Toddlers brighten up the lives of care home residents

In the sunlit front room of Hengrove Lodge residential care home, residents smile with delight as they see how many children are visiting today from the nearby Hengrove branch of Southern Links Children’s Center. 

Two-year-old Lexie-Jay makes a beeline for the home-made play-dough on the coffee table, and everyone becomes absorbed in every move the children make, many waiting in anticipation for a cuddle from their favourites.

Hannah Stopford is a community development worker at Bristol Aging Better, who are running this scheme in partnership with the children’s centre. “We wanted to do more integrational activities in the area,” she explains. “The main aim is to reduce social isolation but it’s also to set up projects that are going to last. We are working with the community to help them run these schemes and we’re also tapping into activities already going on within Bristol.

 “The visits to Hengrove Lodge run on a stay-and-play basis, so the parents bring the children along as they would in the children’s center, and we’ve set up the activities so the residents and children can enjoy them together.”

With many children’s toys brought along to the sessions, as well as art and craft activities, these stay-and-plays sessions last an hour and take place every other Wednesday.

 “Raising awareness of social isolation is key, but these visits are also having a big impact on the elderly who are suffering from dementia,” explains Lil Bowers, centre manager for Southern Links Children’s Centre. Around 850,000 people in the UK live with Alzheimer’s disease – the most common cause of dementia.

Lil says that, following a few visits, the children have started to mean a lot to the residents, who remember more and more about them each time and even ask for them by name. “It’s a real show of community spirit, and having these families visit Hengrove Lodge is vital to the work we do.”

Alex Evans carefully places her eight-month old son Charlie-Jay into the arms 95-year-old resident Dot Whittingham, who coos over him, a picture of happiness. “From the moment Dot’s cuddling Charlie-Jay, she alters,” comments Sue Hodge, deputy manager of Hengrove Lodge. “It’s an indescribable feeling watching one of our oldest residents light up with joy from cradling a child. She just loves to see him and for us that’s a wonderful thing to be a part of.”

As the session draws to a close, Josh Stanford helps his two-year-old son take off his brightly-coloured crocodile suit. “This kind of thing should definitely happen more often,” he says. “It’s a brilliant idea and it makes a lot of sense. I don’t see why this kind of amalgamation couldn’t be developed further across the city. All the residents love it and it’s good all round for everyone involved.”

SOURCE: Bristol247.com, Lily Newton Browne

Are Antipsychotics Used Appropriately for Managing Dementia?

A study reviews data on the indications for use of antipsychotics in elderly patients with dementia across four clinical settings in Canada.

Dementia is a medical condition that affects the brain and causes memory loss. It is more common for older adults. Antipsychotics are a class of medications that are mainly used to manage psychotic disorders, including schizophrenia and bipolar disorder. Symptoms expressed by psychotic disorders include mania, hallucinations, and delusions. The use of antipsychotics is not recommended in managing elderly patients with dementia, in the absence of behavioral or psychotic symptoms. The objective of the study was to evaluate the prevalence of antipsychotic medication use in this patient population.

The retrospective study was published in the journal BMC Geriatrics and included data from eight provinces and one territory in Canada. The researchers obtained their data from four different clinical settings. These include complex continuing care hospitals (CCC), patients in acute care hospitals who no longer required an acute care bed (otherwise known as Alternate Level of Care or ALC), long-term care nursing homes (LTC), and long-stay home care (HC). The researchers included data from adults with dementia, aged 65 years or older, but were unable to determine the name, dose, and duration of use of the antipsychotics administered.

The researchers reviewed behavioral and psychotic symptoms exhibited three days prior to the assessment. They also looked at antipsychotic medication administered seven days before the assessment. Behavioral symptoms reviewed include verbal abuse, physical abuse, social inappropriateness, and resisting care from the caregiver. Psychotic symptoms reviewed include hallucinations and delusions.The results of the analysis show that the use of antipsychotics was most common in elderly patients exhibiting both behavioral and psychotic symptoms. In the absence of behavioral and psychotic symptoms, antipsychotic use was most common in the alternate level of care setting at 32%. The long-term care setting was the second most common at 29%, followed by complex continuing care hospitals (20%) and home care(12%).

