plus! The magazine for active, mature lifestyles
6 Coping with
Dementia When the child becomes the parent
We’re here to help.
4 ADRC 6 Coping with Dementia
BECAUSE PRE-PLANNING MAKES SENSE
ON THE COVER: Jodi Larson, left, poses for a photo with her mother, Ione Larson, at their home in Manitowoc. Jodi takes care of her mother, who has dementia. Matthew Apgar/50 Plus
10 No ‘Magic Pill’ for a good
Pat Pankratz, 50 Plus! Editor 920-686-2138 | firstname.lastname@example.org
By Katie Schroeder
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50 Plus! is published monthly by the Herald Times Reporter Media. It also is distributed to select businesses in Manitowoc County.
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Travel discounts available to older travelers Dear Savvy Senior: What types of senior discounts are available to older travelers? My husband and I are approaching retirement and love to travel, but love to save money too. Almost retired Dear Almost: There is actually wide variety of travel discounts available to older travelers – usually starting at either age 50, 55, 60, 62 or 65. But, you first need to be aware that when it comes to senior travel bargains, the “senior discount” may not always be the best deal. Hotels, airlines and cruise lines, for example, offer advanced bookings along with special deals and promotions from time to time that may be a lower rate than what the senior discount is. Always ask about the lowest possible rate and the best deal available.
find them, see discounts.aarp.org/travel or call 800675-4318. Annual AARP membership fees are $16 or less if you join for multiple years. If you don’t like AARP, there are alternative organizations you can join like the Seniors Coalition or the American Seniors Association that offer discounts on hotels and rental cars.
are also available to AAA members. To shop around for the best rental car deals use travel aggregator sites like orbitz.com or kayak.com.
Airlines: Southwest Airlines has the best senior fare program in the U.S., offering discounts to passengers 65 and older. American, United and Delta offer some senior fares too but they are extremely limited.
Hotels: Most hotels in the U.S. offer senior discounts ranging between 10 and 30 percent off. Age eligibility will vary by hotel. Hyatt offers one of the biggest discounts, up to 50 percent off, to guests 62 and older.
Trains: Amtrak provides a 15 percent discount to travelers 62 and older, and a 10 percent discount to passengers over age 60 on cross-border services operated jointly by Amtrak and VIA Rail Canada.
With that said, here’s a breakdown of some different senior travel discounts that are available today.
Bus travel: Greyhound offers a 5 percent discount on unrestricted fares to seniors over 62. Peter Pan, which serves the Northeast region of the U.S., offers the same deal. Trailways, a privately owned bus company also provides senior discounts but they vary by location. And, most local bus lines and public transportation offer discounted senior passes.
Club memberships: If you’re a member of AARP, there are dozens of travel discounts available on hotels, rental cars, cruises and vacation packages. To
Car rentals: Most car rental companies offer 5 to 25 percent discounts to customers who belong to 50-and-older organizations like AARP. Discounts
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Cruises: Most cruise lines offer special deals to AARP members. But, if you’re not a member, discounts on some cruise lines (like Carnival, Norwegian and Royal Caribbean) are also available to passengers 55 and older. The best way to find these is to contact a travel agent, or check with the cruise line your interested in. Restaurants: Senior discounts are fairly common at mom-and-pop and family-style restaurants, as well as fast food establishments. The discounts will range from free coffee, to drinks, to discounts off your total order. Chains known for their senior discounts SAVVY SENIOR CONTINUED ON PAGE 5
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you may be eligible for a review under this agreement. If your maintenance care denial became final and non-appealable between Jan. 18, 2011 and Jan. 24, 2013, you have until this July 23 to request another review.
By Judy Rank
Anyone with a denial between Jan. 25, 2013 and Jan. 23, 2014 has until Jan. 23, 2015 to request a review. Information on the process is available from the ADRC by calling (920) 683-4180 or 1-877-416-7083.
