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Reasons to Downsize Your Home

Joseph Coupal - Monday, July 17, 2017

Spring Arbor, Greensboro, NCWhen you reach a certain age and you are beginning to think about downsizing, it is likely that you’ll have some doubts. In fact, there can be quite a few worries when thinking about downsizing.

From losing space, to having your family to stay for holiday weekends, to feeling like your home defines you, there are a lot of things to think when thinking about downsizing.

But really, you shouldn't worry - it doesn’t need to be an identity crisis.

Here is the ultimate list of why downsizing is, actually, a great idea.

If you're about to go through with it, or are in the middle of doing so, this is why you should be happy at the prospect.

You'll have less space to clean. And tidy. Does this have a downside?

It's more cost-effective. You might not have fewer bills - because you'll still, presumably, want the same services from your home - but it's likely they will be reduced, because in turn, you have reduced the size of your living accommodation.

With the size comes the added bonus of not having any space. There's no extra space for unwanted guests, and them turning up every weekend when you'd rather they weren't there. And, there is no space for unwanted junk.

Just think of the money you can save - and invest. Selling your old house could generate a whole wealth of income that you weren't expecting.

There's no expectation for you to be the host. Pained at the thought of hosting everyone and their dog during holidays? When you've downsized, you needn't worry. Someone else can do the work, and you won’t be left out of the festivities.

You have the opportunity to make a new home your own. Think of it as starting from the beginning: you can choose the location anew, the size, the everything.

Added to that, you can make your new home age-appropriate. Not enjoying walking up and down the stairs every day? Get an apartment on the first floor. Want a swimming pool for water aerobics without the gym fee? Check out senior living communities with those luxuries.

See, not scary at all. For more information on senior living communities in Greensboro, NC  contact Spring Arbor.


The Telegraph

Signs It Might Be Time for Assisted Living

Joseph Coupal - Friday, July 14, 2017

Spring Arbor, Richmond, VAThe decision to help an aging adult move out of a current home is a complex one -- both emotionally and practically. Above all, you want the person to be safe and well. How can you all feel more confident about whether circumstances suggest that your loved one should no longer be living alone?

Although every situation is different, looking at the following 11 signs will give you valuable information to help make the decision.

1. Big-picture signs it might be time for assisted living

Keep the big red flags in mind. Certain situations make it more obvious that it's wise to start thinking about alternate living arrangements.

Look for:

  • Recent accidents or close calls. Did your loved one take a fall, have a medical scare, or get in a fender bender (or worse)? Who responded and how long did it take? Accidents do happen, but as people get older, the odds rise of them happening again.
  • A slow recovery. How did the person you're caring for weather the most recent illness (for example, a flu or bad cold)? Was he or she able and willing to seek medical care when needed, or did last winter's cold develop into untreated bronchitis?
  • A chronic health condition that's worsening. Progressive problems such as COPD, dementia, and congestive heart failure can decline gradually or precipitously, but either way, their presence means your loved one will increasingly need help.
  • Increasing difficulty managing the activities of daily living (ADLs) and instrumental activities of daily living (IADLs). ADLs and IADLs are the skills needed to live independently -- dressing, shopping, cooking, doing laundry, managing medications, and so on. Doctors, social workers, and other geriatric experts evaluate them as part of a functional assessment, which is one way to get an expert's view of the situation. Difficulties with ADLs and IADLs can sometimes be remedied by bringing in more in-home help.

2. Up-close signs it might be time for assisted living

Give your loved one a big hug. Clues aren't always visible from a distance; especially when you don't see the person every day, you might learn more through touch.

