Saturday, 26 November 2016

Key provider of home care to elderly or disabled has been reprimanded over missed or delayed appointments

A KEY provider of home care to the elderly or disabled has been reprimanded over missed or delayed appointments and is said to have been struggling with staffing, The Argus can reveal.

Such is the concern around Mears, contracted by Brighton and Hove City Council, that the council has stepped in to work with the company on putting extra safeguards in place.
Mears provides help with personal care, cooking, cleaning, medication or shopping to elderly or disabled people in Brighton and Hove.
But the council has told The Argus it is “aware of issues in relation to the Mears Home Care contract and are working closely with the provider on an action plan to address these concern".
There are “a number of issues relating to the delivery of care including staff retention and missed/late calls", the spokesman alleged.

He continued: “We work in close partnership with all home care providers in the city to maintain and improve standards of care for their clients, and our first priority is the safety and wellbeing of vulnerable people in the city.”
In July the Local Government Ombudsman ruled Mears had cancelled care to one woman with little or no notice and carers were unacceptably late, adding; “This is a fault causing injustice".
The ruling added that since the woman’s daughter (referred to as Miss A) complained to the Ombudsman, “there has been a further incident of care cancelled by the Care Provider with little or no notice".

“The Care Provider’s failings caused Miss A inconvenience as their carers enable her to have a break from caring for her mother,” the ombudsman added.
Following the complaint, Mears stopped providing care to the woman altogether, telling The Argus last week: "Unfortunately we found we could not provide the particular service needed. In these circumstances, we felt it better to simply say this, rather than to continue trying but not quite getting to the service level that she needs." A spokesman added they had offered to help find alternative help.
Last month an inquest was told how Mears missed a routine care appointment to Herbert Rogers, 74, on the morning of April 1, meaning he had not been seen by a carer for 24 hours when he was found semi-conscious on the floor that evening, having fallen.
He later died in hospital. His inquest has been adjourned until March.
Brighton and Hove City Council’s lead member for adult social care, Councillor Karen Barford, told the Argus Mears had been “working closely with the council to address the urgent issue of any missed / delayed calls and have put in place immediate measures to address this.”
She added: “This includes the introduction of safeguards to ensure daily handovers in each branch.”

Coun Barford said recruitment and retention of care staff was a national and local issue, which the council had addressed by making contractors pay staff the Foundation Living Wage - higher than the national living wage.

SOURCE: The Argus, Lucy Pearce

Friday, 25 November 2016

Elderly carer, 89, 'shattered' and upset by missed appointments following home care shake-up

An elderly couple have been left shattered and upset by missed appointments following a council shake-up of home care.






 Jack and Christine Harding say they had a settled routine of domicillary care at their Stoney Stanton home until Monday when Leicestershire County Council launched its new Help to Live at Home(HTLAH) scheme to switch from using 150 smaller independent care firms to a small number of larger companies.

Mrs Harding, 87, suffered a stroke last year and has needed four-times-a-day home care for help getting up, bathing, and cooking since being released from hospital.
However Mr Harding said that after the council switched his wife's care from former providers BM Care to new company Allied nobody has turned up for two crucial early morning appointments.
The 89-year-old said: "This new system has only been going for three days but for two of those nobody came to help my wife get up.

"She has had to be ready for 9am for an ambulance to take her to hospital for chemotherapy.
"I have had to get her ready myself - which I don't mind doing but I'm on my 90th year and I'm shattered.
"People did eventually turn up but not at the time we needed them.
"I can't carry on like this if they continue not to turn up.
"It has made my wife very glum.
"We had a great rapport with our last carers and really we would have like to have stuck with them.
"When you call the council first thing to report the problem you can't get through to anyone.
Mr Harding added: "The council has had weeks and months to prepare for this but still it is chaos."

A county council spokeswoman said: "We are sorry that Mr and Mrs Harding have experienced problems with home care visits during the first days of the new service.
"As soon as we became aware, we raised this issue with the provider, Allied and have sought assurances that future visits will be made in time to help Mrs Harding get ready for her appointments.
"If anyone has concerns about their home care, we would encourage them to call the county council on 0116 305 0004."
The launch of HTLAH has been dogged with difficulties after one of the nine larger firms that signed a contract to take on the work of the 150 independent companies.
TLC Homecare backed out days before the launch of the new scheme went live leaving council bossing begging the former providers to continue with their scrapped contracts while recruiting staff from other council departments to plug any gaps in care.


