A housing crisis for seniors

According to this informative article that appeared in the New York times, we are into a housing crisis for seniors. This should not be a suprise to any of us who have or will confront the challenge of finding quality, affordable housing for our elderly parents when they need it.

Read it here:  https://nyti.ms/2jBSNHu

 

 

How technology could help with dementia care

Here is a really interesting recent article on hoe evolving technology could do more to help in the home where demential is an issue and challenge:


A chance conversation was all it took to give Alex Mihailidis’s burgeoning career a new focus.
As a graduate student in 1996, the now 41-year-old met a man whose wife had developed dementia in her early 50s. Her bizarre behaviour, such as taking soiled toilet paper, folding it up and hiding it around the house, had her husband at wit’s end.

Continue reading “How technology could help with dementia care”

Plan good holidays for elderly loved ones

When you’re planning for the festive season, remember that older parents and other aging loved ones often have different needs than our children or we do.

Because they’re such an important part of our sense of family and the holidays, we need to plan good holidays for elderly loved ones. Too often we take for granted that our older family members can be as fully involved as we’d like. The fact is elderly family members may be lacking the stamina we’d wish they had.

That’s why it’s so important to plan all holiday events to ensure aging loved ones can enjoy them fully and that we can have the pleasure of their company.

Here are five steps for you to consider and apply in order to assure elder enjoyment at your family events this holiday season.

1. Reduce ‘wait time’. You can spend a lot of family wait time while meals are being prepared or people are dressing, or getting to a religious ceremony early in order to have good seating. But these are actually tiring times for the elderly. Help them by planning the latest time you can bring them to the event. That way, they don’t have to spend tiring ‘wait time’ doing nothing.

2. Build in ‘down time’. Make sure there’s at least half an hour or hour of rest time between events so your elderly parents can relax and perhaps catch a catnap or at least just have some personal quiet time. Their batteries run down faster now, and some recharge time becomes important.

3. Make meals more manageable. The more courses and the longer time a full meal takes, the more agitated little kids become… and the more aggravated older people become. Elderly parents will find long, drawn out meals fatiguing, even if they pretend to be enjoying themselves. So plan meals to be shorter, or plan strategies to respectfully give them options during a drawn out dinner so they’ll have some rest time.

4. Smart wrap for gift giving. Opening gifts that are tightly taped and tied with lots of ribbons is often difficult for the elderly. With reduced dexterity and maybe some arthritis, they can be stymied by some of the packages we present. Make it easier—and eliminate the embarrassment of being unable to open a package—by either wrapping their gifts much more loosely, or better yet, by putting them into attractive gift bags, covered with colorful issue paper.

5. Slow down and speak up. The elderly tend to process less quickly and don’t hear as well as once ago. To help them get the most out of your holiday events, slow down how fast you talk or do things, and speak more slowly and louder. Be sure to watch their reactions and body language very carefully for clues about how well they’re staying with you in terms of what’s being done and said.

And it’s also important to consider that for an elderly person who has lost a loved one, this is an especially difficult time of year. The loss, and the memories that inevitably freely flow especially during religious festivities, combine to create a level of personal hurt and pain we often don’t understand or respect to the extent we could and should.

When we consciously plan to meet the oft-unexpressed needs of our elderly family members, we’re ensuring they’ll be active participants in our holiday events. And we’ll know that their engagement is satisfying to them and to every person in the family.

Care for yourself during the holidays!

During any festive season we all have our prescribed periods of time to observe, reflect, celebrate; times when families draw close to share and offer thanks for what we have.

For families with aging parents and other loved ones who are no longer in good health, this can be a more difficult and demanding time. How to be together? Where? Under what conditions? If various forms of dementia are involved, what are the implications? If physical disabilities are an issue, how can they be dealt with, or what alternative might there be?

Caring for your loved one requires attention, planning and coordination.

