Caregiver Relief

Slow Alzheimer's better with Weight Training

2012-07-24T00:42:00.000-07:00

Weight-Resistance Training: Best to Prevent and Slow Alzheimer’s?

By Esther Heerema, About.com GuideJuly 19, 2012

As reported this week at the Alzheimer’s Association International Conference, the cost of care for individuals with Alzheimer’s in the United States will exceed $1 trillion by 2050. Researchers are working constantly to determine how we can avert this crisis- not only of cost, but of lost memories and lives.

Four different studies were discussed at this conference that provide interesting insights about the role of exercise and how it affects dementia.

In the first study, 120 sedentary older adults without dementia were randomly assigned to either a walking group or a stretching/toning group. After one year, those in the walking group showed a 2% increase in the size of their hippocampus compared to the stretching group. The hippocampus is a part of the brain that controls memories, and it’s one of the earlier places that shrinks and deteriorates in Alzheimer’s. This study demonstrates that the brain of older adults can continue to grow and improve.

In the second study, 86 adults with mild cognitive impairment (a condition where the risk for developing Alzheimer’s is high) were randomly assigned to one of three groups:

Resistance/Weight Training
Aerobic/Walking
Balance & Tone

The results? The weight training group showed a significant improvement in selective attention (as measured by the Stroop Test), conflict resolution and memory. The participants in this group also demonstrated actual improvements in three areas of their brains.

The walking group did show an increase in the scores on one different memory task called the Rey Auditory Visual Learning Test, but did not demonstrate any other improvements or any physical changes in the brain. The balance and toning group demonstrated no improvements.

The researchers concluded that weight-training for those already diagnosed with mild cognitive impairment was an effective way not just to stave off Alzheimer’s, but even to improve the cognitive function and physical health of the brain.

A third study compared how the initial level of cognitive functioning affected the results after participants were assigned to either a weight training group or a balance/toning group. According to the Alzheimer’s Association International Conference, the results demonstrated that:

The most improvement came from those who were in the resistance training group and had higher cognitive functioning at the beginning of the study.
For participants with lower cognitive functioning at the beginning of the study, the effects of weight training and balance/tone exercises were about equal.
Overall, participants in the balance/tone exercise group were the least likely to demonstrate improvement and the most likely to decline.

What are they saying, in summary? Prevention appears most effective while the brain is healthy, and early detection and exercise (specifically resistance/weight training) is key to maintaining cognitive functioning.

In the fourth study, 47 older adults between the ages of 65 and 93, all of whom had a diagnosis of mild cognitive impairment, were split between a physical exercise group and a control group which received three educational classes on health over the course of 12 months. The exercise group’s curriculum consisted of aerobic exercise, muscle strength training, and postural balance retraining.

The results in this study demonstrated a clear improvement in both memory and in the ability to use language for participants in the exercise group.

I found these studies both encouraging and fascinating, especially as they refer to the weight resistance training. The fact that participants who were already diagnosed with mild cognitive impairment experienced an improvement in cognitive functioning and actual growth in three separate areas in their brains is exciting.

In light of these studies, you may want to read more on how to reduce the risk of Alzheimer’s through exercise. I’ve also added information about what the Stroop Test is and how it’s used to screen for early Alzheimer’s disease.

Please feel free to share any thoughts or experiences related to exercise and dementia.

2012-07-10T20:28:00.000-07:00

Caregiving’s Most Deadly Emotions

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The 7 Deadly Emotions of Caregiving
By Paula Spencer Scott, Caring.com senior editor

GUILT
Nobody would ever choose a smiley face as the perfect symbolic emoticon for a caregiver. Caregiving for an ailing loved one is just too stressful — often triggering damaging emotions that can not only undermine your good work but harm your health, as well. Here’s how to cope:
What causes guilt: Guilt stems from doing or saying what you believe is the wrong thing, not doing what you perceive to be enough, or otherwise not behaving in the “right” way, whether or not your perceptions are accurate. Caregivers often burden themselves with a long list of self-imposed “oughts,” “shoulds,” and “musts.” A few examples: I must avoid putting Mom in a nursing home. I ought to visit every day. I shouldn’t lose my temper with someone who has dementia.
Risks of guilt: Caregiver Guilt is an especially corrosive emotion because you’re beating yourself up over faults that are imagined, unavoidable — or simply human. That’s counterproductive at a time when you need to be your own best advocate.
What you can do: Lower your standards from ideal to real; aim for a B+ in the many aspects of your life rather than an across-the-board A+. When guilt nags, ask yourself what’s triggering it: A rigid “ought”? An unrealistic belief about your abilities? Above all, recognize that guilt is virtually unavoidable. Because your intentions are good but your time, resources, and skills are limited, you’re just plain going to feel guilty sometimes — so try to get comfortable with that gap between perfection and reality instead of beating yourself up over it.

RESENTMENT
This emotion is still so taboo that many caregivers are loathe to admit to it.
What causes resentment: Caregivers often feel put-upon and upset because of imagined slights by others, including siblings and adult children who don’t do enough to help. Caregiver Resentment is especially felt toward the person being cared for, when the caregiver’s life feels hijacked by responsibility and out of his or her own control.
Risks of resentment: Without enough support or noncaregiving outlets, feelings of being ignored, abandoned, or criticized can fester into anger and depression.
What you can do: Simply naming this tricky emotion to a trusted confidante can bring some release. Try venting to a journal or anonymous blog. Know that resentment is a very natural and common response to long-term caregiving, especially if your work life, marriage, health, or outside activities are compromised as a result. Know, too, that you can feel this complicated emotion yet still be a good person and a good caregiver.

ANGER
Some people outwardly show their anger more than others, but almost no one is never angry.
What causes anger: We get mad for reasons both direct (a balky loved one, an unfair criticism, one too many mishaps in a day) and indirect (lack of sleep, frustration over lack of control, pent-up disappointment).
Risks of anger: Chronic anger and hostility have been linked to high blood pressure, heart attack and heart disease, digestive-tract disorders, and headaches. Anger that builds up unexpressed can lead to depression or anxiety, while anger that explodes outward can jeopardize relationships and even harm others. Managing Caregiver Anger not only helps your well-being but makes you less likely to take out your fury on your loved one.
What you can do: Rather than trying to avoid anger, learn to express it in healthy ways. Simple deep-breathing exercises can channel mounting anger into a calmer state, for example. Talk yourself down with soothing chants: It’s okay. Let it go. Ask yourself if there’s a constructive solution to situations that make you angry: Is a compromise possible? Would being more assertive (which is different from anger) help you feel a sense of control? Laughing at absurdities and idiotic behavior can provide a healthier biological release than snapping.

WORRY
A little goes a long way, but sometimes we can’t turn off the fretting.
What causes worry: Good intentions, love, and wanting the best for your loved ones are the wellsprings of worry. Focusing intensely on the what-ifs provides a perverse kind of comfort to the brain: If we’re worrying, we’re engaged. Of course, that ultimately triggers more worry and upset because it’s engagement without accomplishing anything.
Risks of worry: Being concerned is harmless. Overworry and Obsessing, however, can disrupt sleep, cause headaches and stomach aches, and lead to mindless eating or undereating.
What you can do: If you notice worrying thoughts interfering with getting through the day or sleeping at night, force a break to the cycle. Try setting a timer and resolving to focus on something else when the five minutes is up. Then flip negative thoughts to their productive side: How can you help? Who can you call? Are there possible solutions? And don’t be shy about seeking out a trained counselor to help you express and redirect obsessive ruminations more constructively.

LONELINESS
Your world can shrink almost before you realize what’s happened.
What causes loneliness: Friends may back away out of uncertainty or a belief they aren’t wanted. Intense time demands lead you to drop out of outside activities. If you’re dealing with dementia, the loss of your loved one’s former level of companionship is another keenly felt social loss adding to isolation.
Risks of loneliness: Your very brain is altered: People with large, rich social networks have different brain structures, new research finds. Loneliness seems to curb willpower and the ability to persevere, and it can lead to overeating, smoking, and overuse of alcohol. Lonely people also have more cortisol, the stress hormone. And social isolation is a risk factor for dementia.
What you can do: Expand your social circles, real and virtual. Arrange respite help, so you can add at least one outside activity, such as one you’ve dropped. Take the initiative to reach out to old friends and invite them over if you can’t get out easily. Consider joining a support group related to caregiving or your loved one’s illness. In online support groups you can find kinship with those who know just what you’re going through.

GRIEF
Don’t think this one applies yet? Think again.
What causes grief: Although most people link grief with death, anticipatory grief is a similar emotion felt by caregivers who are coping with a loved one’s long-term chronic illness, especially when there are clear losses of ability (as in dementia) or when the diagnosis is almost certainly terminal.
Risks of grief: “Long good-byes” can trigger guilt as well as sadness if one mistakenly believes that it’s inappropriate to grieve someone still alive. Mourning the loss of a beloved companion is also a risk factor for depression.
What you can do: Know that your feelings are normal and as painful as “real” (postmortem) grief. Allow yourself to feel sadness and express it to your loved one as well as to supportive others; pasting on a happy face belies the truth and can be frustrating to the person who knows he or she is ill or dying. Make time for yourself so that you’re living a life outside of caregiving that will support you both now and later.