SOURCE: Leicester Mercury, Dan J Martin

Tuesday, 22 November 2016

Dementia patient left DEHYDRATED: Number of complaints about adult social care rise

CARE of the elderly and dementia patients has been put under the spotlight after a report revealed complaints about care provided in people's homes rose by a quarter over the last year, while those about care homes increased by a fifth.

The Local Government Ombudsman - LGO - received 2,969 complaints and enquiries about adult social care in 2015/16, up 6 per cent on the previous year.
There was a 21 per cent rise in complaints about residential care homes, while complaints about home care rose by 25 per cent.
The LGO found themes across the complaints it received on home care, including staff failing to turn up, being late, not staying long enough or cancelling visits.
Some people received visits from too many different carers, while there was also poor record-keeping.


The ombudsman also revealed one patient with dementia ended up dehydrated because he was not given enough to drink.
The report said medical attention was then delayed because the care home had not registered him with a GP.
It added: "When the provider responded to David's daughter, who made the complaint on his behalf, the explanations about the care her father had received could not be backed up by records or other evidence.”
The report said the rising number of complaints about social care may be ‘indicative of the pressures the sector is experiencing’.

It added: "We know that there are significant and increasing pressures on all areas of adult social care, and not least the home care market.
"Problems with recruitment and retention of staff, the introduction of the national living wage, and underfunded and over-stretched services have been well documented."
The report said the complaints revealed that the quality of care delivered to people ‘often falls below the standard expected’.


"Respect for individual preferences around food and drink, what to wear and when to get up and go to bed are important to any individual and become emphasised when a person is not able to do these things independently,” the report said.


Of the 2,969 complaints received during the year, the LGO investigated 1,115 and upheld 58 per cent overall, up on 55 per cent the year before.
Dr Jane Martin, local government ombudsman, said: "Our complaints show that for people receiving care in their homes, it's often the little things that mean so much to them in maintaining their dignity, independence and a good quality of life. Consistency of care is vital to those who rely on these services.
"We recognise the sector's work signposting people to us may have had an impact on the number of complaints we received. However, we are still upholding nearly two thirds of home care complaints. This is too many.
Janet Morrison, chief executive of older people's charity Independent Age, said: "The sharp increase in complaints about adult social care is yet more evidence of a system in crisis.
"Home care is an incredibly important part of making sure that someone is able to retain their independence and stay in their own home. Inadequate home care can mean that older people lose the support they need for day-to-day tasks such as dressing or washing, and may be left to suffer in silence.
"This rise in complaints is the consequence of a care sector that is stretched to breaking point, with workforce gaps and a shortfall in funding impacting on the care many older people receive."


SOURCE: The Express, Olivia Lerche

Monday, 21 November 2016

They’re dazzling retirement homes to make you green with envy — but might (eventually) benefit us all: Care fit for a millionaire

Breakfast in bed, a spa treatment, pre-lunch cocktails and canapes, a little light shopping, a gourmet dinner, the chauffeur to take you to the opera — welcome to Chelsea Court Place, a home for people with dementia... and lots of money.
It’s a spectacular — if almost entirely unattainable — example of a growing trend for a new kind of upmarket lifestyle for the old and very wealthy.
From swish granny flats with resident medical staff to retirement homes providing bespoke care for people with dementia, retirement professionals have realised that the baby-boomer generation don’t want to give up the good things in life when they get old.

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From swish granny flats with resident medical staff to retirement homes providing bespoke care for people with dementia, retirement professionals have realised that the baby-boomer generation don’t want to give up the good things in life when they get old
And an entirely new industry is springing up to cater for those lucky enough to be able to pay for it. In Chelsea Court Place rooms cost up to £156,000 a year.
Luxury developments like these house rich retirees who are used to first-class food, wine and attentive service, and who don’t see why they should have to make compromises when they get older.

Fitted out by top interior designers and staffed by private nurses, these are places which offer a gin and tonic before lunch and a hydrotherapy treatment before dinner.
Not for them what the rest of us have to put up with for our parents or ourselves: scruffy care homes staffed by underpaid, unhappy care workers, too rushed off their feet to treat residents properly. Then there are the horror stories of neglect and abuse.
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And it’s not even as if it’s cheap — a bed in a nursing home at the lower end of the market can easily cost £40,000 a year.
But before you blanch at the notion of millionaire care, there is a glimmer of good news. Could it be that these upmarket homes may herald a new way of thinking that could benefit us all?

