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Health Daily Journal media

NOVEMBER 2019 | In this issue:

EDUCATION KEY TO HOSPICE CARE What’s on the horizon for Alzheimer’s treatments What is COPD?




At LB Hospice you can count on patient and family centered care. We strongly advocate for patients to live their best life in the time they have.

HOSPICE IS FOR YOUR FAMILY LB Hospice not only concentrates on quality of life for individuals, but also for family caregivers. We provide familys with emotional and spiritual care throughout their journey and beyond.

HOSPICE IS A BENEFIT LB Hospice is a financial BENEFIT. Anything that the patient requires related to their terminal diagnosis and related conditions is provided, including medications, equipment, and care.

About LB Homes LB Homes is the regions best provider of senior care services. Our nursing home and home care services are rated 4+ stars by Medicare. LB Home Care is purposely innovative, monitoring our clients to keep patients at home longer and with greater comfort. Our care is founded on Biblical principles, where nursing staff engage the patient and their family as image-bearers of God. This approach is fundamental to LB Homes, directly referenced in our mission statement and carried through in our care plans. We care for you, wherever you call home.

HOSPICE IS FOR COMFORT Experts agree that most patients need 3 months or more of Hospice to fully experience its value. Instead of curing an illness, LB Hospice treats symptoms, providing comfort for months of life. | 218.998.1400 | 805 E. Channing Ave Fergus Falls, MN


Education is the key to hospice care By Missy Klemin For Your Health

Talking about death makes people uncomfortable. The room grows uncomfortably quiet when the topic is broached with patients and their families. In my 20 years as a medical social worker, and currently in my work with LB Hospice, I gained valuable insights that will help you the next time you’re face to face with death. “He is not ready to give up,” is a natural response for many families facing death. “We are not ready for hospice, she’s not dying yet.” Sadly, the median length of hospice care in the United States is just 18 days. More than 35% of hospice SEE HOSPICE PAGE 4


EDUCATE: Talking about death makes people feel uncomfortable, but education on end-of-life care can help those in need and their families.

IS ASSISTED LIVING RIGHT FOR YOU? Butch and Dianne Preston share their thoughts:

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“There are many features of Park Gardens Senior Living that helped us decide to make this our home in February of 2019. The first thing we found appealing was the choice of living levels that offered a continuum of care, independent, assisted, and memory care. We have found life here to be very comfortable and beneficial. We enjoy the freedom to come and go as we please. In assisted living the weekly housekeeping, laundry services and the professional nursing care has been extremely valuable. The assistance we receive here as the need arises is also a great safety net. We have especially enjoyed the comforts of being able to utilize the dining facilities with excellent food and a friendly staff 3X a day. Activities are scheduled each day for us to participate in as we choose, as well as recreational outings and shopping trips. One of the most valuable assets has been the friendly, competent staff and personnel here. Park Gardens has truly become our home away from home.”


HOSPICE Continued from page Page 3

patients die within a week of being admitted to hospice. Medical providers agree that it takes a minimum of three months of hospice care for patients to receive the full benefit of services. This includes time to create a relationship with and confidence in the hospice team, financial benefit, symptom management and the ability to manage the illness before the patient and family is in crisis. With all the known benefits of hospice care, why are people resistant to accepting it? Coming to terms with our mortality is hard. In my years in health care, I have found that most people aren’t afraid of dying as much as they are afraid of the process of dying. Dying holds a level of uncertainty. Many are afraid of pain. Some are afraid of who will care for their loved ones or pets when they are gone. It is a common fear to feel like we haven’t done enough. Hospice professionals are trained to guide you through the final stages of life, addressing all of your concerns so that you may enjoy the remaining days of your life. Education is key. Here is some general information that I hope helps explain some things about hospice.

What is it?

The definition I use most is that hospice is medical care toward the goal of comfort and dignity for someone whose life is drawing to a close. When a patient chooses hospice care, the focus shifts to providing comfort instead of curing an illness. Hospice isn’t about dying, it’s about living your best life during the time you have left.

Hospice care could actually help you live longer Research shows that on aver-


SEVERAL DIFFERENT SETTINGS: Hospice can be done in several different settings including at home, assisted living, a nursing home and a hospital. age, hospice recipients live longer and report a higher quality of life than those receiving standard care.

