JustCare

Author: Emily Shearer

  • What are the signs of dementia?

    What are the signs of dementia?

    As we age, it is all too common to think that we are beginning to suffer from dementia.  Please be assured that small memory lapses are not signs of dementia.  What are the symptoms? Dementia is an umbrella term for a group of neurodegenerative brain syndromes that affect memory, thinking, behavior and emotion.

    Every person will experience dementia in a unique way, and symptoms can vary among different types of dementia. However, there are general similarities between and within types of dementia.

    Alzheimer’s Disease is the most common form of dementia, accounting for 50-75% of all cases. Other types of dementia include vascular dementia, dementia with Lewy bodies and fronto-temporal dementia. Together, Alzheimer’s Disease and vascular dementia make up over 90% of all dementias.

    The most common signs of dementia are memory loss and the loss of ability to carry out practical skills, which can lead to withdrawal from work or social activities. If you suspect these symptoms in yourself or a loved one, speak to your doctor about the possibility of a dementia assessment.

    The most common early symptoms of dementia include:

    • Memory loss: Memory loss, especially short-term memory loss, is the most common early symptom of dementia.
      • Example: A person with dementia may forget a conversation she had with her friend yesterday, as well as the time and place of the conversation.
    • Difficulty performing familiar tasks: People with dementia may forget how to do tasks that are normally so familiar we do them mindlessly.
      • Example: A person with dementia may forget how to prepare his breakfast, though he has done this every day for years in the past.
    • Difficulty with language: People with dementia sometimes forget simple words or substitute words in the wrong way.
    • Problems keeping track of things: A person with dementia may have trouble with usual tasks, such as bill paying, or putting things in their correct place.
      • Example: A person with dementia may place her keys in an unusual location, such as the fridge, rather than in their normal place near her bedside.
    • Changes in mood, behavior or personality: People with dementia can show differences in mood and personality, including rapid mood swings, increased suspicion, irritability or anxiety. A person with dementia may also experience less emotion than usual.
      • Example: A person with dementia has trouble remembering where he put his glasses, resulting in more agitation and frustration than usual.
    • Disorientation to time and place: Disorientation to time and place is sometimes a symptom of dementia. People with dementia may become lost in familiar places or confuse night and day.
      • Example: A person with dementia may forget the way home from work.
    • Poor judgment: A person with dementia may exhibit instances of poor judgment.
      • A person with dementia may dress in many layers even though it is warm out.
    • Decreased initiative: People with dementia may lose the motivation to perform day-to-day activities, perform hobbies, or engage in social activities.
      • Example: A person with dementia who normally loves to paint may express apathy towards beginning a new painting project.

    There are several benefits to early diagnosis of dementia, which you can read about here. Over time, symptoms worsen, resulting in the progressive loss of ability to carry out day-to-day activities. If someone you know has dementia, here are some tips to help make sure they are safe at home.

    [Editor’s note: This post was originally published on May 28, 2015]

  • Six reasons why you and your loved ones should create advance directives

    Six reasons why you and your loved ones should create advance directives

    Advance care planning is important for your peace of mind and for the people you love. You should begin care planning by creating an advance directive. An advance directive is a legal document that generally includes a living will and names a health care proxy. The living will states your wishes about your health care if you cannot speak for yourself and your health care proxy is someone you name to act on your behalf regarding your medical treatment if you are unable to speak for yourself.

    Here are six reasons why you and your loved ones should create advance directives, even if you’re in good health.

    1. An advance directive is free and easy to create. Advance directives need to be in writing, but creating one comes at no cost and is generally an easy process. Click here to learn what free resources are available and how to download a free advance directive.
    1. An advance directive helps you think about the goals you have for your health and health care. Making decisions about end-of-life care isn’t easy. Some people value prolonging of life over all else, where others prioritize relief of pain and suffering or the effects of one’s care on loved ones. Whatever you decide, planning ahead can help you consider these important issues and communicate them with your friends, family and healthcare providers in a time and place where you can think things through clearly.
    1. An advance directive helps you prepare for unexpected medical situations. Many people think that they do not need to plan for their care until they reach the later stages of life. However, end-of-life situations can happen to anyone. Creating an advance directive ensures you are prepared for any medical situation that may come your way.
    1. An advance directive comforts your family and loved ones. Caregiving is hard. It’s stressful to make an end-of-life decision for someone you love if you don’t know their wishes. And, it can cause friction within a family if people’s views are not aligned. Completing an advance directive and sharing it with the people you love helps bring your family together and provides comfort to them that they are following your wishes should they need to act on your behalf. An advance directive is a legal document that doctors and hospitals must honor. The advance directive ensures the people you love can make decisions on your behalf. 
    1. An advance directive allows your doctors and other care providers to better understand you and your desires. By creating an advance directive and sharing it with your doctors, you are telling them that you are informed and involved in decisions about your care. This can reinforce a meaningful relationship between you and your doctors that, in turn, can serve as an important source of emotional support during difficult times.
    1. An advance directive speaks for you when you cannot speak for yourself. Most importantly, an advance directive makes sure you are treated the way you wish to be treated, no matter what the circumstance. (Of course, if your treatment priorities change, you can change your advance directive.) Click here for a Jon Stewart interview of Dr. Atul Gawande about the value of  sharing your end-of-life priorities with the people you love repeatedly and over time.

