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Hearing Loss -- Education and Prevention

Joseph Coupal - Thursday, September 02, 2010

All of us at Spring Arbor Living seek to promote healthy life styles for both our residents and their entire family.  According to the National Institute on Deafness and Other Communication Disorders (NIDCD), ten million Americans have already suffered irreversible hearing damage from noise and another 30 million are exposed to dangerous levels of noise each and every day. Hearing loss is a common affliction for both the old and the young. So take two minutes to read, reflect, and if need be, change your bad habits that put your hearing at risk.  

The rule of thumb, according to NIDCD, is to be wary of noises that are “too loud”, “too close”, or last “too long”. When exposure to potentially dangerous noise is unavoidable, noise induced hearing loss can be prevented by using effective hearing protection such as earplugs, earmuffs or headsets. These will help drown out the sound from those outside sources and protect your ears.

Make sure to watch out for symptoms of hearing loss, including sounds that appear distorted or muffled a ringing in the ears, a feeling of fullness in the ears and difficulty understanding speech. Any of these signs signal that a hearing test is essential. The test will go through a series of sounds and pitches to determine where your hearing level is and if it is damaged.

Today’s hearing aids are smarter, smaller and more comfortable than ever before. With proper professional hearing care support, they can benefit 95 percent of all those with hearing loss. However, there is no substitute for prevention, and noise induced hearing loss is 100-percent preventable. There are many programs and companies out there that specialize in hearing aids. And most of them would be glad to help out.

As a small quick tidbit, we'll share some quick sound facts since we are on the subject of hearing and sound. We hope this post was informative and everyone protects their ears. Being able to hear is a valuable sense to have and we take it for granted until it is gone.

•   The unit used to measure sound is a decibel: A whisper may be 30 decibels, and typical conversation measures 60 decibels, while a hair dryer can come in at 90 decibels.
•   An increase of 10 on the decibels scale means the sound is 10x more powerful.
•   The Sight and Hearing Association estimates that unprotected hearing can be damaged in four hours when using a power saw (95 decibels), 15 minutes at a stadium football game (115 decibels), and eight hours in truck traffic (90 decibels).
•   A single acoustic trauma can result in permanent hearing loss – or in temporary hearing loss, which may be followed by partial or total recovery. Sudden hearing loss always requires prompt medical attention.

So just exactly what is "too loud too close, or too long".  Unless you carry a decibel meter wherever you go, you just have to trust your instincts. You know, young people just know that they are going to "hear forever".  We, the mature, know better.  Just be honest with yourselves, and don't be lazy.  Reach for your hearing protection each and every time your gut tells you to do so. 

Stop by or call to continue the discussion or for more references on the subject of hearing loss. 


What is Young-Onset Dementia

Joseph Coupal - Monday, August 30, 2010

"Dementia" is a general term that refers to decline in multiple areas of thinking and/or memory while an individual is awake and alert; the decline is enough to interfere with normal daily functioning, whether on the job or at home.

The term "young-onset dementia" refers to dementia that begins before the age of 65, sometimes as early as the 30s and 40s. This is to be differentiated from "early stage dementia," which has nothing to do with age. Rather, it refers to the beginning of a dementia syndrome regardless of the age at which it starts.
Young-onset dementia can be caused by frontotemporal lobar degeneration (FTLD), Alzheimer's disease (AD), cerebrovascular conditions (e.g., multi-infarct disease, stroke), Parkinson's disease, Huntington's disease, prion diseases (e.g., Creutzfeldt-Jakob disease), and other conditions.

These early dementias are devastating neurological conditions that exact a tremendous emotional and financial toll on patients and their families and present a host of challenges never envisioned by the young patients. The condition causes a unique problem not only because it is so unexpected but because most of the potentially helpful programs and services that a younger patient needs have all been carefully designed and targeted for much older people.

One of the major problems with young-onset dementia is that it cuts down a person in their prime wage-earning years. While most older people with dementia are retired, many people with young-onset dementia are still working when they are diagnosed.


Types Of Dementia And Their Characteristics

Joseph Coupal - Thursday, August 26, 2010

We had a family member recently suggest that we post a blog that defines the common forms of dementia and the associated characteristics.  There is a shared bond between patients and family members of those inflicted with dementia. A common observation by these fine people is how little the general public knows about dementia outside of the relatively well known subject of Alzheimer's.  We will be glad to list below the most prolific forms of dementia in America today:  

Alzheimer’s disease: Most common type of dementia; accounts for an estimated 60–80 percent of cases. Difficulty remembering names and recent events is often an early clinical symptom; apathy and depression are also often early symptoms. Later symptoms include impaired judgment, disorientation, confusion, behavior changes and difficulty speaking, swallowing and walking.

