November is National Alzheimer’s Disease Awareness Month. In 1983, President Ronald Reagan declared this month for awareness at a time when fewer than 2 million Americans were affected by Alzheimer’s. Now the number of Americans with Alzheimer’s has soared to nearly 5.4 million and is projected to rise to 16 million by 2050, unless advances in the disease occur.

Alzheimer’s Disease is the most common form of dementia, affecting 1 out of every 10 Americans over age 65. The disease has a devastating effect on patients, caregivers, and the community. Symptoms of memory loss, confusion, behavior and mood changes worsen over time, often to the point that the disease interferes with daily tasks, relationships, and even safety. An estimated 18.2 billion hours of care are provided by family members. These unpaid caregivers experience stress, burnout, and accompanying physical and mental health problems at a high rate.

During Alzheimer’s Disease Awareness Month, you can do the following things to raise awareness and join in the fight against the disease.

• Learn the signs of Alzheimer’s Disease. Early diagnosis and treatment can lead to a better prognosis. Knowing the signs is essential. Also, be aware of the differences between cognitive impairment that is normal with aging and dementia.
• Know and reduce risk factors for both you and your loved ones.
• Participate in research that could lead to developments in understanding the process and progression of the disease.
• Raise funds to support research and programs that help patients and families coping with Alzheimer’s. AccuCare Home Health proudly supports the St. Louis area chapter of the Alzheimer’s Association with an annual donation and the volunteer efforts of President and Founder Jacqueline Phillips. We have witnessed firsthand the valuable support that they give to local families. They are a great resource for those impacted by this disease. Their Walk to End Alzheimer’s takes place on November 18, and it is not too late to participate or donate.
• Talk about it. There should be no shame or stigma in this disease, in being a caregiver, or in needing assistance. Talking about it, online, in support groups, or in person, helps you and others know that you are not alone.
• Take a break. If you are a caregiver, self care is of utmost importance. It not only reduces your risk of disease, but also improves the care that you can give to your loved one. Ask for help, get respite care, get that needed break.
• Get help. AccuCare Home Health of St. Louis offers a variety of in-home health services to care for your loved one’s needs. We evaluate each situation on an individual basis to develop a care plan that meets each client’s specific needs. Engaging professional, compassionate caregivers can improve your loved one’s quality of life and help them remain at home for as long as possible. Additionally, the Alzheimer’s Association of St. Louis is a great resource for families and other caregivers.

This month and always, let’s do our part to advocate for those with Alzheimer’s Disease and their caregivers, as well as to support research to end this horrible disease.

In recent blogs, we have been exploring the topic of cognitive decline. We explored the characteristics of normal cognitive decline, mild cognitive impairment and dementia, as well as how to reduce the risk of abnormal cognitive decline. In this final blog, we will explore how to support an individual who is experiencing dementia. Support will vary from person to person and throughout the process.

In the early stages of mild cognitive impairment or dementia, it is wise to communicate often and clearly about current and future needs.

• Get paperwork in order. Estate plans, living wills, etc., if not already in place, should be taken care of as soon as possible. All those involved in decision-making and care will need to clearly understand the wishes of the loved one facing dementia.
• Communicate well. Say what needs to be said. Plan what needs to be planned. That said, don’t tackle too much at once, as that may make this very stressful time even more stressful.
• Encourage health and well being. As we discussed last week, there are things one can do to improve their prognosis.
• Get educated. Learn about the illness your loved one is facing, the treatments, and what to expect. The Alzheimer’s Association is one resource, and your doctor may also be able to provide assistance.
• Get help. Never in history has support been more available. Whether in person or online, support communities, counseling, legal assistance and other organizations may be able to help. Don’t go through this alone.

As dementia progresses, things will sadly get more difficult for both you and your loved one. You may see your loved one becoming more confused, frustrated, sad or irritated. They may experience drastic changes in behavior, some of which can be dangerous, such as wandering. In addition to maintaining regular contact with a physician to monitor disease progression and for other medical conditions, these steps will help.

• Keep a routine. A simple routine can help ease your loved one’s anxiety and lessen confusion. Reminders and reassurances will still be needed.
• Keep it simple. Ask one question or make one request at a time. Don’t argue or reason, especially when they are upset.
• Keep it safe. Remove anything dangerous from the home. Simplify and declutter the environment. Use simple written signs to convey instructions.
• Enlist help. Caregivers need breaks. Otherwise, they are likely to experience burnout, illness and depression. Be honest and open about your loved one’s needs, and ask for help from family and friends.
• Talk to health providers about dangerous or severe behaviors.