For now let’s take a closer look at the 15-bed Chelsea Court Place in London. Here the residents (they prefer the word ‘members’) are the sort of people used to having housekeepers and travelling the world. They are able to pay for top-notch service.
Fees range from £2,000 to £3,000 a week, depending on the size of the ensuite bedroom. You bring your own furniture (and if you like, your own interior designer). The fees include all your care — no matter how infirm you get — from experienced nurses.
The home’s award-winning chef trained at the Savoy. A typical Sunday lunch menu includes salt-baked celeriac and white truffle soup; chargrilled white asparagus and poached duck egg; aged Aberdeen Angus rib of beef; poached lemon sole; tarte tatin; and Earl Grey panna cotta.
It’s not surprising that this place resembles a five-star hotel: its founder and chairman, Laurence Geller, used to be the boss of the Hyatt Hotel group.
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He has retired and says he now owns and runs ‘a whole series of other hotels. I’ve just opened the Conrad Hotel in Chicago, the second most luxurious in the city. It’s not the most luxurious: that’s the Waldorf Astoria’. He grins: ‘I own that, too.
‘My most successful hotels have always been high luxury. If I can make Chelsea Court Place the equivalent of one of my Four Seasons hotels, I’ll be happy.’
Glamorous fixtures and fittings are important, of course, but Geller believes top-end luxury is less about expensive curtains and designer chairs (though Chelsea Court Place has plenty) and more about extraordinary service.
‘I run the sort of hotels where, if someone loses a cufflink, you ask to borrow the other one overnight while you look for it,’ he says. ‘By the morning you’ve had another one made for them.’
So, at Chelsea Court Place, if residents want a meal in the middle of the night, they can have one. If family members want to come in and see what’s going on at 3am, they’re welcome.
But can it really be right to create a two-tier system with one level of care for the super-rich and another for the rest of us?
Simon Bottery, director of policy at Independent Age, the older people’s charity is not convinced. ‘Of course, there is a place in the market for high-priced care homes but people are often paying for the facilities, and the quality of care will not necessarily increase at the same rate as the price.
‘You would expect higher priced care homes to offer staffing levels that cheaper homes might struggle to match, but you don’t need to pay thousands to get attentive, compassionate care. Some of the best homes I have visited have been some of the cheapest.’ A couple of hundred yards from Chelsea Court Place along the King’s Road is a new development, with flats starting at an astonishing £3 million — and an as-yet-undecided service charge on top.
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Auriens, set to open in 2019, promises to be spacious and contemporary, courtesy of a firm of interior designers who created the look for the flash new Beaumont Hotel in Mayfair.
‘It’s going to be a place, where you’ll be able to get whatever you need, from champagne and chauffeurs to physio and medical care,’ says co-founder Karen Mulville.
‘It will feel like hotel living. Part of the attraction is that residents can walk outside and be on the King’s Road. This generation wants to go on being part of the world, rather than shutting themselves off from it: to live as fully as they can for as long as they can.’
The general atmosphere, Mulville says, will be closer to that of a private members’ club. Residents will be able to live independently, but medical and care services will also be available when they need them. A short walk over Albert Bridge (or you could take the courtesy bus) is another, similar development, Battersea Place, where flats for the over-65s range from £650,000 to £2.95 million.


Residents can take advantage of a spa, heated indoor pool, library, billiards room, chauffeur-driven cars and concerts. And they can also make use of 30 purpose-built nursing suites for convalescence, long-term nursing or palliative care.
Not all affluent retirees want to be in the centre of the city, and the luxury later-life trend isn’t entirely modelled on hip hotels. There’s also the country house style — more rural and chintzy, but every bit as classy.
Chilton House, for example, is a Georgian manor in Buckinghamshire. It’s been in the Aubrey-Fletcher family since the 17th century and they now run it as a nursing and convalescence home.
Lady Aubrey-Fletcher is often in evidence — as is her son Harry.
Their presence adds to the Downton Abbey vibe of gracious country living. All Chilton House residents are addressed as ‘Mr’ or ‘Mrs’, —unless of course, they have a title (which some do).
After breakfast in bed, they typically meet in the front hall for coffee and conversation over the newspapers. There are exercise classes, treatments, and chauffeurs to take people out.