But there’s also you. The caregiver. Care for yourself during the holidays! How will you get through the holidays with the demands you’ll be facing? Because it’s important to realize that in striving to make every holiday a special one for aging and failing loved ones, you’re probably dipping into your personal well of reserve strength.

So just this caution from one whose had to learn the hard way: make some time and room for yourself. Give yourself a much-deserved slice of down time. Whatever the size of that slice, it will be good for your body, mind and soul. Take a moment now to decide how you’re going to do that.

The next blog will give you tips on how to make the holidays better for your aging parents and other elderly loved ones.

Elderly winter wardrobe changeover

We’re well into fall now, the warm days are gone, we’re turning the clocks back, and the nights are cooler.

Those of us in the colder climes all change over our wardrobes, putting the sweaters up front, the corduroy slacks close at hand, and dig out the boots, hats and gloves.

But let’s not forget to help our aging parents and other elderly loved ones do the same. Don’t assume it will happen without your asking, or maybe even your help. Assisted elderly winter wardrobe changeover can make their lives that much easier.

Way too often, many elderly people just don’t think about what kind of preparations are needed for seasonal weather changes, or sometimes, with the onset of diminishing cognitive skills or any form of dementia, there’s a mental disconnect regarding what to do and why, and sometimes how to do it.

That’s why during seasonal changeover times it’s good to ask, check, help in terms of wardrobe changeovers. Have you done that?

 

Giving thanksgiving with our aging parents

Thanksgiving is upon us. It’s a great time to remember that those aging parents who now need some of our support for years selflessly supported us.

The Thanksgiving tables are turning for Boomers and many others with older parents who aren’t as able to look after all their needs as they once could. Now, it’s our turn to help out, whether they’re experiencing some degree of Alzheimer’s, Parkinson’s, or any cognitive or physical challenges.

Remember Thanksgivings from years ago, the sense of family, that amazing meal, the wonderful tastes, the sense of total contentment after a mega-meal?

Well, if you do, help make this Thanksgiving just as memorable for your older loved ones. Let them know they’re important, and give thanks together for being able to be together. Thanksgiving with our aging parents is special ever time we can share it.

Five key tips for interacting with your children about eldercare issues in the family

When you get busy helping your aging parents or other elderly loved ones, make sure you take the time to help your kids understand what’s going on and how you can do things together moving ahead.

Here are five key tips you may want to consider.

Don’t pressure.

Understand that no matter what their ages, your children sense and comprehend the pressures at play. The more you press them to be part of a caregiving team, the more they may well resist, especially as they reach adulthood.

Do explain.

Work hard to explain the situation, the medical prognosis and the timetable to likely events. Giving your children information helps them make their own decisions and take what the right actions are for them.

Ask a lot of questions.

Help your children construct and express their own feelings by asking a lot of questions about how they feel now, how they think they’ll feel when there is a death, how they think they’ll cope after a death and what it all means to them.

Share your feelings.
While it’s hard, share what’s on your mind and your own feelings about your parents’ health and decline, and how you’re dealing with their impending death. Let your children see and feel your emotions: they’ll respect you for it.

Be there for them.
As much as you may love your parents and work hard to help them, never for- get or short change your children: they need you, too. They need to feel and know that they’re also an important part of your life and that they have the comfort of your time and attention. 

More about music and elderly with dementia

We recently posted a blog about music; specifially, how I got my mother, with her advancing Alzheimer's, to get engaged with music that she seemed to remember from her younger years.

Today, CNN online carried the following story that underscores and amplifies my posting. Hope you will read this and find expanded interest in applying music and other active forms of involvement for your aging parent. He or she may have a host of limitations, but music can do so much, as can art, pets, kids… stimulates that engage the brain, regardless of its current state.

 

(CNN) — At 101, Frank Iacono still plays the violin. The concertmaster for the Providence Civic Orchestra of Senior Citizens in Rhode Island, he particularly enjoys playing polkas and jigs.

"It keeps my mind active, and it gives me a lot of pleasure," Iacono said.

