Friday, April 10, 2015

April Break

It is that time of year when I head off to my employer's annual conference.  The conference has me engaged with clients all day, every day, often into the night.  Fundamentally, I'm an introvert and I find this exhausting unlike my more extroverted colleagues who get great energy from spending the day being on point with everyone they encounter.  Don't get me wrong.  I enjoy the conversations which will be held.  I love seeing someone get an answer they needed or have an "Ah-Ha!" moment.  

At the end of the day, however, I retreat to the solitude of my hotel room to call home and check on my family, to quietly eat dinner in my room and to review the presentation scheduled for the next day.    This year, I get to present material for four of the five days.  My presentations are written and prepped but I will review several more times before stepping on stage.  

The conference is in a city that I've not been able to visit before.  I'm fortunate to be able to schedule a few extra days to stay and explore the area at my own pace with my favorite person at my side.  So, don't expect a post until at least Tuesday, April 21.  

In the meantime, step away from the screen and enjoy the Spring as it blooms around you.  

Wednesday, April 8, 2015

Changes from the Team Meeting

Lynn's team met yesterday for their regularly scheduled monthly review.  They discussed the frustration Lyn's experiencing at day hab and the consideration of reducing the days there from 5 to 3.    One of the team members suggested a different modification to Lyn's schedule.

It was pointed out that Lyn's normal pick up time coincides with an uptick in activity at the facility.  Some clients leave at that time while the groups which have been on the day's community activity are returning to the facility.  As a result, there's a lot of noise and people bustling about.  The director at the facility reports that Lyn's actually happy through the majority of the day.  So, the suggestion was made to pick Lyn up a half an hour earlier to see if that alleviates her frustration.  If it works, then she'd still be able to attend 5 days a week.

It is worth a shot and Mom's already made the adjustment to the schedule.  Hopefully, this will make departures less frustrating for Lyn and keep her time at day hab regular and positive.

Tuesday, April 7, 2015

Mind Crowd

Have you taken Mind Crowd's test and participated in TGen's research into Alzheimer's?  If you have not, do so.  The test only take about 10 minutes and your results will be part of a long term research project.  In return, you'll get to see how your results compare to others of your gender, your age and your educational background.

The project is currently in the first phase.  When phase two starts, individuals who have participated previously and who meet certain criteria will be invited to participate in more on-line tests and submit a DNA sample.  The goal of the entire study is to gain a better understanding of how our genome impacts our cognitive functions.

Nearly 52,000 individuals have participated to date.  I participated last year.  The goal is to reach 1 Million participants.  You can help them get a little closer to that goal.

Monday, April 6, 2015

Searching for That Penny

My sister maintains three places for keeping her coins.  The milk bottle I sent her is used to store just pennies.  Her silver coins are stored in her Minnie Mouse and Cinderella banks.

Last week, she pulled out her Cinderella bank and was very concerned because she just knew that a single penny had gotten mixed in with the nickels, dimes and quarters.  She emptied out the bank and searched through, finding not one penny but two.  She was quite upset about this.  What was even more upsetting to her was that the penny she knew was supposed to be in there was not there.

Mom assured her that no one was around to mess with her coins and that the penny may be in one of the other two banks.  Lyn clearly didn't believe Mom on either account.  Without directly accusing Mom of telling a lie, Lyn stated that Mom was clearly mistaken on all accounts as she marched into her room to get the other coins.

She decided to look in the milk bottle first, pouring it out onto the table.  Fortunately, as she sorted through the pennies, she found the one for which she was looking.  She quickly calmed down once she was assured she had the penny she wanted and that it was in the milk jar where it belonged.

Believe it or not, this is common for Alzheimer's patients.  They frequently accuse others of stealing their money.  I thin it is interesting that money is such an issue for my sister.  While she's never had to maintain the finances of a household or worry about paying bills, she's had spending money available to her for at least the last two decades of her life.  She's paid her way into events or for her own meals at restaurants.  While the amounts she's concerned about are insignificant; to her they are meaningful.   Hopefully, future ventures into the lost coin realm will be this easily sorted out as well.

Thursday, April 2, 2015

MIND Your Diet

Scientists, doctors and nutritionists have known for years that what you eat has a huge impact on your health.  We don't need to watch Supersize Me to understand that food high in fat, salt and sugar is really bad for us.  Individuals who have particular medical conditions may follow particular diets to try to improve their overall health.  For example, a colleague of mine eats blueberries every day to keep a lower blood pressure and my father-in-law consumes red rice to reduce cholesterol.  You've probably heard of the Atkins diet for weight loss or the Mediterranean diet for a healthy heart.  Now there's the MIND diet.

