Vol. 2 Issue 3 - August 2009
Home Care and Alzheimer’s
Consider escalating needs, special expertise and peace of mind
Many excellent facilities specialize in the care of dementia and Alzheimer’s disease; but is it possible to provide wonderful care in a home setting? Many families find that home care is a practical option for memory care, but there are number of things you must consider in your evaluation and planning.
First, consider the progressive needs of your loved one. Their needs may well change over time from simple matters of safety and entertainment to more advanced requirements that can become overwhelming. Plan for escalating needs early. Engage home care services at a moderate level at first, then as the disease progresses you will have appropriate, trusted resources in place as the needs of your loved one accelerate.
Families often underestimate how difficult it can be to provide appropriate memory care, so look at things objectively. Many family caregivers enjoy a great sense of privilege and deep satisfaction in this role, but Alzheimer’s disease affects the caregiver unlike any other chronic disease. Carefully consider how much responsibility you can practically assume and at what point you will need to reach out for more help and support.
Finally, consider your own health. Statistics indicate that stressed-out caregivers experience significantly higher rates of depression and ill-health than their non-caregiving peers. Related stress can take as much as 10 years off a caregiver's life. Ignoring your health is bad for both you and your loved one; and home care may be just the answer.
Aging in Place
Build Synergy between Care Management Professionals
Aging in place is growing older without having to move - a concept at the heart of Geriatric Care Management (GCM). GCM professionals expertly assess an older adult’s needs and environment. They develop a care plan customized to that person, where they live, and their unique functional abilities, and then advocate for that older person as they actively coordinate the many different aspects their healthcare.
Allowing your loved one to age in place requires identifying resources available from medical services, community based services (such as senior centers or senior medical day centers) and home care services. GCM professionals take the lead with an environmental safety assessment that shows how to make the home safe. Home care agencies often step in to assist with activities of daily living such as bathing, dressing and cooking.
Changes needed to let your loved one age safely in place are often simple: removing throw rugs, placing frequently used items on lower cabinet shelves, and having a wheelchair ramp installed, for example. Overall, safety awareness is a key to success. GCM experts can also assist older adults and families in searching for available entitlements and other funding (like reverse mortgages) that help make aging in place more happy, healthy and affordable.
Adapted from an article written for Synergy HomeCare by Sophia Heftler, RN, CMC, CALA
Testimonial
Synergy HomeCare appeared as the silver lining in an approaching storm cloud when a crisis pressed us into an immediate need home care for our father. Quickly and with professional competency and caring compassion, Synergy listened to our needs and concerns and addressed them adroitly and appropriately. As we have interacted with the various individuals throughout Synergy HomeCare we have perceived a level of service orientation that has gained our respect, trust and thanks.
Margaret G, Arlington VA
Caregiver Hub
Questions to Ask Before Engaging Home Care
When you choose a home care provider, you are inviting someone into your home. Don’t let “nice” get in the way of asking tough questions. A little precaution and research can go a long way in giving you peace of mind and preventing problems. Asking friends, relatives or a trusted advisor for home care recommendations is a good start. Your medical providers (such as your hospital discharge planner, social worker or your family doctor) may also have suggestions.
Once you have select a few providers to interview, here are some important questions to ask in order to be sure you get the services and expertise you need.
- Are caregivers bonded and insured? (They should be.)
- How long will it take to get a care giver?
- Are the agency’s care givers employees or independent contractors? (You want an agency that knows its employees, not one that just acts as an employment agency.)
- What criminal screening and background checks does the agency run on its caregivers?
- What sort of training do the employees receive? Is training ongoing?
- Will an agency supervisor evaluate the quality of care you receive? How often?
- What provisions are there for backup care? Who do you call if no one shows up?
- What provisions are there for care during a disaster?
- What is the process for resolving problems? Who can you call to discuss any issues and be sure to have them resolved?
- Are you committed to a long contract with the agency?
- How is billing handled? If private insurance will pay for some of the costs, will the agency bill them directly?
- Does my state license home care? If ‘yes’ - is the agency licensed? If ‘no’ - does the agency follow policies and procedures similar to those in a licensed state?
- Is the agency locally owned and operated? Are the owners on-site actively managing the agency?
- If the agency is part of a franchise, what ‘watchdog’ organizations is the franchise a member of?
Sundowners Syndrome
Sunsets are a wonderful time. But for seniors who suffer from Alzheimer’s, sundown can be a time of increased confusion, agitation and even anger. For family members, witnessing an increase in their loved one’s symptoms at sunset can be painful, frightening and exhausting.
“Sundowners Syndrome,” is most often associated with early-stage Alzheimer’s and the cause remains elusive. The symptoms – like rapid mood changes, anger, agitation, fear, depression, and rocking behaviors – tend to worsen as the sun goes down and natural daylight fades. The more severe symptoms like hallucinations, paranoia, violence, and wandering are difficult to manage and put others at risk.
Look for Triggers
Not everyone with Alzheimer’s disease will develop Sundowners Syndrome, but it is important to understand the triggers that cause problems. Some researchers believe the flurry of activity toward the end of the day may lead to increased anxiety and confusion. End-of-day exhaustion or the lack of activity after the dinner hour may also be a contributor. As the sun goes down, the quality of available light may diminish making already challenged vision even more challenging.
Managing the Behaviors
The treatment of Sundowners Syndrome is not well established, but there are a number of approaches that can help. Establishing a routine helps sundowners feel safe. Controlling noise in the early evening is also helpful. Light boxes that contain full-spectrum lights have been found to minimize the effects as well.
It is important to remember that Sundowners Syndrome is not something your loved one can control. Remaining calm will help you both get through these stressful moments.
Resources
– Reverse Mortgage Guides is non-profit organization whose mission is to educate homeowners about the pros and cons of FHA reverse mortgages.
www.ftc.gov – The Federal Trade Commission provides a national resource to learn about the crime of identity theft. It provides detailed information to help you deter, detect, and defend against identity theft.
www.wishofalifetime.org – The Wish of a Lifetime foundation is dedicated to enriching the lives of low-income seniors whose lifelong savings has gone to paying medical bills and other expenses.
www.seniorpeoplemeet.com – This website helps thousands of seniors find relationships each year. Log on to browse pictures, communicate anonymously, and reach out to seniors with similar interests.
www.dakim.com - Dakim BrainFitness is the nation's number one brain fitness system seniors. It’s an easy to use cognitive fitness system that is built entirely around a touch screen.
www.wiredseniors.com – Wired Seniors gives seniors a "web of your own" and serves as the main hub of many senior related web sites.
Inset
Join the Synergy HomeCare recipe club and share your favorite recipes for easy and delicious meals. E-mail your recipes to recipe@synergyhomecare.com for inclusion in an upcoming Synergy Star and to be featured in the special edition “Synergy HomeCare HomeCooking” cookbook. Don’t miss the mouth-watering fun!
