Low levels of good cholesterol linked to memory loss, dementia risk

Journal study highlights:
• Low levels of good cholesterol are associated with diminished memory by age 60.
• Researchers encourage physicians to monitor levels of good cholesterol.

DALLAS, July 1 — Low levels of high-density lipoproteins (HDL) — the “good” cholesterol — in middle age may increase the risk of memory loss and lead to dementia later in life, researchers reported in Arteriosclerosis, Thrombosis and Vascular Biology: Journal of the American Heart Association.

Observing 3,673 participants (26.8 percent women) from the Whitehall II study, researchers found that falling levels of HDL cholesterol were predictors of declining memory by age 60. Whitehall II, which began in 1985, is long-term health examination of more than 10,000 British civil servants working in London.

“Memory problems are key in the diagnosis of dementia,” said Archana Singh-Manoux, Ph.D., lead author of the study and Senior Research Fellow with the French National Institute for Health and Medical Research (INSERM, France) and the University College London in England. “We found that a low level of HDL may be a risk factor for memory loss in late midlife. This suggests that low HDL cholesterol might also be a risk factor for dementia
click here for the whole press release

Communicating With an Alzheimer's Patient

As Alzheimer's progresses, it diminishes a person's ability to
communicate with others and makes it difficult for caregivers to
fully understand a loved ones needs. Alzheimer's patients not only
have a difficult time speaking and expressing their thoughts,
feelings and emotions, but also have trouble understanding others
and tend to confuse words and general conversation. Learning to
communicate with a loved one who has Alzheimer's is essential
because it helps to understand their daily needs.

There are several changes that take place in the communication of a
person with Alzheimer's and you may notice that your loved one has
difficulty finding the right words, uses words they're familiar
with over and over and invents words that don't exist to describe
familiar objects. They may easily lose their train of thought,
have difficulty organizing words in a sentence and begin speaking
in their native language.

When they sense they're not properly communicating, people with
Alzheimer's tend to become agitated and use curse words and stop
speaking all together. Instead of relying on their words, they
might begin using gestures and pointing to convey their message.
Though the process can be frustrating, for both the Alzheimer's
patient and caregiver, it's important to familiarize with your
loved ones gestures and invented words so they're able to
communicate more efficiently.

Make sure your loved one always knows that you're listening and
trying to understand what they're saying. Be patient and make eye
contact, allowing them to finish what they're trying to say without
prodding, corrections or criticism. If your loved one is having
difficulty finding the right word, help them by guessing which word
they're referring to and if you cannot guess, ask them to make a
gesture or point to something that relates to what they're trying
to say.

Patience is the key to communicating with a loved one suffering
from Alzheimer's and if you focus on their feelings, rather than
the facts, you may have a deeper understanding of what they're
really trying to say. Talking slowly, using short sentences and
repeating information can help them to process information easier
with less confusion and frustration.

Brian Willie is an Elder Law Attorney in California and Texas, and is a frequent author and speaker on the topic. He is the founder of the Alzheimer's Legal Resource Center. For more information visit: http://www.alrconline.com

Alzheimer's disease as a case of brake failure?

NEW BRUNSWICK, N.J. – Rutgers researcher Karl Herrup and colleagues at Case Western Reserve University have discovered that a protein that suppresses cell division in brain cells effectively "puts the brakes" on the dementia that comes with Alzheimer's disease (AD). When the brakes fail, dementia results.
This discovery could open the door to new ways of treating Alzheimer's disease, which affects up to half the population over the age of 85.

click here to read the whole story

Dementia and eating difficulties

As Alzheimer's progresses, simple, day-to-day functions become
increasingly difficult and mealtimes could present significant
challenges for your loved one. They may experience a loss of
appetite or interest in food or could forget that they have already
eaten. If you notice that your loved one is having difficulty
maintaining a healthy, regular diet, there are several things you
can do to encourage independence and make mealtimes easier

then Click here for some tips if the Alzheimer's or dementia person is in the early to midstage of these diseases

Begin by setting up a regular mealtime and sticking to it so that
your loved one always knows when he or she will be eating. They
will be less likely to overeat or forget that they're supposed to
be eating if they're used to a schedule. You man need to begin
preparing each meal for your loved one as it may be unsafe for them
to use a stove or dangerous kitchen utensils. Limit distractions
during mealtimes and keep the table settings simple so that your
loved one can focus on their food and eating rather than the
television, a table setting or the telephone.

click here for more
solutions to common Alzheimer's and dementia eating problems

Keep in mind that your loved ones food preferences may change and
be prepared to adapt to their new tastes. Avoid choking hazards,
such as raw vegetables, popcorn, and nuts, and educate yourself on
how to perform the Heimlich maneuver and CPR in case there is an
accident. Alzheimer's patients can become overwhelmed and confused
easily, so serve one food at a time, rather than an entire
plateful, so they can concentrate on eating. Encourage your loved
one to take his or her time chewing and swallow carefully and check
the temperature of their food to be sure it's neither too hot or
too cold, as they may no longer be able to distinguish the
difference.

