AlzNSW Library News

Activities directors’ quarterly - Volume 10, Number 3

nhayward@alznsw.asn.au (Nicky Hayward-Wright) — Thu, 05 Nov 2009 05:28:00 +0000

Full text articles are available to fee paying members of Alzheimer’s Australia NSW at lis@alznsw.asn.au

Notes from nursing : Obtaining information from the Internet p.5
Therapeutic music: name that tune - lesson plan
Goals - to reminiscence and self esteem of the individual increasing quality of life, includes group size, locations, facilitator, staff requirements, duration, equipment needed and objectives .p. 23

Exercise - proven activities, includes seated exercises, walking, and exercise tips. p. 26

Seasonal Planner - Special Pullout Section - includes national pizza month, daylight savings time ends, national chocolate covered anything day - Activities to celebrate the season p. 24

Communicating with Spanish-speaking patients with severe dementia who manifest aggressive behavior
- looks at effective communication - includes a hierarchy of aggression management in bilingual patients with dementia table …..p.9

Washers: A great American game a popular outdoor activity - will benefit those who have an interest horseshoes and need to increase their physical activity, social interaction, cognition, and quality of life - interest may be stimulated by one on one competition such as tournaments. p.13

Intergenerational programs: Connecting young and old through meaningful activities
Great for residents that loved children in the past; expressed an interest in children or teaching, or miss children in their lives… Young and old can connect and help each other live more active and meaningful lives while volunteering to help others ...p. 17

In-service for intergenerational volunteers
Includes learning objectives for teens or adults, stresses that ageing is not the same as disability or disease, things to do when you visit… p.27

Life’s luxuries: Handcrafted herbal soaps
This intervention can be adapted to engage residents of all levels of functioning, can provide opportunities for numerous add on activities and provide the residents with an opportunity to harvest the herbs and flowers in their gardens. p.37

Non-pharmacological approaches to pain
Tips on how to recognize and help alleviate chronic pain for residents of long term care facilities - includes verbal signs of pain, facial expressions, body language, physical relief approaches, cognitive techniques and distraction methods that can be provided by activity staff... p.4

Neurology Now

noreply@blogger.com (Michelle de Mari) — Thu, 22 Oct 2009 03:13:00 +0000

September/October 2009, Volume 5, Issue 5

Rolle With It
Epilepsy is nothing to hide or be embarrassed about, says Baltimore Ravens cornerback Samari Rolle. By speaking openly about his seizures, Rolle has helped show the National Football League-and the world-that epilepsy is a manageable disease, not something to be shrouded in mystery.

Autism
Early Intervention in Autism
Children with autism spectrum disorders can benefit from treatment at any age, but researchers are finding that early diagnosis and intervention may create the most dramatic improvements. Here, we explore some of the major forms of treatment and how they have improved the lives of three children.

Fibromyalgia: Is Fibromyalgia Real?
Fibromyalgia used to be a wastebasket diagnosis for patients with unexplained pain and fatigue. Today, more and more neurologists are acknowledging that fibromyalgia is a real disorder, and one that should be treated by neurologists who care for chronic pain-not only the rheumatologists who originally identified the condition some 100 years ago.

Multiple System Atrophy
You can control orthostatic hypotension in multiple system atrophy.

Get It in Writing!!
Advance directives, such as living wills, put you in charge of your health.

July/August 2009, Volume 5, Issue 4

What to Tell Your Neurologist

Still Alice - book review reserve this book by emailing Alzheimer’s Australia NSW at lis@alznsw.asn.au

Victoria Williams
Bittersweet Symphony: With gratitude and hope, acclaimed singer-songwriter and MS sufferer Victoria Williams faces the music…
You may never have heard of singer-songwriter Victoria Williams, but many of today's legendary musicians, like Lou Reed and Lucinda Williams, cite her as an inspiration. Here, she opens up about her ongoing struggle with multiple sclerosis.

Alzheimer's and dementia
Your Heart, Your Belly and Alzheimer's: People with so-called "metabolic syndrome" may be at a higher risk of developing Alzheimer's disease and dementia. Here's what you should know…
People with metabolic syndrome-obesity, high blood pressure, high blood cholesterol, and diabetes-may be at a higher risk of developing Alzheimer's and dementia. Controlling these risk factors might help prevent or slow disease progression-but the time to act is now.

Caregiving
Who's There? When stroke or Alzheimer's changes a person's behavior, caregiving can become extreme. Here, experienced caregivers, patients, and experts share their stories and advice…
When stroke or Alzheimer's changes a person's behavior, caregiving can become extreme. Who is this person you've known all your life? And how do you handle the agitation, increased aggression, paranoia, and even psychosis that can accompany a neurological condition like dementia? Read on for practical tips from experts, caregivers, and the cared-for.

Wellness in the Workplace: How and why to take advantage of preventive care coverage.

May/June 2009, Volume 5, Issue 3

No Joke
Actor Robert Guillaume has had many memorable roles, including Nathan Detroit in Guys and Dolls and the witty butler Benson DuBois on Soap and Benson. Here, the veteran actor remembers the day a stroke changed his life-and the warnings he didn't take seriously enough.

Stroke
Black, White, & Gray
African Americans are more likely than their white counterparts to suffer and die from a stroke, more likely to suffer a stroke at a younger age, and often take longer to recover than whites. Researchers are just starting to find out why.

Prosthetic limbs
The Six Million Dollar Arm
Just 23 years old and five months out of the Marines, Claudia Mitchell lost her left arm in a motorcycle accident. Jason Koger lost both arms in an electrical accident. Today, they can move their prosthetic arms in complex ways-and in real time-just by thinking about it. These new bionic arms are the product of decades of work by Todd Kuiken, M.D., Ph.D., a physiatrist and biomechanical engineer.

Parkinson's Disease Video with Holly Robinson Peete!!.
Where to go for more information on the topics discussed in this issue of Neurology Now and for a directory of patient advocacy organizations.

March/April 2009, Volume 5, Issue 2

FEATURE
The Great Brain
Computer programmer, entrepreneur, Jimi Hendrix superfan, venture philanthropist-Paul Allen wears a lot of hats. He also founded the Allen Institute for Brain Science in 2003 to help find cures for neurological illnesses. This year the AAN is honoring Allen with their Public Leadership in Neurology award.

Pain
More than a feeling
New approaches to diagnosing complex regional pain syndrome are redefining what was once thought of as mystery pain. For years, doctors have viewed some pain patients as having psychological or substance-abuse problems. But that is changing.

Brain cooling
Your Brain on Ice
Cooling the body after cardiac arrest or stroke can save precious brain function. In Europe, cooling has become the standard of care for cardiac arrest. In the U.S., It's a complete hit or miss, says Stephan Mayer, M.D., who runs a cooling unit, depending on where you live and where the ambulance takes you. Here's what you should know about cooling's risks and benefits.

Eye on therapy
Thinking about Ginkgo?
Thinking about ginkgo biloba for Alzheimer's prevention?

Living well
Proof and Consequences
Before you undergo treatment, look closely at the evidence.

Restless leg syndrome
Answers to your questions about restless leg syndrome, depression, shingles, and autism.

January/February 2009, Volume 5, Issue 1

Screening room
The Savages reserve this DVD by emailing Alzheimer’s Australia NSW at lis@alznsw.asn.au

Holly Robinson Peete
Good Golly, Miss Holly!!.
Here's a lesser-known credit on TV actress Holly Robinson Peete's resume: Parkinson's disease advocate. Holly and her husband, former NFL quarterback Rodney Peete, founded Hollyrod to financially and medically support people with Parkinson's.

Epilepsy
Eating Well for Epilepsy
Epilepsy is the most common major childhood neurologic disorder in the United States. For the children who don't respond to antiepileptic medication, the ketogenic diet-which contains a large amount of fat and few carbohydrates-may be effective treatment.

Multiple Sclerosis
Hitting the Mattress with MS.
Many patients with multiple sclerosis also experience sleep disorders, including sleep-related movement disorder, obstructive sleep apnea, central sleep apnea, Rapid Eye Movement (REM) sleep behavioral disorder, and narcolepsy. Sometimes MS is the cause of sleep disorders and sometimes it is a co-existing condition. Here's what you need to know about treatment.

Eye on therapy
Fueling the Migraine Fire
Overusing narcotics and barbiturates may worsen migraine headache.

Clean Bill of Health.
Should you hire a medical billing advocate?

The State of Stem Cell Research
The state of stem cell research: where we are and where we're headed in

November/December 2008, Volume 4, Issue 6

Access Denied for Muscular Dystrophy Drug.

Diminished Capacity

From Hero to Advocate
TV viewers may recognize Greg Grunberg from his starring role as telepathic detective Matt Parkman on the hit show Heroes. What most people don't realize is that the role closest to Grunberg's heart is advocating on behalf of his 12-year-old son Jake-as well as the roughly 45,000 children under the age of 15 who develop epilepsy each year.

Genetic Testing
Risky Business
Since the sequencing of the human genome was completed in 2003, researchers have found risk genes for numerous medical conditions. Now, there is a growing number of companies offering genetic tests directly to customers. But how valid and helpful are these test results for the average consumer?