Hospice can be provided in many different settings Hospice see patients in many different settings – at their home, assisted living, nursing home and occasionally in the hospital. You may ask what benefit hospice can provide when the resident is already in a care setting. I always tell people to view hospice as a specialty service. For example, when you need treatment for cancer, your physician refers you to an oncologist. When you need care at end of life, you call hospice. Hospice does not replace the care you receive in the nursing home — they offer specialized patient care and extra support for staff, the resident and his or her family.

Anyone is eligible for Hospice care We care for patients of all ages, from infants to the elderly. Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers. If a person does not have insurance coverage LB Hospice will work with the person and their family to ensure that the core services are provided, regardless of ability to pay.

Care is multi-dimensional, caring for the whole person This includes their physical, emotional, social and spiritual needs. In addition to the nursing staff, your hospice team includes: physician, therapy, medical social work, dietary, pharmacy, chaplaincy and volunteer services.

Hospice also offer support for those left behind Sometimes we get referrals

because the hospital staff believe that the family needs ongoing support. One benefit of hospice is bereavement services. Our bereavement social worker is able to follow the designated family member for up to 13 months. This can include home visits, telephone calls, referrals, newsletters and other resources.

When should I call Hospice?

Hospice may be appropriate if they have a life limiting illness with frequent visits to the ER or hospital admissions, a decline in their ability to perform daily tasks including eating, getting dressed, walking, or using the bathroom, an increase in falls, changes to their mental abilities or progressive weight loss. Early referral is the best gift you can give your loved one. For more information or to request a speaker call LB Hospice at 218-998-1400.


National Influenza Vaccination Week Dec. 1-7 By Mayo Clinic

Have you had your annual influenza vaccination? If not, this National Influenza Vaccination Week may be the perfect time. The Centers for Disease Control and Prevention selected the week of Dec. 1-7 to highlight the importance of flu vaccines through the holiday season and beyond. Mayo Clinic internal medicine specialist Dr. Vandana Bhide says influenza can be a serious and potentially deadly virus that causes fever, coughing and muscle aches. The flu also can lead to other complications, including pneumonia, bronchitis and, potentially, death. "Many people who get the flu will have a fever, experience muscle aches and feel the need to stay home from work or school for a few days. Certain people can develop serious complications. The vaccine can help avoid these is-


XXXXX XXXX: Robb Webb, brother of Jim, seated on the Webb Family memorial sues,” says Dr. Bhide. every single year.” She adds, “The “People always ask me why do I important thing to know about the have to get a flu shot every single influenza vaccine is that you have year as with other vaccines, you to get the actual vaccine to the can just get a booster shot every strain that’s active.” once in awhile,” says Dr.Bhide. “With influenza, because it can Tips for avoiding illness change year-to-year, and the imDr. Bhide offers these tips for munization is very specific to the staving off the flu and other illstrain, you have to get the vaccine nesses, regardless of the season:


• Wash your hands thoroughly and frequently with soap and water, or alcohol-based hand sanitizer. This is particularly important before leaving the bathroom, eating, or touching your face. • Avoid others who are sick, and stay home from work or school if you are ill. • Keep your vaccines up to date. Aside from the seasonal flu shot, the most important vaccines, she says, include measles, mumps and rubella and the combined tetanus diphtheria and cellular pertusis (whooping cough) booster, or Tdap. Due to the unpredictability of the flu season, which is typically from October to March, there is no specific date by which you should get your vaccine. The only advice is that the vaccine should be administered as early as possible to be able to take effect before exposure to the virus.

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What is chronic obstructive pulmonary disease? By Mayo Clinic

November is National COPD Awareness Month, which makes it a good time learn more about chronic obstructive pulmonary disease (COPD). This chronic inflammatory lung disease is a major cause of disability and the fourth leading cause of death in the U.S., according to the National Institutes of Health. It’s caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and various other conditions. Learn more about the symptoms and treatment options for COPD. COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It's caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions. Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It's characterized by daily cough and mucus (sputum) production. Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to cigarette smoke and other irritating gases and particulate matter. COPD is treatable. With proper management, most people with COPD can achieve good symptom control and quality of life, as well as reduced risk of other associated conditions.


