Caring Currents

Can seniors with dementia drive? Sure they can. Whether they should is another matter entirely.

Surprisingly, there's no standard-issue medical or legal answer about whether a diagnosis of Alzheimer's or another cause of dementia should require one to automatically give up the keys. That leaves caregivers to finesse the situation.

The usual advice is middle-of-the-(ummm)-road. Some authorities say long-term "automatic" habits like driving may be retained for awhile after diagnosis. The Alzheimer's Association sides with those who say a diagnosis isn't sufficient reason to withdraw driving privileges. 

Instead, individual assessments are usually recommended for those with mild cases. (Although in one Australian study, 63 percent of people with Alzheimer's flunked on-road tests.) Every-six-months follow-ups are urged. If you have any doubts, there are lists of warning signs you can use...  Read more

The hottest tool for people with Alzheimer's and dementia is a baby harp seal. A robot baby harp seal, that is. "Paro" is soft and cute as a stuffed animal, but it also coos when its fur is stroked, wiggles on the lap, bats its eyelashes, and makes little noises. Paro reacts to warmth and sound, and remembers previous interactions.  

Six-pound Paro debuted in the U.S. earlier this year. It was designed as a therapeutic robot by Japan's National Institute of Advanced Industrial Science and Technology back in the 1990s and has been used with elderly people with dementia (and youngsters with autism) in Japan and other countries for several years.

What's so good about it? Lifelike Paro stimulates the senses and encourages communication. It relaxes the person with dementia, lowering the risk of depression and behaviors like agitation, especially during transitions, which can get tense...  Read more

People with advanced dementia have "a duty to die." Or so says Baroness Mary Warnock. My first reaction, after the shiver of shock finished running down my spine, was that whoever this woman is, surely as a baroness she can afford decent care for loved ones in the late stage of disease! And then I discovered that in addition to being a British government adviser, Lady Warnock is its "leading moral philosopher."

"If you're demented, you're wasting people's lives -- your family's lives -- and you're wasting the resources of the National Health Service," this philosopher says. With cold morality like that on their side, no wonder people in the UK are in full-scale panic over its dementia explosion. (You can't even get NHS reimbursement for drugs like Aricept over there.)

Of course she has it all backwards. The duty in end-stage Alzheimer's lies not with the afflicted but with the people around them -- and not to kill them but to love them, or at least act as humanely as possible...  Read more

Here's a phrase you might be hearing a lot more, thanks to a puzzled daughter's investigation, which she describes in the current Newsweek: Pleasant dementia.

Pleasant? Dementia?! The oxymoron describes the drastic shift in personality some people with dementia experience, to a sunny, even cheerful, in-the-moment state of being. Writer Sara Davidson was grappling with  how her once "strong-willed, opinionated, and demanding" mother had become oddly easygoing as she lost her memory. Pleasant dementia isn't an official medical term, but it's a widely recognized phenomenon. And it's useful to give it a name.

I've seen it with one of my own loved ones.  It can seem like a personality transplant. This brings a confusing stew of emotions to the rest of us:

• Relief — if the old personality was sharp, judgmental, or querrelous
• Guilt — for feeling relieved and for finding...  Read more

When she saw the ad for a “senior memory class” in the local paper, my friend doubted she could interest her mom. Her mother’s memory issues had become a tense, hot-button topic that inevitably sent her mom into a snit. “My memory is just fine!”

Never mind that her mom's landlady had called again to say the rent wasn’t paid. Or that her mom kept forgetting to use her inhaler and was wheezing like crazy. Or that she’d sometimes struggle to recognize old friends she passed on the street.

