Deep brain stimulation: Expanding its reach to new patients

LA Times
Electrical therapy, used for years to treat Parkinson's and other movement disorders, may soon tackle depression and more.
By Andreas von Bubnoff

June 1, 2009
Under the skin, a battery is surgically implanted -- generally within the upper chest. From the battery, wires snake up to the head, to tickle different targets deep inside the brain.

Such is the hardware for deep brain stimulation -- the equivalent of a cardiac pacemaker for the mind.

Until recently, deep brain stimulation was approved in the U.S. only to treat certain movement disorders, primarily those of Parkinson's disease, for which it diminishes tremors and rigidity and improves mobility. To date, more than 60,000 patients worldwide have had the devices implanted.

But now use of the technique seems set to mushroom.

This year, the Food and Drug Administration granted a so-called humanitarian device exemption for the treatment to be used in severe cases of obsessive-compulsive disorder -- the first approval of deep brain stimulation therapy for any psychiatric condition.


Large clinical trials are also in the works for use of deep brain stimulation for epilepsy and depression, and experimental studies in the U.S. and elsewhere -- still in their early stages -- are exploring the treatment for obesity, traumatic brain injury, severe chronic pain, Alzheimer's disease, anorexia, tinnitus and addiction.

There are discussions too on the possible use of deep brain stimulation to treat hypertension.

"The field is taking off," says Dr. Ali Rezai, director of functional neurosurgery at the Cleveland Clinic, who has been involved in research on movement disorders, traumatic brain injury, obsessive-compulsive disorder and severe depression, among others.

Some researchers warn, however, that with all this activity -- pushed in part by the industry that makes the brain-stimulation devices -- the field may be moving too fast.

"There is so much progress that's been made and so much potential -- you would hate to lose that potential," says Dr. Joseph Fins, chief of the division of medical ethics and a professor at Weill Cornell Medical College in New York.

Here's a look at deep brain stimulation as it moves beyond Parkinson's disease. (See the related story about reservations scientists have about the growth of the field, and go online at latimes.com/health for a look at less-explored applications such as traumatic brain injury and obesity.)

Obsessive- compulsive disorder

In studies with a total of 26 patients with severe obsessive-compulsive disorder, 60% of those whose device was turned on demonstrated "very much improved" symptoms after months of deep brain stimulation as measured by interviews and questionnaires, says Dr. Benjamin Greenberg, an associate professor at Brown University Medical School and Butler Hospital in Providence, R.I., who was one of the...read the whole story


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Dealing with a loved one’s dementia

Leeza Gibbons on the depression she faced while caring for her mother
TODAY books

In her book “Take Your Oxygen First,” Leeza Gibbons shares the story of her mother, who was diagnosed with Alzheimer’s disease. With the help of medical professionals, Gibbons provides a guide for caregivers to take care of themselves first. An excerpt.

Leeza: Bad news has no regard for timing. Your bubble of domestic bliss is not immune, nor is your job or career. I was happily mothering my children and producing and hosting my own talk show on Paramount’s Stage 26 when Mom's stage went dark. My anxiety spread to every aspect of my life and as much as I tried to present a facade of calm and acceptance, my persona never lasted past my driveway and once home, I became as tightly wound up as an angry fist. I snapped at the kids, withdrew from my husband and stayed up until dawn searching and searching for the latest treatments, the slimmest hope.

As Mom declined, I was trapped on a tilt-a-whirl of emotion. I managed to convince myself that if I just did more, she would be O.K. The talk show ended its run and I immediately went on to the next stop on my career train, hosting the nightly entertainment news magazine Extra. I was all coifed and poised in front of the camera as I delivered the latest celebrity headlines, but the minute the lights went out on the stage, I fell apart. I spent most afternoons leaving through the back door of the lot to wander the neighborhood streets trying to reclaim some control over myself. But bad news can't be controlled and I realized that I was no match for its increasing shadow over my life. My marriage was strained to the breaking point and I was depressed. I needed to let go of the way things were and accept this beast which had pulled up a chair to my dinner table.

I sought the help of a therapist. It turned out to be more than a lifeline, it was the exploration I needed to reclaim my sanity. Robert, my therapist, provided a safe sanctuary in which to share my feelings. Jamie Huysman, the co-author of this book, was my tether to what would become a new life and a new sense of purpose. He was the friend who always had time for me, who never judged and who always reminded me to be kind to myself. When I was unsure, he was certain. When I was a squishy ball of frayed nerves, he was solid, strong and firm in his belief that I could make a difference. Jamie showed me how to fulfill the promise I made to my mother, to tell her story so that others might be........read the whole article

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Making Your Home Safer for a Loved One with Alzheimer's

Expert Tips to Adapt a Home for Alzheimer's Disease
By CARI NIERENBERG
ABC News Medical Unit

After someone is diagnosed with Alzheimer's disease, the first thing the patient and their loved ones want to know is how to treat this progressive, degenerative brain disease.