The orchestra's executive director and co-founder, Vito Saritelli, said Iacono is extremely sharp for his age.

"Music has played a good part of his longevity," said his wife, Mary Iacono, 94. "We're blessed that we're both in good health."

Music meets medicineMusic meets medicine

 

As scientists race to figure out how to promote healthy aging of the brain, and prevent dementia, their preliminary advice for senior citizens has become a chorus of voices: "Stay active! Have hobbies! Be socially engaged!"

Playing music, for some people, is a natural answer to all of those recommendations. Frank Iacono, for instance, has been playing violin since he was 13 — just because he loves it.

But does music playing in particular stave off dementia? What about just listening to music? How many years do you need to engage in music before it benefits your brain?

Researchers are exploring these questions in the face of staggering statistics about the aging population. The number of Americans 65 and older with Alzheimer's is expected to triple nearly by 2050 — 13.8 million from 5 million now. The annual cost of dementia in the United States in 2050 will be $1.2 trillion, according to the Alzheimer's Association.

Early research suggests playing music may hold back dementia symptoms by about five years — which would be significant if it proves to be true, said Brenda Hanna-Pladdy, assistant professor of neurology at Emory University, who studies cognitive functioning among musicians.

"If you can delay the presentation (of dementia) by five years, then you add an extra five years of functioning to an individual at the end of the life span," she said. "In terms of fiscal cost and everything, that's actually quite a lot."

Being engaged

A large study using Sweden's twin registry is looking at intellectually and physically stimulating lifestyle factors that could help stave off cognitive decline. One component of this effort is exploring whether playing music protects against dementia. The results, discussed at the Interdisciplinary Society for Quantitative Research in Music and Medicine meeting in July, are not yet published.

Twin studies carry special importance in science. Usually, when people participate in a study, they each carry a different set of genetics and may have had different upbringings. Those factors could influence whatever researchers want to investigate. Fraternal twins, however, share about 50% of genes, and identical twins share almost all. Twins also likely grew up in the same environment.

"To me, the most intriguing aspect is, in a twin pair, if one becomes demented and the other doesn't, what did (one not do)? Or what did the one who did become demented do that might give you some clues about ways that other people can mitigate their risk?" asked Margaret Gatz, director of the Study of Dementia in Swedish Twins, and professor at the University of Southern California.

Researchers examining the broader twin data have found that, for women specifically, participating in intellectual and cultural activities was linked to lower dementia risk in one study. Activities such asexercise at midlife for both sexes are also protective against dementia, the study suggests.

"All of these kind of add up in suggesting that a more engaged lifestyle is a good thing for the aging brain," Gatz said.

Why would an "engaged lifestyle" help prevent dementia? The idea is that brain stimulation may counteract brain changes that occur because of cognitive decline so that a person can function for longer, Gatz said.

Music playing in particular is something that people can continue to enjoy for longer than their occupations, or strenuous physical activity, Gatz said. It also has cognitive, physical and potentially socially components, so it engages many brain networks.

Unfortunately the twin study has so far only looked at associations between lifestyle factors and dementia; it doesn't prove that music can protect you against cognitive decline. The study also doesn't include brain imaging or autopsies, so the precise mechanism — how engagement in activities would prevent dementia — is unknown.

Music therapy: When patients have 'music emergencies'

The brain's backup

There is other emerging evidence that playing music could help prevent dementia.

Hanna-Pladdy, the Emory neurologist, is interested in exploring the biological underpinnings further. Her theory agrees with Gatz's: Brain networks that have been strengthened by musical engagement compensate to delay the detrimental effects of aging, a process called cognitive reserve.

So far her research has demonstrated that extensive musical instrumental training, even in amateur musicians, provides a cognitive benefit that can last throughout a person's life. Her studies were published in 2011 in the journal Neuropsychology and in 2012 in the journal Frontiers in Human Neuroscience; they included instrumentalists, not singers.

