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Caregiver Dementia – Greensboro, NC

Joseph Coupal - Wednesday, November 16, 2016

For 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 Alzheimer’s Care for loved ones, contact Spring Arbor.

US News - Health

Caring for Yourself While Caring for Someone With Alzheimer’s is Important – Greensboro, NC

Joseph Coupal - Friday, November 11, 2016

It is important to remember just how important it is for caregivers to care for themselves and participate in activities that bring them joy.

Why is this important? 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% 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.

In recognition of Alzheimer’s Awareness Month, here is advice on how to avoid burnout and minimize caregiver-related stress.

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." Our job, in addition to helping the patient diagnosed with dementia, is making sure caregivers don’t forget their care.

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


US News - Health

Reasons All Senior Living Communities Should Offer Memory Care Services - Richmond, VA

Joseph Coupal - Monday, November 07, 2016

As the baby boomer generation enters retirement, senior living providers are realizing that residents who are not necessarily considered to have cognitive impairment may very well need some level of memory care and related assistance. As such, is memory care becoming a necessary component of all seniors housing and care facilities? A look at current development trends coupled with rapidly changing demographics suggests the answer is yes.

1. Demographics. According to the Alzheimer's Association, one in eight people aged more than 65 years has some form of dementia. Further, nearly half of seniors aged 85 or more years and older have it. Compounding this trend is the fact that by 2030, the population of seniors is expected to double, reaching 74 million.

2. Industry trends. According to a survey of nearly 300 leaders at seniors housing and care facilities, a majority of respondents (61%) believed that Alzheimer's/memory care would experience the most growth in 2016 as compared with the rest of the acuity spectrum.

3. Medical and technological advances. As medical advances and technology continue to develop, seniors have the ability to be cared for at home, or take care of themselves, for a longer amount of time than in the past. Therefore, by the time potential residents think about moving into senior living communities, it often is because they don't have another option. Older adults increasingly are choosing senior living communities as a last resort once they no longer can remain at home. Thus, the acuity level of seniors entering these communities has increased significantly from where it has been historically. In many cases, seniors are forced to enter communities due to memory care-related issues such as wandering or loss of mental cognition.

4. Financial opportunity. Seniors housing and care providers that fail to provide memory care services stand to lose residents to competitors that do. If a resident at an assisted living community begins to need memory support services but the community does not offer it, then the resident likely will have to move to a new community. Or, if the resident stays, then expenses to care for him or her will be much higher than for a typical assisted living resident, thus negatively affecting a company's bottom line.

5. No time to waste. Caring for higher-acuity residents is not simple. Providing memory care-related services necessitates increased staff training and labor costs, as well as increased regulatory oversight. The training and development of staff is a critical component to success in the memory care segment, and those operators that are ahead of the curve in this respect will benefit in the future.

Spring Arbor assisted living offers memory care as well. For more information, contact us.


How to Decide on a Home for Your Retirement – Greensboro, NC

Joseph Coupal - Friday, November 04, 2016

Members of the baby boom generation are now moving into their 60s and approaching retirement – a process that brings with it a host of confusing choices and decisions. For many, the first question is often, “Where will I live when I retire?”

Most healthy retirees begin by taking some time to study their options and make a plan. Here are some of the many options.

1. Stay where you are. People who love their home, their neighborhood and their friends may decide to stay – at least, until there’s a good reason to move. But it’s important to be realistic. A big family home can become a burden to its residents as they age. But many empty nesters have hired expert remodelers to adapt their home to make it easy to use and maintain. Stairs often become a problem, but moving the master bedroom and the laundry room to the ground floor can be part of a solution that gives such retirees many more years in the home they love.

2. Downsize. If the current home isn’t easily adaptable, it may make sense to look around for a smaller, newer home – one designed to be easy to live in and take care of. Many retirees look for such homes in one of the two varieties of age-restricted communities: those where most residents are age 55 or older, or those where everyone is 62 or older. And other suitable homes can be found in all-age communities. And don’t forget apartment or condo living – a perfect option for retirees who don’t want to worry about home maintenance, or who plan to spend a lot of time traveling.