COPD symptoms often don't appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues. For chronic bronchitis, the main symptom is a daily cough and mucus (sputum) production at least three months a year for two consecutive years. Other signs and symptoms of COPD may include: • Shortness of breath, especially during physical activities. • Wheezing. • Chest tightness.


WHAT IS COPD?: Chronice obstructive pulmonary disease is an inflammatory lung disease that causes obstructed airflow from the lungs. • Having to clear your throat first thing in the morning, due to excess mucus in your lungs. • A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish. • Blueness of the lips or fingernail beds (cyanosis). • Frequent respiratory infections. • Lack of energy. • Unintended weight loss (in later stages). • Swelling in ankles, feet or legs. People with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse than usual day-to-day variation and persist for at least several days.

Causes The main cause of COPD in developed countries is tobacco smoking. In the developing world, COPD often occurs in people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes. Only about 20 to 30% of chronic smokers may develop clinically apparent COPD, although many smokers with long smoking histories may develop reduced lung function. Some smokers develop less common lung conditions. They

may be misdiagnosed as having COPD until a more thorough evaluation is performed.

How your lungs are affected Air travels down your windpipe (trachea) and into your lungs through two large tubes (bronchi). Inside your lungs, these tubes divide many times — like the branches of a tree — into many smaller tubes (bronchioles) that end in clusters of tiny air sacs (alveoli). The air sacs have very thin walls full of tiny blood vessels (capillaries). The oxygen in the air you inhale passes into these blood vessels and enters your bloodstream. At the same time, carbon dioxide — a gas that is a waste product of metabolism — is exhaled. Your lungs rely on the natural elasticity of the bronchial tubes and air sacs to force air out of your body. COPD causes them to lose their elasticity and overexpand, which leaves some air trapped in your lungs when you exhale.

Causes of airway obstruction

Causes of airway obstruction include: Emphysema. This lung disease causes destruction of the fragile walls and elastic fibers of the alveoli. Small airways collapse when you exhale, impairing airflow out of your lungs.


• Chronic bronchitis. In this condition, your bronchial tubes become inflamed and narrowed and your lungs produce more mucus, which can further block the narrowed tubes. You develop a chronic cough trying to clear your airways. • Cigarette smoke and other irritants. In the vast majority of cases, the lung damage that leads to COPD is caused by long-term cigarette smoking. But there are likely other factors at play in the development of COPD, such as a genetic susceptibility to the disease, because only about 20 to 30 percent of smokers may develop COPD. Other irritants can cause COPD, including cigar smoke, secondhand smoke, pipe smoke, air pollution and workplace exposure to dust, smoke or fumes.

Alpha-1-antitrypsin deficiency In about 1% of people with COPD, the disease results from a genetic disorder that causes low levels of a protein called alpha-1-antitrypsin. Alpha-1-antitrypsin (AAt) is made in the liver and secreted into the bloodstream to help protect the lungs. Alpha-1-antitrypsin deficiency can affect the liver as well as the lungs. Damage to the lung can occur in infants and children, not only adults with long smoking histories. For adults with COPD related to AAt deficiency, treatment options include those used for people with more-common types of COPD. In addition, some people can be treated by replacing the missing AAt protein, which may prevent further damage to the lungs.

Risk factors

Risk factors for COPD include: • Exposure to tobacco smoke. The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers and marijuana smokers also may be at risk, as well as people exposed to large

smoking may reduce this risk. • High blood pressure in lung arteries. COPD may cause high blood pressure in the arteries that bring blood to your lungs (pulmonary hypertension). • Depression. Difficulty breathing can keep you from doing activities that you enjoy. And dealing with serious illness can contribute to development of depression. Talk to your doctor if you feel sad or helpless or think that you may be experiencing depression.