Seizure
The Seizures No One Wants to Talk About
Approximately one-third of epilepsy patients have uncontrollable seizures that don't respond to medication. And about 15-30 percent of these patients actually have psychogenic non-epileptic seizures, which are caused not by abnormal electrical discharges in the brain but by underlying psychological disturbances. One major obstacle on the path to treatment is acceptance of the diagnosis.

September/October 2008, Volume 4, Issue 5

New Study Links Parkinson's and Pesticides

FEATURE
Even Cowboys Get Migraines
During the 1990s, Troy Aikman was a recordsetting quarterback for the Dallas Cowboys, leading them to three Super Bowl wins. He built a Hall-of-Fame career while suffering from migraine, an often debilitating neurological condition that afflicts nearly 30 million Americans. But it was almost 35 years after first experiencing symptoms that Aikman was finally diagnosed with migraine-because he never consulted a doctor about his pain.

Hydrocephalus
Hidden Pressure
Adult normal pressure hydrocephalus is often misdiagnosed as Parkinson's or Alzheimer's disease-or simply chalked up to aging. But it is a reversible condition, and thanks to advances in shunt technology, the treatments are safer than ever before.

Brain Cancer
Life after Brain Tumor
As treatment advances help people with malignant brain tumors live longer, the medical community is paying more attention to the qualities of cancer survivors' lives after surgery.

July/August 2008, Volume 4, Issue 4

Common Drugs May Cause Cognitive Problems.

Compassionate Minds
On the CBs drama Criminal Minds, shemar Moore plays the role of FBI special agent Derek Morgan, part of an elite team of profilers who analyze the country's most twisted criminal minds and anticipate their next moves before they strike again. In real life, Moore is committed to eradicating a different kind of villain: multiple sclerosis, a chronic and potentially debilitating neurological disease that affects over 400,000 Americans, including his mother, Marilyn Wilson-Moore.

Proceed With Caution
Driving advice for people with epilepsy, Parkinson's, and Alzheimer's, and their families…
Many people with neurological conditions-such as epilepsy, Parkinson's disease, and Alzheimer's disease face driving challenges. However, regular driving assessments, treatment of those conditions, and access to alternative modes of transportation can help ensure that people retain their independence without endangering themselves or others.

Amnesia
Am I Nothing but What I Remember?
At 21, Denise Reagor assumed that she knew who she was, sure, there were discoveries to be made, but she figured her personality was pretty much formed. Most of us make the same assumption, and most of us are wrong. If you've ever wondered what it's like to rebuild your life from scratch, read the story of Reagor's amnesia.

May/June 2008, Volume 4, Issue 3

Give Me 5 For Stroke
14 Beauty and the Brain
Despite her pin-up allure, Morgan Fairchild knows the most important part of a woman is her brain. That's why she has teamed up with the American Academy of Neurology, the American College of Emergency Physicians, and the American Stroke Association to raise awareness about stroke. Learn more about the Give Me 5 For Stroke campaign in Beauty and the Brain.

Women and Epilepsy
Nearly 1 million women and girls in the United States are affected by epilepsy. This article discusses the ramifications that epilepsy holds for women -from the impact of menstruation on seizures to the effects of antiepileptic drugs on pregnancy-and provides practical advice to help women manage epilepsy instead of letting it manage them.

Massage
Healing Touch
Research shows that people who suffer with multiple sclerosis (MS)-as well as migraine headaches, Parkinson's disease, and HIV-related neuropathy-may experience benefits from massage therapy. Healing Touch discusses how massage can help people with neurological conditions, when massage should not be used, and how to find a good massage therapist.

http://www.neurologynow.com/pt/re/neuronow/issuelist.htm;jsessionid=KfLVtWhHh9ZXRQcfYPZs1LD2pp0pR0yChWNjnftZC8VnVKSBDdTQ!-1127164547!181195628!8091!-1

Alzheimer's & Dementia: The Journal of the Alzheimer's Association

noreply@blogger.com (Michelle de Mari) — Mon, 19 Oct 2009 02:42:00 +0000

Volume 5, Issue 5, Pages 369-444 (September 2009)

Featured Articles

Treatment effects of Memantine on language in moderate to severe Alzheimer's disease patients
Language impairment is one of the most troublesome manifestations of Alzheimer's disease (AD). The objective of this post hoc analysis was to assess the treatment effects of Memantine on language in patients with moderate to severe AD, using the recently developed Severe Impairment Battery-Language (SIB-L) scale.
Conclusions
Memantine treatment of AD patients results in significant benefits for language function. Our results suggest that it is worth considering this therapeutic option, even for AD patients with marked language impairment.
pages 369-374

Severe Impairment Battery Language scale: A language-assessment tool for Alzheimer's disease patients
Background
Communication problems are common in Alzheimer's disease (AD) patients, but instruments to assess these symptoms are limited. Our objective was to create a new scale, based on the language subscale of the Severe Impairment Battery (SIB), as a sensitive and reliable measurement of treatment effects on language performance.
Conclusions
The new SIB-L is a fast (<15 minutes) and easily administered scale with favorable psychometric characteristics for assessing language impairment and treatment effects on the language performance of patients with moderate to severe AD.
pages 375-379

“Below average” self-assessed school performance and Alzheimer's disease in the Aging, Demographics, and Memory Study
Background
A low level of formal education is becoming accepted as a risk factor for Alzheimer's disease (AD). Although increasing attention has been paid to differences in educational quality, no previous studies addressed participants' own characterizations of their overall performance in school. We examined whether self-assessed school performance is associated with AD beyond the effects of educational level alone.
Conclusions
We suggest an association between “below average” self-assessed school performance and AD beyond the known association with formal education. Efforts to increase cognitive reserve through better school performance, in addition to increasing the number of years of formal education in early life, may be important in reducing vulnerability throughout the life course.
pages 380-387

Current Alzheimer's disease clinical trials: Methods and placebo outcomes
Background
Eighteen-month-long randomized, placebo-controlled clinical trials are common for phase II and phase III drug development for Alzheimer's disease (AD). Yet, no 18-month trial has shown statistically significant outcomes favoring the test drug. We examined characteristics and underlying assumptions of these trials by assessing the placebo groups.
Conclusions
Inclusion criteria are essentially similar to earlier 6-month and 12-month trials in which cholinesterase inhibitors were not allowed, as were mean ADAS-cog rates of change. Yet increasing variability and relatively little change overall in the ADAS-cog placebo groups, eg, about 25% of patients do not worsen by more than 1 point, might make it more unlikely than previously assumed that a modestly effective drug can be reliably recognized, especially when the drug might work only to attenuate decline in function and not to improve function. These observations would be strengthened by pooling individual trials data, and pharmaceutical sponsors should participate in such efforts.
pages 388-397

Association of C-reactive protein with mild cognitive impairment
Background
Inflammation is proposed to play a role in the development of Alzheimer's disease, and may also be involved in the pathogenesis of mild cognitive impairment (MCI). This study examined the association of inflammatory markers in serum or plasma with prevalent MCI and MCI subtypes in a population-based sample.
Conclusions
Plasma CRP is associated with prevalent MCI and with nonamnestic MCI in elderly, nondemented persons in a population-based setting. These findings suggest the involvement of inflammation in the pathogenesis of MCI.
pages 398-405

Defining and labeling disease-modifying treatments for Alzheimer's disease
Alzheimer's disease (AD) might be treated with symptomatic, neuroprotective, or neurorestorative therapies. Neuroprotective and neurorestorative interventions are disease-modifying therapies. Disease modification can be defined as treatments or interventions that affect the underlying pathophysiology of the disease and have a beneficial outcome on the course of AD. In a clinical trial the criteria for affecting the underlying cause of the disease can be supported by demonstrating an effect on a biomarker such as medial temporal atrophy on magnetic resonance imaging (MRI) or diminished tau or phospho-tau levels in cerebrospinal fluid. The claim for a beneficial effect on the clinical course of AD is supported by a drug-placebo difference on the primary clinical outcomes of the clinical trial. A statistically significant correlation between the biomarker outcome and the clinical trial outcome would support the claim that these are based on the same underlying mechanism. Delayed start or staggered withdrawal designs might in themselves support a disease-modifying claim but are difficult to implement. A combination of clinical outcomes and biomarker measures is a more likely pathway to a disease-modifying claim. Labeling of disease-modifying agents might refer to slowing of disease progression, delay in reaching predefined disease milestones, or reduction in progression of a biomarker such as cerebral atrophy or ventricular enlargement on MRI. Prevention claims will depend heavily on biomarker outcomes. pages 406-418

Reducing dangerous nighttime events in persons with dementia by using a nighttime monitoring system
Background
Nighttime activity, a common occurrence in persons with dementia, increases the risk for injury and unattended home exits and impairs the sleep patterns of caregivers. Technology is needed that will alert caregivers of nighttime activity in persons with dementia to help prevent injuries and unattended exits.
Conclusions
When nighttime activity occurred, it resulted in severe injuries sometimes associated with subsequent nursing home placement. The night monitoring system represents a new technology that caregivers can use to assist them in preventing nighttime injuries and unattended home exits in care recipients with dementia.
pages 419-426