Look for:

  • Noticeable weight loss. Does the person feel thinner? Are clothes loose, or has he added notches to his belt? Many conditions, from depression to cancer, can cause weight loss. A person who is having trouble getting out to shop or remembering how to cook (or to eat) can lose weight; check the fridge and watch meal-prep skills.
  • Seeming more frail. Do you feel anything "different" about the person's strength and stature when you hug? Can your loved one rise easily from a chair? Does she or he seem unsteady or unable to balance? Compare these observations to the last time you were together.
  • Noticeable weight gain. Common causes include an injury slowing the person down, diabetes, and dementia (when someone doesn't remember eating, he or she may indulge in meals and snacks all day long). Someone with money troubles may choose fewer fresh foods and more packaged goods or dried pasta and bread.
  • Strange body odor. Unfortunately, a close hug can also reveal changes in personal hygiene habits. Causes range from memory trouble to depression to other physical ailments.
  • Changes in appearance. Does the person's hair and makeup look all right? Are clothes clean? Someone known for crisply ironed shirts who's now in a stained sweatshirt may lack the dexterity for buttons or may have lost the strength for managing an ironing board and iron. A formerly clean-shaven man with an unkempt beard may be forgetting to shave (or forgetting how to shave).

3. Social signs it might be time for assisted living

Think realistically about the person's social connections. Social circles tend to shrink with age, which can have health and safety implications.

Look for:

  • Signs of active friendships. Does your loved one still get together for lunches or outings with friends or visits with neighbors, or participate in religious activities or other group events? Does he or she talk about others or keep a calendar of appointments? Lack of companionship is associated with depression and heart problems in older adults. If friends have died or moved away, moving to a place where other people are around could be lifesaving.
  • Signs that your loved one has cut back on activities and interests. Is a hobby area abandoned? Has a club membership been given up? A library card gone unused? There are many reasons people cut back, but dropping out of everything and showing interest in almost nothing is a red flag for depression.
  • Days spent without leaving the house. This sometimes happens because the person can no longer drive or is afraid to take public transportation alone and lacks a companion to come along. While many older adults fear being "locked away" in a retirement home, many such facilities offer regular outings that may keep them more mobile and active, not less.
  • Someone who checks in on a regular basis. If not you or another family member, who does this? Is your loved one willing to consider a home-safety alarm system, a personal alarm system, or a daily calling service?
  • A plan for a worst-case scenario. If there's a fire, earthquake, flood, or other disaster, is someone on standby to assist? Does your loved one understand the plan?

4. Money signs it might be time for assisted living

Riffle through the mail. Your loved one's mail can offer an often-overlooked clue to how he or she is managing money, a common early warning sign of cognitive trouble.

Look for:

  • Snowdrifts of mail in various places. Finding lots of mail scattered around raises concern about how bills, insurance, and other matters are being managed. (Piles of mail are also a potential tripping hazard.)
  • Unopened personal mail. Everybody skips junk mail, but few of us can ignore a good old-fashioned, hand-addressed letter.
  • Unopened bills. This can indicate that your loved one is having difficulty managing finances -- one of the most common first signs of dementia.
  • Letters from banks, creditors, or insurers. Routine business letters aren't worrisome. But it's alarming if they're referring to overdue payments, overdrawn balances, recent accidents, or other concerning events.
  • Thank-you messages from charities. Older adults are often vulnerable to scammers. Even those who have always been fiscally prudent are vulnerable if they're having trouble with thinking skills (a common sign of Alzheimer's disease). Some charities hit up givers over and over, and your loved one may not remember having donating the first time.
  • Lots of crisp, unread magazines. The person may unknowingly have repeat-renewal subscriptions he or she doesn't need.

5. Driving signs it might be time for assisted living

Take a drive -- with your loved one behind the wheel, if he or she is still driving. Living independently in our culture often depends on the ability to drive (or the arrangement of alternate transportation options).

Look for:

  • Nicks or dents on the car. Notice the car body as you get in and out. Damage marks can be signs of careless driving.
  • Whether the person promptly fastens his or her seatbelt. Even people with mild dementia usually follow the rote basics of driving. It's worrisome if he or she is forgetting this step.
  • "Tension, preoccupation, or being easily distracted. The person may turn off the radio, for example, or be unwilling to engage in conversation while driving. He or she may avoid certain routes, highway driving, or driving at night and in rain -- a safe kind of self-policing but also signals of changing ability.
  • Signs of dangerous driving. People whose driving ability is impaired are more likely to tailgate, drift from their lane, go below the speed limit, react slowly to lights or other cars, and mix up gas and brake pedals. See 8 ways to assess someone's driving.
  • Warning lights. Check out the dashboard as you ride along. Does the car have sufficient oil, gas, antifreeze, windshield-wiper fluid?

