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Home care is generally non-medical assistance offers in home setting. Usually the services are hired for adults who are not in a position to perform daily activities because of one reason or another. Apart from providing family members peace of mind, the adults receiving assistance remain at the comfort of their homes compared to being in a nursing home or facility which is depressing for some. It is important to remember that home care is different from home health care. Home health care requires registered nurses and trained therapists with medical qualifications to offer assistance at home..
Nursing Homes Versus Adult Daycare
CRS is, of course, an acronym for can't remember stuff. Memory is the second thing to go when we age; I used to know what the first one was, but I can't think of it right now. As a practitioner you have no doubt run across older patients who have problems with memory and concentration; and some who have actual dementia.
Mark Goodman Ph.D. believes that many patients diagnosed with Alzheimer's disease actually have dementia caused by a lack of vitamin B12. Dr. Goodman has an accredited Ph.D. in behavioral medicine (with a specialization in clinical neuropsychology) from the University of Maryland School of Medicine.
Dr. Goodman is quoted in an interview by Kirk Hamilton that appeared in Clinical Pearls. Dr. Goodman says, " I initially suspected vitamin B12 limits were too low, when I encountered on consultation, geriatric patients admitted with Alzheimer's diagnosis whose frontal lobe functioning was obviously intact. This is inconsistent with Alzheimer's diagnosis. They were exhibiting other global neuropsychological deficits with a systemic/metabolic profile. They were all following cardiac lipid- lowering diets."
He went on to say that he believed that there are many elderly individuals who are sub clinically B12 deficient. Many times these patients have normal blood levels of B12. He points out that people who are B12 deficient experience neurological changes before there is changes in their blood count (pernicious anemia) and that a good dietary history is an important part of the evaluation. According to Dr. Goodman, "In the convalescent facility diet there is little red meat due to expense and the desire to have residents on a lipid lowering regime. Also, there is a normal increase in gastric atrophy in the elderly which reduces vitamin B12 absorption. Thirdly, there is a down-regulation of the enzymes required for the formation and the manufacture of vitamin B12 when less vitamin B12 is consumed." Dr. Goodman points out that if there is no frontal lobe degeneration, the dementia is not Alzheimer's disease.
Dr. Goodman says that high doses of vitamin B12 are without any serious adverse side-effects. Some reports of reversible symptoms of diarrhea, cutaneous rash, polycythemia and possibly peripheral vascular thrombosis, but these are minor and reversible.
Curcumin is an antioxidant found in turmeric. Turmeric is a perennial plant, botanically related to ginger that is native to India, China and Indonesia. It is a component of curry powder and prepared mustard. It is used in traditional Chinese medicine and in Indian (Ayurvedic) medicine for its anti-inflammatory properties. The lowest incidence of Alzheimer's disease in the world is in villages in India. Only about 1% of Indians over the age of 65 get the disease. So, perhaps the consumption of curry may be the reason that there are so few cases of Alzheimer's disease. Curcumin, found in turmeric, has been shown to fight the build up of the amyloid plaques found in Alzheimer's disease. Dr. Sally Frautschy, of the University of California, Los Angeles, presented these findings at the 2005 annual meeting of the Society for Neuroscience in San Diego, California. Her paper was entitled: Curcumin Reduces Oxidative Damage and Amyloid Pathology in an Alzheimer Transgenic Mouse.
So the things that work for keeping the mind sharp are the same things that work for everything else. You need fresh produce as a source of natural antioxidants, good essential fatty acids, avoid trans fats, exercise and eliminate toxins.
Putting a loved one in a nursing home is a difficult decision regardless of the circumstances. In the case of Alzheimer's, most research shows that at some point in the progression of the disease a nursing home becomes the right decision for the family. According to the US Department of Health and Human Services, there are nearly 2 million people currently living in some form of nursing home. Over 90% of these residents are over 65 years old and most require 24 hour supervision due to some physical limitation or dementia. However, due to the increase in "familial Alzheimer's", aka Early On-Set Alzheimer's, there are many people in their 40's and 50's that are now requiring long term care.
A memory care facility is a specialized nursing home that provides - in addition to a room and food - full time medical (nursing) care and in-house rehabilitative services, along with close supervision to provide some measure of physical protection for the residents. The home will not be designed as an acute care facility, but the goal at an Alzheimer's care facility should be to help people maintain, as much as possible, their daily independent functioning.
It is obvious that when choosing a care facility or nursing home it is first necessary to consider the needs of the individual for whom you are providing Alzheimer's care. You must determine what special care needs the facility can provide. What type of therapy is available. Ask if these needs and therapy are handled by in-house staff or outside care. What are the qualifications of the individuals who provide these.
Before signing a contract for care at a specific facility you should fully review the contract and know your rights and responsibilities as the family and also those of your loved one as the resident. Review the admissions agreement carefully and have anything explained in detail that is not fully understood. Spend $150 or so to have an attorney review this for you if necessary. Do not sign any paperwork that has not been fully explained. The admissions contract should, at a minimum, contain the daily or monthly room and meals rate, any specific reasons for discharge or transfer from the facility (these items should apply to your family member if they do them or to anyone else in the facility if done to your loved one), and the policy regarding payment of the daily room rate if the resident goes to the hospital or the family brings the resident home for a short period of time. Is there a reduced or prorated rate or do you continue to pay full price to keep the room/space available?
You may question if you're really making the right decision to place your loved one in a facility at all. This is an agonizing decision that you will routinely question, but remember, you can do no more than your best. If you have done that, then you should not continue to ask more of yourself and know that you have done the best, as an Alzheimer's caregiver, for your family member.
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