Monday, April 25, 2011

Alzheimer's Blogging:

Dear Readers,


The statistics regarding people who are never diagnosed with Alzheimer's disease are staggering. Although diagnosis of Alzheimer's disease is reliable and valid, as many as half of individuals meeting specific diagnostic criteria for dementia never receive a diagnosis -- and some evidence suggests it could be as high as 80 percent. A formal and documented diagnosis opens access to valuable support and services.

Recently, the Health Outcomes, Planning, and Education (HOPE) for Alzheimer's Act (S. 738/H.R.1386) was reintroduced in the 112th Congress. Passage of this bipartisan legislation would improve care and outcomes for people with Alzheimer's disease by improving diagnosis, care planning, and medical record documentation.

The HOPE for Alzheimer's Act will improve the following:

•Diagnosis - Improve access to accurate clinical diagnosis of Alzheimer's disease and dementia.

•Care Planning – Provide care planning services for individuals and caregivers in the physician's office, which includes information about additional medical and community based services.

•Medical Record Documentation - Ensure documentation of a diagnosis in the person's primary medical record -- enabling health care providers to anticipate and prevent potential complications in the management of other conditions (such as heart disease and diabetes) and allowing for care coordination among treating physicians.

Please ask your Members of Congress to cosponsor the HOPE for Alzheimer's Act and let them know how important diagnosis, care planning, and support services are for American families facing Alzheimer's.

Help us make a difference by sending a message today.

Capitol Hill is the toughest hill to climb, but we can do it with your support. Let's shift Congress into gear.

Robert Egge

VP of Public Policy

Alzheimer's Association

P.S.: Want to do a little more? Light a candle for our virtual rally by go to www.alz.org/virtualrally to learn more about how you can make a difference.

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostno.com/
http://www.mariefostino.blogspot.com/ 

Sunday, April 24, 2011

ALZHEIMER'S BLOGGING:

New Guidelines to detect MCI, Alzheizmer's & Dementia
For the first time in 27 years, new guidelines have been published for the diagnosis of the most common type of dementia: Alzheimer’s. The initial diagnostic criteria for the disease were published by the Alzheimer’s Association and the National Institute of Neurological and Communicative Disorders and Stroke in 1984. The new criteria and guidelines are the result of work that began two years ago, when three expert workgroups consisting of a total of more than 40 Alzheimer’s researchers and clinicians from around the globe began the in-depth process of reviewing the original criteria and deciding how they might be improved by incorporating research advances from the last three decades. Formation of the workgroups was spearheaded by the Alzheimer’s Association and the National Institute on Aging (NIA) of the National Institutes of Health.

To continue reading this article and to watch the video please hit this link: http://alzheimersweekly.com/content/new-guidelines-detect-mci-alzheimer-s-dementia  

This article tells how the criteria are different along with the new guidelines. There is consensus that treating the disease before symptoms occur is what this new goal is about.

Happy Easter :)
Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Saturday, April 23, 2011

Alzheimer's Blog:

Taking care of a loved one with this disease is devastating. Do you ever question yourself about the decisions you make or how you talk to someone whether with a nice tone or not.  I remember getting angry with Grandpa Joe, and I would not want to talk to him. It wouldn't take long before the guilt would control me and make me remember that he does not know what he is doing. I would have to remind myself, it is not his fault.

Yet there were times I think I would see in his eyes, that he was lying to me, or he would be sneaking around quietly trying to get into something that I put off limits.  It is so hard to know if at times he was being deceitful or just didn't know.

One day at the day care that I dropped him off at, my concerns came into reality. One day Grandpa Joe talked the owners husband into opening the outside door a little bit saying he couldn't breath and needed some air. As soon as the door opened a crack, Dad took off. Yes this time Dad did know what he was doing.

It was a bit of relief to know that someone else could confirm that sometimes Dad would lie and be sneaky. That still doesn't help me always know the difference but it made me aware that I didn't have to be so hard on myself.

Please remember that you are only human, and you will make mistakes. But also remember that you love the person that you are taking care of and you would never intentionally try and hurt them. You are only looking out for them and their safely.