Medicare denial information available The Centers for Medicare and Medicaid Services (CMS) has provided the ADRC with information for individuals who may have been denied coverage in a skilled nursing facility, home health care agency or outpatient care. In a settlement in 2013, known as the Jimmo agreement, CMS clarified that maintenance coverage under one of these benefits does not depend on whether the patient can improve, but on whether skilled care is required and whether the services themselves are reasonable and necessary. If you have been denied by Medicare because you were not improving or no longer had the potential to improve and this was the only reason for the denial,
Pro-bono attorney Kewaunee and Manitowoc County each offer pro-bono attorney appointments for seniors age 60 and older who may be dealing with a situation that they are not sure requires the assistance of an attorney. The pro-bono attorney schedules ½-hour appointments and will listen to your concerns and advise you on what course of action to take. If you are advised to contact an attorney for help, the pro-bono attorney does not become your legal counsel. Kewaunee County residents have access to the attorney the fourth Monday of the month. Appointments can be made
by calling 1-877-416-7083 and asking to speak to the elder benefit specialist. The pro-bono attorney is in the Manitowoc office the fourth Wednesday of the month and county residents can make an appointment by calling the ADRC at (920) 683-4180 and asking to speak to the elder benefit specialist.
Power Point The Long Term Care Coalition has developed a Power Point presentation explaining hospital admissions and hospital observations, and the care that can be provided under the separate codings. Any group can request a presentation that can be made by a member of the coalition. Requests for presentations can be made through the ADRC office.
Drug assistance A reminder to individuals who are struggling to pay for prescription drugs that there may be help available through the federal government or other resources. Medicare recipients who have a yearly income of less than $17,235, and a couple whose income is less than $23,265 a year could be eligible for Low Income Subsidy (LIS) or assistance with drugs
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To be eligible for LIS, a person must be both income- and asset-eligible. Assets for a single person must be under $13,300, while a couple cannot have more than $26,580. An application for assistance can be completed online at ssa.gov at any time. Those who qualify may get their premium at no cost while co-payments for generic drugs at the pharmacy are $2.65, and co-payments for brand name drugs are $6.60.
Volunteers sought The ADRC is in desperate need of volunteer drivers to take people to medical appointments. The ADRC has two minivans and one sedan that can be used for transport. Most rides are out of county to medical facilities in neighboring counties. Training is provided. Call the ADRC at (920) 683-4180 and ask for Linda to become a volunteer in the transportation program. Also a reminder that the ADRC is taking names of individuals wanting to participate in one of several prevention programs offered through the agency. The Stepping On program is for those
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who have a fear of falling, or have fallen recently; the Living Well with a Chronic Condition program is for those dealing with a chronic condition such as arthritis, high blood pressure, heart conditions, etc; Living Well with Diabetes is for the person with diabetes; and Powerful Tools is for the family caregiver. Please call the ADRC to register for any of these six-week programs.
Eligible recipients will receive $25 worth of vouchers that can be used at the Manitowoc, Two Rivers and Kiel Farmers Markets, Wilfert Farms, Meyer’s Market, Red Belly Farms and many other places outside of Manitowoc County. They can be used to purchase only Wisconsin-grown fresh fruits, vegetables and herbs. Those eligible must be 60 or older, have an income of $21,590 a year or less for a single person or $29,101 a year or less for a couple. Recipients much provide a proof of income, Social Security number and date of birth. Applications will be accepted on a first-come first-serve basis. Vouchers will be distributed immediately.
Judy Rank is executive director of the Aging and Disability Resource Center of the Lakeshore.
CONTINUED FROM PAGE 3
Representatives will explain the Senior Farmer’s Market Nutrition Program and explain how to use the vouchers. For more information, call Alyssa Weber at (920) 683-4180.
or specials include Burger King, Chick-fil-A, Church’s Chicken, Dairy Queen, Dunkin Donuts, IHOP, Subway and Wendy’s. Entertainment: Most movie theaters, plays, ballets, symphonies, museums, zoos, aquariums, golf courses and even ski slopes provide reduced admission to seniors over 60 or 65. If you’re over 62, you’re also eligible for the popular “America The Beautiful Senior Pass,” which provides a lifetime entry to 2,000 national parks and recreation sites. You can obtain this pass in person at one of the federal recreation sites for $10, or through the mail (see store.usgs.gov/pass/senior.html) for $20.
Farmers Market vouchers offered to seniors
To look for other travel discounts see seniordiscounts.com, a great website that lets you search by location and category for free. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
MANITOWOC - The Manitowoc County Aging & Disability Resource Center of the Lakeshore will be distributing Wisconsin Senior Farmers Market vouchers beginning June 2.
