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Should You Downsize in Retirement

Joseph Coupal - Thursday, November 16, 2017

Spring Arbor, Greensboro, NCOne method for freeing home equity for other uses is to downsize your home as a part of moving. Downsizing could mean either moving to a smaller home, or moving into a similar-sized home in a less expensive community.

The arithmetic is fairly basic. If you’ve paid off your mortgage and live in a $300,000 home, and then sell it and move into a $200,000 home, then $100,000 of your home equity has been freed for other uses.

Another possibility is simply to sell your home and then move to a senior living community. Renting frees up home equity and provides more optionality and flexibility to make more frequent moves before settling down.

When analyzing the decision to rent or buy, you’ll need to consider factors such as the loss of build-up in home equity and its subsequent growth (or loss) and savings on property taxes and other types of home maintenance.

As a part of downsizing, you could consider moving to an assisted living community which may be less expensive because of the amenities offered and provide organized activities and social support.

For more information, contact Spring Arbor.


Excerpts - Forbes

Choosing Memory Care: A Checklist of What to Look for, What to Ask

Joseph Coupal - Friday, November 10, 2017

Spring Arbor, Richmond, VAChoosing the right residential care facility is hard, and choosing the right memory care facility is even harder.

Here are some questions to ask to help make the decision easier. As with any residential facility, try to visit at least once to get a good sense of what the facility is really like, not just what the facility's advertising says about it.

This checklist supplements the more general assisted living checklist by asking memory-specific questions, so be sure to print out both to take on tours.

The basics:

  • Is the facility able to accommodate people at all levels of dementia, or only at specific levels?
  • Why might a resident be asked to leave the facility?
  • Who assesses residents' health and cognitive functioning? How often is that assessment repeated?
  • Does each resident have a formal, written plan of care?
  • Does the facility help with all ADLs, including bathing, toileting, and eating?


  • If the facility is part of an assisted living facility or continuing care retirement community, is the memory care section separate from other areas?
  • Is the memory care area all on one level?
  • Are the residents' rooms private or shared?
  • Is the facility laid out with circular hallways so that residents aren't frustrated by cul-de-sacs?
  • Is there an enclosed, secure outdoor area with walking paths?


  • Does the facility feature even, good lighting in hallways and common areas?
  • Does the facility feature nonslip floor surfaces in all rooms, including bathrooms?
  • Is the interior and exterior of the facility secure? What methods are used to keep tabs on residents and make sure they don't wander out of the building or off the grounds?

Orientation and comfort:

  • Are doors and rooms labeled clearly, both with words and pictures, to help residents orient themselves?
  • Do residents have "memory boxes" outside their rooms to help them identify the right room and to help staff members get to know them better?
  • Are the colors used throughout the facility bold and unpatterned?
  • Does the facility feature good natural or faux-natural lighting in residents' rooms and common areas?
  • Is the facility generally pleasant, clean, and peaceful?

Staff members:

  • What kind of dementia-specific training do staff members have?
  • Do staff members seem to know each resident's name, personality, and background?
  • Do staff members seem kind and attentive to residents' needs?
  • What is the staff-to-resident ratio?
    • The ratio should be at least 1 to 7, especially for later-stage dementia.
  • Is there an RN, LVN, or CNA on staff?
  • How do the staff members deal with difficult behaviors, like aggression, mood swings, and sundown syndrome?
  • What is the facility's policy on the use of restraints -- both physical and chemical?

Food, activities, etc.

  • Do residents seem to enjoy the food?
  • How does the facility encourage eating among residents who are uninterested in food -- or how does it encourage residents who tend to overeat not to be unhealthy?
    • Studies have shown that contrasts, like brightly colored plates, can encourage people with dementia to eat more.
  • Will the facility cater to special nutritional needs or requests?
  • Does the facility offer spiritual or religious services that your loved one would enjoy attending?
  • Does the facility allow pets? Does the facility have any of its own pets?
  • What activities are offered to residents? Do they seem like they would engage your loved one?
  • Does the facility offer regular exercise sessions for residents who are physically able to participate?
  • What resources are available to engage residents' long-term memories?

For more information on memory care, contact Spring Arbor.