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Thursday, April 21, 2011

Alzheimer's Blogging:

SEATTLE, Wash. — The Allen Institute for Brain Science has released the world’s first anatomically and genomically comprehensive human brain map, a previously unthinkable feat made possible through leading-edge technology and more than four years of rigorous studies and documentation. The unprecedented mappings are the foundation for the Allen Human Brain Atlas, an online public resource developed to advance the Institute’s goal to accelerate understanding of how the human brain works and fuel new discovery among the global research community.

In developing the Allen Human Brain Atlas, the Allen Institute has now thoroughly characterized and mapped the biochemistry of two normal adult human brains, providing opportunities for scientists to study the brain with new detail and accuracy. The data reveal a striking 94 percent similarity between human brains, establishing strong patterns as a critical foundation for translational and clinical research. In addition, data analysis from the two human brains indicate that at least 82 percent of all human genes are expressed in the brain, highlighting its tremendous complexity while also providing an essential genetic blueprint to understand brain functionality better and propel research in neurologic disease and other brain disorders.

“Until now, a definitive map of the human brain, at this level of detail, simply hasn’t existed,” said Allan Jones, Ph.D., Chief Executive Officer of the Allen Institute for Brain Science. “The Allen Human Brain Atlas provides never-before-seen views into our most complex and most important organ. Understanding how our genes are used in our brains will help scientists and the medical community better understand and discover new treatments for the full spectrum of brain diseases and disorders, from mental illness and drug addiction, to Alzheimer’s and Parkinson’s diseases, multiple sclerosis, autism and more.”

Similar to a high-powered, multi-functional GPS navigation system, the Allen Human Brain Atlas identifies

1,000 anatomical sites in the human brain, backed by more than 100 million data points that indicate the particular gene expression and underlying biochemistry of each site. Scientists can use the Allen Human Brain Atlas to explore the human brain and identify how disease and trauma, including physical brain injuries and mental health disorders, affect specific areas of the brain. This powerful resource makes it possible to pinpoint where a particular drug acts anatomically in the brain, to ultimately better control the successful outcome of numerous therapies.

“The Allen Institute is a powerful force in modern science,” said Dr. Edward Jones, neuroscientist at the University of California, Davis. “They’ve applied an industrialized approach and high-output technology to accomplish what no other lab has ever done. The original data produced for the mouse brain revolutionized neuroscience and now the Allen Human Brain Atlas delivers extremely rare and essential information that most researchers could not otherwise access. They are truly paving the way for the future of research.”

Previously, as its inaugural initiative, the Allen Institute for Brain Science completed mappings of the adult mouse brain in 2006, similarly making the data available free to scientists. Overall, those data have led to a number of significant research advances around the world, including the publishing of over 500 peer-reviewed papers citing the Allen Mouse Brain Atlas to support research conclusions.

To watch the video please log onto http://alzheimersweekly.com/content/55000000-brain-atlas-offers-new-clues

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Wednesday, April 20, 2011

ALZHEIMER'S BLOGGING:

ABDOMINAL OBESITY AND ALZHEIMER'S


ST. PAUL, Minn. – People with larger stomachs in their 40s are more likely to have dementia when they reach their 70s, according to a study published in the March 26, 2008, online issue of Neurology®, the medical journal of the American Academy of Neurology.

The study involved 6,583 people age 40 to 45 in northern California who had their abdominal fat measured. An average of 36 years later, 16 percent of the participants had been diagnosed with dementia. The study found that those with the highest amount of abdominal fat were nearly three times more likely to develop dementia than those with the lowest amount of abdominal fat.

“Considering that 50 percent of adults in this country have an unhealthy amount of abdominal fat, this is a disturbing finding,” said study author Rachel A. Whitmer, PhD, a Research Scientist of the Kaiser Permanente Division of Research in Oakland, CA, and member of the American Academy of Neurology. “Research needs to be done to determine what the mechanisms are that link abdominal obesity and dementia.”

Having a large abdomen increased the risk of dementia regardless of whether the participants were of normal weight overall, overweight, or obese, and regardless of existing health conditions, including diabetes, stroke and cardiovascular disease.

Those who were overweight and had a large belly were 2.3 times more likely to develop dementia than people with a normal weight and belly size. People who were both obese and had a large belly were 3.6 times more likely to develop dementia than those of normal weight and belly size. Those who were overweight or obese but did not have a large abdomen had an 80-percent increased risk of dementia.