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June 3 from 12:15 to 1:30 p.m. at the Village Green East Apartments, 2401 Polk St., Two Rivers. June 3 from 1:50 to 3 p.m. at the Village Green West Apartments, 2602 Forest Ave., Two Rivers. June 5 from 11 a.m. to 12:15 p.m. at River Hill Apartments, 1500 N. Third St., Manitowoc. June 5 from 12:30 to 1:45 p.m. at Valley View Apartments, 1485 N. Seventh St., Manitowoc. June 6 from 10 to 11 a.m. at the Reedsville Manor Apartments, 431 Madison St., Reedsville. June 6 from 1:30 to 2:45 p.m. at Manitou Manor Apartments, 1433 N. Sixth St., Manitowoc. June 9 from 2 to 3 p.m. at the Kiel Community Center, 510 Third St., Kiel. June 17 from 2 to 3 p.m. at the Aging & Disability Resource Center.
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A sense of humor through dementia is a vital as oxygen. It’s a debilitating disease; it’s perhaps harder on family members to have to watch their loved one go through it than to have the disease themselves.
Progression The disease process started with memory problems. Jodi noticed that her aunts would re-ask Ione questions that she had answered a couple of days before. One aunt lived next door and after dementia had taken its toll, Jodi would regularly go next door to help her shower. “I was more than glad that I could be there to help,” she said. While camping in Wisconsin Dells late spring of 2012 Jodi’s phone rang at 5:30 a.m. It was her mother calling her asking, “Where are you? I was going to call the police!” Ione had forgotten that Jodi was on a camping trip.
“That was my first ‘wake up’ call,” Jodi said about her mother’s illness. “At that time she could still use the phone, microwave… Looking back, I guess there were signs. But you just don’t want to admit it. It’s hard to accept the fact that your mother is declining.”
Jodi Larson, right, helps her mother Ione with a puzzle at their home recently. Jodi said the memory loss of dementia that her mother experiences can be frustrating. Matthew Apgar/50 Plus
When the child becomes the parent
By Joni Shavlik 50 Plus correspondent Ione Larson’s welcome into her Manitowoc home is as warm and friendly as her daughter’s. Her eyes light up, her smile fills her face as she shakes my hand. The 86-year-old enjoys company. She is sitting in a recliner with a thick, fuzzy blanket on. Her daughter, Jodi Larson, knows she doesn’t like to be cold. Their home is a stone’s throw from Lincoln High School and it’s where Jodi grew up. We chatted a bit about the ease of not having to drive the kids to school. Pleasant chatter, and Ione’s answers to my questions sound perfectly normal.
6 . June 2014 . 50
I asked Ione about her husband who had passed away when Jodi, now 52, was only 12 years old. Reuben Larson died of colon cancer in 1973. She knew she had been married, she knew she loved him greatly and still does, but a very disturbed frown crossed her face as she realized that she couldn’t come up with his name. She should know her husband’s name. She knows something’s wrong, but she passes it off with a comment, “I’m so stupid,” and that breaks her daughter’s heart. I showed Ione a family photo. She was able to point out Jodi, but not able to name Jodi’s brothers Jan, who lives in
Florida, and Kim, who lives in Manitowoc. Her number one grandson Josh is spoken of with a smile as are his two boys Jackson and Jacob. She really liked their photo, and she knew them, but the names escape her. Jodi describes her mother as a person who has always been self-reliant. She’d much prefer to give a helping hand than to receive one. Jodi has inherited this giving trait from her mother. Ione’s two sisters were never diagnosed with dementia, but Jodi knows the signs. One had a mild case, and the other had it quite a bit worse, “but I got the prize!” she jokes.