3. Stay nearby, move to an area near adult children and grandchildren or head for a better climate. Research shows that most retirees who move prefer to stay nearby, either in the same town, the same county or the same state. But others look at the move as a liberating opportunity to do something completely different. Some even retire to another country, where the cost of living is lower. Younger retirees often consider moving to communities that focus on an active lifestyle, with enhanced opportunities for continuing education, cultural events or physical fitness programs that foster continuing wellness. In the past, people looked to the sunny Southern states for such communities. But these days, smart builders are locating such active-adult communities even in Northern states.

4. Plan for a smooth transition. Another choice for those who like to plan ahead is a community that offers many living situations. Most have independent cottages or apartments for active younger residents, assisted living options for residents who need some help, and skilled nursing care for residents who become frail or ill. In such a community, a resident can move from one to another with a minimum of disruption.

For more information on senior living, contact Spring Arbor.

November is Alzheimer’s Awareness Month – Richmond, VA

Joseph Coupal - Monday, October 31, 2016

Alzheimer’s is a type of dementia that causes problems with memory and behavior. While it mostly affects older adults, it can appear in people who are in their 40s and 50s.

It is estimated that approximately 5.3 million Americans suffer from this terrible disease. It is a progressive disease, in that it worsens over time.

At first, an individual diagnosed with Alzheimer’s may suffer mild memory loss. Over time, sadly, dementia symptoms worsen and individuals lose their ability to carry on a conversation or perform tasks that used to be handled with ease.

While currently there is no cure for Alzheimer’s, treatment for symptoms is available. Medications such as cholinesterase inhibitors and memantine can, for a limited time, treat symptoms such as memory loss and confusion.

In addition to medicine, some researchers believe that the onset of advanced symptoms can be delayed through exercise and a healthy lifestyle. Other research has shown that some patients benefited cognitively with art and music therapy.

Like with other diseases, early diagnosis of Alzheimer’s is important. While the onset of the disease cannot be stopped or reversed, early diagnosis gives a patient a better chance of benefiting from treatment.

Early diagnosis also gives the patient and his or her family more time to plan for the future and allows the patient to be involved in decisions about care, transportation, living options, and financial and legal matters.

Planning is important because of the significant amount of care that is needed for an individual with Alzheimer’s.

Raising awareness of Alzheimer’s disease will help bring understanding and might give people the ability to spot signs of the disease.

Famous past leaders like Ronald Reagan suffered from Alzheimer’s and his willingness to share his diagnosis helped people understand that the disease does not discriminate.

He expressed hope that by sharing his story, it would help build a constructive national conversation and a clearer understanding of people affected by this awful disease.

To learn more about Alzheimer’s, visit To learn about Alzheimer’s Care, contact Spring Arbor.


Considering Senior Living - Greensboro, NC

Joseph Coupal - Thursday, October 20, 2016

The line between independent living and assisted living isn’t hard and fast. A spectrum of services means individuals can search for the level of assistance that suits their needs and goals of living as independently as possible.

The No. 1 tip that experts in senior living offer on the topic is to plan ahead. Doing so can help one stay in one’s own home longer or retain more independence and control over housing and other decisions.

We often think, ‘This could never happen to me,’ and we always procrastinate. You have to be proactive.

Being proactive can mean everything from downsizing one’s belongings sooner rather than later to exploring senior living options. The goal is to ensure such decisions aren’t made hastily later on, with little time for consideration and preparation.

At the same time, it’s important to inform family members, such as one’s children, about these decisions and plans.

Depending on where an individual lives resources for remaining independent vary. Some areas have publicly funded and private for-pay transportation options, for example, and some have active networks of volunteers ready to assist those who no longer can drive.

The U.S. Department of Health and Human Services also recommends planning ahead, for example by familiarizing oneself with local transportation options before such services are needed.

Additionally, improving or prolonging one’s mobility and flexibility is a key part of staying independent.

Senior living complexes are another option for individuals seeking out such resources, whether they choose to live in independent living or assisted living apartments. In addition to dining and linen services, transportation and other daily chores or living needs that these facilities can help with, they sometimes connect residents with other groups and organizations.