A large belly in mid-life has also been shown to increase the risk of diabetes, stroke, and coronary heart disease, but this is the first time researchers have demonstrated that it also increases risk of dementia.

In the study, women were more likely than men to have abdominal obesity, along with non-whites, smokers, people with high blood pressure, high cholesterol or diabetes, and those with less than a high school level of education.

As with all observational studies, it is possible that the association of the abdominal obesity and dementia is not driven by the abdominal obesity, but rather by a complex set of health-related behaviors, for which abdominal obesity is but one part.

“Autopsies have shown that changes in the brain associated with Alzheimer’s disease may start in young to middle adulthood, and another study showed that high abdominal fat in elderly adults was tied to greater brain atrophy,” Whitmer said. “These findings imply that the dangerous effects of abdominal obesity on the brain may start long before the signs of dementia appear.”

Check this article out and more on Alzheimer's Weekly at http://alzheimersweekly.com/content/larger-belly-mid-life-increases-risk

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Monday, April 18, 2011

ALZHEIMER'S BLOG:

CHICAGO - Memantine goes by the brand names Namenda® or Ebixa®. An analysis of studies involving the drug memantine finds a lack of evidence for benefit when the drug is used to treat patients with mild Alzheimer disease and mild cognitive impairment. This is according to a report posted online today that will appear in the August print issue of Archives of Neurology, one of the JAMA/Archives journals.

"Memantine, indicated for moderate to severe Alzheimer disease (AD), is frequently prescribed off-label [for uses other than those approved by the FDA] either alone or with a cholinesterase inhibitor for mild AD and mild cognitive impairment," the authors write as background information in the article. Cholinesterase inhibitors are drugs like Aricept®, Exelon® and Razadyne®. They increase levels of a brain chemical called acetylcholine. Increasing acetylcholine levels appears to slow mental decline in people with AD.

Lon S. Schneider, M.D., M.S., of the University of Southern California Keck School of Medicine, Los Angeles, and colleagues systematically searched manufacturer-sponsored meta-analyses, registries, presentations, and publications for randomized, placebo-controlled, parallel-group clinical trials of memantine in patients with mild to moderate AD. Three trials were identified that included 431 patients with mild AD and 697 patients with moderate AD. Using several different scales, the researchers assessed cognition, global change, functional activities, and behavior.

"There were no significant differences between memantine and placebo on any outcome for patients with mild AD, either within any trial or when data were combined," the authors report.

Among patients with moderate AD, there was no significant difference between memantine and placebo in any individual trial, although there was a significant effect when the three trials were statistically combined.

"Despite its frequent off-label use, evidence is lacking for a benefit of memantine in mild AD, and there is meager evidence for its efficacy in moderate AD," the authors conclude. "Prospective trials are needed to further assess the potential for efficacy of memantine either alone or added to cholinesterase inhibitors in mild and moderate AD."

Read this and more of Alzheimer's Weekly Magazine: http://alzheimersweekly.com/content/namenda-only-helps-middle-stages  

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Saturday, April 16, 2011

ALZHEIMER'S BLOG:

Alzheimer’s Medications

Health professionals often divide the symptoms of Alzheimer’s disease into “Cognitive” and “Behavioral and Psychiatric” categories.

Cognitive systems affect memory, language, judgment, planning, ability to pay attention and other thought processes.

Behavioral and psychiatric systems affect the way we feel and act.

DONEPEZIL (ARICEPT)- approved to treat all stages of Alzheimer’s disease. Side effects: nausea, vomit, loss of appetite and increased frequency of bowel movements.

RIVASTIGMINE (EXELON)- approved to treat mild to moderate Alzheimer’s disease. Side effects: nausea, vomit, loss of appetite and increased frequency of bowel movements.

GALANTAMINE (RAZADYNE)- approved to treat mild to moderate Alzheimer’s disease. Side effects: nausea, vomit, loss of appetite and increased frequency of bowel movements.

These drugs support communication among nerve cells by keeping acetylcholine levels high. On average delay worsening of symptoms for 6 to 12 months for about half the people who take them.


MEMANTINE- approved to treat moderate to severe Alzheimer’s disease. Side effects; headaches, constipation, confusion, and dizziness. This drug works by regulating the activity of glutamate, a different messenger chemical involved in learning and memory. It temporarily delays worsening of symptoms
for some people.