And so my friend was downright shocked when her mom said she’d noticed the very same ad and would “just maybe” consider checking it out. Delicately holding on to this thread, my friend encouraged her mom. Of course, she'd drive her and go to the mandatory caregiver group held simultaneously in a different room. Fingers crossed, she hoped the class might actually slow her mom’s escalating memory loss, while providing a new social outlet with peers...  Read more

Calling this presidential election "hot" is as much an understatement as saying that watching your parents age is "challenging." As someone who writes a lot about Alzheimer's disease, however, one particular oft-mentioned presumption rankles: the notion that people are unqualified to be president at  72 (or 73, 74, or 75, to run through a full term) because they might get Alzheimer's disease.

Political persuasions aside, the debate is a good opportunity to revisit the facts about who gets Alzheimer's.

Fact: Alzheimer's disease can technically strike anybody, but will not strike everybody. Half a million people in their 30s, 40s, and 50s have "early onset" cases. Classically, Alzheimer's is a disease of aging -- but with emphasis on the word disease. Alzheimer's is not a normal or inevitable consequence of getting older.

Fact: The majority of 72-year-olds do not have the disease...  Read more

My friend Jessie prided herself on living as independently as she possibly could as her body weakened in a kind of variety pack of aging. Of all her debilitating ailments (broken hip, weakening heart and kidneys), one of the hardest things for her to deal with was her arthritis. Her hands and fingers were stiff and painful.

Not quite a fashion queen but a woman who took pleasure in clothes, Jessie was particularly bugged by the difficulty she had dressing. She couldn’t do small buttons; same with bitsy zippers. Tying laces; forget about it. I remember watching her struggle with her favorite winter jacket. I offered to help, and she snorted (as she usually did): “No, I can do it myself.” The truth was, she couldn’t.

This isn't an unusal problem for older people, and it's one that really takes a hit on self-esteem. Arthritis isn’t the only condition affecting the ability to dress...  Read more

It's a chilling paradox: Dementia often causes a person to retreat socially, whether out of embarrassment, depression, or an inability to keep up. Yet a growing body of evidence says that social connectedness can slow mental decline.

Proof is mounting that social stimulation belongs right up there with mental stimulation and physical exercise as a tool to slow dementia. (Just this week, an Australian study in Journal of the American Medical Association reported that moderate exercise boosted cognition in people with memory problems more than medication.)

Connectedness is more than a "feel good" thing. Being chronically lonely disrupts basic human physiology, says John Cacioppo, a psychologist who's the lead researcher in a University of Chicago team which describes these findings in a new book, Loneliness: Human Nature and the Need for Social Connection. Loneliness slows cardiovascular blood flow...  Read more

Baroness Margaret Thatcher has had dementia for at least seven years, her daughter just disclosed for the first time in her new book, A Swim on Part in the Goldfish Bowl: A Memoir. Wonderful title, terrible news. Carol Thatcher doesn't specify the cause of the dementia, although her mother, now 82, was advised to quit public speaking several years ago after a series of small strokes, so perhaps it's vascular dementia.

Here's the part of the excerpt that resonated with me: "I had to learn to be patient. I also had to learn she had an illness and that it wasn’t personal."

The "it" she's referring to is the continual memory loss. It's so profound that the former British prime minister even forgets that her husband of 50 years has died. This happened with my own father in the months after my mother's death, and it was incredibly painful to watch his fresh grief when we'd have to tell him...  Read more

Nighttime can be nightmarish for those who live with someone in the moderate-to-advanced stages of dementia. The sleep patterns of caregivers over age 60 who provide direct, live-in care for people with dementia are significantly worse than those of noncaregivers, says a study in the new Journal of Clinical Sleep Medicine. These caregivers:

• Get less total sleep (an average of 6.5 hours per night)
• Take longer to fall asleep

If you already know basic good-sleep habits and are taking steps to minimize sundown syndrome and wandering (common sleep disruptors), what else can you do to solve the sleep puzzle? Here are two fresh ideas to consider:

1. Night respite care

I recently wrote about vacation respite care. Watch for night care to become the newest variation in the fast-growing respite care field. An innovator: the ElderServ at Night drop-in care program run by Hebrew Home in Riverdale, New York...  Read more