brian on January 10th, 2012

Arthritis is debilitating and coupled with the other concerns that the elderly deal with the stiffness and pain associated with arthritis can be frustrating and frightening.

The major complaint by individuals who have arthritis is joint pain. Pain is often a constant and may be localized to the joint affected. The pain from arthritis is due to inflammation that occurs around the joint, damage to the joint from disease, daily wear and tear of the joint and muscle strains caused by forceful movements against stiff, painful joints and fatigue.

Simple day to day tasks that we take for granted are a challenge to those afflicted with debilitating arthritis. A short walk to the mail box can tax a person’s energy, leaving way for potential accidents. Any activity involving carrying objects can be made dangerous by the fact that the individual is in pain.

Due to the fact that the treatment for arthritis is both medical and physical this makes it an ideal ailment for which home care services might be required.

It has been known for physical exercise to help relieve some of the pain associated with arthritis due to the gentle moving of the joints in question. Doing basic exercises in your home, or a plan made by a medical professional, is something a friend, a family member or a caregiver can assist the elder with.

The other treatment for arthritis is medication. The main importance in using any medication is that it is taken on time and in the correct amount. At the moment the medicinal treatment for arthritis, due there being no cure, is pain relief medication.

If you have a loved one, of any age, who suffers from one of the many forms of arthritis the easiest way to make their lives easier is to be there for them. People love, and need to be, independent – however, when the pain strikes and they are having a bad day help them with the essential chores around the house and help keep their standard of living as decent as possible.


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brian on January 10th, 2012

It’s important to remember that anyone can be injured by doing labor intensive work outdoors, so it is of an even greater importance to proceed with extreme caution when you’re a lone senior. There are many ways you can avoid harming yourself whilst gardening outside. Here are some basic things that you can do to help prevent you from falling, collapsing, hurting your back or otherwise doing physical damage to your body.

Bending and leaning over can cause serious strains in your back, so it might be a good idea to invest into a light weight set of shelves for your safety and convenience. Our caregivers can help set up the shelves and prepare the area for ease of access so you can feel free to weed and water your potted plants. With our home care, you won’t need to worry about having to move anything heavy, bulky, or otherwise potentially dangerous.

If you prefer to move your plants around, we recommend purchasing light weight plastic pots and water jewels – colored plastic bubbles that shrink when dried and fill up when watered, these can sometimes make plant pots lighter due to the lack of wet soil. Though we recommend you ask home care provider for assistance, these bubbles can make it much easier for you to carry your pots around the garden.

As always we recommend insuring you’ve had plenty to eat and drink before going outside, to keep your energy up, and we recommend continuing to drink lots of water whilst you are gardening.

Our caregivers do their best to give you the highest quality of home care and offer only the best service achievable. If we can help you make your garden the safest, most relaxing garden you’ve ever experienced, then we will. Don’t worry about the difficulties of getting outside, our experienced professionals will make it their mission to assist you in any gardening endeavor.

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brian on January 10th, 2012

Taking medication can be frustrating for anyone. However, for the elderly medication is even more difficult as they are usually on many different types of medication. Making matters worse is that some of these pills look the same and different medications have to be taken at different times during the day. It can easily become confusing and difficult to keep track of. However, with a little organization a caregiver can help the elderly deal with their medication and make sure every pill is taken on time.

When receiving home care one of the first things a caregiver can do to help the elderly with their medication is to write down a list of all the medication in a notebook. Write down every pill, what it does, what time it needs to be taken and what the pill looks like. If this list is taken to a new doctor, a visiting medical professional or the emergency services, they can see quickly what the senior is taking. For a caregiver helping the elderly the list can help make sure all the medication is taken, it can serve as a check list. With a description of the medication written down, a caregiver can easily see if every pill that needs to be taken is present before the medication is given.

Another way to help the elderly, who choose home care, to take their medication is to use a pill box. Some pill boxes have the days of the week, while others can be personalized, with not only days of the weeks but different times. A caregiver can use the master list of medications they have made to fill each pill box. This way a caregiver can look in the pill box labeled with the time and date to see if medication has been taken or not. It is easy to tell if a dose has been missed.

With a little organization it is easy to help the elderly with their medications. Just be patient and thorough and many problems can be avoided.