TACTINE (COGNEX)- was approved to treat mild to moderate Alzheimer’s disease, but now one of the least popular medications. Side effects; possible liver damage, nausea, vomit, and diarrhea.

I hope this helps:
Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/ 

Thursday, April 14, 2011

Alzheimer's Blogging:

What happens when your loved one with Alzheimer’s decides not to eat?

This is a very common problem. The real question is, how aggressive should we be in treating our loved one in the late stage of Alzheimer's. Do we authorize medical treatment for our loved one as their minds go away, yet their bodies live on. Alzheimer's patients can not speak for themselves about their care. Some family members argue that intense treatment in late stages of Alzheimer's is inappropriate, even cruel, and the costs are excessively high. For some family members the cost are not an issue, so when their kidneys fail, they get dialysis, and infections are treated with intravenous antibiotics. We want guidance and want to be told what is appropriate.

There is the unspoken concern that if treatment is stopped, we will be judged by family, friends, and church. We need support groups and counseling about the loss of the ability to eat and drink, and to know that now the loved one has entered into the terminal phase of the illness. We should let our loved ones die peacefully. The Alzheimer's Association guidelines on patients in the final stages of the disease say that it is ethically permissible to with hold feeding tubes and that spoon feeding should be continued if needed for comfort.

Daily Tip!
A lesson that I have learned is to not put off what you can say or do today, because tomorrow may not come. Don’t put off any kindness that you can show today. Share your love with the world! You never know how you may benefit them!

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Tuesday, April 12, 2011

ALZHEIMER'S BLOGGING:

What causes Alzheimer’s:
Alzheimer's disease is an irreversible progressive brain disease that slowly destroys memory,
thinking skills and the ability to carry our the simplest task of daily living. Alzheimer's Disease is
the most common cause of dementia among older people, but not a normal part of aging.

Scientist don't fully understand what causes Alzheimer's Disease. Genetics play a role in some
people. Offspring have a 50 - 50 chance of developing Alzheimer's Disease if one of their
parents had it. Research also suggests that other risk factors can be our life style. A nutritious
diet, exercise, social engagement, and mentally stimulating pursuits may help to reduce the risk
of cognitive decline and Alzheimer's Disease.

Cognitive impairment is a condition in which a person has memory problems greater than those
expected for their age.

We cant' control some risk factors for Alzheimer's Disease such as age and genetic profile. But
scientists are studying a number of other factors that could make a difference. Hopefully further
research will tell us whether health, lifestyle and environmental factors can help prevent
Alzheimer's Disease. The only definite way to diagnose Alzheimer's Disease is with an autopsy,
which is an examination of the body after death.

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint Of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Monday, April 11, 2011

Alzheimer's Blog:

Today on my ambulance I have been busy. Usually people think of ambulance people as doing 911 calls. Maybe a car accident or someone calling because a loved one is having a heart attach. But my favorite calls are for normal people with special needs.  

One of my calls today was for an eighty year old female with dementia/ Alzheimer's. This woman lives in a nursing home, and some how fell out of bed. They knew she was up when it happened even though they were not in her room because they have an alarm on her bed to let them know when she gets up. She doesn't really walk, and just a few months ago had a hip fracture. They found her on the floor with a laceration to her head, bleeding. They are real good with their patients, and took her vitals, wrapped up her wound, lay ice pack on it, and gave her Tylenol for the pain. They called us and we showed up to help. This lovely elderly woman did not understand what was going on. She didn't want to get on  our gurney, and fought me when I took her vitals. She mumbled a lot, and didn't make much sense.  All I could do was love her even more.

Another one of my calls was for a fifty six year old male whose Foley was clogged. At the age of twenty four he had a diving accident which broke his neck and left him as a paraplegic. He can move his arms but doesn't have a lot of  control over them. He was frightened when we got him. His big concern was that we were not going to put him in his bed and make sure everything was set up like he would want it before we leave. His care nurse was not around at the time.  With help we sheet lifted him to our gurney, took vitals and off we went to his home. We made his bed, sheet lifted him into it, got his table over to him and made sure the phone and TV controls were in reach. He was very appreciative of our kindness to him. I wonder how other emt's treat him.

