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Posts Tagged ‘Cognitive impairment’

Your Brain Health with Age Well Simply

Thursday – June 24th, 2021 – 2pm EDT, 1pm CDT, 12pm MDT, 11am PDT & 7pm London BST, 8pm South Africa SAST, and on the 25th at 4am in Australia AEST

Watch the Interview Below

Kerry Mills Rutland, has worked solely with people with cognitive impairment since 2002.   She founded and is president of Age Well Simply.  Kerry has shared her expertise and vision here in the United States as well as in Canada, the United Kingdom, Hong Kong and China. She is the co-author of “I Care – A Handbook for Care Partners of People with Dementia” and she has most recently authored “Serving Residents with Dementia: Transformative Care Strategies for Assisted Living Providers.”

Kerry is a regular guest on local radio stations and has been a featured guest on PBS’ as well as CBS television.  She is also a National Board Certified Health and Wellness Coach and a trained practitioner in the Bredesen Protocol. In this capacity, she works with clients and their families, focusing on interventions that can stop the progression of cognitive impairment, including that of Alzheimer’s disease and in many cases, helps clients strengthen and repair lost cognition.

Listen to the Interview Below

Contact Age Well Simply

Website:  www.AgeWellSimply.com

Email

Phone:  (914) 962-0997

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Dementia Chats is a series of video conversations where we talk with the true experts on dementia, those living with a diagnosis. Lori La Bey, founder of Alzheimer’s Speaks facilitates a conversation and is amazed by every conversation what she learns about life with dementia. She encourages everyone not only to watch these videos, but to include those living with dementia in conversations and to listen closely to their insights. They know dementia better than anyone.

Above: Seed Funding for 3 Challenges $50,000 to $100,000

For a Complete List of Dementia Chats Videos – Click Here

Register for a Live Demo Tour of Dementia Map on Zoom!

Upcoming Public Events Lori La Bey Will Be At:

Lori La Bey Can Help Your Organization Switch To Virtual Presentations For Staff Trainings, Family Support, Perspective Clients and Support Gatherings.

See What Others Have Say About Lori La Bey

I want to echo the thanks and appreciation of my colleagues… Your presentations were movingly authentic, fully engaging and wonderfully informative. Thank you for all that you are doing, and all that you’ve done for us!

Carla Koehl, Director of Community RelationsArtis Senior Living of Lexington

 “Feedback from the conference planning committee and our leadership team was extremely positive. Many attendees commented that she was one of the best speakers they had heard.” 

Pat Sylvia, Director of Education & Member Development LeadingAge WA

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Find A Memory Café In Your Area

2 FREE SERVICE OFFERS BELOW

We would love to here your thoughts and comments on this tip.

                                            Diana Pierce and Lori La Bey

Downloadable Tips Below

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Gains Alzheimer's Trail - Premiere on Alzheimer's Speaks YouTube Channel

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Free Youth Camp For Kids Who Have A Parent With Dementia

Thursday – June 3rd, 2021 – 2pm EDT, 1pm CDT, 12pm MDT, 11am PDT & 7pm London BST, 8pm South Africa SAST, and on the 4th at 4am in Australia AEST

Watch The Interview Below

Our Host, Lori La Bey will be talking with Diana Cose is the care partner, for her husband Lorenzo was diagnosed with younger-onset Alzheimer’s.  Diana and Lorenzo have children; and needless to say; she has seen the impact this disease has had on their own family.  She left Perspectives, a Chicago Charter School, to launch a new venture, Lorenzo’s House.  Joining them will be Tessa McEwen is a licensed social worker for The Memory Center and the Outpatient Neurology Clinics at UChicago Medicine.  Their mission is to help those with cognitive impairment and memory loss to feel seen and heard by teaching others how to listen first with compassionate care. Tessa is on the co-founding team and medical sector co-lead for Dementia Friendly Hyde Park and serves on several boards and professional associations in the field for healthy aging, dementia care, and social work leadership in health care.

