Archive for April, 2014


More than 15 million Americans provide unpaid care for people with Alzheimer’s disease or another dementia. 505,000 of them reside in Michigan. In 2013, millions of caregivers provided 17.7 billion hours of unpaid care, a contribution to the nation valued at more than $220 billion.

Alzheimer’s disease (AD) caregivers care longer, on average, than those caring for someone without AD. Caregiver stress is known to increase the longer one provides care, making this population particularly susceptible to burnout, depression and other poor outcomes. Caregivers of loved ones with Alzheimer’s disease are often providing assistance to the person before they even receive a formal diagnosis – making the length of caregiving even greater.

 

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Caregiving for someone with AD can involve multiple types of care, sometimes requiring the acquisition of new knowledge and skills (e.g. how to feed someone), significant time commitments, emotional and psychological stress (e.g. making major decisions), etc.

Clearly, caring for a person with Alzheimer’s or another dementia poses special challenges. For example, the person with AD experiences losses in judgment, orientation, and the ability to understand and communicate effectively. Family caregivers must often help people with AD manage these issues. The personality and behavior of a person with AD are affected as well, and these changes are often among the most challenging for family caregivers. It is not surprising that many areas of the caregiver’s life may be deleteriously affected.

Mental Health

  • 39% of caregivers of people with dementia suffer from depressions compared with 17% of non-caregivers.
  • Increased incidence of anxiety

Physical Health

  • Higher levels of stress hormones
  • Reduced immune function
  • Slower wound healing
  • Increased incidence of hypertension
  • Increased incidence of coronary heart disease
  • Elevated biomarkers of cardiovascular disease risk
  • Impaired kidney function
  • Trouble sleeping

Financial

  • 56% of family caregivers report “a good amount” to “a great deal” of caregiving strain concerning financial issues
  • Poor outcomes at the workplace

Professional Outcomes

 

Want to combat caregiver stress? Review the tips listed below:

1. Get a diagnosis as early as possible. Consult a geriatric physician when you see signs of memory loss or personality changes. Don’t delay! Some of the illnesses causing memory loss or personality changes are treatable.

2. Know what resources are available. Your local Alzheimer’s Association Chapter can help you find adult day programs, respite care, visiting nurses, meals on wheels, physicians and more.

3. Become an educated caregiver. Learn about the disease. As the disease progresses, new caregiving skills are required. Read, research, and learn new skills. Learn about resources that are available. The Alzheimer’s Association offers programs to help you better understand and cope with the behaviors and personality changes that sometimes accompany Alzheimer’s disease.

4. Get help! Caregiving is a job, and just like any other job, you can’t do it 24/7. Ask for help early and often. Seek the support of family, friends, and community resources. Help can come from paid caregivers, family or friends.

5. Take care of yourself! Watch your diet, exercise, and get plenty of rest. Make time for yourself. Manage stress as it occurs.

 

 

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With dementia, the person eventually loses all of the abilities they once possessed and the knowledge that they had acquired over time. Since using utensils and eating politely are acquired skills, they are lost in dementia. Using a fork and knife, for instance, takes practice and we are typically age 6, 7, or older by the time we have mastered all of the fine nuances of eating a meal and utilizing utensils properly. When we are young, we are fed by another person, then we learn how to drink from a bottle unassisted, then a cup or glass, then we learn how to use a spoon, then we master abilities that require more coordination and fine motor skills, such as cutting with a fork and knife or carving a turkey.

It is not surprising that as many as 80% of people with dementia have difficulty with eating and drinking. 50% are no longer able to feed themselves in the later stages of the disease (Ensell & Matheson, 2009). Furthermore, mealtime is an opportunity for individuals with dementia to socialize, feel useful, and embrace culture; if the mealtime experience is unenjoyable or challenging, this may prevent the person from engaging meaningfully with others and could lead to isolation or depression. See the tips below for providing help to individuals at different stages of dementia.

 

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Tips for Early Stage

  • Provide reminders on when to eat.
  • If the person lives alone, clean out their refrigerator regularly. Make sure spoiled foods are not kept or consumed.
  • Drop off pre-made meals or utilize a Meals on Wheels service.
  • Be aware of safety concerns in the kitchen. Supervision may be required, even at an early stage.
  • Declutter the kitchen area. Too much clutter can cause confusion and agitation.
  • Consider assistive devices, such as a rocker knife, that might help the person to remain independent longer. Consult an Occupational Therapist for specific suggestions.
  • Be mindful of the person’s likes and dislikes and life-long habits related to eating.
  • Try to stick to a regular routine.

