Thursday, November 1, 2012

Agressive Behavior in Patients with Dementia

There seems to be an increase in the amount of agressive behavior in patients with Dementia or Alzheimer's disease and families are struggling to understand how to deal with these behaviors.  I usually hear families say "I don't know why my father is behaving like this he was never agressive".   Families still don't understand Dementia let alone the serious issues of agressive behavior. 

Why do some patient's with Dementia develop agressive behavior and other's don't?  What causes this behavior?  And what can be done to control this behavior?  These are some of the most understood issues with this disease. 

First families need to understand that it is not the person but the disease causing the agressive behavior.  Usually this type of behavior occurs when the frontal lobe of the brain is affected by the disease Dementia.  The frontal lobe is where a person's personality and behavior sit within the brain. Some people with dementia involving the frontal lobe undergo dramatic changes in their personality and become socially inappropriate, impulsive or emotionally indifferent, while others lose the ability to use and understand language. It is important to have your loved one evaluated by a Neurologist or Neuropsychiatrist who specializes in Dementia in adults.  Once the right diagnosis is made then the patient can be treated appropriately and the family can be educated on what to expect with this very unpredictable illness.  

The signs and symptoms of this disease often vary from patient to patient.  It becomes progressively worse over time requiring 24 hour care.  Most behavioral changes that a person exhibits are;

  • Increasingly inappropriate actions
  • Loss of empathy and other interpersonal skills
  • Lack of judgment and inhibition
  • Apathy
  • Repetitive compulsive behavior
  • A decline in personal hygiene
  • Changes in eating habits, predominantly overeating
  • Lack of awareness of thinking or behavioral changes
  • Sudden Agression
  • Behavior can change without any warning

  • Once a person has been appropriately diagnosed treatment usually begins with using Antidepressants.  It is usually a long process to find the right combination of medications needed to manage the symptoms.  Often Antipyschotic drugs are needed but they can have adverse affects that need to be closely monitored because of the increased mortality in the elderly. 

    The more that families understand about the illness they can better manage their own behavior around the person with the illness. Families and caregivers can reduce behavior problems by changing the way they interact with the person who has agressive behavior with dementia. Examples include:
    • Avoiding events or activities that trigger the undesirable behavior (sometimes easier said than done).
    • Anticipating needs and alleviating them promptly
    • Maintaining a calm environment
    • If the person is telling a story you know if not true don't try to correct them or tell them it is not true.  Just listen and redirect the individual. 
    • Try to stick to routines.
    • Never assume the individual will not exhibit a specific symptom, remember the behavior can happen without warning. 
    Caring for someone with this type of  dementia can be challenging and stressful because of the extremes of personality changes and behavioral problems that develop. Family caregivers and family members need the support of their friends and professionals. Support groups provide a safety net for many family caregivers.  Put together a care plan that involves not only professional help but also help from others in your community such as church groups.  Often care provided by adult care centers or In-home care agencies are necessary to provide respite to the family.  When the person is end stage with their disease be sure to seek the support of Hospice care. 

    Living with a person with Dementia or Alzheimer's disease is a 24 hour a day job.  Caring for a person with Agressive behavior associated with the disease there just aren't enough hours in a day.  So reach out to others for help.  More more information on Agressive behavior contact us at Family Caregivers Network.  We can direct you to the right help you need.  For anyone who believes they can handle it by themselves or doesn't think it will ever get that bad read the attached article;
    Allentown Police: 86-year-old man shot and killed son

    Tuesday, September 4, 2012

    Anyone who has a loved one with Alzheimer's disease should watch this video.   We all wonder what happens to the brain and if there is anything more that can be done.  This video explains in simple terms what Alzheimer's Disease does to the brain ...  everyone can have a better understanding of this disease and the impact on families.   Share this video with your friends and anyone you know that could benefit from the information.  For more information on how to care for a loved one with Alzheimer's disease contact Family Caregivers Network.   

    Thursday, July 19, 2012

    Caregiving echos uncertainty and stress

    Change; whether change is positive or negative the emotions it echoes is uncertainty and stress.       When we talk about caregiving stress and uncertainty are the emotions that family members experience.  Their life has changed by taking on the role of caregiver.  The uncertainty of the future and the stress of their daily activities causes issues like eating disorders, lack of sleep, and medical problems like high blood pressure.   When you ask family caregivers how caregiving makes them feel, most say depressed.  Depression is the result of the stress and uncertainty of their particular situation.  They feel alone and without answers. 
    That is why it is so important for family members to attend support groups.  Support groups offer the comfort of knowing you are not alone and that others feel the same way.  Support group members provide guidance to each other with instruction tips of how to care for loved ones.  Suggestions of what works for one may help another caregiver’s situation. 
    Family Caregivers Network offers Caregiver Support Groups to family caregivers.  Our initial support group has been running for 12 years.  Held in Quakertown, Independence Court an Assisted Living Facility hosts our meeting on the last Thursday of the month at 6pm.  A second Caregiver Support Group is held the second Thursday of the month at our office in Pennsburg.   Tell your friends, neighbors, or loved ones who are caregivers about these Support Groups and encourage them to attend.   Call Family Caregivers Network
    1-866-539-7515 to attend one of our meetings.    If you live out of the area you can easily find a Caregiver Support Group near you.   Call your local "Office on Aging" or  "Children of Aging Parents" , 1-800-227-7294 to find out more about Support Groups.  