They’d have arguments about things Ione would forget, perhaps a TV program they’d watched together. “Oh you remember that show… We watched that one together last night,” Jodi would say. “Oh no, we didn’t! I’ve never seen that episode before,” Ione would fire back. At this point Ione isn’t capable of doing anything for herself anymore. She’d rather be in bed. Jodi is up at 4:15 a.m. to get ready for work. She wakes up Ione, administers her medications and Ione goes back to sleep. Jodi leaves breakfast out and the TV on for Ione because she won’t remember to eat or how to operate the TV set. It’s stressful for Jodi, worrying about how her mother is doing while she’s away. Her boss’s name, Mike Fredrich, comes up a bit in my conversation with Ione. He’s one of the few people she remembers and matches a name to a face, or at least to his thoughtfulness. He bakes over the weekend and every Monday he sends a treat home with Jodi for Ione. They’ve met, too. Ione says, “he’s a nice guy, that Mike.” Fredrich knows the situation that Jodi
is in, and has no problem with her running home once or twice during the day to check on her mother. “That type of thing is earned” Fredrich said. “She (Jodi) always gets her work done, and does it well.” Mid-morning Jodi might be finally getting her mother out of bed and upon leaving say: “Now don’t go running off to bed right after I leave!” Jodi has already come back 5 minutes later, and had to shag her mother back out of bed again!
Wants to remain home How does Ione feel about extra care for her condition? “Just don’t put me in a ‘home,’” she says. “Put a pillow over my head before you do that!” Jodi laughs at the statement as she tells me, but the guilt it produces is obvious. Jodi doesn’t want to go against her mother’s wishes. Right now, her mother is able to stay for short periods of time by herself. Jodi has finally (over much worry about how her mother would take the change) gotten Homecare Health Services to come in three days a week to stay with Ione for a few hours a day. When she went to an overnight tournament, one of her adopted “sisters” came to stay with Ione, or Jodi would never have been able to go. Her life revolves around her mother’s care. There are good days where Ione is content, but the bad days are hard to take. Ione has hallucinations. It started with a “woman” in the house. Not a nice woman. On a bad day Jodi listens to her mother argue and yell at this “woman” all day long. “Go on! Get out of here! Why don’t you leave me alone!?” she says. “I don’t want you here!” There is not a thing that Jodi can say or do to make this “person” go away.
an is arguing with Ione all over again. Jodi doesn’t understand how she can have a conversation with Ione, leave the room for 2 minutes, come back, and her mother doesn’t remember a word of it. Yet Ione never seems to forget about the “people” living in the house. “It was very frustrating, I was angry at first when she couldn’t remember things,” Jodi said. She finally came to the realization that her mother will never be the mother that she once had. Jodi has accepted that fact, and knows that Ione doesn’t do these things to annoy anyone. She has a problem, and she needs care. It became much less frustrating when she accepted her mother’s illness.
Support system Not only does Ione need help, Jodi needs support, too. Her five “adopted sisters” (Debby, Linda, Cindy, Annie, and Robbie) from her bowling league all help her find some fun and stress relief and help out with Ione. Jodi has gotten into working out a lot more lately and finds stress relief in that. She also found a Facebook site called “Dementia, the Journey Ahead” put out by a woman in Arizona whose husband had dementia and had passed away. The site invites people with the same problems. It’s where Jodi found out that hallucinations are common, and that some days Ione will be more agitated, while others will be wonderfully clear where you’d wonder if anything is wrong at all. It’s comforting to know she’s not alone on this journey, Jodi says. Her uncle, Harold Valleskey, lives next door with his dog, Cody. “He visits Ione every day and the dog flies into her lap looking for treats. She loves that!” states Jodi with a grin.
One day Ione said, “I have to go check on the kids.” “The kids?” Jodi asked. “How many people are living here ma?” Apparently the phantom woman has a husband and three children, all living with Jodi and Ione.
I asked Ione about Cody and she thought he had not been to visit for a while. “I think he was hit by a car,” said Ione about the dog. But Uncle Harold was out of town for the day and just hadn’t been over to visit yet. He’d be coming over a bit later.
Jodi has at one time or another told her mother that she has kicked them all out, taken them to the police station or taken them with her when she gets in her car to go to work. When Jodi comes back home, somehow that family has gotten back into the house and that evil wom-
Ione’s grandson, Josh, lives in Ohio and calls her “GG” because she didn’t care for “Great Grandma,” it sounded so old. They have a special bond and when he comes to visit he sends Jodi off to do whatever she wants, “Go ahead, I’ve got GG covered,” he says.
The reprieve that Uncle Harold, Cody and Josh have to offer is more than welcome to Jodi. She not only needs a break, she wants her mother to have the interaction with her family as her memory declines in hopes of keeping as much mental function and memory as possible. The role reversal of parent/child is prominent, as Ione occasionally calls Jodi by one of her sister’s names, or “mama.” A sense of humor in both Ione and Jodi keep them chuckling about words that Ione cannot come up with, and she blends a few words together to make up something that might fit her sentence. When frustrated with her lack of speech or memory, Jodi knows that ice cream will save the day. “She loves ice cream! Or she likes to go for a ride in the car and go out to eat. She never liked that before!”
