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Sun Downing and How to Help Fight It - Greensboro, NC

Joseph Coupal - Wednesday, September 28, 2016

The Alzheimer’s Association indicates that close to 20 percent of people with Alzheimer’s disease will experience what is often referred to as “sun downing.”

This behavior often presents itself through an increase in anxiety and agitation that usually begins late in the day. It can also lead to pacing and wandering. In reviewing some of the literature it appears that there is no specific cause of the late day change in behavior. However some factors that may exacerbate this unsettled behavior include the consequences of disrupted sleep patterns, namely fatigue and day/night confusion. Dusk results in reduced lighting and increased shadows that can be quite disorienting. As well, thinking that someone or something is present when not can be quite frightening.

While there are some medications to help to treat the discomfort associated with sun downing, there is, fortunately, increasing research pointing to additional options to help manage symptoms. During the past few years, the medical and non-medical health care professionals involved in care decisions have discovered that a number of non-medication interventions may be very effective and helpful without the risk of medication side-effects.

It can be beneficial to watch for triggers that may contribute unsettled behaviors. For example, might mom or dad be hungry, have some pain or discomfort, need to use the bathroom or be troubled by being in a poorly lit room? Many health-care professionals recommend trying to limit daytime naps and late-day caffeine along with a doing one’s best to follow a daily routine. Many people with dementia prefer a calm environment with minimal distractions. Therefore if a loved one seems uncomfortable, then it may help to as best able, help to redirect him or her and or change the environment such as switching the phone to silent, turn off the television along with keeping the multitasking to a minimum.

Some other suggestions to help minimize feelings of agitation might include a gentle hand massage, spending time with a pet, listening to a playlist of familiar songs, looking through photo albums, spending time outside or planting flowers. Engaging in a familiar activity with a loved one or a small group may also prove to be enjoyable. When preferred, participation in a group activity of the individual’s personal interest can evoke pleasant memories along with providing them with a huge plus, most specifically, the opportunity to socially interact with others.

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


Alzheimer’s Diagnosis is Expensive for Famiy Caregivers - Richmond, VA

Joseph Coupal - Friday, September 23, 2016

Costs often exceed other types of elder care.

As the world marks Alzheimer’s Day on Wednesday, a new survey shows just how costly the disease can be for family caregivers.

A poll released this week found that families caring for someone with Alzheimer’s or another dementia tend to spend more of their own money on caregiving expenses than those looking after an older person without dementia. Some 18% of caregivers to loved ones with dementia spent $20,000 or more on caregiving expenses in the past 12 months, compared with 11% of caregivers to loved ones without dementia.

Caring for Alzheimer’s patients and other elderly relatives can weigh heavily on peoples’ careers as well as finances, explaining why both Donald Trump and Hillary Clinton are proposing new benefits for family caregivers.

More than five million Americans have Alzheimer’s disease, a devastating type of dementia with no cure and no lasting treatment. The disease takes an enormous toll on families, emotionally, physically and financially. It devours their loved ones and, in the process, can swallow life savings whole.

“I felt like a money machine, but it was my mom and it was what I wanted to do,” says Dayna Steele, chief caring expert for and author of Surviving Alzheimer’s With Friends, Facebook, and a Really Big Glass of Wine, whose mother had Alzheimer’s disease.

Alzheimer’s becomes more expensive as the disease progresses and the needs of patients mount. People eventually need round-the-clock care, making it very difficult for them to remain safely in their homes. The national median cost of a nursing home is $82,125 for a semi-private room and $92,345 for a private room.

Medicare does not cover so-called custodial care, which is what patients with dementia generally need the most—that is, help with eating, bathing, dressing and other basic daily activities. So those costs must be paid for entirely out of pocket unless the patient’s assets are depleted and she or he meets strict qualifications for Medicaid.

All too commonly, caregivers don’t have the full picture on their loved one’s finances, and it’s tough to put the pieces together once a patient’s memory starts to slip.

Advice: Quit avoiding the conversation. While it’s hard to talk about money and potential future incapacity, it’s even harder to deal with silence around the topic.

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



How to Prevent Alzheimer's Disease – Greensboro, NC

Joseph Coupal - Monday, September 19, 2016

There’s plenty not to love about being middle-aged. But by the time today’s forty- and fifty-somethings reach the age when they may develop Alzheimer’s disease and dementia (one in 20 people develop dementia under 65 but above that age a person’s risk doubles roughly every five years), it’s likely we’ll know more about its early signs and probably have drugs to treat it before it even shows symptoms.

Perhaps even more heartening, increasing evidence shows that dementia is not inevitable. This week, scientists at Harvard published research on an elite group of retired people, dubbed ''super agers’’, who have brains that resemble those of people a third their age, which could provide vital clues about how to prevent declines in memory.

Studies are studying how biomarkers in people aged 40-59 may help predict changes in cognitive function, are set to confirm this further.

“In the next 10 years we’re going to get more and more evidence about the things people can do to prevent Alzheimer’s and dementia,” says Craig Ritchie, professor of the psychiatry of ageing at the University of Edinburgh who is leading the trial.

“Our aim is to be able to take any given individual and say, 'Well your risk is X per cent and here are the things you can personally do to help prevent it.’ ”

So, what do we know?

Forget Sudoku and learn a language

Brain stimulation, not brain training, is essential in preventing cognitive decline. The key to the former is social interaction.

“Chatting, being socially interactive with friends and in a work environment is probably what lights up your brain more than anything else. I often get asked, 'I do lots of crosswords and Sudoku, will that protect me from dementia?’”

But the evidence now suggests that taking up new hobbies and interests that challenge you are more beneficial. “So, if you’ve done crosswords your whole life, learning to play the piano at 65 is going to have more benefit on your cognitive health than keeping doing things you have always done.”

