• May 28, 2012
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The Difference Between Alzheimer's Disease And Dementia

I am often asked to explain the difference between Alzheimer's Disease (AD) and Dementia. In a nutshell, dementia is a symptom, and Alzheimer's Disease is the cause. But the question deserves a much more thorough response, and Dr. Robert Stern, Director of Boston University's Alzheimer's Disease Center's Clinical Core (photo, left) provided this response to the question on their website.  

Source : Boston University's Alzheimers Disease Center and their Alzheimers' Disease Center's Bulletinboth of which are great Alzheimer's Disease resources. 

"What is the difference between Alzheimer's disease and dementia?

“Dementia” is a term that has replaced a more out-of-date word, “senility,” to refer to cognitive changes with advanced age. Dementia includes a group of symptoms, the most prominent of which is memory difficulty with additional problems in at least one other area of cognitive functioning, including language, attention, problem solving, spatial skills, judgment, planning, or organization. These cognitive problems are a noticeable change compared to the person’s cognitive functioning earlier in life and are severe enough to get in the way of normal daily living, such as social and occupational activities.

A good analogy to the term dementia is “fever.” Fever refers to an elevated temperature, indicating that a person is sick. But it does not give any information about what is causing the sickness. In the same way, dementia means that there is something wrong with a person’s brain, but it does not provide any information about what is causing the memory or cognitive difficulties. Dementia is not a disease; it is the clinical presentation or symptoms of a disease.

There are many possible causes of dementia. Some causes are reversible, such as certain thyroid conditions or vitamin deficiencies. If these underlying problems are identified and treated, then the dementia reverses and the person can return to normal functioning.

However, most causes of dementia are not reversible. Rather, they are degenerative diseases of the brain that get worse over time. The most common cause of dementia is AD, accounting for as many as 70-80% of all cases of dementia.

Approximately 5.3 million Americans currently live with AD. As people get older, the prevalence of AD increases, with approximately 50% of people age 85 and older having the disease.

It is important to note, however, that although AD is extremely common in later years of life, it is not part of normal aging. For that matter, dementia is not part of normal aging. If someone has dementia (due to whatever underlying cause), it represents an important problem in need of appropriate diagnosis and treatment by a well-trained healthcare provider who specializes in degenerative diseases.

In a nutshell, dementia is a symptom, and AD is the cause of the symptom.

When someone is told they have dementia, it means that they have significant memory problems as well as other cognitive difficulties, and that these problems are severe enough to get in the way of daily living.

Most of the time, dementia is caused by the specific brain disease, AD. However, some uncommon degenerative causes of dementia include vascular dementia (also referred to as multi-infarct dementia), frontotemporal dementia, Lewy Body disease, and chronic traumatic encephalopathy.

Contrary to what some people may think, dementia is not a less severe problem, with AD being a more severe problem. There is not a continuum with dementia on one side and AD at the extreme. Rather, there can be early or mild stages of AD, which then progress to moderate and severe stages of the disease.

One reason for the confusion about dementia and AD is that it is not possible to diagnose AD with 100% accuracy while someone is alive. Rather, AD can only truly be diagnosed after death, upon autopsy when the brain tissue is carefully examined by a specialized doctor referred to as a neuropathologist.

During life, a patient can be diagnosed with “probable AD.” This term is used by doctors and researchers to indicate that, based on the person’s symptoms, the course of the symptoms, and the results of various tests, it is very likely that the person will show pathological features of AD when the brain tissue is examined following death.

In specialty memory clinics and research programs, such as the BU ADC, the accuracy of a probable AD diagnosis can be excellent. And with the results of exciting new research, such as that being conducted at the BU ADC, the accuracy of AD diagnosis during life is getting better and better."  

  • June 06, 2012
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The Benefits Of Exercise For Alzheimer's Patients

The other day I went to visit a friend who has Alzheimer's Disease at her Assisted Living Facility. She appeared to have declined since my last visit. She was walking very slowly and tentatively, she shut her eyes several times and had to be prompted to open them, and her voice was almost inaudible.

So I went into trainer mode...we walked, climbed stairs and did chair squats for almost one and a half hours. She really perked up during my visit. Her gait and speed improved, her color got better and she was communicating much better by the time I left.  

I later spoke with her daughter who told me that she was able to have a conversation with her! Did I mention that she finished all her lunch, something I hadn't seen her do in a year?

I set out to find out why a good dose of cardiovascular exercise seemed to improve her condition, even if temporarily. As it turns out there is a huge amount of evidence to support the benefits of exercise for Alzheimer's patients. One article posted on the UK Alzheimer's Assocation explained it clearly..."Exercising together will be beneficial to the person with dementia and anyone accompanying them. Exercise burns up the adrenalin produced by stress and frustration, and produces endorphins, which can promote feeling of happiness. This will help both parties relax and increase their sense of well-being. Exercise helps develop a healthy appetite, increases energy levels and promotes a better night's sleep."

