In my blog on Nov 9th, I discussed the end-stage dementia issues and raised the question ‘Is dementia a terminal illness?’  When faced with terminal illness, seniors and their caregivers often choose palliative care.  Today, I’ll discuss that further.

What is a terminal condition?

In most states, a terminal condition is a status that is incurable or irreversible, and in which death will occur within a short time.  There is not a precise, universally accepted definition of “a short time,” but in general it is considered to be less than one year.  When looking at the hospice benefit, it will define “short term” as six months or less.

What is palliative care?

Palliative care is a comprehensive approach to treating serious illness that focuses on the physical, psychological, spiritual, and existential needs of the patient.  Its goal is to achieve the best quality of life available to the patient by relieving suffering, by controlling pain and symptoms, and by enabling the patient to achieve maximum functional capacity.  Respect for the patient’s culture, beliefs, and values are essential components.  Palliative care is sometimes called comfort care or hospice type care.

For more information: go to Caring Connections which is a program of the National Hospice and Palliative Care Organization (NHPCO), is a national consumer and community engagement initiative to improve care at the end of life, supported by a grant from The Robert Wood Johnson Foundation. Caregivers and seniors can find them online at www.caringinfo.org.

Caregivers and seniors can also visit the National Hospice and Palliative Care Organization (NHPCO) home page at http://www.nhpco.org/templates/1/homepage.cfm.
 

November is Alzheimer’s awareness month.  It is time to catch up with discussions about dementia and redefining dementia.  Dementia is often thought of as simply memory loss and/or a memory disorder.  While memory loss is the “hallmark” of dementia in its early stages, most caregivers treat it as illness and do not think of dementia as fatal. According to Catherine Elton at   time.com, “Experts in the field say dementia is more accurately defined as fatal brain failure: a terminal disease, like cancer, that physically kills patients, not simply a mental ailment that accompanies older age.”  Unlike other terminal diseases, as the older adult with dementia approaches the end of their life, they are often treated aggressively rather than with palliative care.  Read more about what experts are saying in Catherine Elton’s report: Experts Redefine Dementia as a Terminal Disease. 

if you're a caregiver, remember, when caring for an older adult with dementia always ask if the treatments are causing more distress AND if their pain being managed.  Check to see if the older adult has made their wishes clear regarding aggressive treatments, feeding tubes and CPR. Then advocate that their wishes are carried out. As a caregiver, if your parent or loved one is in the early stages of dementia and have not made their wishes clear, now is the time to talk to them and complete their advance directives/living will.  A geriatric care manager can help caregivers and their aging loved ones address these issues.

For more information on treating advanced dementia as a terminal illness requiring palliative care go to Catherine Elton’s report: Experts Redefine Dementia as a Terminal Disease.

The holidays are quicky approaching us!  That means traveling near and far to visit with family and loves ones.  This is such a great time of the year so I wanted to provide you with some tips to help traveling go smoothly when you are bringing along someone who has a cognitive impairment.   In addition, November is also National Alzheimer's disease Awareness Month so I wanted to address a topic related to Alzheimer's disease this month.  Below are some holiday travel tips from the Alzheimer's Association:

• Avoid having a rushed schedule.  This only increases anxiety.
• If traveling by plane, minimize stops and long layovers in the airport
• Travel at a time when the person is most alert
• Rely on familiar and comfortable destinations
• Carry identification such as the Safe Return/Medic Alert bracelet, which can be purchased through the Alzheimer's Association.

Following these tips will help the caregiver and the person with dementia have a safe and hopefully a great time when visiting families and friends.  In addition, vaccinations are also important for older adults when traveling.  For more information on vaccinations and traveling with older adults, please refer to Jean Bandos blog titled "Vaccinations and Travel Planning for the Elderly".