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After breakfast in bed, they typically meet in the front hall for coffee and conversation over the newspapers. There are exercise classes, treatments, and chauffeurs to take people out
But there’s no enforced jollity: it’s all very English. And if you want a cup of tea or a glass of bubbly, you have only to ring a bell.
Rooms cost between £1,200 and £1,600 a week. At a minimum of £62,400 a year, life at Chilton House is far from cheap. But it is closer to the average £39,300 a year for nursing home care (there are regional variations), an exorbitant figure that many of us are depressingly familiar with.
As more and more of us live for longer, very many families are facing huge bills for care and wondering about what to do ourselves when the time comes.
Pretty much anyone with assets has to pay for their own care. So do we ask our children to foot the bill? If not it’s probably a question of selling our homes and using the equity.

Even for the wealthy, care is a difficult thing to budget for. The average stay in a care home in the UK is around two-and-a-half years, but for some people it’s significantly longer.
The real problem is getting staff. Quality care requires top-quality staff, who can be hard to find in an underpaid and demoralised profession. ‘I can solve that,’ Laurence Geller says. ‘It may take a while, but we’ll get there.’
Crucially, Geller says he is determined that his high-end approach will filter down, at least to the middle classes. He may be creating a two-tier system of haves and have-nots at the moment — but he wants a much larger group to benefit from his approach.
As financial backer of the first ever MSc in Dementia Care in Britain, Geller intends to train more and better staff. The new course will launch in January at the University of West London, where he is Chancellor.
It’s fair to say that, for him, this is personal. Both his parents had dementia. Unusually, he has taken a DNA test — ‘and guess what? I have the strand’.
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He gave £1 million to dementia causes last year and he leads fundraising for the Alzheimer’s Society. ‘We have to get rid of the stigma surrounding dementia,’ he says.
‘It’s much worse in this country than in the U.S. One person gets dementia every three minutes in the UK. In the time it takes to boil an egg! Twice as many have dementia as cancer, yet cancer gets eight times the funding.’
He’s spending £50 million on Chelsea Court Place and in rolling out up to five more posh dementia care homes in London.
All very well, you might say, if you’re one of the handful of rich people who can afford the couple of grand a week.
But Laurence Geller insists what he’s learning at Chelsea Court Place will benefit everyone. He’s funding an independent study of its first year of operation and the results will be open to all.
‘It’s like fashion,’ he says, ‘what you see on the catwalks makes its way sooner or later into the shops. I believe what we learn about dementia care by doing it in the most luxurious way possible will be really useful.
‘I believe it can trickle down to the middle market and make dementia care better.’
As for me, I’d rather go up in the world as I age — now where did I put that Lottery ticket?



SOURCE: Daily Mail, Geraldine Bedell

Saturday, 19 November 2016

A care home teamed up with an animal shelter to rescue orphaned kittens

Catalina Springs Memory Care facility has teamed up with Pima Animal Care Center to do something truly wonderful.
They’ve created a new kitten-care program, which brings abandoned kittens into the care home so residents can provide them with the care they need.
This is pretty important for the kittens, FYI, as kittens separated from their mothers have a very low rate of survival unless someone steps in to provide feeding and comfort around the clock.
It’s lovely for the residents, too, as they get the joy of playing with tiny kittens. Which is brilliant.
The first kittens to join the program are Peaches and Turtle. They arrived at Pima Animal Care Center in October, weighing under 200g each.
They’ll need feedings, affection, and care – which the care home’s residents are happy to provide.

‘To some it may seem peculiar at first: Residents who are in need of around-the-clock care themselves, given the task to care for these young kittens,’ said Sharon Mercer, the Executive Director at Catalina Springs Memory Care.
‘But there are skills, emotions and needs that do not just leave a person with Dementia or Alzheimer’s.
‘The desire to give love and receive love remains.
The kittens have given us the opportunity to nurture this human condition that lies in each and every one of our residents.’
Peaches and Turtle have already nearly doubled in weight and are happy and healthy.
Once the kittens are fully grown and ready, they’ll be placed up for adoption – although given that one nurse has already applied to adopt one of the kittens involved in the program, we reckon a few may become permanent care home cats.