Guardianship Getting guardianship is necessary for Jodi to make medical decisions on Ione’s behalf, care for her finances and pay her bills. She strongly recommends that if you have the opportunity, get Power of Attorney before incompetency occurs. Because they didn’t do this, Ione had to be evaluated in order for Jodi to get guardianship. “It was heart-wrenching to see the doctors ask her all of those questions that she couldn’t answer,” Jodi recalls. “She comes out to the car and says ‘I’m stupid.’ I was glad that I had my sunglasses on so she couldn’t see my tears.” More interviews with Ione had to be conducted with both the attorney ad litem and at the court. Jodi is now declared guardian of Ione, but she really wishes it would have happened sooner, it would have been so much easier on Ione.
Attorney Terry Fox
Attorney Terry Fox states that there are a number ways to assist a “ward” with control of their property and finances, as well as their health care decisions. The most common method is to utilize a General Durable Power of Attorney that appoints an agent
to control the ward’s assets and finances; and the Healthcare Power of Attorney that appoints an agent to make only health care decisions for the ward. If the ward is competent to understand a “power of appointment” (their right to appoint someone to act in their place), these documents are drafted, reviewed and executed. The Healthcare Power of Attorney is effective only when two medical doctors or a medical doctor or psychologist finds the ward to be unable to make their healthcare decisions. The General Durable Power of Attorney can be effective immediately or upon the ward’s incompetence. That decision is up to the ward. If, as in Ione’s case, neither Power of Attorney was executed prior to incompetency, someone must step in for the ward to act as guardian of the person (the health care guardian) and of their estate (the power of attorney for finances and assets), which is usually the same individual. A Guardianship is a Court supervised procedure that begins with a petition being filed on behalf of the ward due to the ward being incapable of caring for some aspect or all aspects of his/her life. The typical procedure has a guardian ad litem being appointed for the ward’s protection. A medical report is filed by a doctor, which addresses the ward’s medical and emotional condition. The guardian ad litem who protects the ward has full access to the ward, medical records and any other evidentiary material that will be presented to the court to show the ward’s incompetence. The court makes a finding regarding the ward’s competency and deals with the ward’s needs and also determines that the proposed guardian is qualified to act for the ward. Guardians need to file an annual report with the court disclosing the ward’s income, expenses and assets. Fox advises against naming multiple family members as guardians. “It’s less complicated when one guardian is chosen,” he said. “Two or more guardians requires each guardian to be involved in everything that happens in the ward’s life. Timing of signatures, bank withdrawals, transfers of properties, etc., travel from out of state, these things make it difficult with more than one guardian.” COPING WITH DEMENTIA CONTINUED ON PAGE 9
. June 2014 . 7
Crossword: FAMOUS FATHERS
ACROSS 1. “_____ your engines!” 6. Buffoon 9. Dermatologist’s concern 13. Like beaver? 14. Bearded antelope 15. Pertaining to the ear 16. Davy Crockett’s last stand 17. Campaigned 18. Modern day letter
19. *Suri’s father 21. *Kiefer’s father 23. ___ blue 24. Khaled Hosseini’s “The ____ Runner” 25. Brady Bunch daughter 28. Actress Jessica 30. Metal helmet 35. Beehive state 37. “Frasier” actress Gilpin
39. Lacy mat 40. Folk story 41. Throw something heavy 43. Seed covering 44. Quechua speakers 46. “The ____ Not Taken” 47. Greek goddess of youth 48. Half-shell delicacy 50. Joint with a cap 52. *Brady Bunch kids addressed dad this way 53. “____ the slate clean” 55. “___ Doubtfire” 57. *Namesake 60. *Sasha and Malia’s father 63. Come by without warning 64. Frigid 66. Cool & distant 68. Flip-flop 69. French for “word” 70. T in Ferrari TR 71. Actress Hathaway 72. *Widely considered father of the detective story 73. *John Jacob _____, sire to clan of multi-millionaires DOWN 1. Moses parted the Red one 2. After-bath powder 3. Culture-growing turf 4. Romulus’ brother 5. Russian triumvirate 6. Fairy tale villain 7. American Nurses Association 8. Plural of fundus 9. Wild feline 10. Face-to-face exam 11. Surprise attack 12. Building addition 15. Aeneas’ story 20. Air fairy