For more information on senior living, contact Spring Arbor.


Recognizing Dementia and Alzheimer’s Disease - Richmond, VA

Joseph Coupal - Monday, October 17, 2016

Have you ever gone into the kitchen to make a cup of coffee, and then forgot what you went into the kitchen for? You see dirty dishes, start to tidy up, take something out of the freezer for dinner, then try to remember why you came into the kitchen to begin with? This is a normal part of functioning and aging.

Dementia, on the other hand, means going into the kitchen to make coffee and not remembering the steps or how to operate the coffee maker.

Warning signs of dementia include memory loss that disrupts daily life, difficulty in completing familiar tasks, confusion with time and place, decreased or poor judgment, challenges in planning or solving problems and withdrawal from work or social activities.

Early diagnosis is the key. It’s important to get a diagnosis. What you are experiencing may not even be dementia. It might be something that can be fixed. If a dementia diagnosis is made, there is still some time to improve diet and exercise habits, the earlier the better as these can improve the quality of life. If a diagnosis is made early, there is still time to make or review financial, health care and end-of-life plans. It is possible to make decisions for care that can be carried out as the dementia progresses. Most importantly early diagnosis means there is still time to do the things you like and want to do. This may be traveling, spending time with family, volunteering, or running a marathon. Medications are available to moderate symptoms and provide time to do the things you enjoy. The medication does not, however, alter the course of the disease.

People in early stages of the disease have learned to live with memory loss and still maintain productive lives with family and friends. It is important to gather with other people with memory loss for support, to share experiences and identify needs to maintain engagement in order to contribute to family and community.

For more information on memory loss and dementia care, contact Spring Arbor.


Finding an Assisted Living Facility Takes Time – Greensboro, NC

Joseph Coupal - Friday, October 14, 2016

If a family has made the decision to move an elderly loved one into an assisted living facility, the next decision is just as important: which one to choose?

Choosing a facility is a decision that only can be made by family, but some questions to ask when researching and visiting an assisted living home can help to make an informed decision.

Often, the No. 1 question is how much it will cost.

If you haven’t looked at assisted living before, seeing the price is kind of a sticker shock.

The first question families should ask is whether the facility has levels of care and if those levels require an additional cost.

Are there levels that define the care acuity, such as if they need assistance showering, going on the toilet or assistance dressing. Some facilities do have extra charges.

A lot of families ask about Medicaid coverage for assisted living. There are Medicaid-accepted assisted living facilities, but not all facilities will take Medicaid, so it is important to ask at each location.

Another question that is asked a lot is about activities and how residents are transported to off-site activities. Ask to see activity calendars and food menus.

It is common for family members to feel guilty about placing a senior in an assisted living facility and they often look for a facility that is modern looking and high end. Don’t let guilt cause families to worry too much about superficial aspects of the building, however you do want a nice building that is light, airy, modern, has a good feel, and is well-maintained.

It’s about the care, the teamwork of the staff, and the care given to the resident. Don’t worry about a place that is 20 years old compared to a new building down the street.

As much research as possible should be done before reaching a decision, including going online to a reputable source, talking to organizations such as the National Council on Aging and visiting local senior centers.

Take as much time as you possibly can, both when researching online and hopefully when spending time in the community itself. It’s not a decision to rush into and you should be as best prepared as you can.

Also do spot checks of the facility.

After seeing the facility, stop back in and see how it is again. Look behind the door. A lot of time, if you schedule a tour, there’s a specific activity going on, but you don’t know what’s going on at say 6:15 p.m. on a Tuesday. Do a spot check, do two of them and have another family member go, too.

Also, take as long as needed on a tour. Don’t let the community decide how long the tour is. You should go in with your own time frame.

For more information on assisted living, contact Spring Arbor.


Baby Boomers are Redefining Senior Living – Richmond, VA

Joseph Coupal - Wednesday, October 05, 2016

Today's American seniors are used to living in a world that caters to them. All their lives, they've been able to purchase exactly what they needed, when they needed it, and they expect similar accommodations as they move into the later years of their lives. Better yet, they have a larger discretionary income than any previous generation, which means that they have the means to pay for the services they want.