Build your cognitive reserve

Protecting the brain against dementia is all about building cognitive reserve – the connections within the brain network.

As we age, the brain shrinks and these connections weaken but the bigger your cognitive reserve is, the longer you’ll last before suffering memory problems. Stimulating the brain with certain behaviors help to maintain cognitive reserve.

Someone with high cognitive reserve would be someone with a mixture of high education, a complex lifetime occupation and high levels of social engagement in old age.

The more of these factors you have, she says, the more protected you may be – if you develop a bit of cognitive impairment, it will take longer for it to turn into dementia.

In July this year, occupational scientists at the Alzheimer’s Disease Research Centre in Wisconsin graded jobs according to how much intellectual engagement they provide. They found those less associated with the development of Alzheimer’s in later life were those that worked in complex jobs involving other people.

While lawyers, social workers, teachers and doctors were best protected, those who enjoyed the least protection included shelf-stackers, machine operators and laborers.

Aspirin and the brain


Some studies have suggested long-term use of aspirin is associated with a reduced risk of Alzheimer’s. One Swedish study found that women over 70 who took low-dose aspirin because they were at high risk of heart disease were found to have better memory and cognitive function after five years than those who didn’t.

Now, the biggest study into the effects of aspirin on the heart and the brain is set to confirm the link.

“Aspirin acts to reduce the risk of blood clotting and therefore heart attack and stroke, and both of those two things are associated with measurable effects on cognitive function,” says Jane Armitage, professor of clinical trials at Oxford University who is leading the research. Results are expected in 2018.

In the meantime, remember aspirin can have side effects such as gastrointestinal bleeding and hemorrhagic stroke, so talk to your doctor to see if it will benefit you.

Should I take fish oils?

Although small studies such as one, published in 2014 in the Journal of Alzheimer’s Disease, have found that supplementation with omega-3 helped slow the decline of cognitive function on those with Alzheimer’s disease, no substantial studies have yet affirmed the link.

So the jury’s still out, but it does look like eating fish regularly, particularly oily fish such as salmon or mackerel, as part of a balanced diet is good for overall health, including brain health.

Healthy body, healthy brain

The same processes that cause heart attacks and strokes are also associated with the development of dementia. Of the seven key risk factors for the development of Alzheimer’s – high blood pressure and obesity in mid-life, diabetes, smoking, low levels of physical activity, low education and lifetime depression – five are associated with a higher risk of heart disease.

So the lifestyle factors that help the heart – avoiding smoking, keeping to a healthy weight and taking regular exercise – can also maintain cognitive function.

Evidence suggests the ideal diet to prevent dementia is a Mediterranean-style one rich in polyunsaturated fat from nuts, seeds and fish, vegetables, fruit and grains (and small amounts of red wine).

Meanwhile, all the scientists said moderate exercise as the number one factor that could help prevent the onset of dementia. And it doesn’t even have to be very hard.

Just try and move more, from taking a 20-minute walk on most days to having a swim. 'Doing a sport is particularly helpful as it also involves social engagement, which is hugely important.

(A little) red wine is fine

News to pop a cork over came out when scientists found that consuming one to three glasses of bubbly a week might help prevent Alzheimer’s and dementia.

They claimed the phenolic compounds present in pinot noir and pinot Meniere – two of the grapes used to make champagne – had the ability to increase spatial memory, improve cognitive function and promote learning and memory retention.

Although the champagne study was done on rats, Prof. Ritchie says that while high levels of drinking are undoubtedly damaging to the brain, there is some evidence suggesting small amounts of red wine, in particular, may help.

Experts advise sticking to the government recommended limit of 14 units spread over a week – equivalent to six pints of beer or 10 small glasses of low-strength wine.

For information on Alzheimer's care, contact Spring Arbor.


The Telegraph

HHHunt Opening Assisted Living Cottages in Richmond, VA

Joseph Coupal - Friday, September 09, 2016

One of the biggest homebuilders in the Richmond area has added to its assisted-living portfolio with the purchase of a stalled project in western Henrico County.

HHHunt purchased the property at 10601 Barbara Lane earlier this week through federal bankruptcy court. It plans to complete construction and open the facility in December or January as Spring Arbor Cottages of Richmond.

“This really is a nice complement to our current portfolio,” said Rich Williams, HHHunt’s senior vice president of senior living management.

The facility was built for memory care, catering particularly to patients with dementia, including Alzheimer’s. Consisting of three buildings or small houses, with a circular design, it has 16 apartments in each building and private bathrooms for residents.

The design of the facility was especially appealing to Henrico-based HHHunt. They provide memory care services in that small-house model that enables them to provide a totally different service that’s unique to the industry.

Spring Arbor, HHHunt’s senior living division, has another senior living facility about 2 miles from the Spring Arbor Cottages of Richmond. Having this small-house campus right around the corner really expands their platform.

For more information on assisted living that is unique and just like home, contact Spring Arbor.


“Keep Connected” During National Assisted Living Week - Richmond, VA

Joseph Coupal - Wednesday, September 07, 2016

National Assisted Living Week is September 11-17, 2016.The 2016 theme is “Keep Connected,”  through family, friends and technology we can enhance the care and overall experience in assisted living communities.

“Keep Connected” acknowledges the myriad ways assisted living staff and supporting business partners are revolutionizing the care provided in these communities through innovations in technology.

But it is about more than technology. Assisted living reminds us that sometimes the best relationships are formed face-to-face. For many staff members, residents become family, and this bond can never be broken. Meanwhile, assisted living communities are an integral part of the larger community. Staff cultivates connections with local families, business owners, government organizations, community organizers and others to ensure that residents remain an active part of where they call home.

For more information on  an assisted living community that keeps connected, contact Spring Arbor.