The time may come when professional help is needed. For some, this need arises even during early stages of dementia. Others may not require this assistance until it is impossible to be safe when alone for any period of time. AccuCare Home Health of St. Louis is committed to offering the finest home health care in the St. Louis area, delivered with the patience, compassion and peace of mind you expect from a good friend. Whether it is respite care for a family member caring for a loved one, or private in-home health services, we can help. Please call us today for a free, no-obligation initial consultation.

In our last blog, we explored the characteristics of cognitive decline as part of the normal aging process. We also examined mild cognitive impairment and dementia, which are considered abnormal developments. Both require monitoring of a physician and have a better prognosis when detected early.

As loved ones grow older, there are steps to take to help the brain age in a healthier manner and decrease the risk of developing dementia.

• Stay social. Your loved ones should regularly engage in social activities with family, friends and community; this has been proven to delay symptoms of cognitive decline and improve the prognosis of those already experiencing symptoms. It isn’t surprising that this same advice is also relevant to individuals with depression and anxiety, as well as some physical conditions. While some conditions such as hearing loss, memory loss and pain can make it more challenging to continue social activities, it is important to do so.
• Remain physically active. Improvement of cardiovascular health can help with a number of conditions, including cognitive decline. Exercise also reduces stress, which has been shown to worsen brain function both in the short and long term.
• Exercise your brain. The brain needs exercise too. Make sure elderly loved ones engage in challenging cognitive tasks which can protect against mental decline and reduce the risk of developing Alzheimer’s disease. Playing bridge, reading, attending adult education courses, playing a musical instrument or any activity that engages the brain will be helpful.
• Maintain good health habits. A healthy diet and avoiding harmful activities, such as smoking and excessive drinking, can also protect the brain. A diet rich in antioxidants has been found to protect the brain. It is also wise to maintain visits with your physician. As signs of cognitive decline begin to appear, a doctor can help determine whether they could be related to another illness or condition, medication side effects, mood changes, sleep problems or even injuries.

By developing and/or continuing good habits and being aware of the signs of cognitive decline, you can help your loved one face the aging process with confidence and prepare them for the next step, should more severe problems arise. In our next blog, we will address helping your loved one face the unknown with dignity and obtaining help when necessary.

According to the CDC, around 16 million people in the United States are living with cognitive impairment. Individuals with cognitive impairment have trouble

remembering, learning new things, concentrating, or making decisions that affect their everyday life. The severity varies widely, and can progress to the point where an aging person is unable to live independently. Understanding cognitive decline can help you make decisions regarding the treatment and safety needs of your loved one. With that in mind, we will be exploring cognitive impairment in a series of blogs.

What is normal cognitive decline?

As individuals age, it is both common and normal to experience loss of processing speed, as well as certain memory, language, visuospatial, and executive function abilities. Attention span is impaired, as well as the ability to multitask and to recall recently presented information. On the other hand, older adults tend to retain language and vocabulary skills and general information learned at a young age; and may even exhibit improved ability to reason about the “big picture” regarding a specific situation. These changes are believed to be caused by normal changes in the brain, including grey and white matter volume and declines in neurotransmitter levels.

An individual with normal cognitive decline due to aging could exhibit the following behavior: occasional bad decisions, missing a monthly payment, forgetting what day it is but later recalling it, being unable to remember what word to use, or losing things.

What are signs of abnormal cognitive impairment?

Mild cognitive impairment (MCI) is a condition that is not considered part of the normal aging process. It can be a predictor of Alzheimer’s Disease, though this may not always be the case. Some signs of MCI include losing things often, forgetting to go to important events and appointments, and an ever-increasing lack in the ability to find desired words when communicating.

If you or a loved one is experiencing symptoms of MCI, it is important to be monitored frequently by a physician. In the event that symptoms of Alzheimer’s begin, early treatment is vital.

What are the signs of dementia?

The term dementia describes the loss of memory and other mental abilities severe enough to interfere with daily life. It is caused by physical changes in the brain. The most common form is Alzheimer’s Disease. Signs of dementia include asking the same questions over and over again, losing things frequently, getting lost in familiar places, inability to follow instructions, difficulty in making conversation, and confusion about time, people, and places. Individuals with dementia may also undergo personality changes. Early monitoring and treatment can slow progress and greatly improve quality of life.