Each day, more than 10,000 individuals hit the age of 65. These baby boomers are redefining the face of senior living every day with their improved definition of life after retirement.

The healthcare and social assistance sectors are now among the largest in the United States, and thanks to baby boomers reaching retirement age, the number of physicians needed for elderly care likely will double or triple in the coming years. These changes are expected to significantly alter senior services and care for generations to come.

For years, baby boomers have denied that they are going to get old. Now, the defiant generation finally is thinking about the future — especially where and how to live.

Below are some finding on the various senior living industries and the expected effects of this generation of retirees.

Assisted living and skilled nursing

With so many more seniors in America, the demand for high-quality assisted living and skilled nursing never has been greater. For today's senior, the move to a senior living community isn't about medical necessity; it's about a choice of lifestyle.

Many assisted living communities and skilled nursing facilities now make it their aim to appeal to this new generation of seniors, adding amenities and programs that appeal to different lifestyles or that accommodate a wider range of hobbies and activities. Currently, nursing homes are funded primarily by the Centers for Medicare & Medicaid Services, but shifts in policy indicate that more residents will be paying for their own care, just as most independent living and assisted living residents do — meaning that the nursing homes have to be able to measure up.

Baby boomers can't be offered a one-size-fits-all solution. The baby boom generation invented the idea of mass customization, and that's what its members are looking for in an assisted living community or SNF. They're expected to begin critically assessing senior living and nursing homes, lobbying for improved services and care — and more privacy. In nursing homes, for instance, experts assert, boomers will demand availability and responsiveness from physicians and insist on having a psychiatrist on staff to watch for signs of depression. In addition, many will emphasize integrated recreation with qualified counselors and activities that stimulate the mind and body. In short, baby boomers are looking for high-quality services and care that fit all of their needs, and they won't settle for less.

Continuing care retirement / life plan communities

Thanks to the changing trends and new needs of baby boomers, continuing care retirement / life plan communities are considering how to redefine their services for the future.

Baby boomers have an overall mindset of “I'm too young to live in a place like this.” The benefits and luxuries often seen at life plan communities — full-size gyms, trained chefs who have studied at top cooking schools, numerous activities, interiors that have been decorated by professionals — are designed to provide independence and all the amenities and social activities that baby boomers could ask for while still leaving them with the security that assisted living and nursing home care will be available if it is needed.

Outside of life plan communities, many multimillion dollar independent living communities have been built to accommodate the wants and needs of the new generation of seniors. This group tends to embrace an active retirement, with many boomers planning a move to age-focused communities while they can still enjoy themselves, instead of waiting until a move is medically necessary. Today's 55-and-older communities feature everything from entertainment areas with video games and computers to state-of-the-art gyms with personal trainers and activities.

Aging in place

More and more seniors are choosing to age in place, remaining at home (wherever home is, including independent and assisted living apartments) as long as they are physically able to do so. In their minds, aging in place allows for more freedom, safety and comfort while promoting healing, giving aging adults continuing control over their own lives, and creating a healthier and happier lifestyle. The senior can remain in his or her existing community and reduce fears that independence is being lost.

The aging-in-place movement has opened up a variety of needs and services. Single-family homes often must be redesigned to accommodate seniors' increased health needs. They need technology and medical services that consider both their needs and their wants. Those include accommodations for in-home caregiving, principles of green building, and eliminating preconceptions that aging in place needs to be like living in a hospital.

Of course, independent and assisted living apartments designed with older adults in mind are built with necessary features or are built in a way that more easily can accommodate features that residents may desire.

Many other “silver industries” also have arisen: certified aging-in place specialists, geriatric care managers, senior relocation specialists, senior concierge services, home healthcare agencies and a vast array of technology services. As technology improves, many individuals predict more services steadily being offered to allow seniors to remain at home even longer.

It's an exciting time for seniors.  They have access to a vast amount of information online, and they're taking advantage of it to acquire the services that they want and need for themselves.

For more information on luxurious senior living communities and assisted living apartments where you can age in place, contact Spring Arbor.


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.