6. Kitchen signs it might be signs for assisted living

Go through the kitchen, from fridge to cupboards to oven. Because people spend so much time in this room, you can learn a lot.

Look for:

  • Stale or expired foods. We all buy more than we need. Look for signs that food is not only old but that this is unnoticed -- mold, sour milk that's still used, or expiration dates well past due, for example.
  • Multiples of the same item. Ten bottles of ketchup? More cereal than can be eaten in a year? Multiples often reveal that the shopper can't remember from one store trip to the next what's in stock at home.
  • A freezer full of TV dinners. Your loved one may buy them for convenience sake, but frozen dinners tend not to make healthy diet. If there's not much fresh food in the house (because it's too hard to for the person to procure or cook), your loved one might be ready to have help with meal prep or delivery services.
  • Broken appliances. Check them all: microwave, coffeemaker, toaster, washer, and dryer -- any device you know your loved one uses (or used to use) routinely.
  • Signs of fire. Are stove knobs charred? Pot bottoms singed badly (or thrown out)? Do any potholders have burned edges? Also look for a discharged fire extinguisher, smoke detectors that have been disassembled, or boxes of baking soda near the stove. Accidents happen; ask for the story behind what you see. Accidental fires are a common home danger for older adults.
  • Increased use of takeout or simpler cooking. A change in physical or mental abilities might explain a downshift to simpler recipes or food choices.

7. Around-the-house signs it might be time for assisted living

Look around the living areas. Sometimes the most obvious sign is hard to see because we become so used to it.

Look for:

  • Lots of clutter. An inability to throw anything away may be a sign of a neurological or physical issue. Obviously it's more worrisome in a neatnik than in a chronic slob. Papers or pet toys all over the floor represent a tripping hazard.
  • Signs of lax housekeeping. Spills that haven't been cleaned up are a common sign of dementia -- the person lacks the follow-through to tidy. Keep an eye out for cobwebs, bathroom mold, thick dust, or other signs of slackness. Physical limitations can mean your loved one needs housekeeping help or a living situation where this is taken care of for him or her.
  • Bathroom grime and clutter. A common scenario: Your loved one makes an effort to tidy up living areas but overlooks the bathroom. Or the guest bath is clean, but not the one the person uses all the time (the one off a bedroom, for example). Here you may see a truer picture of how your loved one is keeping up.

8. Pet-care and plant-care signs it might be time for assisted living

Be sure to check out how the other living things are faring. An ability to take care of pets and plants goes along with self-care.

Look for:

  • Plants that are dying, dead, or just gone. Most of us have seen plants go brown sometimes. Keep an eye out for chronic neglect, especially in a former plant-lover's home.
  • Animals that don't seem well tended. Common problems: dogs with long nails, cat litter boxes that haven't been changed lately, or dead fish in the fish tank. Poor grooming, overfeeding, and underfeeding are other red flags.

9. Home-maintenance signs it might be time for assisted living

Walk around the yard. Yard maintenance -- or lack of it -- can yield clues that your loved one isn't faring as well at home alone anymore.

Look for:

  • Signs of neglect. Look for discolored siding or ceilings that might indicate a leak, gutters choked with leaves, broken windows or fences, dirty windows.
  • Newspapers in the bushes. Are papers being delivered but ignored? Sometimes people pick up those they can see on a driveway but not those that go off into the yard.
  • Mail piled up in the mailbox. Go out and check -- it's an indication that your loved one doesn't even retrieve it regularly.

10. Get help looking for signs it might be time for assisted living

Get the input of others who know your loved one in order to collect a fuller picture of reality. Gently probing about what others think isn't nosy; you're being loving, concerned, and proactive.

Look for:

  • Input from those in your loved one's circle. Talk to old friends and close relatives to get their sense of how the person is faring. Listen for stories that hint that the person doesn't get out much ("She doesn't come over anymore." "She quit book club."). Pay attention to comments that indicate ongoing concerns ("Has he had that heart test yet?" "We were worried the day the ambulance came.").
  • Medical insight. With appropriate permission, your loved one's primary doctor may share your concerns about his or her patient's safety at home -- or may be able to alleviate those concerns or suggest where to get a home assessment.
  • A second opinion. A social worker or professional geriatric care manager visits older adults' homes and does informal evaluations. While your loved one may initially resist the notion of a "total stranger" checking on them, try pitching it as a professional (and neutral) second opinion, or ask the doctor to "prescribe" it. Some people wind up sharing doubts or vulnerabilities with a sympathetic, experienced stranger that they're loathe to admit to their own children or family.

