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Sunday, October 30, 2011

Living with

Alzheimer’s

How to improve your memory Page 5F

What’s the difference? Forgetfulness or Alzheimer’s disease? Page 6F

A special supplement to The Daily Nonpareil

Healthy living could help fight dementia Page 7F


2F Sunday, October 30, 2011

LIVING WITH ALZHEIMER’S

The Daily Nonpareil

A LOCAL WOMAN’S STORY BRAVE STRUGGLE

Disease can produce variety of symptoms In Benne Sue Davey’s case, Alzheimer’s also manifested itself with physical ailments TIM JOHNSON TJOHNSON@NONPAREILONLINE.COM

It has been said, “Alzheimer’s is not just the forgetting disease,” and that has been true of Benne Sue Davey. “Mother’s seems to have manifested itself more in physical decline, to this point,” said Judy Kilnoski, one of Davey’s 11 living children. “She started having Davey a physical decline probably six or seven years ago. It started with her ability to walk and her gait.” As she has aged, Davey, 85, has had trouble keeping her balance, she said. After Kilnoski’s father died in 1994, Davey continued to live in her own home for another 10 years, Kilnoski said. When she took on a lot of debt to fix up her house, her kids persuaded her to sell it to her son – Kilnoski’s brother – who tackled some of the expensive repairs Davey could not afford. Davey kept driving until four or five years ago when she was rear-ended, Kilnoski said. Having the car wrecked made it easier for her to stop driving. She lived with one of Kilnoski’s sisters, then another. A combination of factors brought the disease to the forefront last year, Kilnoski said. Davey had a bowel resection and some complications that made it very taxing for her. “She was in the hospital for two months because it had abscessed and everything,” she said. As they watched her recover, Kilnoski and her sisters realized Davey wasn’t the same. Once a “tournament cribbage player,” she could no longer stand to play, because it took her too long to add up the numbers, Kilnoski said. She has also experienced some mood changes. “Mother had always been a real easy-going person, and she started being impatient in situa-

tions that normally she wouldn’t,” she said. “These changes are so gradual that you don’t think of them as part of a disease process.” They decided they should have her tested, and the result was an Alzheimer’s diagnosis, Kilnoski said. Having managed her mother’s finances while she was in the hospital, she decided to continue with that. “We tried to have her stay alone, but her balance is so bad,” she said. Davey was using a walker, but was putting her weight on it – instead of just using it to steady herself, she said. For a period of time, Davey lived by herself in a house the Kilnoskis own across the street from them. “I was over there most of the day, and she still fell and cracked her head open” after Kilnoski had left, she said. “Even if I was standing right next to her, I couldn’t have prevented her from falling. I also thought isolating her like that wasn’t good for her.” Davey stayed in a nursing home temporarily to recover and receive physical therapy, and that presented an opportunity to move her into an assisted living facility, Kilnoski said. While the transition wasn’t easy, Davey has adjusted and made some new friends, she said. “At least she gets out three times a day to get her dinner,” she said. “She loves television, and she loves game shows.” She takes medication for Alzheimer’s and tries to keep her mind active, Kilnoski said. “I know she works really hard at things that stimulate

Diagram of the brain of a person with Alzheimer's disease. herself,” she said. “She reads a lot – she always did read a lot. She does all the game shows she can. She participates in some of the activities at the assisted living facility. She’s glad she doesn’t have to cook. She likes the ladies there.” Davey’s offspring have had two key factors to help them cope with it all, Kilnoski said. For one thing, they had, collectively, a good knowledge base on Alzheimer’s – she and four of her sisters are nurses or retired nurses, and they had already watched Davey’s mother go through the disease process. “If you can understand what’s going on intellectually, it makes it a little easier emotionally,” she said. And, also important, they are a close-knit family, and most of the siblings live in the OmahaCouncil Bluffs area. “We’re like our own little support group,” she said.