DEFENSIVENESS
Protecting yourself is good — to a point.
What causes defensiveness: When you’re doing so much, it’s only natural to bristle at suggestions that there might be different or better approaches. Especially if you’re feeling stressed, insecure, or unsure, hearing comments or criticisms by others, or reading information that’s contrary to your views, can inspire a knee-jerk response of self-protection: “I’m right; that’s wrong!”
Risks of defensiveness: While nobody knows your loved one and your situation as well as you do, being overly defensive can make you closed-minded. You risk losing out on real help. You may be so close to the situation that you can’t see the forest for the trees, for example; a social worker or friend may have a perspective that points to what really might be a better way.
What you can do: Try not to take everything you hear personally. Instead of immediately getting cross or discarding others’ input, vow to pause long enough to consider it. Remember the big picture. Is there merit in a new idea, or not? What you’re hearing as a criticism of you might be a well-intentioned attempt to help your loved one. You may decide things are fine as is, and that’s great. But if you start from a point of calm and confidence, the focus becomes (as it should be) your loved one, not you

Is There An Alzheimer's Cure?

2012-06-28T21:03:00.000-07:00

Participating in Alzheimer’s Disease Clinical Trials and Studies

FACT SHEET
Alzheimer’s Disease Education & Referral (ADEAR) Center
A Service of the National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services

When Margaret was diagnosed with early-stage Alzheimer’s disease at age 68, she wanted to do everything possible to combat the disease. She talked with her doctor about experimental treatments and clinical trials she had heard about in the news and worked with the doctor to find a trial that was right for her. Margaret appreciated being able to talk to experts about Alzheimer’s and felt she was doing something that might also help her children and children avoid the disease.

This is an exciting time for Alzheimer’s disease clinical research. Thanks to advances in our understanding of this disease and powerful new tools for “seeing” and diagnosing it in people, scientists are making great strides in identifying potential new interventions to help diagnose, slow, treat, and someday prevent the disease entirely. But Alzheimer’s research can move forward only if people are willing to volunteer for clinical trials and studies. Before any drug or therapy can be used in clinical practice, it must be rigorously tested to find out whether it is safe and effective in humans. Today, at least 50,000 volunteers, both with and without Alzheimer’s, are urgently needed to participate in more than 175 actively enrolling clinical trials and studies in the United States. To reach that goal, researchers will need to screen at least half a million potential volunteers. This fact sheet describes. Alzheimer’s disease clinical trials and studies, explains their scientific design, and offers key facts and questions to consider about volunteering for clinical research.

Comparing Alzheimer’s Disease Clinical Trials and Studies
Clinical research is medical research involving people. It includes clinical studies, which use long-term observation and analysis in large groups to determine how a disease or condition may occur and progress, and clinical trials, which test possible interventions to diagnose, prevent, treat, and someday cure a disease.
Clinical studies observe people in normal settings, with less direct intervention than in clinical trials. Researchers gather baseline information, group volunteers according to broad characteristics, and compare changes over time. Studies of Alzheimer’s disease may help identify new possibilities for clinical trials. The National Institute on Aging (NIA), part of the National Institutes of Health (NIH), sponsors several major ongoing studies, such as: investigators study brain images and biomarkers in people with normal cognitive aging, mild cognitive impairment (MCI)—a disorder that may precede Alzheimer’s disease, and earlystage Alzheimer’s to develop better indicators of the disease and its progression. For example, they have found that certain changes in biomarkers, like proteins or enzymes in blood or cerebrospinal fluid, may signal early Alzheimer’s and have established a method and standard for testing these biomarkers.

Alzheimer’s Disease Genetics Studies
Researchers analyze DNA from persons with and without the disease to identify genes that may be Alzheimer’s risk factors. Clinical Trials test interventions such as drugs or devices, as well as prevention methods and changes in diet or lifestyle. (See examples below.) Drug testing is the focus of many clinical trials. Currently, more than 90 drugs are in clinical trials for Alzheimer’s disease, and more are in the pipeline awaiting U.S. Food and Drug Administration (FDA) approval to enter human testing. FDA-approved clinical trials are always preceded by laboratory analyses in test tubes and in tissue culture, followed by studies in laboratory animals to test for safety and efficacy. If these show favorable results, the FDA gives approval for the treatment or intervention to be tested in humans. Clinical trials advance through four well-defined phases to test the treatment, find appropriate dosage, and monitor side effects in increasing numbers of people. If investigators find an intervention safe and effective after undergoing the first three phases, the FDA decides whether to approve it for clinical use. In Phase IV, the FDA continues to monitor the effects of a new drug after its approval for marketing and clinical use. If problems occur, approval may be withdrawn and the drug recalled. After the efficacy of a drug for one health condition is established, Phase IV studies can evaluate the activity of the drug in other conditions.

Clinical Trials Seek Answers Through Rigorous Testing
Scientists conducting Alzheimer’s disease research test a theory by using the classic scientific method. They first identify a valid question related to Alzheimer’s. The question is posed as a hypothesis that is either proven or disproven by the clinical trial. For example, research has linked high blood cholesterol with Alzheimer’s disease. Scientists asked: Will medications that lower cholesterol also have an effect on Alzheimer’s disease? They formed a hypothesis: IF reducing blood cholesterol has a beneficial effect on Alzheimer’s disease, THEN statins (drugs to reduce cholesterol) will slow the progression of Alzheimer’s disease. To test that hypothesis, NIA has funded a number of clinical trials, which are ongoing.
Why Placebos Are Important
The “gold standard” for testing interventions in people is the randomized, placebo-controlled clinical trial, because it is designed to reduce error or bias. Volunteers are randomly assigned—that is, selected by chance—to either a test group receiving the experimental intervention or a control group receiving a placebo, an inactive substance resembling the drug tested. Comparing results indicates whether changes in the test group result from the treatment. In many trials, no one—not even the research team—knows who gets the treatment, the placebo, or another intervention. When the participant, family members, and staff all are “blind” to the treatment, the study is called a double-blind, placebo controlled clinical trial.
Placebo and test groups are equally important, as shown in the results of numerous clinical trials. For example, early research suggested that ginkgo biloba, an herbal supplement, might be effective in delaying dementia. To find out, NIA sponsored a 6-year, Phase III clinical trial with more than 3,000 participants age 75 and older. In 2008, scientists reported no significant differences in effect on dementia in adults who received ginkgo biloba or placebo.
This result was disappointing, but scientists gained a wealth of information to inform future research. For example, researchers learned more about subgroups of participants who may be at greater risk for developing dementia, and ginkgo’s possible effects on cardiovascular disease, cancer, depression, and other age-related conditions. They also gained insights on issues related to the design and conduct of large dementia prevention trials in older adults, such as the number of participants needed to provide clinically significant measures on outcomes like occurrence of dementia.
Benefits of Volunteering
Help others, including future family generations, who may be at risk for Alzheimer’s disease
Receive regular monitoring by Alzheimer’s professionals Learn more about the disease from experts. Get information about support groups and resources.
Participating in a Trial or Study
How Can People Find Out About Alzheimer’s Disease Trials and Studies?
Information about Alzheimer’s disease clinical trials and studies is available through a number of sources. First, talk to your doctor, who may know about local or specific research studies that may be right for you. NIA supported Alzheimer’s Disease Centers or specialized memory or neurological clinics in your community may also be conducting trials. You might also learn of clinical trials through newspapers or other media. To search more widely for trials or studies, you can also visit websites like ClinicalTrials.gov or the NIA Alzheimer’s Disease Education and Referral (ADEAR) Center clinical trials database. See the “For More
Information” section at the end of this fact sheet for resources and contact information.
What Happens When a Person Joins a Clinical Trial?
First, it is important to learn as much as you can about the trial. Staff members at the research center are trained to explain the trial in detail and describe possible risks and benefits. They clarify participants’ rights. Participants and their families can have this information repeated until they are sure they understand it. After questions are answered, participants sign an informed consent form, which contains key facts about the trial. Next, they are screened by clinical staff to see whether they meet criteria to participate in the trial. Screening examines the characteristics people must have to participate in a particular trial, as well as characteristics that may exclude them. The screening may involve cognitive and physical tests that provide baseline information to compare with future changes. If participants meet all criteria, they are enrolled in the trial.