11. Caregivers' signs it might be time for assisted living

Finally, realize that some of the information you collect is intangible -- it has to do with feelings and emotions, and the stress levels of everyone involved.

Look for:

  • How you're doing. While this decision to remain in one's home is not primarily about you -- the son, daughter, grandchild, caregiver -- your own exhaustion can be a good gauge of a decline in older adults' ability to care for themselves. Keeping someone at home can require lots of hands-on support or care coordination, and this is time-consuming. If your loved one's need for care is just plain wearing you out, or if a spouse or children are feeling the collective strain of your caregiving activities, these are major signs that it's time to start looking at other options.
  • Your loved one's emotional state. Safety is crucial, of course, but so is emotional well-being. If someone living alone is riddled with anxieties or increasingly lonely, then that may tip the scales toward a move not solely based on health and safety reasons.

If your loved one has a full life, a close neighborhood and community connections, and seems to be thriving, it's worth exploring as many in-home care options as possible before raising stress levels by pressing a move from a beloved home.

If, on the other hand, your loved one is showing signs that living alone is a strain, it may be time for a talk. Broach the subject of where to live in a neutral way and you may find that your loved one harbors the same fears for current and future safety and security that you do. Find out what your loved one fears most about moving and about staying before launching into your own worries and what you think ought to be done.

For more information on assisted living, contact Spring Arbor.


When is it Time for Assisted Living?

Joseph Coupal - Tuesday, July 11, 2017

Spring Arbor, Greensboro, NCWhen a loved one is diagnosed with Alzheimer's disease, it's normal for the first reaction to be: "We'll never put mom in a nursing home. We're going to take care of her at home."

That's an admirable sentiment, but it can become an unrealistic one.

No matter how great your determination or how broad your shoulders, the demands of around-the-clock care for someone with advancing dementia may eventually become more than you can provide at home.

That's when families confront one of the hardest decisions they'll ever make. Is it time to move mom into assisted living?

It's almost always an emotional decision. There's some level of emotion tied to it that can cloud the decision.

Older adults who are on five or more medications — a practice known as "polypharmacy" — may experience side effects or bad interactions that increase their risk of cognitive impairment.

Families struggle with that dilemma on a daily basis.

As families face this agonizing decision, families should go through a careful analysis of what's best for all involved, recognizing that's never an easy process.

It's important for families to know there are resources available and that in some cases, placement may be the safest and most reasonable option for their loved one. But it's hard. Really, really hard. It's a very emotional decision-making process that you have to try to put objectivity around, and that's very challenging for a family.

Part of the emotional burden is the perception of what it means to "put mom in a nursing home." In reality, there are many other options.

One of the issues with people at this stage in their life, they fear the term 'nursing home. So there has been an effort to educate people on the term 'community living.''

Community living can encompass everything from a "55 and over" residential setting to assisted living to a memory care community. Nursing care is available for those who need it. But experts say if you understand the options and do some planning in advance, it's possible for your loved one to be in the appropriate setting at every stage of the disease without ever requiring placement in a nursing home. Yet even with so many options now available, the emotional burden often causes families to put off the decision.

Experts say it's common for families to wait far too long to move someone with Alzheimer's into assisted care, when both the patient and the family would have benefited from that move having come sooner.

If people do wait it's hard to say whether their situation would have been improved.

However, families should try to consider the question early on, before they are thrown into crisis.

If you wait, your decision becomes much more rushed and pressured. If you're making decision quickly because of a crisis, it's a lot more difficult.

What are the warning signs that it may be time to consider placement? It could be that the loved one is losing weight, or is dehydrated, or not cooking anymore. It could be acts of neglect, such as not feeding a pet, or letting bills go unpaid, or a "close call," such as leaving the stove on and unattended.

There are so many factors in making this decision. For every family it's different, and it's about how their loved one is progressing. There's a very long list of signs you can look at.

