1. Frequently Asked Questions for Assisted Living, Home Care, Care Management, Hospice, Alzheimer’s and Other Dementias

2. What To Do When Placing a Loved One for Long Periods?

3. Protecting Caregivers Health

Answers

1. Frequently Asked Questions for Assisted Living, Home Care, Care Management, Hospice, Alzheimer’s and Other Dementias

What is Dementia?

Dementia is an umbrella term used to describe the loss of cognitive or intellectual function. Many conditions can cause dementia. Dementia related to depression, drug interactions, and thyroid and other problems may be reversible if detected early. That’s one of the reasons it’s important to obtain a professional assessment, so that the actual cause can be identified and proper care provided. Several other diseases also cause dementia, such as Parkinson’s, Creutzfeldt-Jakob, Huntington’s, and multi-infarct or vascular disease, caused by multiple strokes in the brain.

What is Alzheimer's?

Alzheimer's disease (pronounced Alz-hi-merz) is a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking and behavior. It affects an estimated 4 million American adults. When it was first diagnosed by German physician Alois Alzheimer in 1907, Alzheimer's disease was considered a rare disorder. Today, it is recognized as the most common cause of dementia. Alzheimer's disease is distinguished from other forms of dementia by characteristic changes in the brain that are visible only upon microscopic examination. Another characteristic of Alzheimer's disease is the reduced production of certain brain chemicals, especially acetylcholine, but also including norepinephrine, serotonin and soma-tostatin. These chemicals are necessary for normal communication between nerve cells.

What are the warning signs of Alzheimer’s?

The Alzheimer’s Association has developed a list of warning signs that include common symptoms of Alzheimer’s disease (some also apply to other dementias). Individuals who exhibit several of these symptoms should see a physician for a complete examination.
1. Memory loss that affects job skills. It’s normal to occasionally forget an assignment, deadline, or colleague’s name, but frequent forgetfulness or unexplainable confusion at home or in the workplace may signal that something’s wrong.
2. Difficulty performing familiar tasks. Busy people get distracted from time to time. For example, you might leave something on the stove too long or not remember to serve part of a meal. People with Alzheimer’s might prepare a meal and not only forget to serve it but also forget they made it.
3. Problems with language. Everyone has trouble finding the right word sometimes, but a person with Alzheimer’s disease may forget simple words or substitute inappropriate words, making his or her sentences difficult to understand.
4. Disorientation to time and place. It’s normal to momentarily forget the day of the week or what you need from the store. But people with Alzheimer’s disease can become lost on their own street, not knowing where they are, how they got there, or how to get back home.
5. Poor or decreased judgment. Choosing not to bring a sweater or coat along on a chilly night is a common mistake. A person with Alzheimer’s, however, may dress inappropriately in more noticeable ways, wearing a bathrobe to the store or several blouses on a hot day.
6. Problems with abstract thinking. Balancing a checkbook can be challenging for many people, but for someone with Alzheimer’s, recognizing numbers or performing basic calculations may be impossible.
7. Misplacing things. Everyone temporarily misplaces a wallet or keys from time to time. A person with Alzheimer’s disease may put these and other items in inappropriate places — such as an iron in the freezer or a wristwatch in the sugar bowl — and then not recall how they got there.
8. Changes in mood or behavior. Everyone experiences a broad range of emotions — it’s part of being human. People with Alzheimer’s tend to exhibit more rapid mood swings for no apparent reason.
9. Changes in personality. People’s personalities may change somewhat as they age. But a person with Alzheimer’s can change dramatically, either suddenly or over a period of time. Someone who is generally easygoing may become angry, suspicious, or fearful.
10. Loss of initiative. It’s normal to tire of housework, business activities, or social obligations, but most people retain or eventually regain their interest. A person with Alzheimer’s disease may remain uninterested and uninvolved in many or all of his usual pursuits.

What is Parkinson's disease?

Parkinson's disease (PD) is a degenerative neurological disorder of the brain related to a depletion of a neurotransmitter called dopamine. PD strikes people of all ages and ethnic groups. The average age of diagnosis is 60. However, 10 - 20% of persons with PD develop it before the age of 50. About half of these are diagnosed before the age of 40. The cause of PD is still under investigation, however there may be multiple factors including genetic predisposition and exposure to environmental toxins. Symptoms can include: Rigidity or stiffness of arms, legs or neck Tremors, mostly in the hands (at rest) Instability in posture or balance Slowness in movement Secondary symptoms may include facial "masking", depression, confusion, difficulties in speech or swallowing. PD affects individuals differently, but if managed carefully, each person can live well.