But the next thing they want to know more about is safety -- a huge issue, since adults with Alzheimer's and dementia have a much higher risk of injuring themselves around the home than their healthier counterparts.

Although safety becomes a primary concern, people often don't know where to begin or the practical things they can do in their homes. Plus, making a caregiver aware of these options can be a challenge.

"We need to find a balance between.................read the whole story

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Still hope for those with Alzheimer's

Huntsville Times

In one of today's most famous love stories, "The Notebook," author Nicholas Sparks portrays a love between Allie and Noah that withstands her parents' disapproval, her engagement to another man and even later her Alzheimer's disease.

When my great-aunt was diagnosed with Alzheimer's two years ago, I watched her inevitable downward spiral into oblivion with helplessness and confusion, much as Noah must have watched his beloved wife gradually relinquish her abilities to perform simple tasks such as cooking, cleaning and dressing.

My great-aunt began brewing coffee at 2 a.m., pacing aimlessly around her house and panicking at the first sign of sundown. Her attention span diminished to that of a young child, and she no longer had the patience to sit and watch her beloved Alabama football games on television. My aunt was eventually moved into a facility with trained nurses.

Her communication skills disappeared much too quickly, and when her lips no longer formed words, she found other methods of expression. My family refused to give up on her. Whenever I visit, we piece together puzzles she loves, and I encourage her to play songs on the piano from memory.

My aunt still remembers her baptism, smiles at the mention of her famous red velvet cake and kisses us when we visit.

One of her deepest desires in life was to have..........read the whole story

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Impact of Alzheimer's disease growing

Fort Myers News-press.com

Impact of Alzheimer's disease growing
Alzheimer's disease has joined cancer as the word that people do not want to utter aloud for fear it might happen to them. Alzheimer's disease is second only to cancer as the illness we worry most about getting Ironically, the projected number of new cases of Alzheimer's disease exceeds that of breast and prostate cancer combined. The Centers for Disease Control's Web site lists Alzheimer's disease as one of the top 10 leading causes of death. The CDC reports that "notably, mortality rates for Alzheimer's disease are on the rise, unlike heart disease and cancer death rates which are continuing to decline."

Alzheimer's disease affects approximately 5 million Americans. The number of estimated cases in Lee County exceeds 22,000. In virtually every neighborhood across our community, someone is touched by Alzheimer's disease.

Despite these grim facts about the disease, there is hope for the future. The attention that Alzheimer's disease is receiving in the media is paramount in helping raise awareness and emphasize the need for continued research and care.

The news also brings hopeful information about current research and progress toward early detection, better treatments and strategies for prevention.

The Alzheimer's Project introduced by HBO this month is a wonderful example of the positive message we can deliver about what's happening with treatment and research for Alzheimer's disease.

HBO's Web site nicely summarizes the goal of the project with these words "While there is no cure for the disease, The Alzheimer's Project shows there is now genuine reason to be optimistic about the future."

Recent news stories and heightened awareness also call attention to the significance of supporting families who are caring for someone with Alzheimer's disease. Treatment, research, and care are each equally important in addressing the impact of Alzheimer's disease on our society and the health care system.

The Alzheimer's Project, which is a ......read the whole article

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Memorial Day-a perfect time to honor folks with dementia

healthnews-stat.com

Dementia,including Alzheimer disease, affects about one in 13 seniors,many of them veterans. As you remember our war heroes on Memorial Day,think about what you can do for them.They did so much for us.
Veterans who suffer from various forms of dementia, including Alzheimer disease, often have very specific care needs. It is important that these veterans are cared for by people who understand their condition and have the appropriate instruction and skills.

Therefore encourage family members of veterans to gain the training they need to care for their loved one with dementia.

For those in nursing homes and other institutions, make sure veterans with dementia are visited often.

All people, including those with memory loss, need human contact. They need to be hugged. They need to hear your voice. They may not know you but as long as you know who they are, that's all that matters.

Talk to them about their service to our country. Often they will share stories with you because their time in the service made a huge impression on them

Tell them how proud you are of them. Thank them for their service. This is sure to make them feel good. Most likely, it will make them smile

Smile with a veteran. Laughter is wonderful medicine...

Sing patriotic songs with a veteran with dementia. Often they will be able o sing many familiar songs even though, they may not be able.......read the whole article

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Alzheimer's, dementia day care works to improve memory, skills

Nashua Telegraph

It's estimated that as many as 5.2 million people in the U.S., mostly 65 or older, have Alzheimer's.

The disease is the most common form of dementia, a term used to describe a group of brain disorders that cause memory loss and make it harder to carry out daily tasks, according to AlzheimersRx Treatment.com.

The Mailbag is hoping to make daily tasks easier for patients, as well as for some dedicated day-care volunteers.

Plugging in to help



"I volunteer at a day-care program....read the whole article

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The blessing path

Sharon K. Brothers
from OPrah.com
Practical coping strategies

As I interviewed people who are known in demographics as "unpaid caregivers," I thought I'd hear a few logistical hints. But that turned out to be like seeking just a few general rules on "how to heal sickness" or "controlling bad emotions."

