Diamond Geriatrics

HBO Series on Alzheimers

2009-05-06T06:32:00.000-07:00

The following is from the Gilbert Guide Newsletter. If you don't subscribe to it, you might want to start.

New Light on Alzheimer’s Disease
INSIDER TIP: Caregivers can find new perspectives on the Alzheimer’s condition and treatment with an HBO-original documentary miniseries that is available to everyone.

Beginning May 10th, HBO will broadcast a new miniseries based on the accounts of those with Alzheimer’s disease and those whose lives are touched by their condition. The 4-part miniseries is the cornerstone in an overall effort to raise awareness and increase public understanding of the disease that will also involve a public awareness campaign and book. HBO is ensuring that the series can be viewed by all—even if a person does not have HBO. Cox Communications for digital cable subscribers can find it On-Demand for free. Portions of each show will appear on YouTube, iTunes, MySpace and Facebook —and the entire series will be available on HBO.com in installments beginning May 8. The series is also available for purchase. Each episode will approach Alzheimer’s disease from a different perspective:

The Memory Loss Tapes. This introductory episode presents the stories of several people with Alzheimer’s, shedding light on the disease by showing it through the unique perspective of the person living with the disease.
Grandpa, Do You Know Who I Am? Hosted by Maria Shriver and based on her book, What’s Happening to Grandpa?, this segment aims to help children and teens to cope with Alzheimer’s disease in their families and understand how it can affect their loved ones.
Caregivers. This segment presents five stories of caregivers working with seniors in various stages of the disease.
Momentum in Science. This two-part installment is the hopeful core of the series, spotlighting various clinics and laboratories to showcase the latest advances and research in Alzheimer’s treatment and the search for a cure.
The material for the miniseries is drawn from recent research, personal accounts of the disease, and a new HBO-commissioned Alzheimer’s Survey inspecting the impact of Alzheimer’s disease in America.

Refresher: HBO’s new documentary series offers new insight on Alzheimer’s disease for today’s caregivers and future generations.

Re: Prescriptions for those 80 and older are 5 times norm

2009-04-15T21:38:00.000-07:00

Below is a copy of an email I sent to the Vancouver Sun letters page, following their article on Seniors and medication use:

To the Editor:

The issue of medications and Seniors is greater than just the number who are hospitalized due to adverse reactions from multiple medications. For one, complicated medication regimes make it less likely that medications will be taken as prescribed . This is especially true for Seniors who have some cognitive impairment. They miss doses or take too many, leading to toxicity, delirium, falls, and other dangers. Many older people will cut down on medications because of the costs, they do not know about Fair Pharma-care or that they can ask for generic equivalents. Sometimes people do not understand why they are taking medications and so will stop, or stop when they feel better. Also, people will take supplements, vitamins, or other over the counter medications and not tell their physicians; not realizing that their can be serious interactions with the prescribed medications. Some things that can help:

1. Always review with a pharmacist all medications being taken and diagnoses.
2. Always ask about, and be aware of potential side effects.
3. Keep a list of medications and diagnoses, bring it when you go to a specialist, and make sure your family doctor knows about all medications you have been prescribed.
4.. If someone is having trouble remembering to take pills, medications can be bubble packed and labeled. There are also medication dispensing machines, some with verbal reminders to take medications.
5. Family members should monitor that medications are being taken correctly by reviewing with elderly relatives and actually looking at the medications.
6. There are several online websites that can be used so that consumers can see for themselves potential side effects.
7. If there are concerns about memory impairment and home functioning, have an assessment. Talk to your local health authority, hire a professional Care Manager or home support help who can help people manage at home.

Peter Silin, MSW, RSW

Amica at Arbutus Manor

2009-03-26T09:07:00.001-07:00

I had a tour of Amica at Arbutus Manor yesterday. I was very pleasantly impressed with the outlook of Andy Walker, the General Manager and the atmosphere at the Residence. I very much had a feeling that it was not just a job, but the caring came from the heart. They are doing some renovations and the completed areas are bright and calming, and there are some very nice public spaces and gardens.They have a good selection of exercise equipment, and a large room where they do exercises. Now, if they would only invite me to lunch or dinner, I could tell you how the food was.....

SIX MISTAKES BABY BOOMERS MAKEWITH THEIR FINANCES

2009-03-24T15:41:00.000-07:00

Heidi Pullem has a very interesting seminar on the

SIX MISTAKES BABY BOOMERS MAKEWITH THEIR FINANCES And How To Avoid Them

For Investors Over Age 50 Who Are Planning To Retire Or Have Already Retired
And Who Want to Avoid Costly Mistakes
Call Heidi at 604-602-7851 to book a seminar for your clients.