Programs and services As the premier source of information, support and education for those with Alzheimer’s disease and other dementias, their families and caregivers, the Alzheimer’s Association Midlands Chapter offers a broad range of programs and services including: 24/7 Helpline Community Presentations Caregiver Educational Presentations Support Groups Care Consultation Program MedicAlert Safe Return Program TrialMatch Clinical Trial Locator Dementia Care Education for Healthcare Professionals Professional Conferences and Workshops Lunch and Learn Presentations Resource Lending Library Chapter ENewsletter: “Perspectives” When you have questions about Alzheimer’s disease or other dementias, turn to us. 24/7 Helpline – 1 (800) 272.3900 Visit us online: alz.org/midlands

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LIVING WITH ALZHEIMER’S

The Daily Nonpareil

Sunday, October 30, 2011 3F

BEING EMOTIONALLY AND FINANCIALLY PREPARED

Long-term care insurance a good idea Burden can be reduced for families who have a loved one with Alzheimer’s MIKE BROWNLEE MBROWNLEE@NONPAREILONLINE.COM

If you can afford it, long-term care insurance is a great idea. And while it often ends up as a benefit for those in their golden years, the insurance is for everyone. According to the National Clearinghouse for Long-Term Care Information, 40 percent of people who receive long-term care are between the ages of 18 and 64. Among the 40 percent are those who’ve been involved in automobile and recreational accidents, or have an illnesses such as multiple sclerosis, stroke or heart attack. For those with Alzheimer’s disease, the insurance provides one less thing to worry about for family members and others charged with care. Assisted living costs can be as much as $150 per day, but long-term planning with long-term care insurance can reduce the financial burden. According to Wise Choice LTC, a long-term care insurance provider, long-term care planning is not about determining if it will or will not happen to you, but instead about finding the answer to one very important question: If I am faced with a need for long-term care services, will I be emotionally and financially prepared to handle it? That is the goal of long-term care planning, according to Wise Choice.

Long-term care insurance is a great option to help care for your loved one.

Helping the person with dementia settle financial issues One of the many services the Alzheimer’s Association Midlands Chapter provides to families struggling with a diagnosis of dementia are our Caregiver Educational Presentations. These presentations provide critical information to the caregivers both on the disease and the many legal issues they will face. Understanding money matters is especially vital for the person with dementia. Once a person is diagnosed, family and friends should help the person make financial plans. The sooner plans can begin, the more the person with dementia may be able to participate. The majority of calls we receive from caregivers involve money matters. The Alzheimer’s Association has put down the following steps to take in the planning process. ■ Involve all other people concerned as much as possible. Talk about financial and care plans, and encourage the sharing of care-giving duties. Discuss how finances might be pooled to provide necessary care. Now is the time to find the professionals you will need as well. The Alzheimer’s

Association Midlands Chapter can provide resources for professional services. On your team you will need qualified financial advisers to: ■ Identify potential financial resources ■ Identify tax deductions You should also seek an experienced elder law attorney to help: ■ Address estate planning issues ■ Prepare legal documents, especially powers of attorney for

health and finance If you cannot afford legal assistance, find out if pro bono legal aid is available in your community. You will need to plan a longterm budget now. Consider all the costs you might face now and in the future. Look for financial resources that are available to help cover the costs throughout the course of the disease. Insurance. If you are 65 or older, the primary source of health care coverage is usually Medicare. ■ Disability insurance, either employer-paid or personal-paid. ■ Long-term care insurance may cover Alzheimer’s disease. ■ Life insurance can be a source of cash. To learn more about financial issues and care options, contact the Alzheimer’s Association Midlands Chapter office at 502-4301 in Omaha or 322-8840 in Council Bluffs or go to alz.org/caresource. There you’ll find a set of online tools and services that will help you coordinate and plan to pay for care. – Rosalie Shepherd, BS – Alzheimer’s Association Midlands Chapter

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4F Sunday, October 30, 2011

LIVING WITH ALZHEIMER’S

The Daily Nonpareil

10 WARNING SIGNS OF ALZHEIMER’S Those experiencing these symptoms are urged to seek help MEMORY CHANGES THAT DISRUPT DAILY LIFE One of the most common signs of Alzheimer’s, especially in the early stages, is forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. WHAT’S TYPICAL? Sometimes forgetting names or appointment, but remembering them later. CHALLENGES IN PLANNING OR SOLVING PROBLEMS – Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. WHAT’S TYPICAL? Making occasional errors when balancing a checkbook. DIFFICULTY COMPLETING FAMILIAR TASKS AT HOME, AT WORK OR AT LEISURE – People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. WHAT’S TYPICAL? Occasionally needing help to use the settings on a microwave or to record a television show. CONFUSION WITH TIME OR PLACE – People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how the got there. WHAT’S TYPICAL? Getting confused about the day of the week but figuring it out later. TROUBLE UNDERSTANDING VISUAL IMAGES AND SPATIAL RELATIONSHIPS – For some people, having vision problems is a sign of Alzheimer’s. They

