“You’re never too old to improve strength and stamina,” I find myself saying to yet another new home care client at our first meeting. This time, it’s a delightful woman who is no longer able to care for herself. It’s not due to a specific disease or injury. It’s a generalized weakness and a loss of mobility developed over time that keeps her now from doing her own personal care, housework, and errands.

She’s lost her independence to a large degree because of too little walking, stretching, lifting, and reaching. As it common, she’s also developed a terror of falling, which keeps her even frozen to the couch – a fear that becomes a self-fulfilling prophesy, as more muscle loss causes greater unsteadiness on her feet. Surely this is the harbinger of some future fall if it’s allowed to continue in this direction.

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I took a short break this afternoon, and when I tuned back into the world of news, I found that the expected winter storm Friday into Saturday was now being called a BLIZZARD WATCH!  Eighteen to twenty-four inches are being forecast with high winds. My goodness... 

We rolled into action to consider the safety of every shift change Friday and Saturday... will the roads the safe? Will it be snowing too heavily? How can we serve clients Saturday night and Sunday morning safely? We will work with families and caregivers to create a plan for any shift changes that may be made unsafe or impossible by this storm. We will be in touch wiht impacted families and caregivers.

In the meantime, this is the right moment to share two blog posts I wrote from a past winter storm/blizzard. They contain info about prepping clients' and the caregivers' homes, and other important information. Please review this and then get into action to get ready.

Who Will Shelter Your Elder Loved One in an Emergency?
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First Possible Winter Storm Coming, Eastern Massachusetts 
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Easten Massachusetts Winter Storm Forecast Upgraded To a Blizzard
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Intro to Habilitation Therapy for Alzheimerʼs Disease &
Related Dementias

Habilitation Therapy (HT) is considered by the Massachusetts Alzheimer’s Association to be the best caregiving practice that exists today. Learn about this comprehensive behavioral approach that will help both dementia patient and caregivers alike, which can help improve their quality of lives dramatically. HT helps difficult symptoms be reduced or eliminated, regardless of what stage of the illness the patient is current experiencing, by skillfully adapting to the capacities of the patient and communicating accordingly. Habilitation Therapy helps caregivers have positive and successful interactions with dementia patients, reducing stress, allowing greater enjoyment of each day.

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Truths & Lies I Told My Father

A person with dementia can be said to be inhabiting a different world with a different reality than the rest of us. Habilitation Therapy (HT) tells us that they cannot leave there to be with us, no matter how much we may want them to. (Alzheimer’s Association, 2011) It is the job of care partners to be with that person by traveling to their world. This is done by understanding what they are experiencing, and respecting — never negating — their experience.

If, in the world of a person with Alzheimer’s Disease or a related dementia (ADRD), she is 8 years old (not 80), and waiting for Mother to pick her up after school to go home and milk the cows, then that is the world to which care partners must travel. It doesn’t matter a bit that Mother died 50 years ago because that is not true in the reality where the person with dementia is living... (see the rest of this article here)

Alzheimer’s & Dementia: Environmental Impact

While vigilance must be maintained and approaches honed as the disease progresses, simple but vital changes to the dementia patient’s environment can make a real difference in quality of life, safety and ability to function more independently. Applying our understanding of what isn’t working right in the visual cortex of the ADRD brain is central to creating the right interventions.

Here follow some concrete examples.... (see here for the rest of this article)

Alzheimer’s & Dementia: Emotions Rule

Habilitation Therapy (HT), a comprehensive behavioral approach to caring for people with Alzheimer’s Disease and related dementias (ADRD), is considered to be a best practice by the Alzheimer’s Association (Alzheimer’s Association, 2012). HT is best used for every interaction a person with ADRD has with their care partners, from the moment they rise until they fall asleep at night. One of Habilitation Therapy’s primary goals is to create day-long positive emotional states for dementia patients (Alzheimer’s Association). His or her capabilities, independence and morale are thoughtfully and continuously engaged to produce a state of psychological well-being.

Why such an enormous focus on emotions?.... (see the rest of this article here)

Alzheimer’s & Dementia: The Eyes Have it

Seeing is believing, yes? In our day-to-day world, we believe that what we see around us is pretty much what others with healthy eyes can see. We see a clear glass filled with milk sitting on a white table, and we assume that others can see a clear glass filled with milk sitting on a white table, too.