Topics:

# Not understanding or covering your risks
# Failing to understand the stock market
# Paying excessive taxes
# Having the wrong time horizon
# Choosing the wrong retirement income strategy
# Not taking care of your family

Heidi Pullem is a well known financial educator in Vancouver. She has
counseled government employees, teachers, health care workers,
professionals and business executives approaching retirement. Her articles
have appeared in The Vancouver Sun, Financial Forum News, Today’s
Investor, CARP Magazine, Investment Executive and Advisor.ca. Heidi is
regarded as an expert in helping baby boomers increase their assets, reduce
income taxes, create income, and take care of major risks. She is a Certified
Financial Planner, proving her expertise in investments, taxes, insurance,
and estate planning, and maintains her designation with diligent ongoing
education. She is also a member of the Estate Planning Council of
Vancouver and Advocis (Financial Advisors Association of Canada).

B.C. Association of Geriatric Care Physicians

2009-03-07T16:47:00.000-08:00

The BCAGCP just wrapped up their conference, the first after not operating for awhile. They had some excellent prresenetations on a range of subjects. One discussed the Healthy Brain programme by Dr. Steven Kirally ( www.healthybrain.org) which targets keeping the brain healthy and how one can deal with risk factors for dementia, and also increase brain power/compensate for some loss. Other presentations dealt with keeping seniors healthy and out of hospital, and getting them the best care possible. One aspect of that is total, and interdisciplinary interventions-- making sure we treat and assess the whole person. Overseen by Dr.John Sloan, this was a great comeback for the organization, and Dr. Sloan deserves great thanks for his perseverance and vision.

Helping Yourself and Your Loved One in Seniors Housing

2009-03-03T19:42:00.000-08:00

I am speaking for the North Shore Community Resources on Saturday, March 28th, a two hour lecture and workshop.

Workshop for Family Caregivers

Saturday March 28, 2009
10:30 -12:30
Capilano Mall Community Room
(up the escalator from Starbucks)
#203-935 Marine Drive
Free
To register please call
North Shore Community Resources at 604-985-7138

Half of Family Caregivers Admit Abusing Loved Ones with Dementia: Study

2009-02-09T09:49:00.000-08:00

I don't know where this article came from originally, I found it on caregivercompanion.com

Half of Family Caregivers Admit Abusing Loved Ones with Dementia: Study

Half the family caregivers surveyed admitted abusing their family member with dementia, and a third reported “significant” levels of abuse, according to a British study that surprised experts by how common the abuse was.

While most of the abuse reported was verbal in nature, some of it was physical, researchers from University College London reported in the British Medical Journal.

"Many people think about elder abuse in terms of ‘lashing out’ and other similar acts, but abuse as defined by [British] government guidelines can be as simple as shouting or swearing at the person being cared for," said the study’s lead author, Dr. Claudia Cooper of the UCL Department of Mental Health Sciences.

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Cooper said one reason that abuse was found to be so common could be that family caring for a demented loved one often do so with little or no support, heightening the stress and anxiety levels.

The UCL researchers conducted a survey of 220 family caregivers of seniors with dementia who were newly referred to psychiatric services and living at home. A total of 115 (52.3%) of the caregivers reported some abusive behavior, such as very occasionally screaming or yelling, and 74 caregivers (33.6%) reported significant levels of abuse, such as more frequent insulting or swearing at the person for whom they care. Only 1.4% reported significant physical abuse.

“We found few cases of physical or frequent abuse, although those with the most abusive behavior may have been reluctant to report it, or take part in the study in the first place," Cooper noted.

Cooper and colleagues noted that physicians too often fail to inquire about any form of abuse when examining a dementia patient or talking with the patient’s family, and in doing so are missing an opportunity to help caregiver and patient alike.

“Healthcare professionals can be reluctant to ask about abuse by family caregivers, but this attitude can be very unhelpful to caregivers who are worried about their own actions and want to talk about them and get help,” said study co-author Professor Gill Livingston. “Considering elder abuse as a spectrum of behaviors rather than an ‘all or nothing’ phenomenon could help professionals to ask about it and therefore offer assistance."

This was the first representative survey to ask family caregivers about abusive acts, according to the authors. They said the findings suggest that any policy for safeguarding vulnerable adults must consider strategies directed towards families who provide the majority of care for older people, rather than exclusively at professional caregivers, who have been the focus of concern to this point.