Sometimes, it is human nature to focus on what “is lost.”   The focus can be on tangible things such as a job, a sporting event, a favorite item or it can be on intangible things like a train of thought, youth or innocence.  When there is an Alzheimer’s diagnosis it becomes very easy to focus on what is lost, for example  when your parent forgets how to get dressed, how to use the phone and how to pay their bills.  Yet, focusing on what is lost isn’t helpful to anyone.  It causes extreme frustration for the senior and sadness within the family.  I’d like to suggest a new frame of reference for caregivers – to focus on things that are “still here” like a sense of humor, a smile returned and a love for movies and chocolate. 
Earlier this week I participated in an activity with my Mother and her fellow neighbors at a memory care unit.   The game was called Penny Ante and began with everyone receiving 25 pennies and a pot holding pennies in reserve.  Everyone took turns drawing cards from a deck and following the instructions.  For example –  “Take a penny from the pot if you have ever seen the Golden Gate Bridge” or “Give every player a penny if they have blue eyes. “ There was a lot of laughter as pennies were lost and gained.  To be honest there was some confusion too.  One player drew a card – “Take a penny if you have ever visited New York City,” but could not remember if she had been to NYC or not.  This is when my Mother shined.  For her response was “I bet you have, you should take a penny.” 

When it was my Mother’s turn, she had to give a penny to everyone wearing blue.  I happened to be the only one at the table wearing blue…which meant she had to give me a penny.  She hesitated for a minute or two and I teasingly reminded her she needed to give me a penny…thinking she had forgotten that part of the game.  She looked at me and said – “I know, I am looking for a shiny one for you.”  A few seconds later, she pushed  a shiny penny towards me, the best of the ones she had before her.   My eyes filled as I realized she wanted to give her daughter the best she had….just as she had always done. In that moment, her love shined through the memory loss, the dementia, the falls and the frailty, to remind me that the Mother I know is “still here” shining bright as a new penny. 

Hoarding is a common behavior exhibited by older adults with later stage Alzheimer’s Disease, and many caregivers will see this behavior in their loved ones.  Some seniors hide belongings, some won’t throw anything away and some spend lots of time rummaging through drawers, closets, even refrigerators.  In many cases, seniors with Alzheimer’s engage in all of these activities.

Experts have suggested that seniors with Alzheimer's engage in these behaviors because they:

• were impacted by the Great Depression and “save” things just as their families did in the past
• come across an item, don’t recognize it, don’t know why they have it, and don’t know what to do with it and because they don’t want to ask someone about it, they hide it to get rid of it
• are fearful they are going to run out of something, for example -  money, food, clothes – so hide these items from others.
   

During the past few weeks, I have been getting my Mother ready to move to a new apartment in a memory care facility.  The new apartment isn’t as large as the old one, which meant that some furniture and personal items needed to be discarded or donated.  This became a good time to reorganize and go through the apartment contents to ensure that we moved the items she was currently using or had sentimental value.  I thought this would be a relatively easy task, but I couldn’t have been more wrong. As I began the process of packing, I soon found items in strange places.  For example, I found a set of silverware in my Mother’s dresser, framed family pictures in her purse and a shopping bag with shoes, figurines, and greeting cards behind the couch.   I also learned to look through everything, such as old purses and jacket pockets, to make sure I didn’t give away anything important – and it’s probably wise for other caregivers to do the same.  For example, I found my Mother’s Medicare card innocently wrapped in a scarf at the back of a dresser drawer.

As I continued to find more items, I realized there was a theme.  The belongings hidden away were obviously things that were important to my Mother.  The family pictures, the figurines that were passed down from my Grandmother, and the greeting cards my sister and I had sent through the years had all been carefully saved, hidden and protected.  My Mother’s hoarding activities may be a “typical” Alzheimer’s behavior, but the treasures she chose to protect were mostly family mementos with great personal meaning. 

Many adults question their memory as they get older and wonder if losing their keys is a part of normal or healthy aging.  Recently, the Alzheimer’s Association came out with a list of 10 signs to help distinguish between what is normal and what is not with your memory as you age. 
So, what is normal and what isn’t?