Though there may come a point when your loved one is unable to feed
themselves, it's important to encourage independence and allow them
to eat as much on their own. Offer finger foods, such as chicken
fingers, cheese cubes, cherry tomatoes and cheese slices, if
they're having difficulty using utensils and don't worry about
neatness. If your loved one has a habit of pushing his or her
plate or glass around the table, invest in spill proof cups and
plates with suction cups so they are easier to manage. Demonstrate
how they should be using their utensils and remind them how to chew
so that they are less likely to choke. Most importantly, make a
point to eat every meal together so that you not only get to spend
quality time with one another, but so you can keep a watchful eye
and make sure they're actually eating their food and doing so in a
safe way.
See what Pallimed had to say

For more information contact us

Link to more items of interest in Alzheimer's and dementia eating difficulties

Interested in an eating disorder study? click here
Until next time
Brian Willie

Alzheimer's disease,other dementias, and personal care contracts

Millions of Americans are currently caring for a loved one or friend with Alzheimer's disease or a related dementia without receiving compensation. Depending on the circumstances, however, it may actually be beneficial for both parties to enter into a care contract wherein the caregiver accepts payment for the care they are providing their loved one. They also formally assume responsibility for that care of an elderly family member or friend with Alzheimer's disease or a related dementia.

If the loved one you are caring for reaches a point where nursing home placement is the only option, all of their money will be considered available to pay for their care at the nursing home and they will not be eligible for Medicaid assistance until all of their assets have been depleted. Certainly the care they were provided by you, while they remained in the community, is just as valuable to them and worthy of payment as that they will be provided in the nursing home. With a care contract in place, they can pay their caregiver, and every penny spent will count towards their "Medicaid spend down" should they apply for benefits.

It is important to note that without a proper contract in place, Medicaid will assume the money paid is a "gift" or a "transfer of assets" and will impose penalties resulting in ineligibility for Medicaid benefits.
While most of you may already be aware that Medicaid allows care contract payments for caring for loved ones living at home, you may not be aware that payments made via personal care contracts for providing care services for nursing home residents are also an allowable spend down.

Support group with some answers click here

Let's give an example: Imagine that daughter agrees to perform a number of services for her mother, including but not limited to preparing meals, cleaning, laundry, assistance with grooming, bathing, personal shopping; monitoring her mother's physical and mental conditional and nutritional needs in cooperation with health care providers; arranging for transporting; visiting weekly and encouraging social interaction; interacting with and/or assisting in interacting with health care professionals, etc. for her mother's lifetime, in exchange for a lump sum of $30,000 via a care contract.

Now, whether this will be allowed will be dependent upon the state determining that the Contract in place had fair and valuable consideration. While a personal care contract may not be appropriate in everyone's situation, if you are caring for your loved one at home or in a nursing home, it is something that you may want to discuss with a knowledgeable Elder Law Attorney who can advise on possible tax consequences and/or Medicaid and estate planning issues.

visit the Alzheimer's Legal Resource Center by clicking here

click here for more information about this policy

forms for legal contracts click here

click here for a practical guide for caregivers

Knowing when dementia and driving do not mix

The Hartford Financial Services Group, Inc. and the MIT AgeLab have developed this guide to help people with dementia and their families prolong independence while encouraging safe driving. This guide provides suggestions for monitoring, limiting, and stopping driving. The information incorporates the experiences of family caregivers and people with dementia, as well as suggestions from experts in medicine, gerontology and transportation.

Click here to a link to it

Driving requires good judgment, quick reaction times and
split-second decision making, all qualities that are affected by
Alzheimer's. Families often struggle with the decision to limit or
stop the driving of a loved one suffering from the illness, but the
reality is that, for a person with Alzheimer's, driving becomes
difficult and unsafe.

click here to read more

Allowing a loved one to drive in this confused state
could leave them lost and in a bad situation they may not be able
to get themselves out of.