But that’s not necessarily true if someone has Alzheimer’s Disease — they may only see the white table. Though it is not widely recognized, it is a fact that people with several types of dementia (but especially Alzheimer’s Disease) experience significant changes in the way their brains take in and interpret visual information, generally unconnected to eye health and function. These changes follow several predictable patterns that powerfully influence the behavior of people with dementia... (see the rest of this article here)

Habilitation Therapy for Alzheimer’s & Dementia

According to Silverman, Flaherty and Tobin (2006), …”[I]t is a better understanding of the psychology of dementia – how a person thinks, feels, communicates, compensates, and responds to change, to emotion, to love – which may bring some of the biggest breakthroughs in treatment….”

A parent, sibling or spouse has been just diagnosed with Alzheimer’s Disease or a related dementia (ADRD). In a somewhat perfect world, family members would receive an orientation to the disease, and learn how it affects their loved one’s behavior. They would quickly begin to learn how to deliver daily care and maintain best function. They would find out how to prevent many common, difficult behaviors, and address those that arise with some consistently applied, fairly easy-to-use psychosocial interventions.

The entire family and all other members of the care team in this somewhat perfect world would receive training and ongoing support to learn and apply Habilitation Therapy (HT), accepted as the best standard of care and psychosocial intervention by the Alzheimer’s Association (Massachusetts/New Hampshire Chapter), where it was first developed in the 1990s...(see here for the rest of this article)

Note: The following was published in our monthly column "Living and Loving: Elder Care in the 21st Century" in Gate House News' Concord Journal.  We will continue this theme of Alzheimer's and dementia in this blog with periodic articles on the subject.

The weeping elderly woman is pleading. “I want to go home! Please find out why my ride isn’t here!” Exasperated, her daughter snaps at her, “You are already home, mom! I keep telling you, why can’t you remember? You moved in with us last year!” More weeping, snapping, pleading and exasperation follow. Around and around this goes, several times a day. Both women end up beside themselves with frustration, sadness, anger, and fatigue.

While looking at books at their local library, a man suddenly jumps to his feet, announcing loudly to his wife, “I have to go to the bathroom, now!” Five seconds later, he wets his clothing, urine puddling around his feet. “I asked you to go before we left home and you refused! Why can’t you control yourself?! I can’t take you anywhere like this!” she says to him in despair and exhaustion. They are both embarrassed and ashamed, a wedge stands between them and tension hangs thick in the air.

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The National Private Duty Association (NPDA) recently asked us to present a webinar for a national audience of both professional and family caregivers to discuss the Habilitation Therapy curriculum recently developed by the Commonwealth of Massachusetts and the Alzheimer's Association.  I was certified in the first class given using this curriculum designed to help people managing Alzheimer's Disease and other related dementias.  The reception to our presenation was so good that the NPDA has asked us to present a series of three more webinars on the topic. We will post details on those as soon as they are scheduled. 

You can watch and listen to our webinar on Habilitation Therapy for Alzheimer's at your convenience.  Fill out the simple registration form to proceed.

Caring Companion Home Care of Concord, MA was selected by the industry's most prominent national trade organization, the National Private Duty Association (NPDA), to deliver a consumer seminar entitled "When Dementia Strikes: Managing Care and Making the Most of Each Day."  It will be delivered as a free webinar on May 16 at 3:30 PM EST.

Alzheimer's Disease and Related Dementias (ADRD) cause grief for families and increasingly complex cases for home care agencies. The Alzheimer's Association and the Commonwealth of Massachusetts have developed an innovative new program to train family and caregivers in the use of Habilitation Therapy to reduce the care challenges in these difficult cases.  Participants will learn about best practices in the industry as the country faces this growing challenge.

"We are truly honored to have been selected to deliver this information, among the roughly 17,000 thousand homecare agencies nationwide," says Caring Companion owner and long-time Concord resident, Jim Reynolds. "We owe this to our Concord office director, Dr. Deborah Bier, who has become a recognized expert on dementia and home care." 

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Capacity is limited. Reserve your Webinar seat now here.

Alzheimer's Disease and Related Dementias (ADRD) cause grief for families and increasingly complex cases for home care agencies. The Alzheimer's Association and the Commonwealth of Massachusetts have developed an innovative new program to train family and caregivers in the use of Habilitation Therapy to reduce the care challenges in these difficult cases. Come learn about best practices in the industry as we face this growing challenge.

Bios of Presenters

Dr. Deborah Bier has been certified to train dementia caregivers and coach dementia families in Habilitation Therapy -- an approach recommended by the Alzheimer's Association that serves as the basis of a cutting-edge program recently developed by the Alzheimer's Association of Massachusetts and the Commonwealth of Massachusetts. As District Director of Caring Companion Home Care, Dr Bier was in the first class certified in this new program. She has a 25-year career as a counselor and agency director helping multi-generational families apply wellness approaches to managing chronic illness.