Every aging-parent scenario is unique, and there are precious few generalities that apply. One thing I can say is that you'll have fun with the responsibilities of eldercare if you enjoy running the high hurdles while juggling angry badgers. If not, you might try these techniques.

Trust your intuition about how much care is needed.

"There are hundreds of lines between being a little daffy and needing constant supervision," says Polly, describing her father's Alzheimer's. "At first my dad wasn't totally out to lunch; he was just...snacking. Then he definitely went out to lunch, then breakfast, then dinner. I've had to trust my instincts to increase care as he crossed each new line." Oprah.com: How to trust your gut

Denial is potent and seductive when it comes to dealing with aging. No one wants to acknowledge that a family member is in permanent decline.

But when your parent gets really sick, or begins, um, lunching out, you'll feel an uneasy warning from your gut. Pay attention. The sooner you acknowledge the truth -- "I must intercede" -- the sooner you can begin exploring care options. And there's a mess of exploring to do.

Prepare for a logistical wilderness.

There's no rule book to guide you through the morass of eldercare tasks and demands. Your best source of information is the Internet, where you can e-mail friends and family and research everything from buying walkers to curing constipation.

If you're a caregiver and you don't like computers, get over it. Buy a laptop -- it will cost far less than the mistakes it will help you avoid -- and make some 8-year-old teach you to cruise the Web. Everyone I interviewed, even the technophobes, told me that the Internet was a lifeline in negotiating eldercare obligations.

Online information can prepare you -- sort of -- for the pragmatic tasks you may encounter: filling out medical paperwork, hiring a care nurse, wrestling the car keys out of a beloved parent's desperate clutches.

Many of these duties will be indescribably difficult. But if instincts and information tell you to take a step, take it firmly, without second-guessing, the way you'd lead a frightened horse out of a burning barn. And don't try to manage everything alone.

Create your own village.

The Navajo and other traditional cultures understand that there's nothing more soulful than supporting people at the margins of life, those who can't walk fast or talk sense or remember how to use a toilet. They also know that this takes a village.

It really does.

Most eldercare providers in our village-less society end up jury-rigging systems of helpers. The common refrain I heard from people in the trenches? Take notes. Write down every bit of advice you get, from every person who interacts with your family member: doctors, pharmacists, neighbors, hairstylists. Write down these people's contact information. For good or evil, they're your village. Oprah.com: Do you have a hard time asking for help?

Jennifer has 45 people on her call list should her elderly parents encounter a crisis. Polly rallied support from her parents' church congregation. Not everyone in the village will help care for an elderly person, but a long list gives you multiple possibilities for support.

"No one can tell you what to expect," Anne said to me. "You have to live like a firefighter, ready to call other firefighters to solve whatever problem arises."

Psychological coping strategies

Once you've adopted this firefighting mentality about your parent's needs, you'll need a whole new set of strategies like the ones below to deal with the emotional wreckage that piles up along the way.

Surrender to the emotional grinder.

"The thing that galls me most about caring for my mother," one woman told me, "is that she's the only one who gets a morphine drip."

The emotional pain suffered by caregivers is intense -- and unlike the elderly, caregivers are expected to live through it. With every new issue your elderly relative develops, you'll head into the emotional grinder called the grief process: bargaining, anger, sadness, acceptance, repeat.

Grieving, like physical caretaking, differs from case to case. If you had a troubled relationship with an aging parent, expect to spend lots of time in the anger stage. Use this time to clean your emotional closet. Explore the anger with a therapist. Journal it. Process it with friends. Clean the wounds. Oprah.com: 4 healthy ways to grieve

On the other hand, if your declining parent was your main source of emotional support, you'll find yourself spending lots of time in sadness. You'll feel as though it's killing you. It won't.

As Naomi Shihab Nye wrote, "Before you know kindness / as the deepest thing inside, / you must know sorrow / as the other deepest thing.... / Then it is only kindness / that makes sense anymore...."

As the grieving process scrapes along, you'll learn to offer kindness to everyone: your aging relative, the people of your village, yourself. When you snap under stress and begin to rail at Nana, God, yourself, and the cat, you'll learn to be kind to yourself anyway. At that point, you'll find relief and an unexpected gift: laughter.

Nourish a sick sense of humor.

A morbid sense of humor isn't listed in any official guides to eldercare, but to the caregivers.......read the whole article

DID YOU KNOW?
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Groundbreaking Drug Helping Alzheimer's Patients

Channel 6 WLNS News

Right now there is no cure for Alzheimers Disease, but those struggling with it here in mid-Michigan have the chance to be part of a groundbreaking clinical drug trial aimed at slowing the progression of the disease. One local woman says she's already seeing positive results.

Barbara Loudon, Alzheimer's patient: "I have been dealing with this since 1998. Short term memory loss is the big problem."