Listen To The Show Below

Contact Lorenzo’s House and Youth Camp

Website:  www.lorenzoshouse.org

Camp:  https://www.lorenzoshouse.org/event-details/free-virtual-youth-camp

Email

Be Our Next Guest. Email us at Alzheimer’s Speaks Radio

Join Alzheimer’s Speaks Radio and Learn More!

All Shows are Archived

Dementia Chats is a series of video conversations where we talk with the true experts on dementia, those living with a diagnosis. Lori La Bey, founder of Alzheimer’s Speaks facilitates a conversation and is amazed by every conversation what she learns about life with dementia. She encourages everyone not only to watch these videos, but to include those living with dementia in conversations and to listen closely to their insights. They know dementia better than anyone.

Above: Seed Funding for 3 Challenges $50,000 to $100,000

For a Complete List of Dementia Chats Videos – Click Here

Register for a Live Demo Tour of Dementia Map on Zoom!

Calling All Senior Living Communities – Join The Challenge!

Upcoming Public Events Lori La Bey Will Be At:

Lori La Bey Can Help Your Organization Switch To Virtual Presentations For Staff Trainings, Family Support, Perspective Clients and Support Gatherings.

See What Others Have Say About Lori La Bey

I want to echo the thanks and appreciation of my colleagues… Your presentations were movingly authentic, fully engaging and wonderfully informative. Thank you for all that you are doing, and all that you’ve done for us!

Carla Koehl, Director of Community RelationsArtis Senior Living of Lexington

 “Feedback from the conference planning committee and our leadership team was extremely positive. Many attendees commented that she was one of the best speakers they had heard.” 

Pat Sylvia, Director of Education & Member Development LeadingAge WA

For More Testimonial


Find A Memory Café In Your Area

2 FREE SERVICE OFFERS BELOW

We would love to here your thoughts and comments on this tip.

                                            Diana Pierce and Lori La Bey

Downloadable Tips Below

This image has an empty alt attribute; its file name is when-caring-takes-courage-book-cover.jpg
Gains Alzheimer's Trail - Premiere on Alzheimer's Speaks YouTube Channel

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Dementia or Delirium- Which one is it?

By Carole Larkin

Not long ago I attended a wonderful lecture on delirium by Dr. Vivyenne Roche of the University of Texas Southwestern Medical School. I am going to give you some facts and statistics from her lecture and then try to help caregivers use that information in their own lives and the lives of their loved ones.

 What is Delirium?

Delirium is defined as the change of a person’s mental status from what it was before. It is temporary, meaning that there is an end to it, not like a dementia which has no end to it (except death). Delirium can go on for hours, days, weeks, even months, but eventually the person returns to their former cognitive state. 25 percent of persons with delirium still have it one month after leaving the hospital and 18 percent still had delirium 6 months after leaving the hospital! Delirium can fluctuate (be stronger or weaker or change subtype) even during a single day.

There are two subtypes of delirium. The first is the hyperactive type we think of when hearing the word delirium.  Symptoms are agitation, hallucinations, inappropriate words or behavior, among other symptoms. Between 22 and 30 percent of people have this type of delirium. Another subtype is the hypoactive type, which looks very much like depression or even dementia of the Alzheimer’s type. The symptoms are lethargy and hypersomnolence (excessive sleeping). Between 24 and 26 percent have this type of delirium. Some people actually show both types within a day’s time and it is called mixed delirium. Between 42 and 46 percent have the mixed type, and isn’t that confusing to us caregivers?

Delirium usually shows up at the time of hospitalization, although 40 percent of elderly patients come into the hospital already delirious. Of those not already delirious upon admission, another 5 to 35 percent go on to develop it while in the hospital. There is a high occurrence of delirium in patients who have had operations, especially orthopedic operations like spine operations and knee replacements (65 percent!). Nursing home patients over the age of 75 who are brought to the hospital for any reason have delirium at the rate of about 60 percent. What is termed “terminal delirium”, that is, delirium which is followed by death, happens in 25 to 85 percent of patients.

How is Delirium Diagnosed?