Perspectives

Alzheimer's disease drug development and the problem of the blood-brain barrier
Alzheimer's disease (AD) drug development is limited by the presence of the blood-brain barrier (BBB). More than 98% of all small-molecule drugs, and 100% of all large-molecule drugs, do not cross the BBB. Although the vast majority of AD drug candidates do not cross the BBB, the present-day AD drug-development effort is characterized by an imbalance wherein >99% of the drug-development effort is devoted to central nervous system (CNS) drug discovery, and <1% of drug development is devoted to CNS drug delivery. Future AD drug development needs a concerted effort to incorporate BBB sciences early in the CNS drug discovery process. This goal can be achieved by a reallocation of resources, and an expansion of research efforts in the pure science of BBB biology and the applied science of brain drug-targeting technology. pages 427-432

Commentary on “Alzheimer's disease drug development and the problem of the blood-brain barrier”
The perspective by Dr. William Pardridge entitled “Alzheimer's Disease Drug Discovery and the Problem of the Blood-Brain Barrier” makes a strong case for the imbalance in resource distribution to the drug-discovery and brain drug delivery processes, where the latter received less than 1% of the investment of the former. My own calculations are consistent with this striking imbalance. Dr. Pardridge predicts that current trials of passive immunity against β-amyloid peptide will likely fail, whereas past trials of active immunization exhibited trial-ending side effects, in part because of disruption of the integrity of the blood-brain barrier. To bring an assessment of the physiology of the blood-brain barrier and the brain delivery of drugs to the fore, several changes are needed in the way we perceive the problem, train our young scientists, organize research efforts, and incentivize reaching our common goals of effective drug therapy for Alzheimer's disease. pages 433-434

A caregiver's training manual for the elderly : Alzheimer's and other dementia

noreply@blogger.com (Michelle de Mari) — Fri, 16 Oct 2009 02:47:00 +0000

A caregiver's training manual for the elderly : Alzheimer's and other dementia

reserve this book by emailing Alzheimer’s Australia NSW at lis@alznsw.asn.au

This manual is a detailed caregiver's guide to activities of daily living for the elderly with Dementia and Alzheimer's Disease. Lesson plans are included, giving practical advice on daily tasks of dining, bathing, grooming, dressing, toileting and behavior. This book addresses those skills that individuals with Dementia lose as the disease progresses. Teaching examples of how to help the loved one learn, unlearn, relearn, or at least maintain his/her skills at their present level and improve their quality of life is stressed.

Total Relaxation - Healing Practices for Body, Mind & Spirit

noreply@blogger.com (Michelle de Mari) — Fri, 16 Oct 2009 02:28:00 +0000

Total Relaxation - Healing Practices for Body, Mind & Spirit - reserve this book by emailing Alzheimer’s Australia NSW at lis@alznsw.asn.au

DOES STRESS HAVE A GRIP ON YOUR BODY, MIND AND SPRIT?

Whether it shows up as lower-back pain, insomnia, low-level anxiety, or just general malaise, tension can grip our lives and keep us from living up to our full potential.

Dr. John Harvey has organized his relaxation techniques into five different categories to help you discover where your tension resides.

Using a symptom checklist, you can match your symptoms against the five levels of relaxation - muscular,

autonomic,

emotional,

mental,

or spiritual...

Learn the proven techniques that will guide you to a relaxed, tension-free state quickly and effectively. Some of these relaxation techniques have been practiced for centuries, some of them were developed by twentieth-century physicians who have researched the effects of prolonged stress on the human body, and some of them have been developed by Dr. Harvey himself, drawing on his years of treating patients worn out by thestress of everyday life. Using these techniques, anyone can achieve Total Relaxation.

A sixty-minute CD containing four guided relaxation techniques is included at the back of this book.

New resources for carers of people with dementia

noreply@blogger.com (Michelle de Mari) — Tue, 13 Oct 2009 22:45:00 +0000

Dementia
Offers young readers and researchers a means of understanding various ailments and conditions, explaining what these conditions are, what causes them, how people live with them, and the latest information about treatment and prevention.

Therapeutic art activities for Alzheimer's / dementia patients
Offers young readers and researchers a means of understanding various ailments and conditions, explaining what these conditions are, what causes them, how people live with them, and the latest information about treatment and prevention.

And still the music plays
Using 22 stories, the author draws on his memories of people with dementia he has met to bring the reader a greater understanding of the condition and why some people behave in the way they do. The central theme is that everyone with dementia is unique, with a distinctive personality and experiences, and it is only by thinking deeply about each person individually that we can respond to their unique needs and give the best care possible.

Living well with dementia
DVD offers descriptions of how a person living with dementia can have an enjoyable life by examining; living at home with the care of family members and social activities and residential care facilities that are person centred and use dementia specific training, environments and activities to help the person with dementia and their family and friends to live well.

On any given day : June 21
This presentation represents a typical day for UnitingCare Ageing...it reflects what happens across UnitingCare Ageing on any given day. Our vision - inspired care…enriching lives together. Our mission -To enable well-being, we care for people in our living and working communities.

INsite - October / November 2009 Issue 56

noreply@blogger.com (Michelle de Mari) — Tue, 13 Oct 2009 01:17:00 +0000

Full text articles are available to fee paying members of Alzheimer’s Australia NSW at lis@alznsw.asn.au

Penalised facility speaks out
The Minister for Ageing, Justine Elliot, publicly declared a facility “non-compliant” before the investigating officers had finished their report on which she based her statement. She also directed the Accreditation Agency to conduct an unannounced, full audit at the same time the investigation was boosted by a police presence, and reported on by TV, radio and print media. Peninsula Village, a not-for-profit, 263 bed facility on the NSW Central Coast, has detailed the horrifying treatment it experienced, in the hope that other facilities can learn from and avoid similar instances. Speaking at the recent ACSA national conference in Perth, CEO Terri Parker and supported care services manger Melinda Dempsey detailed the “compliance chaos” which followed an incident on the long weekend in October 2008. Following an initial report, a male staff member was suspended. Parker then reviewed the documentation on the Tuesday and sought advice from the quality and compliance unit as to whether it was a compulsory report. They advised reporting as “better than safe than sorry”….p.4

Mandatory reporting not working: survey
Just one in every 100 mandatory reports of physical or sexual abuse results in police charges, while one in every 200 results in a conviction, new research claims…p. 1

Awards will cost nurses, and care
Aged care nurses look set to be further financially disadvantaged with the introduction of the government’s award modernisation process… p. 3

Bonds issue slammed
The Australian National Audit Office has attacked the Department of Health and Ageing’s monitoring and regulation of $8 billion worth of aged care bonds. p. 4

Consumers, providers agree on road map for future
Older people should contribute to the costs of care according to their capacity to pay. And the costs of accommodation should be separate to the costs of care and support. p. 5

Debate over right to refuse treatment
A recent West Australian Supreme Court ruling has revived debate about the right to refuse medical treatment and the “right to die” issue. It has also raised the role of palliative care in such cases. p. 7

Cleaning up a worrying problem
Discusses the issue of elderly living in squalor and moves to address it…The majority of older people living in squalor have cognitive impairment. Most have alcohol-related brain damage or schizophrenia…p. 9

The importance of image
It is time to create a positive perception of the industry…employees surveyed said the industry should promote itself as caring, compassionate, understanding and supporting, using positive testimonials…11

Ten green bottles
Are we being driven by the care needs of the residents or by the fear of non-complience… Once upon a time my only experience of an agency was to book staff and the only thing I ever validated was my parking ticket. I actually believed a support contact was just that, so I was very surprised, to say the least, when the agency was not what I would describe as supportive. p. 12

Doing it differently

Capacity building and empowerment should be at the forefront of community care…p. 15

One world, one home
There can be no denying the significant challenge posed by the growing number of culturally and linguistically diverse residents. A provider
new inclusive facility is home to 19 different nationalities…p. 18

Clever moments
A burning question
…using a quality improvement questionnaire to educate staff and imporove their standards of care - by raising awareness of workplace policies and procedures..
Playing around
…connecting older people living in the home with younger mothers and their children (via play group associations). The group allows its members to share precious moments together in the home, and to play together and learn in a fun environment…p. 19

Continence
Forecasting future industry need…p. 25
A little care goes a long way…p. 26
Continence first hits Australia …p. 29
New device hits market …p. 30

Technology
A gain for the brain
A brain fitness program in WA has produced exciting results
see www.brainfitnessaustralia.org.au

Getting from A to B
Advances in GPS navigation systems could revolutionize the delivery of community care…p. 33

On the record
The government is behind on e-health records, but providers are making it happen for themselves…p. 34

Nutrition
Now is the ideal time to get out the summer menu and put some thought into how you could maximize differences to the winter menu. Use seasonal variations, puddings can also create a way to help create seasonal variations…p. 36

Interior design
A coming of age
A competitive environment and client expectations are upping the ante on aged care interior design. The development of the extra service standard of facility paved the way for more innovative design and decoration…p. 38
Five star designs
Sir Moses Montefiore Aged Care recognised there was a need a high standard of accommodation, and they have been proven correct with all 276 residential rooms occupied..p.40
The re-emergence of small?
The funding model and regulatory framework have been the driving forces behind the trend towards larger facilities, but will this continue…p. 41

Poster
Multicultural activities
Ways to foster and value individual customs, culture and ethnic backgrounds
eg - continental breakfast; Culture club: exploring the traditions and customs of other countries; Etude seated dance; Still life displays and 3D art hostel and low care settings; Spirituality and food: exploring Bible stories and cultures through food; Shavout - sensory enrichment dementia activity: Cultural food themes: Corroboree

New DVD on volunteering

noreply@blogger.com (Michelle de Mari) — Thu, 08 Oct 2009 23:31:00 +0000

True friendships : volunteering in day clubs

A key message is that anyone interested in working with older people in a friendly, local community setting can volunteer to work in a day care club. The volunteers on the DVD convey a sense of fulfillment, enjoyment, reward and good fun from being a volunteer.