Hanna-Pladdy and her colleagues found in their first study that even if participants did not continue playing music as they aged, they still performed better at tasks of object-naming, visuospatial memory and rapid mental processing and flexibility than those who didn't play at all — as long as they had played for at least 10 years. That's critical because as they age, people may lose motor skills or eyesight that prevents them from playing their instruments.

 

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The study also suggests the cognitive benefits of instrumental training can last a lifetime.

One of the study's participants said in an interview that he felt like having played for so long was akin to "an insurance policy," Hanna-Plady said.

The researcher's more recent study showed that musicians who began playing before age 9 had better verbal working memory functions than those who started later or didn't play at all.

This finding is consistent with verbal language acquisition — linguistics studies have shown that there is a critical period during which the brain is open to learning a language, and fluency becomes far more difficult after a certain age in childhood.

It also jives with the findings of a 1995 study that showed professional musicians who began training before age 7 had a thicker anterior corpus callosum, part of the pathway that links the right and left hemispheres of the brain.

And participants who continued to play their instruments at older ages tended to perform better on tasks of visuospatial judgment, "suggesting that there continues to be plasticity in advanced age," Hanna-Pladdy said.

"Finding a way to harness this plasticity is probably one of the biggest hopes we have for treating brain disorders or dealing with cognitive decline in advanced age," she said. "Similarly, continuing to play music in advanced age added a protective benefit to individuals with less education, which has previously been demonstrated (to be) one of the most robust ways to create cognitive reserve. Thus, musical training appears to be a viable model for cognitive stimulation, and can be conceptualized as an alternate form of education."

Should we start now?

Is it worth it then to teach an older person to play an instrument, perhaps one who already shows signs of cognitive decline? Recent research suggests it's harder, but still possible, to modify the brain in an older person. But no one has a definitive answer on whether teaching an elderly person a new instrument would lead to the same kinds of benefits that scientists have found in lifelong musicians.

"It would be pretty challenging, considering they're having a hard time remembering," Hanna-Pladdy said of dementia patients. "It may be beneficial to provide musical stimulation to individuals in the earlier phases (referred to as mild cognitive impairment) or to re-initiate musical practice in individuals who are no longer engaged."

Regardless, since people find music enjoyable, trying to learn an instrument won't hurt. But more research is needed over a long period of time to assess fully the benefits of music among elderly people, Hanna-Pladdy said.

Music: It's in your head, changing your brain

Evidence may continue to emerge that long-term music playing has a preventive effect against dementia, but that's not to say that nonmusicians are totally out of luck, Hanna-Pladdy said.

Music is becoming a hot area of study because it's easier to quantify the number of years that people play music than, for instance, the length of time reading or playing games.

"This is just meant to be a model for cognitive stimulation, and how cognitively stimulating activities can change your brain," Hanna-Pladdy said.

So music may be good for you, but so may other pastimes.

After all, violinist Frank Iacono and his wife, Mary — married for 66 years — play Scrabble together every night.

Tuning in

For patients who already have dementia, music can be used in a different way to help the mind.

The emotional response that people get from listening to music, and the brain chemicals associated with pleasure that get released in the process, are distinct from the structural changes in the brain that playing music over time may instigate, scientists said.

Dr. Sanford A. Shmerling, who has Alzheimer's, joined in drum circle activity recently at his nursing home in Atlanta.
Dr. Sanford A. Shmerling, who has Alzheimer's, joined in drum circle activity recently at his nursing home in Atlanta.

 

Trends emerging from research show that music exposure — whether through casual listening or more formalized music therapy — can help reduce the incidences of behavioral issues and generally calm dementia patients, said Beth Kallmyer, vice president for constituent services at the Alzheimer's Association.

"Anecdotally what we hear is that people can be upset, even a little agitated, and when they're listening to music, even in the late stages, people can appreciate music," Kallmyer said.

Family members should help caregivers choose music that is meaningful to a person with dementia, she said. "The most important thing is keeping your interventions person-centered as much as possible."