may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not realize they are the person in the mirror. WHAT’S TYPICAL? Vision changes related to cataracts. NEW PROBLEMS WITH WORDS IN SPEAKING OR WRITING – People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a “watch” a “hand-clock”). WHAT’S TYPICAL? Sometimes having trouble finding the right word. MISPLACING THINGS AND LOSING THE ABILITY TO RETRACE STEPS – A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time. WHAT’S TYPICAL? Misplacing things from time to time, such as a pair of glasses or the remote control. DECREASED OR POOR JUDGMENT – People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. WHAT’S TYPICAL? Making a bad decision once in a while. WITHDRAWAL FROM WORK OR SOCIAL ACTIVITIES – A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to compete a favorite hobby. They may also

avoid being social because of the changes they have experienced. WHAT’S TYPICAL? Sometimes feeling weary or work, family and social obligations. CHANGES IN MOOD AND PERSONALITY – The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or at places where they are out of their comfort zone. WHAT’S TYPICAL? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

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LIVING WITH ALZHEIMER’S

The Daily Nonpareil

Sunday, October 30, 2011 5F

Exercise is beneficial in many ways, especially its effect on the memory.

How to improve your memory MCC – Everyone forgets something from time to time. Whether it’s misplacing car keys or missing a doctor’s appointment, no man or woman is immune from forgetful moments. For some men and women, however, memory loss goes beyond routine forgetfulness. Should men and women find themselves growing increasingly forgetful, there are ways to improve memory, regardless of an individual’s age. Thanks to the human brain’s ability to adapt and change, men and women can improve their memories by employing a few simple strategies and exercises. ■ Routinely get a good night’s sleep. The brain needs adequate sleep to operate at full capacity. For students, it’s important to keep in mind that without adequate sleep, the brain’s ability to solve problems or think critically is greatly compromised. Research has shown that essential memoryenhancing activity occurs during the deepest stages of sleep. Men and women both young and old can improve memory by routinely getting a good night’s sleep. ■ Exercise. Exercise is beneficial in many ways, but men and women might not know the effects routine exercise can have on memory. Exercise increases the flow of oxygen to

A healthy lifestyle is important to those suffering from Alzheimer’s the brain, which reduces the risk for disorders that can lead to memory loss. Cardiovascular exercise that increases oxygen flow to the brain can reduce risk for stroke and diabetes while simultaneously improving memory. ■ Work to reduce stress. Stress is harmful in a number of ways, and memory loss is no exception. The hippocampus is a region of the brain thought to be responsible for memory. When men and women are stressed and do nothing to positively address that stress, the hippocampus is damaged, negatively affecting the brain’s ability to form new memories. Men and women can reduce stress in a number of ways, including daily exercise and eating a healthy diet. In addition, coping with stress in a healthy way, such as through exercise or even meditation, and not through unhealthy, harmful channels like consuming alcohol or overeating, can greatly improve quality of life and help improve memory as well. ■ Eat right. What you eat can also impact what you

remember. An unhealthy diet can be just as harmful to the brain as it can be to the rest of the body. While it’s best discuss any potential dietary changes with a physician first, look for foods that are not high in saturated fat. Foods high in saturated fat increase a person’s risk of dementia and make it harder for a person to concentrate and remember things. Other foods that researchers are finding to be brain-friendly are those that contain omega-3 fatty acids. Omega-3 fatty acids are especially beneficial to brain health and researchers feel might also help a person lower his or her risk for Alzheimer’s disease. Men and women can take omega-3 supplements or look for foods that are rich in omega-3 fatty acids, including fish like salmon, tuna, halibut, and trout. Men and women looking to improve memory should also start including more fruits and vegetables in their daily diets. Fruits and vegetables are loaded with antioxidants, which protect brain cells. Green vegetables like spinach and broccoli, and fruits like apricots and even watermelon are rich in antioxidants that can help men and women protect their brain cells and improve memory at the same time. Memory loss is often seen as an inevitable side effect of aging.

However, people can take several steps that improve memory and overall health at the same time. Routine exercise increases

the flow of oxygen to the brain, which can reduce the risk for disorders that lead to memory loss.