Assisted Living Checklist: What to Look for, What to Ask

Joseph Coupal - Tuesday, November 07, 2017

Spring Arbor, Greensboro, NCHunting for assisted living can be hard. After all, you want to make sure you find the best place for your loved one -- and it also needs to be clean, well run, and within your price range. You need to get a good sense of what each community is really like, not just what its advertising says about it.

Still, the process doesn't have to be intimidating or overwhelming. Here are three simple steps you can follow to help narrow down the choices to the perfect community. First, you'll do research online and by phone. Then, you'll tour to see what each community feels like in person. Finally, for the communities you like best, you'll want to follow up for more in-depth information.

This is a checklist you'll come back to over time. Print one for each community that you're considering. As you learn more, note your observations.

1. Assisted Living Research Checklist

Online Research

Start with online research to find facilities near you or your loved one. has a nationwide directory of assisted living communities or you may be able to find facilities listed in the phone book or through word-of-mouth recommendations. The Departments of Health and Human Services for each state are also good resources for finding facilities. These questions can help narrow down the options:

  • Is the location close to shops, doctor's offices, a pharmacy, and other important places? Try some of the features on Google Maps to explore the neighborhood virtually.
  • Is the location convenient for family and friends to visit? Google Maps can help you figure out driving distances to and from the community.
  • If the facility is not in your town, are there hotels nearby for when you visit the area? Use Trip Advisor to search for area hotels.
  • Is the neighborhood generally considered safe, or is there a high crime rate? Crime Reports, Trulia, and Neighborhood Scout have tools to help you evaluate neighborhood safety and crime rate.
  • What are others saying about this provider in reviews?
  • Can you find any information about the provider through the Better Business Bureau or your local Area Agency on Aging?

Phone research

The first time you speak to providers on the phone, find out whether they're currently accepting new residents. If not, ask about their waiting lists. It's worth keeping in mind that families often put their names on waiting lists at several facilities, so the list may be shorter than it seems. Don't hesitate to put your name on a list just because the waiting time is significant. You also want to ask questions early on about how expensive the provider is. Pricing for assisted living can vary significantly based on your loved one's needs, so this may not be the time to pin down specific pricing. That said, it is wise to ask general questions to determine whether a provider is way out of your price range.

  • What types of payment are accepted, and/or do they have programs to help residents afford care?
  • If there are any negative online reviews about them, what is their response or explanation?
  • When do they offer tours, and how long do tours last?
  • What will they show you when you tour -- will you have a chance to try the meals or meet with residents?

2. Assisted Living Tour Checklist

Experts say that the most important part of making a decision is listening to your gut instincts. Even beautiful facilities with huge advertising budgets can be cold, dreary places, while older facilities with a little missing paint can be cheerful and happy. Going for a visit -- or several -- can help you determine if the community will be right for your loved one.

Figuring out how to tour is a little more difficult, especially if your loved one is not very mobile or if you live out of town. It may be worthwhile to tour several facilities before bringing your loved one to see the two or three you think might be best. Or ask a friend or family member to tour facilities (and take copious notes and photos).

Geriatric care managers can also help find the best assisted living facilities for older adults -- they often know a great deal about all the care options in their town. has a directory of Geriatric Care Managers across the country.)

Before your visit, review your checklist. Underline or circle the questions you care most about. Cross off any that aren't relevant to you.

On the way in

  • Is the neighborhood quiet and pleasant?
  • Is there easy parking outside, including handicapped spaces?
  • If your family member will be bringing a car, is parking provided?
  • Is the building's exterior clean and attractive?
  • Are the grounds attractive, with plants and trees?
  • Is there a safe, enclosed area where residents can walk and socialize?

The greeting

Most tours start in someone's office or in the lobby -- the director of marketing or another staff member will spend time talking to you about the community in general. He or she should be asking you questions about your needs and what you want to see, so the tour can be tailored for you.

  • Do you like your tour guide?
  • Do you feel that he or she is listening to your needs and questions?
  • Do you feel pressured in any way, or like someone is "selling" you?
  • Does the tour guide speak only to you (the adult child) or does he/she make an effort to include your loved one?
  • Are you able to talk to staff members other than the tour guide, either in a formal session or informally during or after the tour?