In future blogs, we will continue to explore both normal and abnormal cognitive decline, as well as what contributes to both and how to maintain safety and dignity throughout the aging process.

Over the past few days, our thoughts and prayers have been with those displaced and affected by Hurricane Harvey, and now Hurricane Irma. A devastating weather event such as this highlights the great importance of emergency preparedness. Of course, many disasters cannot be prevented, but being prepared can improve your chances of surviving such an emergency.

September has become known as National Emergency Preparedness Month, a time when we are encouraged to create plans for evacuation and sheltering, as well as to have necessary supplies in place. This is important for everyone, but for aging people dependent upon assistance, preparedness is even more crucial.

These steps will help you and your aging loved one prepare for an emergency:

• Copy important documents. Ensure that copies of important paperwork such as identification and legal documents are stored in a safe and dry place. Those who are caregivers should have a copy of documents for their dependent loved ones. Identification and prescriptions should be readily accessible in case of evacuation.
• Stock up. It is recommended that each individual have water and nonperishable, easy to prepare food for at least three days. Those on medication should have at least a three-day supply, preferably more. If you live apart from your aging loved one, make sure that they have the supply on hand and can access it. Consider limited dexterity and purchase only easy-to-open supplies.
• Know what disasters are most likely to occur in your area and create a plan for each. Sign up for alerts from agencies that provide alerts. Talk to your loved one about how to get out of the house in a fire, where to shelter during a tornado, etc. Write it down or draw pictures if needed. Practice.
• Plan for making contact. Your loved one should have a list of multiple people to contact in an emergency. Take the initiative to check in with them as soon as possible. Do not count on phones working, and be sure to include an alternate method of contact.
• Talk with other care providers. Talk with your relatives or other care providers about what would happen if they were with your loved one in the event of an emergency. Where would they go? How would they contact you? If your loved one has a service where they can get help by pushing a button, make sure all contact information stays up to date.

For more information on becoming prepared, the Red Cross, Ready.gov, the CDC and FEMA are helpful resources. We wish you a safe and prepared September.

In our last blog, we discussed the importance of maintaining a healthy blood pressure. In order to do this, it is important to monitor your numbers, follow you’re doctor’s instructions, eating a healthy diet, and maintaining an active lifestyle. Also vital to treating hypertension is keeping a healthy outlook on life and minimizing stress. This is, of course, easier said than done. With that in mind, we have a few tips for keeping stress at bay.

• Stay active. Yes, staying active helps with blood pressure on its own, but it is also important for managing stress. Exercise increases endorphins, which makes you feel better.
• Sleep well. Keep a regular schedule and eliminate things that interfere with sleep, such as light, caffeine and electronic devices. Aim for roughly eight hours. It may be more difficult to sleep during more stressful times, but having a solid base will help you accomplish that.
• Don’t self medicate. A glass of wine or a pill to relax sounds like a good idea, but can lead to problems with addiction. It can also increase stress, as the problems you’re avoiding may grow when not addressed. Talk to your doctor about finding the right solution for you.
• Ask for help. It can be difficult to ask for help, especially if you fear losing independence. Still, going it alone increases stress. Everyone needs help from time to time, so don’t be afraid to ask.
• Stay social. As individuals age, it is important to maintain social activities. Feelings of loneliness and isolation will only increase stress. Many, if not most, of the difficulties that bring stress are common. You’re not alone.
• Listen to music. Research shows that music decreases stress and can even lower heart rate and improve cognitive function. Make music a part of your daily routine.
• Get spiritual. Many individuals find comfort and peace in their faith. Prayer, meditation and other reflective activities can help you find your calm.
• Breathe. Deep breathing, where the diaphragm lifts and the abdomen extends to allow the lungs to fill completely with air, has been shown to reduce stress in the short and long term. Make it a habit to regularly take deep breaths.
• Get it out. When stressors come into your life, don’t ignore them. Talk, write, draw, or otherwise express your feelings about relationships, getting older, etc. Confronting life head on will help you to cope well and meet each challenge that come your way.

Reducing stress is important for those addressing hypertension. The benefits also extend to managing blood sugar, dealing with chronic pain, and even coping with memory loss. Aging individuals, as well as their caregivers and other loved ones can reap the positive effects of dealing with stress well.