Sometimes I think my partner and I are hand picked for some of these jobs. These people need someone that is kind, compassionate, not in a hurry and ready to help where ever needed. These calls are the ones I love the best.

Be an angle, practice random acts of kindness.
Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Saturday, April 9, 2011

Alzheimer's Blog:

Importance of personal health!

Keep your mind active and sharp through various activities. Keep the mind healthy. Mental stimulation helps ward off memory loss. Watch a movie -- Watch a ball game -- Work on a cross word puzzle -- Join a chess
club or gardening group -- Volunteer in your community -- Work a part time job -- Have a hobby -- Eat a healthy diet -- Include physical activity during your day, at least 30 minutes to increase your blood flow to your brain. It is important to get respite care which is a temporary break from your daily care giving
responsibilities. If you choose to take care of your loved one at home it is important that you take care of yourself. Look around in your area for respite care. It can be in the form of an adult day care center so you can get a few hours of relief every week, or a nursing home so you can have a few days to rest. It is important to find a good support group. Support groups provide a forum to share feelings, concerns, and information as a way of supporting and encouraging each other. Look for support groups in your area on
the Alzheimer’s Association web-site.   http://alz.org/apps/findus.asp 

Remember life is an adventure and we need to take it, enjoy it, learn from it, and to take care of each other. That is what life is all about. Not what we can do for ourselves but what we can do for others.

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Friday, April 8, 2011

Alzheimer's Blog:

Things to know aboutAlzheimer’s

As I took care of my father-in-law I did a lot of research. So I hope to give you is some valuable research about this terrible disease. I truly hope this will help you understand this disease and help you with your decision on what you want to do.

Dementia (noun): Is defined as severe impairment or loss of intellectual capacity and personality integration, due to the loss of-or damage to neurons in the brain.

Alzheimer’s (noun): A progressive form of percentile dementia that is similar to senile dementia except that it usually starts in the 40’s or 50’s; First symptoms are impaired memory which is followed by impaired though and speech and finally complete helplessness.

Currently it is estimated that as many as 5. 2 million people in the U.S. have Alzheimer’s disease. This number is expected to grow over the next 50 years as the population ages and life span increases. Alzheimer’s disease affects three percent of the population between the age of 65 and 74. But estimates suggest that 19% of those older than 75 yrs and 47% of those older than 85 yrs have the disease.

Currently there is no cure for Alzheimer’s. Alzheimer’s disease it the most common form of dementia. Dementia is a term that is used to describe a group of brain disorders. These brain disorders cause memory loss and make it harder to carry out daily tasks. Alzheimer’s disease develops slowly over time. The symptoms begin to appear so gradually that it is often mistaken for normal aging. It is a progressive and degenerative disease, which means that it gets worse over time. When someone has Alzheimer’s disease nerve cells die in areas of the brain that are vital to memory and other mental abilities, and connections between nerve cells are disrupted. There are also lower levels of some of the chemicals in the brain that carry messages back and forth between nerve cells. This affects memory, judgment, and thinking, which in turn may hinder a person’s ability to handle day to day tasks.

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pup., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Thursday, April 7, 2011

ALZHEIMER'S BLOG:

Joe Fostino, U.S. Army Veteran, suffered from Alzheimer’s
Joseph A. Fostino was born on January 20, 1926 on the south side of Chicago. Except for his time in the Army, he lived there all his life. Like many youngsters who grew up during the Great Depression day, Joe only completed the tenth grade. Along with thousands of others like him, Joe became a soldier in the United States Army on 4 May 1944 shortly after his 18th birthday. He served in Europe and near the end of the
conflict, just as he was poised to invade Berlin, the Russian army arrived and his unit was recalled to France. From there he was sent to San Francisco where his unit, along with thousands of other soldiers, spent two
weeks of intensive training in preparation for a beach invasion of Japan. As he was traveling east by ship, the atomic bombs were dropped on Japan and World War II came to an end. Joe’s unit went on to the Philippines where he learned his civilian trade, truck driving. He fought with the Eagles 86th Infantry Division, Black Hawks. Joe left the armed services on April 16, 1946. On August 24, 1962, Private First Class
Joseph A. Fostino, of the United States Army, was awarded a Bronze Star Medal for meritorious achievement in ground combat against the enemy during WWII in the European African Middle Eastern Theater of Operations. Joe never mentioned this honor to most of his friends and co-workers.