Steps in Clinical Trial Participation
1. After initial phone screening, interested persons go to the study site.
2. Staff members explain the trial and gather more information.
3. The participant or proxy signs an informed consent.
4. The participant undergoes a screening process that indicates whether he or she qualifies for the trial.
5. A first visit (called the “baseline” visit) is scheduled, in which cognitive and/or physical tests may be administered.
6. Selected participants are randomly assigned to distinct treatment groups.
7. Participants and family members follow the trial protocol and report any issues or concerns to researchers.
8. They may visit the research site for new cognitive, physical, or other evaluations and for discussions with staff.
9. Investigators collect information on effects of the intervention, disease progression, and the safety and well-being of the participant and caregiver.
10. The participant continues to see his or her regular physician for usual health care.
Informed Consent
Each participant must sign an informed consent agreement, affirming that he or she understands the trial and is willing to participate. Laws and regulations regarding informed consent differ across States and institutions, but they are all meant to ensure participant safety and protection, and to prevent unethical experimentation on vulnerable populations. Researchers conducting clinical Alzheimer’s research must consider the declining memory and cognitive abilities of people with this disease or another dementia and must evaluate their ability to understand and consent to participate in research. If the person with Alzheimer’s is deemed unable to provide informed consent because of problems with memory and confusion, an authorized legal representative, or proxy (usually a family member), may be able to give permission for the person to participate, particularly if it is included in the patient’s durable power of attorney. A durable power of attorney is a legal agreement designating who will handle the patient’s affairs when he or she no longer can. NIA’s Legal and Financial Planning for People with Alzheimer’s Disease Fact Sheet (available at www.nia.nih.gov/Alzheimers/Publications/legaltips.htm) provides more information.
Inclusion and Exclusion Criteria
In the experimental protocol (written research plan), researchers define the inclusion criteria volunteers must meet to participate, such as age range, stage of dementia, racial and/or ethnic group, gender, genetic profile, and family history. The protocol also defines exclusion criteria, such as health conditions or medications that prevent volunteers from joining a trial. Many volunteers are needed for screening to find enough people for a study. Generally, volunteers can participate in only one trial or study at a time. It is important to realize that different trials have different inclusion and exclusion criteria, so being excluded from one trial does not necessarily mean exclusion from another.
What Happens During a Trial?
Usually, participants are randomly assigned to one of the trial groups. People in each group represent selected combinations of characteristics (such as age, sex, education, or cognitive ability). The test group receives the experimental drug or intervention. Other groups receive a different drug, a placebo, or another intervention. Participants and family members follow strict instructions and keep detailed records. Every so often, they visit the research site to receive more physical and cognitive exams and talk with staff. Investigators collect information on the effects of the test drug or treatment, evaluate disease progression, and see how the participant and caregiver are doing.
What Volunteers Need To Know
The following issues are some of the key concerns potential participants should consider before deciding whether joining a trial or study is right for them.
Expectations and motivations.
Single clinical trials and studies generally do not have miraculous results, and participants may not directly benefit.
Uncertainty.
Some people have problems because they are not permitted to know whether they are getting experimental treatment or a placebo, or may not know results. Can you live with these sorts of uncertainties?
Finding the right clinical trial or study.
Volunteers must meet the inclusion and exclusion criteria listed by researchers. Even if a participant is not eligible for one trial or study, another may be just right.
Time commitment and location.
Clinical trials and studies last days to years and may require multiple visits to study sites, such as private research facilities, teaching hospitals, Alzheimer’s research centers, or doctors’ offices. How much time and travel are you willing and able to undertake?
Risk.
Researchers make every effort to ensure the safety of participants, but all clinical trials have some risk. What level of risk are you comfortable with?
Rights of Volunteers
Clinical trial volunteers have important rights, including the rights to receive clear, complete information and to withdraw from a trial anytime.
Right to Clear Information
Understanding what is involved in a clinical trial or study can relieve anxiety. Potential volunteers have the right to a thorough explanation and answers to all of their questions.
Participants and family members can have information repeated and explained until they understand it.
Right To Withdraw
Volunteers can withdraw from a trial or study anytime they or their physician feels it is in their best interests. For example, a new health condition in a volunteer may require medications that are risky if combined with experimental treatments.
Clinical Trials and Studies Need All Kinds of People
Clinical trials and studies are a partnership between researchers and volunteer participants, who work together to answer questions about humans we can answer in no other way. Ensuring that those answers are correct requires including volunteers of all kinds: men and women, African Americans, Latinos, Native Americans, Asian Americans, whites, people with Alzheimer’s or a family history of the disease, people with conditions that may lead to Alzheimer’s, and those without the disease (controls). An intervention may work differently in one group than in another. Without adequate representation of a particular group, questions about safety and effectiveness of a treatment in that group may remain unanswered. In addition to diversity, the number of people included in research can affect results. Changes or effects seen in smaller groups may or may not show up significantly in larger groups.
For More Information
To find out more, talk with your healthcare provider or contact NIA’s ADEAR Center at 1-800-438-4380. Or, visit the ADEAR Center clinical trials database at www.nia.nih.gov/Alzheimers/ResearchInformation/ClinicalTrials. You can sign up for e-mail alerts that identify new clinical trials added to the database. More information about clinical trials is available at www.ClinicalTrials.gov.
Alzheimer’s Disease Trials and Studies
Alzheimer’s Disease Education and Referral (ADEAR) Center
P.O. Box 8250 Silver Spring, MD 20907-8250 1-800-438-4380 (toll-free)
www.nia.nih.gov/Alzheimers The National Institute on Aging’s ADEAR Center offers information and publications for families, caregivers, and professionals on Alzheimer’s disease research, diagnosis, treatment, patient care, caregiver needs, long-term care, and education and training. Staff members answer telephone, e-mail, and written requests and make referrals to local and national resources, including clinical trials and studies. The ADEAR website offers a searchable database of Alzheimer’s clinical trials and studies (www.nia.nih.gov/Alzheimers/ResearchInformation/ClinicalTrials), as well as free, online publications in English and Spanish; e-mail alert and online newsletter subscriptions; the Alzheimer’s Disease Library (AD Lib) database; and more.
Questions To Ask About Clinical Trials and Studies
What is the purpose?
What tests and treatments will be given?
What are the risks?
What side effects might occur?
What may happen with/without this research?
Can I continue with treatments for Alzheimer’s and other conditions as prescribed by my regular doctor?
How will you keep my doctor informed about my participation in the trial?
Does the study compare standard and experimental treatments?
How long will it last? How much time will it take?
Where and when will the testing occur?
How much flexibility will I have?
How will it affect my activities?
If I withdraw, will this affect my normal care?
Will I learn the results?
Could I receive a placebo?
What steps ensure my confidentiality?
Are expenses reimbursed?
Will I be paid?
Alzheimer’s Association
225 North Michigan Avenue, Floor 17 Chicago, IL 60601-7633 1-800-272-3900 (toll-free) www.alz.org
The Alzheimer’s Association is a national, nonprofit organization with a network of local chapters that provide education, support, and referrals to local resources and services for people diagnosed with Alzheimer’s disease, their families, and caregivers. The Association also funds Alzheimer’s research.
Alzheimer’s Disease Cooperative Study (ADCS)
www.adcs.org
The ADCS, funded by the National Institute on Aging, is a consortium of medical research centers and clinics working to develop and test drugs to treat Alzheimer’s disease.
General Information About Research Participation
ClinicalTrials.gov
www.ClinicalTrials.gov
ClinicalTrials.gov is a comprehensive, searchable online registry of federally and privately funded clinical trials and studies.
U.S. Food and Drug Administration (FDA)
www.fda.gov/ForConsumers/
ByAudience/ForPatientAdvocates/
ParticipatinginClinicalTrials/
The FDA regulates all U.S. clinical trials of drugs and devices and offers information and resources for clinical trials participants and professionals.
Center for Information and Study on Clinical Research Participation
(CISCRP)
www.ciscrp.org
www.smartparticipant.org
CISCRP is an independent, national nonprofit organization working to promote greater understanding and awareness of clinical research participation and the role it plays in
public health.
Project IMPACT (Increase Minority Participation and Awareness of Clinical Trials)
www.impact.nmanet.org
Project IMPACT, an initiative of the
National Medical Association, seeks
to increase awareness and participation
of African Americans and other
minorities in clinical trials and research.
NIH Publication No. 09-7484 September 2009

Caregiver's Do It...Alone

2012-06-27T23:00:00.002-07:00

I don’t remember where I found this article…but it bears repeating. When you think about it, how many caregivers are providing care without support from other family? If this is you, please stop waiting for others to volunteer to help. My experience is it will NEVER happen. Acutually, the opiside is happening…the longer you don’t ask for the help, the more they all think you are doing fine without thier assistance and are relieved.

If you are at the end of your rope…or if you are just starting out providing care, there are ways to ask for help…and you should!
There are many reasons that people take on the role of primary caregiver, such as closer proximity to the elderly parent or greater availability to help out. But just as often it’s because they see themselves as most able to do the job. Unfortunately, a competent and capable adult child who has taken on the role of caregiver often begins doing more and more until eventually she or he becomes responsible for the majority of the caregiving duties.
While it’s best to involve other siblings early on before such a pattern develops, it is possible to redistribute the responsibility later in the game. Here are some ideas for opening the lines of communication and enlisting the support of your siblings:

Call a family meeting – Whether by conference call or in person, schedule a time to meet with all of your siblings, even those from out of town, to discuss what needs to be done to help your parents.
Make a written agenda – “Write down an agenda for discussion,” says Wendy Kaufman, a family and life-balancing specialist and CEO of Balancing Life’s Issues, Inc. “Write down details of all you are doing now, such as health care, home obligations and transportation.”
Do as much listening as talking – Explain how you feel in a matter-of-fact way. But be open to other’s feelings and viewpoints, too. Your siblings may not have been aware of how much you’ve been doing. Or perhaps they are feeling hurt and angry about being left out and uninformed about your parent’s needs.
Be specific about what you want – Have an idea beforehand about which tasks you’d like to be relieved of rather than just a general appeal for help. Perhaps you’d like someone to take over the driving to physical therapy appointments, or give a hand with grocery shopping or meal preparation.
Divide up tasks – Split up the labor among those present. While there are many ways of doing this, for example dividing chores by expertise. A family member with experience in health issues could take on all of the medical appointments, for example. Or the person with good business sense might handle legal issues. And make sure to include siblings who live a distance away. Even if they can’t help with day-to-day needs, they might offer money for a housekeeper, or be willing to come every few months to take over and give others a break.
Don’t expect total equality – It’s not likely that you’ll achieve total equality in division of tasks. This is okay, says Kaufman. “It’s more important to make sure that all siblings have a manageable lifestyle, that all can help to alleviate some of the stress on each other.”

p.s. if you know the source of this article I would like to know to give them credit.

Sneak Tricks That Stores Use To Sucker You

2012-06-26T19:38:00.001-07:00

Being a caregiver means that your budget has to stretch even further than it used to. Not only is your time limited, but your income is probably reduced and you have absorbed extra health care costs. Saving money now become even more critical. So we scour the internet looking for ways to help.