Over Medication of Seniors

2009-01-26T08:43:00.000-08:00

An excellent article on overmedication: http://www.prevention.com/cda/article/is-your-parent-over-medicated/f06d800cf0ffc110VgnVCM20000012281eac____/news.voices/in.the.magazine/december.2008.issue?print=true&url=http%3A%2F%2Fwww.prevention.com%2Fcda%2Farticle%2Fis-your-parent-over-medicated%2Ff06d800cf0ffc110VgnVCM20000012281eac____%2Fnews.voices%2Fin.the.magazine%2Fdecember.2008.issue

Use of Zyprexa with the Elderly

2009-01-15T09:40:00.001-08:00

Zyprexa (Olanzapine) is what is called an atypicl antipsychotic, often used off label, with the elderly who may have behavioural disturbances or dementia related psychosis. There have been warnings about this use, and now the maker, Eli Lilly is reportedly near a setlement in the U.S. concerning it's marketing of the drug. REad the story in the New York Times

http://www.nytimes.com/2009/01/15/business/15drug.html?_r=1&scp=7&sq=Zyprexa&s

And click on the link below to read about Zyprexa

http://alzheimers.about.com/od/medication/a/Olanzapine.htm

Article on Ezinearticles.com

2008-11-03T18:36:00.001-08:00

My article on Hiring Home Help For Seniors was just published on www.zinearticles.com. The direct link is http://ezinearticles.com/?id=1636419 .

Elderpost, my new website featuring free classifieds for seniors, caregivers, and prouct and service suppliers has gotten great feedback. It is a good place to search for, or provide anything for seniors and eldercare, or just tell people about your events .

Freedom of INformation and Fraser Health

2008-10-29T19:44:00.000-07:00

Once again, I have run into people at the Fraser Health Authority who basically do not wish to cooperate in the provision of care to our elderly. they hide behind a need for release of information: they tell me that the Freedom of Information Act prohibitis them from talking to me, even when a client has given permission. Today I called my client while their personnel were there. I told the Nurse that I wanted to speak to her , and to make sure they ask if that is all right, as she had already told me it was. Later they called and told me they could not speak to me. Meanwhile, the result of their visit was a potential gap in care because my client was feeling overwhelmed and confused. This is not the first time this has happened. The people at Fraser Health are just intellectually lazy and do not wish to figure out how to work with private practitioners. However, I bet if I were a physician they would talk to me, even though a physician is no more part of the health authority than a Geriatric Care Manager.

Caregiver Education--Free Seminar

2008-10-07T19:12:00.000-07:00

>FREE Caregiver Education Series
with a Palliative Care focus

My loved one has a serious illness.
How do I cope?

Join with others who are caring for a family member or friend with a life-limiting diagnosis. Getting information, answers and support from professionals in the field will help combat the isolation you feel and give you a chance to network with people in a similar situation.

3 Thursday evening sessions
held at
Pacific Spirit Community Health Centre
2110 West 43rd Avenue Vancouver BC

Temporary caregiver relief may be available for caregivers wishing to attend the sessions but are unable to leave the person they are caring for home alone (or unattended).

1
Thursday November 25th, 2008
6:30 – 8:30 pm

Legal and Health Care Decisions

2
Thursday, December 9th ,2008
6:30 – 8:30 pm

Community Resources
A brief overview
The Medical Picture
Have all your questions answered
by a palliative care doctor and home care nurse.

3
Thursday, December 16th, 2008
6:30 – 8:30 pm
Loss and Grief
Managing your stress
Taking care of yourSELF

For Information and Registration: Call Will Tessier at (604) 688-5161
or email: willtessier@gmail.com

Note: These 3 sessions will focus specifically on palliative care issues.If you are interested in a more extensive 6-week caregiver series, call (604) 263-7377.

HOme Safety--A Great Resource

2008-10-03T19:57:00.000-07:00

If you are looking for a great resource for reviewing safety in the home, there is a great list at the National Institue on Aging website:

http://www.nia.nih.gov/Alzheimers/Publications/homesafety.htm

Actually, the whole site has incredible information, so just go to

http://www.nia.nih.gov/

New Website: Elderpost www.Elderpost.com

2008-09-26T12:11:00.000-07:00

We are very happy to announce the launch of our new website, Elderpost, at

www.elderpost.com

Elderpost is an online marketplace for services and equipment and support and everything else regarding older people and caregiving.

People who have something to give away, or sell used can do so on elderpost.

Families and older people can find--equipment, services, housing, live in caregivers, businesses and professionals that work with older people and caregivers.

Professionals can list themselves and services--real etate, nursing, care managers, financial advisors, etc.

Providers of equipment, housing, etc, can list their housing,services, etc. on elderpost.

Listings are FREE

Second Annual Positive Aging Conference.