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6F Sunday, October 30, 2011

LIVING WITH ALZHEIMER’S

The Daily Nonpareil

What’s the difference? ROSALIE SHEPHERD FOR THE NONPAREIL

We’ve all forgotten a name, where we put our keys, or if we locked the front door. It’s normal to forget things once in a while. However, forgetting how to make change, use the telephone, or find your way home may be signs of a more serious memory problem. It is important to know the differences between mild forgetfulness and more serious memory problems. Memory loss is not a normal part of aging, but as we age, we accumulate so much information that it sometimes takes longer to pull it out. The Midlands Chapter, Alzheimer’s Association receives phone calls weekly from concerned individuals like Joan. Joan couldn’t find her car keys. She looked on the hook just inside the front door. They weren’t there. She searched in her purse. No luck. Finally, she found them on her desk. Yesterday, she forgot her neighbor’s name. Her memory seemed to be playing tricks on her. She was starting to worry about it. She took our advice and saw her doctor for a complete checkup. Her doctor said she was just fine, but that she should do some things to help sharpen her memory. He suggested that she learn a new skill, find a hobby, volunteer in the community, socialize with friends, exercise and eat well, and don’t drink alcohol to excess. It is true that some of us get more forgetful as we age. It may take longer to learn new things, remember familiar names and words, or find our glasses. These are usually signs of mild forgetfulness, not serious memory problems. But if you’re worried about your forgetfulness, see

your doctor. It could be a more serious memory problem, and the sooner you get a diagnosis and on treatment, the better. Serious memory problems affect your ability to carry out everyday life activities such as driving a car, shopping, or handling money. Signs of serious problems may include: ■ Asking the same questions over and over ■ Becoming lost in familiar places. ■ Unable to follow directions ■ Confusion about time, people, and places ■ Not taking care of yourself – eating poorly, not bathing, or being unsafe It is important to find out what is causing serious memory problem because some causes are treatable. Following is a list of medical conditions that can cause serious memory problems. These problems are treatable, and should go away once you receive proper treatment. ■ Severe reaction to certain medicines ■ Depression ■ Dehydration ■ Malnourishment ■ Minor head injuries ■ Thyroid problems Alzheimer’s disease is the cause of more than 70 percent of dementia cases. If you are in the early or middle stages of Alzheimer’s disease, medications can help delay the onset. Other medications can help if you are worried, depressed or have sleeping problems. However, the disease will progress, and is incurable at this time. For more information, contact Rosalie Shepherd at the Alzheimer’s Association, Midlands Chapter, (712) 322-8840 or alz.org/midlands.

Forgetfulness or Alzheimer’s disease?

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F A C T S & FIGURES Alzheimer’s Association’s 2011 Alzheimer’s disease facts and figures report many as 69,000 Iowans are living with Alzheimer’s disease. Growing impact of Alzheimer’s on families The new report reveals there 5.4 million Americans living with Alzheimer’s disease, including 69,000 Iowans shedding light on the growing impact of a disease that is the sixthleading cause of death and the only cause of death among the top 10 causes in America without a way to prevent, cure or even slow its progression.

Most caregivers are family members who take on a tremendous financial, physical and emotional burden to help care for a loved one with Alzheimer’s or a related dementia. Alzheimer’s impact on states Alzheimer’s has profound implications for future state budgets, and states must prepare now to address the multiple and complex challenges that Alzheimer’s poses to individuals, families and state governments, particularly Medicaid. Medicaid covers nursing home care and other long-term care services in the community for individuals who can no longer afford to pay for long-term care expenses. Ensuring access to Medicaid for those who need it must remain a priority for states as they deal with the escalating

Alzheimer crisis. Importance of early detection Early diagnosis allows affected people, relatives and their caregivers to plan for the future, obtain medical care to manage symptoms and optimize function, and assists Alzheimer’s families in taking steps to reduce the risk of accidents requiring further medical care. The new report explores the issue of early detection and outlines the various benefits it provides families, including access to valuable support services and resources and also helping to reduce anxiety among caregivers. The full text of the Alzheimer’s Association’s “2011 Alzheimer’s disease facts and figures” can be viewed at alz.org/midlands.

