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My wife has Alzheimer’s. Can she be affected by “Sundowning?”

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January 17, 2012

- Alzheimer's Care, Blog

“Sundowning” is the name of condition that results in a person becoming increasingly confused or agitated as the day wears on. While the actual cause of it is unknown, its occurrence can be somewhat predictable once a pattern begins. Fatigue, low lighting and increased shadows — the basis for the sundowning label — are factors known to bring on the condition. As they become more prominent during the day, an individual with Alzheimer’s tends to become more confused. Certain steps can be taken to make things easier on individuals with Alzheimer’s and their caregivers. For example, urging your loved one to nap after lunch, or at least have some “quiet time” during his or her daily schedule is a good idea. Relaxation can help a person “recharge” to deal with the rest of the day with less confusion or agitation. Create a good setting to promote relaxation by considering all five senses:
  1. put on relaxing music,
  2. get your loved one to a comfortable chair or bed,
  3. burn incense or a fragrant candle,
  4. dim the lights,
  5. turn on something that can create “white noise,” such as a bubbling water or a fan.
You can also gently massage her hands and arms with pleasant lotion. Always soothingly inform your loved one of the changes you are introducing, especially if you’re going to turn the lights off altogether or otherwise drastically change the atmosphere. This relaxation period is an excellent time for an outside volunteer (a neighbor, friend, church volunteer or other family member) to get involved your loved one’s care. It’s also a good way to get you, or whoever the regular caregiver is, a break from regular duties. Since shadows and darkness are what tends to make “sundowners” confused, make sure there is plenty of lighting after the relaxation period, and throughout the rest of the day. Placing nightlights throughout the living quarters is a good way to keep lighting up. To avert problems with sundowners who are in non-typical settings, such as a hospital room, be sure to keep familiar things on hand. These could include pillows, stuffed animals, a special radio or quilt and so on. As a person’s typical sundowning time period begins, try to keep him or her very busy. If they feel they are involved in something worthwhile, it could be enough of a distraction to lean toward neutralizing the agitated, confused behavior. More information on this topic, and others about living with Alzheimer’s disease, can be found in our free Alzheimer’s Resource Guide.  Whether you’re in Illinois or beyond, Alzheimer’s disease is a difficult challenge with which to deal. Don’t try to do it without help.
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Can a person lose speech with early-stage Alzheimer’s Disease?

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January 16, 2012

- Alzheimer's Care, Blog

Because Alzheimer’s affects individuals in different ways, at different rates, with different symptoms and at different times, it is impossible to say that no one with early-stage Alzheimer’s will ever lose the ability to talk. But it is not likely. If loss of speech happens at all, it is typically occurs in mid- to late-stage Alzheimer’s. The brain deteriorates and systematically starts to shut down certain body functions, one of them being speech. At first, a person might struggle with words, and then phrases or concepts. Eventually, entire sentences could be lost. There is also the possibility that someone will talk gibberish: He or she could be talking in full sentences but the words make no sense. Complications of neurological diseases such as Alzheimer’s could include mini-strokes, which could lead to the loss of speech. These mini-strokes, also known as TIAs (for transient ischemic attacks), are not uncommon in people with dementia. Sometimes, strokes come first and a person develops dementia secondarily. Severe strokes can result in the loss of speech. In these cases, time spent with a speech therapist can result in regained speaking abilities. It’s important to consult a doctor if speech is lost soon after a patient’s dementia/Alzheimer’s diagnosis. And, as always with such professionals, if you’re not satisfied with what you hear or how you’re treated, keep looking until you are. Consulting a specialist such as a neurologist is very important, too. Mini-strokes often may be too small to detect with an MRI, experts remind. Doctors who are experienced will be able to determine diagnoses through observation and interviews with family members. Although it is not common to lose speech with early-stage Alzheimer’s, you should always consult your physician whenever a medical condition like this is in question. Remember: Alzheimer’s treats people uniquely. While some characteristics — such as memory loss and insecurity — may be common, some symptoms may never appear in certain individuals. There are, for better or worse, few definites with Alzheimer’s. For more information about Alzheimer’s and how it might affect a loved one, check out the free, Indispensable Alzheimer’s Resource Kit from The Law Offices of Anthony B. Ferraro, LLC.      
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Should I automatically be concerned about wandering when Alzheimer’s is diagnosed?

