This year, the Alzheimer’s Association is taking a closer look at Mild Cognitive Impairment (MCI) and encouraging greater awareness and understanding of this condition and its relation to Alzheimer’s disease.
Here are some of the top takeaways:
More than 6 million Americans are living with Alzheimer’s
1 in 3 seniors dies with Alzheimer’s or another dementia
In 2020, COVID-19 contributed to a 17% increase in Alzheimer’s and dementia deaths
More than 11 million Americans provide unpaid care for people with Alzheimer’s or other dementias and in 2021, these caregivers provided more than 16 billion hours of care valued at nearly $272 billion.
Fewer than 1 in 5 Americans are familiar with mild cognitive impairment (MCI), which can be an early stage of Alzheimer’s
About one-third of people with MCI due to Alzheimer’s disease develop dementia within 5 years of diagnosis
I recently had the privilege of writing a blog post for The Conversation Project. My father died 10 years ago and in May, I will be marking seven years since my mother’s death. I’ve had a lot of time to think about end of life issues in the years since their passing and I’ve shared my perspectives here on The Memories Project blog and in my book, The Reluctant Caregiver.
In my post for The Conversation Project, A Good Death Is More about the Journey than the Destination, I discuss my family’s reluctance to talk about death and end of life issues, and how that impacted their end of life journeys, albeit in very different ways. My father’s death impacted how I cared for my mother, when just several months later, she was diagnosed with cancer.
Neither of my parents experienced the kind of death that I would want for myself, and that is why it has become such an important advocacy issue to me. Please talk to your loved ones, discuss your end-of-life wishes and document it all so that you can have some peace of mind when that phase of life is reached. What I wish for everyone is that you can find the time to simply be with your loved ones who are nearing the end of life, and not overly preoccupied with medical care duties. Just like at the beginning of life, it’s important we have those bonding moments at the end of life as well.
Visit The Conversation Project for tips and guides on how to start these important conversations with your own family.
I’ve written before on this blog about having a keen interest in studies that involve dementia, Alzheimer’s and overall cognitive health, while also maintaining a healthy skepticism. This week a preliminary study about how having a pet could benefit cognitive health made the rounds on social media. Those of us who are pet owners know how much love and joy they can bring to our lives. But it’s also important to understand and be able to manage the challenging moments as they age and develop health issues of their own.
The study found that those who had owned pets for five or more years were able to delay cognitive decline by 1.2 points vs. those in the study who did not have pets over a six-year period. The study analyzed cognitive data of more than 1,300 adults age 50 or over. While researchers were only able to establish an association, not a cause and effect with this study, the findings support prior research in this area.
Pets offer loyal companionship and keep us on a routine. Dog ownership encourages daily walks, and regular exercise has been demonstrated to have cognitive benefits. By just being their unique and adorable selves, pets can offer us moments of joy that help relieve stress and lift our spirits. As a society, we should do everything we can to make sure elders and those with health issues have the support they need to keep their beloved pets with them, whether its at home or in a residential facility.
Pets can also present a host of challenges, from behavioral to health issues. I personally have experienced this and dealt with an extended period of sleep deprivation. Researchers believe our quality of sleep, especially in middle age, has an impact upon our cognitive health and that poor sleep may increase our risk of Alzheimer’s and other dementias later in life.
I cannot imagine my life without my pets, but I also accept the considerable responsibility that I have in maintaining their well-being. If you have elder loved ones with pets, check on them to make sure that there are no care issues that need to be addressed.
I came across an interesting discussion recently about whether Ensure and other nutritional beverages marketed towards older people are really the best option.
Despite being a geriatrician, I *don't* like Ensure
It's an expensive chemical milkshake laced w/ empty calories that can cause cavities if not careful
Would you want real food if you drink a heavy milkshake before every meal?
The discussion that followed the geriatrician’s perspective included interesting pros and cons. It made me think about my parents’ experience with the beverages. My father had never been a fan of milkshakes or similar beverages, but he seemed to enjoy the Ensure drinks, so I would ship cases of them to the memory care center where he spent the last year of his life. My mother existed on Ensure for the last month or so of her life. I have regrets about that, wishing I had taken time to make her something that she would have enjoyed more.
This is why I’m such a strong believer in expanding inpatient hospice and providing more robust home hospice care. As the sole caregiver for my mother at the end of her life, things like whipping up something delicious for her to eat didn’t cross my mind because I was so busy focusing on the “important” things, like her pain medication, treating her bedsores, etc. While I managed to mainly keep her suffering to a minimum, there was no joy in her final weeks.