2008-09-21T19:39:00.000-07:00

The Second Annual Positive Aging Conference can be seen via webcase in Kelowna on Wednesday November 12th sponsored by, among others, Life Planning Matters, (wwwlifeplanningmatters.com ) Broadcast from the University of Minnesota's Centre for Spirituality and Healing, world-renowned experts and best selling-authors will address the importance of purpose and meaning in later life as well as lessons for health and longevity learned from regions around the world.

The conference will feature experts and thought leaders including Richard Leider, author of the newly published Something to Live For; Richard Bolles, author of What Colour is Your Parachute; Harry R. Moody, PhD., Director, Academic Affairs for AARP; Dan Buettner, explorer, educator and author of the Blue Zone: Lessons for Living
Longer from the People Who Live the Longest; and Joanne Disch, PhD,RN Director at the Densford International Centre for Nursing Leadership.

For more information, please see www.positiveagingconference.ca

For

Ombudsman of BC Investigation

2008-08-21T15:17:00.000-07:00

OMBUDSMAN LAUNCHES SYSTEMIC INVESTIGATION INTO SENIORS’ CARE

VICTORIA – B.C. Ombudsman Kim Carter announced today that she has launched a systemic investigation into problems with seniors’ care, including residential and assisted living facilities and home support services.

The Ombudsman’s office is already responding to more than 50 individual complaints about seniors’ care that it’s received since late June, when the Ombudsman issued a news release about her office’s role in the investigation of these types of complaints. For example, the office has received complaints about neglect in care facilities, accessibility of services, placement decisions, separation from spouses and the closure of facilities. Ms. Carter said she decided to launch the systemic investigation in response to these complaints, and after meeting with a number of seniors groups about their concerns.

“Seniors are part of a generation that had to do without and overcome adversity, so they may be less inclined to complain,” Ms. Carter said. “Some seniors may be unable to complain effectively because of their physical or mental challenges, or may be reluctant to do so because they feel vulnerable.”

The systemic investigation will examine various aspects of seniors’ care, including access to services, standards of care in facilities, and monitoring and enforcement of those standards. It will also look at how information about seniors’ care services is provided to the public and to those affected by decisions.

The Ombudsman’s mandate is to ensure that public administration in B.C. is fair, transparent and accountable. In addition to investigating individual complaints, the Ombudsman also conducts systemic investigations into complex issues and makes recommendations for improvement. The public bodies over which the Ombudsman has jurisdiction include: provincial ministries, health authorities, Crown corporations, colleges and universities, school districts and municipalities.

As part of the investigative process, the Ombudsman has posted a questionnaire about seniors’ care at www.ombudsman.bc.ca, to which the public is invited to respond in confidence. People who have a specific complaint about seniors’ care services may submit a complaint online or by calling 1-800-567-3247.

Why We Need to Monitor

2008-08-07T15:42:00.001-07:00

Had a client recently who had to have several teeth out. She lives at a very expensive care facility. The teeth were removed (ten of them). No prescriptions for any pain medication or for follow up oral care. This is a very, very cognitively impaired woman. She cannot express that she is having pain. She has a standing order for tylenol regular "if necessary." One nurse gave it to her, but she received nothing after the extraction. I went in and checked on this the day after the extraction, and had to speak to nursing and the Director of Care. It seems to me that it is pretty obvious that if you have ten teeth out, you are likely to have pain. Pain medication should have been prescribed in case she had pain. This is an example, I think, of very poor care, and very poor dental work.

Overmedication and Dementia

2008-06-24T08:04:00.000-07:00

Very good and scary article in the New York Times regarding the use of medication to control behaviour in Nursing Homes.

http://www.nytimes.com/2008/06/24/health/24deme.html?_r=2&emc=tnt&tntemail1=y&oref=slogin&oref=slogin

ALWAYS ALWAYS:
be aware of the medications your relative is on when in a care facility, or at home

know the side affects.

Make sure a proper assessment has been done to see if there are reversible causes for what looks like a non-reversible dementia

Nursing Homes and INspection Reports

2008-06-22T21:23:00.000-07:00

Thanks to the Vancouver Sun for their investigative report on incidents and care in nursing homes. They identified some serious issues, but best of all, they have listed incident reports and inspection reports for Fraser Health and Vancouver Coastal.

It is pretty amazing that this information had to be obtained through Freedom Of Information, and not just posted as a matter of course for the public. In the U.S. you can get copies of all medicare funded (which is most) facilities, and what they have done to correct deficiencies.

Be aware: It is important that people read these with a bit of care. Take note of what the actual incidents and citations were for, some facilities may have lots, but they are relatively minor. If you use them to make a decision, ask during a tour about the problems, and what they did to fix them.

