compassionate Touch program.