The walking tour

While you're walking around, don't worry about checking things off. Instead, pay attention to what you're seeing, hearing, smelling, and feeling in each of the spaces. Try to talk to different residents and staff members, not just the director of marketing. This will help you get a fuller idea of what the community is really like.

Common spaces:

  • Are the common spaces in the community pleasant and appealing?
  • How many rooms are there where the residents can spend time with each other and with visiting family members, and can you imagine your loved one using these common spaces?
  • Are hallways well lit and easy to navigate, with handrails for safety and plenty of room for wheelchairs?
  • Are there shared pets in the community (such as dogs, cats, miniature horses, fish, or birds)?
  • Are there plants, and do they look well cared for (free of dust and well watered)?

Residents' living spaces:

  • Do most residents have a private room or share a room?
  • Is it possible to view all the different types of rooms available?
  • Does each room have a private, handicapped-equipped bathroom, or is there one shared bathroom?
  • Are residents' rooms personalized with photos, mementos, or other possessions?
  • Is there adequate closet and storage space?
  • Is there good lighting and are there attractive views in each room?


  • Are the dining rooms clean and attractive?
  • How many meals per day are provided?
  • Are there snacks and, if so, how and when do residents get them?
  • Can the community cater to specific dietary needs or special requests?
  • Can the residents bring food back to their rooms, and/or are there kitchens in the rooms?
  • Can visiting family members join the residents for meals?
  • Do the residents seem to like the food?
  • Can you taste the food or come for a meal to try it yourself?
  • Is there a private room available for family celebrations or private family dinners?


  • Is there a posted, varied schedule of activities, and are there any activities that you think your loved one would participate in?
  • Do the residents have any scheduled interaction with the outside local community, whether because volunteers come into the community or residents go on regular outings?

The pitch

You can expect the tour to end in the tour guide's office or in a common space. At this time the tour guide will likely ask you questions and answer any you have. You'll also probably hear "the pitch" -- the tour guide will be promoting his or her community as the best choice for your loved one. If possible, ask for a moment to review your checklist before or just after this conversation. Check off all the items that were addressed and all the questions that you've already had answered. If you're still interested in the community, go ahead and ask any of the remaining questions that you want answers for, or plan to ask them in a follow-up phone call or visit.

3. Assisted Living Follow-Up Checklist

For any facilities where the initial visit was positive, here's how to follow up:

Surprise visit

Pop in for an unannounced visit in the next week or so, potentially in the evenings or on a weekend. If everything looks just as pleasant as it did during the tour, that's good. If the atmosphere is completely different, it might be worth considering other facilities. And if the staff won't let you in other than during a tour, it might be a signal that you should look elsewhere.

Documents to request

It's a good idea to get as many of the following documents as possible. They can help you compare the fine details of one facility versus another.

  • Sample admission contract
  • A copy of the Resident Bill of Rights
  • A copy of the most recent survey results from state regulatory inspectors
  • A recent list of weekly activities and events
  • A recent weekly menu of meals and snacks

Follow-up conversations

Schedule another visit or phone call to ask these more detailed questions about costs, care, and services.


  • How much will assisted living care cost for your loved one? The answer will be different depending on your loved one's needs, so allow ample time for this conversation. Be sure you feel the staff understands your needs and is communicating the answers clearly.
  • Does the cost include any special move-in fees or fees for services, such as laundry?
  • Is there an extra charge for transportation to doctor's appointments or outings?
  • Under what circumstances might costs go up?
  • How is the community funded, and is the funding stable?
  • Will the community help with the paperwork involved with getting Medicare, Medicaid, V.A., and other sources to pay for care?


  • What's the ratio of staff to residents?
  • What's the staff turnover rate?
  • Are background checks performed before hiring staff? If so, when and how?
  • How much training do staff members have?
  • What does the facility do to avoid staff burnout and/or retain great staff members?
  • Is there an RN, LVN, or CNA on staff?