Naomi Ziv of the Academic College of Tel Aviv Yaffo in Israel and her colleagues showed in a Journal of Music Therapy study that background music is associated with an increase in positive behaviors — laughing, smiling, talking — a decrease in negative ones, including aggressiveness and crying.

Music attracts attention; it also enhances focus and affects emotion, Ziv told CNN in an e-mail.

"When we hear familiar and preferred music, we mentally follow it," she said. "It seems that whereas general memory deteriorates in dementia, memory for music remains relatively intact."

Familiar or preferred music evokes memories and influences mood, which is perhaps the underlying reason for these results, Ziv said.

Catherine Shmerling appreciates the effect that certain musical events have had on her father, Dr. Sanford A. Shmerling, 85. The elder Shmerling used to be the medical director of the William Breman Jewish Home in Atlanta; now, he lives there. He has Alzheimer's, and most of his speech is not comprehensible, his daughter said.

On a recent weekend, a swing band performed at the nursing home. At first the former medical director sat in his wheelchair staring into space, but soon his daughter noticed him clapping his feet. She started swinging his arm with the music, and after a few minutes he gave her "a cute little smile."

"It's gratifying," Catherine Shmerling said. "There is something about — I don't know, the music or the auditory or something — that does seem to get past whatever it is that's blocking their normal communication, and somehow it gets in there."

Science may not have all the answers, but Shmerling savors these small signs that her father is listening.

Yet new data about elder caring gaps, this for Canada

Here is the start of a Globe & Mail article the other day, and it totally supports our ealirer UK posting on this subject:

Sys­tem must fo­cus on se­nior care strat­egy
AN­DRÉ PI­CARD api­card@globe­and­mail.com
The Globe and Mail Metro (Ontario Edition)
19 August, 2013

Cana­di­ans have lit­tle con­fi­dence in the abil­ity of the health-care sys­tem to meet the needs of a bur­geon­ing num­ber of se­niors and they are look­ing to gov­ern­ment to shift their pri­or­i­ties and come up with a plan.

That’s the mes­sage that emerges from a new poll com­mis­sioned by the Cana­dian Med­i­cal As­so­ci­a­tion.

“The anx­i­ety Cana­di­ans have about health care in their so­called golden years is both real and well-founded,” said Anna Reid, out­go­ing pres­i­dent of the CMA.

Na­tion­wide, three in five re­spon­dents said they be­lieved there would not be suf­fi­cient hos­pi­tal beds, long-term care and home-care ser­vices to meet de­mand in their golden years.

How­ever, there are sig­nif­i­cant re­gional dif­fer­ences. In Que­bec, for ex­am­ple, 56 per cent of those polled said the health sys­tem is ready for the so-called grey tsunami, com­pared to 31 per cent in At­lantic Canada.

Where there is near-unan­i­mous agree­ment – 93 per cent – is around the idea that gov­ern­ments should unite to de­velop a com­pre­hen­sive se­niors’ strat­egy. A large num­ber of re­spon­dents, 78 per cent, said Ot­tawa should play a sig­nif­i­cant role in de­vel­op­ing the strat­egy, de­spite the fed­eral gov­ern­ment’s stand that health is strictly a pro­vin­cial mat­ter.

“Let there be no doubt that a na­tional strat­egy for se­niors’ health care should be a fed­eral pri­or­ity,” Dr. Reid said.

She added that the poll re­sults send a strong mes­sage that the pub­lic wants ac­tion.

The repeating key point is that the system can't deliver to meet our expectations about eldercare. We need to work harder than ever to plan ahead, to research needed resources, to define and enlist  the help of others… lots to do! And we can't start soon enough anymore. 

Care of the elderly a challenge that’s growing everywhere

Take a look at this short story on the BBC tonight: http://www.bbc.co.uk/news/health-23810109
 
It's an excellent example of the kinds of help and support shortages that will keep growing not just in England, but across Canada and the United States, too.
 
All the more reason to think about what kind of care our aging parents will need and likely when, and then plan now for how to get that help.