Barbara Louden is battling Alzheimer's disease and she's hoping that by taking part in a clinical study at Michigan State University, it will lead to developing a drug that will slow the progression of the disease. Barbara was one of the first patients to join the 18-month study . Every 3 months she gets an infusion, followed up with an MRI.

Dr. Andrea Bozoki, Asst. Prof., MSU neurology: "We know that people with Alzheimers have brain shrinkage over time due to the death of neurons. The MRI's help us to evaluate volume changes and compare it with the active drug as with a placebo."

After several months in the program, Barbara says she's noticed some improvement in her ability to read and do crossword puzzles.

Barbara Loudon: "Before I got into the study, I had to give up reading, I couldn't carry the characters from chapter to chapter."

And it's reactions like Barbara's that researchers are hoping others will see and then decide....read the whole article

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Making Your Home Safer for a Loved One with Alzheimer's

Expert Tips to Adapt a Home for Alzheimer's Disease
By CARI NIERENBERG
ABC News Medical Unit

But the next thing they want to know more about is safety -- a huge issue, since adults with Alzheimer's and dementia have a much higher risk of injuring themselves around the home than their healthier counterparts.

Although safety becomes a primary concern, people often don't know where to begin or the practical things they can do in their homes. Plus, making a caregiver aware of these options can be a challenge.

"We need to find a balance between not scaring a caregiver about what could happen when a loved one has Alzheimer's disease and supportively making them aware of what to be thinking about and watching for," said Scott Trudeau, project director for a home safety study of people with dementia funded by the Department of Veterans Affairs.

Fortunately caregivers usually don't need to make elaborate and costly modifications to their homes, as there are simple things they can do to help their loved one remain safe -- and live more happily as well.


After someone is diagnosed with Alzheimer's disease, the first thing the patient and their loved ones want to know is how to treat this progressive, degenerative brain disease. Click here to read more

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The Tricky Question of Competence

New York Times
By Paula Span
Socialite Brooke Astor was losing ground cognitively, a procession of friends testified last week in a Manhattan courtroom. She no longer recognized people she’d been close to for decades. She wandered. Hosting a dinner party for the former secretary general of the United Nations, she had to ask another guest — Henry Kissinger, as it happened — who “that man” Kofi Annan was. She was unable to draw a clock face accurately, according to the geriatrician who diagnosed her Alzheimer’s disease.

But was the elegant philanthropist competent to make significant changes to her will at age 101? Her son Anthony D. Marshall, 84, and estate lawyer Francis X. Morrissey Jr., 66, stand accused of diverting tens of millions of dollars from her estate, and that legal question lies at the heart of their fraud and conspiracy trial. Questions of competence, however, are not always simple to answer, even after a dementia diagnosis, experts say.

“If the prosecutor can show that when she signed these codicils, she didn’t have capacity, then it’s over,” said Craig Reaves, president of the National Academy of Elder Law Attorneys. But, he added, “Capacity is........read the whole story

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"I Promised My Parents I'd Never Put Them In a Nursing Home"

Never make this promise
Aging Care
by Carol Bradley Bursack

Our parents cared for us and now, as they age, it’s natural that we want to care for them. At first, we figure we’ll stop over at their home and do what they need us to do. That can work for while, when all that’s needed is some help with errands, the lawn or fixing a meal now and then. It’s kind of a pleasant way to help out and show our love for our parents.

However as care needs increase, we are faced with more decisions. Many of us promised in good faith, back when our parents were healthy, that we wouldn’t ever put them in a nursing home. That would be abandoning them. We aim to care for them ourselves until they die.

Admirable thinking. However, as years go by and care needs mount, we find ourselves faced with the fact that we can’t raise our families, work our jobs and run to Mom and Dad’s condo three times a day.

So, with some guilt, we start looking at other options. For some people, this means having your parents move in with you. If there is enough room so everyone has privacy and the personalities blend, this can work. However, before making such a move, make sure your head is as engaged as your heart. While you are considering this option, you also may want to read “Living With Elderly Parents: Do You Regret the Decision?”

Another option you might start with, though there is some guilt attached, is getting some in-home agency help. Why the guilt? Because you are now sharing the caregiving with someone else. Someone who is not a family member. You are hiring help for your parents. That isn’t what you had in mind for them, but they are not safe alone all day, and you can’t be there all the time. You have to do something.

The same guilty feelings are often attached to adult day care. Adult day care can be a wonderful choice for many seniors, as they get care and supervision, plus peer interaction and activities more stimulating than watching TV all day. But, this too means you are turning over some of the care to strangers. You were going to handle it all yourself. You told them you would. And now? You can’t. You need help.

Then the day comes where in-home care can’t handle all of their needs. Adult day care can’t take care of them. Only one choice remains, and that is a nursing home.

Cheryl E. Woodson, MD (and caregiving daughter) wrote a wonderful book titled “To Survive Caregiving.” One of the most important things Woodson says is that, while you may have to “break your promise” – you know, the one you should never have made – and put your parent in a nursing home, you have still honored the spirit of the promise.