Those with dementia may struggle with solid food as they enter the final stages of the disease, so liquid forms of nutrition may become a necessity. Homemade smoothies, puddings and milkshakes may interest those who have grown tired of the commercial products. If you can, consult with a nutrition specialist or dietitian about tasty, safe options for your loved one. Bringing loved ones small moments of joy can also lift the spirits of family caregivers.
The pandemic’s impact on health goes beyond those who contracted the coronavirus. Even those who managed to avoid the infection may have suffered consequences to their health, and in an area that many take for granted.
In December, I fell while walking my dog. I slipped going down a moderate slope in the park and landed straight on my rump. The fall knocked the wind out of me for a minute, but I was fortunate not to break or sprain anything. My back was very sore and remained so for about a week. I treated it using over-the-counter pain medication and homeopathic balms. My mobility was limited and I was forced to slow down and take it easy, but fortunately I fully recovered and don’t have any lingering issues.
I’m in my late 40s and in decent health. This was a minor fall, but it reminds me that as I get older, recovery from such incidents takes longer. We often take our mobility for granted, but the pandemic may have a lingering impact on our physical conditioning, making us more prone to falls. Studies suggest that some older adults have experienced a decrease in mobility during the pandemic, The New York Times reported.
Those who now work from home full-time may be moving less than when they went into the office, even if they drove to work. Pandemic restrictions may have shut parks, gyms, malls, and other outlets that older people used to exercise. Depression and anxiety can dampen the desire to exercise. Those who did contract COVID-19 may have battled lingering symptoms that made exercise difficult. And those who received benefits from physical and occupational therapy may have not been able to receive those services during the pandemic.
What geriatric health experts are concerned about is that decreased activity levels may result in worse physical functioning, which is key to older adults’ ability to live independently. A fall can lead to a lengthy recovery and trigger a fear of falling again, creating a vicious cycle with significant health consequences. The good news is that we can engage in simple activities that will help us reverse the impacts of our sedentary lifestyle and regain our mobility. Walking, yoga, and tai chi are all great ways to get moving and improve physical functioning.
Take inventory of your mobility and your elder loved ones and make an action plan if you desire to increase your mobility. Taking small steps now can make all the difference in keeping ourselves and our elder loved ones living independently.
As difficult as it can be to find a good nursing home and secure space for your loved one, the challenge doesn’t end there. Dementia caregivers in particular must be aware and be prepared to take action if the nursing home tries to evict your loved one.
So many people are not aware of the amount of nursing home evictions that take place each year in the US and the chaos and stress it causes families. I experienced a form of this when the skilled nursing facility where my father was placed after being discharged by the hospital said it could no longer care for him because they didn’t have staff that could provide dementia care. My father was not able to return home because he could no longer walk and my parents’ condo had stairs. My father was stranded and eventually was placed over an hour-and-a-half away from my parents’ home in the closest facility with a memory care wing.
First-hand account that illustrates the incredible harm caused to older adults and their families when long-term care facilities evict people from their homes. In many cases it’s illegal, but they still get away with it. https://t.co/vkWv93wxzg 1/5
One aspect of the pandemic that could be seen as a benefit to family caregivers is the embrace and expansion of technology that assists with basic tasks in our daily lives. While some of us were already utilizing such services before the pandemic, many others learned the convenience of having groceries delivered to their home, for example.
A sandwich caregiver interviewed by MarketWatch recounted what a major benefit it was to have groceries delivered. She used to spend a good chunk of her day off taking her elder parents to the grocery store. When the pandemic struck, she shifted to grocery delivery and signed up her own family as well. Sometimes it is the simple things that can make all the difference. A caregiver reclaiming a few hours of her life each week can have a major impact on her wellbeing and those in her care.
Of course, there is always a price to pay for that convenience, and I never forget the fact that there is a human being who is picking out my groceries and delivering them, putting their own lives at risk to complete a chore for me. I always make sure to tip well.
Zoom and other video calling tools also exploded in popularity during the pandemic. While some are understandably suffering from Zoom fatigue at this point, for those families who were able to get their elder loved ones comfortable with the technology, video calls served as an important lifeline for those separated during the pandemic. Being able to check in on an elder loved one from afar with a simple video call helped put a family caregiver’s mind at ease. Of course it’s not the same as being able to hug and socialize in person, but for elders who otherwise may have been completely isolated, video calls kept the connection to family intact.