Now here is the really scary part. Physicians directly involved in the patient’s care miss diagnosing the delirium between 33 and 67 percent of the time. Common ways of diagnosing delirium are: administering the Mini Mental State Examination (MMSE), doing a Digit Span Test, and asking the person to name the days of the week in backward order. But individuals present the condition differently. Sometimes the delirium is the only presentation of severe illness in older patients. Sometimes the delirium means that the person has had a silent heart attack (up to 40% of patients with delirium). 25% of persons who have delirium associated with pneumonia, TB, endocarditis (inflammation of the sac that holds the heart) or sepsis (whole body infection) have no fever. Even 13% of older patients who have a bacterial infection have no fever. Delirium is truly hard to diagnose. It would help if doctors always suspected it on admission into the hospital (in the emergency room) but many doctors don’t think about it. What can be done to diagnose it is to do an immediate cognitive screening in the ER as a baseline to compare with later in the hospitalization, a medication review, run blood tests like CBC, Bun, Creatinine, glucose, calcium, phosphate, liver enzymes, blood alcohol, and ammonia levels.  Also an EKG (for abnormal heart rhythms) and/or an EEG (for abnormal brain activity).

Some risk factors influencing a higher rate of delirium in the elderly are:

Electrolyte abnormalities

Gastric disorders

Trauma (falls, fractures, pain)

Cognitive impairment (MMSE below 24)

Use of physical restraints in the hospital

Malnutrition

Use of a bladder catheter in the hospital

3 medications added within a 24 hour period

The 3 most common reasons delirium exists in people are infection, metabolic disturbance and medications. 62% of people with a hip fracture had multiple reasons for having delirium.

How do doctors treat Delirium?

Basically there are two approaches to treatment and many times doctors turn to the pharmacological treatment before they consider the environmental types of treatment. The pharmacologic treatment of choice is the drug Haldol. It inhibits dopamine in the brain. Haldol is the drug that has been studied the most. It sedates, treats hallucinations, paranoia and delusions and it is less detrimental to the dementia (in patients who have a form of dementia as well as delirium) and causes blood pressure to go up less than other drugs used for the same purposes. It works quickly and has a reasonable safety profile. Its antipsychotic effects can last 3 to 6 days and it can be administered in a number of different ways. Generally the starting dose is 0.5 mg. It can be repeated every half hour until the desired effect appears. The maximum dose should not be more than 5 mg within 24 hours. Some doctors add Lorazepam (Ativan), but adding it sometimes makes the delirium worse instead of better.

The second way is non pharmacological. That way is to modify the patient’s environment at the hospital. The environment can be modified by :

using clocks and calendars to improve orientation to time and day,

opening the curtains to let natural light into their room,

making sure that they have their hearing aids and glasses and that they use them,

having family members there as much as possible,

asking the doctors and nurses to let them walk the hallways with an escort,

taking off any physical restraints on them,

removing catheters if not needed for urinary function, and

finally, having the person moved to a room next to the nurses’ station where they can keep an eye on him/her easily.

What lessons can families take away from this information on delirium?

Delirium before, during and after hospitalization is common. In time it usually resolves on its own, but it may take weeks or months to do so.

Families should not automatically think that their loved one has taken a huge nosedive in cognition right after leaving the hospital. Sometimes it’s the delirium, instead of dementia.

Give it time to see if your loved one comes back up a little. Maybe as much as several weeks to 6 months is the amount of time to wait. Don’t go trotting off to the doctor for more antipsychotics right away.

And Haldol is NOT the answer to regular agitation! Changing the environment around the person is the best answer. That means changing your attitude to a positive one, changing your communication to emphasize the things they can do as opposed to the things they can’t do, adapting the physical environment to lower agitation like letting in natural light as much as possible, not using the TV as a babysitter all day (having them engaged with a person at times during the day),  and simplifying what they see all around them (decluttering the area where they spend most of their time)

Carole Larkin is a Geriatric Care Manager with ThirdAge Services. 

Carole is doing some amazing work in the area of dementia and has nominated for the “Dementia Professional of the year.”   By clicking on the logo below you will be taken to a page which will give you more information on Carole, as well as a link to the nomination page.    

Phone  214-649-139

thirdageservices@gmail.com

www.thirdageservices.com

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