Care plan:

  • Is an initial assessment of needs conducted and a written care plan developed? Who's involved in developing the care plan? How often are the needs reassessed?
  • What specific care is available from doctors, nurses, physical therapists, occupational therapists, and others?
  • Who handles medication management, and how well trained are they?
  • Is the facility affiliated with a hospital or nursing home if more care is needed?
  • What medical emergency procedures are in place?

Other questions:

  • Are residents required to have renter's insurance for their units?
  • Is housekeeping for units provided -- and included in the price?
  • Are barber and beauty services provided -- and included in the price?
  • Are pets allowed?
  • Are there religious services on the property or nearby?
  • Are visits to the residents allowed at any time, or are there set visiting hours?
  • Are residents allowed to have overnight guests, such as a family member from out of town?
  • How does the community accommodate private time for couples if only one spouse is living in the community?
  • What is the facility's policy on sexual interaction between residents? A good facility will have a written policy in place.
  • What is the facility's emergency preparedness strategy -- do they have a backup generator or evacuation plan?
  • Does the facility have an adult day program? Sometimes older adults are more comfortable moving into a facility if they've already spent several hours having fun with some of the residents.
For more information, contact Spring Arbor.


Nursing Home, Assisted Living, or Independent Living?

Joseph Coupal - Monday, November 06, 2017

Spring Arbor, Richmond, VAThe first step to finding the best senior housing for your loved one is to understand what type of care facility is the best fit. There are six main types of residential elder care options:

Independent living facilities are ofen the best senior housing options for active adults who want built-in community without giving up their privacy. Most feature studio or multi-bedroom apartments with kitchens so residents can stay independent as long as possible.

Continuing care retirement communities, or CCRCs, are best for those seeking a continuum of care from independent living to skilled nursing, all in one location. CCRCs generally have studio or multi-bedroom apartments for their most independent residents and private or shared rooms for residents who need more care.

Assisted living facilities are best for for those who need some care and supervision but who don't need skilled nursing care. Most assisted living residents live in private or semi-private rooms within a complex.

Memory care communities are facilities designed specifically for seniors with Alzheimer’s disease or other forms of dementia or serious cognitive impairments. Also known as dementia care, memory care communities are often housed in one part of an existing assisted living community or skilled nursing facility. These communities are best for those with severe dementia or cognitive impairment who are no longer able to live independently.

Board and care facilities, also known as care homes, are best for those who can't live independently due to physical or mental disabilities but who don't require fulltime skilled nursing care. They feature private or semi-private rooms in a complex (often a large home) that usually provides communal dining.

Skilled nursing facilities, also called nursing homes, are residential care facilities that are best for those with illnesses or mental conditions requiring fulltime monitoring and medical care. Most skilled nursing residents live in semi-private rooms, and meals are generally provided.

Want more information? Contact Spring Arbor.


Alzheimer’s and The Holidays

Joseph Coupal - Monday, October 30, 2017

Spring Arbor, Greensboro, NCAccording to the Alzheimer's Association, Alzheimer's disease is the sixth leading cause of death in the United States today, with more than 5 million Americans currently living with the disease. Since 2000, deaths by heart disease have decreased by 14 percent while deaths from Alzheimer's have increased by 89 percent. The disease, which causes memory loss and dementia, kills more people than breast and prostate cancer combined.

Holiday gatherings are just around the corner, and although many love spending time with Grandparents and parents, Thanksgiving and Christmas can be overwhelming and confusing with the large crowds and new places outside of their typical routine.

The author of "I Care — A Handbook for Care Partners of People with Dementia," offers some tips for helping an elderly family member get through these holiday events with minimal stress.

Try not to get frustrated. Older adults may not remember everything, but they are aware if you are frustrated with the conversation. Be patient. Dedicate someone to help seniors during the gathering. A son or daughter may be able to fill in the gaps, assist with details such as where the bathroom is or where to sit at the dinner table or answer other questions as they arise.

Try to keep grandma or grandpa busy with a task in the kitchen or a walk around the yard or home while dinner is getting ready. Give them a purpose, so they feel useful and stay engaged.

Use pictures to stimulate memories, but don't force them to recollect something they simply don't remember.

And don't forget safety first. Make sure someone drives your elderly relative to the event and keep a watchful eye out for potential dangers to someone who can't remember things clearly.