Tips for Middle Stage

  • Serve finger foods or serve the meal in the form of a sandwich
  • To avoid spilling, serve food in large bowls instead of plates or use plates with rims or protective edges.
  • Consult with an Occupational Therapist to help promote independence. Specific assistive devices may be recommended.
  • Consult with a Speech Therapist/Pathologist if there are chewing or swallowing challenges.
  • Avoid foods such as nuts, popcorn, and raw carrots, which may be hard to chew and swallow.
  • Serve soft foods such as applesauce, cottage cheese and scrambled eggs. Serve thicker liquids such as shakes, nectars, and thick juices. You may also purchase powders that can thicken liquids in order to assist with swallowing.
  • Try to stick to a regular routine.
  • Help the person maintain good oral hygiene.
  • Be alert for signs of choking. Learn the Heimlich maneuver in case of a choking incident.

Tips for Late Stage

  • Weight loss, malnutrition (Sharp & Shega, 2009) and loss of appetite are considered hallmark signs that the person is entering the last stages of the disease. In the Late Stage, the person may eat less and have difficulty swallowing.
  • Consult with a Speech Therapist/Pathologist if there are chewing or swallowing challenges.
  • Consult with an Occupational Therapist to help promote independence. Specific assistive devices may be recommended.
  • Gently place the person’s hand on or near an eating utensil.
  • Show the person how to eat by demonstrating.
  • Try hand-over-hand assistance.
  • Give the person plenty of time to eat. Keep in mind that it can take a person an hour or more to finish.
  • Be conscious of physical illnesses or disabilities that may affect their eating.
  • Help the person maintain good oral hygiene.

 

References

Ensell, C., & Matheson, N. (2009). Mealtime behaviours in people with dementia in the absence of dysphagia. Acquiring Knowledge In Speech, Language & Hearing11(2), 92-96.

Hansen, T. (2011). Measuring elderly dysphagic patients’ performance in eating – a review. Disability & Rehabilitation33(21), 1931-1940.

Logemann, J. A., Gensler, G., Robbins, J., Lindblad, A. S., Brandt, D., Hind, J. A., & … Gardner, P. (2008). A Randomized Study of Three Interventions for Aspiration of Thin Liquids in Patients With Dementia or Parkinson’s Disease. Journal Of Speech, Language & Hearing Research51(1), 173-183.

Sharp, H. M., & Shega, J. W. (2009). Feeding Tube Placement in Patients with Advanced Dementia: The Beliefs and Practice Patterns of Speech-Language Pathologists. American Journal Of Speech-Language Pathology18(3), 222-230.

As the Alzheimer’s Association, we advocate and give voice for those who can no longer speak for themselves. Your voice is the most powerful tool to fight this disease on Capital Hill.

In 2014, the National Institutes of Health (NIH) will spend about $5.4 billion on cancer research, nearly $3 billion on HIV/AIDS research; about $2 billion on cardiovascular disease research; and about $1 billion on diabetes research. Meanwhile, the NIH will spend just $566 million on Alzheimer’s research. We have made great strides in developing effective treatments for other chronic illnesses. Experts say Alzheimer’s disease will require a similar level of investment in order to help us find compelling interventions, and ultimately, a cure for this devastating disease.

 

 

NIH Research Funding 2014

What can you do?

  • Educate yourself about the issues at http://www.alz.org.
  • Find and contact your local chapter at http://www.alz.org. The Greater Michigan Chapter’s website is http://www.alz.org/gmc. The Greater Michigan Chapter serves more than 60 counties in Michigan, including Wayne, Oakland, Macomb, St. Clair, Sanilac, and Huron.
  • Meet with your members of Congress locally to discuss legislative issues.

 

 

Be the catalyst that helps to propel us into a future without Alzheimer’s disease! Sign-up to become an advocate today!!

 

 

 

The Alzheimer’s Association 2014 Alzheimer’s Disease Facts and Figures report reveals that there are more than five million Americans living with Alzheimer’s disease, including 170,000 here in Michigan.

 

Additionally, there are 15.5 million Americans caring for someone with Alzheimer’s or another dementia. 505,000 of them are Michigan residents.

 

The Alzheimer’s Association Facts and Figures reveals that a woman’s estimated lifetime risk of developing Alzheimer’s at age 65 is 1 in 6, compared with nearly 1 in 11 for a man.

In addition to the human toll, Alzheimer’s Association Facts and Figures confirms that Alzheimer’s is the most expensive condition in the nation. Nearly one in every five dollars spent by Medicare is on people with Alzheimer’s or another dementia.

 

We have seen diseases like breast cancer, heart disease and HIV/AIDS make tremendous progress in prevention, early detection and treatment after the federal government made a significant investment. Comparable investments in Alzheimer’s are now needed to realize the same successes and save millions of lives.

 

If we could eliminate Alzheimer’s tomorrow, we could save half a million lives every year.

 

 

 

Want to learn more about this report? Check out the links below.

2014 Facts and Figures Full Report

2014 Facts and Figures Fact Sheet

2014 Facts and Figures Michigan Fact Sheet

2014 Facts and Figures Infographic

2014 Facts and Figures Chalk Infographic

http://www.alz.org

Want to become an advocate for Alzheimer’s public policy? Click here.