Advocacy for Nursing Home Staffing

Part of my work as The Dementia Nurse includes advocating for safe staffing ratios in nursing homes and assisted living facilities. Owners are notorious for slashing staffing levels in order to increase profits. The end result is that residents suffer, particularly those who are living with dementia. Providing optimal dementia care requires time. When staffing levels are low, there simply is not enough time to provide proper care. Here’s part of an interview I gave while in Washington, DC for the National Nurses for Safe Staffing Ratios Rally at the Capitol.

Wishing you strength, hope, and courage,


Virginia License Plate for Alzheimer’s Awareness

I’m excited about this campaign in my native state of Virginia. Learn more here. For the many who have said to me, “I wish we had this in my state.”, google “how to petition for new specialty license plates in XXX” for your state or contact your local chapter of the Alzheimer’s Association at alz.org.

Wishing you peace, hope, and courage,

Save

Save


How Brain Illness Causes Dementia

Why people with dementia do the odd things they do can seem like an unsolvable riddle. But with a basic understanding of how the brain operates, we see patterns that are less random than they may seem.

The human brain is a vast, four-pound wilderness that continues to defy thorough explanation. The brain is made up of one hundred billion cells – yes, that’s billion with a B, even for those of us who may have killed off a few over the course of time.

At a hundred billion in number, is it any wonder that brain cells have no trouble hiding answers as to how and why they operate? All is not lost though. From centuries of examination with lots of trial and error, there are a few things we do know on the subject.

Different regions of the brain are called lobes. You can break these down to quite a long list of sections.  We are concerned with the six biggies: frontal lobe, temporal lobe, parietal lobe, occipital lobe, the cerebellum and the brain stem. Each lobe or region carries out distinct operations.

When disease hits the brain, we can guess where the damage is by which operations are affected. For example, vision changes could indicate damage in the occipital lobe, the area that controls vision. Personality changes point to both the frontal and/or the temporal lobes being diseased.

To understand some of the changes we see in the person with brain illness, we need an understanding of the functions of each region of the brain. Don’t panic that this is getting complicated. One advantage of having gotten a D in anatomy and physiology in college is I learn to adapt simple definitions and explanations. Sharper brains than mine have developed a diagram that helps us understand brain operations.

Another axiom on how dementia develops is that brain illness may start in any region, but it then marches through the rest of the brain. Alzheimer’s Disease (AD), for example, is believed to begin in a part of the midbrain that controls memory.

As the disease progresses, surrounding cells are damaged. Surrounding cells of each diseased area are damaged until the process reaches the parts of the brain that keep us alive. It may take a few years or a few decades for this process to come to completion. It may progress in a stairstep fashion with periods of plateau followed by “sudden” drops in function. Unfortunately, predicting a timeline is almost impossible to do accurately.

Part of the difficulty in treating brain illnesses that cause dementia is that with 100B cells, the brain can cover for a very long time before function starts to decline. So by the time we see changes in a person, their brain has been under assault for quite a long time with irreversible damage already done. Hence, we have the difficulty in stopping the disease rather than merely slowing it down.

Here’s an exercise that might help this information gel in your brain. Make a scribble list of changes you see in the person living with dementia. Then compare that list to the functions described in the brain diagram we are using. When you see a match between change and brain region function, you can guess that this is a region of the brain that is damaged and diseased.

I would love to hear how this simple exercise worked out for you. Did it make sense? Did it shine a light on some of the problems you see? Let me know in the comments if you will.

Wishing you peace, hope, and courage,

 

 

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save


Alzheimer’s Disease or Dementia: What’s the Difference?

mail-logo-ii2Dear Dementia Nurse,

My mother-in-law’s doctor sometimes says she has Alzheimer’s and sometimes says she has dementia. How do we know which it is?

Baffled in Birmingham

 

 

Dear Baffled,

Great question! Terms that are used in relation to brain illness can be confusing. Different health care providers may or may not use them correctly. Here’s the scoop: “dementia” refers to a group of symptoms while Alzheimer’s Disease is an illness that causes dementia.