5 Shopping Tricks to Save You More at the Store

by Mary Hunt, founder of Debt-Proof Living

Retailers work hard to get our money. They offer “special promotions” and put other tactics into play, even hiring human behavior specialists to figure out our shopping habits and how to get us to spend more. But by having a few tricks of your own, you can foil those plans and save big.

Trick to Use: Buy only the “loss leaders,” then leave. A loss leader is something retailers sell so cheaply, they’re willing to lose money on the deal. The first clue to finding one: astonishingly low prices. And if the item is limited, i.e. “Limit 2,” that’s a dead giveaway that it’s a loss leader. It’s also not unusual for supermarkets to tie loss leaders to a holiday, Memorial Day by offering something like, “Buy the Hot Dogs and Get the Buns Free!” My personal benchmark is if it’s at least 50% of the regular price, that’s a loss leader. Stores use these as a way to get you there, knowing you’ll stay a while and buy other items at full price. Studies show that half of all supermarket purchases are unplanned. But when you arrive having scoured the circulars and savings blogs and are armed with a list to buy just loss leaders, you upset their plans and they lose. You win.

Trick to Use: Pay with cash. Even though retailers don’t have to pay fees when you pay with cash, they hate it. They know that if you pay with a stand-in, like a credit or debit card, you will spend more and boost their bottom line. In fact, researchers at the Massachusetts Institute of Technology found that consumers will spend up to 100% more on an item when using plastic. So unless you are paying by mail or online, always use cash. You win.

Trick to Use: Say no to the extended warranty. This is all you need to know: The profit margin on an extended warranty is huge—much greater than the profit on the item itself. Meaning, stores make their money on the warranty more than the sale of the item. Just keep saying: “No thanks.” Most appliances and electronics come with a manufacturer’s limited warranty for the first 90 days, which is generally sufficient. If you’re worried about the product breaking, say “no” to the store warranty, but put that same amount money you would have spent on it, into a special account. If the item fails, use that money to pay for the repair. If it doesn’t, a nice nest egg awaits. And keep in mind that some credit cards extend your warranty for free. For example, anything purchased with an American Express card automatically receives an additional year extension beyond the manufacturer’s warranty; Visa Signature Cards also give one additional year. Call your card company to learn if you have this benefit already. You win.

Trick To Use: Grab the amazing deal, but pay it off ahead of time. Stores often offer zero-interest when you pay over a period of time, or they will defer payment for a period of time. The reason they do this? Statistics say that you won’t pay it off on time, even though you are sure you will when you enter into the deal, and that you will end up paying a high interest rate, which will be retroactive to the date of purchase—meaning, the interest will be waived if paid in full within, say, 12 months of purchase. But if you do not pay in full, you will automatically owe something like 29.99% interest starting back at the date of purchase. On a big ticket item like a television or furniture, that could add hundreds of dollars to your balance. Instead, always pay off the item within the given time frame. Automate your payments using your bank’s online auto bill-pay feature and you won’t have to rely on your memory to make those payments on time. If the term is for 12 months, give yourself some breathing room by creating your payback schedule for say 10 months. You win.

Trick To Use: Wait to buy seasonal items at clearance prices. Retailers are in the business to make big profits on full-priced items, and they know you can’t resist new items to decorate your home or outfit your family. They want you to feel compelled to buy new stuff each season and each holiday. Doing otherwise messes with their plans.So instead of buying, stop yourself from running to the store right away, and wait until seasonal stuff goes on sale. You win.

* I hope you found this article useful…if you ever want to know which websites I search to bring you cool articles, ideas, and statistics don’t hesitate to ask. –yours, Donahueg

30 Signs Your Parents Are In Danger

2012-06-22T22:35:00.000-07:00

When it comes to older parents we expect some declines in functioning. Albeit physical or mental, certain changes are bound to occur. As their adult children, they may become dependent upon our help. For many of us this is perfectly acceptable.
But at what point should we become seriously concerned and step in, against their express wishes, and start directly providing them care or move them into a safer environment like a senior board & care or an assisted living community.
It's never easy. Because they will rarely admit that they have lost the ability to take proper care of themselves. If dementia is involved you will face strong resistances. Because the ability to reason is severely damaged.
But waiting too long has serious consequences: accidents, illness that become crippling or terminal, injury to others, etc. etc.
The following are 30 signs that your older parent is not doing well. 3 or 4 of them are acceptable. 5 or 6 are a serious concern. 7 or more indicate it's time to take action.

Signs that You need to Increase the level of care Provided

by Diane Carbo

Here is a list of things that you may want to observe to identify that more help is needed.

PHYSICAL SIGNS

1. There will be some difficulty with walking. May start to hold onto furniture or walls when ambulating.

2. Experiencing frequently falls or unsteadiness. You may see the presence of bruises.

3. Decline in personal hygiene or grooming. May start to wear stained clothes, have body odor, infrequently bathes or washes hair. May wear the same clothes day after day.

4 Experiences changes in eating habits. May only snack, have a decreased appetite, eat one meal a day, forget to eat, makes poor food choices, or has a refrigerator of expired food or no food in the refrigerator.

5. Starts having problems with incontinence.

6. The home environment is unsafe. Maybe it is unclean, has cluttered walkways or poor lighting. The home may need repairs. There are broken or missing smoke detectors, lack of security, may leave doors unlocked or the stove or oven on.

7. Experiences significant weight loss or gain.

8. Lives in chronic pain

9.Abuses alcohol or prescription drugs.

FINANCIAL SIGNS

10. There are unpaid or past due bills.

11. Unopened piles of mail.

12. Becomes unable to manage their checkbook.

13. Difficulty dealing with money properly.

14. May be a victim of scams or financial abuse.

COGNITIVE SIGNS

15. Experiences poor or decreased judgment.

16. Has difficulty coordinating or monitoring prescriptions and being compliant with different medications.

17. May experience paranoia, forgetfulness or memory loss.

18. Gets lost and can't find their way back home, in familiar surroundings.

19. Leaves stove on, unplugs the refrigerator.

20. Has difficulty recognizing friends or family members. May not remember them at all.

21. Forgets to take medications, or taking it improperly.

22. Becomes increasingly forgetful. Misses doctor's appointments, family events. May forget names of individuals or objects. Frequently loses things or places things in unusual places.

23. May start to be repetitive in questions or stories.

24.May become physically or verbally abusive.

25. May start to experience delusions or hallucinations. This may exhibit as a different perspective of objects or events that others don't see or developing false beliefs.

26. May start to call adult children or friends repeatedly at inappropriate hours of day or night.

SOCIAL / EMOTIONAL SIGNS

27. Social Isolation

28. Experiences mood changes such as anger, suspicion, paranoia, or agitation.

29. Becomes depressed or feels lonely. May exhibit this by crying, feelings of sadness or have lack of energy or feelings of hopelessness. May experience an increase or decrease in sleeping and/or appetite.

30 Exhibits a lack of interest in formerly enjoyable activities, may stop participating in social, church or volunteer activities.

Promising Drug for Lewy Body Dementia in Trials

2012-06-17T20:06:00.002-07:00

The Lewy Body Dementia Association just posted an article about a promising treatment for Lewy Body Dementia.

But let me take a moment to ask you: Do you ever read articles like this and think to yourself that even if the damn drug works it will not reach the Market in time for your family? Well why wait? Why not get personally involved in a drug trial? The risk verses rewards is in your favor…your parent or spouse is not going to get better, but a drug trial may have benefits, possibly tremendous ones! There is always a risk of a medical complication, but even if the trial does not work for you, you have played your part in finding an eventual cure.

Here in Southern California, a wonderfully run small firm PRI (Pharmaceutical Research Institute) did the initial research that brought Aricept and Namenda to market. They were not the only one, those very common medications were once part of a trial and were tested in research centers all over the Country. My experiences is these centers are ALWAYS looking for volunteers. (if you want help finding a drug trial or have questions about it…post a comment or write me directly)

Not only are you giving your loved one a fighting chance, most companies offer financial compensation for time, give great medical attention, and offer tremendous support for caregivers.

Open Label Trial of Armodafinil Shows Promise in LBD

June 12, 2012 – At the American Academy of Neurology’s annual meeting in April, researchers from the Mayo Clinic reported on a small clinical trial which assessed the safety, tolerability and efficacy of armodafinil therapy for excessive sleepiness (hypersomnia) associated with dementia with Lewy bodies (DLB).

Twenty subjects were enrolled in this open label trial, with three people who did not complete the trial due to worsening disease or death from community-acquired pneumonia. Individuals in the study had mild to moderate dementia and were already being treated with medications routine in DLB clinical care for dementia, behavior, sleep and movement symptoms. Individuals were treated for 30 days with 150 mg armodafinil to set up safety and tolerability and were increased to 250 mg for an additional 60 days.

Mild to marked clinical improvement was observed in 90% of participants, with moderate to marked improvement seen in 45% of participants. Improved caregiver quality of life was reported as well. “The majority of patients experienced some degree of improvement in key features associated with DLB, and most tolerated the medication without significant side-effects,” said Dr. Brad Boeve who directed the trial. “Yet some patients continued to experience significant daytime sleepiness and other problematic DLB features. This medication should obviously not be considered a cure for DLB, but it is another option for clinicians and patients to consider as they work together in treating bothersome symptoms associated with DLB – particularly excessive daytime sleepiness.” Significant improvement over baseline was reported in the ability to maintain wakefulness, and significant improvement was reported in apathy and improvement occurred in visual hallucinations, delusions and anxiety, with the exception of the 3 individuals who discontinued participation.