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brian on January 10th, 2012

As we age things tend to become quite a bit more physically taxing and pain can begin to develop, due to illness or just plain old wear and tear, this is why it is important for people of old age to have access to the best care possible. Home care is one way to provide this, by doing tasks for the elderly that they have trouble doing themselves, and this can have a huge impact on their lives and reduces how much they have to deal with pain.

Pain can take many forms but often times it manifests itself as arthritis and other joint related conditions that cause shooting pains every time a movement is made repeatedly, that is why it is important to help out those in need to eliminate this unneeded pain. Caregivers can do things like housework and landscaping that the elderly would otherwise not be able to do (or very painfully), or be forced to pay out for manual labor and assistance.

Having an elderly person over-exert themselves can actually be dangerous, so if someone is suffering from an illness or can’t do certain tasks, it is wise to have another caring person take over it for them. Pain can also greatly reduce their overall quality of life and make even simple things seem like difficult tasks to overcome. Caregivers manage to provide so much by simply taking this burden off of the senior client.

Our caregivers who do this work are genuine and it shows that they truly care about the well-being of their elders, which has more of an impact than can really be measured on a day to day basis. Many lives are touched and overall quality improved when caregivers help out those in need, and the effect trickles down to more than just the people directly involved, which in turn ends up helping everyone.


brian on January 10th, 2012

Swimming is one of the best exercises for people of all ages. Recent statistics state that people who swim may actually live longer. This is great news for the ageing population and there is no age limit on swimming. Even people who are receiving home care can benefit from swimming because water holds up the body, less pressure is felt on joints, bones and muscles when exercising in the water. Water creates resistance and is a great way to build muscle while enjoying the freedom of movement.

Many indoor pools keep water warmer for seniors and those with disabilities. Caregivers can accompany seniors to their swimming classes, helping them with transportation and mobility problems.

There are classes available for those who want to do water exercise instead of just swimming laps. Everything from rousing zumba in the water to slow and steady water exercises are available. Going to a water exercise class can mean more for the person attending than just exercise. The companionship of friends exercising together is of benefit for all seniors. Those receiving home care may enjoy the chance to leave their home. It may be wise to look for a pool that uses one of the newer types of water purification systems when joining a swim class. Ultra violet light and saline water have now taken the place of chlorine in many public pools. These filtration systems make swimming easier on the older generations skin and eyes.

Keeping active is of the utmost importance for people of all ages, but it is especially true for those who are older and those receiving home care. Keeping the body flexible while building muscle can help with many of the everyday aches and pains experiences by the older person. Most doctors find that patients who swim can help alleviate back pain and other arthritic pain. Find a local pool and start the journey to better health with a swimming program designed to your abilities. Find the joy of swimming that many older people know about.


Rick on February 26th, 2011

It’s a rainy Saturday morning here in San Diego. The local weather services have been whipped into an absolute frenzy predicting the mother of all storms and 100 year record setting cold temperatures for the local area. There’s no question that this is a big Arctic system and that it’s raining outside, but I see some blue in the sky and I’m just not getting the whole natural disaster vibe. I believe they’re taking the brunt of this system due east of us. With this backdrop, it seems like a perfect time to crank out Part 2 of our blog series on Long Term Care Insurance (LTCI). We’ll take a look at the types of policies, what is covered and what we need to think about when evaluating various policy options.

Types of Policies

LTCI is usually available as a standalone product or on an employer sponsored, group insurance plan. The majority of policies are sold by insurance agents to individuals/couples.  There are many varieties and packages available. Where is the care to be received? Policies can be designed to pay benefits only when the insured is in a facility (skilled nursing  and/or assisted living) or only when care is received at home, or a comprehensive policy that pays regardless of where the care is provided.

Policy Features

Benefit amount – Amount the policy will pay; sometimes referred to as the daily benefit (DB) or maximum daily benefit (MDB).  Most LTCI policies are reimbursement policies. This means the insurance pays the actual cost of care up to the maximum daily benefit.