Dementia can show up in a variety of ways. Forgetfulness usually starts gradually before progressing into real memory impairment. In many cases, dementia first appears as subtle changes in a person’s personality. For example, someone who has always been careful of their appearance may lose interest in how they look.

Confusion about how to say or do simple things may come and go. In rare instances, dementia may first manifest as seeing or hearing things that are not there. All of these changes are not diseases. They are the result of having brain disease.

Brain illnesses come in all shapes and sizes. The different illnesses are classified by two main factors. These are 1) the mechanism that harms the brain’s cells and 2) where in the brain the damage tends to start. The specific brain illness that causes a person’s dementia will govern the nature of their symptoms.

Alzheimer’s Disease is the most common brain illness that causes dementia. Approximately 60% of people living with dementia have Alzheimer’s disease. If other brain illnesses cannot be clearly identified, doctors tend to assume that Alzheimer’s Disease is the correct diagnosis.

Aside from Alzheimer’s, the most common brain illnesses causing dementia are vascular dementia (VD), frontotemporal dementia (FTD), Lewy Body dementia (LBD) or dementia with Parkinson’s disease.Each illness affects the brain differently. The treatment of each varies based on the mechanism of the disease.

Hope that clears it up a bit, Baffled. Thanks again for asking. 

Wishing you peace, hope, and courage,

my-signature-the-dementia-nurse

 

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save


Alzheimer’s Disease: The Drive-Thru Diagnosis

clock grYou sat in the doctor’s office. You heard the words. Alzheimer’s Disease. In many ways, you aren’t surprised. But that little corner of your mind that was hoping for a different verdict feels like Hiroshima on the day after.

The doctor hands over a prescription for Aricept (donepazil)  and says to come back in three months. Pay the copay, and you’re out of there.

You have just been dropped in the middle of the ocean with a two-person raft and warm best wishes for finding your way to shore.

The above scenario now takes place every 66 seconds in the United States alone. Many clinicians do a bit better with cushioning the blow and providing resources to start the journey. The vast majority do not. The public deserves better.

In his poignant memoir, While I Still Can,  activist Rick Phelps describes the doctor visit in which he and his wife received his diagnosis. He noted the time frame. Seventeen minutes is all it took.

Seventeen minutes from the time of entering the doctor’s office to the time they were ushered out the door with a prescription and a return appointment. I would hate to have been on the two-hour ride home.

Alzheimer’s and related dementias (ADRD) are fast overtaking cancer as the most dreaded diagnoses among consumers. (Go here to learn the difference between dementia and Alzheimer’s Disease). When patients and families are reeling from the news, they deserve immediate support in knowing which way to turn next.

The Dementia Nurse was borne out of the public’s need to find reliable information and advice. As the epidemic grows and the snake oil salesmen emerge, I am committed to doing my part to guard and to guide.

Nurses have long been the consumer’s best friend when it comes to navigating health care. It is my fervent hope that The Dementia Nurse will give you hope and confidence on the long ride of dementia.

My secondary passion is for the precious individuals who provide dementia care for a living. The Dementia Nurse is designed to be a resource for them as well as for unpaid care partners. A loving professional care partner is worth his or her weight in gold and deserves all the encouragement possible.

Many thanks to you for stopping by. Feel free to say hi and tell me who or what brings you to my doorstep today. With all good intentions,

my-signature-the-dementia-nurse

 

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save


Alternative Treatments for Alzheimer’s Disease

medical-report-graphicHello, friends!

Today, I am over at AgingCare.com discussing alternative treatments for Alzheimer’s Disease. Charlatans are out there, ready to pounce on the sick and the desperate. At the same time, there are legitimate options outside the Big Pharma machine. To get the low down on sorting fact from fiction, click here to come on over!

Peace, Love, and Courage,

my-signature-the-dementia-nurse

Save

Save

Save

Save

Save

Save

Save