For more information on assisted living and memory care, contact Spring Arbor.


Caregiver Dementia

Joseph Coupal - Tuesday, June 27, 2017

Spring Arbor, Richmond, VAFor years, we’ve read that Alzheimer’s disease is the leading cause of dementia. That’s not entirely true.

The leading cause is “caregiver dementia,” which strikes an estimated 100 million overwhelmed and stressed-out caregivers worldwide. The term was used initially in the 1980s, and while not an official medical diagnosis, it includes symptoms such as disorientation, forgetfulness and depression.

Stressful conditions produce high levels of the hormone cortisol, which, over time, may contribute to memory loss. Think about it: You’re working long hours, you see no end in sight and you’re exhausted. Who can think straight under those conditions?

A 2010 Utah study published in the Journal of the American Geriatrics Society of 1,221 couples tracked for 12 years found that seniors caring for a husband or wife with dementia had six times the risk of getting dementia as members of the general population. Surprisingly, men were most susceptible, facing double that risk.

Some Dementias Are Reversible

Even undiagnosed urinary tract infections may lead to sudden behavior changes such as confusion, agitation, withdrawal or delirium.

Medicines will also have varying effects, as we grow older. As we age, our liver and kidneys don’t work as efficiently resulting in a buildup over time of unprocessed medications. These chemicals become toxic leading to dementia symptoms or delirium.

Which leaves us with caregiver dementia.

Until caregivers are able to take proactive steps to overcome feelings of hopelessness resulting from the stress of caring for another person, they’ll continue to endure embarrassing and even scary moments.

Caregivers Will Overcome

The onset of caregiver dementia is real and it strikes primary caregivers. Those who heed the call and take action will survive.

But there’s more to being a caregiver than just surviving. We need to apply both legs of our “caring” and “giving” nature to overcome and thrive. We start with a break. As little as a five-minute respite can make all the difference. Ultimately, we’ll need help. Today, caregivers have a variety of options to choose from, including in-home and adult day care, residential care and assisted living. The only other cure is to stop caregiving, and this is not an option for many.

For more information on caring for those with Alzheimer's or Dementia, contact Spring Arbor.


US News - Health

June is Alzheimer’s & Brain Awareness Month: Know the 10 Signs

Joseph Coupal - Tuesday, June 20, 2017

June is Alzheimer’s & Brain Awareness Month, and the Alzheimer’s Association® needs you to get involved and raise awareness about Alzheimer’s disease and other dementias. Everyone who has a brain is at risk to develop Alzheimer’s, a disease that is often misunderstood. Did you know:

  • Alzheimer’s is fatal. It kills more than breast and prostate cancer combined.
  • Alzheimer’s is not normal aging. It’s a progressive brain disease without any cure.
  • Alzheimer’s is more than memory loss. It appears through a variety of signs and symptoms.

During the month of June, the Alzheimer’s Association asks you to learn more about Alzheimer’s, share your story and take action.

Know the 10 Signs - Early Detection Matters

You can help raise awareness of the truth about Alzheimer’s.

For more information on Alzheimer’s or memory care, contact Spring Arbor.


Memory Changes: When They Are More Than Just "Getting Older"

Joseph Coupal - Friday, June 16, 2017

Spring Arbor, Richmond, VAYou've probably heard this phrase before: "I'm just getting older." The statement is often made to explain myriad aches and pains, memory lapses and mobility limitations, and may reflect acceptance that some parts of the body do not work as well as they once did due to aging – a truth that all creatures experience.

The explanation should be used with caution, though. No one should blame something they are experiencing on "just getting older," because they might miss something that could be treatable. This expression is frequently used to dismiss daily symptoms, which could result from an underlying disease, leading to needless suffering that could have been evaluated and appropriately treated.

Memory complaints do occur very frequently as one gets get older. Delays in recalling words and names – feeling that what you want to say is "just on the tip of your tongue" – are a part of normal aging, and unfortunately these delays lengthen as a person gets older. Multitasking and learning new things also become more challenging. These are normal aging experiences, but none of these changes should affect one's ability to remain independent in performing basic and instrumental daily living activities.