Most of all, continue to love, spend time with and have conversations with those suffering from Alzheimer's. You may repeat yourself often. You may feel hurt if they forget your name. But you'll never regret the precious moments spent with your loved one.

For more information on Alzheimer’s Care, contact Spring Arbor.


Time to Downsize Your Home: How to Prepare

Joseph Coupal - Monday, October 23, 2017

Spring Arbor, Richmond, VAConsider this: Your kids have all moved away from home. Their rooms are now empty and filling with dust. You’ve thought about making one bedroom a “home office,” but the issue remains: You have more space than you really need.

What do you do now? One option is to downsize your home.

There are plenty of things to look at before making that move, so we’ve put together a list to get you thinking about what might be best for you.

Less Space, More Money, More Time

Those empty rooms we mentioned are still being heated, air conditioned and cleaned. By moving into a smaller space, you’re likely to save on utility bills and maintenance costs. Depending on where you move, your utilities may even be covered at your next home.

You can also use the time you spent cleaning all that extra square footage for more enjoyable activities, like visiting your children in their new homes or playing with the grandkids.

Using Home Equity as Secondary Income

After years of owning a home and paying off the mortgage, or at least a part of it, you earn equity in your home. When you move to sell your property, that money can help supplement your lifestyle. Because most properties that are smaller in size tend to be lower in cost, you may see some profit off your home sale.

Consider the Emotional Costs

They say home is where the heart is, and that can be true for many. Leaving behind the place you raised a family can be difficult, so thinking about the emotional side of the move is big part of this decision.

It can also be a difficult thing for your adult children to deal with. Remember, this was their childhood home, too. Perhaps having a final get-together with your family in the home could help alleviate some of that anxiety. It can help create closure for everyone about the move, and it gives them a chance to come pick up any memory boxes or mementos they want to keep from the house.

Keep in mind the best thing for you and your partner may not be the most comfortable one for everyone in your family, but by taking time to acknowledge those emotions, you can get moving in the right direction.

What to do With All That Stuff

One option is selling any unwanted items before your move. This can be done at estate sales, auction or consignment stores. If you have items you’re planning to gift to your children or grandchildren or leave as a legacy item, consider doing it before you move. Then you know it’s gone to the intended person and you’ll have less to pack up if you decide to downsize.

Moving into any new place can be a cause of stress, so consider hiring a moving company and packing up each room one-by-one to avoid the anxiety of trying to get everything out at once. Don’t be afraid to eliminate unnecessary items. It’s not likely you’ll be able to fit everything you own into a smaller space, so try to only bring your most used and needed items with you.

Deciding to move into a smaller home is not an easy decision to make, and it’s not one you should make alone. Be sure to talk over these factors with your spouse, and consider speaking with a financial adviser about how a move could affect your wallet. By using these tools, you’ll be able to make the best choice on whether downsizing your home is the right move for you.

For more information on senior living communities and assisted living, contact Spring Arbor.


Caring for Yourself While Caring for Someone With Alzheimer’s

Joseph Coupal - Monday, October 16, 2017

Spring Arbor, Greensboro, NCWhy is it important for caregivers to care for themselves and participate in activities that bring them joy? Because caregiver burnout is real and can inadvertently lead to losing the very person providing care due to their own neglected health, financial strains and other accompanying problems. In a recent study, caregiver "strain" was associated with a 63 percent increased mortality risk, even after controlling for presence of cardiovascular disease and sociodemographic factors. Caregivers might even be at higher risk of cognitive impairment or dementia than non-caregivers.

According to 2015 figures, 5.4 million Americans are living with Alzheimer’s disease. It is the 5th leading cause of death for Americans over age 65. With an increase in the number of diagnoses comes an increase in the need for care provided by caregivers. In 2015 alone, 15 million Americans dedicated over 18 billion hours and provided $221.3 billion worth of caregiving services. Yet, when asked to spend just a few dollars or hours on their own care, caregivers often initially react with resistance.

Here is advice on how to avoid burnout and minimize caregiver-related stress.

