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Is it a Senior Moment or Is It More Serious?

Joseph Coupal - Monday, April 29, 2019
Spring Arbor, NC, VA

Everyone has moments of forgetfulness, especially as they age. Losing car keys, forgetting what you need to buy at the grocery store or where you parked your car can all be jokingly attributed to “senior moments.” For most people that would be the right analogy.

Short-term memory is often the first thing to go with age. This is sometimes particularly true of women because they are often more apt to be distracted or thinking about multiple things at the same time. This in turn interferes with their ability to retain memories. As we age, the amount of time our memory can store short-term memories becomes shorter and shorter, explained Hyannis neurologist Karen Lynch, MD.

For others, however, memory lapses are a foreshadowing of more serious cognitive decline. A recent study, published by the journal Neurology, involved 1,107 women age 65 and older. At the beginning of the study, about 8 percent of the women reported having memory lapses.

Nearly 20 years later 52.8 percent of that subgroup of 89 patients had suffered significant cognitive decline, compared to 38 percent of the people who didn’t report memory lapses at the beginning of the study.

The fact that it took close to two decades to see those results means that most people don’t have to worry. When a patient comes in with subjective complaints of forgetfulness, she may run some tests, and sees them again in six months or a year, and sometimes annually, depending on the concerns. If everything is stable, she leaves the door open for them to come back if their symptoms worsen, but often continued close neurological care isn’t necessary.

“When a patient comes in and tells me they’re worried that they have Alzheimer’s disease, the vast majority of the time I can usually say that they don’t,” she said. “Most people with Alzheimer’s never realize their cognitive failings, and have little insight into the memory loss. They can go many years not really aware that they are having difficulties. It’s usually a family member or friend who brings them to the attention of the physician. If somebody, themselves, admits that they are having memory issues, most likely it may simply be normal aging.”

It’s Different If You’re Younger

The exception to that is someone who is in their 40s through early 60s. People who are still working are more apt to notice cognitive decline because they have trouble doing their job. They also tend to be more active than most retired people and, as such, cognitive decline and the associated withdrawal from normal activities can be more obvious and picked up sooner.

Orientation is another big clue, Dr. Lynch said. Frequently, not knowing where you are or the month and year can be signs of Alzheimer’s.

It’s the difference between not being able to find your car keys and not remembering that you own a car. People experiencing senior moments are still able to function in life. When memory starts to interfere with that, it is a sign something is going wrong, she said.

“It can be hard to figure out, so if you are worried you should talk to your primary care doctor,” Dr. Lynch said. “If your physician evaluates you and thinks there might be something more to it, then certainly it is best to have it checked out. Sometimes that reassurance is all you need.”

Certain people are harder to diagnose than others, but researchers are now in the process of using imaging to diagnose Alzheimer’s disease. Dr. Lynch is participating in a $100 million nationwide study called Imaging Dementia – Evidence for Amyloid Scanning (IDEAS). The study is supported by the Alzheimer’s Association.

The study began in 2015 and is expected to recruit up to 18,000 participants. To qualify for the study, a patient must be 65 or older, Medicare eligible and showing mild signs of dementia where the cause is unclear. Participants are given a PET scan that can reveal clumps of amyloid, a malformed protein found in the brain of people with Alzheimer’s disease.

For more information on memory care, contact Spring Arbor.


Music Can Revive Memories in Dementia Patients

Joseph Coupal - Thursday, April 25, 2019
Spring Arbor - VA, NC, TN, SC

Modern researchers have now discovered that music can soothe those suffering from dementia or Alzheimer’s disease.

Researchers at University of Utah Health recently tested whether they could alleviate anxiety in patients with dementia by playing familiar music to them using headphones and a hand-held music device. Anxiety and agitation are two of the most disruptive aspects of living with dementia and Alzheimer’s disease for both patients and caregivers.

After the researchers helped the patients pick meaningful music, they used a functional MRI to record the changes in the brain while the music played. The brain images showed that music helped the areas of the brain known as the salience network, the visual network, the executive network, and the cerebellar and corticocerebellar networks all work with better connectivity. These areas of the brain activate language and memory, according to the study’s authors.