Read my book, "Nursing Homes: the Family's Journey." On my website I have some tools and info about getting good care in nursing homes.

For inspections in Vancouver Coastal: http://www.canada.com/vancouversun/features/care/vcinspections.html

For inspections in Vancouver Coastal: http://www.canada.com/vancouversun/features/care/vcincidents.html

For Fraser Health Complaints: http://www.canada.com/vancouversun/features/care/complaints.html

For Fraser Health and Coast Garibaldi inspections: http://www.canada.com/vancouversun/features/care/fcginspections.html

For Fraser Health and Coast Garibaldi incidents: http://www.canada.com/vancouversun/features/care/fcgincidents.html

Alzheimers as a leading cause of death

2008-06-15T17:10:00.000-07:00

This factoid from the Alzheimer's Association:

" The Centers for Disease Control and Prevention (CDC) National Center for Health Statistics today reported that Alzheimer's disease has surpassed diabetes as a leading cause of death. Alzheimer's is now the sixth-leading cause of death in the United States."

What do we know about keeping our brains healthy: well, many things, actually, but a couple basics.

1. Exercise
2. Social interaction

Personally, I am optimistic that within ten years there will be huge advances in our treatment of Alzheimer's Disease. The impact of this treatment will be enormous. The major one is that it means that many, many older people will have more choice about where they live the last years of their lives. It also means that there will be considerably less spending on older people than is currently projected, because of decreased needs for caregivers, care facilites.

And unfortunately for yours truly, less need for people like me and companies like Diamond Geriatrics.

Oh well. I always wanted to be in theatre anyway.

Bank Trusts

2008-06-02T12:54:00.001-07:00

I just had a meeting with Christie Walker at Scotiatrust. She is one of the people who manage people's things when they aren't able to or takes over from families when they feel overloaded. Often people see private banking or trust companies as just an expensive luxury. But they have their place--they can take the stress out of busy family members, and they can take the conflict out of family relationships. They can help restore trust between family members. For long distance caregivers, they can be available to do the banking things that are hard to do from far away. They can protect the elderly from fraudsters and scammers. Different trust companies have different services. You can contact Christie at 604-718-7120

Emergencies in Care Facilities

2008-05-17T11:19:00.001-07:00

I recently had a client who was sent to hospital at 10:00 on Saturday night.The staff left a message on my answering service, but I did not get it till the next day. They did not call the family, who were second and third on the call list. I was outraged--the woman has a severe dementia, and would have been totally confused and anxious in a strange environment, especially one in which there is a high level of stimulation such as an emergency room.I found after doing a survey of other care facilities, that this is not an unusual policy.

I understand that for some occurences the care staff will only call the first contact and leave a message, but for something like a transfer to hospital, i do not think a message left on an answering service is sufficient.

I said to the Nursing Director at the home where this happened, "If it was your mother being sent to hospital, and they phoned you and you weren't home, would you want them to call someone else? Would you want your mother brought to emergency by herself?"

To be fair, she did tell me that the ambulance personnel had to stay with her until she was treated. So that made things a bit better. But sufficient? I don' think so.

On Music Therapy

2008-04-24T11:57:00.000-07:00

The following article link was sent to me by the author, Alpha Woodward,BMT, MMT, MTA, a wonderful music therapist here in Vancouver. She originally wrote it for Canadian Journal of Music Therapy Vol. IX, no. 1 2002

"Finding the Client in Their Environment: A Systems Approach to Music Therapy Programming," http://www.voices.no/mainissues/mi40004000156.html

Hiring Live In Caregivers

2008-04-21T17:18:00.000-07:00

I was recently interviewed for CBC Radio about Live in Caregivers. More and more, people are going to be turning to this as a means of helping their parents or themselves continue to live in their own homes as they age.

There are a number of things to consider here--cultural differences, quality and training, monitoring, the work it takes to be an employer.

People also need to be aware that the process of hiring a live in caregiver can take several months, three is not unusual. It is not a quick fix. That means, one more reason why you need to be aware of what is coming down the road.

Plan, plan, plan. Just like your mother told you.

Okay, actually, she probably said, "Eat your vegetables." But she could have said that.

Outsourcing Eldercare?

2008-04-01T21:21:00.001-07:00

Well, that is one way to think about it. Outsourcing--when there are tasks you want done, and you don't have the time, or the expertise, you hire someone. That is one way to look at Diamond Geriatrics, and Geriatric Care Management.

See our interview in the Vancouver Sun on Friday, March 28, 2008:

http://www.canada.com/vancouversun/news/story.html?id=ce689c24-20a5-4a7c-b83b-ad2f22edcbc6