    “Your life does not get better by chance, it gets better by change.   Fear, uncertainty and discomfort are your compasses toward growth.”

    Tuesday, July 10, 2012

    How to Reduce Medication Errors

    Half of heart patients make medication errors within a month of being discharged from the hospital, according to a study conducted by Vanderbilt University Hospital in Tennessee and Brigham and Women's Hospital in Boston, published earlier this week in the Annals of Internal Medicine. Of the 50 percent who made errors, nearly a quarter (23 percent) was considered to be serious errors, and 1.8 percent were deemed to be potentially life-threatening, U.S. News & World Report noted.

    The study found even highly educated patients made serious medication errors, as did patients who were given guidance and individualized instructions by a pharmacist, according to MedPage Today. Patients who received a follow-up phone call from their physicians post-discharge didn't reduce the number of mistakes, the data showed. Despite intervention by pharmacists and medical staff, these frequent errors are cause for concern.

    There needs to be better supervision and management of medications in patients, especially older patients.  New automated medication systems have ensured better compliance with medication administration with less errors.  The Lifeline Personal Medication Dispenser does just that,

    Seniors rely on their medications to keep them healthy, but complex medication schedules can lead to mistakes: missing doses, taking incorrect amounts, or taking medicines at the wrong times. These mistakes could lead to unnecessary doctor or hospital visits, illness and even death.
    • For seniors, approximately 1 out of 10 hospital admissions are the result of the incorrect use of medications.*
    • Not taking medications correctly can have serious consequences, including increased discomfort, inadequate disease prevention and possibly even death.**
    • Lifeline is the only service with a 98.6 % dispensing adherence, among monitored subscribers. 
    For more information about the Lifeline Personal Medication Dispensing system contact Family Caregivers Network.

      Friday, May 25, 2012

      Heat Safety Awareness Day May 25, 2012

      The Hazards of Excessive Heat

      When the body heats too quickly to cool itself safely, or when you lose too much fluid or salt through dehydration or sweating, your body temperature rises and heat-related illness may develop. Heat disorders share one common feature: the individual has been in the heat too long or exercised too much for his or her age and physical condition.

      Studies indicate that, other things being equal, the severity of heat disorders tends to increase with age. Conditions that cause heat cramps in a 17-year-old may result in heat exhaustion in someone 40 years old, and in heat stroke in a person over 60. Sunburn, with its ultraviolet radiation burns, can significantly retard the skin's ability to shed excess heat. Acclimatization has to do with adjusting sweat-salt concentrations, among other things. The idea is to lose enough water to regulate body temperature, with the least possible chemical disturbance--salt depletion.

      The atmosphere and the windows of a car are relatively transparent to the sun’s shortwave radiation (yellow in figure below) and are warmed little. This shortwave energy, however, does heat objects it strikes. For example, a dark dashboard or seat can easily reach temperatures in the range of 180°F to more than 200°F. These objects, e.g., dashboard, steering wheel, childseat, heat the adjacent air by conduction and convection and give off longwave radiation (infrared), which efficiently warms the air trapped inside a vehicle.

      Heat Safety

      Child Safety Tips

      • Make sure your child's safety seat and safety belt buckles aren't too hot before securing your child in a safety restraint system, especially when your car has been parked in the heat.
      • Never leave your child unattended in a vehicle, even with the windows down.
      • Teach children not to play in, on, or around cars.
      • Always lock car doors and trunks--even at home--and keep keys out of children's reach.
      • Always make sure all children have left the car when you reach your destination. Don't leave sleeping infants in the car ever!

      Adult Heat Wave Safety Tips

      • Slow down. Reduce, eliminate or reschedule strenuous activities until the coolest time of the day. Children, seniors and anyone with health problems should stay in the coolest available place, not necessarily indoors.
      • Dress for summer. Wear lightweight, light-colored clothing to reflect heat and sunlight.
      • Put less fuel on your inner fires. Foods, like meat and other proteins that increase metabolic heat production also increase water loss.
      • Drink plenty of water, non-alcoholic and decaffeinated fluids. Your body needs water to keep cool. Drink plenty of fluids even if you don't feel thirsty. Persons who have epilepsy or heart, kidney or liver disease, are on fluid restrictive diets or have a problem with fluid retention should consult a physician before increasing their consumption of fluids. Do not drink alcoholic beverages and limit caffeinated beverages.
      • During excessive heat periods, spend more time in air-conditioned places. Air conditioning in homes and other buildings markedly reduces danger from the heat. If you cannot afford an air conditioner, go to a library, store or other location with air conditioning for part of the day.
      • Don't get too much sun. Sunburn reduces your body's ability to dissipate heat.
      • Do not take salt tablets unless specified by a physician.
      Heat Disorder Symptoms

      SUNBURN: Redness and pain. In severe cases swelling of skin, blisters, fever, headaches. First Aid: Ointments for mild cases if blisters appear and do not break. If breaking occurs, apply dry sterile dressing. Serious, extensive cases should be seen by physician.