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January 11, 2012

- Alzheimer's Care, Blog

Wandering isn’t a universal symptom of Alzheimer’s but it definitely can be a concern. Unfortunately, you won’t know if your loved one is a wanderer until he or she wanders for the first time. Each person with dementia travels through this journey at his or her own pace. Upon diagnosis of the disease, immediately register your loved one in the “Safe Return” program with the Alzheimer’s Association. Contact the national organization (http://www.alz.org) or your local Alzheimer’s Association for information about the program and how to enroll. When you register, you will choose the form of jewelry you would like your loved one to wear. The jewelry (a bracelet, pendant or other item) has the Alzheimer’s Association logo on the front and the wearer’s identification number on the back. Most people choose the bracelet because it can be worn with, or like, a watch. Even individuals who did not wear jewelry in the past typically will agree to wear a bracelet. Many caregivers have overcome a loved one’s suspicions or reluctance about wearing this special jewelry by ordering a second piece for themselves. When the caregiver is seen wearing it, the patient often drops resistance. It pays to plan ahead for a variety of situations. Talking with other caregivers at support groups about strategies, devices and interventions that have worked for them is a sound advice. You also should browse electronics stores to what the market has to offer. (The Alzehimer’s Store [http://www.alzstore.com] is a good place to look.) There are also agencies you can hire. They will assess your home and the patient’s living environment and make recommendations about them. Waste no time when you suspect you might have a wanderer. At the first indication, put a baby monitor in the bedroom at night so you can hear if and when your loved one gets up. Also, install safety devices in your home. And by all means, inform your neighbors. Of course, also talk with your physician about treatment for this symptom. When your loved one does wander, call 911 immediately. Many police departments give their officers special education about Alzheimer’s. This can include training officers how best to deal with wandering and other troublesome situations. Another way to prepare is to read an excellent book by Nancy Mace and Peter Rabins, “The 36-hour Day: A Family Guide to Caring for Persons with Alzheimer’s Disease, Related Dementing Illnesses, and Memory Loss in Later Life.” It is both informative and enlightening about the various stages of the disease and what you might encounter.
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Identifying with the person who has Alzheimer’s

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January 9, 2012

- Alzheimer's Care, Blog, Elder Law Articles

It’s said the best way to understand a person’s perspective is to “walk a mile in his shoes.” It’s true that no one can truly empathize with another’s situation without being in it himself or herself. But even when people are in the same situation, we know that each individual will respond to it differently.  The best way to understand how a person diagnosed with Alzheimer’s is feeling might be to read about the experiences of others in similar situations. Numerous people have written books and educational material that reflect on their personal experiences caring for someone with Alzheimer’s or other dementia.  You can “walk” together with others who have “been there.” At times it might be heart-wrenching to hear of their devastating experiences, but they also can prove helpful and educational. Your own emotions might be stirred, but you also might realize how your loved one might be feeling.  You might want to start with either of these books:   * “A Personal Journey Maze of Alzheimer’s,” by Dianna Friel McGowin (Dell/Doubleday Dell Publishing) * “Show Me the Way To Go Home,” by Larry Rose (Elder Books)  They’re available online, at your local bookseller and at your nearest Alzheimer’s Association outlet.
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How long can an Alzheimer’s patient survive?

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January 4, 2012

- Blog

A general review of various expert sources tells us that a person with Alzheimer’s disease can survive from three to 20 years after the first symptoms begin. The average length is about eight years.  Realize that individuals with Alzheimer’s progress at a different rates. Furthermore, not every victim experiences every symptom or ever stage. In addition, some people will plateau at a stage for a long time, while others might speed right through it to the next level. Alzheimer’s itself does not cause death, but it can be a contributing factor. The disease typically progresses to the point where the body’s organs begin to shut down. This, in turn, can cause myriad other problems. For example, some patients become bedridden. This can lead to deadly bedsores or other infections, or an illness such as pneumonia, which a patient might not be able to fight off. An excellent resource for families and caregivers can be purchased online or in bookstores. It is “The 36-hour Day: A Family Guide to Caring for Persons with Alzheimer’s Disease, Related Dementing Illnesses, and Memory Loss in Later Life,” by Nancy L. Mace and Peter V. Rabins. For further information please see the following links Alzheimers: https://abferrarolaw.com/chicago-illinois-alzheimers-caregiving-planning.html Medicaid (Don’t Go Broke in a Nursing Home): https://abferrarolaw.com/paying-for-nursing-home-care-in-chicago-illinois.html
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What is Dementia and How is it Related to Alzheimer’s Disease?