According to the CDC, one in every three adults has high blood pressure. As people age, the likelihood of developing high blood pressure increases. In fact, 64% of men and nearly 70% of women aged 65-74 have high blood pressure. For those 75 and over, the risk increases to 66.7 and 78.5 percent, respectively.

Blood pressure is the force of blood against artery walls as it circulates through the body. A normal blood pressure reading is less than 120/80 mmHg. Many people are unaware that they have high blood pressure, as there are no visible symptoms. High blood pressure increases the risk for several dangerous health conditions, including heart attack, stroke, chronic heart failure and kidney disease.

If you or your loved one is at risk for high blood pressure, take these steps:

• Monitor your numbers. The AHA recommends that those at risk check blood pressure twice daily. Record those numbers and discuss them with your health care provider regularly.
• Take your medicine. A surprising number of people on hypertension medicine quit taking it once their blood pressure lowers. It’s lower for a reason: the medicine is working. NEVER reduce or quit a medication without your doctor’s approval.
• Quit smoking. Smoking increase blood pressure. Reducing or stopping this habit will help with blood pressure and other conditions.
• Limit alcohol. A small amount of alcohol can lower blood pressure, but drinking more than recommended exacerbates many conditions, including hypertension. Any alcohol intake should be discussed with a physician, as it can interfere with medication.
• Limit sodium. Even a small reduction in sodium can help. Don’t add salt, and watch labels for added sodium.
• Eat a healthy diet and maintain a healthy weight. Watching what you eat, and even writing it down, can help lower blood pressure and reduce the risk of disease.
• Be active. Getting 30 minutes of physical activity on most days of the week can lower blood pressure significantly.
• Calm yourself. It’s impossible to avoid all of life’s stressors. Instead, focus on deep breathing at least twice daily and also when confronting stress. Consider yoga, meditation, prayer, or other stress-reducing activities.
• Don’t go it alone. All of these changes can be difficult to maintain on your own. Ask for help, get a buddy to get healthy with you, or reach out for professional support; do whatever it takes to maintain your health.

Don’t take hypertension lightly, in yourself or your aging loved one. Keep an open dialogue with health care providers, and live a healthier, longer life with those you love.

Sources: 1, 2, 3, 4

Something very exciting is coming soon to the area! In just a little less than a month, we will experience a spectacular event. A total eclipse of the sun is coming on August 21, 2017. The moon will completely cover the sun. According to NASA, those in the path of totality will be able to see the sun’s tenuous atmosphere, the corona. In the AccuCare Home Health Care area, we are very fortunate.

Missouri residents have a wide range of options for viewing the eclipse. St. Louis is along the northern edge of the eclipse. The further south in the metropolitan area, the better the view. Many areas south of the city will begin seeing the visible partial eclipse before noon and will experience around two and a half minutes of total eclipse, beginning after 1:00 pm. If you and your loved ones plan on viewing this phenomenon, now is the time to discover the details of the eclipse in your town and get your protective glasses.

This is the first total solar eclipse visible to us in our country in many years! Your aging loved one may remember other total eclipses, so this is a great opportunity to take a trip down memory lane. If conversations about the past are enjoyable for an elderly person in your life, take the time to ask questions and explore the history of these events in the United States.

• 1991: Unfortunately, most of us missed this eclipse, which was only visible to U.S. residents in Hawaii.
• 1979: On February 26, 1979, the northwestern United States experienced a total eclipse.
• 1970: The east coast of the U.S., mostly the southern portion, witnessed a total eclipse on March 7, 1970.
• 1963: On this side of the world, the Great Maine Eclipse of 1963 (July 20) was visible only in Alaska, Canada, and Maine.
• 1932: The Great Maine Eclipse of 1932 was experienced by those in the Northeastern United States and Canada.
• 1925: NYC’s Winter Morning Eclipse occurred on January 24, 1925, extending through many of the U.S. Northeast/northern regions.

This is truly a once in a lifetime event! Officials are expecting more than a million people to visit Missouri. We advise you to be prepared, especially south of St. Louis. Traffic is expected to be quite heavy, and you can also expect to wait longer than usual at your favorite restaurant or even in grocery store lines. MODot has advised that people leave very early to arrive at their chosen viewing area and to be patient on the roadways. Be certain the gas tank is full before getting on the highway. Motorists are cautioned not to pull to the side of the road during the eclipse and not to drive while wearing eclipse glasses.