Often, a person who experiences a memory complaint never brings up the issue with his or her doctor. Sometimes the same patient has so many medical problems that, despite the best efforts of the patient's primary care physician, managing other medical problems takes away the time needed to address a memory concern appropriately.

Memory complaints become significant when you start to see them affect daily life. Sometimes a person's ability to remain employed, perform work-related tasks, participate in community activities or maintain hobbies declines, leading that person to retire or quit an activity. When memory problems impair a person's ability to engage in everyday routines such as managing finances, driving in familiar areas or taking medications regularly and reliably, then the memory problems should not be ignored or brushed off as a normal part of aging. An evaluation focused on memory complaints should be performed if such signs are observed.

A basic workup includes a review of the memory or cognitive issues, specifically how long the problems have been noted, and any other associated mood, behavioral or movement problems. Cognitive testing (such as a Folstein Mini-Mental State Examination or Montreal Cognitive Assessment) should be performed to document the presence and severity of the cognitive impairments. A screening for depression should also be performed, along with routine bloodwork. A CT scan of the brain could also be performed to exclude other problems. Ultimately, all of this information should be reviewed to uncover the most likely explanation for the memory problems and to determine the best ways to manage those issues.

Though dementia may be the first cause that comes to mind, there can be others. Sometimes depression can trigger memory complaints, although they're often accompanied by other symptoms, such as loss of interests in hobbies or activities a person previously enjoyed, a feeling of worthlessness, sleep problems or loss of appetite. A recent illness or hospitalization could cause a temporary period of confusion called delirium, which typically resolves over time. Medications – prescribed, over-the-counter or herbal – that affect the brain, and medical conditions such as stroke, thyroid problems or vitamin deficiencies, could also produce memory and/or cognitive problems.

It's important to remember that changes with memory and cognitive function accompany, but aren't necessarily explained by normal aging. If there is a concern or if function becomes compromised because of memory problems, it should always be brought up with your physician. The ultimate goal is to preserve independence and to plan ahead if you need assistance.

For more information on memory care, contact Spring Arbor.


US News - Health

Downsizing? What to Look for in an Age-Friendly Community

Joseph Coupal - Monday, June 12, 2017

Spring Arbor, Greensboro, NCEmpty-nesters in search of new digs may have a wish list that looks something like this: warm climate, tennis courts, golf courses, walking trails and a spare room for the grandchildren to stay.

But here’s the thing. What we want at age 65 may not be what we need 10, 20 or 30 years down the road. Even the most physically active among us could have a stroke or end up in a wheelchair in early retirement.

As boomers cash out, gerontologists are urging newly minted seniors to think hard before choosing their next place to live. Cognitive decline, or loss of a spouse, could push them out sooner than they think.

Instead of just downsizing into a condo or one-story home, researchers say retirees should consider what their broader surroundings may offer as their needs change.

Here are five things to look for in an age-friendly community:

Car-free transportation

Many of us assume we’ll be driving until the day we die. But now that people are living longer, more and more of us will end up with vision problems, physical disabilities or cognitive impairments that prevent us from driving years before we take our last breath.

House hunters nearing retirement should think about how they would get to the grocery store, pharmacy, swimming pool or a friend’s house without a driver’s license. When retirees choose to live in car-oriented communities, it may actually curtail the amount of time they can live independently.

Meaningful relationships

When deciding to move later in life, it’s important to choose a community where you can either maintain, redevelop or re-establish your social network.

Older adults should think twice about moving to places that lack community centers and activities that draw like-minded people. Finding friends to go bowling with may not be enough. You want to have reciprocal relationships with the community so you’re looking for opportunities for employment, or volunteering.

Before moving, older adults should pay close attention to their specific social needs. Social isolation, especially later in life, is quite literally deadly.

Mental stimulation

Many new retirees can’t wait for all the golfing, Zumba classes and exotic travels in their future. But a leisure-focused life may quickly lose its charm.

Boomers are no longer interested in bingo. Check for lifelong learning opportunities in a neighborhood of choice. Many colleges and universities offer free tuition to people over 65 for a variety of courses. Other adults may prefer to search out creative activities, such as community arts projects and music groups.