    After you’ve created your advance directive, be sure to give a copy to your doctor as well as to the people you love. And, if you’re not ready to share it with the people you love, at least be sure they know where you keep it.

    To learn about Medicare coverage of hospice care, click here.

    [NB: This post was originally published on May 8, 2019.]

    Here’s more from Just Care:

  • Six things to know about your over-the-counter medications

    Six things to know about your over-the-counter medications

    Over-the-counter medications are drugs you can buy without a prescription to treat common problems. However, you should still use them with caution. A number of recent studies have revealed worrisome side effects from incorrect use of OTC medicines. Here are six things you should know about over-the-counter medications (OTC) to keep you and your loved ones safe.

    To minimize the risk of harmful drug interactions, always keep a list of all the drugs you are taking in your wallet (both prescription drugs and OTC drugs) and share the list with your doctors and the people you most trust. If you are getting headaches, diarrhea, constipation, or have a dry mouth, it might be a minor side effect of the drugs you’re taking; some side effects can be life-threatening, including severe bleeding or liver or kidney damage.

    1. Just because medicines are OTC does not make them risk-free. Do not assume that because you do not need a prescription for OTC medications that they are always safe to use. Depending upon the other medications you are already taking and your health condition, OTC drugs may be dangerous and can be toxic if overused. While it is generally okay to take the correct dose of an OTC drug for a specific problem (for example, taking ibuprofen to help relieve a headache), all medications carry different risks and benefits. If you have a complex health condition or simply have concerns about an OTC medication, check with your doctor before taking it. People with very bad symptoms, who do not know what is wrong with them, or with long-term medical problems also should check with their doctor before taking an OTC medication.
    2. Our knowledge about the risks and benefits of different OTC drugs is continuously changing. As with other areas of medicine, researchers are constantly learning new things about OTC drugs that change the way they should be used. For example, after receiving numerous reports of severe liver damage associated with the use of acetaminophen (the active ingredient in Tylenol), in 2011 the FDA changed the maximum amount of acetaminophen that could be contained in single OTC dosage to 325 mg. And the risks may differ depending upon your age, weight and medical condition.
    3. OTC drugs may interact with other medications you are taking. Just as two or more prescription medications can interact with one another, creating adverse or unintended side effects, OTC drugs can also change the way a prescribed medication works in your body. If you are taking prescription medications, including opioids, check with your doctor before combining them with an OTC medicine.
    4. OTC drugs may interact with diet or lifestyle factors. OTC medications can be harmful if they interact with alcohol in your system or certain foods in your diet. They can also affect other health conditions. Check with your doctor if you have specific medical or lifestyle considerations that may need to be taken into account when starting an OTC medication. As a general rule, you should not consume alcohol when taking any type of medication, unless your doctor gives you permission to do so.
    5. OTC drugs may affect older people differently. While everyone should be careful when taking medications, older people need to take extra caution. The body changes how it absorbs food and drugs as it ages; and, older people generally take more medications than younger people, putting them at higher risk for adverse interactions.
    6. Your doctor may decide to provide you with different treatments based on the OTC medications you take. Always report your OTC medications to your doctor, whether at check-ups or during hospital visits. Always let healthcare providers know about any medications you are currently taking, including OTC medicines.

    Many people take vitamin and herbal supplements to feel better. As a general rule, eating a healthy diet of foods with different vitamins is the best way to make sure you have the vitamins you need. Like over-the-counter drugs, vitamin supplements are not risk-free. Watch John Oliver explain the issues with vitamin supplements. You can learn more from about vitamin supplements on this site from Dr. Salomeh Keyhani, including vitamin C supplements, vitamin E supplements, vitamin B6 supplements, and vitamin B12 supplements.

    Dr. Keyhani’s evidence comes largely from Cochrane.org, which is an independent group that analyzes a range of studies and summarizes the best evidence from research. Also keep in mind that vitamin supplements you buy at the drugstore or other retail stores are not regulated by the Food and Drug Administration, and so they may not be what they appear to be, as the New York Attorney General’s office found. 

    Here’s more from Just Care:

  • Living well with dementia: The benefits of early diagnosis

    Living well with dementia: The benefits of early diagnosis

    Are you concerned that you or someone you love is showing signs of dementia? If so, the benefits of early diagnosis of dementia are significant. There are some treatments for dementia, including medications and psychosocial interventions. Without a diagnosis, there’s no way to benefit from them.

    The thought of getting a dementia diagnosis can be intimidating. Many people fear the idea of losing their independence if they are diagnosed with dementia or facing increased caregiving responsibilities if they suspect it in someone they care for.