DON’T SMOKE: COPD prevention is easy as not smoking or stopping immediately. Lung irritants are the cause of this inflammatory disease. amounts of secondhand smoke. • People with asthma who smoke. The combination of asthma, a chronic inflammatory airway disease, and smoking increases the risk of COPD even more. • Occupational exposure to dusts and chemicals. Long-term exposure to chemical fumes, vapors and dusts in the workplace can irritate and inflame your lungs. • Exposure to fumes from burning fuel. In the developing world, people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes are at higher risk of developing COPD. • Age. COPD develops slowly over years, so most people are at least 40 years old when symptoms begin. • Genetics. The uncommon genetic disorder alpha-1-antitrypsin deficiency is the cause of some cases of COPD. Other genetic factors likely make certain smokers more susceptible to the disease.


COPD can cause many complications, including: • Respiratory infections. Peo-

ple with COPD are more likely to catch colds, the flu and pneumonia. Any respiratory infection can make it much more difficult to breathe and could cause further damage to lung tissue. An annual flu vaccination and regular vaccination against pneumococcal pneumonia can prevent some infections. • Heart problems. For reasons that aren’t fully understood, COPD can increase your risk of heart disease, including heart attack. Quitting smoking may reduce this risk. • Lung cancer. People with COPD have a higher risk of developing lung cancer. Quitting

Unlike some diseases, COPD has a clear cause and a clear path of prevention. The majority of cases are directly related to cigarette smoking, and the best way to prevent COPD is to never smoke — or to stop smoking now. If you’re a longtime smoker, these simple statements may not seem so simple, especially if you’ve tried quitting — once, twice or many times before. But keep trying to quit. It’s critical to find a tobacco cessation program that can help you quit for good. It’s your best chance for preventing damage to your lungs. Occupational exposure to chemical fumes and dust is another risk factor for COPD. If you work with this type of lung irritant, talk to your supervisor about the best ways to protect yourself, such as using respiratory protective equipment.

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Alzheimer’s treatments: What’s on the horizon? By Mayo Clinic

Current treatments for Alzheimer's disease temporarily improve symptoms of memory loss and problems with thinking and reasoning. These Alzheimer's treatments boost performance of chemicals in the brain that carry information from one brain cell to another. However, these treatments don't stop the underlying decline and death of brain cells. As more cells die, Alzheimer's disease continues to progress. Experts are cautiously hopeful about developing Alzheimer's treatments that can stop or significantly delay the progression of Alzheimer's. A growing understanding of how the disease disrupts the brain has led to po-


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tential Alzheimer's treatments that short-circuit basic disease processes. Future Alzheimer's treatments may include a combination of medications, similar to how treatments for many cancers or HIV/AIDS include more than a single drug. The following treatment options are among the strategies currently being studied.

Taking aim at plaques

Some of the new Alzheimer's treatments in development target microscopic clumps of the protein beta-amyloid (plaques). Plaques are a characteristic sign of Alzheimer's disease. Strategies aimed at beta-amyloid include: • Recruiting the immune system. Several drugs — known as monoclonal antibodies — may prevent beta-amyloid from clumping into plaques or remove beta-amyloid plaques that have formed and help the body clear the beta-amyloid from the brain. Monoclonal antibodies mimic the antibodies your body naturally produces as part of your immune system's response to foreign invaders or vaccines. The monoclonal antibody solanezumab did not demonstrate any benefit for individuals with mild or moderate Alzheimer's disease. It's possible that solanezumab may be more effective when given earlier in the course of the disease. The drug seemed safe in recent studies, and solanezumab continues to be evaluated in the preclinical stage of the disease. Aducanumab is another drug that has shown promise in preliminary studies. Study participants taking aducanumab had reduced amyloid plaque levels and a suggestion of possible delayed cognitive decline. More studies are underway for this treatment. • Preventing destruction. Several years ago, researchers learned that beta-amyloid inter-


FINDING THE ROOT: Some of the new Alzheimer’s treatments have targeted protein beta-amyloid or plaques. Plaques are a characteristic sign of Alzheimer’s. acts with another protein called Fyn. When combined with beta-amyloid, Fyn is over-activated, which triggers a destruction of connections between nerve cells (synapses) in the brain. Studies are currently in progress for drugs that inhibit the Fyn protein.A drug initially developed as a possible cancer treatment — saracatinib — is now being tested in Alzheimer's disease.In mice, the drug turned off Fyn, which allowed synapses to start working again, and the animals experienced a reversal of some memory loss. Human trials for saracatinib as a possible Alzheimer's disease treatment are now underway. • Production blockers. These therapies may reduce the amount of beta-amyloid formed in the brain. Research has shown that beta-amyloid is produced from a "parent protein" in two steps performed by different enzymes.Several experimental

drugs aim to block the activity of these enzymes. They're known as beta- and gamma-secretase inhibitors. Recent studies showed that the beta-secretase inhibitor verubecestat did not slow down cognitive decline and was associated with several side effects in those with mild or moderate Alzheimer's.