Typical/Normal
1. Sometimes forgetting names or appointments but remembering them later
2. Making small errors sometimes when balancing a checkbook
3. Sometimes needing help with recording a TV show or help with microwave settings
4. Getting confused what day of the week it is but later figuring out what day it is
5. Visual changes due to cataracts or other eye problems
6. Sometimes having a difficult time coming up with a word while in conversations
7. Misplacing things once in a while such as the remote control or eyeglasses
8. Sometimes making a bad decision
9. Sometimes feeling of weary of family, work or other obligations
10. Developing a routine of how to do certain things and getting irritable when the routine is done a different way

What could be signs of Alzheimer’s?
1. Memory changes that disrupt life – Asking information repeatedly
2. Challenges in planning or solving problems – May have difficulty following a familiar recipe 3. Difficulty completing tasks at home or work – May have trouble finding the location of a     place or remembering the rules of a favorite game
4. Confusion with time or place – Sometimes they forget where they are or how they got there
5. Trouble understanding visual images and spatial relationships – They may have trouble reading or judging distances
6. New problems with words with speaking or writing – May have trouble following or joining a conversation
7. Misplacing things and losing the ability to retrace steps – A person with Alzheimer’s may put things in unusual places and not remember where they put it
8. Decreased or poor judgment – They may use poor judgment when dealing with money such as giving large amounts of money to telemarketers
9. Withdrawal from work or social activities – They may have trouble remembering how to do their favorite hobby
10. Changes in mood and personality – They may become confused, suspicious, depressed, etc.

For more information on differences between normal and healthy aging vs. dementia, please visit the Alzheimer’s Association at www.alz.org or call their 24 hour helpline at 800-272-3900.

“Still Alice,” a wonderful novel written by Lisa Genova,  is about a woman named Alice with early onset Alzheimer’s Disease.  The author, who is a neuroscientist, weaves scientific and emotional details of the disease throughout the story.  The story is told from Alice’s perspective – a 50 year old Harvard professor who begins to show symptoms of Alzheimer’s disease.  The book follows her journey from her initial assumption that her forgetfulness is due to menopause, through medical exams and testing, to telling family members and friends of her diagnosis, to living a life she had not expected.  As the story evolves, the reader learns how Alice feels as she struggles with day to day activities such as getting dressed, taking a walk and using her Blackberry.   The reader also experiences the pain felt by family members who learn how to be caregivers for Alice while coping with the knowledge that they may have inherited the gene that causes the disease.  The awkwardness expressed by former friends and colleagues jumps off the page as they struggle to interface with an Alice who is different from the Alice they remember.

The book is an emotional, honest read.   It boldly examines the frustration, depression and decline that accompany an Alzheimer’s diagnosis.  It explores Alice’s life over a three year period and is an honest, haunting and heartbreaking portrayal of life with Alzheimer’s.  Yet, the book shares hope by including discussions of possible treatments.  Most importantly, it teaches readers to view people with Alzheimer’s not as victims, but as people living their real lives. 

“Still Alice” has received high marks from the National Alzheimer’s Association… the book is featured on their website (www.alz.org).  For more information visit www.stillalice.com.   I recommend that everyone read this book, as it puts a very human face on a disease that will shape our future.

For caregivers of aging parents, insurance coverage is an important topic, especially if your loved one suffers from Alzheimer’s, congestive heart failure, or other common conditions.  My last post covered the eligibility requirements for Medicare.  Once you determine eligibility, you’ll need to decide which policy or policies to choose.


1. Original Medicare Plan – If you are eligible, you will be automatically enrolled in Medicare A and then you have the option of adding Medicare Part B and Medicare Part D.  The federal government manages the Original Medicare Plan.  It operates on a fee-for-service plan. Most people pay a deductible and then a co-pay or co-insurance.  Original Medicare Plans do not cover everything. Costs that you may incur include co-insurance, co-pays, deductibles, etc.  These costs are called gaps. To help cover these costs, you might want to buy a Medigap policy.

2. Medicare Advantage Plan (Plan C) -  Seniors much choose to join.  The Medicare Advantage Plan or Plan C combines your Part A and B coverage. You have the option of adding Part D if coverage is not already included.  Medicare Advantage Plans include HMO, PPO, private fee-for-service plans, and Medicare special needs plans. The main difference in Part C is that it is provided through private insurance companies approved by Medicare. With this program, you may have lower costs and receive extra benefits. With this plan you do not need to buy a Medigap policy. 