Daily, weekly or monthly? – The manner or formula that a policy uses is important and can provide either serious constraints or valuable flexibility for clients. Daily benefit policies typically have the lowest premium but provide the least flexibility for care at home. These policies will not reimburse more than the daily limit for care on any given day even if the expenses are actually higher. Many clients enjoy enhanced flexibility with a weekly or monthly home care policy. This is a good solution when little or no care is needed on some days and a lot of assistance is needed on others. For example, a daily limit policy with a benefit of $150.00 per day will never pay more than $150.00 for any given day. A weekly policy provides seven times this amount or $1050.00 per week. A monthly policy provides 30 times the daily benefit or $4500.00. If the care requirements are widely different during the week (for instance, if a client  only needs 2 hours help with a shower and breakfast on 3 days, but needs 10 hours per day for the other 4 days so the family caregiver can go to work, then a weekly or monthly limit is the way to go). This option allows a client to borrow from days when little or no care is needed to help pay for days when a lot of care is required. The only difference between a weekly or monthly policy is simply how often the pooling resets. 

Elimination Period – Also called a waiting period. Similar to the deductible found in an auto or homeowners policy. Please bear in mind that while a longer elimination period (deductible) may reduce premium costs, it also increases the amount of money the policyholder must pay before the policy begins paying benefits.

Benefit Period- Policies are available with an unlimited or lifetime benefit that can never run out, once a claim begins. They are also available with limited benefit periods for lower premiums. Options generally range from 2- 10 years. While these limited benefit periods are expressed as a unit of time, most contracts use the benefit period as a multiplier. For example, the total benefits are determined this way: daily benefit amount X 365 days X # of years in the benefit period = total lifetime benefit.  In this example, $150.00 per day x 365 days = $54,750 X 10 year benefit period = $547,500 total lifetime benefit. If the claimant received $150.00 in long- term care services each and every day, their policy limit would be exhausted in 10 years. How long would it last if the insured only used $75.00 in LTC services each day? 20 years. And if the services weren’t provided every day, it could last longer.  Before deciding on the length of the benefit period, please remember that while most nursing home stays are relatively short in length, there may be much longer periods prior to admission, for example at home or in an assisted living facility.

Inflation Protection – Very important. I’ve never seen or heard a client complain who purchased this added layer of protection.  Adding the inflation rider allows the insured’s benefit amount to keep pace with the ever increasing cost of healthcare and long term care. Usually a buyer can select from the following menu of inflation protection:

  • Simple Inflation A typical annual increase of 5% is based on the daily benefit amount originally purchased. Using 5%, simple inflation doubles the daily benefit and the maximum total benefit every 20 years.
  • Compound Inflation – Annual increase is based on the daily benefit compounded annually. Using 5%, compound inflation doubles the daily benefit and the maximum total benefit every 15 years.
  • Guaranteed Purchase Option – The premium starts much lower than with an automatic inflation option.  The insurance carrier then offers a guaranteed option to periodically buy more coverage in the future, typically every 1 – 3 years. Premiums increase with each purchased benefits increase, and the added coverage is priced at the insured’s current age, thus adding to the increased cost.

Inflation protection is so important that it must be offered to policy applicants. It’s hard to say which type is best for each individual applicant. A general consensus is that compound inflation is the most appropriate protection for applicants under age 70, because the benefits grow the fastest over time. 

Guaranteed Renewable - It is mandatory that LTCI policies be guaranteed renewable. This means the insurance carrier cannot cancel the policy or change the benefits as long as premiums are being paid. This does not mean the premiums are guaranteed to remain the same (fixed). LTC insurance companies can raise rates if they are needed to pay claims and are approved by the regulators. The rate increase is filed based on the experience of a series or entire class of policies, unlike an auto policy which sets rates based on an individual’s personal claims experience.

Also, please remember LTC insurance policies do not annuitize. In other words, with an annuity, the holder pays in for several years and then turns on the spigot and the policy pays out. An LTC insurance policy is more like your homeowner’s policy in this regard. It pays out as long as you continue to pay the premiums. 

Questions To Help Evaluate Various Policies

  • What level of care (skilled vs. unskilled) is covered? Some older policies that cover only skilled care would not cover custodial/companion services unless skilled care was received first.  New policies must cover all levels without the prerequisites.
  • Can I receive care at any licensed facility?
  • Does it cover in-home care?
  • Does in-home care need to be through an agency or can I hire private as well?
  • Is an adult day care facility covered?
  • Is care covered in an assisted living facility?
  • What are the benefits per day for home care? Assisted living facility? Alzheimer’s facility? Adult day care?
  • When do benefits start and how are they triggered?
  • Is there a waiver of premium benefit?
  • What type of inflation protection are you comfortable with and willing to buy?
  • Tax qualified?
  • Is there a couples discount if they both purchase a policy from the same carrier?
  • How much premium can you afford to pay on a monthly and/or annual basis?
  • What waiting periods are available and exactly how do they work? 