Keeping tau from tangling

A vital brain cell transport system collapses when a protein called tau twists into microscopic fibers called tangles, which are another common brain abnormality of Alzheimer's. Researchers are looking at a way to prevent tau from forming tangles. Tau aggregation inhibitors and tau vaccines are currently being studied in clinical trials.

Reducing inflammation

Alzheimer's causes chronic, low-level brain cell inflamma-

tion. Researchers are studying ways to treat inflammatory processes at work in Alzheimer's disease. The drug sargramostim (Leukine) is currently in research. It's thought that the drug may stimulate the immune system to protect the brain from harmful proteins. Researchers studied the diabetes drug pioglitazone (Actos) because it may lessen beta-amyloid and inflammation in the brain, but this trial was negative.

Researching insulin resistance

Researchers are studying the effects of insulin on the brain and brain cell function, and insulin changes in the brain that may be related to Alzheimer's. A trial testing an insulin nasal spray to determine whether it slows the progression of Alzheimer's was SEE TREATMENTS PAGE 10


TREATMENTS: CAMD sharing data from Alzheimer’s clinical trials Continued from Page 9

recently reported as negative.

risk of Alzheimer's disease. But further research has been conflicting, with some studies indicating that estrogen didn't offer any benefit. More research and a better understanding of the relationship between estrogen and cognitive function are needed before any recommendations can be made.

Studying the heart-head connection

Growing evidence suggests that brain health is closely linked to heart and blood vessel health. The risk of developing Alzheimer's appears to increase as a result of many conditions that damage the heart or arteries. These include high blood pressure, heart disease, stroke, diabetes and high cholesterol. A number of studies are exploring how best to build on this connection. Strategies under investigation include: • Current drugs for heart disease risk factors. Researchers are investigating whether drugs such as blood pressure medications now used to treat vascular disease may also help people with Alzheimer's or reduce the

Speeding treatment development


CONTINUED STUDY: Studying the heart-head connection may find data about Alzheimer’s and who is at risk. risk of developing the disease. • Drugs aimed at new targets. Additional projects are looking more closely at how the connection between heart disease

and Alzheimer's works at the molecular level to find new drug targets. •Lifestyle choices. Research suggests that lifestyle choices with known heart benefits, such as exercising on most days and eating a heart-healthy diet, may help prevent Alzheimer's disease or delay its onset.



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In one study, taking estrogen-based hormone therapy for at least a year during perimenopause or early menopause appeared to protect thinking and memory in women with a higher

Developing new medications is a slow and painstaking process. The pace can be especially frustrating for people with Alzheimer's and their families who are waiting for new treatment options. To help accelerate discovery, the Coalition Against Major Diseases (CAMD), an alliance of pharmaceutical companies, nonprofit foundations and government advisers, has forged a first-of-its-kind partnership to share data from Alzheimer's clinical trials. The CAMD has also collaborated with the Clinical Data Interchange Standards Consortium (CDISC) to create data standards. Researchers anticipate that these data standards and the sharing of data from more than 6,500 study participants will speed development of more-effective therapies.

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Make changes to stop prediabetes from developing into diabetes By Mayo Clinic

Dear Mayo Clinic: Is it possible to reverse prediabetes by taking medication? Answer: Prediabetes means that your blood sugar level is higher than normal but not high enough to be considered diabetes. It is a warning sign that if you don't make changes, the condition may eventually progress to diabetes. But those changes typically don't include taking medication. Instead, lifestyle changes, such as improving your diet, losing weight and exercising regularly, may lower your blood sugar to a healthy level. Diabetes happens when you have too much sugar, also called glucose, in your blood. This comes from what you eat, but during the fasting state it is released by the liver into the circulation to keep levels constant. The hormone insulin, which is made in the pancreas, is sent into your blood continuously but increases significantly after you eat. The insulin moves through your blood and works like a key, allowing the sugar from your food to enter your cells. As the sugar goes into your cells, the amount of sugar in your blood goes down. It also “puts the brakes” on the liver to prevent too much glucose release during fasting and after meals. When you have diabetes, this process doesn’t work the way it should. Sugar then accumulates in your blood. There are several kinds of diabetes, the most common being Type 2 diabetes. It develops when your body cannot make enough insulin to keep your blood sugar at a healthy level or


