Category Archives: alzheimer’s

Understanding Home Health Care

One of the most confusing elements of securing care for seniors is deciphering the difference between home health versus home care. Although it might seem like a minor difference, the distinction between the two terms is more than splitting nouns to professionals in the industry – especially for insurance providers.

One of the most important differences is that care provided by home health agencies are usually covered by medical insurance because these services are prescribed by a doctor and are often part of a transition from a hospital stay back into a home. Home care services are not usually covered by medical insurance but may be covered by long term insurance. The main reason why medical insurance covers one and not the other? Home health services require a trained professional, such as a physical therapist, occupational therapist, registered nurse or certified nurse assistant, while home care services generally not to require professional training or education.

The type of care and the insurance coverage that will be provided depend on each individual but these are some of the key terms you should know.

HOME CARE/ASSISTED LIVING/COMPANION OR RESPITE CARE
This type of care is often provided by friends or family members and includes assistance with daily living tasks. When looking for an extra pair of hands outside your immediate circle, Home Care Agencies can offer assistance. The types of services provided may include light housekeeping, shopping, cooking, laundry, medication reminders, companionship and even transportation to doctor’s appointments, shopping or recreational activities. These agencies usually charge by the hour and may require a minimum number of hours for each shift. Beyond any minimum shift requirements, these types of agencies may offer services for up to 24 hours, allowing the primary caregiver (often a spouse) the opportunity to get away for a few hours or even for several days. Benefits of using a home care agency include care coverage in the case the regular agency care provider is unavailable, employment taxes and fees are handled by the agency and agency caregivers often have some related training. Depending upon your policy, these services may be covered by long term insurance.

HOME HEALTH (AGENCY)
Generally licensed by each state, home health agencies primarily provide skilled care, although some may also provide companion and home care services. Common services provided by home health include nursing care, physical therapy, occupational therapy, speech therapy and respiratory therapy. Some agencies may also provide medical equipment and supplies as well as home health aide services, such as assistance with bathing, dressing and eating. In addition to providing services to patients in private homes, home health agencies may also be able to provide services to patients in assisted living facilities and adult family care homes. Scheduling the services of the medical professionals, including the nurses and therapists, is not as definite as with home care staff as home health professionals are usually going from one patient home to another. The services for skilled home heath care are usually paid in part or entirely by an array of health insurance and long term care insurance, depending upon the policy. Services may also be paid out of pocket or on a fee-for-service basis.

MEDICARE HOME HEALTH AGENCY
These agencies provide skilled care in a person’s home and paid for by Medicare if the following conditions are met: the patient must be under the care of a doctor and you must be receiving services under a care plan established and reviewed on a regular basis by a doctor. As part of this process, a doctor must certify that the patient needs one of more of the following: intermittent skilled nursing care, physical therapy, speech-language pathology services and/or occupational therapy. The agency must be approved by Medicare (aka Medicare certified) and doctor must also certify that the patient is homebound. If these conditions are met, Medicare is likely to pay for your covered home health services for as long as the patient is eligible and the doctor certifies that the services are necessary. Usually homebound patients are still permitted to leave home for medial appointments or procedures as well as brief non-medical reasons, such as a haircut or to attend religious services. Please consult your doctor and agency for specific requirements and eligibility.

These are the most common types of agencies to provide in-home or outpatient care. In case of injury, such as a broken hip or knee replacement, in-home care may only be needed for several weeks. Navigating the system of elder care services and agencies can be confusing for anyone. Sometimes it can be overwhelming. Finding the appropriate level of care and caregivers you can trust can take time but it is time well spent.

If the time has come when your aging loved one is no longer able to live independently, please contact the knowledgeable staff at ElderLink. We will help you find elder care services or an assisted living facility within California that is customized for the requirements of your family.

How To Help Alzheimer’s Patients Enjoy Life, Not Just ‘Fade Away’

Alzheimer’s disease has an unusual distinction: It’s the illness that Americans fear most — more than cancer, stroke or heart disease.

The rhetoric surrounding Alzheimer’s reflects this. People “fade away” and are tragically “robbed of their identities” as this incurable condition progresses, we’re told time and again.

Yet, a sizable body of research suggests this Alzheimer’s narrative is mistaken. It finds that people with Alzheimer’s and other types of dementia retain a sense of self and have a positive quality of life, overall, until the illness’s final stages.

They appreciate relationships. They’re energized by meaningful activities and value opportunities to express themselves. And they enjoy feeling at home in their surroundings.

“Do our abilities change? Yes. But inside we’re the same people,” said John Sandblom, 57, of Ankeny, Iowa, who was diagnosed with Alzheimer’s seven years ago.