New resources on depression

noreply@blogger.com (Michelle de Mari) — Thu, 08 Oct 2009 23:24:00 +0000

Stories of hope & recovery : personal accounts of depression, anxiety and related disorders

Features the 20-minute ABC Landline "Black dog" program on rural men, alcohol and depression.

Beyondblue guide to the management of depression in primary care : guide for health professionals

The word depression can be used to describe a mood (sometimes normal, sometimes signalling a problem) or an illness (or disorder). It is a word that has meaning in common parlance as well as in the clinical setting. Whether we are talking about the common parlance depression, or a severe clinical depression, each may require help, be it from friends or professionals.

New books on dementia care

noreply@blogger.com (Michelle de Mari) — Thu, 08 Oct 2009 22:39:00 +0000

Come into my world : how to interact with a person who has dementia : an educational resource for undergraduate healthcare students on person-centred care

Though the educational resource has been developed for undergraduate students in the first instance, it is also intended to be helpful for educators across multiple undergraduate healthcare disciplines. It is envisaged that the combined use of the DVD and workbook, by illustrating examples of the person-centred care approach in real-life situations, and behaviours of concern, will help undergraduate healthcare students to enhance their professional practice.

A guide to dementia care

A Guide To Dementia Care is a wide ranging introduction to the nature of dementia and also the existing support framework. Now revised and updated to 2009, it is the perfect book for all those who wish to develop their knowledge of this area. Includes information on the brain, behaviour, causes and symptoms, treatments, therapies, and financial support.

Contented dementia : 24-hour wraparound care for lifelong well-being

...outlines a groundbreaking and practical method for managing dementia that will allow both sufferer and carer to maintain the highest possible quality of life, throughout every stage of the illness. A person with dementia will experience random and increasingly frequent memory blanks relating to recent events. Feelings, however, remain intact, as do memories of past events and both can be used in a special way to substitute for more recent information that has been lost. The specal method (specialized early care for alzheimer's) outlined in this book works by creating links between past memories and the routine activities of daily life in the present.

Courage to care : a caregiver's guide through each stage of Alzheimer's

Alzheimer's disease is often referred to as a family disease because of the constant emotional strain it places on family members as they watch their loved ones slowly slip away. But for those left with caring for their loved ones, the emotional, physical, and financial toll can be enormous-so much so that most caregivers fail to take care of themselves and become depressed, ill and unable to continue their role as caregiver.

Alzheimer Disease & Associated Disorders

noreply@blogger.com (Michelle de Mari) — Thu, 08 Oct 2009 03:21:00 +0000

23(3), July/September 2009

Full text articles are available to fee paying members of Alzheimer’s Australia NSW at lis@alznsw.asn.au

Cardiorespiratory Fitness and Preserved Medial Temporal Lobe Volume in Alzheimer Disease
Exercise and cardiorespiratory (CR) fitness may moderate age-related regional brain changes in nondemented (ND) older adults. The relationship of fitness to Alzheimer disease (AD)-related brain change is understudied, particularly in the hippocampus, which is disproportionately affected in early AD… In early-stage AD, CR fitness is associated with regional brain volumes in the medial-temporal and parietal cortices suggesting that maintaining CR fitness may modify AD-related brain atrophy. p188-197

Prevention of Dementia by Intensive Vascular Care (PreDIVA): A Cluster-randomized Trial in Progress
Background and Purpose: Cardiovascular risk factors are associated with an increased risk of dementia. Treatment of hypertension and hypercholesterolemia is associated with a decrease in incident dementia. Whether interventions aimed at cardiovascular risk factors in late life also reduce dementia risk is unknown. Here, we report the outline of a pragmatic study that will attempt to answer this question and we describe the prevalence of cardiovascular risk factors in the target population.
Conclusions: In this older age group, the very high percentage of elderly subjects with cardiovascular risk factors illustrates the large window of opportunity for therapies directed to lower the cardiovascular risk and potentially also the risk for dementia.
p. 198-204,

Computer-based Cognitive Training for Mild Cognitive Impairment: Results from a Pilot Randomized, Controlled Trial
We performed a pilot randomized, controlled trial of intensive, computer-based cognitive training in 47 subjects with mild cognitive impairment. The intervention group performed exercises specifically designed to improve auditory processing speed and accuracy for 100 min/d, 5 d/wk for 6 weeks; the control group performed more passive computer activities (reading, listening, visuospatial game) for similar amounts of time…However, we observed a pattern in which effect sizes for verbal learning and memory measures tended to favor the intervention group whereas effect sizes for language and visuospatial function measures tended to favor the control group, which raises the possibility that these training programs may have domain-specific effects. We conclude that intensive, computer-based mental activity is feasible in subjects with mild cognitive impairment and that larger trials are warranted. p. 205-210,

An Open-label Study of Memantine Treatment in 3 Subtypes of Frontotemporal Lobar Degeneration
There are currently no Food and Drug Administration-approved treatments for frontotemporal lobar degeneration (FTLD). The objectives of this study were to explore the tolerability of memantine treatment in FTLD and to monitor for possible effects on behavior, cognition, and function…Variable declines were observed on the ADAS-cog, EXIT25, Frontal Behavior Inventory, NPI, TFLS, and UPDRS scores. The FTD and SD groups declined on most of the cognitive and behavioral outcome measures, but remained stable on the UPDRS, whereas the progressive nonfluent aphasia group remained relatively stable on the ADAS-cog, NPI, and TFLS, but declined on the UPDRS. Memantine was well-tolerated in these subjects. Future placebo-controlled trials of memantine in FTLD are warranted and may have greater power to detect behavioral and cognitive effects if focused on the FTD and SD clinical syndromes. p. 211-217

Bivariate Heritability of Total and Regional Brain Volumes: The Framingham Study
Heritability and genetic and environmental correlations of total and regional brain volumes were estimated from a large, generally healthy, community-based sample, to determine if there are common elements to the genetic influence of brain volumes and white matter hyperintensity (WMH) volume. Moderate, yet significant, heritability was observed for the other measures. Bivariate analyses demonstrated that relationships between brain volume measures, except for WMH, reflected both moderate to strong shared genetic and shared environmental influences. This study confirms strong genetic effects on brain and WMH volumes. These data extend current knowledge by showing that these 2 different types of magnetic resonance imaging measures do not share underlying genetic or environmental influences. p. 218-223,

Association Between BDNF Val66Met Polymorphism and Alzheimer Disease, Dementia With Lewy Bodies, and Pick Disease
A functional polymorphism of the brain-derived neurotrophic factor (BDNF Val66Met) has been reported to affect memory-related hippocampal activity. Apolipoprotein E (ApoE) gene polymorphism is known to be associated with Alzheimer disease (AD), dementia with Lewy bodies (DLB), and Pick disease (PiD). We tested the hypothesis that BDNF Val and ApoE [varepsilon]4 alleles confer susceptibility to AD, DLB, and PiD... Genotypes containing both ApoE [varepsilon]4 and BDNF Val alleles occurred more frequently in all investigated dementias than in HC. We suggest that the presence of the BDNF Val allele in itself and in combination with the ApoE [varepsilon]4 allele can be risk factors for AD, and the results indicate a synergistic effect of the 2 polymorphisms on DLB and PiD risk. p. 224-228,

Correlation of Clinical Features With Argyrophilic Grains at Autopsy
Argyrophilic grains (AGs) are a pathologic feature found in association with neurodegenerative disease. Some have suggested that these features may occur as a distinctive condition… Subjects with AGs tended to be older but only significantly so in AD. Many comorbid non-neurologic health conditions were seen in cases of AGs without any single predilection emerging. AGs occur in approximately 22% of the entire autopsy cohort and are likely associated with advanced age. No distinctive antemortem clinical features were over represented in the AG cases. AGs can occur with or without neurodegenerative conditions and can occur in the absence of significant cognitive decline. AGs are not clearly associated with any single comorbid health condition. p. 229-233,