EXERCISE: Diet and exercise have shown to be the most effective treatment for combating prediabetes. when your body’s cells become resistant to insulin. Your health care provider can diagnose diabetes using several different tests. One of the most common is the fasting blood glucose test, in which a sample of your blood is taken after you have not eaten for at least eight hours. The test analyzes how much glucose is in your blood. A normal glucose level range is 70 to 100 milligrams per deciliter, or mg/dL. You have diabetes when glucose is consistently above 126 mg/dL. Prediabetes is when your fasting blood sugar is between 101 to 125 mg/dL. Being in the prediabetes range signals that you are at high risk of developing diabetes if something doesn’t change. The exact cause is not known, but excess fat — especially abdominal fat — and inactivity seem to be important factors in the development of prediabetes. In addition, the risk for diabetes goes up as you get older, especially after age 45. You can't

do anything about your age, but you can make other changes to lower your risk. Studies have found that diet and exercise are the most effective treatments for combating prediabetes and preventing its progression to diabetes. Being sedentary can raise your diabetes risk, even if you don’t carry excess weight. Make regular exercise a priority. It doesn’t have to be a strenuous workout. A brisk walk, a bike ride, an afternoon spent gar-

dening — anything that gets you moving helps. Aim for 30 minutes of moderate exercise each day. If you can’t fit it in all at once, try several 10-minute sessions throughout the day. If you choose an activity that you enjoy, you're more likely to stick with it. The availability of step counters — even those on smartphones — can help you keep track of your activity. You should aim for about 10,000 steps per day. When it comes to diet, concentrate on foods lower in fat and calories and higher in fiber. Focus on eating fruits, vegetables and whole grains. If you aren’t sure what’s right for you, consider meeting with a dietitian to review your diet and help you make changes. There are numerous apps and online platforms that can help you track your food intake. Finally, have your blood sugar checked on at least an annual basis so you know if you are making progress. Talk to your health care provider about how often you need your blood sugar tested. In many cases, blood sugar that falls in the prediabetes range can be successfully controlled without medication.

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Tips to support Alzheimer’s caregivers during the holidays (StatePoint) More than 16 million family members and friends are serving as Alzheimer’s caregivers in the U.S. As families approach the holiday season, there are easy ways to support caregivers that can ease the burden of caregiving and help make the holidays a joyous time for everyone. “Holidays can be stressful for all of us, but they can be especially demanding for caregivers,” says Ruth Drew, director of information and support services at the Alzheimer’s Association. “It’s easy to get lost in the hustle and bustle of the holidays, but little gestures can go a long way and can be easier than you think – just one hour of help can make a big difference for a caregiver.” An Alzheimer’s Association survey reports that many caregivers are not getting the help and support they need – an overwhelming 84 percent of caregivers say they would like more support in caring for someone with Alzheimer’s, especially from family members. The Alzheimer’s Association offers tips for families that can help ease the burden on caregivers this holiday season: 1. Build on traditions: Caregivers may feel overwhelmed by maintaining traditions. Experiment with new traditions that might be less stressful or a better fit for the caregiver. For example, turn the traditional holiday dinner into a lunch. 2. Adjust expectations: The stress of caregiving responsibilities layered with holiday traditions can take a toll. If a caregiver has traditionally hosted family celebrations, offer to host instead. 3. Give them a break: Make a standing ap-