    Dementia affects not only people with dementia, but also their families and the people who care for them. In many cases, certain lifestyle and environmental adaptations are needed at some point along the disease journey. About 3.4 million adults over 71 have dementia, almost 14 percent of that population.  

    The good news is that there are ways to maximize wellbeing while living with dementia, and no one should have to face the challenges of dementia alone.

    The benefits of early diagnosis of dementia should not be underestimated. Evidence suggests that when families feel well prepared and supported, initial feelings of grief are replaced with ones of reassurance and empowerment.

    Getting a diagnosis at early stages of the disease has three significant benefits:

    1. Enabling people with dementia and those who care for them to prepare for disease progression,
    2. Giving people with dementia the opportunity to make legal and financial decisions while they are still able to, and
    3. Giving people with dementia a better chance to benefit from drug and non-drug treatments that may delay disease progression and enhance their quality of life.

    Dementia is increasingly gaining attention at the national and international levels as an important health care issue, and there are now many resources and supports available for both people with dementia and their caregivers, including these from the National Institutes on Aging. You should also contact your local area agency on aging to learn about community supports and services. With proper planning and knowledge about the resources available, it is possible to help yourself or a loved one maximize happiness and independence while living well with dementia.

    Here’s more from Just Care:

  • How to prepare for your hospital stay

    How to prepare for your hospital stay

    Going to the hospital for an overnight stay, whether it is for a scheduled surgery or for medical tests, can cause irritation, stress, and even anxiety. Knowing how to prepare for your stay can help relieve these feelings, making your stay as comfortable and stress-free as possible. If you or a loved one has an overnight hospital stay coming up, follow these tips to help get ready.

    First and foremost, keep in mind that it is generally a big help to bring along a health care buddy–a partner or child or dear friend–who can make sure your needs are met, help ask questions of the medical team on your behalf, and keep track of all advice you’re given. You might check to see whether your buddy is permitted to stay overnight with you; and, if so, you should consider asking your buddy to stay with you in case you need help in the middle of the night. Hospitals are often short-staffed, particularly at night.

    What to bring

    When packing your bag for the hospital, be sure to bring these essentials:

    • Your current medications
    • Your health insurance card
    • A credit card
    • Toiletries, including a toothbrush, toothpaste, a comb, deodorant and a razor
    • Bed clothes and slippers and comfy clothes to wear on the way home
    • Accessories you need daily, such as hearing aids or glasses
    • Books, crosswords, magazines, or other fun things you can do in bed

    It’s best to leave valuables, non-essentials, and electronics at home.

    Information to have on hand

    Doctors or other hospital staff may need information from you during your stay. Be prepared to answer their questions by having the following pieces of information on hand when you check in at admissions:

    • Your health insurance information
    • A picture ID
    • A list of your current medications, including prescription drugs and over-the-counter medications, along with a list of any allergies you may have
    • Emergency contact information, along with advance directives (be sure to let hospital staff know you have a health care proxy or ask for a health care proxy form to complete)

    During your stay

    You may interact with a number of different healthcare professionals during your stay. Remember – it is their job to help you! Ask questions if you don’t understand something or want more information, whether it is about what is happening during your stay or about what the next steps are once you’re back at home. Before you leave, make sure you have the contact information of the individuals responsible for your care, so you can follow up with any questions that might come up once you’re home.

    For more information, visit the National Institutes of Aging or Brigham and Women’s.  Also keep in mind that hospitals have different patient safety records.  And some hospitals have lower rates of hospital-acquired conditions than others.

    Here’s more from Just Care:

  • The Five ‘Rights’ Rule for Taking Medications

    The Five ‘Rights’ Rule for Taking Medications

    We all know that both prescription drugs and over-the-counter medications can help keep us healthy. But, it is estimated that 50 percent of people do not comply with their medication regimens. About half of this non-adherence is intentional, because medications are expensive, (some are unaffordable), or they may have side effects that don’t feel good. People also may not understand their medication regimens and are therefore unable to follow them.

    The number of medications we take has steadily increased over the past ten years. And, this can lead to harmful mistakes when it comes to taking our daily doses.

    How can you make pill-taking safer for yourself and your loved ones at home? Hospital staff and ambulance workers frequently use the Five ‘Rights’ of medication management to help them give medications correctly.

    Before taking or giving someone else a medication, you too should follow the Five ‘Rights’ rule to keep you and your loved ones safe at home. Check that these five things are right:

    1. Right person (Is the right person taking the medication?)
    2. Right medication (Is it the right medication?)
    3. Right dose (Is it the recommended dose?)
    4. Right route (Is this medication being taken in the right way? For example, orally?)
    5. Right time (Is this medication being taken at the right time of day? Has the right amount of time elapsed between doses?)

    To help ensure the people you love are safe and healthy, make sure you have a list of their medications and follow these other tips. Also, make sure the primary care doctor knows all the drugs they are taking, both prescription and over-the-counter to avoid risky drug interactions.