I loved the way she put that. None of us knows the future. Our healthy parents have visions of nursing homes decades ago, and the very idea of living in one is unthinkable to them. You tend to agree. Yet, now the day has come where Mom is incontinent, confused and paranoid. She has wondered away from home twice, and once you had to call the police. Dad had a stroke and needs a lift to get him out of bed and two strong people to get him into his wheelchair. You’ve run up against a brick wall. There is no choice but a nursing home.

When the guilt starts to overwhelm you, stop it. Adjust your attitude. You have done all you can. You have honored the spirit of your promise. People live longer now, in far worse condition, than they did in the past. You know that both of your parents would be dead, had this been the 1970s. Because of medical advances, their hearts are still ticking. However, they are in such frail health that there is no way you can care for them alone. No one could have foreseen this way back when they were younger and healthy.

There are still some bad nursing homes. So, be proactive and tour the ones in your parent’s area long before the need arises. Be realistic but be aware. Find the best one you can. Hang around and you’re likely to find family members visiting their loved ones. Ask them what they think of the home.

Then, if it’s good, get your parents names on the list. The good homes are often full and hard to get into. You can always say no if they call with a room and you aren’t ready. But when you hit that brick wall of reality and know you must, for your elders’ safety and your health and sanity, put them in a nursing home, you have done your best. You cared for them in every way possible before turning to this last option. You have found the best home available. Now, you are ready to really share the care.

Even when your elders are in a nursing home, you are still a caregiver. I had a time when I had three people in a home (plus two others in separate apartments) and I was at everyone’s place every day. It wasn’t a cakewalk, by any means. I was still a caregiver.

If you put your parents in a nursing home, they still need you, the primary caregiver. They need you as an advocate. They need you to put the personal touches on their rooms and to be visible to the home staff and the other residents. They need you to help them settle in and make friends. The best part of this, if you will let the guilt go and think for a moment, is that you now can enjoy them again. You aren’t tied to doing everything for them, so when you visit, you can do extra little things. You aren’t too worn out to be pleasant. You can surprise them by bringing the children. You can bring their favorite chocolates or wine. You can make this their new home, and be the person who visits, without all of the exhaustion that used to make you crabby. And you can do it without guilt.

Caregivers can be dedicated, but that dedication can turn into martyrdom, and frankly, martyrs aren’t good caregivers. Using the help of a good facility, while keeping an eye on things and continuing to care for your elders in this new role, allows you to take off your martyr hat. You can do it without guilt because you have done your best. You are still doing your best. You are providing them with the best care humanly possible. Accept your humanity without guilt. Honor the spirit of your promises by being the best caregiver you can be. Be a caregiver who knows when to say when.

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Switching Patients With Moderate Alzheimer's Disease From Donepezil to Rivastigmine Effective, Well Tolerated: Presented at AGS

DG Guide
By Beatriz Manzor Mitrzyk

CHICAGO -- Patients with moderate Alzheimer's disease (AD) not responding to donepezil tolerated the switch to rivastigmine transdermal patch or oral rivastigmine well, according to results from 3 open-label, multicentre trials presented here on April 30 at the 2009 Annual Scientific Meeting of the American Geriatrics Society (AGS).

In addition, the rivastigmine transdermal patch was associated with fewer gastrointestinal (GI) adverse effects (AEs) than oral rivastigmine, making the patch better tolerated in patients.

Jason Olin, PhD, Psychiatry and the Behavioral Sciences, University of Southern California School of Medicine, Los Angeles, California, and colleagues conducted a 26-week prospective clinical trial (Study US13) of rivastigmine capsules 1.5 mg twice daily titrated up to a maximum of 6 mg twice daily in patients responding poorly to donepezil; patients were switched within 24 to 36 hours after the last dose of donepezil.

Study US18 used the same study protocol; however, patients may have also been switched after up to a 7-day washout period.

A total of 331 patients were evaluated in these 2 trials and 224 (67.7%) patients completed either study.

The most common reasons for discontinuation were AEs (59.8%), unsatisfactory treatment response (15.9%), and withdrawal of consent (15%). At least 1 AE was reported in 83.4% of patients taking rivastigmine capsules. Serious AEs were reported in 16.6% of these patients, including...read the whole article

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Family frustrations: caregiver challenges within the family

Sharon K. Brothers, MSW
My sister and I have never been really close. She's three years younger than me, but very different in her preferences and lifestyle. She makes a living training horses, for example; I'm essentially afraid of all big animals.

It shouldn't have surprised me, then, when my mom needed lots of assistance after an accident that my sister and I approached it from very different perspectives. My mom lives close to my home (my sister lives two states away), so naturally many of the day-to-day tasks fell to me and my family. Somehow that didn't stop my sister from weighing in on a regular basis. The conversations often went like this:

Mom: "Sharon came by and took me to the doctor this morning."