Dr. Peter Rabins, a psychiatrist and co-author of “The 36-Hour Day,” a guide for Alzheimer patients’ families, summarized research findings this way: “Overall, about one-quarter of people with dementia report a negative quality of life, although that number is higher in people with severe disease.”

“I’ve learned something from this,” admitted Rabins, a professor at the University of Maryland. “I’m among the people who would have thought, ‘If anything happens to my memory, my ability to think, I can’t imagine anything worse.’

“But I’ve seen that you can be a wonderful grandparent and not remember the name of the grandchild you adore. You can be with people you love and enjoy them, even if you’re not following the whole conversation.”

The implication: Promoting well-being is both possible and desirable in people with dementia, even as people struggle with memory loss, slower cognitive processing, distractibility and other symptoms.

“There are many things that caregivers, families and friends can do — right now — to improve people’s lives,” said Dr. Allen Power, author of “Dementia Beyond Disease: Enhancing Well-Being” and chair for aging and dementia innovation at the Schlegel-University of Waterloo Research Institute for Aging in Canada.

Of course, the final stages of Alzheimer’s disease and other types of dementia are enormously difficult, and resources to help caregivers are scarce — problems that shouldn’t be underestimated.

Still, up to 80 percent of people with dementia are in the mild and moderate stages. Here are some elements of their quality of life that should be attended to:

Focus On Health

One notable study analyzed lengthy discussions between people with dementia, caregivers and professionals at six meetings of Alzheimer’s Disease International, an association of Alzheimer’s societies across the world.

Those discussions emphasized the importance of physical health: being free from pain, well-fed, physically active and well-groomed, having continence needs met, being equipped with glasses and hearing aids and not being overmedicated. Cognitive health was also a priority. People wanted “cognitive rehabilitation” to help them learn practical techniques for promoting memory or compensating for memory loss.

Up to 40 percent of people with Alzheimer’s disease suffer from significant depression, and research by Rabins and colleagues underscores the importance of evaluating and offering treatment to someone who appears sad, apathetic and altogether disinterested in life.

Foster Social Connections

Being connected with and involved with other people is a high priority for people with dementia. Based on research conducted over several decades, Rabins listed social interaction as one of the five essential elements of a positive quality of life.

But fear, discomfort and misunderstanding routinely disrupt relationships once a diagnosis is revealed.

“The saddest thing that I hear, almost without exception, from people all over the world is that family, friends and acquaintances desert them,” said Sandblom, who runs a weekly online support group for Dementia Alliance International, an organization for people with dementia that he co-founded in January 2014.

Adapt Communication

Not knowing how to communicate with someone with dementia is a common problem.

Laura Gitlin, a dementia researcher and director of The Center for Innovative Care in Aging at Johns Hopkins School of Nursing, offered these suggestions in an article in the International Encyclopedia of Rehabilitation: Speak slowly, simply and calmly, make one or two points at a time, allow someone sufficient time to respond, avoid the use of negative words, don’t argue, eliminate noise and distraction, make eye contact but don’t stare, and express affection by smiling, holding hands or giving a hug.

Also, understand that people with dementia perceive things differently.

“You have to understand that when you have dementia you lose a lot of your natural perceptions of what others are doing,” Sandblom said. “So, a lot of us get a little nervous or suspicious. I think that’s a natural human reaction to knowing that you’re not picking up on things very well.”

Address Unmet Needs

Needs that aren’t recognized or addressed can cause significant distress and a lower quality of life. Rather than treat the distress, Power suggested, try to understand the underlying cause and do something about it.

Which needs are commonly unmet? In a study published in 2013, Rabins and colleagues identified several: managing patients’ risk of falling (unmet almost 75 percent of the time); addressing health and medical concerns (unmet, 63 percent); engaging people in meaningful activities (53 percent); and evaluating homes so that they’re safe and made easier to navigate (45 percent).

Respect Autonomy And Individuality

Rabins called this “awareness of self” and listed it among the essential components of a positive quality of life. Sandblom called this “being seen as a whole person, not as my disease.”

At the Alzheimer’s Disease International meetings, people spoke of being listened to, valued and given choices that allowed them to express themselves. They said they wanted to be respected and have their spirituality recognized, not patronized, demeaned or infantilized.

In a review of 11 studies that asked people with dementia what was important to them, they said they wanted to experience autonomy and independence, feel accepted and understood, and not be overly identified with their illness.

None of this is easy. But strategies for understanding what people with dementia experience and addressing their needs can be taught. This should become a priority, Rabins said, adding that “improved quality of life should be a primary outcome of all dementia treatments.”

By Judith Graham | California Healthline. This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips.