Our caregivers have found these tips helpful:

  • Seek help, whether it's professional or informal from family, friends or religious institutions. You don’t have to do this alone.
  • Connect with your local chapter of the Alzheimer’s Association or similar organizations to inquire about caregiver resources, like grants to pay for respite programs.
  • If employed, speak with your HR department and ask about family or other leave policies. For example, the Family Medical Leave Act of 1993 can be used to secure time to care for a loved one diagnosed with Alzheimer’s.
  • Let go of little details (e.g. your mom wants to wear rain boots on a sunny day) and celebrate small victories (e.g. she is dressed and arrives for an appointment). This is a point I emphasize often; in the daily life of an Alzheimer’s caregiver, letting go of what one thinks should be happening will reduce stress.
  • Choose an enjoyable activity as effortless as ordering a cup of coffee. Say, “Will I have a small, medium or large?”

Commit to one small thing daily, a medium monthly and a large annually.

  • Small: Take a 15-minute walk, listen to music or practice meditation.
  • Medium: Go out for a meal/movie, secure reliable help, say yes to family/friends offering to help or attend support group meetings.
  • Large: Book a day at the spa, secure a stay at a respite program for your loved one or go on a cruise.

Caring for a family member with Alzheimer’s has been described by caregivers as "‘my honor; my job." In addition to helping the patient diagnosed with dementia, make sure caregivers don’t forget their care.

For more information on Alzheimer's Care, contact Spring Arbor.


Reasons to Consider Moving to Senior Living Communities

Joseph Coupal - Tuesday, October 10, 2017

Spring Arbor, Richmond, VAFor many, the American Dream is all about owning your own home. But when kids leave the nest and retirement looms, that sprawling home can start to feel more like a burden than a dream. There are gutters to clean, lawns to be mowed, garages to organize – not to mention the daily household duties of cooking, cleaning and endless laundry.

Eventually, the idea of downsizing can be a welcome relief — one that more and more seniors are starting to explore. If you haven't yet thought about your next move, there are a few reasons you should probably start.

It's not exactly downsizing

Think of it as supersizing rather than downsizing. Senior living residents have so much less to deal with, from cleaning to cooking. All of those things go away, but in the meantime, they gain access to fitness centers, dining, activities, excursions, and more. So the personal space might decrease, but in the meantime, they have many more activities and amenities available to them.

When you think of your golden years, chances are they don't include the daily grind and upkeep of maintaining a home and household. When you downsize to a senior living community, you can focus on making your retirement an enriching and rewarding time. Make new, like-minded friends — all in the comfort of your own comfortable, private apartment.

Moving is the scariest part

For many, giving up “home” is a big decision – one that can seem intimidating, but many wish that they moved sooner.

You're investing in your future

For many seniors, downsizing to a senior living community isn't just about convenience, though it certainly provides that. If you decide to move to a Continuing Care Retirement Community, this can be a wise move for your financial future. According to Kiplinger, a CCRC can be a wise investment, as they allow seniors to age in place, with skilled nursing and long-term medical care available on-site. And with several financial plans from which to choose, you can select the program that works with your health, your budget and your needs.

It's peace of mind

Even if you're not yet ready to downsize, it's important to understand your options.

There are people who talk to communities before turning 62 and the minute they turned 62 they move in. And there are those people who move in at 85. It's never too late, and talking to someone about it doesn't mean you have to make the decision now. But, it's better to plan earlier so you know what your options are.

For more information, contact Spring Arbor.


Early Signs and Symptoms of Dementia

Joseph Coupal - Monday, October 02, 2017

Spring Arbor, Greensboro, NCThis article outlines some of the early signs and symptoms of dementia and Alzheimer’s. Keep in mind that some symptoms can also be attributed to the normal effects of aging. If your loved one experiences any of these symptoms, detecting Alzheimer’s or dementia early on is important and it’s best to consult a physician for a proper diagnosis. Because Alzheimer’s and other dementias affect the brain and its functioning, both behavioral and cognitive changes are apparent early in the course of the disease. Some of the most common behavioral and cognitive changes are listed below.

Cognitive Changes

Difficulty or issues in any of the following cognitive areas should be brought to a physician’s attention immediately. The doctor can then perform the necessary tests required for detecting Alzheimer’s disease and forms of dementia.