This data suggests treatment with armodafinil offers reasonable safety, tolerability and improvements over baseline in excessive sleepiness in individuals with DLB, and may reduce neuropsychiatric features as well.

Fall Prevention by the Numbers part 1

2012-06-17T10:59:00.003-07:00

The single best tip sheet for Alzheimer’s Caregivers

2012-06-15T00:01:00.000-07:00

The single best tip sheet for Alzheimer’s Caregivers was produced by the National Family Caregivers Association

Caring for someone with Alzheimer’s disease can be a full-time job, but often it is also one of the most rewarding. In every job, there are stresses that can affect performance. Sometimes, the best advice for family caregivers comes from those who have walked the path before you. After listening to 674 Alzheimer’s disease family caregivers who participated in a 2011 national survey, NFCA selected the following tips that may help you navigate life as a caregiver.

Improve Communication

With Your Loved One

· Talk slowly and speak in a calm and reassuring tone. Maintain eye contact and use positive reinforcements, such as a smile or gentle touch, to put your loved one at ease.
· Remember to ask one question at a time. Try using signals, such as gestures, in addition to your words, to start communication.
· Although it may be frustrating, be sure to allow your loved one to communicate their thoughts—be careful not to interrupt, criticize, or correct too quickly.

With the Doctor

· Before you go to a doctor’s appointment, write down your questions and the thoughts you want to share. Daily records of your loved one’s ability to function independently, both mentally and physically, can be helpful at these meetings.

· Try to set aside any frustration stemming from your situation with Alzheimer’s disease. Recognize that your doctor may not have answers to all of your questions, but he/she is there to support you.
· Familiarize yourself and your loved one with the doctor’s staff and office, so your loved one feels safe there.

With Family, Friends and Other Support Networks

· Your family, friends, and neighbors may not know what you are going through. If you do not feel comfortable discussing your loved one’s condition with others, ask another family member, or perhaps a member of your faith community, to talk about it on your behalf. You do not have to do this alone!
· Teach others how to communicate with your loved one. Share tips you have learned and methods that work best.
- · Speak up for the rights of all family caregivers in your community by talking about the need for education, financial support, and better illness care.

Take Care of Yourself

· Believe in yourself, trust your instincts, and let your inner voice guide your decision making.
· Protect your health. Recognize that taking care of yourself is just as important as taking care of your loved one.
- · Caregiving is mentally, emotionally, and physically draining. If you feel your own health and well-being are suffering as a result, be sure to talk to your doctor.
- · Schedule brief periods of rest or breaks often. Respite is not a luxury. You need regular breaks in order to stay healthy and strong.
- · Join a support group. It can be a safe haven for sharing feelings, a place to make new friends and a place to receive information and resources on how to deal with what lies ahead.

Ask for Help

· Recognize that asking for help is a sign of strength, not weakness. Get comfortable with the idea of talking about your need for assistance and reach out to someone you trust for help.
· Recognize your own strengths and limitations to help assess when you need assistance.
· Create a list of tasks that need to get done.
- · Hold family meetings to review the needs of your loved one and divide the responsibilities. Reviewing individual responsibilities is a good way to engage others to share the burden of caregiving.

The survey referenced was conducted online by GfK Roper Public Affairs & Corporate Communications, on behalf of the

National Family Caregivers Association and Forest Laboratories, Inc.

How To Prepare For A Doctor's Visit

2012-06-10T21:19:00.001-07:00

OBTAINING GOOD HEALTHCARE & INFORMATION

Communicating with Your Loved One's Healthcare Team

You can make a difference in your loved one’s health. It just takes a little effort and time.

How Can You Prepare Before Each Medical Visit?	How Can My HealtheVet Help You?
How Do You Involve Yourself During Each Medical Visit?	Remember
What Questions Should You Ask?	More Resources

How Can You Prepare Before Each Medical Visit?

To prepare before each medical visit:

Make a list of questions. Put the most important questions first.

Describe the problem or symptom on paper. Note when each symptom occurs, how long it lasts, and what makes it better or worse.

Write down changes in your loved one’s diet, mood and behavior.

Bring stroke information you learned from friends, the media or on My HealtheVet and the Internet.

Bring a list of all your loved one’s medicines. Include vitamins and over-the-counter medicines. Bring results of tests and reports of visits to non-VA medical offices.

How Do You Involve Yourself During Each Medical Visit?

Communicating with your healthcare team isn’t always easy. Show interest in your loved one’s health. You’ll be surprised with the results.

If possible, let your loved one take the lead.

Update the provider on your loved one’s health changes. Tell the provider if treatments or medicines are not working.

Take notes.

Bring up any point the healthcare provider did not cover.

Use Your Time with Your Healthcare Team Wisely

Providers only have a short time to talk. Remember to do the following:

Talk about the most important concerns first.

Be brief and stick to the point.

What Questions Should You Ask?

Ask the provider to explain anything you don’t understand.

Ask the provider about the survivor’s diagnoses and what to expect.

Find out different choices for treatments.

Find out why tests are being done.

Ask why your loved one is taking each medicine.

Talk about local stroke support groups and other resources in your area.

Make Sure You Understand the Provider

Repeat instructions or treatment information. Ask if you understood correctly.

Call the provider’s office later if you are unclear.

Ask pharmacists questions about medicines.

Contact your healthcare team with new problems and adverse effects from medicines. Your healthcare team wants to know right away about new symptoms.

How Can My HealtheVet Help You?

Ask a VA staff person to show you how to use My HealtheVet. With just a few clicks on My HealtheVet (www.myhealth.va.gov) you can keep track of personal health information. For example, you can record blood pressure readings and daily weights. You can find handy tools to record medicines and lab test results. Print and bring this information to visits with the healthcare team.

Remember

Make a list of questions to ask the healthcare team.

Use your time wisely on each medical visit. Stick to the point.

Be sure you understand what the provider tells you.

More Resources

The following resources are related to this fact sheet only. View a full list of the resources from all RESCUE fact sheets.

My HealtheVet
Web: www.myhealth.va.gov

My HealtheVet (MHV) provides trusted information on stroke and other health conditions. It also provides resources for stroke caregivers and tools to track your loved one’s health.

Visit the My HealtheVet Caregiver Assistance Center for more information on caregiving.

National Institute on Aging (NIA)
Web: www.nia.nih.gov*
Phone: 1-800-222-4225

The National Institute on Aging has guides on obtaining good healthcare and information. Information also available in Spanish.

Read their fact sheet on "Talking with Your Doctor: A Guide for Older People"*

Need Cash For Caregiver (seen on freeway on-ramp)

2012-06-05T23:34:00.001-07:00

The cost of health care is undeniably high. Most people that don’t provide care think of health care costs as the money that Medicare and Medicaid provide. But the real struggle with these costs is not what the government pays (ultimately out of our taxes), but the out-of-pocket expenses the we caregivers have to shell out of our own pockets. That’s the piece that hurts us every month when we are buying the groceries and filling up the gas tank.
Well, some caregivers have found a creative solution to the problem. The internet!
That’s right, now there are websites that you can go to where seriously kind-hearted people will help you out directly. One site that got some attention in the news recently is www.youcaregiving.com Listen to this, your story may be similar to Vicki’s. Vicki, a 52 year old from Chicago was traveling 400 miles to get treatment for a heart defect with only $200 to her name when a friend recommended she try www.youcaregiving.com and by the time she got out of the hospital she learned that friends, family and even complete strangers had donated over $1,000 towards her medical bills. Over the next few months she pulled together $7,000 more.
But there are other online fundraising websites: www.giveforward.com and www.Fundly.com It’s called crowdfunding, and it might just be your salvation.
Word of caution however, if you are going to try one of these websites, please check the rules. Some charge a large percentage and others will not release funds until your requested amount is reached.
Ultimately, my sincerest wish is that you never need it. Hopefully, you are on the other end of the spectrum, a potential doner. Interestingly, about 1 in 4 people that donate are over 50, while the those that are on the receiving end represent a slightly larger percentage overall.
* If you want to stay current on news like this, please come to Facebook.com and take a peek at the Dementia Care Secrets fanpage.

How many years does smoking cost you - exactly?

2012-05-27T09:58:00.000-07:00

Great little calculator. use it for yourself or with a loved one.

Cool Little Smoking Calculator

and come visit us on facebook at:

FACEBOOK: Dementia Care Secrets

FREE MONEY! - SERIOUSY...free. no kidding

2012-05-26T14:15:00.001-07:00

Are you one of the millions of American's that bought those Sketcher 'shape ups'? Well they lost a class action lawsuit and have to refund $40 million. For you piece of the pie go here: http://www.skecherssettlement.com/

Its on the honor system, you don't need a receipt.

But if you get 30 or 40 bucks because of this can you do me a favor? Go to my friends facebook page and 'like' it.

DementiaCareSecrets

Ever go into a room and forget why?

2012-04-19T23:06:00.000-07:00

EVER GO INTO A ROOM AND FORGET WHY?

We all forget, and as we age we start to worry. Am I getting "it"? Well here's a reason not to worry so much. A recent study from the University of Notre Dame finds that doorways serve as "event boundaries." ?When you walk through a doorway from one room to another, your mind processes a new event, making what you were thinking about slip your mind, says study author Gabriel Radvansky, PhD. -- Prevention Magazine April 2012.
Whew, now if I can remember what I was going to do this information once I wrote I down???

MAYBE YOU WERE WONDERING WHAT TO FOR THE REST OF YOUR LIFE.