      HEAT CRAMPS: Painful spasms usually in the muscles of legs and abdomen with heavy sweating. First Aid: Firm pressure on cramping muscles or gentle massage to relieve spasm. Give sips of water. If nausea occurs, discontinue water.

      HEAT EXHAUSTION: Heavy sweating; weakness; cold, pale, clammy skin; thready pulse; fainting and vomiting but may have normal temperature. First Aid: Get victim out of sun. Once inside, the person should lay down and loosen his or her clothing. Apply cool, wet cloths. Fan or move victim to air conditioned room. Offer sips of water. If nausea occurs, discontinue water. If vomiting continues, seek immediate medical attention.

      HEAT STROKE (or sunstroke): High body temperature (106° F or higher), hot dry skin, rapid and strong pulse, possible unconsciousness. First Aid: HEAT STROKE IS A SEVERE MEDICAL EMERGENCY. SUMMON EMERGENCY MEDICAL ASSISTANCE OR GET THE VICTIM TO A HOSPITAL IMMEDIATELY. DELAY CAN BE FATAL. While waiting for emergency assistance, move the victim to a cooler environment reduce body temperature with cold bath or sponging. Use extreme caution. Remove clothing, use fans and air conditioners. If temperature rises again, repeat process. Do NOT give fluids. Persons on salt restrictive diets should consult a physician before increasing their salt intake.

      Heat Stress in the Elderly

      Elderly people (that is, people aged 65 years and older) are more prone to heat stress than younger people for several reasons:
      • Elderly people do not adjust as well as young people to sudden changes in temperature.
      • They are more likely to have a chronic medical condition that changes normal body responses to heat.
      • They are more likely to take prescription medicines that impair the body's ability to regulate its temperature or that inhibit perspiration.
      Heat Stroke

      Heat stroke is the most serious heat-related illness. It occurs when the body becomes unable to control its temperature: the body's temperature rises rapidly, the body loses its ability to sweat, and it is unable to cool down. Body temperatures rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not provided.

      Signs and Symptoms of Heat Stroke

      Warning signs vary but may include the following:
      • An extremely high body temperature (above 103°F)
      • Red, hot, and dry skin (no sweating)
      • Rapid, strong pulse
      • Throbbing headache
      • Dizziness
      • Nausea
      For more information about Heat Safety contact the National Weather Service or request the Excessive Heat Events Guidebook.

      Tuesday, May 15, 2012

      May is Older Americans Month, a perfect opportunity to show our appreciation for the older adults in our community. Since 1963, communities across the nation have joined in the annual commemoration of Older Americans Month—a proud tradition that shows our nation’s commitment to celebrating the contributions and achievements of older Americans.

      The theme for Older Americans Month 2012—Never Too Old to Play!—puts a spotlight on the important role older adults play in sharing their experience, wisdom, and understanding, and passing on that knowledge to other generations in a variety of significant ways. This year’s celebrations will recognize the value that older adults continue to bring to our communities through spirited participation in social and faith groups, service organizations, and other activities.  As large numbers of baby-boomers reach retirement age, many communities have increased their efforts to provide meaningful opportunities for older adults—many of whom remain physically and socially active through their 80s and beyond. Current trends show that people over age 60 account for an ever-growing percentage of participants in community service positions, faith-based organizations, online social networking as well as arts and recreational groups.

      Lifelong participation in social, creative, and physical activities has proven health benefits, including retaining mobility, muscle mass, and cognitive abilities. But older adults are not the only ones who benefit from their engagement in community life. Studies show their interactions with family, friends, and neighbors across generations enrich the lives of everyone involved. Young people who have significant relationships with a grandparent or elder report that these relationships helped shape their values, goals, and life choices and gave them a sense of identity and roots. While Family Caregivers Network provides services, support, and resources to older Americans year-round, Older Americans Month is a great opportunity to show special appreciation for some of our most beloved citizens. We have many reasons to celebrate them!

      Family Caregivers Network is joining in the national celebration of Older Americans Month 2012 with activities and events to promote intergenerational engagement and recreation. We invite you to join in the fun! To find out how you can support Older Americans Month 2012, contact Family Caregivers Network.