Sis: "I hope she didn't just drop you off in the waiting room!"

Mom: "Well, I'm perfectly able to talk to the doctor without her in the room."

Sis: "Still, she should have stayed with you through the whole visit. I don't know what she was thinking!"

Of course, what I was thinking was that I have three kids at home, a business to run, a house, a husband and a dog. If my mom can manage any aspect of her care needs without my hands'-on help, I'm going to step aside and let her!

Most families, I've discovered, have similar sibling dynamics. One sibling (or sib-in-law) becomes the primary caregiver, responsible for the regular tasks like transportation, shopping, laundry and more. Other sibs, often living across the country (or maybe just a few miles away) are content to let the one sib do most of the work.

You'd think that the other family members would recognize the hard work of the caregiving sibling and be profoundly thankful - and you'd be wrong. Most often, siblings who don't have the direct experience don't really know what is involved, or how hard the caregiving sibling works.

It's easy to second-guess someone whose shoes you haven't walked in. It's not easy being on the receiving end, though.

What can you do?

1. Take it easy. Recognize that only you know how much effort is involved for you to keep all your balls in the air. There's no way anyone else can know exactly what your life is like, so don't expect them to know. Try to breath, smile and say, "I'd like to see her give this a try!"

2. Pass the torch. This is especially important for those distance siblings who say, "What are you thinking - moving mom into an assisted living center?! She can't be that much care!" Invite your mom to their house, and let them have a chance to see first hand exactly what mom does need.

3. Gather support. If you've got other siblings who can rally to your support, pull them in. In my case, my brother offered me constant support while my sister second-guessed every move I made - or at least it felt like it to me. So, every time I finished talking to my sister, I'd pick up the phone and call my brother. He would patiently reassure me that what I was doing was exactly right, and we could laugh together at my sister's many comments.

4. Hold a family meeting. Every family should sit down together and talk about big decisions, preferably before those big decisions need to be made. Involve the parents, if possible, and talk about choices for care (at home with help? At an assisted living center? Sell the house? Rent to a grandchild?). Make sure you talk about money, too, as decisions come with price tags that often are surprising. For example, keeping mom at home, no matter what, is fine if mom can afford to pay for around-the-clock-care (expect to pay several thousands of dollars for 24-hour in-home care), but if money is restricted other options need to be carefully considered. If you can do this together you may be able to avoid some of the worst family conflicts.

5. Get company. You can take comfort from knowing that you're not alone - in fact you're more like most families than unlike them, if you have some sibling discord. You might want to join a support group of other family caregivers (check with your local hospital) to share your frustrations and get support. You'll not only get an outlet for your own feelings, you'll gain new friends and helpful tips for survival from others in similar situations.

My sister and I are closer these days, but we still see mom's care from very different perspectives. Most days, I can smile and nod when I talk to her. Some days it's not so easy. But like all family dynamics, it's a work in progress.

DID YOU KNOW...

Many long term care insurances will cover the cost of caregiver training. Many will also help pay for in-home caregiving provided by Certified Caregivers. Our Caregiver Certification Course is approved by most insurance companies - check it out! We can offer you and your caregivers the training you need - 100% online. For training details and sample course modules, For information on being the best caregiver you can be, click here

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Free program offered for caregivers

The Mercury
POTTSTOWN — The TriCounty Community Network is providing a free event for anyone caring for the ill or disabled, of all ages and in all types of settings. The program is being held on Saturday, May 16, from 8:30 a.m. to 3 p.m. at Parkhouse Providence Pointe, 1600 Black Rock Road, Royersford.

"With nearly 1 out of 12 Pennsylvania residents currently caring for a loved one, finding supportive community resources, such as financial and emotional services, is a priceless gift. Today the typical caregiver is a woman over the age of 45, working full or part time, raising children and/or teens, while caring for a loved one (e.g. an elderly parent, a disabled child). The majority of caregivers simply do not have the time or money to find the support they truly need," said Mandy Blake-German, executive director of TriCounty Community Network. "This free event is meant to not only educate caregivers and the professionals who serve them, but provide a full day to be supported and nurtured."

Participants will start off the day with an interactive drumming circle facilitated by John Seitz, who has a master's degree in music therapy and regularly holds drumming activates with residents at assisted-living and nursing care facilities.

Afterwards there will be a variety of workshops to attend and professionals will be available to talk about available services in surrounding communities. Workshops will cover topics on aromatherapy, dementia care, ethical issues of older adults, pet therapy, reflections of hope, waiver funding, elder law issues, how to identify when someone is ready for hospice and much more.

The event will provide.....read the whole article

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Seattle Parenting Examiner
Kristy S-Y
My Mom has passed on. It wasn’t hard to accept: she had cancer and was suffering from Dementia. She lived with us her last year and a half and it was extremely hard to watch as she deteriorated and in the end, she would often forget where she was and didn’t even recognize her beloved cat. But, I know that she was better off with us and I am grateful we were in a position to have her here. I try to focus on what she was like before she became ill and remember what she was like as my Mom. Here is one of my strongest Mother’s Day memories I have of her.......read this article

What great memories are you making with your MOM?