Joe married “Jean” (Virginia) Gaeta on May 19, 1948 and they had three children, Jimmy (1953), Janet (1956), and Joann (1959). Tragedy struck early for Joe and Jean
when Janet was born severely handicapped. Janet was placed in a state institution at the age of twelve.
Joe’s wife, Jean, passed away in the summer of 1999. Friends and relatives alike feel that the death of his wife marked the beginning of Joe’s long battle with Alzheimer’s disease. Joe loved driving his big rig almost as much as he loved his family. He drove big rigs his entire working life, mostly for the Teamster’s Local 705.

He was a devoted husband, father and friend as well as a war hero. Joe will be sorely missed by all those
whose lives touched his over the years. He leaves behind three children, six grandchildren, and three great-grandchildren.

Alzheimer's doesn't care who it strikes. Every one has a story about his or her life before this terrible disease came along and took it from them.  Share yours!

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/

Monday, April 4, 2011

Alzheimer's Blog:

CAREGIVERS ARTICLE From Alzheimer's Weekly this week:

Great results were attained by the U.S. Department of Veteran Affairs' pilot program called REACH (Resources for Enhancing Alzheimer’s Caregiver Health). Now, it will expand nationally to support caregivers of veterans with dementias such as Alzheimer’s.

WASHINGTON – The Department of Veterans (VA) is expanding support nationally to caregivers of Veterans with Alzheimer’s disease. A pilot program of the REACH VA (Resources for Enhancing Alzheimer’s Caregiver Health in VA) program showed great success in reducing stress on caregivers while improving care outcomes for the Veterans.

“The REACH VA model exemplifies the many different kinds of support VA offers to the caregivers of Veterans,” said Secretary of Veterans Affairs Eric K. Shinseki. “This program has been proven to provide the right resources, training and a renewed focus on personal health that can make a world of difference to those caregivers and their Veterans.”

“Caregivers step up every day to serve Veterans they love who sacrificed to defend our Nation,” Shinseki added. “To them, caregiving is a labor of love and devotion, but that alone does not ease the burden and personal stress placed on those who provide daily care for the disabled.”

REACH VA involved 127 caregivers connected to 24 VA medical centers. The median age for the caregiver was 72 and the majority of the participants were spouses.

Typical issues caregivers face when caring for Veterans with Alzheimer’s disease and dementia include memory problems, behavior problems and the need to provide basic attendance such as grooming assistance. Caregivers typically reported feeling overwhelmed, frustrated, cut off from family and friends, lonely, prone to bouts of crying and having worse physical health than the year before.

For six months, the REACH VA caregivers were provided 12 individual in-home and telephone counseling sessions; five telephone support group sessions; a caregiver quick guide with 48 behavioral and stress topics; education on safety and patient behavior management; and training for their individual health and well being.

Caregivers saw their burden reduced; drops in depressive symptoms and their related daily impacts; fewer frustrations, including those that have clinical potential for abuse; and decreases in dementia-related behaviors from the Veterans they cared for. Caregivers also reported they were able to spend fewer hours per day devoted to caregiving duties.

“Dementia caregiving is such an all encompassing task,” said Dr. Linda Nichols from the VA medical center in Memphis, Tenn., and co-author of a recent study on the program. “The intervention provided time for themselves, which caregivers never have enough of. REACH VA improved our caregivers’ knowledge to manage care, made them feel more confident and competent as they formed bonds with the VA staff supporting them, and decreased the inevitable feelings of isolation and loneliness that come from a selfless, but very sacrificial duty of care.”

VA will roll out REACH VA on a national basis through home-based primary care programs across the country. In addition, the program will be modified to assist caregivers of Veterans with other diagnoses like spinal cord injury and traumatic brain injury.

“Providing support to caregivers who sacrifice so much to allow Veterans to remain at home surrounded by loved ones is the right thing for VA to do,” said Dr. Robert Petzel, VA’s under secretary for health.

An article on the REACH VA program is being published in the Feb. 28 issue of the Archives of Internal Medicine. Nichols and Dr. Jennifer Martindale-Adams, also from VA’s Memphis facility, are the lead authors and based the VA pilot on the National Institute on Aging and the National Institute for Nursing Research funded REACH II study. REACH VA is the first national clinical implementation of a proven behavioral intervention for stressed and burdened dementia caregivers.

