Posts Tagged "dementia"

Photo of Francey Jesson and her mother

For Family, Caregiving is a Choice

Francey Jesson’s life took a dramatic turn in 2014 when she lost her job at Santa Fe, New Mexico’s airport after a dispute with the city. In 2015, she relocated to Sarasota, Florida to be close to her family. One day, her mother, who has dementia, started crying over the telephone.

Jesson had always known she would be her mother’s caregiver, and that time had arrived. She and her brother combined resources and bought a house in Sarasota, and Jesson and her mother moved in.

“It wasn’t difficult to decide. What was difficult was everything that came with it,” she said.

One reason for the rocky adjustment was that Jesson, who is single, had been preparing herself mentally to take care of her mother’s physical needs in old age. But Kay Jesson, at 88, is in pretty good health. She requires full-time care because she has cerebral vascular dementia, the roots of which can be traced back to a stroke more than 15 years ago.

She is still able to function and has not lost her social skills. Her muscle memory is also intact, allowing her to chop onions while her daughter cooks dinner. But she forgets to turn off the water in the bathtub, mixes up her pills, can’t remember who her great-grandchildren are, and is unable to distinguish fresh food from rotting food in the refrigerator.

She’s also developed a childlike impatience and constantly interrupts her daughter, who works from home for her brother’s online company. “When she’s hungry, she’s hungry,” Francey Jesson said about her mother.

“Nothing ever stops for me. I can’t sit in a room and not be interrupted,” she said. “Sometimes I just want to watch TV for an hour.”

One way she copes is to approach caregiving with a combination of love and bemusement. She uses “therapeutic fibbing” to protect her mother’s feelings, for example, telling her that a friend who died has moved instead to Kansas so she doesn’t grieve over and over again.  Francey Jesson also resorts to humor in a blog she writes about her day-to-day experiences. In one article, “Debating with Dementia,” she recounted a conversation about the best way to repair some bathroom floor tile: …Learn More

Medical Costs Slam a Minority of Seniors

As retirees’ health declines, their medical costs go up. These costs include both everyday healthcare expenses and long-term care costs.

The everyday expenses that Medicare does not cover – Part B and Part D premiums, copayments, eyeglasses, and dental care – consume about 20 percent of the incomes of households ages 75 and over. While not exactly good news, 20 percent is “perhaps manageable” for most, concluded researchers at the Center for Retirement Research in a summary of various studies in this area.

The real problem comes for the unlucky minority – about 5 percent of seniors – who spend more than half of their income out of their own pockets for healthcare.

Turning to long-term care, these services are less frequently required but can be very costly. For example, while many nursing home stays are relatively short, a lengthy stay is a potentially crippling expense. One common trigger for a long-term stay is dementia.

The retirees facing the greatest financial risk from health care expenses tend to be those who earned enough to buy a house and put money away in their employer’s retirement plan. They have more to lose if their wealth is eaten up by exorbitant medical costs. The poor, in contrast, are covered by Medicaid, which often pays for Medicare premiums and long-term care. …Learn More

3 trees with gradually less leaves

Dementia is a Threat to Managing Money

The perils of aging generally escalate around 75, and they are becoming more pervasive as more Americans live to very old ages.

One of these perils – declining cognitive ability – often creates financial problems. A new study that summarized the research on this side of the retirement equation identified the financial fallout from dementia.

Currently, dementia afflicts roughly a quarter of seniors in their early 80s. And geriatricians and demographers have predicted for years that dementia will become a serious societal problem in the future as the tsunami of baby boomers reach older ages.

The first sign of deteriorating financial skills might be forgetting to pay a bill. But when severe dementia sets in, the vast majority completely lose their ability to manage their finances and risk making big mistakes, such as losing money in a fraudulent investment scheme.

Another concern is retirees’ growing reliance on 401(k)s for more of their income. Increasingly, they are grappling with the complicated question of how much money to withdraw each year from their 401(k) accounts – this is difficult for anyone but virtually impossible for people with dementia.

Fortunately, most of them get assistance managing their finances. But the seniors who don’t get help face potentially grave repercussions, such as having difficulty affording food, housing and medical care.

Managing money is not the only financial risk posed by dementia. A more serious issue is the potential need for a lengthy stay in a nursing home, which will be addressed in a future blog post. …Learn More

An elderly woman making pies with a young woman

Holidays with Dementia in the Family

When my grandmother was spirited away by dementia and no longer recognized me, I stopped visiting her in the nursing home.

I didn’t understand this at the time but now think that I just wanted to remember her baking lemon cream pies or waving at me as she rode around on her lawnmower cropping the lot next to her Indiana farmhouse.

I wish I could get another chance and do things better this time. Regret is hard to live with.

Psychologist Ann Kaiser Stearns views the holidays as a precious time of year to make elderly family members feel they are loved and included in the festivities.

“People respond for as long as they live to smiles, to touch, to music, to kindness, to sitting in the sun, to pumpkin pies,” Stearns, a professor of behavioral science, said in an interview.

“We just need to remember that all of that nourishes an elderly person to whatever degree they have impairments,” said Stearns, who also wrote “Redefining Age: A Caregiver’s Guide to Living Your Best Life.”