Differences in Coated-platelet Production Between Frontotemporal Dementia and Alzheimer Disease
Objective: Coated-platelets are a subset of platelets produced by dual-agonist activation with collagen and thrombin. These platelets retain full-length amyloid precursor protein on their surface and correlate inversely with disease severity in Alzheimer disease (AD). We have now investigated coated-platelet production and its relationship with disease severity in frontotemporal dementia (FTD) patients to determine whether our earlier observations were unique to AD.
Conclusions: In contrast to AD, there is no significant relationship between disease severity and coated-platelet levels in FTD. Differences in coated-platelet levels between early-stage AD and early-stage FTD patients warrant further investigation for potential clinical applications in helping to differentiate between these 2 disorders.
p. 234-237,

Depression and Plasma Amyloid [beta] Peptides in the Elderly With and Without the Apolipoprotein E4 Allele
Depression associated with low plasma amyloid-[beta] peptide 42 (A[beta]42) leading to a high ratio of A[beta]40/A[beta]42, a biomarker of Alzheimer disease (AD), may represent a unique depression subtype. The relationship between low plasma A[beta]42 in depression and the major risk factor of AD, apolipoprotein E4 (ApoE4), is unknown. With the goal of clarifying this relationship, we analyzed 1060 homebound elders with ApoE characterization and depression status in a cross-sectional study… As a combination of low plasma A[beta]42 and high plasma A[beta]40 has been shown to increase the risk of AD in 2 large cohort studies, amyloid-associated depression shown in this study may suggest a risk factor of AD in the absence of ApoE4. p. 238-244,

Patterns of Cerebral Hypoperfusion in Amnestic and Dysexecutive MCI
Although early studies on mild cognitive impairment (MCI) focused on memory dysfunction; more recent studies suggest that MCI is clinically heterogeneous. The objective of this study is to examine patterns of cerebral perfusion in anmestic (N=12) and nonamnestic (N=12) single-domain MCI patients from 4 a priori regions of interest: middle and superior frontal cortex, posterior cingulate, and precuneus, to compare them relative to healthy controls (N=12), and to correlate perfusion with neuropsychologic measures. Relative to controls, all MCI patients had hypoperfusion in the posterior cingulate, bilaterally... The finding that single-domain MCI patients with prominent deficits in different cognitive domains exhibited different patterns of hypoperfusion relative to controls supports the existence of distinct subgroups of MCI. These data further suggest that cognitive impairment in MCI is related to cerebral hypoperfusion. p. 245-252,

A Comparison Study of Mild Cognitive Impairment With 3 Memory Tests Among Chinese Individuals
Objective: To examine whether 3 common memory tests differ statistically in terms of mild cognitive impairment (MCI) discrimination rates and conversion rates to Alzheimer disease.
Conclusions: The MCI discrimination rate and the conversion rate among different episodic memory tests are differ considerably. p. 253-259,

Characteristics and Performance of a Modified Version of the ADCS-CGIC CIBIC+ for Mild Cognitive Impairment Clinical Trials
Introduction: The Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC) was modified for use in mild cognitive impairment (MCI) trials and tested in the ADCS MCI randomized clinical trial of donepezil, vitamin E, and placebo. We assessed feasibility for its use by determining whether or not: (1) it distinguished a medication effect at 6 months and 12 months, (2) baseline demographic or clinical characteristics predicted change, (3) there was an association between MCI-CGIC and change in other clinical measures in order to evaluate external or concurrent validity.
Conclusions: Change detected by the MCI-CGIC was associated with baseline clinical severity and with change in clinical ratings over 6 and 12 months, supporting the validity of a CGIC approach in MCI. The effect size of the donepezil-placebo difference was similar to that of other outcomes at 12 months. About 40% of MCI patients were judged worse and about 11% improved, consistent with clinical experience and other ratings. p. 260-267,

Rate of Decline in Alzheimer Disease Measured by a Dementia Severity Rating Scale
Objective: To measure clinically relevant change in Alzheimer disease (AD) using a family member-completed Dementia Severity Rating Scale (DSRS) questionnaire.
Methods: DSRS and Mini Mental State scores were prospectively collected on 702 patients with AD from first evaluation until they became too impaired to return to clinic.
Conclusions: The DSRS provides a clinical measure of functional impairment in AD that increases about 4.48 points/y from the earliest symptomatic stage until patients become too severely impaired to return to clinic. p 268-274,

Evaluation of the Validity and Reliability of the Alzheimer Disease-related Quality of Life Assessment Instrument
The Alzheimer Disease-related Quality of Life (ADRQL) instrument was developed to assess health-related quality of life in people with AD using assessments from family caregivers or professional staff. Validity and reliability of the ADRQL in its original form and a revised version are assessed in a sample consisting of persons in 3 residential settings (community, assisted living, nursing home)…The results support the use of the ADRQL to evaluate health-related quality of life in persons with AD across various care settings and various stages of the disease. Modest correlations with cognitive and functional disability levels suggest that the ADRQL provides insight into other important dimensions of life experience in persons with dementia. The revised version has improved measurement properties and is recommended for use over the original. p. 275-284,

Changes in the Quality of Life of People With Dementia Living in Care Homes
Quality of Life (QoL) is now an established outcome measure for people with dementia. There is a need to understand if measures are sensitive to change and what factors are associated with change in QoL in dementia to develop interventions to improve QoL and identify who may be most likely to benefit. This study aimed to assess change in QoL in people living in 24-hour care homes using the Quality of Life-Alzheimer's Disease (QOL-AD) scale and investigated which clinical factors predicted changes in QoL in dementia... A reduction in residents' QoL was predicted by lower baseline depression and anxiety symptoms, higher baseline QoL ratings, and an increase in depressive symptoms and cognitive deterioration at follow-up. Although QoL does not necessarily diminish as dementia progresses, it is strongly influenced by the person with dementia's mood. Improvement in cognition and mood may lead to increased QoL. p. 285-290,

Brief reports

Associations Between Microinfarcts and Other Macroscopic Vascular Findings on Neuropathologic Examination in 2 Databases
Clinicians may undervalue brain microinfarcts because they are defined by neuropathology and not seen on magnetic resonance imaging (MRI). We sought to identify what neuropathologic vascular findings-likely to be evident on brain MRI during life-would predict the presence of microinfarcts. We sought associations between such findings and microinfarcts in neuropathology databases from the National Alzheimer's Coordinating Center (NACC) and the Adult Changes in Thought (ACT) study. Considering only subjects 65 years or older at death, microinfarcts were evaluated in 6189 from NACC and 219 from ACT. Despite different definitions being used, microinfarcts were common in both studies (19.7% in NACC and 16.0% in ACT), and their frequency increased significantly with age. In NACC specimens, after controlling for age and sex in multivariable models, microinfarcts were strongly associated with macroinfarcts [odds ratio (OR): 4.4, 95% confidence interval (CI): 3.8, 5.0], leukoencephalopathy (OR: 2.6, 95% CI: 2.1, 3.3), and hemorrhages (OR: 2.0, 95% CI: 1.6, 2.6). Similarly in the ACT specimens, microinfarcts were strongly associated with macroinfarcts (OR: 2.9, 95% CI: 1.4, 6.3). These neuropathologic associations suggest that people whose cranial MRI shows macroinfarcts, hemorrhages, or leukoencephalopathy are more likely also to have microinfarcts. p 291-294

Parkinson Disease With Dementia: Comparing Patients With and Without Alzheimer Pathology
Subjects with Parkinson disease (PD) frequently develop dementia with greater than one-third meeting neuropathologic diagnostic criteria for Alzheimer disease (AD). The objective is to identify clinical and neuropathologic differences between Parkinson disease with dementia (PDD) subjects, with and without coexistent AD pathology. Neuropathologic examination was available on subjects diagnosed by clinicopathologic criteria with PDD-AD (N=23) and PDD+AD (N=28). A small subset of subjects with PDD-AD and PDD+AD had received at least 1 standardized neuropsychologic assessment. PDD+AD subjects were significantly older at age of PD onset and death, progressed to onset of dementia in less time, and had a shorter duration of PD symptoms before the onset of dementia. Education, responsiveness of L-dopa and dopaminergic medications, presence of cognitive fluctuations and hallucinations, and mean Mini-Mental State Examination, Global Deterioration Scale, Functional Assessment Staging, and Unified Parkinson Disease Rating Scale scores did not differ significantly between the 2 groups. The PDD+AD group had significantly greater total plaques, neuritic plaques, total tangles, and Braak stages compared with PDD-AD. This study suggests that it is difficult to distinguish PDD+AD and PDD-AD on the basis of movement, clinical, and neuropsychologic assessment. PDD-AD and PDD+AD have similar degrees of dementia and approximately half of PDD subjects have enough AD pathology to attain a neuropathologic diagnosis of AD. PDD can develop in the absence of significant Alzheimer pathology. p. 295-297,