Click here to see what might happen to your loved one
If your loved one is not obeying traffic signals, driving an
inappropriate speeds, hitting curbs, confusing the brake and gas
pedals or swerving back and forth between lanes, they are a danger
not only to themselves, but to others on the road and should not
continue to drive. It's likely that your loved one will become
angry and upset when you approach them about not continuing to
drive. They'll feel as though their independence and dignity is
being taken away and will be reluctant to rely on others for
transportation. It's essential that you remain sensitive but firm,
hearing your loved one out but insisting that they no longer
operate an automobile.

In some cases, you'll discover that your loved one is continuing to
drive even though they promised they would not. To prevent them
from injury themselves or others, there are several ways in which
you can limit their driving. First of all, speak to your loved
ones doctor and ask them to write a "do not drive" prescription and
send it to the Department of Motor Vehicles and show it to your
loved one.

Control access to their car by holding on to their keys, parking it
on another block or in the driveway of someone you know. If your
loved one continues to drive, despite the fact that they no longer
have a legal license, you may need to disable the vehicle by
removing the battery or distributor cap.

Taking away the driving privileges of an Alzheimer's patient is an
exhausting process that could leave your loved one feeling like
they've lost their freedom and family members feeling guilty for
taking that freedom away. It's important to be sensitive to your
loved ones needs and arrange for other modes of transportation so
they can continue to go about their daily routines.

Above all, Alzheimer's patients tend to mourn for their
independence and feel useless relying on others to do the things
that they used to do for themselves. Maintaining a relatively
normal schedule can offer stability and a strong sense of
self-satisfaction, for both you and your loved one.

Until next tme

Brian Willie

Elderlaw attorney

Medicaid myths and dementia

Medicaid was considered a complicated program when President
Lyndon B. Johnson first signed it into law at the Truman Library in
Independence, Missouri, and it has grown even more complex during
each of the thirty years since.

Although it is a national program, it is administered by each
state. The rules and regulations are constantly changing and can
vary widely from state to state. So, it's no wonder there are many
myths and inaccuracies surrounding the program.

"My mother heard about someone who..."

All too often, we meet people who have heard horror stories
about Medicaid from well-meaning friends or family members. These
stories are often filled with inaccuracies and half-truths that
frighten people into spending every last dime on nursing home care
for themselves or a loved one before turning to Medicaid for help.

That's why it is important to contact an attorney who
concentrates his or her practice in elder law. With a clear picture
of your specific situation, an elder law attorney can explain those
laws that should allow an individual or married couple to preserve
their house and enough of their assets to live comfortably for the
rest of their lives

Those who work in the Medicaid office cannot offer you legal
advice. You may not learn about laws that may allow you to receive
Medicaid and still keep part or all of your spouse's income as well
as your own. Nor can they represent you or give you advice on the
laws that, depending on your specific situation, may allow you to
keep all of your assets without spending down a single penny.
Medicaid has rules and regulations in place to ensure families
don't lose everything to nursing home costs. An elder law attorney
can explain how those laws may benefit you and your family.

...More on this later. Until then...

Warmly,


Brian Willie
Elder Law Attorney

Assisting A Dementia Person With Dressing & Grooming

The appearance of a person with Alzheimer's or a related dementia can help to promote his or her self-worth, so it's essential that a caregiver help them to
get dressed and assist with daily grooming routines. Depending on
the progress of the Alzheimer's, your loved one may need only a
little bit of help with tougher activities, such as clipping their
finger nails, or they might need full supervision and assistance on
a day-to-day basis.

People with Alzheimer's may forget how to get dressed or feel
overwhelmed by the clothing choices they need to make each day.
You can simplify the process by going through their wardrobes and
eliminating any items they will likely never wear again. Help them
to choose an outfit by laying out two choices on their bed where
they can see their options. If you find that your loved one likes
to wear the same outfit each day, buy two or three duplicates of
each article so that they wear clean clothes instead of ones
they've worn earlier in the week.

When it comes time to actually get dressed, people with Alzheimer's
can become confused and lose track of what they're doing. To
encourage them, give them one piece at a time with specific
instructions rather than asking them to just get dressed. For
example, hand them their pants and ask them to put them on,
repeating the same procedure with the rest of their outfit. Make
sure they have comfortable, non-slip shoes and replace buttons,
zippers and snaps with Velcro, which can be a lot easier for your
loved one to handle.

When left to their own devices, Alzheimer's patients may not
continue with certain grooming rituals, such as brushing their
teeth, shaving and combing their hair. They may not only forget
how to do these things, but it's possible that they don't realize
they need to be done in the first place. To encourage daily
grooming, buy your loved ones favorite products so the activities
are more enjoyable for them. Spend time with your loved one and
get ready together so you can show them first hand how to do things
and they can watch and mimic your activity.

