I spent half of Jaws under my seat and have not watched horror movies since. This seems like one. I can't see, my feet hurt and there is constant noise. This is just like that party last week.

The four of us from Caring Companion Home Care are starting a "virtual dementia tour" at Atria in Kennebunk,. ME.The form asks: Do you feel confused, anxious, disoriented? I don't know what is going to happen. Maybe anxious. 

We each put plastic soles with spikes face up in our shoes. Next are yellow goggles and big gloves. Lastly, ear buds playing constant noise- I keep trying to hear what the people are saying but it is a jangle of ...well, noise. Susan leads me into an apartment, promising not to leave me and asks me to do four tasks. I immediately forget number four. 

1- Find and put on the white sweater. I head for the bedroom, walking slowly and hunched over because I can't see my feet. My co-worker (at least I THINK it is Maggie) is folding clothes on the white bedspread. That wasn't on my list - or was it? The sweater is not there but here it is in the white closet. 

2- Write three sentences in a letter to your family and put it in the envelope. Is the paper in the bedroom? No. Kitchen, no. Score! Living room. I can't see if my pen is writing and jeesh, I can't feel the paper to rip off the pad. These people are mean and I now hate envelopes. 

3- Set the table for four. They didn't get me this time. Only 2 mats are out. But, dang. Paper plates. How many are here? Plates and mugs, not so bad. I can't feel the weight of the plasticware. 

I hear Maggie asking questions. "She won't answer you!" I yell. I can hardly hear myself. Can she hear me? She is counting out her tasks and says "water". That's it! My fourth thing. I feel around for the clear plastic cup. 

Yay, I win. What do I win? Awareness of fear, frustration, disorientation and wanting help, feet that still tingle and thankfulness that I do not have dementia. 

Susan gives us therapy...er...talks to us about the experience. We talk about color contrast and keeping items where they belong. It's hard for dementia patients to see white on white which is why it's a good idea to use colored plates so they can see their food. It's good to greet someone from the front, waving hello, saying their name aloud and extending your hand. I can see that these steps will help to orient someone. 

An hour later, we have put the episode behind us. Because we can. I am so glad I can. 

Will the weather outside be frightful? Read the following to help prepare yourself and your family for this winter’s “big one”.

Each June in Florida, hurricane preparation begins. Personal “Hurricane Boxes” are stocked and insurance policies
checked. When Home Depot runs out of plywood (to cover windows), stores run out of bottled water and more than a #1 level hurricane is approaching, reality hits.

After being without electricity for several days, I have learned the following lessons- the hard way:

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I am in the tail end of the baby boomer generation and the elder care industry is preparing for the Silver Tsunami we will create. I suspect that you, as well as I, have pretty much not prepared ourselves for the health care and end-of-life care we will need.

As my father's disease progresses, I find that what I am learning for my work for Caring Companion Health Care is extremely helpful for my own family. Hospice started working with my father and mother about 18 months ago. Our hospice social worker provided answers to every question I could come up with and gave us emotional support. They are a wonderful, caring, and knowledgeable group of health professionals.

I was lucky enough to attend the recent hospice conference in Bangor, ME. Women I had not met talked to me in the buffet line, at my table and in the halls. That conference room was full of kind people, working in health care. The woman seated next to me, quietly left the room during the key note speech and returned with a muffin. When I whispered "Where did you get that?" she offered it to me. I glanced down at her nametag, already guessing; yes, she was a hospice social worker.

The first thing Dr. Ira Byock, (palliative care expert, author of three books, a Dartmouth professor, and a frequent TV and radio guest), said was: "I have some bad news that I hate to tell you, but...we all are going to die". After about two seconds of shocked silence, the laughter erupted.  Of course we are all going to die, but how often do we talk about it?

Did you know that hospice is available starting 6 months before death? Right now, 1/3 of the patients use it only for 7days or less. Hospice actually provides many kinds of care, including pain management, while not hastening or postponing death, just making it easier. Dr. Byock pointed out that the end-of-life has many aspects. Relationships can be resolved. Families can talk about the meaning of life.

The most important thing I learned that day was actually the basis of his book, The Four Things That Matter Most About Living.

When your loved one is dying and you don't know what to say, say these four things:
1- Please forgive me
2- I forgive you
3- Thank you
4- I love you

As Dr. Byock says, "You will never be sorry that you did."

We sincerely appreciate our caregivers and we thank them often. The work they do, their devotion and our work have brought tenderness into my life. I often tell my coworkers that my job has changed me. I am not making that up, anticipating my next raise!