“When you put headphones on dementia patients and play familiar music, they come alive,” Jace King, lead author of the study, said in a press release. “Music is like an anchor grounding the patient back in reality.”

Music and movement are the last things to go in the brain.

It’s almost miraculous what music can do for Alzheimer’s patients and the research about the benefits is there.

Patients Respond

Health care providers have seen firsthand how much music helps dementia patients. with the clients there.

Play songs from their era that they might recognize. Patriotic songs are also popular.

Music touches people on so many levels.

The reaction by dementia patients to music was also dramatically demonstrated in the 2014 documentary, Alive Inside. Elderly care professionals can set up personalized playlists on iPods for their patients. The music helps the patients access the deep memories not lost to dementia. It also helps them converse and socialize in ways they weren’t doing before the familiar music became a part of their daily life.

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


There are Ways to Prevent Dementia

Joseph Coupal - Monday, April 22, 2019

Spring Arbor - VA, NC, TN, SCDementia threatens to rob us of treasured memories. But there are ways to reduce your risk.

A new study followed 15,744 people over 25 years and found that people ages 45-64 who have diabetes, high blood pressure (also called hypertension) and prehypertension have a higher chance of developing dementia.

The good news is that a study shows that there are many lifestyle changes you can make that will reduce your chances of developing dementia later in life.

There are many other studies that reinforce these findings, but this study is major and reaffirms the importance of the healthy habits we’ve been focusing on for years.

Dementia is a group of symptoms caused by disorders that affect the brain. Memory loss is usually the earliest and most noticeable symptom of dementia.

To lower your risk for dementia, stroke and cardiovascular disease, you need to do everything possible to maintain brain health and healthy blood vessels, he said. You will stay your healthiest if your blood pressure, cholesterol and blood sugar are good and you avoid toxins like tobacco and alcohol.

There are several key ways to reduce your risk of dementia, including:

  • Control your blood pressure
  • Maintain a healthy cholesterol level
  • Keep blood sugar levels under control
  • Don’t smoke
  • If you drink alcohol, drink in moderation
  • Eat a healthy diet rich in fruits and vegetables
  • Exercise at least three days a week

You want to invest money in your grocery store, not the pharmacy. When you make the right food choices, you are doing the best thing you can to stay healthy. Also, drink plenty of water each day.

When patients who have experienced strokes ask what they can do to prevent further memory loss, the answer is the same: Control your risk factors, eat a healthy diet and exercise.

For more information on dementia care, contact Spring Arbor.



Some Simple Facts About Assisted Living

Joseph Coupal - Monday, April 15, 2019
Spring Arbor, Richmond, VA

It's important to know that assisted living is an industry term. It isn't strictly defined, and there's great variety in terms of assisted daily living services provided. For example, some but not all assisted living centers have 24/7 nurse staffing. The following facts about assisted living can help you understand the diversity. The more you know about possible differences from place to place, the better your odds of making a great move.

  1. Cost is usually a top concern whenever people hunt for housing. Below we give details about assisted living expenses and how to pay for long-term care. But here's a good basic fact: Assisted living generally costs much less than nursing home care. Prices vary by region and the services needed. Also, individuals and families find many ways to pay for assisted living without draining their resources. Below we look at veterans' benefits, Medicaid, long-term care insurance and other solutions.
  2. Services with assisted living vary from place to place. The US lacks a nationwide or federal definition for assisted living, and state governments all have different industry regulations. Many states issue more than one type of license for assisted living facilities, resulting in different levels of care being allowed. Licensing also matters for payment to be covered by Medicaid, private insurance and other sources. Facilities with the most advanced licenses may provide advanced medical care when a resident becomes bedridden or has symptoms of dementia. Others might need the resident to transfer to a nursing home, hire a personal nurse, or choose in-home healthcare. Main categories of assisted daily living services (ADLs) are:
    • Bathing
    • Dressing
    • Medication Management
    • Meal Services
    • Transportation

    Residents might also get help with housekeeping needs such as dishwashing, laundry and vacuuming. Examples of specialty services that might cost extra are hairdressing, physical therapy, memory therapy, and help with scheduling appointments. Besides providing personal care services, most independent living centers facilitate social groups and outings. With everything from Bible study groups to casino gambling trips, there's something for everyone! Educational activities such as art classes and computer lessons are offered too. Generally the larger the assisted living community, the more activities it sponsors.