3. Medicare Part D  - Part D is stand-alone prescription drug coverage insurance.  Most people do have to pay a premium for this coverage.  Plans vary and cover different drugs, but all medically necessary drugs are covered.  You can choose what drug plan will be best suited to your needs.

For more information regarding Medicare, contact your Medicare representative or visit www.medicare.gov and click on “Medicare and You 2009” for more information to help you meet your individual needs (or those of your aging loved one).  Also, the Medicare Options Compare website (http://www.medicare.gov/MPPF/Include/DataSection/Questions/Welcome.asp) will direct you through the various types of policies and explain what is covered under your policy.  Information is categorized on the home page by the type of plan that you have questions about.

My next blog will explain Medigap policies and Medicaid.

We know so much, yet so little about Alzheimer’s Disease.  And what we do know can be very, very discouraging.  Today we know that ….there is no cure, the disease worsens as it progresses, and while the drugs available may slow down the progression, they do not stop the disease.  I find myself wondering – “Where is the hope?” “What does the future hold?” …… and most importantly “Where is the research?” 

To learn more about the disease and what is being discussed for the future – visit HBO online and view the documentary “The Alzheimer’s Project” (http://www.hbo.com/alzheimers/).  The series is divided into four segments.  Each segment focuses on a different aspect of the disease including:  The Memory Loss Tapes, Grandpa Do You Know Who I Am?, Momentum in Science, and Caregivers.

As an active caregiver for a Mother with Alzheimer’s, I found the series difficult to watch at times.  Yet, I felt an instant bond with the other families I saw struggling with the same disease and, who like me; don’t seem to have all the answers.  It was also comforting to learn about the research being done and the minor discoveries made to date.  Hopefully the research will lead to a significant breakthrough to help better understand and eventually cure Alzheimer’s Disease.

At a recent appointment with a new doctor, I revealed my family’s history of Alzheimer’s Disease.  To date, the cases I am aware of are Grandmother, Mother and Aunt.  Of course I wonder if the next generation – me and my sister- will inherit this insidious disease.  My doctor counseled that inflammation may seem to contribute to the disease.  So, I left with advice to take a daily low dose aspirin and  fish oil capsules.  How much happier I would have been to receive a vaccine like the ones available for mumps, measles, shingles, etc.   Maybe this will happen in the future – I certainly hope so.   

Likely you have seen some variant or another of this article "Helping the Elderly Keep Their Driving Skills" talking about helping seniors keep their mind sharp.  Whole companies have cropped up like the one mentioned in this article, Posit Science, around the idea computers and software can help. 

Certainly games like these are interesting and often fun, but their claims are largely unproven.  Comments like the brain is "the most important muscle in the body" is, at best, metaphorical.  The brain is, of course, nerve tissue not muscle tissue.  "Exercising" the brain has little impact on senior memory loss brought on by Alzheimer's or other serious forms of dementia. 

Driving is one of the big safety issues with seniors and for those people who are not facing serious cognitive decline, they may find these games fun and somewhat beneficial.  Of course, physical limitations such as immobility are not impacted.  At a minimum, I would expect some gains in driving skill just from the heightened awareness.  Likely most of us could gain from that lesson.

See more on Posit at http://www.positscience.com/. 

The final installment of the SCANS 1.3 rolling release is complete.  The July release includes some 22 new and revised tools and resources.  The list includes:

• Medicare Summary
• Medicare A Information
• Medicare B
• Insurance Resource
• SHIP
• Medigap
• Medicare C and Advantage Plans
• Earwax
• Visual Impairment Websites
• Hearing Impairment Websites
• Visual Impairment Devices
• Optometrist vs. Ophthalmologist
• Bladder Training
• Foley Catheter Care
• Urinary Continence Education
• Incontinence Supplies
• Catheter Education and Support
• Brain vs. Bladder
• Incontinence – Foods to Avoid
• Tips to manage Incontinence with dementia
• Continence Bladder Diary
• Modify Environment to Assist with Continence

Thanks to the SCANS research team for this successful (and popular) release which included some 74 new tools!  You can read more about these topics from a caregiver's perspective directly from one of our researchers Karen Witt Kelsey.  Click here to read more in her Caregiver Support blog.  Karen is a key member of the research team as well a caregiver for her own mother.  You'll enjoy her unique perspective on senior health care.