Fill in the blank squares in the grid, making sure that every row, column and 3-by-3 box includes all digits 1 through 9. Crossword and Sudoku solutions on page 11. 22. Pro baseball’s “Master Melvin” 24. Modern sing-along 25. *Enrique Iglesias’ father 26. Lack of muscle tension 27. Drug agents 29. Porter or IPA, e.g. 31. *Last of the pre-flood Patriarchs in the bible 32. Employees, often preceded with “new” 33. Legal excuse 34. *U.S. President with the most children 36. Furnace output 38. *This Russian father was famously terrible
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42. Swelling 45. Sweatshop activity 49. Orinoco or Grande 51. Misprints 54. Get ready for a date 56. Company department 57. *John-John’s father 58. Fairytale’s second word? 59. Common workday start 60. Information unit 61. C in COGS 62. Japanese zither 63. School organization 65. Bird word 67. Frequent partner of “away”
Providing Wound Care
COPING WITH DEMENTIA
Laura graduated as an LPN in 2005 and then as an RN in 2006 from Lakeshore Technical College in Cleveland, Wisconsin. She started her career with Extendicare Health Services as an LPN at River’s Bend Health and Rehabilitation Center where she received several promotions, each providing valuable experiences. Laura expanded her nursing skills outside of Extendicare’s centers by becoming Wound Certified from The Wound Care Institute in 2012.
Jodi Larson helps her mother, Ione, from the table after working on the puzzle. Matthew Apgar/50 Plus
CONTINUED FROM PAGE 7
With a family history of dementia, I asked Jodi if she was worried that she might take the same path as her mother. “They say it’s really not hereditary. And if I get like her I’m really not going to know the difference anyway,” she said.
Risk factors for dementia Dr. Steve Erlemeier, a neurologist at Holy Family Memorial, said there are several risk factors for dementia, including: closed head injuries; Dr. Steve Erlemeier
diabetes and anything vascular such as high blood pressure or cholesterol;
thyroid conditions; vitamin B12 and folate deficiencies; syphilis; infections; pseudo dementia (depression) where neuro transmitters are deficient; prion disease (wasting disease); and some dementias are hereditary – it is only 4 to 5 percent and depends on your DNA. Some of these are short-term and can be cured, some have a moderate duration and are occasionally curable, while others take a long time to develop and are not reversible, Erlemeier said.
Erlemeier states that loss of memory, language, temporal-spatial disorientation (loss of time or space), loss of personality, or a change in the ability to reason are all symptoms of dementia.
Laura Weber, RN, Wound Care Certified
“Age and stress related memory loss is normal,” he said. “There is a processing speed that diminishes over time and it’s made up for with wisdom.”
Lisa graduated as an LPN in 2007 and then as an RN in 2009 from Lakeshore Technical College in Cleveland, Wisconsin. She started her career with Extendicare Health Services, and at River’s Bend Health and Rehabilitation Center in 2012 as Unit Manager. Lisa has also enjoyed the opportunity to expand her nursing skills outside of Extendicare’s centers by becoming Wound Certified from The Wound Care Institute in 2013.
The first sign of dementia is a change in memory that is out of proportion to normal aging. “Dementias that are treatable are thyroid, B12, Folate, depression. Also, keeping the brain active is helpful,” states Erlemeier. He suggests crossword puzzles, keeping socially interactive and in particular to use support groups which has been shown to allow patients more longevity in these illness patterns. Websites like Luminosity.com are helpful to stimulate the brain
Lisa Oney, RN, Wound Care Certified Let River’s Bend Health and Rehabilitation Center be your choice for wound care management.
Erlemeier suggests that a plant based diet is best, and to add in some exercise.
For more information about our Wound Care Services or tour our center and meet the Wound Care team, please contact us at:
For now it seems that Jodi and Ione really enjoy each other’s company and are best right where they are. When asked: “When is it time for a nursing home?” Jodi replied “When she doesn’t know who I am anymore or if she is capable of harming herself.”