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LIVING WITH ALZHEIMER’S

The Daily Nonpareil

Sunday, October 30, 2011 7F

Healthy living could help fight dementia Healthy living could help fight dementia Many people are apprehensive about getting older because of the fear of losing their faculties. Individuals may worry that dementia could rob them of precious memories and make daily living more difficult. Many factors can contribute to the onset of dementia, and recent research notes those factors include heart disease, strokes and other serious health conditions that affect the circulatory system. But other seemingly harmless conditions can play a role, too. Maintaining a healthy lifestyle could help seniors fend off dementia. Researchers in Canada studied data on more than 7,000 survey participants who answered questions of overall health. While circulatory diseases did correlate high to dementia onset, researchers discovered additional conditions, including

Maintaining overall health is one way seniors might stave off the onset of dementias, including Alzheimer’s disease. arthritis, sinus infections, incontinence, and poor hearing, also played a role. The correlation between circulatory issues and brain function may be obvious, but

researchers aren’t exactly sure why minor health infractions could contribute to senility. Some suggest that people with the burden of health problems may not be able to successfully thwart

What is an Alzheimer’s caregiver support group all about?

O

ne of the many services the Midland Chapter provides is the caregiver support groups. What is it? A caregiver support group is a safe, non-threatening environment to discuss strategies in coping with issues of caregivers and family members of loved ones with dementia who need an empathetic ear to problemsolve. Most groups meet once a month at a community center, senior center, care facility, hospital, library or church varying from one hour to one and one-half hours long. We have two types of caregiver support groups, general and specialty. A general group consists of a facilitator (and a co-facilitator in some groups) and caregivers (spouses and family members). A specialty group includes loved ones with dementia and their caregivers. Within the specialty group, there are two categories, one designated for loved ones with dementia older than 65 (early stage), and one for loved ones with dementia younger than 65 (younger onset). In southwest Iowa, a general group meets in Sidney on the fourth Monday, 7 p.m., each month at The Ambassador, 115 Main St.; in Harlan on the second Tuesday, 9:30 a.m., each month at the Harlan Senior Center, 706 Victoria St.; in Missouri Valley on the last Tuesday, 2:30 p.m., each month at the Rand Community Senior Center, 100 S. Fourth St. (this new group started Oct. 25); in Council Bluffs on the last Tuesday, 6:30 p.m., each month at Bethany Lutheran Home, 7 Elliott St.; and one in Mills County (Glenwood) to be announced.

deterioration of the brain that comes with dementias, including Alzheimer’s disease. The World Alzheimer Report states that more than 35 million people around the world are living with Alzheimer’s disease and other types of dementia. These are largely brain-destroying illnesses that have no cure. But adults might be able to prevent or delay its onset. Placing a greater emphasis on overall health may help. According to Dr. Kenneth Rockwood, MD, a professor of geriatric medicine and neurology at Dalhousie University, in Halifax, Nova Scotia, who participated in the dementia study published in July 2011 in the journal Neurology, “the best thing people can do to stay physically healthy – and thus maintain their brains, too – is to exercise.” Other things that can be done include adopting a healthy, balanced diet and keeping the

brain active as much as possible. Here are ways to do just that. ■ Seniors can participate in low-impact exercises that promote muscle strength and flexibility. Water exercises are very good because they don’t place strain on the joints. Stretching routines, like yoga or tai chi, are also effective. Exercise plans should be discussed with a health care provider prior to starting. ■ Work with a nutritionist to develop a healthy eating plan. A healthy diet is essential to keep many diseases at bay, including diabetes, obesity, heart disease, and even to help maintain proper digestion. ■ Keep the brain active by engaging in puzzles, like crosswords or sudoku. Reading is a way to stimulate vocabulary and also keep the brain sharp. Interact with people on a daily basis and engage in conversation.

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A general group consists of a facilitator and caregivers – spouses and family members. The early stage support group (older than 65) meets in Council Bluffs on the second Wednesday, 4 p.m., each month at the American Red Cross building, 705 N. 16th St. We have more than 25 groups in the Northeast Nebraska area. Three of them are specialty ones. Two are younger onset support groups, and one early stage support group located in Omaha. If you have an interest in learning more about support groups or becoming a facilitator or cofacilitator, contact Betty K. Chin at (800) 272-3900 for details. A complete listing of support groups is available on the website at alz.org/midlands.

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The Daily Nonpareil

8F Sunday, October 30, 2011

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Living with Alzheimer's 10-30-2011