Frontotemporal Dementia-amyotrophic Lateral Sclerosis Complex is Simulated by Neurodegeneration With Brain Iron Accumulation
We describe a case of late onset neurodegeneration with brain iron accumulation (NBIA) presenting as frontotemporal dementia (FTD) with amyotrophic lateral sclerosis (ALS). A male patient presented at age 66 with change of personality: disinhibition, emotional blunting, and socially inappropriate behavior, coupled with dysarthria, dystonia, and corticospinal tract involvement. Magnetic resonance imaging showed general cortical atrophy, iron deposits in the globus pallidus, and the "eye of the tiger" sign. Neuropsychologic performance was globally reduced, especially executive functions. Fluorodeoxyglucose positron emission tomography showed hypometabolism predominantly in frontal and temporal areas. Repeated neurophysiologic examinations showed signs of chronic denervation. The patient was diagnosed with NBIA but fulfilled consensus criteria for FTD and had a clinical picture of ALS, without neurophysiologic confirmation. Our finding introduces NBIA as a possible cause of FTD and as a differential diagnosis of the FTD-ALS complex. p. 298-300,

Diversity age Issue 6 Winter 2009

noreply@blogger.com (Michelle de Mari) — Tue, 06 Oct 2009 02:23:00 +0000

Aged Care assessment and quality of life p. 1

Fairfield Initiative
ABS shows that Italian, Vietnamese, Cantonese, Assyrian and Spanish are the top 5 in the 70+ GALD groups…council responded in late 2008 by commissioning a report that will seek some solutions to the specific ageing communities needs …p. 4

OYO inter-language tool
OYO is a fantastic new language tool designed to facilitate effective communication between English speakers and non-English speakers. It's easy format enables you to communicate comfortably with 90% of your non-English speaking and communication-challenged care recipients, in 90% of day-to-day interactions.
www.oyo.net.au/index.html

Chinese Cultural Information kit
The Australian Nursing home Foundation through community partners Program have produced a Cultural information kit as a reference for aged care service providers communicating with elderly Chinese…phone 8741 0214

Healthier lives - Health fact sheets form the Council for Intellectual Disability
For fact sheets and other information
www.nswcid.org.au

Community aged care Cultural assessment check list
Patient identified cultural/ ethnic group and religion
Etiquette and Social Customs
Typical greeting. Form of address? Handshake appropriate?
Shoes worn in home?
Social customs before “business”. Social exchanges?
Refreshment?
Direct or indirect communication patterns
Nonverbal Patterns of Communication
Eye contact. Is eye contact considered polite or rude?
Tone of voice. What does a soft voice or a loud voice mean in
this culture?
Personal space. Is personal space wider or narrower in their
culture?
Facial expressions, gestures. What do smiles, nods and
hand gestures mean?
Touch. When, where and by whom can a patient be touched?
Client’s Explanation of Problem
Diagnosis. What do you call this illness? How would you
describe this problem?
Onset. When did the problem start? Why then? What started
the problem?
Cause. What caused the problem? What might other people
think is wrong with you?
Course. How does the illness work? What does it do to you?
What do you fear most about this problem?
Treatment. How have you treated the illness? What treatment
should you receive? Who in your family or community can help
you? Traditional practitioners?
Prognosis. How long will the problem last? Is it serious?
Expectations. What are you hoping the nurses will do for you
when we come?
Nutrition Assessment
Pattern of meals. What is eaten? When are meals eaten?
Sick foods
Food intolerance and taboos
Pain Assessment
Cultural patterns to pain
Patient’s perception of pain response
Medication Assessment
Patient’s perception of “western” medications
Possible pharmacogenetic variations
Psychosocial Assessment
Decision maker
Sick role
Language barriers, translators
Cultural/ethnic community resources
p. 5

Western Sydney Regional snapshot
43.62% were born overseas (compared to 23.8%
in NSW)
♦18,978 people 70+ nominated they speak another
language in the home
♦ 18% of people in Auburn LGA speak English ‘not
well’ or ‘not at all’ (compared to 6.4% in the
region)
♦ 12 clusters targeting 6 languages currently exist
in mainstream aged care facilities …p.6

Journal of dementia care - Vol 17 No 5 Sept/Oct 2009

nhayward@alznsw.asn.au (Nicky Hayward-Wright) — Fri, 02 Oct 2009 06:12:00 +0000

Alzheimer’s Lounge: stimulating interest and communication
Any common space within a care setting will work, the room is set up with a number of ‘strength- based stations’ - tables loaded with a generous array of colorful items, each focused on a theme. One table may display a vast amount of jewelry, another mountains of fabric squares, another a range of different hats…Individual residents are welcomed into the lounge by carefully chosen staff ‘butterflies”- based on their knowledge of the individuals’ interests and needs…p. 10

Satellite TV channel offers care training
Describes one of the programmes available through a new staff training and education resource - the aged care channel … p. 11

Restrictions and restraint: the current legal position
Explains what new Deprivation of Liberty safeguards mean for people with dementia and dementia care professionals…p. 12

Reaching out to combat stigma
Shows how the Alzheimer's Society (UK) has been working over the past year to increase public awareness…p. 15

A volunteer’s experience
Share some experiences of facilitating positive social interactions while volunteering at a nursing home for people with dementia .. p. 16
Life memory albums
talks about a life memory album project that has benefited from involving volunteers … p. 18

Steps to a better quality of life
Describes the PEARL project - which recognizes good dementia care practice
Knowing residents
Training and development
Person-centred care
achieving fundamentals
Documentation
Life story
Activity and engagement
Nutrition
Privacy and dignity
End-of-life-care
Mental capacity
Environment
Medication … p. 22

The importance of listening to family cares
Shares some of the striking themes to emerge from the book “telling tales about dementia” - Battle for services; What carers want; Confidnetiality barriers; Family knowledge disregarded: Monitoring care; Medication effects; Partners in care; Dying at hoe; Culture changes needed …p.24

What shall we do tomorrow?
Describes a new range of innovative board games developed for people with dementia attending day hospital - secret of working skillfully with groups si to focus on the group members, avoid going too fast and encourage spontaneous responses - Remember to provide triggers and prompts, with no winners of losers - Try to broaden out discussions, listening intently to people’s responses….p. 28

A license to be free : changing the way we see dementia
Discovering and enjoying new aspects of creativity since the diagnosis of dementia - looks at humour, being active, on being creative,

Creative encounters : applying skills learned from the arts
looks at the work of an artist being a helpful guide for working creatively with people with dementia - looks at who is creative - left brain, right brain - creative thinking… p. 33

Books

Person-centred counselling for people with dementia
Although currently many people with dementia are not given the opportunity to receive professional counselling, this book explores the value of counselling for men and women living with this condition and how it enables them to make sense of their lives and their notions of themselves. The author explores the pervasive myth that all experiences of living with dementia are entirely negative and shows counsellors and carers how a person-centred counselling experience can have positive outcomes for those with dementia and the people who care for them.

Research
Assessing the impact of sleep disorders on people with dementia and their caregivers - looks at symptoms assessed in sleep disorders inventory…p. 38

New resources for the health care professional

noreply@blogger.com (Michelle de Mari) — Thu, 24 Sep 2009 06:04:00 +0000

Guidelines for working with people with challenging behaviours in residential aged care facilities - using appropriate interventions and minimising restraint

Dementia care practice recommendations for assisted living residences and nursing homes : phase 1 and 2

Dementia care practice recommendations : phase 3 end-of-life care

Peer support and personalisation : a review prepared for the department of health

Out and aging : the MetLife study of lesbian and gay baby boomers

Lesbian and gay carers : policy briefing

Behaviour support: policy and practice manual part 2 : DADHC procedures and templates

Managing loss and grief : guidelines to assist in the management of loss and grief in residential aged care facilities and community care

An excellent read

noreply@blogger.com (Michelle de Mari) — Thu, 24 Sep 2009 05:35:00 +0000

Dementia in closeup: understanding and caring for people with dementia

Part 1 The Process

If only I had known that
What does dementia involve?
Seeking a handhold
In search of safety
Families and a 'missing' person

Part 2 Caring In Practice

Working with persons with dementia
How family members first notice dementia
From working to caring
Adoption
Power
Transference and counter-transference
Intimacy and sexuality
Aggression
A basis for tomorrow

Dementia in Close-Up is a clear and practical guide to dementia and the world of the dementia sufferer. Bere Miesen assumes no medical or specialist knowledge and uses first hand accounts and real-life examples to examiners on patterns of behaviour and responses of sufferers and their carers.

He focuses on the complex and varied relationships between the sufferer, their family and professional carers, and explores the conflict that can sometimes be engendered by dependency, fear and sustained closeness.

Going beyond the purely medical descriptions of dementia, Dementia in Close-Up strives to give families and health professionals the means to form caring and rewarding relationships and to help everyone involved

Depression and Parkinson's disease

noreply@blogger.com (Michelle de Mari) — Wed, 23 Sep 2009 00:37:00 +0000

Depression and Parkinson's disease

A Parkinson's patient and a carer of his wife with Parkinson's disease tell their story about coping with depression. Psychatrist Malcolm Hopwood discusses diagnosis and treatment options for anxiety and depression.