Are you getting close to retirement? Maybe you are just tired of doing the same job for 20 years? Well, many middle aged adults are are finding new careers. A good resource for ideas is A new book by author Patricia Cohen called "In Our Prime: The Invention of Middle Age". Perhaps you have been away from you career for a few years as a caregiver? Two place that you go to find more information is encore.com and idealist.org.
-- source Prevention April 2012

Alzheimer's is incurable

2012-03-24T10:04:00.000-07:00

You heard Glen Campbell has Alzheimer's, right? Here is a video interview with him:

http://youtu.be/BCBCPVT93eg

Second Careers for Caregivers...easier than you think

2012-03-07T00:42:00.000-08:00

At some point caregiving ends. Its not a nice thought, but if you have been taking care of someone with Alzheimer’s for more than a couple of years, then you are probably very “reality based”. The shine has come off of the gung-ho and the relentlessness of the illness has convinced you.
But you know all to well caregiving does end.
And when it does you may want to pick up your life and get back in the swing of things. In fact you may actually be very eager to return to the workplace.
Perhaps you want to do something completely new and different. But what? you ask yourself.
Take a look at http://www.encore.org/ And even though I personally have not used them…I met the founder years ago on a spiritual retreat. Don Coyhis. No spring chicken himself, he has spent a lifetime helping people. I met Don Coyhis at a retreat in Santa Barbara, and fell in love with his unique blend of Western and Native American spiritual systems. Yes, Don is a Native American. I enjoyed Don so much that I took job in Colorado Springs to be near him and another dear friend, Don Pruit. I jokingly called myself “the lesser of 3 Dons” whenever we got together. When I left Colorado Springs a few months later, I lost touch with Don. Surprisingly I stumbled across his organization while doing some research tonight. And I can tell you there is nobody like him, and I have no doubts that his organization will be reflective of that easy going, motivational and practical personality.
I predict that in the next decade, as us Boomers start “filling up the Stadium” Don’s little non-profit organization will be getting a lot of attention. So I want you to know about it now. If you are looking to do something different, or if you have been out of action because of caregiving responsibilities, take a look at aka Encore Careers.
Good Luck, Donahue
p.s. for the record – I am NOT getting paid to promote Don, or his organization. Truth is, they don’t even know I am recommending them and I like it that way…

Mom Sure Takes A Lot Of Meds

2012-02-21T20:42:00.000-08:00

Q: I need to get a handle on all a these medications?
A:
Americans over the age of 65 take lots of medications: the average "healthy" adult takes 9 different drugs. If you are taking care of sick parent or spouse (or sibling), the average can be substantially higher. Do you ever wonder if the side effects of one drug have caused the need for one of the other drugs? What about side-effects? Drug interactions? How about this: Do you ever think that your loved one is unnecessarily taking multiple medications for the same condition? At the end of this article I am going to show you a free website that you can use to compare any two medications! My favorite part about this tool is that you don't even have to know how to spell them...it's like Google - when you start typing the name it will try to guess what you are attempting to spell (that saves me everytime).

But first allow me to state the obvious. You know that whenever you are taking your parent or spouse to the doctor you should take all of the medications that they own with you, so the doctor can check. (Don't count on your memory). Also remember to include over-the-counter meds and even bring supplements and vitamins. Why? I am glad you asked.

The perfect example "why?" is baby aspirin. Doctors are fond of prescribing 81mg baby aspirin to reduce the risk of stroke and heart attack because aspirin is a mild blood thinner. If your loved one has ever had a stroke then the doctor has probably also prescribed a stronger blood thinner like Warfarin (Coumadin). But lets look at something else. If you have ever researched anti-oxidants maybe you added supplements like Garlic, or Ginger. Maybe you added a little Ginko Biloba because you read (erroneously) that it is just as effective as Aricept? Fish Oil for Omega 3 seems to be on everyone's supplement list for heart health too. But you may not be aware that every one of the supplements I have just mentioned are also blood thinners! So it's best not to take chances and take everything to the doctor.
On average, Americans over the age of 65 have seen more than 28 different doctors in their life () In a Country with every kind of specialty under-the-sun, many seniors are regularly visiting their family doctor, a podiatrist, a neurologist and an internist. Each one may be prescribing different medication, with significant overlap. This is yet another reason to take every pill bottle you can find with you to your next visit to the MD.
Considering how many doctors and medications you're juggling for your parent or spouse, you may have other reasons to compare drugs and their interactions: Saving money, eliminating unnecessary prescriptions and researching the source of side effects. However, considering how little "face-time" time you get with the doctor, it is a good idea to do your homework first. Generally, a doctor will respect a caregiver that has done a little research. At the very least it gives them a chance to show off their superior knowledge.
Now for that website I promised you in the first paragraph: is my secret website that has wonderful and well written information, and the specific URL that has an amazing free tool that compares medication is: http://healthtools.aarp.org/drug-compare
Please look below for an example of what you will see when you go to the website. I tested it out by comparing Namenda and Aricept. Not only did it give me a great description...it also asked AND answered the most frequent questions that people have...
Please feel free to share this great tool with your friends.

Help for Alzhiemer's

2011-10-28T12:21:00.000-07:00

Having posted information for the past 5 years, I want to offer you a more direct way to get information:

I tend to post articles on topics that I think are important to family caregivers. To be honest, my motives were in part to promote the assisted living communities that I worked at. My reader's followed me, but as new families came to my community, I could direct them to these blogs, and give them confidence that they were putting their loved one in safe place. So there was a duel purpose.

But it occurs to me, rather than guess what you might need to know and write an article about it, I could answer you questions directly.

If you are taking care of a parent or spouse with Alzheimer's, you can write me at askdonahue . that link is askdonahue@aol.com. I really look forward to answering your questions...my agenda is only to help. If you need another email address to reach me for any other reason, you can find me at
donahueg@alumni.usc.edu

yours, Donahue Vanderhider, MSG

caregiverrelief

What The Heck Is A Gerontologist And What Good Are They?

2011-09-30T21:33:00.000-07:00

Its a fair question. What exactly makes a Gerontologist any different from other quasi-medical professional?

P.S. For a short period of time you can get personalized care and coaching from a gerontologist for less than $40 a month! (This is about a 90% discount).
But its a little complicated.

First sign up for a free membership at http://dementiacaresecrets.com

Second once inside look to the bottom of the page for the words Ultimate Care
and click on the entire paragraph...

Alzeimer's Secret #4: You Are Being Over Charged

2010-10-17T15:16:00.000-07:00

OK, before I continue, I want to share some exciting news with you. I will soon be launching a caregiver membership website! My partner, Diane Carbo and I have joined forces to bring you the first ever, exclusive membership site devoted entirely to caregivers helping their parents suffering from Alzheimer's dementia. We are hoping to launch before Thanksgiving. Nobody will be excluded, the site will have 2 membership levels, Free and Gold Level. We are committed to drop dead honesty, and making sure you are saving money and have peace of mind. Please go to Dementia Care Secrets and sign up. I will personally respond, and you will have the opportunity to sign up at DementiaCareSecrets.com" as a founding member (with even more bonuses than the Gold Level).

Alzheimer's Secret #4 You are being over charged

Medications, insurance co-pay, incontinent supplies, adult day care, home health care workers, assisted living, you name it? There are people trying to make money off of you, and they are trying to make as much money as possible.

Medication
Before I continue, I must advise you that I am not an MD doctor or a pharmacist, so the following is purely my opinion, and you should make up your own mind and discuss all medication issues with your own doctor and pharmacist.
You already know about generic drugs, and that's a good start. However, you may had heard that there are some drugs that you should not get generic versions of. Hogwash. According to Consumer Reports, "Generics are copies of brand name medicines whose patents have expired". As you can imagine the FDA has strict rules about drug preparation, purity, and strength. The only place you should concern yourself with quality is when taking vitamins and supplements. The FDA does not oversee the makers of supplements, and there is huge disparity with manufactures. But that is a story for Dementia Care Secrets.com

Insurance Co-pay
Time for another qualification: I am not a financial advisor, my comments again, are only my opinion, and quite frankly might be dead wrong. For example, personally I will never pay for my dad's doctor or hospital co-pay. After all what are they going to do, ruin his credit? In my experience, most doctor's do not care about collecting co-pay, but they are required by the government to charge Medicare and private pay patients the same, so to get the maximum Medicare reimbursement they have to ask for a co-pay. (It’s a long explanation) Especially in nursing homes and assisted living, doctors could not care less about it.
As far as I know hospitals cannot refuse you treatment, even if you owe them a million dollars. If you show up in ER (or the paramedics deliver your mom or dad there) they will not be sent away. That leaves insurance companies: The best insurance you can have is Medi-Medi. But if you do not have the income qualification for Medicaid, then you need a good secondary, like AARP. And if you are paying more than a nominal fee for meds or services, then you need to change your secondary. Which is very easy, and we will show you how do it on the membership site.
Incontinent supplies, bath chairs, hospital beds, etc.
If you parents are broke then you qualify for Medicaid, no problem. Medicaid covers it. Including wheelchairs (electric and regular). But if they are not broke…and their secondary insurance does not pay, you can go on Craigslist or eBay. Also check Thrift stores, and call those charities that pick up like the Vietnam Veterans groups and ask where their retail stores are. Places that pick up usually have the best selection. Even the Penny Saver carries most of the stuff you need (chairs, beds, walkers, etc.). Incontinent supplies on the other hands can be found at discount stores like Walmart.
If you have home health workers or your folk live in assisted living, or skilled nursing, make sure they are not putting two diapers on at a time. They will give you some malarkey and say that it prevents or catches leaking. That’s plain not true. the adult briefs made today can hold plenty. They are just trying to get away with changing your loved one less often - which is a major contributor to skin breakdown. So if you catch it, raise hell.