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What to do if your loved one with dementia refuses to bath?

Caregivers of those with dementia,
the problem of not bathing is more common than you think
Aging Care
by Carol Bradley Bursack
“How can I get Dad to shower and change his clothes?”

The issue of elders who were once reasonably clean adults refusing to take showers and wear fresh clothes is one that is far more common than most people think.

Sometimes the issue is depression. If we have a parent who no longer takes an interest in staying clean or wearing clean clothes, it’s wise to look at depression first. A checkup with a doctor is a good idea, especially if low energy is also part of it, or if they just don’t care about anything at all. Depression isn’t always obvious to an observer.

Another factor is control. As people age, they lose more and more control over their lives. But one thing they generally can control is dressing and showers. The more they are nagged, the more they resist. “This younger generation is trying to take over everything. Well, they aren’t telling me when to shower, that’s for sure. Besides, I’m just fine!”

A third issue is a decreased sense of site and smell. What your nose picks up as old sweat, they don’t even notice. Not on themselves. Not on their mate. Their senses are not as acute as yours, or as theirs once were.

A fourth cause is memory. The days go by. They aren’t marked with tons of activities as they were when they were young. If there isn’t something special about Wednesday, well – it could be Tuesday or Thursday. They simply lose track of time and don’t realize how long it’s been since they showered.

Also, working in with memory is the fact that many of our elders didn’t bathe or shower every day when they grew up. We now take daily bathing for granted in this country, but when our parents were young, a weekly bath was likely more the norm. They may have gotten into a more frequent bathing habit in their last decades, but their brain is taking them into the past. Once a week, it’s bath time. Then, they forget what day it is, or even forget when they last took a bath or changed clothes. Time just slides by.

Another big issue can be.......read the whole article

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Alcoholic dementia often overlooked

Connecticut Post Staff

Q: "What is alcoholic dementia? What are its signs and symptoms? How different is it from other forms of dementia? Does it progress in symptoms? Does it continue if a person stops drinking?"
A: The above are all questions asked during my recent public dementia lecture.

Alcoholic dementia is often an overlooked type of memory dysfunction. It is estimated that about 8 percent of people in the U.S. over age 65 may have an alcohol abuse problem. Sixty percent of the elderly drink and 5 to 10 percent are binge drinkers. It may be hard to believe, but Medicare, which is the major insurance for patients over 65, spends more on alcohol-related problems than on treatment for heart attacks. Unfortunately, doctors fail to recognize this type of dementia more than 60 percent of the time. Families and spouses also do not seek medical attention as frequently as with other forms of dementia.

Before going over the signs and symptoms of alcoholic dementia, let's remind everyone what the acceptable amount of alcohol is for a person over 65. It is actually different for men and women. Women can safely have a four-ounce glass of wine, bottle of beer or one two-ounce drink of hard liquor daily. Men can have double that. Anything more is considered excessive. It is believed that the aging liver cannot process alcohol as effectively as the liver of a younger person.

To diagnose dementia, one has to have memory loss and it has to be severe enough to affect......read the whole story

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HBO's Alzheimer's series aims to push for cure

* Alzheimer's is second most feared illness in America

* Series aims to change how people think of Alzheimer's

* Maria Shriver calls it "epidemic for this generation"

By Jill Serjeant

LOS ANGELES, (Reuters) - It's been almost 15 years since former U.S. President Ronald Reagan told the world he had been diagnosed with Alzheimer's disease, hoping his disclosure would promote awareness of the heart-breaking brain disorder that slowly destroys memory.

Now, with an estimated 26 million people worldwide living with disease and a predicted 11 million by 2050 in the United States alone, a unique series by cable TV network HBO (TWX.N) aims to change how people think of Alzheimer's so they will put time and money into finding a cure.

The unprecedented multi-platform series runs throughout May and features four documentaries, 15 short films, a book, a community outreach program and a website (www.HBO.com/alzheimers) covering every aspect of Alzheimer's.

"The numbers are growing at a rate that nobody ever fathomed. As babyboomers age, it is coming right at us and we have to do something," said Maria Shriver, wife of California Governor Arnold Schwarzenegger and executive producer of "The Alzheimer's Project."

"This is an epidemic for this generation. A cure is within our reach if we......read the whole article

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UW-Madison Medical School gets Alzheimer's grant

Chicago Tribune

MADISON, Wis. - The University of Wisconsin School of Medicine and Public Health has been awarded a grant of $6.9 million to create an Alzheimer's disease research center.

The five-year grant comes from the National Institute on Aging, which is part of the National Institutes of Health. The goal is to develop ways of detecting the disease at the earliest possible stage and find treatments that can slow or stop its progression.

Gov. Jim Doyle said the new center "will build on the innovative approaches by the Wisconsin Alzheimer's disease research team."