To prevent injuries, replace dangerous grooming tools, such as nail
clippers or razors, with safer options, such as emery boards or
electric shavers. Since going to a hair dresser can be an
overwhelming, frightening experience for your loved one, ask your
barber or hairstylist to come to your home, where your loved one
will be more comfortable. The important thing is to encourage as
much independence as possible without sacrificing your loved ones
hygiene or safety.
click here for helpful legal assistance

Dementia and the importance of the Power of Attorney

Especially important if you care for someone with dementia is a Power of Attorney
It is one of the most important legal documents a
person can have. Without a comprehensive power of attorney, many
people are neither able to handle their loved ones' financial
matters nor make health care decisions without seeking court
intervention (Guardianship and/or Conservatorship).

We often have clients come into our office assuming that, just
because their assets are titled jointly with their spouse, parent
or partner, they are able to liquidate accounts to pay bills,
hire attorneys, sell their jointly titled real estate, etc.

Unfortunately, that isn't that case. In fact we frequently see
clients how have failed to put in place properly drafted Power of
Attorney documents allowing them to act. And now, their loved one
has developed dementia or is incapacitated in some other manner, an
can no longer legally create a Power of Attorney document (a person
must have capacity to sign legal documents). We have to tell those
people that in many cases, in order to handle the financial affairs
and medical decision making of their loved one,
A Guardianship (also called a Conservatorship in some states) is
likely required.

What is a Power of Attorney?

A power of attorney is a legal document where one person (the
principal) authorizes another (the agent) to act on their behalf.
There are financial powers of attorney which allow your agent to
make decisions regarding your property and healthcare powers of
attorney which allow your agent to make decisions regarding your
health care needs. NOTE: They go by different names in different
states such as Medical Power of Attorney, Health Care Power of
Attorney, Advance Directive etc.

Your power of attorney can be broad in scope, giving your agent the
ability to make any and all financial and personal decisions for
you (a General Power of Attorney) or you can limit your agents
authority by specifying the types of decisions you would like them
to make on your behalf (a Limited Power of Attorney).

You also have a choice whether you would like your agent to have
the ability to make decisions both now and if you become
incompetent (a Durable Power of Attorney) or your agent can be
limited to make decisions only when you become incompetent (a
Springing Power of Attorney).

What is a Guardianship?

Guardianship is a legal relationship whereby the Probate Court
gives a person (the guardian) the power to make personal decisions
for another (the ward). A family member or friend initiates the
proceedings by filing a petition in the appropriate court
where the individual resides.


A medical examination by a licensed physician is necessary to
establish the condition of the individual. A Court of law then
determines the individual is unable
to meet the essential requirements for his or her health and safety
and appoints a guardian to make personal decisions for the
individual. Unless limited by the court, the guardian has the same
rights, powers and duties over his ward as parents have over their
minor children. The guardian is required to report to the court on
an annual basis.

*A Conservatorship (sometimes also called a Guardianship in some
States. And to confuse matters, sometimes called both Guardianship
and Conservatorship) is a legal relationship whereby the Probate
Court gives a person
(the conservator) the power to make financial decisions for another
(the Conservatee).

The Court proceedings are very similar to those of a Guardianship
except the Court
determines an individual lacks the capacity to manage his or her
financial affairs and appoints a conservator to make financial
decisions for the individual. Often the court appoints the same
person to act as both guardian and conservator for the individual.
Like the guardian, the conservator is required to report to the
court on an annual basis.



The Differences

A power of attorney is a relatively low cost and private way to
decide which family member or trusted friend will have the legal
authority to carry out your wishes if you can no longer speak or
act for yourself.

If you do not have a power or attorney or if your power of attorney
is not drafted properly, and something happens that results in your
inability to make decisions, your
family/friends may later face court proceedings and court
supervised Guardianship and/or Conservatorship.

A court proceeding is not only costly, but the person appointed as
your
Guardian/Conservator may not be the person whom you would have
chosen yourself. Additionally, there can be constant court
supervision for that person's lifetime, with on-going reporting
required and permission to take almost any action on behalf of the
incapacitated person.

And, as stated above, not having a properly drafted power of
attorney could significantly limit financial and/or medical
decision making that could be done on behalf of the
principal.

I often tell my clients that if you do nothing else, at the
earliest signs of dementia (if you haven't already done so) get
properly drafted power of attorney documents put in place
immediately. They are really that important.

Until next time....

Warmly,

Brian Willie
Serving seniors and those who love them.