Remote tools, whether for working, socializing, or caregiving, are now receiving greater public interest, which is sparking investments from major technology companies like Amazon, who has developed a caregiving hub called Alexa Together. While there are security, privacy, and ethical concerns when it comes to monitoring technology, overall I think these tools can be helpful for the long-distance caregiver.
From my experience, I found tools such as a cellphone designed for older people, fall-sensing technology, and automated shipping of supplies to be of great help as a long-distance caregiver. As I wrote in my book, The Reluctant Caregiver, I was able to convince my mother, long skeptical of high-tech gadgets, to embrace these tools to help keep her living at home safely, versus having to enter assisted living.
As I grow older, I will be watching this growing field of technology with interest.
Plaques and tangles in the brain have been a focus of Alzheimer’s researchers and some believe ridding the brain of the buildup will help in treating the disease. Approximately 20 percent of people have plaques detected in the brain, but do not develop dementia, prompting researchers to do a deeper investigation of the tau protein. Their results suggest that a specific presentation of the protein was linked to the development of dementia. The body has an automatic mechanism called autophagy to clear defective proteins from cells, but that process slows as we age, especially for those over the age of 65.
The researchers described the defective tau protein as “trying to put a right-handed glove on your left hand.”
If their preliminary research proves to be correct, there are drugs being tested to improve the autophagy process, which could potentially be used to treat Alzheimer’s disease.
I hope that you are having a wonderful holiday weekend with loved ones and appreciating the simple joys of being together, something that many had to sacrifice over the last two years.
Black Friday has earned a sordid reputation as displaying the worst of consumerism, but there is another notable day happening soon that may be worthy of participation: Giving Tuesday. If you have nonprofits and charities that you donate to or volunteer with, you probably are aware of the upcoming Nov. 30th event.
Giving Tuesday is a relatively new movement, beginning in 2012 as a way to simply designate a day to encourage people to do good. The movement has now spread globally. It’s easy to participate, and giving support to our elder community is one of the movement’s areas of focus. It can be as simple as checking in on a neighbor, writing a letter to an elder in a nursing home, supporting a local fundraiser, or donating your time and skills virtually or in-person.
Whether it’s Tuesday or any other day this holiday season, let’s find our own unique way to support the elders in our families and communities.
A new AARP survey found that older Americans continue to have a strong preference to staying in their homes as they age, even if they have found themselves stuck at home for long stretches of time during the COVID-19 pandemic. Over three-quarters of those age 50 and over (77 percent) prefer to remain in their home as they age, according to the survey results. That statistic has remained steady for over a decade, according to AARP.
However, there is another way in which older people get stuck in a living situation that doesn’t meet their needs as they age. A third of survey participants said they’d need to modify their homes in order to accommodate a physical limitation. These modifications can be pricey and not feasible for those on fixed incomes. The same financial challenges apply to moving into a more aging-friendly home or moving into a senior living facility.
When my father landed in the hospital for emergency surgery, he had a difficult recovery due to his mid-stage dementia and could no longer walk. The condo that my parents had was not safe for him to return to, so the hospital would not release him home. One had to access a staircase to get to the entrance and the rear entrance was wooded land that was not safe for unsteady gaits. Any modifications would have to be approved by the HOA, a lengthy process. Instead my father got transferred to a skilled nursing facility and then, a memory care facility an hour and a half away from home.
Another solution to these housing challenges was met with support from survey participants. Sixty percent of those polled said they would consider living in an accessory dwelling unit (ADU), sometimes referred to as a “granny pad” or a tiny house. These affordable, small-footprint homes can be built adjacent to a primary home (depending upon local permitting) and allow independence and privacy while also benefitting from having loved ones nearby for help with daily chores and activities and for companionship.
According to the AARP survey, “access to clean water, healthy foods, quality health care and safe outdoor spaces” were important considerations when it came to what communities offer those aging in place. High-speed internet service was also deemed important. Developers and city planners should take note as they build communities and offer flexible, adjustable housing options that can meet the needs of an aging population.
![Pageflex Persona [document: PRS0000038_00069]](https://memoriesproject.files.wordpress.com/2014/02/reluctant-caregiver-cover.jpg)
The Memories Project 