Among its innovations, the UW-Madison Alzheimer's Institute has developed a Wisconsin registry of more than 1,300 middle-aged, asymptomatic children of Alzheimer's patients for research into such things as....read the whole story

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Still looking for a Mother's Day Gift

Do you want to give a gift that a lady with dementia will enjoy and help Alzheimer's research at the sametime. Choose a gift from giftback.com
10% of the cost of the gift goes to your favorite charity

The book, Adorable Photographs of Our Baby-Meaningful Mind Stimulating Activities and More for the Memory Challenged, Their Loved Ones and Involved Professionals a book for those with dementia and an excellent resource for caregivers and healthcare professionals, is another good choice.

The author is donating a potion of the cost of the book to the Alzheimer's Association.

If neither of those appeal to you, you can always get a gift card from Amazon.com

Leave a comment if you have any questions

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How Alzheimer’s Families Can Immediately Stop Depleting Assets

Brian Willie

This program could help you and your family save
thousands or maybe even hundreds of thousands of dollars on
long-term care costs (in-home health care, assisted living and
nursing homes).

You'll also learn exactly what Medicare covers and does not cover,
plus
I'm also throwing in bonuses from some of the top Alzheimer's and
long-term care experts in the country.

Dr. Vincent Fortanasce for instance, is considered to be one of the
foremost experts on Alzheimer's disease and has developed a program
that can prevent Alzheimer's in 70% of the population, and ward off
Alzheimer's for an extra 10-15 years in people that are genetically
predisposed to it.

He has treated high profile people such as Pope John Paul II and
former LA Dodger's coach Tommy Lasorda, and has appeared on 60
Minutes, CNN, Dr. Phil and many more. He has a syndicated radio
show with a listenership of over 170,000. His book was #1 on
Amazon.com in its category for 9 straight weeks and really struck a
chord with so many people. You won't want to miss this!
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2. Early Words of Praise for "Ultimate Alzheimer's Care Rescue
Program"

"This is the kind of information I
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"I have only listened to a couple of the recordings so far, and
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You can get all of the information on my program here:

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Challenges with care eased by music

Sharon K. Brothers, MSW

There's a beautiful story in a recent New York Times article that illustrates just how important music is to the person with memory loss.

Tom was a wanderer. When his wife, Elsie, came to visit him at a care unit for patients with dementia, he would give her a perfunctory kiss, then wander off through the rooms and stare out the window. Elsie tried to walk with him and hold hands, but he would shake her off, leaving her heartsick.

A music therapist at the facility, Alicia Clair, was searching for ways to help couples like Elsie and Tom connect. Ms. Clair asked Elsie if she'd like to try dancing with Tom, then put on some music from the '40s - Frank Sinatra singing "Time after Time." Ms. Clair said recently, "I knew Tom was a World War II vet, and vets did a lot of ballroom dancing."

As Sinatra began singing, Elsie opened her arms, beckoning. Tom stared a moment, then walked over and began leading her in the foxtrot. "They danced for thirty minutes!" Ms. Clair said. When they were finished, Elsie broke down and sobbed. "I haven't been held by my husband in three years," she told Ms. Clair. "Thank you for bringing him back."

It's a lovely story, and it illustrates the power of music in the lives of the person with memory loss.

I remember the first time I heard one of our caregivers explain how she got a client to bathe. This client resisted everyone's effort to help him bathe, and could quickly become angry and aggressive if pushed. We'd all tried every approach we knew, and then Wanda stepped up.

An hour later, the client was bathed, relaxed and smiling. We had to know: how did she do it?

Here's what she said: "I just started singing with him. We sang, and walked, arm in arm to the sink. The room was already nice and warm, and the towels, soap and washcloth were already there (I did plan ahead at least that far). We stood in front of the sink and I turned on the water and just started splashing my hands in the water, all the time singing together and smiling.

"Pretty soon, his hands are in the water, too, and we're soaping them up, laughing - and singing. Next, we washed his arms, slipped off his shirt and washed his torso.

"We got through an entire sink-and-washcloth bath just by singing and playing in the water together."

It was a beautiful, relaxing and enjoyable event for the caregiver and the client, rather than a frightening time for both.

Music has some wonderful qualities. According to the article, people respond to music even when all other forms of communication no longer work. "Music, unlike language, isnot seated in a specific area of the brain but processed across many parts. 'You can't rub out music unless the brain is completely gone.'"

If you can't carry a tune, there's good news for you, too. People with memory loss don't seem to be picky: just start the music and let the caregiving - and relationship nurturing - begin.

DID YOU KNOW...

Many long term care insurances will cover the cost of caregiver training. Many will also help pay for in-home caregiving provided by Certified Caregivers. Our Caregiver Certification Course is approved by most insurance companies -
Check it out, Just click here

For a great resource for those with dementia, caregivers and healthcare professinals, click here

For more interesting dementia articles and activities, click here