The Italian experience

noreply@blogger.com (Michelle de Mari) — Wed, 23 Sep 2009 00:03:00 +0000

Migrant grief : the Italian experience in Australia

The incidence of complicated grief for Australians of Italian background will increase in frequency given the accelerated nature of ageing in the community. Isolation too, which has become more and more the experience of the aged, is exacerbated in terms of grief. Today’s cities don’t allow the close on-going contact with children and family members that occurred in Italian towns from which many of the elderly Italians come from. This booklet is the first attempt in addressing the issues of complicated grief in Australian Italian communities.

A profile of Italian Australian culture : for aged care service providers

This profile of the Italian Australian culture has been developed as a resource tool to assist staff in the aged care services sector to provide for the cultural and linguistic needs of their Italian speaking clients. This booklet contains information on key topic areas such as the migration experience, language and communication style, attitudes to aged care services, family dynamics, religion, food preferences, attitudes to death and dying, health and sickness and social customs.

For the family and carers…

noreply@blogger.com (Michelle de Mari) — Tue, 22 Sep 2009 23:16:00 +0000

Caring for a person with Alzheimer's disease : your easy-to-use guide from the National Institute on Aging

...sometimes, taking care of the person with AD makes you feel good, because you are providing love and comfort. Other times, it can be overwhelming. You may find yourself dealing with problem behaviors or just trying to get through the day. You may not even realize how much you have taken on because the changes can happen slowly over a long period of time. We’ve written this guide to help you learn about and cope with these changes and challenges. The guide tells you how to: learn more about AD; understand how AD changes a person; learn how to cope with these changes; help family and friends understand AD; plan for the future, make your home safe for the person with AD; manage everyday activities like eating, bathing, dressing, and grooming, take care of yourself; get help with caregiving; find out about helpful resources, such as websites, support groups, government agencies, and adult day, care programs; choose a full-time care facility for the person with, AD if needed; learn about common behavior and medical problems, of people with AD and some medicines that may help; cope with late-stage AD.

Taking care of yourself and your family : a resource book for good mental health

This book has been compiled primarily for use by people in rural and remote areas who have little or no useful access to the kinds of counselling and psychotherapy support that people in urban centres can generally take for granted. The intended uses of the book include: A source of basic information about a range of mental health and related issues. A guide for helping others, or prompting them to seek assistance, in the event of a mental health issue.

Forget me not

Young Becky describes the moving story of her family's discovery that their grandmother has Alzheimer disease. This is a gentle and sensitive story told from the perspective of children trying to overcome feelings of dislike and understand what is happening to their grandmother. The water-colour illustrations executed by the youthful artist are unsophisticated but have a strong feeling for the subject. It is a book for families to share, particularly with very young children. The book raises lots of points for families to talk about.

Journal of Gerontological Nursing Vol. 35 No. 9 September 2009

noreply@blogger.com (Michelle de Mari) — Fri, 18 Sep 2009 05:51:00 +0000

Full text articles are available to fee paying members of Alzheimer’s Australia NSW at lis@alznsw.asn.au

Guest Editorial
Optimal Parental Care: Suggestions for Children of Aging Parents

As children of aging parents, we may become aware of “red flags” that indicate parental concerns. It is important to pay attention to these signals and investigate further. This should be done in a caring context in which your parents may voice any concerns and feel that you will be there for them. Open and honest communication can be effective in averting dilemmas, but this is the optimal scenario. Living in the real world, not all families are open to sharing their issues. It may be that they have always been private people and do not share their problems openly. It may also be that when you discover help is needed, you realize this opens new responsibilities, or that when you have only one parent left, you feel even more responsibility.

Letter to the Editor
Story sharing an invaluable experience
In reading the June 2009 issue of the Journal of Gerontological Nursing, my attention was captured by Heliker’s article, “Enhancing Relationships in Long-Term Care Through Story Sharing” (Vol. 35, No. 6, pp. 43-49). My clinical experience this past school semester took place in a long-term care facility. Here, I met a 99-year-old woman who had lived in assisted living for nearly 30 years, until 6 months ago, when she was transferred to the long-term care unit. When I met her, she was sad and distant. On one of my days off, I visited her and asked what I could do to help cheer her up. She told me I just needed to listen; she wanted to tell me her story…

Public Policy
The Systematic Review of the Literature: A Tool for Evidence-Based Policy
The systematic review of the literature is a valuable tool for gerontological nurses to influence policy decisions. There are several organizations that provide helpful guidelines for the conduct of systematic reviews of the literature, including the Cochrane Collaboration, the Joanna Briggs Institute, and the Evidence for Policy and Practice Information Co-Ordinating Centre at the Institute of Education, University of London. Gerontological nurses who have a strong foundation in research methodology and the skills to synthesize scientific evidence for the purpose of promoting evidence-based policy have the potential to positively influence health care outcomes for older adults. For nurses to assume a leadership role in synthesizing scientific evidence for evidence-based policy development and refinement, nursing education will need to assume a more active role in teaching systematic review methodology. This article presents an overview of resources for conducting systematic reviews of the literature and discusses the use of the systematic review as a tool for evidence-based policy.

Clinical Concepts
Early Detection of Functional and Cognitive Decline After Hospital Discharge: The Role of Community Nursing and Multidisciplinary Teams
This article features an individual example describing the multifactorial interventions of community nursing and a multidisciplinary team as they assess an older man’s progressive functional decline, changes in behavior, and loss of previous social habits after being discharged from the hospital for the treatment of community-acquired pneumonia. Such nursing evaluation should include the following aspects: social environment, home environment, neighborhood characteristics, architectural barriers, capacity to perform activities of daily living, walking difficulties, risk of falling, changes in behavior and social habits, cognitive-affective state, pharmacological management, and the existence of nearby social organizations. The different approaches of community nursing and the multidisciplinary team are discussed.

Feature Articles
Successful Aging with HIV: A Brief Overview for Nursing
Adults age 50 and older with HIV represent approximately 20% to 25% of the entire HIV population in the United States. This unique clinical population is expected to grow; therefore, understanding how to facilitate successful aging in this population is needed. Issues that can negatively affect successful aging with HIV have been identified, and include social isolation, suicidal ideation, HIV-related stigma, cognitive decline, sarcopenia, HIV-medication toxicity, osteoporosis, and fatigue. This brief overview provides nurses with specific insights for practice, intervention, and research.

Psychotropic Medication Use among Older Adults: What All Nurses Need to Know
Psychotropic medications are commonly administered to elderly clients to manage behavior and psychiatric symptoms. These drugs are known to have potentially serious side effects, to which older adults are more vulnerable. Nurses care for older adults in many different practice settings but have varying degrees of knowledge about these kinds of medications. The purposes of this article are to (a) provide information to geriatric nurses in all settings about how the most commonly prescribed psychotropic medications (i.e., anxiolytic, antidepressant, and antipsychotic drugs) differentially affect older adults; (b) examine recent concerns about the use of psychotropic medications with older adults; and (c) discuss nursing implications for those administering psychotropic medications to older adults.

Breast Cancer Screening Beliefs among Older Korean American Women
Korean American women’s breast cancer screening rates are low, and the rates among older Korean American women are even lower. This article describes health beliefs related to older Korean American women’s screening behaviors, comparing them to beliefs of younger Korean American women. The 73 women age 65 and older had significantly different health beliefs than the 114 women between ages 40 and 64. Further, older women’s perceptions of the seriousness of the disease and benefits of and barriers to taking action to prevent the disease predated their screening behaviors. Interventions to change the health beliefs of older Korean American women are suggested.

Book review - Could it be dementia? losing your mind doesn't mean losing your soul

noreply@blogger.com (Michelle de Mari) — Tue, 15 Sep 2009 23:50:00 +0000

Could it be dementia? losing your mind doesn't mean losing your soul

review by (Rev. Dr) Gordon Dicker

This book clearly represents itself as a Christian book and in places that comes through very directly. Political correctness might suggest that for this reason it should not be included in a public library. However that is not my view. If Christians facing dementia or caring for dementia patients wish to understand dementia in a Christian religious context, I believe they should have access to responsible treatments of the subject in that context.
The book is a source of valuable and correct information. It describes the various kinds of dementia, how dementia can be diagnosed, things that may retard it or even [reduce the risk of getting dementia]. There is advice for carers and for elderly people who may be worried about developing dementia.

Bearing all these things in mind, I conclude that it is a book worthy of being held in a library that caters for people interested in the subject of dementia or dealing with it either in their own life or in the lives of family and friends.

A sponsored book - Caregivers : drowning in a sea of cognitive challenges

noreply@blogger.com (Michelle de Mari) — Tue, 15 Sep 2009 01:29:00 +0000

Caregivers : drowning in a sea of cognitive challenges
(book sponsored by Jackie Wesson - Occupational Therapist)

The book explains what happens to them as a consequence of their unrelenting responsibilities and duties as caregivers, including the emotional and physiological effects. It contains detailed descriptions of what happens neuro-biologically to people with deficits in functional cognition and relates true to life stories which demonstrate and provide understanding of the cognitive patterns of functional performance.