SOURCE: metro.co.uk, Ellen Scott

Friday, 18 November 2016

TOO MANY CARE HOMES 'SIMPLY NOT COMING UP TO SCRATCH', FORMER CARE MINISTER

There are "still dark corners" among Britain's care homes that need to be investigated to restore public confidence, a former health minister has warned.
Alistair Burt joined Tory backbencher Peter Heaton-Jones (North Devon) in demanding urgent action to address standards in Britain's care homes, amid claims too many are "simply not coming up to scratch".

Among their concerns were care homes banning families who complained about their relative's treatment - a practice dubbed "completely unacceptable" by Health Minister Nicola Blackwood.
Speaking in an adjournment debate on the issue in the Commons, Mr Burt (pictured) said: "For the great work that's done in care homes, there are still dark corners, and it's those corners that a light must be shone on.
"In order to protect families, it's essential that the sort of things that have been brought out, both by my honourable friend's campaign and what we've seen in the media the past couple of days, have got to come to an end to give the public confidence."
Mr Heaton-Jones, who led the debate, told MPs there were a growing number of cases where relatives were being banned from care homes for complaining about care.
He added: "In some cases, it has been known to lead even to the eviction of the elderly person from the home.

"Private care homes are defined in law as ultimate landlords. Quite simply, they can decide who goes on the premises, or not.


"A private care home also has the power to prevent health professionals from visiting the home. Just think about that for a moment."
MPs heard that on Wednesday, ahead of this debate, the CQC published new guidance saying care homes must keep records of such incidents.
Mr Heaton-Jones also raised concern about the proportion of care homes rated as either inadequate or requiring improvement, which accounted for around 200 of the 450 most recently inspected establishments.
He also said the CQC was more than a year behind schedule with a major inspection programme, while the complaints procedure for care homes was a "bewildering labyrinth" of different organisations.
He added: "We have a growing number of cases where care homes are simply not coming up to scratch."
In reply, Ms Blackwood said a new, tougher inspection regime had been brought in and was leading to improvements in standards.
She added that the CQC had been ambitious in its original timetable for inspections, but was now on course to complete this work by March.

As for complaints, Ms Blackwood said there was a statutory requirement for care home providers to operate a complaints system, which was enforced by the CQC.
She added: "We do know that this system is not working perfectly.
"Despite the progress we're making we still hear too many stories that highlight people's real concerns about the quality and safety in social care, and we are determined to do better.
"We also hear that those receiving care or their families can be reluctant to make a complaint for fear of consequences, especially if it's about the care home where they're living.
"Indeed, only this week there was a story on the Victoria Derbyshire Show about care homes banning relatives who make a complaint about the quality of care.
"We find this completely unacceptable. It is right that people and their families should feel able to raise concerns without fear of reprisals."

SOURCE: careappointments.co.uk, The Press Association

Wednesday, 16 November 2016

Rarer causes of dementia

There are many other diseases that can lead to dementia. These are rare: together they account for only about five per cent of all dementia. They tend to be more common among younger people with dementia (under the age of 65).
These rarer causes include alcohol-related brain damage (including Korsakoff's syndrome), corticobasal degeneration, progressive supranuclear palsy, HIV infection, Niemann-Pick disease type C, and Creutzfeldt-Jakob disease (CJD).
Some people with Parkinson's disease or Huntington's disease develop dementia as the illness gets worse. People with Down's syndrome are also at a particular risk of developing Alzheimer's disease as they get older.
Mild cognitive impairment
Some people have problems with their memory or thinking but these are not severe enough to interfere with everyday life. In this case, a doctor may diagnose mild cognitive impairment (MCI). Research shows that people with MCI have an increased risk of developing dementia; about 10-15 per cent of this group will develop dementia each year.
However, MCI can also be caused by other conditions such as anxiety, depression, physical illness and side effects of medication. Because of this, some people with MCI do not go on to develop dementia, and a small number of people will even get better.
Who gets dementia?
It is predicted there will be around 850,000 people in the UK with dementia in 2015. It mainly affects people over the age of 65 (one in 14 people in this age group have dementia), and the likelihood of developing dementia increases significantly with age. However, it can affect younger people: there are more than 40,000 people in the UK under 65 with dementia. Dementia can affect men and women.
Scientists are investigating the ways dementia might run in the family. In a very small number of people, certain types of dementia are inherited as a single gene that causes the disease, usually before age 65. A much larger number of people will inherit a combination of genes that increases or decreases their risk of developing dementia in much less direct ways.
How can I tell if I have dementia?
Becoming a bit more forgetful does not necessarily mean that you have dementia. Many people notice that their memory becomes a bit less reliable as they get older - for example they might forget someone's name. Memory loss can also be a sign of stress, depression or certain physical illnesses.
However, anyone who is worried that their memory is getting noticeably worse, or who has other symptoms such as those listed above, should discuss their concerns with the GP.
Diagnosing dementia
It is very important to get a proper assessment of problems with memory or thinking. They may be caused by a treatable condition such as depression or an infection, rather than dementia.
If the cause is dementia, a diagnosis has many benefits. It provides someone with an explanation for their symptoms, gives access to treatment, advice and support, and allows them to prepare for the future and plan ahead. Knowing the type of dementia (eg Alzheimer's disease, vascular dementia) may allow appropriate drug treatments to be offered.
Dementia will usually be diagnosed by a specialist doctor such as a psychiatrist (a mental health specialist), a geriatrician (a doctor specialising in the physical health of older people) or a neurologist (someone who concentrates on diseases of the nervous system). Occasionally a GP or specialist nurse will make the diagnosis, depending on their expertise and training.
There is no single test for dementia. A diagnosis is based on a combination of things:

  • taking a 'history' - by the doctor talking to the person and someone who knows them well about how their problems developed and how they are now affecting their daily life
  • cognitive tests of mental abilities (eg memory, thinking) - simpler tests will be carried out by a nurse or doctor, more specialist tests by a psychologist
  • physical examination and tests (eg blood tests) - to exclude other possible causes of the symptoms
  • a scan of the brain - if this is needed to make the diagnosis.

A common pattern is for the GP to make an initial assessment and then refer the person to a memory clinic or other specialist service for more detailed assessment. A specialist doctor will have more expertise in dementia and will be able to arrange more detailed tests and brain scans if needed. The diagnosis should be communicated clearly to the person and usually also those closest to them, along with a discussion about the next steps.
How is dementia treated?
The vast majority of causes of dementia cannot be cured, although research is continuing into developing drugs, vaccines and other medical treatments. There is also a lot that can be done to enable someone with dementia to live well with the condition. Care and support should be 'person-centred', valuing the person as a unique individual.
Non-drug treatments and support
A range of support, therapies and activities that don't require medication can help someone to live well with dementia. The GP, memory service or local Alzheimer's Society should be able to advise on what is available.
Support for the person and their carer after a diagnosis should give them a chance to talk things over with a specialist, ask questions about the diagnosis, and think about the future. Information should be given on where to get help if needed in the future and how to stay physically and mentally well.
Talking therapies, such as counselling, can help someone come to terms with their diagnosis. Another treatment called cognitive behavioural therapy (CBT) may be offered to help with depression or anxiety.
Cognitive rehabilitation can enable an individual to retain mental skills and raise their confidence. There is also lots that can be done at home to help someone with dementia remain independent and live well with memory loss. Support ranges from devices such as pill boxes or calendar clocks to practical tips on how to develop routines or break tasks into simpler steps.
Activities that help to keep the mind active, such as cognitive stimulation, are popular. As the condition progresses, many people with dementia enjoy reminiscence and life story work (in which the person is encouraged to share their life experiences and memories). Such activities may help improve someone's mental abilities, mood and wellbeing.
It is vital that people with dementia stay as active as they can - physically, mentally and socially. Everyone needs meaningful activities that they enjoy doing and which bring confidence and self-esteem.
Drug treatments
There are drugs that can help to improve the symptoms of dementia or that, in some cases, may stop them progressing for a while.
A person with mild to moderate Alzheimer's disease or mixed dementia may be prescribed donepezil (often known by the brand name Aricept), rivastigmine (eg Exelon) or galantamine (eg Reminyl). These may temporarily relieve memory problems and improve alertness, level of interest and daily living. In the moderate or severe stages of Alzheimer's disease someone may be offered memantine (eg Ebixa). This may help with mental abilities and daily living, and ease distressing or challenging behaviours and delusions.
Donepezil, rivastigmine and galantamine can be helpful for someone with dementia with Lewy bodies who has distressing hallucinations or delusions, or who has behaviours that challenge.
For a person with vascular dementia, drugs will be offered to treat the underlying conditions. These conditions often include high blood pressure, high cholesterol, diabetes or heart problems. Controlling these may help slow the progression of dementia.
A wide range of other drugs may be prescribed at different times for a person with dementia. These include drugs for depression or anxiety, sleeping tablets or antipsychotics. Note that some of these drugs can have severe side effects. Not all are recommended for all types of dementia. Health professionals will generally advise that a non-drug approach is tried first before prescribing medication.
Can dementia be prevented?
It is not usually possible to say for sure why a particular person has developed dementia. It is known that high blood pressure, lack of physical exercise and smoking - all of which lead to narrowing of the arteries - increase the risk of developing Alzheimer's disease and vascular dementia. There is evidence that a healthy lifestyle, especially in mid-life, can help reduce the risk of dementia. Regular physical exercise (eg cycling, brisk walking), maintaining a healthy weight, not smoking, and drinking only in moderation are all linked to a reduced risk of dementia.
It is important that conditions such as diabetes, heart problems, high blood pressure and high cholesterol are all kept under control. Getting depression treated early is also important.
A balanced diet may help to reduce risk. A balanced diet is one which is low in saturated fat, does not have too much salt, dairy or meat, and includes plenty of fish and fresh fruit and vegetables.
All these healthy lifestyle choices will also reduce the risk of other serious conditions such as stroke, heart disease and cancer.
It also seems that keeping socially and mentally active into later life may help lower the risk of dementia. Being socially active could include visiting friends or going to a place of worship, while being mentally active could include doing puzzles or reading.