  • June 06, 2012
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When Good Herbs Have Bad Reactions

I’m sure you’ve heard this: Herbal remedies are all natural, so they must be safe.

While these ancient therapies have been known to cure - or at least help - many maladies, they can also cause serious health problems if mixed with certain prescription drugs. In other words, more is not always better.

Taking ginko to help improve your memory? Don’t mix it with anticonvulsants - it will increase your risk of seizures. And if you’re taking medicine to control your diabetes, steer clear of garlic pills or you’ll risk very low blood sugar. Even drinking aloe, touted as a cure for digestive issues, can be dangerous if you’re also on digoxin for heart problems. “Our seniors are taking a lot of prescriptions and they are often taking herbal remedies as well. But if they mix the wrong ones, it can diminish or enhance the effect of their prescriptions,” notes Wendy Blair Stephan, Health Education Coordinator at the Miami Florida Poison Information Center at Jackson Memorial Hospital/University of Miami Miller School of Medicine. “Some interactions can cause things like dizziness and when person falls they may not realize that what caused their fall was a drug interaction. We also see issues with combining garlic pills and blood thinners, where it can thin the blood too much.”

So if you aren’t sure - ask your doctor, pharmacist or contact the Poison Help Line. The helpline number (800-222-1222) is staffed 24/7 by doctors, pharmacists and nurses who are experts in poison management. “We’re here to give out information as well as help in an emergency. Seniors are the least likely to be aware of us and to know they can call for help with a medicine mistake or a question about medication safety,” she notes. “They can call and ask questions without feeling like they are challenging their physician. It’s free, confidential and we don’t put people on hold.”

For more information on drug interactions, visit Memorial Sloan Kettering's Integrative Medicine wesbiteThe University of Florida's Drug Interaction Center, or get information from the University Of Miami's Poison Control Center

  • June 25, 2012
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Introducing Ric Pertierra And Personal Protection Corp. He Makes Planning For Your Future Easier.

A bird’s natural instinct is to faithfully and diligently guard its nest. Your nest egg is just as important - and protecting it against the ravages of long term care is imperative. That’s Principal Protection Corp’s expertise. The Miami Beach-based company, a recent addition to the Seniority Matters Service Provider list, knows that since one out of every two people will need long-term care (with costs of up to $75,000 a year!) it is crucial to have a plan to pay for these expenses.

Ric Pertierra of Principal Protection Corporationis an expert in navigating all the ins and outs of the all-important pre and crisis-planning. With a focus on estate preservation and asset protection (from small to large estates), Principal Protection Corp expertly guides seniors, their families and caregivers through this daunting maze - everything from arranging finances to meeting eligibility guidelines for Florida Medicaid and Veterans Aid benefits.

As they say, there’s no time like the present to plan for the future. Principal Protection Corp offers free consultations and educational workshops. To learn more about the company, please consult its Seniority Matters Directory listing or peruse its website.

  • July 11, 2012
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Books By Mail Program Delivers

Anxious to kick back with the latest James Patterson thriller? Or escape on a rainy afternoon with a Danielle Steel tome? Perhaps listen to a captivating book on tape or watch a video?

Our libraries are brimming with enticing books, marvelous music, interesting videos and the newest books on tape - and they’re available even for those people who are physically unable to get there. Miami-Dade, Palm Beach and Broward County libraries offer a books-by-mail service for homebound readers - those with chronic illnesses, physical disabilities and frailties of age (they even offer services to facilities such as nursing homes and groups who serve the elderly). Here’s how it works: Fill out an application form (see links below for contact information), qualified applicants can then call or e-mail in their requests and they’ll be mailed to them. Those who can only read large print books due to a visual impairment can file a "Certification of Disability" form to qualify for free postage. Other Broward and Miami-Dade applicants will receive the books postage free, but have to pay return postage unless a friend, family member or caretaker can return them; Palm Beach County picks up the postage tab for its recipients. (This is for county libraries only, check with your city library for its policy). 

For more information: (click to view their websites)
  • July 11, 2012
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Here's Your Chance To SHINE

Navigating the mind-boggling maze of Medicare and Medicaid rules is daunting. But there’s help - and it’s not one of those infuriating recorded messages. The compassionate souls at SHINE volunteer their time and energy to give seniors free and unbiased information about Medicare and Medicaid - and they’ll even help them apply for Medicare and prescription drug assistance programs. They’re a great group of volunteers - and they need people like you to join them and help others.