New DVDs and books for carers

noreply@blogger.com (Michelle de Mari) — Tue, 15 Sep 2009 01:19:00 +0000

The savages DVD

Jon and Wendy Savage are two siblings who have spent their adult years trying to recover from their abusive father, Lenny. Suddenly, a call comes in that Lenny's girlfriend has died and he cannot care for himself. Lenny suffers from dementia and her family dumps Lenny on his children. Despite the fact Jon and Wendy have not spoken to Lenny for twenty years and he is even more loathsome than ever, the Savage siblings feel obliged to take care of him....

Where did that man go

This book is a true account of day to day living with someone suffering from Lewy Body Dementia. It is a degenerating brain disease, progressive and relentless, which changes many lives from what they were and were going to be.

Caring for Coco : a carer's diary

This book is one person's story about caring for her aged mother until her death. The author kept a diary of events that occurred while her mother was still living in her own home and her progression through residential to nursing care. It tells of the concerns, small and large, and logistical, faced by the elderly and by their carers.

The Alzheimer's alphabet : self-care from a-z for family caregivers

This little book can be tucked in an apron pocket, briefcase, purse or glove compartment; open on a bedside table, bathroom shelf or kitchen table, easy to pick up and put down, read or re-read “in the cracks” of busy lives. A helpful and useful reminder that few words can go a long way to advance a broad ethic of care.

Alzheimer’s and risk reduction

noreply@blogger.com (Michelle de Mari) — Mon, 14 Sep 2009 23:59:00 +0000

The anti-alzheimer's prescription : the science proven plan to start at any age

Doctors now know that the damage associated with Alzheimer's begins decades before any symptoms appear. That is why it is never too early to start applying Dr Fortanasce's straightforward and sensible lifestyle prescription. This involves first of all identifying your specific risk profile and then following his 4-step program to improve brain health.

The CSIRO healthy heart program

This book is your comprehensive guide to the CSIRO's CLIP (Complete Lifestyle Program) eating and exercise plan, which is designed to look after the health of your whole cardiovascular system and helps you to cut your risk of heart attack, stroke, Type 2 diabetes and other complications of carrying too much weight.

See our reading list with more resources on Risk reduction

American Journal of Alzheimer’s Disease and other Dementias

noreply@blogger.com (Michelle de Mari) — Fri, 11 Sep 2009 04:43:00 +0000

August/September 2009, Volume 24, No. 4

Full text articles are available to fee paying members of Alzheimer’s Australia NSW at lis@alznsw.asn.au

The Media and Cognitive Health in Our Aging Population

Cognitive Function of Donepezil in Binswanger-Type Subcortical Vascular Dementia
To evaluate the efficacy and tolerability of donepezil in patients with Binswanger type subcortical vascular dementia.
Conclusions: Donepezil-treated patients with Binswanger type subcortical vascular dementia demonstrated significant improvement in cognition compared with baseline, and donepezil was well tolerated. p. 293-301

What Are The Top-Circulating Magazines in the United States Telling Older Adults About Cognitive Health?
There is growing evidence that healthy behaviors may promote cognitive health. The behaviors include physical activity, heart-healthy diets, and social engagement. Popular print media helps disseminate health information. This study examines the content focused on cognitive health in 5 top—circulating magazines marketed to older people in the United States.
Articles focused on physical activity, with information directing readers to credible resources, and by writers with health or science backgrounds, could enhance the quality of cognitive health communication in popular media. p. 303

Visuospatial Function is a Significant Contributor to Functional Status in Patients With Alzheimer’s Disease
Background: Contribution of visuospatial abilities to the functional status in patients with Alzheimer’s disease (AD) has been controversial. Aim: To address whether visuospatial abilities have independent association with functional measures in patients with AD. Visuospatial ability is one of the important contributors to functional status. p. 313

Scheduled Medications and Falls in Dementia Patients Utilizing a Wander Garden
Little has been reported about the relationship of a dementia wander garden with scheduled psychiatric medications in addition to changes in fall number and severity. The 28 participating residents of a dementia unit were divided into high (HUG) and low (LUG) wander garden user groups and assessed for the number and severity of falls. High wander garden user group required fewer scheduled medications and experienced reduced falls and lower fall morbidity than the LUG. The most significant changes in scheduled psychiatric medications were reductions in scheduled antipsychotics and an increase in residents requiring no antipsychotics. p. 322

Dementia-Friendly Architecture: Environments That Facilitate Wayfinding in Nursing Homes
Spatial disorientation is a prime reason for institutionalization. The autonomy of the residents and their quality of life, however, is strongly linked with their ability to reach certain places within their nursing home. The physical environment has a great potential for supporting a resident’s wayfinding abilities.
Results confirm that people with advancing dementia are increasingly dependent on a compensating environment. The significant factors include a small number of residents per living area, the straight layout of the circulation system without any changes in direction, and the provision of only 1 living/dining room. These and additional results were transformed into architectural guidelines. p. 333

Apathy and Depressive Mood in Nursing Home Patients With Early-Onset Dementia
The study explored whether apathy and depressive mood symptoms (DMS) are related to cognitive and functional features of dementia in 63 nursing home (NH) residents with early-onset dementia (EOD).
In line with previous research in older patients, the higher apathy scores were associated with more cognitive and functional problems in EOD. p. 341

ApoE Genotype and Family History in Patients With Dementia and Cognitively Intact Spousal Controls
Objective: To test that a positive family history and ApoE e4 genotype are prevalent among dementia patients with onset before 70 years of age compared with healthy spousal controls.
Conclusions: In our sample of patients with Alzheimer dementia, approximately 3 of 4 (72.0%) were homozygous for the genotype Apo e4 when they had a positive family history. p. 349

News Briefs

Most Support Alzheimer’s Research Based on Family Consent Decisions Made by Surrogates Are Vital for Advancements in Treatment of Dementia …By the time they have been diagnosed with Alzheimer’s disease (AD), many patients’ decision-making ability is so impaired that they cannot give informed consent to participate in research studies...

Young Adults at Future Risk of AD Have Different Brain Activity, Says Study Young adults with a genetic variant that raises their risk of developing AD show changes in their brain activity decades before any symptoms might arise, according to a new brain imaging study by scientists from the University of Oxford and Imperial College London. The results may support the idea that the brain’s memory function may gradually wear itself out in those who go on to develop AD….

Nondrug Treatment of AD: Long-term Benefit Not Proven Reliable Conclusions About the Potential for Benefit and Harm Are Currently not Possible—in General There Is Still a Great Need for Good Studies on Nondrug Interventions Whether people with AD benefit in the long term from nondrug treatment interventions remains an unanswered question. This unsatisfactory finding is mainly due to the fact that convincing studies are lacking so far. For individual approaches, the studies provide indications of a benefit, and also of harm….

Discovery of AD Could Bring Early Diagnosis, Treatment Closer
McGill and Lady Davis Institute Findings Help Pinpoint Molecular Cause of the Disease A discovery made by researchers at McGill University and the affiliated Lady Davis Research Institute for Medical Research at Montreal’s Jewish General Hospital offers new hope for the early diagnosis and treatment of AD.

Early Diagnosis of AD Offers Large Social, Fiscal Benefits — Early diagnosis and treatment of AD could save millions or even billions of dollars while simultaneously improving care, according to new work by University of Wisconsin-Madison researchers…

New Tool Can Help Predict Risk of AD in Elderly A new tool can help predict whether people aged 65 years and older have a high risk of developing AD. Research on the tool is published in the May 13, 2009, online issue of Neurology, the medical journal of the American Academy of Neurology

Study Makes First Connection Between Heart Disorder and AD ...Study of More Than 37 000 Patients Shows Relationship Between Atrial Fibrillation and Development of AD Researchers at Intermountain Medical Center in Salt Lake City believe that they have made a breakthrough connection between atrial fibrillation (AF), a fairly common heart rhythm disorder, and AD, the leading form of dementia among Americans.

New Study May Help Understand How AD Robs Sufferers of Episodic Memory —Memory loss is love’s great thief. Those who suffer aren’t just the ones who can’t remember— family, friends and loved ones agonize over how to react when the disorder begins its often inexorable progress.

Automated Analysis of MRI May Identify Early AD Analyzing MRI studies of the brain with software developed at the Martinos Center for Biomedical Imaging at Massachusetts General Hospital (MGH) may allow diagnosis of Alzheimer’s disease and of mild cognitive impairment, a lesser form of dementia that precedes the development of AD by several years.

New dementia education resources for health care workers

noreply@blogger.com (Michelle de Mari) — Fri, 11 Sep 2009 04:23:00 +0000

Come into my world : how to interact with a person who has dementia : an educational resource for undergraduate healthcare students on person-centred care

DVD and workbook together will be illustrating examples of the person-centred care approach in real-life situations, will help undergraduate healthcare students to enhance their professional practice.

Demistifying dementia : flexible learning package

Includes:
Module 1 : Understanding Dementia
Module 2 : Communicating in Dementia Care
Module 3 : Meaningful Activities in Dementia Care
Module 4 : Identifying Challenging Behaviours
Module 5 : Looking Behind
Module 6 : Responding to Behaviours
Trainer's Guide Resources
Workplace Activities Guide