Back in the dark ages, I found socializing to be awkward, embarrassment-inducing and

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I posted recently about a Johns Hopkins study on aging senior citizens: For Older Adults, Participating in Social Service Activities Can Improve Brain Functions. Today's story is about a man who could be Exhibit A for this point: local hero Al Armenti.

Al is well-known in his home town of Concord MA.  Well into his 90s, he is very active in many social service activities, in his church (First Parish in Concord, a Unitarian Universalist congregation), and in music circles.  He is a combat veteran and has been a peace activist for decades.  Recently, I received an email from Al reporting on his participation in the St Patrick's Day with the Veterans For Peace.  He writes by way of explanation that "As a long-standing member and, because of my age, I was allowed to ride in the back seat of an open convertible."  That's okay, Al, I hope that if I am still fighting the good fight when I'm nearly 100, someone gives me a ride in the parade, too.

Although it seems that Al has been a dedicated member of Veterans For Peace for since the Revolutionary War, his participation is somewhat more recent.  This is not a small commitment: a few days before the parade, Adrian Walker wrote a column in the Boston Globe about VFP's efforts to march in the traditional St Patrick's Day parade:  Antiwar Veterans Group Battles to March in St Patrick's Day Parade.  Al also sent along a video of the event (he appears in the red convertible toward the end).

The picture above at the right is Al playing his mandolin, which he still does in public.  One of his favorite songs is Pete Seegar's humorous My Get Up and Go Has Got Up and Went.  Delivered with a twinkle in his eye and an engaging smile, the song as Al sings it is clearly ironic.  His 'Get Up and Go' is doing just fine.

So here's to you, Mr. Armenti! You aren't old - you have just been young for a very long time!

Karen Tannenholz works in our office, and last summer she faced the kind of sudden medical emergency we help many people through. Stressed families often imagine their circumstances are unique, but Karen’s story reveals threads common among many: feelings of growing confusion, helplessness, stress, anger, and even humor are all normal. Ultimately, deeper appreciation of each other can emerge as we navigate together through some of life’s most difficult passages. To hear Karen’s story, click 'Read More' below:

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Concord Park in West Concord, MA announced the opening of The PhotoVoice Project, a distinctive exhibit featuring the photographs and writing of older adults living with memory loss (see video below for a view of last year's exhibit in a sister community in Hopkinton, MA).

The Opening Reception for the exhibit is Thursday, November 29, 2012 from 4:00-7:00pm at Concord Park located at 68 Commonwealth Avenue, Concord. The public is invited to attend to view the works and will have an opportunity to meet the artists.

The PhotoVoice Project was developed by several researchers at the University of Michigan to enable individuals with disabilities to identify, represent and articulate aspects of their lives by working with cameras to capture images of interest and then giving meaning to those images through words.

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The "Sages and Seekers" program will be unfolding again at Concord, MA's Concord Academy. This program brings "Sages" over 65 and "Seekers" among the CA student population together for 8 weeks to learn about one another. This excellent video shows the program from several viewpoints.

They are seeking several Sages to participate in this semester's program, which begins next week. If you are interested in being part of the event, please  contact the creator and coordinator, Ms. Elly Katz at  508 444 8821, 508 333 0490 (cell) or This email address is being protected from spambots. You need JavaScript enabled to view it. .

Course instructor Deborah Bier, PhD (photo, below right) has been a health care educator, author, and wellness coach for over 20 years. She holds a doctorate in therapeutic counseling, and has helped hundreds of individuals and families to live better with chronic illness and disability. She is the director of the Concord, MA office of Caring Companion Home Care. (www.CaringCompanion.Net) and has lived in Concord for 30 years.

Middlesex Community College's MILES Program (Middlesex Institute for Lifelong Education for Seniors) offers intellectual stimulation, interaction, and friendship for adults ages 50+. Some of the topics explored through MILES include history, politics, arts, fitness, health, safety, music, computers, internet, travel, business, psychology, law, poetry and opera. Courses have no term papers, exams or grades, and are held at their Bedford campus. They are facilitated by individuals with expertise in topics based on professional, educational or personal experience. Semester membership fee of $95 includes access to all MILES courses. MILES is an afffiliate of the Elderhostel Institute Network.

For more information or to register, call 781-280-3570 or e-mail Chris Lindsey at This email address is being protected from spambots. You need JavaScript enabled to view it. . Find a list of all their courses here. To reach the instructor, email This email address is being protected from spambots. You need JavaScript enabled to view it. .