Long-term care insurance is an affordable strategy for managing the potential financial burden of long term care needs. Unfortunately, talking about long-term care is something most people avoid. Most of us don’t want to think about it, and we most definitely do not think it could possibly happen to us. Thus, the elephant in the room syndrome is ever present, yet again. As I mentioned in Part 1 of this series, please make a decision to explore and examine this critical component of long-term care protection.  The consequences of not doing so can be devastating, and after all, it’s you and I and our loved ones that we’re talking about here. I think we all deserve it. At least avail yourself of the opportunity to make an informed decision that you can be comfortable with going forward.

Thanks for staying with me on this. I know it can be a bit tedious, but I believe it is vitally important to get this information out to the community, in whatever way possible.  In the final Part 3 of this series, we’ll look at new and innovative developments, pricing, and the current state of the LTCI market.

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Rick on February 8th, 2011

I was riding around the lake this afternoon and a giant Red Tail Hawk flew within a few feet of me. I’m normally not a huge fan of birds, but there is a small family of the Red Tails that have lived around these parts for years. Their wing span is enormous and their flight is elegant, graceful and majestic. They soar like an Eagle and it’s a beautiful thing to watch them do so. Every time I see one up close, it’s almost a spiritual type of experience in which I can bask in the warm afterglow for a little while afterwards. Well, that sensation is a thing of the distant past, and now I have to write about long-term care insurance. Admittedly, this is a dry subject and sure to put the most inspired caffeine to the test. The reality is that this is an often overlooked, yet critical component of a robust financial and long-term care plan. What may seem like such a trivial and irrelevant decision today will often have life changing consequences, when we least expect them. This is part 1 of 3 and will attempt to identify what it is and lay a basic foundation. We’ll unpack it in parts 2 and 3, in subsequent weeks.

Long-term care expenditures represent a significant financial risk for the elderly. According to the US Department of Labor, long-term care is the greatest uninsured risk Americans face.  The 2010 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs helps make this point crystal clear:

Home Care

National average hourly rates:    Home health aides = $21.00    Companions = $19.00 

Combined national average hourly rate = $20.00 (unchanged from previous year)

Average yearly rate (assumes five hours a day, five days per week) = $26.000.00

Assisted Living

National average base rate = $3293.00 (up from $3131.00 in 2009)

National average yearly rate = $39,516.00 

Nursing Home Costs for Semiprivate Room

National average daily rate = $205 (up from $198 in 2009)

National average yearly rate = $74,825.00 

Long-term care (LTC) can encompass a wide range of services, from skilled nursing care to unskilled assistance or supervision. Most LTC is unskilled, companion type care, also known as custodial care. Custodial care means assistance with activities of daily living (ADLs) which include bathing, eating, dressing, eating, transferring, toileting, etc.  Custodial care also refers to supervision for people with cognitive impairment such a dementia.

The majority of the American public is uninformed about the risks of needing long-term care, the associated costs and who pays for it. Most people believe Medicare pays for long-term care – it does not.  It may pay for a portion of skilled and rehab care needs, but only if an array of strict requirements are met.  Most health insurance policies for working adults cover only skilled care, not long-term custodial care. Long term disability insurance may cover lost wages during an illness or injury, but it does not provide coverage for the additional costs of long-term care, and it ends at retirement.

Medicaid – the health care component of our welfare system, does not cover long-term custodial care costs. It is primarily used for nursing home care and is typically available only to those who have exhausted all their other assets.

The only other options are private pay (out-of-pocket) or purchasing long-term care insurance. The major reasons people choose to buy long-term care insurance (LTCI) are:

  • To maintain independence – both physical and financial.
  • To retain control – manage the quality of care and choose how and where care is received.
  • To not become a burden to family.
  • To preserve assets and income. 