OFFERING HELP: Caregiving needs will intensify and become more demanding as Alzheimer’s progresses. While it’s important to check in and support caregivers throughout the year, offering additional help during the holiday season can ensure that caregivers have a reliable and flexible support network. pointment to give caregivers a break. Offer to spend time with the person living with Alzheimer’s to allow the caregiver a chance to run holiday errands or engage in an activity that helps he or she recharge. 4. Check in regularly: It’s easy for people to lose touch during the holidays. Calling to check in, sending a note or stopping by for a visit can make a big difference in a caregiver’s day and help them feel supported. 5. Tackle holiday to-do lists: Caregivers are often overwhelmed by the demands of caregiving and it can be hard for them to find time

to complete simple tasks that others may take for granted. Offer to tackle a caregiver’s holiday to-do list – cooking, cleaning, gift shopping or wrapping. 6. Adapt gift giving. Caregivers often neglect their own well-being. Select gifts that can help them take care of themselves and provide some relief. For example, gift a household chore service or meal delivery service. To learn more and access resources, visit, the website of the Alzheimer’s Association or call its 24/7, free Helpline, even during the holidays, at 800-272-3900.


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Benefits of physical therapy for Parkinson’s Parkinson’s disease is a neurological disorder that affects the brain. It causes impairments in balance and coordination, weakness, and shaking/tremors. Individuals with Parkinson’s often start to notice a decrease in the quality of their movements. They GWEN may notice that they are not able HUMANN to take as large OSPTI of steps as they used to. They may also notice that are slower at completing activities, with increased effort needed for daily tasks. Parkinson’s affects the individual’s perception of movement, meaning that someone with Parkinson’s may feel like they are walking with a normal walking pattern, but

they are actually taking very small steps. When they then walk with what would be considered normal steps, they feel like they are taking excessively large steps. Only a doctor can diagnosis someone with Parkinson’s disease. Physical therapy can help individuals with Parkinson’s relearn what it feels like to move with larger motions. Physical therapy is able to help the symptoms of Parkinson’s through a standardized program called LSVT Big. The program can only be administered by therapists certified in the course. The focus of the program is to help improve the quality and magnitude of movements. The program trains the individual with Parkinson’s to recalibrate what it feels like to move with an appropriate amount of motion, and then works to integrate these motions into functional and daily tasks. This program

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Handwashing tips to help kids avoid germs and illness By Mayo Clinic

Basic rules to prevent illness during the cold and flu season are as simple as knowing how to wash your hands properly, when to wash your hands, what products to use and why you should pay special attention to skin cleanliness. "Teaching kids healthy hygiene habits is essential, because young children are more likely to bring respiratory illnesses home from school or daycare, which can infect your entire family," says Peggy Decker, M.D., a Mayo Clinic Health System pediatrician. Dr. Decker encourages people to keep the five Ws in mind when teaching your children about proper hand hygiene.




Running water and plain soap, followed by moisturizer, is best where running water is available.


Where running water and soap is available, wet hands thoroughly. Apply soap and lather, paying special attention to nails and between fingers.

ROW, ROW, ROW YOUR BOAT: Following the five Ws of handwashing will help children to avoid germs and illness. Rub for 10 to 20 seconds — long enough to sing the “Happy Birthday” song twice. Dry with a clean towel. Use the towel to turn off the faucet.


• Visibly dirty hands.

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• Before eating and before/after food prep. • After toileting. • After shaking hands with someone. • On arrival home from school, daycare and playdates. • After touching something dirty. • After coughing, sneezing or wiping nose.

Skin is usually a great barrier to infection. You can help maintain that barrier by regularly using moisturizers during cold, dry winter months to prevent cracked or chapped skin. You can also remove infectious organisms from your hands before you transfer them to your eyes, nose or mouth. This is often how common cold and influenza viruses are spread.


Research indicates that hand washing regularly in classrooms decreases school absences due to illness. In some situations, hand sanitizer is a good alternative. You use a dime-sized amount and rub it thoroughly over the hand surfaces until hands are dry. Hand sanitizers usually contain 60 to 90 percent alcohol, which kills many bacteria and viruses that cause infection. Hand sanitizer doesn’t work if it doesn’t have good contact with the skin, so opt for soap and water when hands are extremely soiled. "As a parent, you can’t prevent your kids from contact with dirt and germs," says Dr. Decker. "But you can teach them the right way to wash their hands and protect themselves by making frequent hand washing a life-long healthy habit."


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Your Health November 2019  

Your Health November 2019