Last week I had the opportunity to present a paper at the Human-Computer Interaction International Conference.  This was the 13th occurrence of the conference and the event was well attended by key researchers and companies concerned about how computers interact with people. 

Jean Bandos co-authored the paper titled "Impacting the Continuum of Caregiving through Innovation in Informatics: Senior Care Navigation System (SCANS)".  Other members of the SCANS team contributed, as well.  You won't find the paper in the conference proceedings however, due to Intellectual Property concerns with the conference publisher's copyright requirements.  In spite of those restrictions the paper and the presentation were well received.

What struck me about the conference on a general level was the amount of attention being given internationally to the challenges of older adults and senior health care.  Conference attendees came from China, Japan, UK, Germany, India, Spain, and many other places - representing some 49 countries in all.  Support for seniors living independently and dealing with challenges like immobility, well-being, and cognitive decline surfaced as a major sub-theme to the conference.  World wide researchers are examining how computers can help with aging parents.  

The specifics were wide ranging from topics like augmented navigation for assistive mobility devices to ontologies for adaptive user interfaces to cope with the specific needs of the elderly. 

I was genuinely encouraged that so many top brains are looking for ways to improve eldercare services.

A colleague handed me a flyer today from a local cardiac physician group for cool little wallet sized CD they provide their patients with key medical information on it. 

The idea is that you carry this card in your wallet and in an emergency situation you can hand the card to a provider who can then view it on a computer capable of reading a data CD.  Even if you are unconscious, medical personnel can find the card style CD and view it.

The CD contains things like:

• medication lists
• current diagnosis
• current allergies
• discharge summaries
• diagnostic test results
• and even educational materials

All in all this is a good thing.  It also points out some of problems with "high tech" solutions to emergency information. 

• First, not all emergencies will allow time for medical staff to leave the patient in order to find a PC with a CD drive and review a set of unfamiliar computer documents.   
• Second, in order for this information to be easily read in an emergency situation, it is also easily read by anyone who steals or even simply has access to a person's wallet.  Because it's a CD, it's also not clear exactly what data is on the record; leaving seniors and families caring for aging parents to wonder what information is potentially disclosed.
• Additionally, the currency of the data may be questionable.  Frequent health and medication changes are common in older adults and this approach requires notification back to the provider, payment of an update fee, and the reissuing of the wallet CD.  Allowing reasonable times for such activity, it could be very difficult to keep this up to date.
• Even small scratches from "wallet wear" on the CD can render it unreadable.  Something that wouldn't be readily apparent until the CD was checked in a computer drive.  Often, I fear, at the time the information is most needed. 
• Lastly, the completeness of the data may be in question as it relies on the patient, often a senior with depression or memory loss, to report the activities of the disjoint senior health care system.

My Health Care Manager approaches this problem differently.  Our geriatric care managers collect, review, and update information across all of a client's health providers.  This Personal Health information (PHI) is then used to inform all providers engaged in the client's health.  For example, each of the client's physicians receives the medication list initially and then again for every medication update. 

For emergency situations, clients are given a Ready Reference Card which contains all the key medical information and alerts.  This PHI easily folds to the size of credit card for wallet use and multiple copies can be kept in other key areas, for example in a specially identified pocket on the client's refrigerator where emergency personnel are trained to look. 

Because the Ready Reference is a paper record it is immediately available to emergency personnel in settings where a CD reader may not be at hand such as the senior's home, as shopping center, and so on.  It is also quick and very inexpensive to reprint when updates are needed.

The point here is not that technology is bad.  On the contrary, technology enables both of these solutions.  We should put it to work in the most effective ways we can devise for seniors and their families.

Lately, it has become increasingly difficult for my Mother to reach my sister and me by phone.  She gets confused about how to find our numbers and how to actually dial the phone.  We tried to solve the problem by posting our cell numbers near her phone, but over time she removed the information and we would be back to square one.