Health services

Planning for healthy aging after retirement goes beyond choosing to live near a hospital. The community should have an adequate number of family doctors and medical clinics, too. Health and social services should be accessible to older adults using any mode of transportation.

Care in the twilight years

Boomers may see retirement as a last chance to live on a houseboat or a quaint island before senescence forces them into a nursing home. But the plan to move again sometime in the distant future could set them up for a harsh transition, and ultimately, poorer health. With every move, especially later in life, the change is really hard on people. The research shows that elderly people tend to be healthier and happier when they stay in their homes.

Giving up the houseboat fantasy may be worth the price if older adults can remain or settle in a community where family and friends can help. Otherwise, retirees should make sure that affordable home-care services are available in their area. Personal care, housekeeping, snow removal and yard work services could help them remain at home until their last days.

For more information senior living communities, contact Spring Arbor.


Downsizing Your Home

Joseph Coupal - Friday, June 02, 2017

Spring Arbor, Richmond, VADownsizing your home can be stressful enough as it is, let alone without worrying about what to do with a lifetime of possessions.

Whether you’re moving to a retirement village, a smaller home or unit, or to an aged care facility, there is ways you can keep some of your unique personal style and make your new home just as homely as your family home.

One of the biggest obstacles is sorting through possessions.

A lot of people put off doing this, that’s why they put off downsizing.

Family dynamics can make it worse, especially if mother has furniture that the kids don’t want or the kids start to make decisions about possessions for her. Here is some advice for the main downsizing decisions – assisted living, and retirement living.

Assisted Living

Even if you’re not downsizing to an aged care facility, chances are you may have to help a loved one such as a parent through that process.

Some assisted living facilities may have shared rooms or there is just limited space in a private room for you or your loved one.

It’s important to measure up and see if any existing furniture can be taken to the assisted living facility.

That can be important to a lot of older people, but often their furniture is too big or it’s not stable enough.

There are really simple inexpensive storage options out there, such as the little cube units, that people can put their belongings in before they are ready to let them go.

All those little treasures in their home can still fit in their room if they have a small shelf.

It’s important to bring those little touches with you to make it homely.

If you’re helping an elderly relative through this process of downsizing to assisted living, then it can be very stressful on everyone.

You may need to bring a specialist third party in to assist you.

It’s important to include your loved one in the process, even if they don’t completely have mental or physical capabilities to assist.

Retirement living

Most retirement villages, over-55s communities or lifestyle resorts offer small, one-and-a-half or two bedroom units.

This is the downsizing scenario you’re most likely to undertake.

It’s one of the biggest, most life-changing events you can experience after you retire.

But instead of viewing it as a stressful experience, look at it as a good opportunity to “cleanse your life”.

If you don’t make it a nice living space, and fill it with clutter, it can be overwhelming for you.

Moving is a good opportunity to get rid of some of the clutter, not just possessions, but also to cleanse your head and address those things that have been living in the background for some time.

For more information on moving to assisted living, contact Spring Arbor.


Stages of Alzheimer’s Disease - Greensboro, NC

Joseph Coupal - Monday, May 22, 2017

Alzheimer’s disease is the most common form of dementia in individuals older than 65 years and affects more than 5 million Americans, according to the Alzheimer’s Association. Dementia is a general term for a decline in mental ability severe enough to interfere with daily life.

Alzheimer’s progresses slowly in three stages: an early stage with few symptoms, a middle stage of mild mental impairment and a final stage of Alzheimer’s dementia (Table).

These stages are general descriptions, as each individual with Alzheimer’s experiences it in a unique way. Mental, physical and functional phases often overlap, the time in each stage varies widely from patient to patient and not every patient experiences all Alzheimer’s symptoms.

Memory problems and changes in behavior and thinking are common as people age, so tests are needed to rule out other causes of symptoms that appear to be related to Alzheimer’s. Some conditions (such as stroke, tumor, Parkinson’s disease, sleep disturbances, adverse effects of medication, infections or non-Alzheimer’s dementia) can mimic the symptoms of Alzheimer’s disease, but many of these conditions are treatable and possibly reversible.