Adult Day Care
There are two types: regular adult day care and adult day health care. Both are subsidized by the government. If you are in a big city or town, shop around, if you are more rural you will most likely have to us IHSS (a government subsidized home companion service). But when it comes to adult day care; bargain like you are in Tijuana, try to get their daily rate for half of what they initially quote you.
home care workers
The dilemma with home health is deciding to hire your own help, or paying an agency and using their staff. They both have pluses and minuses. But if you decide on using an agency, again…shop it around for the best price. Here agencies are less likely to negotiate, BUT you can let your fingers do the shopping and find another one that is cheaper. Also, do not pay for more service than you need. (a Care Manager would be helpful here). Finally, you can get free home care if you have the right doctor. Basically you need to ask the doctor to write an order home health and if he/she does Medicare will pay for it. A good doctor will know what conditions and illnesses warrant home health and be able to write an order for it easily. Generally the best time for getting these orders is during a short hospitalization or a short stay in a Rehab care center or nursing home.

assisted living
Times are hard for assisted living. In the last decade they over built and big companies bought too many properties. Therefore no matter what the marketing persons says, they have a lot more vacancies than they are admitting to. So the best way to save on assisted living is to first ask them to waive whatever admission fees they try to slap on you. They might try to break it down into payments, don't fall for it. It's pure profit for them and negotiable. Then get them to reduce the price of the room and board. Most good places will not reduce their fees for care (medication, bathing, escorting, etc.). But the board and care portion of the fees are negotiable. Example: "We have a $1000 pre-admission free, and your mom needs X, Y and Z services for another $1500 plus room and board of $1000 for a total of $3500 move in, and $2500 per month after that." You can fight to have them waive the $1000 pre-admission and take around 20% off of the room and board for a total of $2300 per month. The saving will add up over time.
Also most assisted living communities will give you a cost of living rent increase every year. These are negotiable and can even be waived. Just claim financial hardship. Let them know you can't pay and will have to look a new place for your parent. Be creative, negotiate, try to postpone it 6 month. If it’s a percentage of the rent, try to get them to lower the percentage.
Another good trick, if you are just now looking to move your parent into an assisted living, show an interest in the smallest room they offer and once they have told you the cost of, then ask that they give the larger room for the same price. This will often save you thousands a year.
nursing home
These people charge by the day and are heavily regulated. But it pays to shop around. Most people get into nursing homes / rehab hospitals when they are discharged from a hospital. The hospital has a person that is supposed to help you with the transition, and they often recommend certain homes that they have a relationship with…or your doctor may work in certain nursing homes and want to discharge your parent to the place they want them to go to (usually those places are paying the doctor and this is a secondary income for him/her).
Often the hospital will TELL you were they are sending your parent, hoping you will be sufficiently docile and not challenge them. But it is strictly up to you what nursing home your parent goes to. Not the hosptial's nor the doctor's. But make sure you are prepared: as soon as your parent is admitted to the hospital start shopping nursing homes. Just walk into them and ask to speak to someone about bringing your mom or dad. Ask them what their basic daily rate is. They will say one of two things: They will either say, it doesn’t matter Medicare pays 100% or they will say it depends on what services your mom or dad need. (both are smoke screens). You want to know their daily base rate (never mind the extras it's too confusing). The reason you are asking, is if your mom or dad needs a few days beyond their Medicare days, they will want to bill you directly and you want to compare and use the one with the lowest daily base rate.

Tip: Just because a nursing home is newer doesn't mean it's good. Some of the best care I have seen was in older established nursing homes. Two big clues: smells, and yelling. You don't want to experience either one when touring.

Then when your mom or dad is getting discharged, and the hospital discharge planner (social worker) tells you where they are sending them you simply say…no, I want them to go here: name your place Better yet, when you have decided on which nursing home, let them deal with the hospital (it's in their interest to fight for you). Finally, the hospital's last line of defense will be your parent's doctor who may say, but if you go to that nursing home, I cannot follow them. Your response should then be, that’s ok, as soon as they are discharged we will come by your office, and perhaps you can talk to the doctor at the nursing home and coordinate a care plan for mom or dad. (The only reason a doctor would say no, is they are being cheap because they cannot bill Medicare for the consultation).
This is a lot of information, and an example of the stuff you will find on the membership site where you will be able to selectively choose the material you need and ignore the rest. Not to mention that there will be a deeper explanation as well as some advocacy tools that you can access to make all this as simple as possible.

2010-10-08T21:21:00.000-07:00

Alzheimer's Secret #3: They are lying to you.

When you are caring for a parent or spouse with Alzheimer's I expect you are looking for guidance from professionals like me. Unfortunately, I can tell you unequivocally, whoever is giving you advice is coming from a very self-serving place. Be warned, they have an agenda, and if it matches yours, well that’s just a happy coincidence. Because they will do their best to twist the particulars of your circumstances to convince you of what they want you to believe.

Whatever your goals are for you and your loved one; keeping your parents in their own home, or finding a community to move them into. When you go out into the marketplace to help you make your decision, you will often be met with thinly disguised sales people. They may call themselves placement counselors, or family liaisons, but their sincere advice is rarely motivated by what's best for you, and more likely what's best for them. I have sat in the training classes that teach us how create anxiety in such a way that the best solution is the one we want you take. Often, they consciously steer you away from alternatives that serve your goals, and emphasize the parts that support their goals.

I am sure this has happened to you already. You may have suspected it, but you may not have wanted to give people the impression that you were a paranoid jerk. So maybe you nodded, and heard them out, and you walked away feeling like something important was left out of the conversation. It was.

Let me explain it this way: Where do you go when you are trying to decide on how best to care for your parents? A marketing director of an assisted living or board and care? A placement counselor for a home health agency? Maybe your parent is in the hospital and the discharge planner is helping you figure out what to do with mom or dad when they are discharged? Each one of those people, whether they even realize themselves, is going to try to convince you that what they are selling/suggesting is what is best for you. And in a lot of cases the size of their paycheck depends on their success.

"Surely my doctor is honest"? Most doctors try to be non-committal in non-medical matters, but if they do express an opinion, it is to send you to one of the people I just mentioned above.

Look these folk may be genuinely sincere, and even believe what they are telling you. But their bias is built into how they think. For example, when I was a marketing director of an assisted living, I believed that the best course that any family could take, was to let us provide the care for their parent, so they could enjoy their parents and not have to worry about them. Keeping a frail adult, was a risky proposition, and hiring help around the clock was cost prohibitive. Conversely, when my friend talked about aging in place, she sincerely believed that you should keep your parent at home as long as possible, and hiring aides and companions is the best for all concerned, and in keeping with their wishes.

You could put both of us on a lie detector and it would say we were both telling the truth - even though we were saying the opposite things. The same is true for every professional out there (except one, and I will fill you in on that in a moment)

Of course that’s the best case scenario. I can also tell you that I know of many nursing home discharge planners and hospital discharge planners that get a kick-back whenever they can convince you to move your parent into a board and care home that they are recommending.

So who are you going to believe? You have to decide that for yourself. When you are caring for a parent you must plan ahead. One thing that I tell adult children all the time is…what is the one thing that you absolutely do not want to do? Change your mother when she is bowel incontinent? Give your father a shower when in his mind he sees you as his young wife, rather his older daughter? Or is it simply when you have to physically transfer them from the bed to a wheelchair? If you have a line in the sand that you can draw, good for you. The point is only you know what is best for you and your parent.

Here's a big head start on figuring out where you want to draw the line: go to this site and get my pre-planning assessment for free at http://www.easycaregiving.com/DementiaAssessment and download the .pdf document. you are going to need it anyway, and there is a good chance that filling it out will bring up important questions for you to consider.

Which brings me to that one professional that will listen to your story and advise you based on you and your parent's wishes not according their job description. A geriatric care manager. (with one stipulation: make sure they don't work for a company that also provides home health workers because then you have that personal agenda thing again). An independent Care Manager will offer advice based on your needs and wishes, nothing else. You can take what they tell you to the bank because they serve no other master but YOU their client.

As a caregiver coach, and care manager, I can assure you that while my paycheck does depend on you, meeting your goals is my only concern. With the added bonus, a good care manager will give you options that you had not even thought of! And after all isn't that want you want? Someone who knows the system inside and out?

Have you ever wondered why you rarely hear about Geriatric Care Managers? It's because nobody wants you have that kind of firepower at your side. They prefer you to be malleable and open their sales pitch. To find out more about care management and caregiver coaching please go to CAREGIVER COACHING and read up on it. Trust yourself, a small investment with a coach or care manager will save you hundreds if not thousands of dollars.