Jim Reynolds, CEO of Caring Companion Home Care outside Boston MA, has established CCHC as a leader in developing innovative technology and care solutions applied to elder care. CCHC has been praised for their unique proprietary family communications platform as well as its focus on wellness and use of Habilitation Therapy to care for ADRD clients.

After registering you will receive a confirmation email containing information about joining the Webinar.

http://www.musicandmemory.org/

New technologies to help seniors, the disabled and their caregivers are being launched every day. It's a huge, growing industry worth billions of dollars annually. But there are so many new products and services coming to market that most people feel confused and overwhelmed.  Do these devices mean  real aid for aging in place, or just a new way to part elders with their money?

Learn how to sort out the "toys and gadgets" from the helpful technologies on the market today. "Aging, Disability & New Technologies: Real Hype or Real Help?" Instructors Jim Reynolds and Deborah Bier, PhD will help participants make more wise choices in this bewildering, rapidly expanding marketplace.

The session will review some of the

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Caring Companion Home Care has adopted and trains our caregivers in habilitation therapy when caring for clients with Alzheimers Disease and related dementias (ADRD). This approach was developed at the Massachusetts Chapter of the Alzheimer's Association, and is considered to be the best standard of care for all types of dementia. Sadly, it is not in as widespread use in all aspects of elder care as it should be.

Habilitation therapy is a comprehensive behavioral approach to caring for people with dementia. It focuses

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Note: The following was published in our monthly column "Living and Loving: Elder Care in the 21st Century" in Gate House News' Concord Journal.  We will continue this theme of elders and emergency preparedness in this blog with periodic articles on the subject.

We are now in the middle of the Holiday Trifecta -- Thanksgiving is past, and the year-end holidays are around the corner.  Holidays can be especially stressful for those of us whose parents may be declining. This covers a wide range -- in some cases, it can be as simple as realizing that you will need to begin to devote regular efforts to help a loved manage through daily life; in others, we might face the grief of knowing, or fearing, that this is probably the last holiday season together.

Because remote family members visit so often during the holidays, we often receive requests at this time of year to help assess whether someone is still safe, and to identify the kinds of help available and what might be needed.  We also notice enormous stress in uncertain adult children hoping to do the right thing with their parents while navigating uncharted waters.  In this column, we will provide holiday visit guidelines, from how to manage a short trip to considering whether a member can continue to live alone, safely and unaided.

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There are plenty of quotable quotes about aging to go around; the ones below particularly appeal to me. They feel truthful, they're upbeat, and they demonstration that our cultural youth bias is just plain incorrect.  These all focus on the power and possibility of later years. I start with the Concord (Massachusetts) authors -- living here for so long, I just couldn't resist.  Enjoy them all, and add any of your own favorites in comments.

To keep the heart unwrinkled, to be hopeful, kindly, cheerful, reverent that is to triumph over old age.
Amos Bronson Alcott

The age of a woman doesn't mean a thing. The best tunes are played on the oldest fiddles.
Ralph Waldo Emerson

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You want your loved one with Alzheimer's Disease or related dementias (ADRD) to be cared for at home by someone experienced in meeting their needs, right?  Someone trained specifically to care for those with dementia.  Of course!

But does experience really mean that home caregivers are offering the care that's truly right for people with such diseases?  All too often, the answer is: NO.  Caring for dementia patients is specialized and requires training for a set of skills all-too-often missing in the homecare setting.

Did you know that dementia-specific training is not included in home health aide or nursing assistant certifications? "While many home care aides have experience with dementia patients, few are actually adequately equipped to do so," said Deborah Bier, PhD, the director of Caring Companion Home Care's metrowest Boston, MA office located in Concord, MA. "As a result, many don't know or use the best, most proven approaches -- the very ones that dementia patients and their families most benefit from."  The result can be challenging behaviors difficult or even impossible to manage in the home setting. But proper training for homecare workers can help make the difference between patients being able to stay comfortably (and less expensively) at home or being institutionalized.

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Anyone who works at a Massachusetts home care agency is surrounded by a wealth of resources, but none of them is more valuable than Joanne Koenig-Coste, the nationally-known author of Learning to Speak Alzheimer's.  Joanne spoke recently at Newbury Court, an assisted living facility in Concord Massachusetts, on her passionate devotion to people with Alzheimer's over the past 40 years.  At Caring Companion, we recommend her book over all others to families and those who work with Alzheimer's people.  Anyone who has heard her speak knows that her compassion and energy flow freely from her, and many more ideas flow from her than can be captured in a single blog post. Rather than try that, I have captured three great ideas from her recent address. I'll blog on others at another time.  So for this week, here we go from Joanne:

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