Memory loss is one of the most common signs of dementia or Alzheimer’s. While occasionally forgetting names or appointments is normal, a person in the early stages of Alzheimer’s or dementia will often be unable to recall recently learned information. That person’s forgetfulness also will occur with increasing frequency.

Familiar Tasks

Everyday tasks such as acts of basic hygiene (e.g., showering or brushing one’s teeth), meal preparation or placing a telephone call can seem unfamiliar to someone in the beginning stages of Alzheimer’s or dementia. Sometimes all or most of the steps required to perform the action are recalled, but the order is jumbled.


Although occasionally forgetting the correct word for an object is normal, a person in the early stages of Alzheimer’s or dementia will forget simple words or use unusual terms. Both speech and writing can be affected and might be slightly puzzling or difficult to understand. Be aware that the onset of jumbled speech could also be a symptom of a stroke.


Occasional bouts of forgetfulness are normal, but early symptoms of dementia or Alzheimer’s make people unaware of their surroundings even in familiar places, such as his or her neighborhood or inside the home.

Abstract Thinking

Complex mental tasks or ones that require several steps may become difficult (if not impossible) to perform. The difficulty usually becomes apparent in tasks that require a person to input information from various sources and then combine, assess or analyze that information. Depending on the individual and the stage of the disease, this could include an activity such as balancing a checkbook or following a group discussion.


An inability to make a sound decision based on a given set of factors, when a person normally shows sound judgment, is one of the other possible signs of dementia or Alzheimer’s. A common example is dressing inappropriately for the weather.

Putting Things in the Wrong Place

Another of the more common early warning signs of dementia or Alzheimer’s is placing objects in inappropriate or nonsensical places, such as putting keys in the refrigerator.

Behavioral Changes

Major shifts in personality, behavior and mood or energy levels can also be indicative of early-stage symptoms of dementia or Alzheimer’s.


A noticeable shift in personality can be one of the early signs of dementia or Alzheimer’s. Sometimes personality changes are hard to pinpoint, but take note if the person isn’t acting in accordance with his or her normal patterns of behavior. In the early stages of Alzheimer’s and dementia, an individual often understands that he or she has forgotten an important piece of information, and the inability to recall it causes frustration.

Behavior or Mood

Alzheimer’s and other dementias can cause severe and rapidly changing moods, resulting in an individual experiencing various emotions ranging from rage to sadness and complete calm within the course of a few minutes.


Passivity, sleeping for prolonged periods of time, and sitting for hours watching TV or otherwise not speaking with anyone are other early warning signs of dementia or Alzheimer’s. A lack of energy or passion for life can manifest in a lack of desire to participate in normal activities, especially ones that the person previously enjoyed. A physician should be consulted to rule out the possibility that these symptoms are not signs of depression.

Detecting Alzheimer’s Disease and Dementia

Detecting Alzheimer’s and dementia early is important for treatment and the progression of the disease course. If your loved one is experiencing any of the signs of dementia and/or Alzheimer’s outlined above, contact a physician right away. There are basic tests that doctors use when detecting Alzheimer’s, dementia, or mild cognitive impairment. These include Mini Mental Status Exam (MMSE) and/or Saint Louis University Mental Status Exam (SLUMS).

For information on memory care, contact Spring Arbor.

Virginia: On the List for "Best State to Retire"

Joseph Coupal - Friday, September 29, 2017

Spring Arbor, Richmond, VAIt's time to retire, to downsize, maybe to move, to enjoy life. You’re really going to do it. You worked your last day, you ate the cake and you decided to move to the best retirement spot in America. Next question: Where is that?

Bankrate looked at costs, weather, health care, crime, taxes, cultural amenities and a few other things important to seniors and have determined the best 10 places to retire.

Before you start packing, find out if you’ll need snowsuits or swimming suits.

Virginia is for lovers of affordable prices, communities where you can feel safe and relatively pleasant weather year-round. The fall foliage in the Shenandoah Valley is an annual treat, spring brings cherry blossoms, and in summer you can hit the state’s Atlantic beaches.

#6 Virginia Scores highest for:

  • Cost of living
  • Relatively low crime rates
  • Weather

For more information on senior living in Richmond, VA, contact Spring Arbor.