The MIND diet combines aspects of the Mediterranean diet with the DASH diet which reduces hypertension and appears to help protect against Alzheimer's.  Strict adherence to the diet suggests greater than 50% risk reduction while moderate adherence seems to impart about a 35% reduction of a person's risk of developing Alzheimer's.

While diet is just one component of a person's risk factors, this study is very interesting.  A second study released this week also indicates that green leafy vegetables are beneficial for slowing cognitive decline.  Given these studies, my husband will have to just accept that his salads will no longer contain iceberg lettuce.

Tuesday, March 31, 2015

Day Hab Changes

Over the past several weeks, Mom has noted that Lyn comes out of day hab in one of two moods.  Either the day has gone perfectly and she's happy as can be, or something went wrong and she's ready to explode.  

A happy day is a result of the day hab schedule being kept 100% with no variations.  If they were to go out, they went out to the originally planned location.  

An unhappy day is a result of a number of things such as the weather was too nasty for the originally putting to be kept.  The day could also become a challenge if another client gets into Lyn's face and starts telling her what to do.  There are two women who are known to do this.  The staff will intervene but are not always aware of it.  The day could become a challenge simply because all 40+ clients show up and Lyn becomes over stimulated.  

Unfortunately, the unhappy days are starting to out-number the happy days.  This is a pattern with Lyn and something we witnessed when she was still working and again at her last day hab.  At this point, we pretty clearly see this as originating with her.  Yes, the in-her-face clients are a direct challenge.  However, Lyn is no longer able to let things go.  She doesn't have the mental flexibility to accept a change in schedule or the ability to tell someone to back off.  If there's even a minor disturbance, she's fixating on it.  For example, her period started an hour before Mom was to pick her up one day last week and Lyn hounded a staff member into calling Mom "just to let her know."  There was no accident or soiled clothing to worry about but Lyn couldn't move on until Mom was informed.  

So now what?  Something needs to change because the unhappy days lead to a miserable afternoon for both Lyn and Mom.  Lyn is routinely asking if she can stay home and not go.  The issue really isn't with the staff or the day hab facilities.  The issue is with Lyn and the changes resulting from her Alzheimer's.

One of the two clients who get into into Lyn's face will no longer be attending.  (To be clear, they have not been singling Lyn out.  They just want to be in charge of everyone and everything.  I don't believe this is malicious.  It is just not something with which Lyn can deal.)  A 50% reduction of that tension will help.  

Mom reached out to Lyn's behavioral therapist to get a second opinion of what's happening at day hab and what is needed for Lyn.  The assessment of them both is that perhaps Lyn should attend fewer days of day hab.  Lyn will soon switch to attending day hab three times a week instead of four or five.  Additionally, the therapist conducts her visits with Lyn at day hab and will work with the staff to help them be more aware of Lyn's body language as well.  If they notice she's getting stressed or over stimulated, they may be able to direct her into one of the many spaces designated for quiet activities and out of the busier rooms.  

As Mom and Lyn were telling me this over the weekend, Mom clearly stated several times that this also means there are going to be quiet, at home days.  Lyn should not expect to go out every day that she stays home with Mom.  If they need to go out, they will but Mom's not going to create an excuse to go out every single day.  Lyn surprisingly didn't object to this.

Monday, March 30, 2015

Auditory Follow Up

In the middle of last week, Lyn had a follow up appointment with an ENT regarding the hearing loss in her left ear.  The doctor was kind and really listened.  He checked her ears and reviewed the results of the recent hearing tests.  He also read the notes from the audiologist and Lyn's primary care physician.

While noting that Lyn is intellectually disabled, he was surprised at the diagnosis of early on-set Alzheimer's.  He does not believe the hearing loss is in any way related to Alzheimer's and felt that such a loss would be rare and manifest first in the other ear.  He also does not believe that her hearing loss is the result of a sinus or ear infection and indicated there was no fluid built up behind her ear drum.

He suspects that at some point over the winter she had a virus that led to the hearing loss.  At this point, she doesn't appear to have an active infection which would cause the problem.  She's been treated for the previous sinus and ear infections which were bacterial based and those are fully resolved.  There's really nothing more that can be done.  Her hearing loss may be permanent.