Only 10 percent of the elderly have a private long-term care insurance plan, and because coverage under these plans is often limited, only 4 percent of long-term care expenditures are paid by private insurance, while fully one-third or more of expenditures are paid out-of-pocket.  The difference between the care available to those with coverage and those without, all else being equal, can be enormous, and often appears extremely unfair. I believe many of my parents’ generation did not buy coverage, but feel their children will, as we witness the financial chaos and destruction, including potential bankruptcy, brought on by a combination of unexpected illness and lack of a well conceived plan to foot the bill. Everyone has a horror story how of how such an unexpected calamity wreaked absolute havoc on the ill-prepared. I’ve seen it up close, and it’s both devastating and permanent for everyone involved. 

Unfortunately, the insurance companies are not exactly giving away this coverage. It’s expensive, which is why so many folks choose to self insure, or to not purchase LTCI in the first place. Some of the major factors that determine the cost of a long-term care insurance policy are: 

  • Applicants age at time of purchase.
  • Applicants current health and history.
  • Preexisting medical conditions.
  • Smoking history.
  • Weight, height, etc. 

The cost of waiting is also very significant, to say the least. The major reason people don’t buy LTCI is they don’t understand the need to plan for their long-term care. Waiting to purchase LTCI could result in not being insurable as a result of health issues at the time of application. Since these policies are medically underwritten, and conditions such as Parkinson’s disease, Alzheimer’s disease,  or diabetes can prevent insurability, waiting can at times be a very costly mistake. 

Next week in Part 2 of 3, we’ll take a peek at the various types of policies, what is typically covered and what is not. The following week, part 3, we’ll look at new and innovative developments, price ranges and discuss the LTC market as a whole

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Rick on February 2nd, 2011

When people grow old in many parts of the world, family and friends care for them at home until the end. In America, the elderly are more typically sent to an assisted living or a skilled nursing facility, a contrast that may appear selfish, uncaring and even callous.

It’s easy to make harsh comparisons between the East and West when it comes to the issue of elderly care. Values of Western cultures tend to celebrate youth, self reliance and individualism. Eastern cultures place enormous value on family and the elderly, often adhering to traditional age hierarchies.  A traditional Asian household is far more likely to include a grandparent, whereas nursing homes in the United States, Australia and many parts of the West are increasingly overcrowded.

The Confucian doctrine of ‘filial piety’ continues to have a strong presence in Chinese and Asian culture. It simply means showing obedience, respect and deference to your elders. It’s considered a privilege to be in the enlightened company of an elder, and ancestral reverence remains vitally important today. In these and other cultures, it is considered utterly shameful not to take care of your aging parents. The same goes for Mediterranean cultures, where multi-generational families live together in the same house.

In stark contrast, Western culture encourages families to strike a balance between allegiance to the elderly and individual freedom. Quite often, the pursuit of individual freedom assumes priority, resulting in a meltdown of harmony and any reasonable sense of family dependence and unity. Routinely, seniors do not live with their children and it’s often considered a big hassle to take care of your parents, even if you really want to do so.

According to UCLA professor Jared Diamond, Pulitzer Prize winning author of “Guns, Germs, and Steel: The Fates of Human Societies” and recipient of a MacArthur Foundation “genius” award, “The idea that it’s human nature for parents to make sacrifices for their children and, in turn, for their grown children to sacrifice for their aging parents — turns out to be a ‘naïve expectation,’ This assumption, he said, ignores undeniable conflicts of interest between generations.” From a common sense perspective, “Parents and children both want a comfortable life — there are limits to the sacrifices that they’ll make for each other.”

Yet the fact remains, Diamond said, that many societies treat their elderly better than Americans do. In some cultures, he said, children are so devoted that when their aging parents lose their teeth the children will pre-chew their food. A closer look at how traditional societies value (or don’t value) their old people might teach us what to emulate and what to avoid.

While modernization has brought many benefits to the elderly — most notably improved health and longer life spans — it has also led to a breakdown of traditions. For example, multigenerational families are becoming a thing of the past in many modern cities in China, Japan and India, Diamond said, where “today’s young people want privacy, want to go off and have a home of their own.”

In America, Diamond said, a “cult of youth” and emphasis on the virtues of independence, individualism and self-reliance also make life hard on older people as they inevitably lose some of these traits. Then, there’s America’s Protestant work ethic, “which holds that if you’re no longer working, you’ve lost the main value that society places on you.” Retirement also means losing social relationships, which, coupled with America’s high mobility, leaves many old people hundreds or even thousands of miles away from longtime friends and family.