SOURCE: Alzheimers Society

Tuesday, 15 November 2016

Many choices of care exist for dementia

Caregivers living with a family member or spouse already have to cope with stress as they watch their loved one’s mental acuity slowly regress to the point where it becomes a full-time job.

There comes a time when the always-painful decision must be made: do we keep those afflicted at home or do we seek professional care.
Either way, it’s costly. Housing someone with dementia can mean making physical changes to bathrooms, kitchens and perhaps purchasing walkers and other items. Placing mom or dad in an assisted living facility or nursing home can be expensive, depending on the stage of the disease and the level of care.
What’s a person to do?
Debbie Selsavage, owner and president of Coping with Dementia LLC, said there are many options, ranging from home care to assisted living facilities. Citrus County also has programs available.
Given its aging demographic, Citrus County is fortunate to have a wealth of facilities to assist the elderly. As of September 2015, there were 22 assisted living facilities and nine nursing homes, according to nonprofit health council WellFlorida Council.
Selsavage said many ALFs have sliding rates, depending on the level of care. Others have set fees and also offer memory care services, she added.
An ALF is not a nursing home. That’s a place where people go if their health gets so bad that it is beyond the scope of an ALF. Nursing homes cater to people with advanced medical issues, including moderate to severe dementia. 
An ALF is more like a home, with residents living in their own apartments. People who live in an ALF can have physical disabilities, limited mobility or a certain amount of memory loss. In fact, for people with declining health, the appeal of an ALF is having someone on staff 24-7 to assist. 
Selsavage said spouses or family members should not feel guilty when placing someone in a care facility. It comes to a point where the caregiver risks harming their own health by taking care of the dementia patient. Also, they may require more medical care than the family is able to provide.
And as dementia worsens and death nears, Hospice can be called in to either the home or ALF.
“I don’t think it’s a bad thing at all,” she said. “You’re looking at placing someone, for their own safety and care when it gets to the point where they can no longer dress them or bathe them. It’s a better quality of life for both of you to find that right place.”

Often, people will swear they never want to be placed in a care center, Selsavage said. But often there is no other choice.
While the idea of living in a large ALF with hundreds of people may seem like paradise to some, for others it may be overwhelming. For those people, smaller residences run by licensed individuals who take in a small number of folks in their own homes. In these adult group homes, mom or dad lives with the family running the place and is treated to home-cooked meals and given assistance.
Yet another option is home health care. Some people prefer to stay in the familiar confines of their home and age in place, taking visits from nurses, certified nurse assistants or therapists by appointment. Home health care works best when dementia is not an issue or when there is a primary caretaker living in the home.
Dementia is a disease that affects whole families because everyone seems to have a different treatment opinion.
“They will have conflict and they will have different ideas as to care — what is needed and what is required,” she said. “It can divide families.”
Selsavage urges caregivers to seek out support groups in Citrus County to help them through the difficult journey.
“It shows people are not alone,” she said.