I asked Jodi if there was anything else I could add to the story and she really wanted me to make sure her mother was seen in a good light. ... helping people live better
“It’s not all bad, we laugh all the time,” she said.
960 S. Rapids Road • Manitowoc, WI 54220 920.684.1144 • www.riversbendskillednursing.com
Jodi’s strong, protective instinct reminded me of a mother protecting her own child. WI-5001798177
. June 2014 . 9
No ‘Magic Pill’ for a good night’s sleep health By Katie Schroeder As a community pharmacist, one of the most common questions I get is, “What can I take to get a good night’s sleep?” Unfortunately, there is no magic pill to help my patients fall asleep, stay asleep and wake up completely refreshed. Although older adults need the same amount of sleep as younger adults, older adults can experience changes in their sleep patterns. Oftentimes, older adults take longer to fall asleep and wake up more frequently during the night. In addition, they may get less deep sleep and more light sleep than they did in their younger years. Changes in sleep patterns can make older adults feel exhausted, irritable and sleepy during the day.
One of the main reasons older adults have trouble sleeping is caused by other medical conditions. In 2009, 80 percent of older adults with four or more medical conditions reported problems sleeping! For example, uncontrolled pain can wake people up during the night, depression or anxiety can make falling asleep difficult, and breathing problems can cause sleep disruption. So sometimes the first step to improving sleep is to first control other medical conditions. Once medical conditions are well controlled, the next step is to improve your sleep hygiene. Just like having good hand hygiene prevents you from getting a cold, good sleep hygiene can prevent insomnia!
Below are 10 sleep hygiene tips you can try to improve your sleep: 1. Keep the same bedtime and wake time every day - even on weekends! This is important for setting your body’s internal clock. 2. Develop a relaxing bedtime routine. Relaxation techniques that work for some people include reading, taking a warm bath, or aromatherapy. 3. Avoid taking naps. Especially afternoon naps, these can make it more difficult to fall asleep. 4. Exercise daily. Even light exercise is better than nothing! However, avoid exercising within one hour of bedtime. 5. Create a healthy sleeping environment. Remove noise with ear plugs or white noise machines, remove light with blackout curtains or eye shades, and remove dust by cleaning weekly. 6. Sleep on a comfortable mattress and pillow. Mattresses start to lose their support after about 10 years. 7. Avoid bright light one hour before
bedtime. The bright light (including the light from television and computer screens) can make it difficult to fall asleep. 8. Avoid alcohol, tobacco and caffeine in the evening. All of these products disrupt the sleep cycle. 9. Avoid heavy meals two hours before bedtime. Heartburn can get worse when lying down. 10. If you can’t fall asleep after 20 minutes, leave the bedroom and do something relaxing until you feel tired. Only use the bedroom for sleep and sex to strengthen your body’s association between the bedroom and sleep. If improving sleep hygiene is not improving sleep, the last step to consider is medications. Many medications are not recommended for sleep in older adults because of harmful side effects. The most common over-the-counter sleep aid contains diphenhydramine (brand names include Benadryl, ZzzQuil) to help patients fall asleep. However, diphenhydramine can decrease cognition, increase the risk of a fall, and cause blurred vision. Prescriptions for benzo-
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diazepines like alprazolam, lorazepam, and clonazepam can help patients fall asleep but they have been shown to decrease cognition and increase falls. There are some patients who will need to use medications to help with sleep. Always talk with your health care provider or pharmacist before starting any new medication to make sure the benefits of taking medicine outweigh the side effects. To lower the risks of side effects, use medications at the lowest dose
for the shortest time possible to get you back into a normal sleep pattern. To my patients’ disappointment, getting a good night’s sleep can’t be cured with a “magic pill.” The good news is that treating sleep problems can be improved with simple changes to your routine. Sleep tight; don’t let the bed bugs bite! Katie Schroeder is a pharmacist at The Medicine Shoppe in Two Rivers and can be reached at (920) 794-1225.
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(born May 8, 1964) is an American actress and television director. Gilbert began her career as a child actress in the late 1960s, appearing in numerous commercials and guest starring roles on television. From 1974 to 1984, she starred as Laura Ingalls Wilder on the NBC series “Little House on the Prairie.” During the run of Little House, Gilbert appeared in several popular television films, including “The Diary of Anne Frank” and “The Miracle Worker.”
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