Modern literacy and its ties to technology are also putting the elderly at a disadvantage. “Modern literacy means that we look up things in books or on the Internet — we don’t go ask an old person,” Diamond said. “Formal educational systems, such as UCLA, replace old people with highly trained professors for transmitting specialized knowledge.”

And lightning-speed technological advances “mean that the things that old people do understand got technologically outdated,” Diamond said, adding that his ability to multiply two-digit numbers in his head has now been superseded by pocket calculators. He even admitted to having to consult his teenage sons to use the TV’s “remote with 47 buttons on it.”

Still, steps can be taken to improve the lives of our elderly, Diamond said. Understand their changing strengths and weaknesses as they age, he advised, and appreciate their deeper understanding of human relationships and their ability to think across wide-ranging disciplines, to strategize, and share what they’ve learned.

“So if you want to get advice on complicated problems, ask someone who’s 70; don’t ask someone who’s 25,” Diamond concluded. “Old people can have new value … although we often don’t recognize that this is possible.”

Please  note that I am not crusading, advocating or presuming to be knowledgeable  enough about this matter, to suggest or imply whether a particular tradition, society or culture is right or wrong, better or worst. That’s not  the point. I simply wish to explore the general differences between cultures in an effort to increase awareness of same. Individuals from all cultures and backgrounds go to extraordinary lengths for their elderly parents and loved ones out of sincere love, respect and a strong sense of duty. In the end, there is no doubt that we can all learn a lot from each other.

Footnote:  Quotations and comments by Professor Jared Diamond excerpted from a lecture he presented as part of the Molecular Medicine Institute Seminar series: “Honor or Abandon: Why Does Treatment of the Elderly Vary so Widely Among Human Societies?”

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Rick on February 2nd, 2011

I have a favorite topic that I love to present out in the San Diego community – it’s an Advanced Directive called Five Wishes. There are so many things in life that are out of our hands,  but Five Wishes gives you a way to control something very important – how you are treated if you become seriously ill. It is a user friendly, easy to understand tool that lets you say exactly what you want. It was inspired by Mother Teresa of Calcutta and developed by Jim Towey, founder of Aging with Dignity, a non-profit organization out of Tallahassee, Florida.

When facing end of life decisions, most of us would want the following wishes honored:

  • To die at home.
  • To be free from pain.
  • To be in the company of loved ones.
  • To retain control of the care we receive.

The harsh reality is that less than 25% die at home although more than 70% say it is their wish. Dying is often unnecessarily painful and isolating – we all have horror stories of loved ones dying alone and in severe pain. Believe it or not, only 15 to 20% of the population has completed an Advanced Directive, and most of their primary care physicians aren’t made aware that one exists. In the absence of a plan or decision to do otherwise, life-saving treatments and life-prolonging care will be provided.

A very useful solution to help bridge the chasm between what we say we want and what actually occurs is the little booklet called Five Wishes. It’s a great vehicle to start and structure important conversations about the elephant in the room with both family and healthcare professionals. It can bring incredible peace of mind for family members by ending the bed side guessing game and guilt about what their loved one really wants.

It is changing the way America plans for care at the end of life. More than 14 million copies of Five Wishes are in circulation across the nation, written in 26 languages and distributed by more than 23,000 organizations. It meets the legal requirements in 42 states and is useful in all 50. It’s a valid and legal document in California.

Five Wishes is often referred to as the living will with a heart. It addresses the normal living will and durable power of attorney for healthcare medical issues, but also covers personal, emotional and spiritual needs as well. 

The Five Wishes let your family and doctor know:

  • Who you want to make health care decisions for you when you can’t make them.
  • The kind of medical treatment you want or don’t want.
  • How comfortable you want to be.
  • How you want people to treat you.
  • What you want your loved ones to know 

It’s written in plain, easy to understand language.  It’s inexpensive – each booklet cost $5.00, unless 25 or more are ordered and then the price drops to $1.00 per booklet. It allows our seniors to communicate and retain control of the care they want and deserve. It allows our loved ones to face end of life challenges with grace, dignity and respect.  It takes a lot of the angst out of an already stressful time for family members by ending the bedside guessing game and guilt. It addresses not only medical, but personal, emotional and spiritual needs. It can bring peace of mind because now everyone knows exactly what their loved one wants.  Not bad for a buck?