“Volunteering for SHINE is one of the best kept secrets in Miami-Dade County! We have a great group of people and we need more because so many people are turning 65 and going on Medicare,” explains SHINE Liaison Kathy Sarmiento. You don’t need to know the ins and outs of Medicare/Medicaid - volunteers are trained by the Florida Department of Elder Affairs. And they meet once a month to learn more and have lunch at the Alliance for Aging. Volunteers counsel a minimum of five people a week via telephone or in person - and those interested can do Medicare 101 presentations in the community. Ready to SHINE? Call Kathy Sarmiento at 305-670-6500 x 270 to arrange an interview.

  • July 12, 2012
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Here's To A Long Bright Future

Longevity expert Dr. Laura Carstensen poses a thought provoking question: What are we going to do with our enhanced life spans? After all, Carstensen points out in her book, A Long Bright Future, our generation didn’t expect to live this long. We complain about not having enough time, she notes, but here’s the good news: science and technology have bestowed an extra twenty or thirty years upon us. The problem, she believes, is that too many people are convinced that old age is a time of desolation - and refuse to see the bright side of their destiny. Her mission (as a psychologist and author) is to debunk the myths and misconceptions about aging that prevent people from preparing for healthy, fulfilling and financially stable long lives. Naysayers who claim it’s all downhill after 50 will be heartened to know, she reveals, that studies show that “some abilities do not decline and some even improve .... Older people may be slower on the uptake, but in many instances their knowledge...allows them to outperform their younger counterparts.” While the 318-page book imparts important knowledge, it does so with a sense of humor. Carstensen, the founding director of the prestigious Stanford Center on Longevity, writes: “Make sure you don’t isolate yourself within a group of similarly aged people. As we age, our social networks naturally narrow to those we care for most, so make sure you prune carefully. If everyone on your speed dial went to high school when you did, you’ve pruned too far.”

She isn’t afraid to buck the system, suggesting an alternative to traditional retirement: “Instead of sending older people the message that their usefulness is over at age sixty-five, society should encourage them to continue working in the ways that best suit them. Rather than a firm cutoff age for retirement, I propose a gradual phaseout of work.”

She leaves readers with this inspiring thought: “In this country, which is expected to have more than one million centenarians by the year 2050, the challenge of reinventing very old age will be the greatest social revolution the Baby Boom generation ever faced. ... If there’s one idea you should take away from this book, it’s that there’s much to look forward to. Let’s get moving. Our revolution isn’t over yet.”

  • July 30, 2012
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Everything Is Negotiable

Have you ever bought a car without haggling over the sticker price? Or paid “asking price” for a house? While most people don’t think twice about negotiating for everything from to washing machines to garage sale discoveries, few would dare bargain when entering an independent living facility.

And that’s a big mistake, according to a story published in the Wall Street Journal in May. It notes that although the average entrance fee for a unit in a continuing-care retirement communities is $259,000, the real-estate slump has made it tougher for seniors to sell their houses and move to these communities, sparking unwanted vacancies. The story shares the experiences of financial planners who were able to wrangle everything from a golf-cart-for-life deal for a client moving to a large continuing-care retirement community to a dishwasher and a "bigger, fancier stove" for another client. Another senior was able to get a 20 percent discount on the $100,000 "refundable endowment" at a continuing-care retirement community in Orlando. It’s wise to remember the age old adage: It never hurts to ask….

For the full story, click here

  • August 03, 2012
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Massage Therapy: So Many Types---So Many Benefits

Massage therapy is one of the oldest healing arts and is found in most cultures around the world. There are so many different kinds of massage, that I will only describe some of those that are well known and widely done in the US.

  • Accupressure: uses the fingers to press on key points on the skin. When pressed, these points release muscular tension and promote blood circulation and the qi (life force energy) to assist healing. Accupressure helps to relieve headaches, sinus problems, neck, back and muscular aches, eyestrain, menstual pain, constipation and indigestion. When you have a headache and hold your head or temples, that is instinctive accupressure
  • Deep Tissue Massage: affects the sublayer of musculature and fascia. I've personally had this kind of massage and found that I was temporarily sore, but that the muscle pain disappeared quickly. According to my masseuse this is very nornal. Deep tissue massage helps with chronic muscular pain and injury rehabilitation and reduces arthritis pain.
  • Reflexology: In this form of massage, specific reflex areas of the feet, hands and ears (that happen to correspond to other parts of the body) are manipulated.  Pressure is applied to these reflex areas to stimulate the organs and to help the body to maintain it's natural balance.  Reflexology is often used to reduce pain, stimulate the circulation of blood and lymphatic fluid, and promote relaxation. 
  • Swedish Massage: perhaps the best known and most widely used in the US, the Swedish massage is designed to energize the body by increasing circulation. The massage therapist uses oil to reduce friction on the skin and applies tapping, percussive, kneading, rolling and vibrational movements. Some benefits of Swedish massage are relaxation, improved circulation and the lessening of scar tissue. 