California Neurologist Develops New Protocol to Fight Alzheimer’s Disease

Cognitive impairment, which is most commonly diagnosed as dementia or Alzheimer’s disease, affects millions of people around the world, with Alzheimer’s currently affecting approximately 5.4 million Americans and 30 million people globally. Reportedly, 75 million Americans have ApoE4, a key genetic risk factor for Alzheimer’s disease. According to UCLA Newsroom, there could be more than 160 million people with Alzheimer’s disease globally by 2050, including 13 million Americans, without effective prevention and treatment. Alzheimer’s is on the rise and recent estimates suggest that it has become the third leading cause of death in the U.S. behind cardiovascular disease and cancer.

Though those statistics are daunting, a California neurologist, Dr. Dale Bredesen, has been developing a new protocol to fight Alzheimer’s disease and it has been receiving international attention for its results so far. A professor at the Buck Institute and professor at the Easton Laboratories for Neurodegenerative Disease Research at UCLA, Dr. Bredesen believes Alzheimer’s is caused by dozens of imbalances in the body and has been working to create a protocol designed to address these imbalances.

Dr. Bredesen told Today  that his protocol only works for patients in the early stages of the disease and is not a cure. Elements of his daily protocol include:

  • A Mediterranean diet high in vegetables and good fats
  • Cardio exercise
  • Fasting for at least 12 hours after dinner
  • Brain training exercises
  • At least 8 hours of sleep
  • A personalized regimen of supplements that address each patient’s deficiencies

The results of Dr. Bredesen’s protocol were published in the June 16, 2016 issue of ScienceDaily, “pre and post testing show reversal of memory loss from Alzheimer’s disease in 10 patients: Small trial succeeds using systems approach to memory disorders.” A joint effort from the Buck Institute for Research on Aging and the UCLA Easton Laboratories for Neurodegenerative Disease Research, ScienceDaily says the study is “the first to objectively show that memory loss in patients can be reversed, and improvement sustained, using a complex, 36-point therapeutic personalized program that involves comprehensive changes in diet, brain stimulation, exercise, optimization of sleep, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry.”

According to the study’s author, Dr. Bredesen, “all of these patients had either well-defined mild cognitive impairment (MCI), subjective cognitive impairment (SCI) or had been diagnosed with AD before beginning the program. Follow up testing showed some of the patients going from abnormal to normal.”

While improvement demonstrated by the ten patients is unprecedented, Dr. Bredesen acknowledged it was very small study that needs to be replicated in larger numbers at various sites and he has reportedly partnered with the Cleveland Clinic for a larger clinical trial of his program.

For an overview of this groundbreaking research, watch the Today show report below. To learn more about Alzheimer’s disease and caregiving, please visit Alzheimer’s Association  or to find out more about Dr. Bredesen’s program and how you might be eligible to participate, visit MPI Cognition.

If the time has come when your aging loved one is no longer able to live independently, please contact the knowledgeable staff at ElderLink  to help you find elder care services or an assisted living facility within California that is personalized for your family.

 

New Study Says Alzheimer’s Protein May Help Brain Fight Infection

Researchers have been studying the causes, effects and treatment options for Alzheimer’s disease for many years. Until now, the majority of researchers believed that the main cause of the debilitating disease has been a protein called amyloid beta, a protein that is not known to play any useful role in the body.  According to Scientific American, “when amyloid beta is not properly cleared from the brain, it builds up into plaques that destroy synapses, the junctions between nerve cells, resulting in cognitive decline and memory loss. The protein has thus become a major drug target in the search for a cure to Alzheimer’s.”

But recently, a team of researchers at Harvard Medical School and Massachusetts General Hospital are proposing a different theory. In a May 2016 study published in Science Translational Medicine, neurologists Rudolph Tanzi and Robert Moir discovered evidence that amyloid beta serves a crucial purpose: protecting the brain from invading microbes.

If the new study is proven, it could affect the way researchers and the medical community approach treatment of the disease, including the development of future drug protocols. This study suggests that amyloid buildup may be a protective measure when the brain is trying to fight off infections. According to an article in Time, “Alzheimer’s disease may be caused when an infection causes too much amyloid buildup. As people age, it may be easier for infections to reach the brain, triggering the amyloid and spurring the cascade of problems that lead to the disease.”

The Harvard Medical School and Massachusetts General Hospital researchers infected brain cells in lab dishes, worms and mice with bacteria and then studied how the brain created amyloid and plaque in response.  Scientific American reported the study results might indicate that a small amount of amyloid protein could be good for the brain and instead of getting rid of all of the protein; future research may want to focus on ways to lower the levels.

Although additional research will be needed to replicate the study results and determine whether the link is definitive, some experts in the field are calling the findings “provocative.”

If the time has come when your aging loved one is no longer able to live independently, please contact the knowledgeable staff at ElderLink to help you find elder care services or an assisted living facility within California that is customized for your family.