SOURCE: Citrus County Chronicle, Michael D Bates

Sunday, 13 November 2016

What is dementia?

The word dementia describes a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. These changes are often small to start with, but for someone with dementia they have become severe enough to affect daily life. A person with dementia may also experience changes in their mood or behaviour.

Dementia is caused when the brain is damaged by diseases, such as Alzheimer's disease or a series of strokes. Alzheimer's disease is the most common cause of dementia but not all dementia is due to Alzheimer's. The specific symptoms that someone with dementia experiences will depend on the parts of the brain that are damaged and the disease that is causing the dementia.
Symptoms
Each person is unique and will experience dementia in their own way. The different types of dementia tend to affect people differently, especially in the early stages. How others respond to the person, and how supportive or enabling the person's surroundings are, also greatly affect how well someone can live with dementia.

A person with dementia will have cognitive symptoms (problems with thinking or memory). They will often have problems with some of the following:

  • day-to-day memory - difficulty recalling events that happened recently
  • concentrating, planning or organising - difficulties making decisions, solving problems or carrying out a sequence of tasks (eg cooking a meal)
  • language - difficulties following a conversation or finding the right word for something
  • visuospatial skills - problems judging distances (eg on stairs) and seeing objects in three dimensions
  • orientation - losing track of the day or date, or becoming confused about where they are.
  • Alzheimer's disease - This is the most common cause of dementia. Brain cells are surrounded by an abnormal protein and their internal structure is also damaged. In time, chemical connections between brain cells are lost and some cells die. Problems with day-to-day memory are often noticed first, but other symptoms may include difficulties with: finding the right words, solving problems, making decisions, or perceiving things in three dimensions.
  • Vascular dementia - If the oxygen supply to the brain is reduced because of narrowing or blockage of blood vessels, some brain cells become damaged or die. This causes vascular dementia. The symptoms can occur either suddenly following one large stroke, or over time through a series of small strokes or damage to small blood vessels deep in the brain. The symptoms of vascular dementia vary and may overlap with those of Alzheimer's disease. Many people have difficulties with problem-solving or planning, thinking quickly and concentrating. They may also have short periods when they get very confused.
  • Mixed dementia - This is when someone has more than one type of dementia, and a mixture of symptoms. It is common for someone to have Alzheimer's disease and vascular dementia together.
  • Dementia with Lewy bodies - This type of dementia involves tiny abnormal structures (Lewy bodies) developing inside brain cells. They disrupt the brain's chemistry and lead to the death of brain cells. Early symptoms can include fluctuating alertness, difficulties with judging distances and hallucinations. Day-to-day memory is usually affected less than in early Alzheimer's disease. Dementia with Lewy bodies is closely related to Parkinson's disease and often has some of the same symptoms, including difficulty with movement.
  • Frontotemporal dementia (including Pick's disease) - In frontotemporal dementia, the front and side parts of the brain are damaged over time when clumps of abnormal proteins form inside nerve cells, causing them to die. At first, changes in personality and behaviour may be the most obvious signs. Depending on where the damage is, the person may have difficulties with fluent speech or may forget the meaning of words or objects.


As well as these cognitive symptoms, a person with dementia will often have changes in their mood. For example, they may become frustrated or irritable, withdrawn, anxious, easily upset or unusually sad.
With some types of dementia, the person may see things that are not really there (visual hallucinations) or believe things that are not true (delusions).
Dementia is progressive, which means the symptoms gradually get worse over time. How quickly dementia progresses varies greatly from person to person.
As dementia progresses, the person may develop behaviours that seem unusual or out of character. These behaviours may include repetitive questioning, pacing, restlessness or agitation. They can be distressing or challenging for the person and their carer.
A person with dementia, especially in the later stages, may have physical symptoms such as muscle weakness or weight loss. Changes in sleep pattern and appetite are also common.
What causes dementia?
There are many diseases that result in dementia. The most common types of dementia are outlined below:
The symptoms of these types of dementia are often different in the early stages but become more similar in the later stages. This is because more of the brain becomes affected as the different diseases progress.
In the later stages of dementia, the person will need more and more support to carry out everyday tasks. However, many people with dementia maintain their independence and live well for years after their diagnosis. Information, advice and support are available for the person and their carer to help them live well with dementia.

SOURCE: Alzheimers Society