Stearns encourages people to make an extra effort to connect with a loved one over the holidays and provides some tips:

Be patient. Take the extra time to sit down with your parent, aunt, or uncle and talk to them. Encourage them to reminisce. “Don’t do something if you don’t have the time,” Stearns said.

Be present. If grandma doesn’t remember you or something that happened in the past, do not argue with her or ask, “Why don’t you remember?!” She advised that it’s better to say, “Remember grandma, it’s your granddaughter from Baltimore.” When an elderly person repeats or forgets, connect with them where they are now, even if it means going through the same conversation again.

Stir sweet memories. Stearns said that her friend’s father, a former minister, has Alzheimer’s but the friend brings him to church anyway. When Stearns’ parents were old, they used to sit happily watching the squirrels in their yard while her father smoked cigars. It’s important to repeat rituals that are uplifting and have always brought meaning to their lives. …Learn More

Caregiver Guides Detail Financial Duties

The federal government has released online brochures to give people who are thrust into a caregiving role a better idea of what they’re getting into.

“It’s a big shock at first and a big adjustment,” an Episcopal priest says in the video above. He became his mother’s caregiver after she developed dementia.

But people who anticipate they will one day be a caregiver can soften the blow by studying up on their future responsibilities with the Consumer Financial Protection Bureau’s new guides to caring for a loved one.

The brochures are free and cover four financial responsibilities: guardian, trustee, power of attorney, and fiduciary for a Social Security or Veterans Affairs beneficiary.

They can be downloaded in English or in Spanish at the federal Consumer Financial Protection Bureau (CFPB) website, or the agency will mail them.

CFPB has also posted brochures detailing the caregiver regulations and laws specific to six states: Arizona, Florida, Georgia, Illinois, Oregon, and Virginia. The state guides each cover the same four topics: guardian, trustee, power of attorney, and fiduciary for a Social Security or Veteran Affairs beneficiary.

Non-profit organizations in Michigan and Texas have also published their own brochures on caregiver issues in their states – links to these brochures are also on CFPB’s website. …Learn More

Maybe You Can Slow Cognitive Decline

After decades of study devoted to describing the negative effects of dementia, a new generation of researchers is pursuing a more encouraging line of inquiry: finding ways that seniors can slow the inevitable decline.

One vein of this research, still in its infancy, considers whether seniors could reduce the risk of dementia if they engage in volunteer work. Several studies focus on volunteering, because most of the population with the greatest risk of dementia – people over age 65 – is no longer working.

There’s no suggestion that volunteering can prevent dementia. However, one new study, by Swedish and European researchers, found that Swedes between 65 and 69 who volunteer had a “significant decrease in cognitive complaints,” compared with the non-volunteers. The seniors answered a survey questionnaire at the beginning and end of the 5-year study that gauged whether they had experienced any changes in each of four complaints: “problems concentrating,” “difficulty making decisions,” “difficulty remembering,” and “difficulty thinking clearly.”

The study didn’t go so far as to claim that volunteering actually caused the improvements either. But it highlighted how volunteering might reduce the symptoms, possibly because it keeps older people more physically and mentally fit.

Ruth Bader Ginsburg's headshot

Collection of the Supreme Court of the United States

Indeed, the cognitive benefits of exercise have been understood for so long that they’ve become a perennial topic in the mainstream media. Supreme Court Justice Ruth Bader Ginsburg, 85, has become the poster child for elderly exercisers, with a personal trainer overseeing her push-ups and turns on an elliptical machine in a CNN Films documentary, “RBG.”

The research confirms that she’s doing what she needs to do to stay sharp for her beloved job: aerobic exercise in particular protects seniors’ brain matter from deterioration; weight training and stretching exercises do not.

A research team’s 2014 review of 73 prior studies on volunteer work found multiple benefits: “volunteering in later life is associated with significant psychosocial, physical, cognitive, and functional benefits for healthy older adults.” The paper, which appeared in the Psychological Bulletin of the American Psychological Association, defined psychosocial well-being as having greater life satisfaction, higher executive function, being happier and having a robust social network. …Learn More

Dealing with Alzheimer’s in the Family

Caregiver in a nursing home can be grueling work, but my aunt loved it. In one of life’s cruel ironies, she died soon after retiring to take care of her husband, who is developing dementia.

The great responsibility for his care fell suddenly on his children and grandchildren, and they’re struggling with it.

I texted this video to a couple of my uncle’s daughters because it provides invaluable information and insight into the myriad causes of Alzheimer’s and the unique way its symptoms manifest in each individual. It also explains why diagnosis by a physician is critical – turns out, some people appear to have dementia, but the cause of their cognitive decline isn’t Alzheimer’s and may be reversible.

The speaker, Tammy Pozerycki, owns Pleasantries, which operates adult day care centers in the greater Boston area. In 1906, Dr. Alois Alzheimer, a brain researcher, first identified and described the disease. “It’s 2018, and we have no cure,” said Pozyercki. This places the burden on caregivers to manage the disease.

Full disclosure: her presentation was sponsored by Boston College’s human resources department for the benefit of employees. This blog is based at the Center for Retirement Research at Boston College.Learn More

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