While perusing The Alzheimer’s Store catalogue (www.alzstore.com), I found a solution to our problem.  They sell a phone that has 3 pushbuttons and each pushbutton has a place for a picture.  After some programming was complete (thanks to my sister), the push buttons were aligned with our pictures and respective cell numbers!  Now, all my Mother has to do is push one of our pictures and the phone automatically dials our cell phone.  My Mother loves it and has been able to work it easily.  
 
The phone also features a button to increase the volume in the earpiece and an extra loud ringer option.  It includes a very easy to operate answering machine too – that clearly indicates when a message is present. 

The phone has helped my family stay connected and has given my Mother a measure of independence she was close to losing.  I am thankful that this product and others like it are addressing the needs of Alzheimer’s patients.

You can find the Memory Phone with a built-in Answering Machine at The Alzheimer’s Store as well as other products that can make life for caregivers and seniors a little bit easier.

Not to be out done by the Navigator development team, the SCANS team is continuing their "rolling release" of V1.3.  SCANS is the Senior Care Navigation System that provides geriatric care managers with expert advice, best practices, and practical tools to help families with the well-being or their parents.

The June edition of V1.3 includes 26 new resources, process, or tools.  The list includes items like these:

• Death in the Home – Information for Caregivers
• Tips for Alzheimer Caregivers
• Delirium vs. Dementia
• Transitioning an Individual with Dementia into a Facility
• Member Portal Instructions
• Continence Education – Constipation
• Urinary Incontinence – When to Seek Immediate Medical Attention
• Crime Prevention Education for Older Adults
• IADL (Independent Activities of Daily Living) Education
• Physical Therapy and Occupational Therapy
• My Medicare Matters
• Advance Directives for Mental Health Treatment
• Drug Review and Side Effects
• Geriatric Friendly Pharmacy
• Medicine Reconciliation:  Brown Bag Consultation
• Feeding Tube Education
• Special Diet Needs Education
• Defibrillator Education
• Diabetes Education
• Fibromyalgia Education
• Pacemaker Education
• Physician Planner Case Note
• Alternative Living Options Education
• Speech Therapy Education
• Social Participation Barriers
• Social Support Plan

These tools are available to the clients of My Health Care Manager and our affiliates.  Some of the content is also discussed in our blogs and can be accessed for free.  Check out Natalie Langley's blog titled "Healthy Aging".  Natalie is one of the principle researchers and authors of the tools in SCANS.  Her blog covers a holistic look at healthy aging and senior well-being.

My Mother has lived in an Assisted Living facility for almost two years.  In many ways she has adapted well and I think she is comforted by the fact that I live nearby.  However, as her Alzheimer Disease progresses, I often hear “I want to go home.”  In talking with others, I’ve learned that this is quite common... yet hearing it tears at the heart of every caregiver I know. 

Following are some tips you may find helpful when the senior in your life tells you repeatedly:    “I want to go home.”

• Remember that it is very common for a senior to repeat this request often.  Usually they mean the home from 60 or 70 years ago, not the one they left most recently.
• “Home” means different things to different people – love, security, belonging, safety.  When a senior asks to “go home,” try to determine if there is an “unmet” need (i.e. need to feel safe, need to belong) and try to fill that as best you can.
• Don’t refer to the senior’s current location as home.  Point out that they are staying there for “awhile.”  When they say “I want to go home” tell them you will talk about it and name some future date.
• Find a good reason for them to stay where they are – i.e. people are nice, good food, close to family, nice apartment, fun activities and try to get them to “buy into it.”

As a caregiver, the responsibility for decisions regarding your parent’s care falls to you.  Often you wish you could discuss the options, choices and next steps with your parent, just as you discussed so many choices in the past…where to go to college, where to have your wedding reception, which neighborhood to select.  But parents with Alzheimer’s cannot help with current decisions as their ability to reason, compare and choose has been ravaged by the disease.  Sadly, dementia robs them of their ability to chart their own course.

So, what should caregivers do when faced with a variety of paths – how do you know how to choose what is best for your parent? How do you know when a parent’s living environment is no longer safe? How do you know when a parent needs more assistance? 