The amount of time an individual can live with Alzheimer’s can range from three or four years, if older than 80 years when given a diagnosis, to as long as 10 years or more if younger than 80 years. Alzheimer’s can only be definitively diagnosed after death, however, by linking symptoms with examination of brain tissue in an autopsy.

Stage 1: Mild/Early (Lasts 2 to 4 Years)

Alzheimer’s disease begins slowly and initially involves the parts of the brain that control thought, memory and language. In the very early stages, minor memory lapses or losing things around the house may be the only symptoms. Toward the end of the first stage, friends and family may recognize there is a problem. They may begin to notice their loved one frequently repeating questions, having difficulty finding the right word in conversations and losing understanding of language. Over time, the disease deprives individuals of more memory, particularly the ability to remember new information, such as recent conversations or events. Based on performance on memory and mental tests, a physician will be able to detect impaired mental function at this stage.

Stage 2: Moderate/Middle (Lasts 2 to 10 Years)

Moderate Alzheimer’s can last for many years. During the moderate/ middle stage, brain function gets worse, affecting areas of the brain that control language, reasoning, sensory processing and thought. The symptoms of moderate Alzheimer’s disease are mostly an increase in the severity of stage 1 symptoms. Professional and social functioning continue to deteriorate because of increasing problems with memory, logic and speech.

The signs of the disease become more pronounced, and behavioral problems often occur. Individuals have greater difficulty performing tasks and begin to forget some details about their life. Affected individuals may still know their family members and some details about their past, especially their childhood and youth. Symptoms may include mood and behavior changes, social withdrawal, confusion, changes in sleep patterns and an increased risk of wandering and becoming lost.

Information, skills and habits learned early in life, such as the ability to read, dance, sing, enjoy music and hobbies, are among the last abilities to be lost as the disease progresses. The part of the brain that stores this information tends to be affected later in the course of the disease. Making the most of these abilities can help maintain quality of life, even in the moderate phase of the disease.

Stage 3: Severe/Late (Lasts 1 to 3-Plus Years)

In the last stage of Alzheimer’s, nerve cells in the brain are extensively damaged, causing a severe decline in vocabulary, emotions and the connection of the brain to body parts. Full-time care is required as patients lose the ability to walk, sit up straight, hold up their head and smile. It is not possible for patients to move the hand to the mouth, place one foot in front of the other or urinate on their own. Speech becomes severely limited.

Death often occurs when the body can no longer fight off infection or because the organs begin to break down. Pneumonia is one of the most frequent causes of death in late-stage Alzheimer’s disease. In patients who do not succumb to infection or other conditions that are not directly related to Alzheimer’s disease, death usually occurs when the brain can no longer control the body and organs.

Reasons for Hope

Although the onset of Alzheimer’s disease cannot yet be stopped or reversed, an early diagnosis can allow individuals the opportunity to live well for as long as possible and plan for the future. Current treatment approaches focus on helping patients maintain mental function, manage behavioral symptoms and improve the symptoms of disease. In the future, therapies may be available that target specific genetic, molecular and cellular mechanisms so that the underlying cause of the disease can be stopped or prevented.

For more information on memory care, contact Spring Arbor.


US News - Health

Identifying Alzheimer’s Symptoms – Richmond, VA

Joseph Coupal - Friday, May 19, 2017

Spring Arbor, Richmond, VACognitive impairment is unrecognized in 27 to 81 percent of affected patients in primary care. Patients with memory trouble may also be non-compliant with medical care.

If you suspect a loved one might be displaying symptoms associated with the early stages of Alzheimer's, pay attention to these warning signs. If a few of these sound a little too familiar, schedule an appointment with your family's primary care physician:

  • Memory loss that disrupts daily activities
  • Challenges with planning or solving problems
  • Confusion with time and place or understanding of visual images
  • Withdrawal from work or other social activities
  • Changes in mood or personality
  • Difficulty with speech and/or writing

By getting in touch with a primary care provider, concerns can begin to be addressed, and you can identify what other types of specialists might be most helpful in caring for your loved one. As a caregiver, there are many resources available for you as well.

Comprehensive approaches improve identification and support of caregivers in need. This can help enhance quality of life for all impacted by Alzheimer's.

For more information on caring for a loved one with Alzheimer’s Disease, contact Spring Arbor.

US New - Health