Advanta Home Care is not affiliated with Aging with Dignity, financially or otherwise. It’s simply an awesome tool that people need to know about, for their own well being. For more information, please visit Aging with Dignity’s website:

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In a nutshell, dementia is a symptom, and AD is the cause of the symptom. When someone is told they have dementia, it means that they have significant memory problems as well as other cognitive difficulties, and that these problems are severe enough to get in the way of daily living…..

Alzheimer’s Reading Room

Too often, patients and their family members are told by their doctors that the patient has been diagnosed with “a little bit of dementia.” They leave the doctor’s visit with a feeling of relief that at least they don’t have Alzheimer’s disease (AD). There is great confusion about the difference between “dementia” and “AD.” The confusion is felt on the part of patients, family members, the media, and even healthcare providers. This article provides information to reduce the confusion by defining and describing these two common and often poorly understood terms.

“Dementia” is a term that has replaced a more out-of-date word, “senility,” to refer to cognitive changes with advanced age. Dementia includes a group of symptoms, the most prominent of which is memory difficulty with additional problems in at least one other area of cognitive functioning, including language, attention, problem solving, spatial skills, judgment, planning, or organization. These cognitive problems are a noticeable change compared to the person’s cognitive functioning earlier in life and are severe enough to get in the way of normal daily living, such as social and occupational activities.

A good analogy to the term dementia is “fever.” Fever refers to an elevated temperature, indicating that a person is sick. But it does not give any information about what is causing the sickness. In the same way, dementia means that there is something wrong with a person’s brain, but it does not provide any information about what is causing the memory or cognitive difficulties. Dementia is not a disease; it is the clinical presentation or symptoms of a disease.

There are many possible causes of dementia. Some causes are reversible, such as certain thyroid conditions or vitamin deficiencies. If these underlying problems are identified and treated, then the dementia reverses and the person can return to normal functioning. However, most causes of dementia are not reversible. Rather, they are degenerative diseases of the brain that get worse over time. The most common cause of dementia is AD, accounting for as many as 70-80% of all cases of dementia. Approximately 5.3 million Americans currently live with AD. As people get older, the prevalence of AD increases, with approximately 50% of people age 85 and older having the disease. It is important to note, however, that although AD is extremely common in later years of life, it is not part of normal aging. For that matter, dementia is not part of normal aging. If someone has dementia

(due to whatever underlying cause), it represents an important problem in need of appropriate diagnosis and treatment by a well-trained healthcare provider who specializes in degenerative diseases.

In a nutshell, dementia is a symptom, and AD is the cause of the symptom. When someone is told they have dementia, it means that they have significant memory problems as well as other cognitive difficulties, and that these problems are severe enough to get in the way of daily living. Most of the time, dementia is caused by the specific brain disease, AD. However, some uncommon degenerative causes of dementia include vascular dementia (also referred to as multi-infarct dementia), frontotemporal dementia, Lewy Body disease, and chronic traumatic encephalopathy. Contrary to what some people may think, dementia is not a less severe problem, with AD being a more severe problem. There is not a continuum with dementia on one side and AD at the extreme. Rather, there can be early or mild stages of AD, which then progress to moderate and severe stages of the disease.

One reason for the confusion about dementia and AD is that it is not possible to diagnose AD with 100% accuracy while someone is alive. Rather, AD can only truly be diagnosed after death, upon autopsy when the brain tissue is carefully examined by a specialized doctor referred to as a neuropathologist. During life, a patient can be diagnosed with “probable AD.” This term is used by doctors and researchers to indicate that, based on the person’s symptoms, the course of the symptoms, and the results of various tests, it is very likely that the person will show pathological features of AD when the brain tissue is examined following death. In specialty memory clinics and research programs, such as the BU ADC, the accuracy of a probable AD diagnosis can be excellent. And with the results of exciting new research, such as that being conducted at the BU ADC, the accuracy of AD diagnosis during life is getting better and better.

This contribution was made by Dr. Robert Stern, Director of the BU ADC Clinical Core.

Source BU ADC Bulletin

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