Sincerely,
Marie Fostno
Seaboard Press An Imprint Of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/


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Sunday, April 3, 2011

Alzheimer's Blog:


Today I want to talk about Ethics.


I looked it up and here is the definition I found.

eth·ics   /ˈɛθɪks/ Show Spelled [eth-iks] Show IPA –plural noun 1. ( used with a singular or plural verb ) a system of moral principles: the ethics of a culture. 2. the rules of conduct recognized in respect to a particular class of human actions or a particular group, culture, etc.: medical ethics; Christian ethics. 3. moral principles, as of an individual: His ethics forbade betrayal of a confidence. 4. ( usually used with a singular verb ) that branch of philosophy dealing with values relating to human conduct, with respect to the rightness and wrongness of certain actions and to the goodness and badness of the motives and ends of such actions.


Than I looked up Quality of Life:


Within the field of health care, quality of life is often regarded in terms of how it is negatively affected, on an individual level, a debilitating illness that is not life-threatening, life-threatening illness that is not terminal, terminal illness, the predictable, natural decline in the health of an elder, an unforeseen mental/physical decline of a loved one, chronic, end-stage disease processes. Researchers at the University of Toronto's Quality of Life Research Unit define quality of life as “The degree to which a person enjoys the important possibilities of his or her life” (UofT). Their Quality of Life Model is based on the categories “being”, “belonging”, and “becoming”, respectively who one is, how one is connected to one's environment, and whether one achieves one's personal goals, hopes, and aspirations.


I know you are wondering where this is coming from. I wrote on March 23 about one of my patients that I ran who had Alzheimer's, can not communicate and was having respiratory distress. I ran on her again early this morning. The nurse at the nursing home begged me not to bring her to the same hospital because she said that this patient came back three hours later and not stable. So she insisted that I go to a hospital fifteen minutes away. She said she had a DNR but there was no doctors signature on it so it was not valid. If you could understand my position you would realize how risky this was. I had an unstable patient, in respiratory distress, by my self. If this patient stops breathing and her heart stops, it will be very hard for me to work a code by myself.


My EMT and I were busy after we loaded her on my gurney and in my ambulance. We took vitals, placed ecg leads on her moist and cool body. Gave her a SVN albuteral treatment and solu-medro to help her with her breathing. It was hard but we even got in an IV.


We reached the hospital with the doctors angry with me for passing up other hospitals due to her respiratory distress. They finally got a hold of the family who said it was fine to intubate her but no compressions is she codes. I am so confused. Do these people know what they are doing to there mom. This patient is confused, scared, and has no idea what is going on. Yet her family is trying to keep her alive so they can visit her once in a while at the nursing home. What kind of quality of life is that for her?


Sorry I just had to vent. Think about this as you make your living wills for your loved ones with Alzheimer's.


Sincerely, Marie Fostino


Alzheimer's A Caretaker's Journal - Seaboard Press An Imprint James A Rock Pub., Co.


www.mariefostino.com www.mariefostino.blogspot.com

Friday, April 1, 2011

Alzheimer's Blog:


Assisted Oral Feeding and Tube Feeding


The Alzheimer’s Association has addressed the issue of end-of-life nutrition and hydration in several documents. The 1994 statement Guidelines for the Treatment of Patients with Advanced Dementia includes the following position: Severely and irreversibly demented patients need only care given to make them comfortable. If such a patient is unable to receive food and water by mouth, it is ethically permissible to choose to withhold nutrition and hydration artificially administered by vein or gastric tube. Spoon feeding should be continued if needed for comfort.

Ethical Issues In Alzheimer's Disease


http://www.alz.org/alzwa/documents/alzwa_Resource_EOL_FS_Oral_Feeding.pdf


Hope this helps. It is a hard decision on what to do toward the end stages of Alzheimer's. You are not alone. I have been there. If you need to discuss this please e-mail me.


Sincerely, Marie Fostino


Alzheimer's A Caretakers Journal - Seaboard Press An Imprint of James A Rock Pub., Co.


www.mariefostino.com www.mariefostino.blogspot.com