Here are a few suggestions:

• Pay attention to your parent – they may be confused, but they will give you clues when things aren’t going well.  They may seem more agitated, confused or disoriented.  Their routine may change and a situation that has worked well in the past, now poses problems.  For example, they may no longer want to eat dinner because they either can’t remember where the Assisted Living Dining Room is located, or they are afraid to leave their apartment.  
• Check in with their caregivers – have other family members, a companion, assisted living staff or adult day care workers noticed a change in your parent?  Are they concerned? 
• Take your parent in for a check-up – have the Doctor evaluate your parent and review their medications and mental and physical health. 
• Review your parent’s ability to complete Activities of Daily Living – things like bathing, dressing, continence, mobility, feeding.  Has there been a change in their ability to do these things?
• Engage a Geriatric Care Manager – have them conduct an independent assessment to provide an unbiased view of the situation.

Once you have gathered the above information, spend time thinking and talking to others you trust about the findings.  Choose the next step based on what you think is best for your parent at this moment in time.   For instance, if you determine that they need more assistance, think about the pros and cons of providing additional assistance in their current environment vs. moving them to a new environment such as a Memory Care Unit.   There is no “right” decision.  Take comfort in the fact that you have been both thorough and thoughtful when you made the decision.  Always remember that your parent is better off when you address concerns as they arise vs. postponing decisions until a crisis arises.

The SCANS content team headed by Jean Bandos along with the development team announced today that the SCANS Version 1.3 - May release is now available.  SCANS Version 1.3 is a major content release to the SCANS Knowledge Base.

In order to make more real-world tools for eldercare available more quickly, Jean and the team have devised a "rolling release".  For 3 months beginning in May another group of resources, processes, and tools will be made available to geriatric care managers at My Health Care Manager and our affiliates.

The May release contains 57 new and/or revised resources, processes and tools.  Some sample items include: 
 

• Behaviors and Alzheimer's Disease
• Grief Education
• Activities of Daily Living Education
• Depression and Alzheimer's disease
• Early Stages and Impact on Health
• Memory & Cognition Questions
• Memory Care Unit Checklist
• Memory Care Unit Education
• Mild Cognitive Impairment
• Sobriety Programs Resource
• Handyman Resource
• Private Handyman Contractor Checklist
• Smoke & Carbon Monoxide Detectors
• Daily  Money Management Education
• Financial Planning Education
• Trust Education
• Verifying Funeral Arrangements
• Veterans Benefit Information
• Elder Law Resource & Checklist
• Medication Management Procedure
• Medication Reconciliation
• Polypharmacy
• How to Find a Pain Specialist
• Pain Education
• Pain Resources
• Pain Visual Analog Scale
• Arthritis
• Heart Failure
• Hypertension Education
• Family History - Cancer Education
• Family History - Dementia
• Family History - Diabetes Education
• Family History - Heart Education
• Seat Belt Education
• Cataracts Education
• Glaucoma Education
• Hearing Aid Education
• Sensory Changes
• Assistive Devices
• Hospice Education
• Spiritual Connections

Stay tuned; the June release will include resources on incontinence, cognition, supporting services, and more processes.

Be sure to visit Jean's blog, click here.

As a follow up to my last blog, if you missed “The Alzheimer's Project", the groundbreaking HBO documentary series aired May 9 – 12, the films are available online at www.alz.org/HBO and also at http://www.hbo.com/alzheimers/. They will also air again throughout May on HBO and HBO2.

If you were able to watch, please share your thoughts about ‘The Alzheimer's Project’ at http://alzheimers.infopop.cc/eve/forums and here on my blog.  The Alzheimer’s forum page has several opportunities: not only can you discuss the project, but it also has forums for those who have Alzheimer’s Disease, questions about medication treatments, caregiving, and forums in Spanish.

Remember that Alzheimer's is not a normal part of aging – it's a progressive and fatal disease.  Every 70 seconds someone develops Alzheimer’s and now Alzheimer's disease is rated the seventh-leading cause of death.

If you are assisting someone with memory loss or Alzheimer’s Disease, speak with your loved one’s health care provider and visit www.alz.org to learn more on how to support yourself and your loved one.