The upcoming film, Last Will and Embezzlement, starring Mickey Rooney and a host of legal and elder experts, will shine a light on the huge and growing problem of financial abuse of elders. The movie-makers' hope is to help those who have potentially-vulnerable adults in their lives to be on the look-out for signs of victimization, and maybe even make some waves in the communities where the rights of these citizens are not being looked after and protected by the public servants and law enforcement officials who are charged with that responsibility.

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Aging has changed during the past generation.  From an elderly woman choosing to live alone in Belmont, MA rather than enter assisted living, to a Concord wife with mild dementia struggling to provide senior care for her ailing husband, to a Bedford couple in their 90s and still home with outside help, we see many more families with elders who have moderate to significant needs. Those terms of care can stretch into years.

This requires a change in attitudes and expectations for families to reduce their stress. It’s necessary to reset our expectations and assumptions that result from such widespread changes. Let me illustrate with a story.

Ted and Mikie

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Hi Deborah,
I read your article online about normal forgetfulness and wanted to ask where you would turn if you were 44 and worried about this.  I do live with quite a bit of stress (divorce, own business, a somewhat mentally abusive boyfriend, etc), and have always been a multi-tasker who doesn't like to focus on details.  Since high school, I've been awful with names and memories of long term events.

So it didn't concern me when my boyfriend became concerned I didn't remember seeing a movie (I slept through it), or that we discussed something.  We had a rocky relationship and I thought he was excusing his behavior.  Recently, though, I had an intern work 3 months for me, and when a month later I tried recalling his name, I could not for the life of me remember until I looked it up.  If you think I should worry?  I've mentioned this to my primary and they excuse it to juggling.

On the bright side, I've noticed I am able to remember more things now that I've left the boyfriend, but I want to double check... Thank you!!  -- Signed, Worried

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The post below is adapted from an except of our white paper, Re-Imagining Home Care: New Needs, New Approaches.  This is the 2nd in a series of of 11 posts.

Ted and his wife Marian – everybody called her "Mikie" – retired to Cape Cod in the 1970s. In 1984, at only age 60, Mikie was diagnosed with terminal cancer.  Its progress was quick: she received home medical care from visiting nurses, but within six months, with her children at her bedside, she died.

Home care aides were soon back at the house, however.  Years earlier, a stroke had left Ted with limited mobility.  He was able to walk with a cane, and even to drive short distances; he could manage through a day. Now a widower and alone, he declined noticeably and was in a wheelchair within a year.  So after a family conference, the home care aides returned: twice daily visits for meal preparation, medications, grooming, hygiene, and related needs. But Ted spent his days in his wheelchair watching TV reruns.  His adult children, with jobs and families off the Cape, visited often and managed his care from afar, but they were sometimes unaware of changing needs or significant events until they came for weekend visits and read the care log kept on the kitchen counter. Otherwise reasonably healthy, Ted’s daily routine did not change much until he entered a nursing home 16 years later, in 2000.

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I had lunch with my mother at her home earlier this week. She also invited Tillie Sweet, whom I know from Concord's Medical Reserve Corps, but hadn't seen for quite some time. Tillie is a registered nurse who's had a varied and fascinating career, and it was a delight to see her again and to hear her stories.

It turns out that Tillie had been a part of early innovations in home care. She told us that around 1981, she answered an ad from BayPath Elder Services. They were looking for their very first RN to be part of a brand new, innovative program. Those crazy kids were going to try to keep seniors in their houses and out of nursing facilities by delivering personal care and homemaking services right where they lived!

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Toot

This is what it's all about! On the heels of our 100-mile Alzheimer's Memory Ride fund-raiser, here is the story of a man whose efforts cast ours in a pale light.  Carleton-Willard Village resident Bob Sawyer of Bedford, MA, is an active cyclist approaching 90 who might easily have given up when his health declined.

But he didn’t, and those around him didn't, either. In a recent article in the Boston Globe, Sawyer’s physician describes his “recovery as a case in which the presence of friends, the efforts of medical professionals, and the patient’s inner drive conjoined to turn a dire situation around.”

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Alzhiemer's

“So what’s it like to ride 100 miles with 4400 feet of vertical climb on a really hot, humid day in July?”

That’s the question I heard most often following Saturday’s Alzheimer’s Memory Ride.  And I'd like to answer it here: like many athletic challenges, the key to success is psychological – you have to be crazy! Fortunately, I was the right man for the job, and was joined by more than 50 similarly-minded folks.  I’m not a skilled cyclist – Concord has dozens of people who ride faster and farther and more challenging routes than I do – but I do it enough that I knew I’d be fine, and I really enjoyed the ride.

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