Parkinson’s disease: Many people who have Parkinson’s disease (a disorder that usually involves movement problems) also develop dementia in the later stages of the disease. The hallmark abnormality is Lewy bodies that form inside nerve cells in the brain.

Vascular dementia: Considered the second most common type of dementia. Impairment is caused by decreased blood flow to parts of the brain, often due to a series of small strokes that block arteries. Symptoms often overlap with those of Alzheimer’s, although memory may not be as seriously affected.

Dementia with Lewy bodies: Pattern of decline may be similar to Alzheimer’s, including problems with memory and judgment as well as behavior changes. Alertness and severity of cognitive symptoms may fluctuate daily. Visual hallucinations, muscle rigidity and tremors are common.

Front temporal dementia: Involves damage to brain cells, especially in the front and side regions of the brain. Typical symptoms include changes in personality and behavior and difficulty with language. No distinguishing microscopic abnormality is linked to all cases. Pick’s disease is one type of front temporal dementia.

Mixed dementia: Characterized by the hallmark abnormalities of Alzheimer’s and another type of dementia — most commonly vascular dementia. Recent studies suggest that mixed dementia is more common than previously thought.

Creutzfeldt-Jakob disease: Rapidly fatal disorder that impairs memory and coordination and causes behavior changes. Variant Creutzfeldt-Jakob disease is believed to be caused by consumption of products from cattle affected by mad cow disease. Caused by the misfolding of prion protein throughout the brain.

These are some of the most common types of dementia. While Alzheimer's is the leading type of dementia there other forms that we thought everyone should be aware of the many forms of dementia. Each and every one of these disease is devastating on both the patient and their support team.  And always realize, your support team at Spring Arbor Living is always well educated, well versed in these diseased, and most importantly, well stocked in the passionate care of you all.  


Mental Exercise Tip: Adding Associations To Strengthen the Mind

Joseph Coupal - Monday, August 23, 2010

This Spring Arbor Living blog offers new tips on battling forgetfulness.  We'd like to introduce to you another another great book we've discovered, Harry Lorayne's "Ageless Memory: Simple Secrets for Keeping Your Brain Young".  This book is yet more validation that we need to exercise our minds like we do our bodies.  This work is very insightful and offers new tricks to train your brain to focus. Here are some things from his list of ideas for helping to strengthen your mind.

- Pay attention: Create links to something else when you’re trying to remember something.

- Visualize the name: Link an image to a name with similar characteristics based on sound.

- Create memorable associations: Even if the association is out of character of the object or person you are trying to remember, the image will stay in your mind.

- Give a play-by-play: Living in the moment and being conscious of what you’re doing helps to remember what you’ve done.

- Make it a habit: For things that are done on a regular basis, be sure to do them in the same way every time.

- Sing it: Putting lists or things to remember to a tune helps it stick in your memory.

- Try mnemonic devices: Using the first word of each item in a list can help.

- Use your body: Create connections to what you’re trying to remember with body parts to create a stronger, closer connection.

- Go Roman: Use well-known areas as a map, where you can place items to remember along the map.

- Use color: Adding color to notes helps create a stronger linkage.

As you can see, most of these ideas are very visually and linkage-related. We feel it is a service responsibility to share our educational findings with you as often as we can.  Our minds like organization and by giving these things that we need to remember a place to be in our minds, even if it’s a weird place, it sticks with us better.

So don't forget to exercise today.....mind, body, and soul. Picking up Lorayne's book might just be great exercise.


Financial Tips For Families and Recipients of Assisted Living

Joseph Coupal - Wednesday, August 18, 2010

Do you know that there are wide ranging personal finance and tax saving opportunities that only a professional adviser is likely to be aware of. The staff at Spring Arbor Living would like to point out a few of the not so commonly known proactive measures that you can  take to ease the cost burden of assisted living serves.  If you are either the benefactor of assisted living services OR financially contributing to the same, you owe it to yourself to speak with a professional tax attorney about the implications on your Federal and State tax burden.   Under the federal Health Insurance Portability and Accountability Act (the "HIPAA"), seniors may be eligible to deduct portions or all of assisted living costs as a medical expense on their Federal tax returns.   ALL costs related to senior care may be deductible if the resident is unable to perform (without substantial assistance) at least two activities of daily living, such as eating, bathing, dressing, etc. It can also apply to seniors who require substantial supervision to protect the individual from himself or herself because of severe cognitive impairment. Again, we encourage you to discuss the subject of assisted  living expense with an certified tax law professional.

For those of you financing a loved one’s assisted living, that is not reimbursed please realize that elder care medical expenses above 7.5 percent of adult children's adjusted gross income may be tax-deductible. You can and should contact your tax attorney or directly contact the e Internal Revenue Service.