What are our Residential Options?

Independent Living
For seniors able to determine their own activities of daily living (ADL) … this is similar to apartment dwelling for retirees.
Assisted Living
For seniors no longer able to care for themselves in daily needs such as grooming, medication management, continence, feeding or physical movement, assisted living helps with these tasks. Silverado Senior Living communities go far beyond mere ADL care needs by engaging our residents with activities of their choice, surrounding them with sensory experiences, and enlivening them with pets, children, laughter and love.
Skilled Nursing
For those rehabilitating from some kind of medical condition (stroke, operation, etc.), skilled nursing facilities are typically hospital-like settings. Silverado now offers Skilled Nursing units in a few of our communities, allowing those needing rehabilitation services to reside in an uplifting and engaging environment.
Home Care
Home care is a way for families to enable their loved ones to safely remain in their home environment, through the assistance of hourly or live-in caregivers. Silverado At Home brings their Care Plan Program to this option, which includes creating an individualized care plan that collaborates the client, family, geriatric care manager, caregiver, and other invested parties (doctors, lawyers, other family members, etc.)
Hospice
Hospice is palliative end-of-life care. Palliative means comfort care, and the purpose of Hospice is to ease pain, and bring relief to the patient and their family. The process of life includes this journey. Hospice utilizes interdisciplinary teams including medical, spiritual, and psychosocial aspects, each bringing their own level of care and expertise to your loved one. Silverado Hospice additionally offers dementia care expertise to their list of specialties.

2. What To Do When Placing a Loved One for Long Periods?

Is the staff happy and involved with the residents?

Are there licensed nursing services onsite 24 hours a day, directed by a full-time R.N.?
What is the resident-to-direct care/caregiver staffing ratio?
Do you see residents restrained in wheelchairs, unattended and looking over-medicated?
Are residents involved in activities designed to eliminate feelings of boredom, loneliness and helplessness?
Is there a physician Medical Director with expertise in gerontology coordinating medical care?
Is there a full-time Social Worker on staff to help families?
Does the facility have outdoor areas that encourage exercise?
Is the outdoor area locked? 
Is the outdoor area accessible from the inside during the day? 
Does the facility have walking paths to encourage physical movement and help relieve frustration?
Does the facility have pets?
Do they allow residents to bring their pets to live with them?
What are the facility’s visiting policy and hours?
Are there any restrictions for children or pets?
What is the pricing structure? 
Is it a fixed rate or “tiered structure” with added unpredictable costs for increasing levels of care?
What happens if my loved one’s physical condition/behavior deteriorates? 
What would be the circumstances or medical conditions under which I would be required to move him/her? 
How often are residents discharged to hospitals and skilled nursing facilities for medical problems?
If a resident needs to go to the emergency room or hospital, does a staff member accompany them at no extra charge?
Does the facility provide care for residents at all stages of dementia – from early stages through hospice?
Does the facility collect data on clinical outcomes? 
What are the clinical outcome results for residents?
How is the Living Environment?
Is it homelike?
Is it carpeted?
Are there any unpleasant odors? 
Are the planned activities appropriate for the age/skill levels of the residents? 
Are there activities of interest to both men and women? Are there community?
outings or are residents isolated from the outside world?
What is the dining area like? 
Is food service available to residents 24 hours a day?
Are families invited to meals at no extra charge?
Are there routine care planning meetings and are the family and resident included?
Are the residents dressed and out of bed by 9 a.m.?

3. Protecting Caregivers Health

How do I know when it's time to seek help for the care of my loved one in order to maintain my own health?

A study of elderly spouse caregivers, aged 66 to 96: found that caregivers who experience mental or emotional strain have a 63% higher risk of dying than non-caregivers. Caregivers are often so concerned with care for their relative’s needs, that they lose sight of their own well being.

Please use the caregiver self-assessment questionnaire below to help assess your need for help. Please take just a few minutes to answer the following questions.

Answer Yes or No

During the past week or so, I have…

To determine the score total the number of "yes" responses.  Chances are you are experiencing a high degree of distress if your total score is 10 or more; you answered "yes" to questions 4 and 11 or your score on either question 17 or 18 was 6 or higher.

Next Steps:
Consider seeing a doctor for a check-up for yourself.
Consider having some relief from care giving. Contact the Silverado Senior Living community nearest you. Short respite care is also available, and every Silverado community offers support groups with free respite care during the program at no charge to you.

Consider joining any support group!