It is unclear whether the patients with no behavioral and/or psychotic symptoms had a psychotic disorder diagnosis. A prior diagnosis would explain the need for the medication. While the results of the study indicate the possible over-use of this drug class in elderly patients with dementia, more information is required. The higher prevalence of antipsychotic use in institutions indicates that staff education in managing uncomfortable behavior in elderly patients might be beneficial.

Antipsychotics, as with all other drug classes, should be used only as indicated except when appropriately used for off-label purposes. Elderly patients are more sensitive to medications and it is important to avoid exposing them to the risk of medication side effects when possible.

SOURCE: Medical News Bulletin, Anuolu, Bank-Oni

Dementia ravaged David Cassidy – and its going to devastate the world

David Cassidy, a teen idol from the 1970s and one of the stars of the hit television show the “Partridge Family,” died Tuesday, after suffering from a disease expected to afflict over 100 million people in the next three decades: dementia.

The 67-year-old performer, who died from organ failure in a hospital surrounded by family and friends, first revealed he had dementia earlier this year after falling on stage and forgetting the lyrics mid-performance. Some critics incorrectly assumed he was intoxicated. Soon after, he retired. His mother and his grandfather had dementia, and he said during an interview with Dr. Phil earlier this year, “A part of me always knew this was coming.”

Dementia is a neurological illness that affects the mind and memory, and it can affect a person’s ability to perform everyday tasks. There are numerous types of dementia, including Alzheimer’s disease, Parkinson’s disease and Huntington’s disease, according to the Alzheimer’s Association.

More than 47 million people worldwide have dementia, with about 10 million new cases every year. The number of people with dementia is expected to rise to 75 million in 2030 and 132 million by 2050, according to the World Health Organization.

It’s also expensive — it costs $215 billion a year to care for dementia patients, according to the National Institute on Aging, more than double what it costs overall to care for patients with heart disease and almost three times as much for patients with cancer.

People normally don’t detect dementia until years after the disease has developed, but researchers are working on diagnosing it earlier, said Luigi Ferrucci, scientific director of the National Institute of Aging. Although it appears more prevalent in older people, there is a rise of early-onset dementia among those younger than 65, according to research by Bournemouth University.

Some theories behind the rise in dementia cases, aside from the more obvious knock-on effects of an ageing population, include air pollution and the growth of insecticides. Additionally, people who have dementia end up living longer now, Ferrucci said, and some form of dementia is more likely to show the longer people live.

Telltale early signs of dementia include forgetfulness, losing track of time and becoming lost in familiar places, according to the World Health Organization. As the disease progresses, the patient will also become forgetful of recent events and people’s names, and eventually need help with personal care. The late stage of dementia means the patient is completely unaware of the time and place, does not recognize relatives and friends and has trouble walking.

There’s good news: More than a third of dementia cases may be preventable, by controlling nine lifestyle factors, which include not smoking, lowering high blood pressure, maintaining a healthy weight and managing midlife hearing loss, according to a report presented at the Alzheimer’s Association International Conference last summer.

Brain exercises haven’t been proven as successful, but learning new skills has, as well as following a Mediterranean diet which could prevent or even slow down dementia, particularly Alzheimer’s disease, said Kim Gerecke, director of the neuroscience program at Rhodes College in Memphis. Practicing two and a half hours of moderate exercise per week also helps, according to the Centers for Disease Control and Prevention.

SOURCE: New York Post, Alessandra Malito

The truth about who really picks up the tab for care home provision

Your article (Soaring care home costs mean you now pay £34,000 a year, 18 November) fails to give an accurate account of the financial obligations of self-funders. This happens all too often across the media. 

Local authorities do not “pick up the tab” when a person’s assets fall to £23,250. In fact, LAs continue to take £1 per £250 on a sliding scale until a person’s assets reach £14,250. At this point a care home resident is allowed to hold on to the remaining sum. However, their contributions do not end there as a council will claw back any pensions, state or private, while also expecting families to pay top-up fees. 

My mother has severe dementia and has been in a nursing home for over four years and has paid over £250,000, having been compelled to sell her two-bedroom flat and use her savings.

One of the major problems is the privatisation of care homes as there is no limit to what they can charge a self-funder when demand is so high. This inevitably means that a person’s resources diminish quickly and then the LA has to step in.