For those who have or are about to enter resident assisted living, very often there is an emotional attachment to the family home that they are vacating.  Children can consider buying it from their senior parents and even  carry back the mortgage of the parent to increase the parents fixed income. If the family wants a formal loan structure, consider looking online or if you have a family financial adviser they can handle the paperwork and collection of payments, etc.

Of course financial matters are very private in most families. Don't be insulted if your parents refuse to share the details of their money while they retain full control. Do guide them to seek reputable guidance. If there is no family financial adviser you can find a very skilled and reputable financial planner through the National Association of Personal Financial Advisers (www.napfa.org) who can provide a second opinion and peace of mind for lifelong do-it yourself investors.


New Scientific Discoveries About Cancer and Vitamin D

Joseph Coupal - Monday, August 16, 2010

In one of our older posts we discussed vitamin D, and its two forms; D2 and D3.  Today, we'd like to share with you some recent  new discovery about the health benefits of vitamin D.  New medical research reveals that Vitamin D could very well be THE most effective “medicine” to use in the war against cancer. 
 
According to Joel Fuhrman, M.D., vitamin D "has now emerged as a positive contributor to many non-skeletal physiological processes which contribute to the prevention of cancer, cardiovascular disease, infections, autoimmune diseases, and more Researchers at Creighton University’s  School of Medicine discovered that supplementing your diet with vitamin D and calcium can reduce your risk of cancer by an astonishing 77 percent. This includes breast cancer, colon cancer, skin cancer and other forms of cancer. This research provides strong new evidence that vitamin D is the single most effective medicine against cancer, far outpacing the benefits of any cancer drug known to modern science.

The study involved 1,179 healthy women from Nebraska. One group of women was given calcium (around 1500 mg daily) and vitamin D (1100 IU daily) while another group was given a placebo. Over four years the group receiving the calcium and vitamin D supplements showed a 60 percent decrease in cancers. Considering just the last three years of the study reveals an impressive 77 percent reduction in cancer due to supplementation.

The research at Creighton University continues  and we hope to they publish more findings soon.  The medical community and the Food and Drug Administration have not altered the official language of the recommended daily dosage of Vitamin D, but stay tuned.  This could soon be one of the more talked about medical breakthroughs.   


Special Events Announced For The Outer Banks Cottage Opening

Joseph Coupal - Thursday, August 12, 2010

The excitement is growing as we witness the finishing touches being placed on Spring Arbor’s newest Alzheimer’s Cottage facility at the Outer Banks of North Carolina. Although the official opening day is scheduled for October 1, 2010, please mark your calendars for two important upcoming events associated with the opening.

Alzheimer’s Cottage Grand Opening Questions/Answer Summit: Thursday, August 19, 2010, 7:00 PM at Spring Arbor of the Outer Banks, 803 Bermuda Bay Blvd, Kill Devil Hills, NC. The event will be hosted by our new Cottage Program Coordinator, Ms. Tamara Mullen. Tamara will present to you all the latest updates that we have available and engage any and all questions that you might have about your new facility.

Ribbon Cutting and Pig Pickin’ (with performance by “The Embers Band”). Sunday, September 26, 1:00 – 5:00 PM ($10 Donation). Come out, celebrate, and socialize what is sure to be a fun packed day.

If you have any questions in advance of these two events, please call our Executive Director, Ms. Debra Warren, (252) 449-4455 or email Debra at obxexecdirector@hhhunt.com.


Forget Memory-- A Quality Book by Anne Davis Basting

Joseph Coupal - Tuesday, August 10, 2010

We want to share with you a quick summary of a book that dementia caregivers might find insightful.  The book, "Forget Memory" is focused on “Creating Better Lives for People with Dementia.” This is in fact the book's subbitle and central focus.  

Basting opines that while scientists try to find a cure for Alzheimer’s and dementia patients, caregivers should maintain faith in the scientific community but focus energy on the issues of today. She discusses the importance of living "in the moment".  In cases of extreme dementia,  memories are essentially not accessible and therefore it is the quality of the moment that defines quality of life.   Basting relates stories about caregiver fear of being a burdened, fear of the unknown, fear of being out of control, a fear of a loved one being violated or robbed, and a fear of a meaningless existence. Dementia sufferers at all levels can sense emotion.  Quality of life would have them stare into the face of confident caregivers, not fearful ones. The fear that one's loved one is indeed "senseless" contributes to a common (and quite natural defense) to dismiss the patient's behavioral ownership in lieu of blame on the disease itself. This is when caregiver fear becomes dangerous.  

There is a good excerpt from the beginning of the book: “That’s not him, it’s the disease”.  When we conclude that a man with dementia shouts out in anger solely because of his disease, it eliminates the caregiver from the burden of addressing the tougher issue of misbehavior.  It offers an excuse to give up and forgo the labor of an honestly assessment.  The danger of course is when the patient has very real issues (injury or need) and the caregiver simply dismisses the notion as non-existent, or even if it is deemed to be legitimate, the condition will not be remembered.   Dismissive behavior within caregivers affects dementia patients more than we realize.