If your aging loved one is able, this will be a great experience to share. Be sure to take the time to plan for the event well. Happy Eclipse viewing!

The average American worker only uses about 54% of their paid vacation time. Though 96% of people say that using their vacation time is important to them, workers in the U.S. rack up about 662 million unused days, according to Project Time Off. Financially, this results in $66 billion lost in benefits and a $236 billion loss in the economy, money that would have been spent during vacation time. The costs are higher than that for the people who forfeit vacation, as being overworked can lead to burnout, poor satisfaction, strained relationships, health problems, emotional problems, poor sleep and even increased addictions.

There are already overworked employees that come home to another full-time job, that of being a caregiver for an aging loved one. While others have left or limited their paid employment in order to care for an aging loved one, which involves many more hours than the typical 40-hour workweek. This adds up to an estimated 44 million unpaid caregivers, 40-70% of whom will experience depression. Nearly all of these caregivers report a higher level of stress. Some unfortunately also develop health problems and addiction issues; and many fail to engage in preventative care, which leads to disastrous outcomes.

Let’s make this personal. Do you need a vacation from work, caregiving, or both? Ask yourself these questions to determine the answer.

• Is there always a long to-do list left at the end of the day, even if I worked hard all day long?
• Have I begun resenting those I work for or with, or even those I care for on a daily basis? Have I nearly lost my patience with my loved one?
• Do I have difficulty concentrating or staying on-task?
• Am I experiencing more minor health issues than normal, such as headaches, heartburn, aches and pains or minor colds?
• Have I been neglecting self-care in the form of missing doctor appointments or failing to get enough rest, eat properly or exercise?
• Have I begun making mistakes that are unusual?
• Do little things seem like huge issues?

If you find yourself answering yes, it is time for a vacation. AccuCare Home Health Care of St. Louis offers a valuable service called Respite Care. Respite Care is available to provide for your aging loved one’s needs while you take that much-needed vacation or even just a short break.

Get away. Breathe. Enjoy. Then return to your paid and/or unpaid tasks with renewed focus, clarity, concentration, increased patience and decreased stress. It is so important to also take care of yourself, it’s a necessary part of being able to truly care for others.

If you and your loved one would benefit from our respite care services, contact us today to explore our program. YOU deserve it!

Summer is a time for celebration, vacation, and fun in the sun. Next week, we’ll celebrate Independence Day with parties, barbecues, swimming and fireworks. Often, aging persons find themselves staying at home or limiting activities due to health problems or other issues related to aging.

Social activity is beneficial, however, and should not be neglected. With July 4^th festivities in mind, we have a few tips to make the most of the holiday for your aging loved one.

• Know their limits. Each individual is different, so it is important to think about your loved one’s special needs and preferences. Does a large crowd make her nervous? Has hearing loss affected his ability to enjoy certain activities? Be aware of which times of day your loved one feels best and how long they can tolerate activity. Plan accordingly, but don’t leave them out altogether.
• Involve them. Whether it is menu planning, cooking, making crafts, decorating, or just dreaming up ideas, most people enjoy participating in the preparation. If they are unable to help, discuss plans and ask for opinions.
• Be mindful of the temperature. Help your loved one stay out of the sun, and be sure to bring along a wide-brimmed hat and a light jacket. Make certain that they remain well hydrated. Alternate their favorite nonalcoholic drinks with water; and if they do wish to drink alcohol, be certain their doctor allow it, as it may interact with medications.
• Remember special needs and comfort measures. Of course, don’t forget to bring along any medication needed. Avoid accidents by taking frequent restroom breaks. Bring along a chair and/or cushion that is comfortable and easy to get in and out of.
• Keep expectations realistic. Expect that things will change as your loved one ages. He or she may not remember everyone. They may get upset if things get too loud or move too quickly. They may not be able to stay for the whole party. This is normal and it is fine. Be patient and adapt plans as needed.
• Relax. Allow your aging loved one to just sit back and observe if they wish. If they’d prefer to have someone with them at all times, take turns with others so that everyone can have some time to relax.
• Have an escape plan. If your loved one is sometimes agitated or easily tired, it is a good idea to have a safe, quiet place for them to take a break and rest. Have someone designated to deliver them safely home if they desire to leave early.

With a bit of thought and preparation, Independence Day can still be a fun and exciting holiday for aging individuals. We wish you and yours a very happy Fourth of July!