  3. Memory care is an option at select assisted living centers. If you or a loved one is in an early stage of Alzheimer's or other dementia, then choosing an assisted care facility might be your best option in terms of stretching your money and allowing a longer period of independent living. Staff at specially licensed centers can help delay the progression of dementia with various therapies. They can also help minimize or prevent common dementia-related challenges such as wandering and anxiety. When the condition becomes advanced, it might be possible to live at the same facility, but in a different area with secured doors and other special accommodations.
  4. Culture or “personality” matters. The US has thousands of assisted living facilities and no two are quite alike…
    • In some the decor is formal; in others it's relaxed.
    • Some are very small communities and others have hundreds of residents.
    • Depending on the property's layout, and also the local climate, residents might tend to spend lots of time outdoors, or else tend to stay inside.

    And of course residents bring different cultures along. When you search for assisted living centers, you can find homes that tend to attract residents from specific ethnic backgrounds, language groups, religious affiliations and so forth. Lately as more baby boomers are moving to assisted living, we're seeing more and more “special interest” communities too. Residents are brought together by shared interests in areas as diverse as art, golf, LGBT issues, vegetarianism and community service

  5. Pets are welcome in many independent living communities. Sometimes animal care services such as grooming and dog walking are available for an extra charge. Some communities have their own “mascot” dogs and cats. When animal companions are allowed, generally there are restrictions about the size or breed. Homes have different policies about aquariums, birds and other “pet issues” — so before choosing an assisted care facility, verify that the pet policy fits your preferences.

For more information, contact Spring Arbor.


Assisted Living and Residential Memory Care

Joseph Coupal - Thursday, April 11, 2019
Spring Arbor, SC, NC, VA, TN

are long-term housing for seniors, including those with dementia. Residents live in private suites or apartments, but some do share a living space with another individual.

According to the Alzheimer’s Association, of those residing in residential care homes, 40% have some sort of dementia. Memory care , also called Alzheimer’s care, is similar to assisted living, but are specialized in people with dementia, and in most cases, are wings of assisted living facilities. It’s common for dementia care to have more staff than regular assisted living, and for the units to be locked to prevent patients from wandering.

Regular assisted living may be appropriate for those in the early to middle stages of dementia, but as the disease progresses, residential memory care is more appropriate for those who require a greater degree of care. Along with services provided in regular assisted living, such as assistance with daily activities (bathing, personal hygiene, dressing, etc.), meals, basic housecleaning, 24-hour emergency care, medication management, and social activities, residential memory care caters specifically to persons with dementia. Staff is knowledgeable about how the disease progresses, common problematic behaviors and how to handle them, and provide activities that engage persons with dementia.

Memory care is more expensive than is regular assisted living, given the specialty training of staff, the higher level of supervision, and the increased patient to staff ratio. Click here to learn more about how assisted living differs from assisted memory care.

Finding the right assisted living / residential memory care community for your loved one is difficult both emotionally and logistically. For more information, contact Spring Arbor.


Memory Care Checklist

Joseph Coupal - Monday, April 08, 2019
Spring Arbor - VA, NC, TN, SC

Choosing the right care facility is hard, and choosing the right memory care home is even harder.

Here are some questions to ask to help make the decision easier. As with any senior living home, 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 memory care residence 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?

Some facilities offer fake kitchens where former bakers can feel at home, or stations where residents can fold laundry or do other familiar tasks that might be comforting.

For more information, contact Spring Arbor.