South Florida has many terrific spas, healing centers and independent therapists. To find a therapist in your area check the Seniority Matters directory, ask your friends for a recommendation, or go to www.massagetherapy.com

Which type of Massage therapy do you think is best for you?

  • August 28, 2012
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Stay Limber!

Staying limber is so important.....and so easy! These exercises can be done before, after or even replace a workout if you're short on time.

I. Start with the head and neck

  1. Do ten slow head circles in each direction(if you become dizzy, stop).
  2. Next, turn your head from right to left 10 to 15 times.

II. Shoulders

  1. Do 15 shrugs (move your shoulders up towards the ears, then lower them).
  2. Do 15 shoulder circles in each direction. Arms are out at a 45 degree angle. Make small circles, gradually moving to larger cirles.

III. Wrists

  1. Hands at your sides, but away from the body, do 15 circles in each direction.
  2. Up and downs....flex your wrists so your fingers come towards your forearms. Next, move the fingers toward the back of the arm. Do 15 on each wrist.

IV. Hips and waist

  1. Hip circles...stand with your feet apart and knees slightly bent. Do 15 hip circles in each direction.
  2. Side to sides...standing with feet apart, move your hips from left to right 15 times.
  3. Leg swings...stand next to a counter or chair and steady yourself by holding onto that surface. Swing one leg up towards the front of your body, then back as far as you can comfortably go. Do 15 reps on both legs.

V. Ankles

  1. Ankle circles...you are still standing and holding onto the counter or chair while you make 15 circles in each direction.
  2. Up and downs...flex the feet so that your toes move toward the shin. Next point your toes toward the floor. Do 15 reps for both ankles.

Try these exercises a few times and let us know how you feel. I think you'll feel more limber!

  • September 20, 2012
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Meet Candice Brown, RN: A Certified Geriatric Care Manager And A Very Welcomed Addition To Our Provider Directory

It's no secret that I feel very strongly about Geriatric Care Managers (GCM's) and how important they can be in senior care. A previous blog post described what they do.  I am thrilled that Candice Brown, RN has joined the Seniority Matters Service Provider Directory.

Candice is an expert at navigating mazes. And that’s imperative when dealing with the daunting health care labyrinth. Her company, Brown's RN's And Geriatric Care Managers, Inc., specializes in determining, planning for and monitoring the complex/chronic healthcare needs of your elderly loved ones - while keeping them safe, independent and healthy in their current residence (after all there’s no place like home). She's experienced in working with challenging, complex cases

Candice has only been part of our directory for only a few months, but already our clients are talking about professionalism, expertise and efficiency.  One couldn't believe the speed with which Candice got things going, and noted that she “certainly doesn't let grass grow under her feet."

Brown's RN's And Geriatric Care Managers, Inc. strives to cut through the red tape: An initial needs assessment is completed, then a plan is put into action. Among their duties: communicating your loved ones’ needs to their doctors, setting up home care, therapies, medical consultations, making weekly visits and helping families plan now and for the future. And just as important: reporting back and collaborating with families and the patient to come up with the best possible solutions.

After all, knowledge is power. To learn more about Brown's RN's And Geriatric Care Managers, Inc., please view her Seniority Matters Directory listing.

  • October 11, 2012
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DrugsDB.com: A Great Resource For Caregivers Who Manage Their Parents' Medications

Caregivers often ask me for suggestions about how to make sure their loved ones are getting more benefits than negative side effects from their medications. My response and one of the most important caregiving tips: is to understand the medications that your loved takes.

"Medication Management" is a critical responsibility of the caregiver.  Considering the staggering amounts of medications older adults are typically prescribed (five to twelve, often prescribed by a plethora of doctors), its a challenge to monitor side effects, interactions, and make sure they're being taken as directed.

I discovered a wonderful and free online resource a few years ago.  Drugsdb.com (db stands for database) provides information on the top 1,000 most commonly prescribed drugs, including what they're prescribed for, suggested doses, side effects, and how they may interact with other commonly prescribed drugs (there's also information for Over-the-Counter-drugs).

The website has been especially popular with consumers seeking information on heart and cholesterol drugs as well as anti-despressants, notes founder and Pharmacist Kevin Clarke, who designed the site so that the content isn't overly technical or difficult to understand. And, he adds, information is updated as soon as the FDA issues a new safety alert or amends a drug's label to reflect new warnings or recommendations.

"There's a misconception that prescription drugs aren't as dangerous or addictive as illegal drugs, or that a doctor cannot prescribe something that can harm or even kill,  if used inappropriately," notes Clarke.

All the more reason to check out this website.

If you've found this article interesting, you may want to read other related posts from the Seniority Matters website.

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