 A few years ago I became aware of newspaper advertisements around the world encouraginge people to invest in UK care homes as they’d be assured of a 8% return on their stake. 

Yes, there is a compelling need for a concrete plan on the future of social care, but it must re-examine the whole structure on which provision is founded. Our elderly must not be treated as mere commodities but with the dignity and fairness they deserve.

SOURCE:The Guardian, Diane Wall

Care homes to take in lonely, older people for free over Christmas

While the Christmas build-up is a time of excitement for many, for the thousands of older people living alone, it signals a countdown to the time of year when feelings of isolation and anxiety can be at their greatest.

As part of its annual Companionship at Christmas campaign, care homes belonging to Abbeyfield Society will open their doors for six weeks to provide overnight stays, meals and entertainment for people affected by loneliness, completely free of charge.

With an estimated 500,000 older people expected to spend Christmas alone, Abbeyfield chief executive, David McCullough, said: “The Christmas build up resonates with excitement and celebration for many of us, yet it’s a time when older people can feel at their most isolated and alone. Their usual clubs or activities close down for Christmas, relatives are dotted across the UK far away from them and feelings of bereavement for lost loved ones is amplified at a time when families traditionally come together.

“Abbeyfield was founded over 60 years ago in response to the crippling loneliness endured by a forgotten generation of older people. That ethos continues today with campaigns such as Companionship at Christmas as Abbeyfield continues to enrich the lives of older people and make their later years happy, easy and more fulfilled.”

Now in its eighth year, Companionship at Christmas has offered a lifeline of warmth and friendship to thousands of older people at Christmas, such as 83-year-old Ron Hoverd, who lives on the Isle of Wight.

The former RAF corporal and his wife, Mary, were inseparable during their 45-years of marriage but her death left him devastated and struggling to cope.

Ron said: “I couldn’t have had a better woman which made losing her so difficult. I watched her die, which was heart-breaking. After the funeral I reached rock bottom and was struggling to get by. I was so lonely. Everything was so quiet.”

For Ron, who has no immediate family, Christmas was one of the most difficult times. “There’s nothing worse than being on your own at Christmas,” he said. “You know you’re supposed to be enjoying yourself, but you’re sat there by yourself, wishing the day would end.”

Age UK put Ron in touch with his local Abbeyfield House in Cowes, where staff invited him to join them for Christmas Day lunch, and since then, he has become a regular at Abbeyfield Clifton House.

“It’s a lifesaver from my point of view,” he said. “It means so much having Abbeyfield there.”

Abbeyfield patron Aled Jones will be bringing Christmas cheer to the charity’s Victoria House in South West London on 27 November, where he will be supporting the campaign with a Christmas singalong for residents. The popular singer and presenter will also be helping to carve the turkey at a Christmas lunch on 28 November at The Kingslodge Inn, County Durham.

He said: “I’m very much looking forward to sharing an early Christmas with Abbeyfield residents and getting into the Christmas spirit! Christmas is a time of love and sharing and no one should be alone at Christmas.”

SOURCE: carehome.co.uk, Melissa McAlees

Specialist care home deemed inadequate in damning report after inspectors visit five times in three months

A specialist dementia care home has been deemed inadequate in a damning report after a series of inspections.

Inspectors from the care watchdog the Care Quality Commission visited the home five times in the past three months.

A report from the CQC deemed Allison House, part of Cleveland Alzheimer’s Residential Care Limited, to be inadequate or to require improvement in all areas of assessment.

The single story, purpose-built home on Fudan Way, Thornaby , has the capacity to care for up to 38 people living with dementia.

Concerns were raised about:

• Infection control procedures in the home

• “Areas of malodour” being present, furniture was worn and carpets frayed

• repairs “not always undertaken in a timely manner”, with some remedial work taking up to five months

• a bathroom window with no restrictor being able to be “opened wide enough to climb through”

• residents at risk of malnutrition as their weight was not being accurately monitored

• “inadequate signage” and “poor use of colour”, meaning people with dementia were unable to navigate their way around the home independently.

• the dining experience being in need of improvement, as people were seated at dining tables for up to half an hour before receiving their meal.

Despite staff assuring inspectors mealtimes were to become staggered to combat the problem, this had not been put into place effectively.

Allison House was given an overall rating of ‘inadequate’ and has been placed into ‘special measures’ by the CQC.