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December 29, 2011

- Alzheimer's Care

It’s important to know the distinctions between dementia and Alzheimer’s disease. The rates of individuals diagnosed with dementia and Alzheimer’s in the general population are both rising. But be clear that the terms are not synonymous. In brief, dementia is a syndrome or group of symptoms that causes loss of intellectual function and usually progresses over time. Alzheimer’s is the leading cause of dementia and the one we hear about the most. In other words, not all people who are diagnosed with dementia have Alzheimer’s disease. To explore it a bit further, consider that according to the American Heritage Dictionary of the English Language, dementia is the “deterioration of intellectual faculties, such as memory, concentration and judgment, resulting form an organic disease or a disorder of the brain. It is sometimes accompanied by emotional disturbance and personality changes.” There are conditions besides Alzheimer’s, such as depression, that also will cause dementia symptoms. Careful diagnosis of any dementia is essential in determining proper treatment and intervention. Some types of dementia are reversible, including: Parkinson’s disease, vascular dementia (stroke), Pick’s disease, AIDS, multiple sclerosis, Huntington’s disease, Wilson’s disease, Lewy body dementia, Creutzfeldt-Jakob disease, frontotemporal dementia and Wernicke-Korsakoff syndrome (alcohol-related dementia) Possible causes of reversible dementia include: depression, drug use, alcohol and other poisons, nutritional deficiencies, brain disorders, certain diseases, a metabolic condition, organ dysfunction, traumatic brain injury, brain tumor, hydrocephalus, syphilis, encephalitis and meningitis. Alzheimer’s disease is an irreversible dementia condition. However, with appropriate interventions, even irreversible dementias can be managed. Family caregivers should seek reliable education and other assistance wherever possible. A good place to start is the doctor’s office, which typically has resources to get families started with this difficult process. For more information on the different types of dementia, visit any of these websites:
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How the Tough New Medicaid Rules for Long Term Care Affect You!!

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December 23, 2011

- Blog, Medicaid and Paying for Nursing Home Care

As we have been anticipating for over a year now, the Department of Healthcare and Family Services (“the Department”) has finally adopted amendments to  “Medical Assistance Programs”, which can be found in 89 Illinois Admin. Code Part 120. These amendments will become effective on January 1, 2012, and will serve to implement the provisions of the Federal Deficit Reduction Act of 2005 (“DRA”) regarding Medicaid assistance for long-term care in Illinois. Before being finalized, the rule changes went through many different revisions. Myself and several other elder law attorneys participated in the review of these rule revisions. The rules that have changed are many and complex.  For example, the new rules change the lookback period for reviewing prior transfers to as far back as January 1, 2007. This means that the rules regarding transfers are being applied retroactively despite outcry from the elder law community and many other industry groups.  The new rules will be applied to persons who file an application for Medicaid long-term care assistance on or after January 1, 2012. Also, regarding asset transfers for which a Medicaid applicant has received less than fair market value, (for example gifts to children or other persons- other that  what the Department considers “incidental”), there will be a period of Medicaid ineligibility for long-term care. This period of ineligibility will not begin,  however,  until the Medicaid Applicant is in the nursing home, spent down to poverty level and a Medicaid application is filed. Then, and only then,  will the ineligibility period begin to run! More specificity about how the new rules are  implemented will hopefully be available once the state issues its Policy Manual about the new rules. As of this date, no revision to the Policy Manual has been published to reflect the new rules. Read more about the devastating impact these rules will have on the senior and disabled community and why “Senior” Estate Planning is more important than ever. A more in depth discussion can be found in the “Elder Law Articles” section of our website. Look for many future blog entries on this topic. This is a “sea change” in the way our taxpayer – clients will become eligible for Medicaid payment for their nursing home care in the days ahead.  
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