Alzheimer's Secret #2: Yes The Are After Your Money

2010-09-29T20:32:00.000-07:00

According the Alzheimer's Association report for 2010, caregivers will have 172 billion dollars of expenses in 2010 alone. That’s 1000 super lotto's combined, and there are people that want a piece of that big juicy pie. Businesses are lining up to get your money, and with little exception they don't care about what is best for you and your loved one. I will explain that in detail on Alzheimer's Secret #3. For now, just know that Medicare and Medicaid attract a lot of bad people looking to make money off of you and our crippled health care system.
Remember "Caveat Emptor" (Buyer Beware). As a caregiver you are going be dealing with the following three businesses: durable medical equipment companies, home health care agencies and adult day care centers. Let's talk about them:
DME (durable medical equipment) companies sell things like hospital beds, scooters and wheelchairs, walkers, and shower chairs. All of these things are paid for by the government. A doctor writes an order for it, just like he writes a prescription, and they deliver it to your door. Great if you need it…but easy to bilk the government. For example, I know of a DME that was giving those expensive memory foam mattresses to people and charging the government! Yes, I am talking about those mattresses that you and I can't afford because they start at around $4,000. They were getting delivered to every Tom, Dick and Harry that had a doctor's order for it and sneaky devils were teaching the doctors what to write to justify it. Medicare eventually closed that loophole.
Nevertheless back to you; if you are thinking of getting a walker, hospital bed, etc., ask your doctor to write an order for it. Even if you want the nice walker with the handbrakes and the bench to sit on, it is covered by Medicare. But to be on the safe side, you may want to talk to a medical equipment provider (often a pharmacy), and ask them what the doctor's order should say so you can get the "good" walker. But do NOT go out buy one yourself until you have at least asked a doctor for it.
Home health care companies seem to be everywhere. There's a reason - they are making a killing off of you. If you are at home taking care of loved one, and you decide to hire help. Shop around! The price variation is wide, and when it comes to hiring help in the home, "you get what you pay for" rarely applies. The real trick to hiring home help is hiring at the right level. You should not expect a simple paid caregiver or companion to give medications, yet you should not hire a nurse or even a nurse assistant to give showers or take your parent to a medical appointment. If you are dealing with Alzheimer's, you should reevaluate your care needs at least every 6 months. A geriatric care manager can help you with this. And over time, it will save you a lot more money than you are paying the care manager.
Adult Day Care and Adult Health Day Care, sound the same, but are very different. Adult Day Care provides more of a social environment for your parent, and is less expensive. $25 - $70 per day. However both types generally offer a sliding scale payment, so it's worth negotiating. Adult Health Day Care on the other has added services. They can handle incontinence, they often have a licensed nurse on staff, and other medical professionals. They charge more money, but often Medicaid will pay for some or all your care there. But if you don't need incontinence are or diabetic care, then save yourself money.
However, if you are nearing the end of your rope and you feel that your parent can get better help and socialization in an Assisted Living community, and you can't afford a private geriatric care manager to find the best one for your circumstances there is a great free service from A Place For Mom: Free Referral Service
As an administrator for over a decade I have dealt with a lot of placement agencies, A Place For Mom is hands down the best. They are completely respectful of your time and your budget. Even if you are in the early stages, they will not rush you. They listen...which is a rare thing these days.
Here's link to their services:

#1 Alzheimer’s Secret: “Almost nobody tells the truth”

2010-09-24T23:37:00.000-07:00

Thus we start a series of the Alzheimer’s Secrets. We are going to talk about the stuff nobody tells you. The big grey elephant in the living room. No more fluff, no more beating around the bush, no more pretending everything is ok. Its not. And if its going to get better we need to acknowledge it and address it. If you have a great hunkydorie experience as a caregiver, these next few week are not for you.

#1 Nobody is telling you the truth about Alzheimer’s

Go to any number of online forums for caregivers, and you will read over and over again how the caregiver is at the end of their rope: financially and emotionally!
A quick look at any one of the many caregiver forum websites and you will see comments like this:

“How do I approach the subject of assisted living with my brother and sister? Mom gets angry at everyone and everything that is not done the way she wants it. I want my life back. I have sacrificed 15 years for her with no appreciation.”

“I hate the way most doctors pass the buck and will not commit to any answers. I just want a straight answer for once! If this is the end I want to know what to expect and what kind of time frame.”

“Dad is horribly depressed and just can’t seem to get moving. I honestly don’t know what to do. I want to be there for him, but I get so frustrated when I go over to his house. He just doesn’t seem to want to “help himself”. It gets so that I almost cringe when I see his number on caller id because it’s depressing me to be around him.”

This is the norm! And let’s face it, there is little or no help out there. Not from the government, not even from your family. They are fast and loose with advice about what you should do, but they don’t get it, because they are not living it 24/7 like you are. So, you have no help, not even financial, and most of your friends have seemingly moved on too. Who can blame them, right?
Granted, this sounds terribly negative. But I bet most people agree with me than disagree. A lot more!

Look, there IS help out there. There ARE solutions. But they are hard to find, and your circumstances really are unique! So the solution has to be hand tailored to your situation.
If you found my website recently it is probably because of the free Geriatric Assessment that I am offering. I hope you downloaded it, and to get the most out you should watch the videos. More importantly, make an effort to reach me. You would be surprised how many people do not even try. They are desperate for help but if its free it must not be any good, or be “common knowledge that I can figure out on my own”.

If you are new here, or did not get the assessment form: Go Here For Your Free Geriatric Care Assessment Form, and videos explaining it

A Last Will and Testament is perhaps the most important legal estate planning document the average American will ever sign. Yet, over seventy percent of all American Adults have not filed any form of estate plan, including any Last Will and Testament Documentation.

We created Create My Will.com to provide an easy and affordable solution for everyone to receive all of the documents needed for their estate planning, including the Last Will and Testament Forms. We took the time to also create estate planning attorney authorized guides to help walk you through the process of filling out your Last Will and Testament.

New Vistas for Alzheimer's Care: Caring for the Caregiver

2010-09-23T13:47:00.000-07:00

COACHING FOR CAREGIVERS

Caregiver Coaching is a more versatile way to provide Care Management. Traditional Care Management is limited to the care and supervision of your older family member who is incapacitated. Typical uses of Care Management are:

Facilitating medical appointments, conversations with medical professionals, interpreting and explaining doctor’s orders and recommending other medical interventions and treatments.
Hiring and supervising private caregivers for your family member, knowing what level of training a caregiver should have based on the current care needs, and saving you money by structuring caregiver schedules.
When placement is needed, care managers will find the best community for your loved one so that their needs, both physical and social are going to be best met. Negotiating the price, they can also provide follow up supervision to mediate between the family and the facility when complaints or concerns are expressed. (ask your friends who have their parent in home how valuable that is)
Care managers can save you a lot of money when there is a significant amount of savings/pension/stocks and bonds that you do not want to lose paying for care and treatment that the government gives to other people. They know the best elder-law attorneys and investment counselors. Even if the only asset is a home, care management is a wise investment.
And all the other services and needs listed above in the description of the assessment.

My caregiver coaching provides all that, plus I am always tempering my recommendations with you, the caregiver in mind. Your well-being, financial, physical, and emotional are paramount and embedded in all of my actions and recommendations. Caregivers, often working alone struggle with the day-to-day decline and difficulties of the care of their loved one. With a Coach, you will never be forgotten or fade into the background.

Before you were a caregiver you had plans and dreams and goals. They need to stay on the front burner, and a Coach knows how to do it. You should not have to wait years to start living your life again. You will be nurtured and you receive concierge like guidance to make caregiving as easy and painless as possible.

Better yet, you don’t have to be rich to get this service. You can get private caregiver coaching with as little as a couple of hours per week.
Imagine, you have had another rough night with your Alzheimer’s suffering Mom or Dad (or even spouse in many cases), your phone rings and there is your personal Coach who is concerned for YOU, and who can listen to what you are going through, and then give you the perfect solution that had been eluding you?

Imagine your loved one has declined again, and now there is a new behavior or problem that you are not familiar with: incontinence, wandering, abusiveness, etc. Why wait for doctors appointment, that in all likelihood will only get you a medication change, or wait for a support group meeting that is 2 weeks away. Thirty minutes on the phone with your Coach may be all that you need to get a solution or tool that will address the issues.

When you invest in coaching you are actually saving money and maximizing your health care expenses. For rates please check here:

Caregiver Coaching Rates

Cool Websites To Speed Your Learning Curve Along

2010-09-22T22:29:00.000-07:00

Everything That Makes Your Life Easier

Ever go to the doctor, and get a bunch of mumbo jumbo? You are hoping for a simple explanation, but it's like they are getting paid by the syllable?

On the other hand you may have the best family physician, Would help if you could follow his or her descriptions better?

Or have you ever gotten a medical report and had some medical terms or conditions on that you were not sure exactly what it meant?

Here is a super simple tutorial on medical terms:
"Understanding Medical Words
This is brought to you by the NIH National Institutes of Health and its F.R.E.E. and no sales pitch.

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We talk a lot about the dangers of stress. It's practically my mission in life to get caregivers to de-stress their life. Well Medline Plus does it better than I. Here is an excellent tutorial from X-plain.com. It's even narrated:"Patient Education Institute"

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Better yet, here are about 50 separate videos from the NIH Senior Health people on a variety of topics from Alzheimer's to Osteoarthritis The NIH: Video List

You will find a wide variety of conditions here: Dry Mouth, Prostrate Cancer, Diabetes, Kidney Disease and much more.

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How often have you thought about making a Will or a Living Will but were put off by the complexity of it, having to find a lawyer, etc.? Here is a super simple website:

CREATE MY WILL.COM

As seen on CNN, MSNBC and USA Today

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Disabled Adaptive Clothing: Alzheimers, Arhritius, Parkeinson's. Even Shoes!

SILVERTS: HARD TO FIND WEARABLE CLOTHING

My HealtheVet Web: www.myhealth.va.gov My HealtheVet (MHV) provides trusted information on stroke and other health conditions. It also provides resources for stroke caregivers and tools to track your loved one’s health. Visit the My HealtheVet Caregiver Assistance Center for more information on caregiving.
National Institute on Aging (NIA) Web: www.nia.nih.gov* Phone: 1-800-222-4225 The National Institute on Aging has guides on obtaining good healthcare and information. Information also available in Spanish. Read their fact sheet on "Talking with Your Doctor: A Guide for Older People"*