Services in special measures will be kept under review and inspected again within six months, where “significant improvements” should be made.

A statement released by the home highlighted good work at the home including how staff are “caring and kind”.

It read: “The safety, well-being and happiness of those entrusted to our care is always our top priority.

“As a charitable provider of specialist dementia care for more than 25 years, Cleveland Alzheimer’s is absolutely committed to providing the best possible service we can. “We would like to reassure residents and their families that the matters raised in the CQC report are being urgently addressed through a robust, far-reaching and thorough action plan and wherever possible, have been rectified immediately. “An on-going programme of replacement for furniture, flooring and equipment is underway.

“The report acknowledges that people and their relatives are happy with the care provided at Allison House and that staff are caring and kind.

“We thank the CQC for highlighting this and other positives around the quality of care provided at the home.

SOURCE: Gazettelive, Bethany Lodge

Aging for Amateurs: Hearing loss tied to dementia

Earlier this year, a group of international experts on dementia commissioned by The Lancet, a British medical journal, to study “dementia prevention, intervention and care,” reported their findings.

Part of the report took a fresh look at risk factors for dementia and found that more than a third of our risk is likely modifiable. That is, we can do something about it, as opposed to risk controlled by genetics. Most of the modifiable risk factors have been discussed in previous columns (increasing formal education, controlling high blood pressure and diabetes, exercising regularly, avoiding obesity and smoking, treating depression adequately and being socially engaged). But the single strongest potentially modifiable risk factor in their research was a surprise to me and many others — hearing loss.

According to their calculations, 35 percent of dementia can be blamed on the nine risk factors listed above. Among those factors, more than one-fourth is linked to hearing loss. 

Why does hearing loss make dementia more likely? The mechanism for creating problems with thinking due to decreased hearing is “not yet clear," according to the authors of the report, but is probably related to adding to the “cognitive load” of a vulnerable brain. If you don’t hear well, it makes the brain work harder to try to interpret what is going on around it, increasing levels of background stress in many minute-by-minute interactions. In addition, not hearing well may lead to increased risk of social disengagement and even depression.

Certain subgroups seem more likely to develop poor hearing. Men are twice as likely as women to have hearing impairment. Years in school also seem to matter, less education is associated with hearing loss. However, noise on the job (previously associated with lower education levels in workers) didn’t seem to matter, even though very loud noise can damage hearing.

People are exposed to less noise at work than they were 30-50 years ago due to changes in regulations regarding noise on the job and an increase in white collar positions. Obesity also increases the risk for hearing loss, as does smoking and poorly controlled diabetes (but the high level of risk for dementia due to hearing loss is present even without these “co-factors”).

What can we do to protect our hearing? First, avoid very loud noises. Prolonged exposure to any noise over 85 decibels (dB), such as heavy city traffic, a busy school cafeteria or a lawn mower, can cause gradual hearing loss.

No more than 15 minutes of unprotected exposure to noise above 100dB (wood shop, snowmobile, maximum volume level of a personal listening device) is recommended.

Remember that few types of headphones shut out all or even most ambient noise, so listening to music on your iPhone or other device while mowing the lawn creates additive noise levels. Regular exposure to more than a minute of 110dB noise risks permanent hearing loss (rock concerts, ambulance sirens, jet take-offs, fireworks at close range , shotgun blasts, etc.)

If your ears ring after a noise exposure, this suggests that a least a tiny bit of permanent damage has been done to your hearing. 

What about dietary supplements? We have said before that a wide variety of fruits and vegetables (filling half our plates when we eat) is better than a load of supplements. Research suggests that folate, beta-carotene and other carotenoids, and omega-3 fats are some of the likely protective components, but there are likely many more in that half plate of fruits and vegetables. The healthy fats in a couple of servings of fish per week are also likely to help us hear better.

What about hearing aides? We don’t have research to support their use to decrease risk of dementia yet.

But we do know that effective aides can improve social interactions and make interpersonal relationships less stressful. If you are over 50 and haven’t had your hearing tested, it is probably a good idea (at your primary doctor’s office; ear, nose and throat specialist, or independent audiologist). If you prefer, another low cost screening called the National Hearing Test requires only a land line telephone and a quiet room in your home.

SOURCE: The Post and Courier, Lauren Sausser