Basting makes a great case that caregivers should "forget memory" as an excuse to dismiss the issues of the demented moment.  The issue of the moment may be all that they have, and the only thing that is truly real. Those moments define their cognizant existence and demand very real and non-dismissive attention.

 It is impossible to capture the genuine depth of Basting's reasoning. We believe that by reading her book, you will certainly achieve new enlightenment about the dreaded disease of dementia and empower you to be a more loving and understanding caregiver.  


Attention Spring Arbor Veterans

Joseph Coupal - Thursday, August 05, 2010

Location - Williamsburg, VA: One of the Veterans Administration's best kept secrets is a non service connected pension to help pay for assisted living, home health care and even nursing home care. Most Veterans think VA pensions are only for service-connected disabilities. However, there is a service connected pension available to pay for disabling conditions such as Alzheimer's, Dementia, MS, Parkinson's and blindness. This can be a great benefit for Veterans, their spouses, widows, and widowers.

For Veterans 65 years of age or older: If you are housebound or in assisted living and over age 65, the VA presumes you to be in need of "Aid & Attendance". NOTE: you do not need to be helpless, only in need of the help of others.

For Veterans under the age of 65: You must be totally and permanently disabled if you are under age 65 to receive this pension. "Aid & Attendance" is a part of this pension that is very important. Simply put, if you need the aid & attendance of another person in order to live in a safe and healthy environment (for example you need someone else to help you bathe, dress, ambulate or prepare meals you could be entitled to this benefit.

The maximum benefit amounts for 2010 are: Veteran with spouse $2,047.00 per month, Veteran only $1,794.00 per month and a surviving spouse $1,100.00 per month TAX FREE. This is not a Medicaid program. Medicaid benefits are part of the welfare system with strict income and asset limits. VA non-service connected pensions are an entitlement because you served your country. They have been around since 1951. You do not have to be broke to qualify for this pension. There are limitations that can be very confusing. Your income must be less than the maximum allowable pension. Income can be reduced by recurring, non-reimbursable monthly medical expenses. This includes the cost of assisted living or home health care. Therefore income is not typically a problem for qualification.

A Veteran over age 65 with $1,500.00 per month of income and $2,500.00 per month cost of care would be entitled to a pension of $1,646.00 per month due to income being reduced to zero. This is only one example. Each client has a different set of circumstances requiring a different approach to qualification and the calculation of benefit amount. There is no established asset limit for benefit entitlement. Again the VA has various calculations that apply depending on individual circumstances. Note: the value of your home is not included as an asset.

To apply for this pension, it is advisable to seek the help of an experienced VA advisor. A VA advisor can provide pre-application consultations to determine the steps that must be taken in order to determine if you should apply for this benefit.


Engaging with Dementia Patients has Benefits

Joseph Coupal - Tuesday, August 03, 2010

Location - TN: Keeping a family member with dementia focused and engaged in activities can be a challenge, but he or she may light up if offered the opportunity to give advice or teach, according to a pair of studies reported in The Gerontologist.

In one study, researchers tried to engage individuals with early to advanced dementia at an adult day care center in a purely social way, asking them to talk about their marriage, children, and church activity. Later, the investigators approached them for guidance: "I'm thinking about having children. What kind of advice can you give me on that?" The researchers reported that the participants took their advice-giving role seriously and were more coherent, informative, and focused than when asked strictly for information about their personal life.

A second study examined the effects of offering people with dementia the opportunity to instruct. The elderly participants -- some with dementia and others who were cognitively intact -- received a booklet of pictures to help them teach someone how to prepare food from a recipe. Participants in both groups successfully taught their "students" how to prepare the food. The individuals with dementia needed some prompting to keep the process going, but they still accomplished the teaching task.

The researchers speculated that the advice-giving and teaching roles enabled the people with dementia to access knowledge gained when they were younger that was essential in their parenting or mentoring. The fact that other people needed the information empowered them to assume an established social role and probably motivated them to complete the tasks.

Finding ways to include a family member with dementia helps relatives remember the person who has difficulty participating but is still there. Plus it imparts a sense of belonging and competence that may improve his or her mood. People with dementia are often able to take part in various family-oriented pastimes. Reading aloud, for example, is a skill that can persist even in later stages of cognitive decline. With simple, large-print books, individuals may be able to read to grandchildren or other family members. As with leading or mentoring, reading to others gives the person a social role in the family.

These and similar activities help family members connect. They encourage communication and may help take the edge off what can be an exhausting and frustrating care giving situation.