Wednesday, December 13, 2017
Are games and food supplements that promise to stave off the onset of dementia the modern day version of "snake oil?" I promised to write more about the Aging Brain Conference at Arizona State University's Sandra Day O'Connor College of Law on December 8, 2017. Speaker Dr. Cynthia Stonnington, Mayo Clinic, offered an important look at ways in which law, ethics, medicine, and commerce can collide with her survey of a host of approaches receiving "popular" press treatment.
She examined self-described "brain-training" programs, miracle diets, supplements and targeted exercise programs, noting that most studies that purport to demonstrate positive results from these items have serious flaws. Thus, at best, programs that claim to provide "protection" against dementia are usually promising more than has been proven. Dr. Stonnington, along with the morning keynote speaker, former U.S. Surgeon General Richard Carmona, reminded us that
- maintaining social engagement,
- engaging in lifelong learning,
- getting regular exercise of any type,
- having good blood pressure control,
- getting adequate sleep, and
- focusing on good nutrition (including eating plans such as the Mediterranean, DASH or MIND diets)
are far more important than any single, magic game or exercise.
One of the most lively discussions of the day came near the end, in response to presentations by Dr. Patrica Mayer of Banner Health in Phoenix, Amy McLean of Hospice of the Valley. and Life Sciences Professor Jason Robert (ASU) speaking for himself and Susan Fitzpatrick (James S. McDonnell Foundation), about end-of-life considerations for persons with dementia or other serious illnesses. What would be the most likely response of a physician or emergency personnel confronted with a "do not resuscitate" tattoo on the chest of an emergency patient? Dr. Mayer stressed that she is seeking reliable methods of communicating end-of-life wishes, and for her that means a preference for a written, Medical Power of Attorney. She wants that "live" interaction whenever possible, in order to fully explore the options for care for individuals unable to communicate for themselves. But she also noted a frequent frustration when she contacts designated POAs about the need to make tough decisions, only to learn they were completely unaware before that moment of having been named as the designated agent.
I was part of a panel of court-connected speakers, including Arizona Superior Court Judge Jay Polk (Maricopa County), neuropsychologist (and frequent expert witness) Elizabeth Leonard, and experienced Phoenix attorney Charles Arnold. I was interested to hear about -- and will pursue more information on -- the psychologists' use of evaluative tools for clients that use scenarios that would appear to test not just for loss of memory, but impaired judgment. I was speaking on the unfortunate need for judicial inquiries into "improvident transactions" by persons with problematic cognition and I used litigation approaches from other locations -- Ireland (common law) and Maine (statutory) -- as examples. The Arizona legal experts reminded me to take a closer look at Arizona's financial exploitation laws.
For more from this conference, see Learning to Say the Word "Die" -- about a pilot program developed by Dr. Mayer while she was an advanced bioethics fellow at the Cleveland Clinic. I also recommend Dr. Mayer's article on CPR & Hospice: Incompatible Goals, Irreconcilable Differences,
December 13, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Games, Health Care/Long Term Care, Legal Practice/Practice Management, Programs/CLEs, Science, Statistics | Permalink | Comments (0)
Friday, November 3, 2017
One of my favorite parts of the LeadingAge Annual Meeting is my first tour of their Expo. Law conferences are so dull by comparison! There are hundreds of vendors at the LeadingAge expos. You can find a smorgasbord of senior housing options, architects eager to help you with your purpose-designed projects, all kinds of communications systems, management software and health-related devices, even cooking classes. I often find information that helps my research, including data complications by actuaries, accountants and marketing firms about trends in housing and care systems. This year I heard about an "app" in development with a university team that included law students, to offer caregivers options to identify potential concerns, such as financial abuse.
In the years I can attend, I keep my eyes open for my own personal "That's Creative" award. This year, it was the Sky Factory -- where, using solar energy, the company offers a wide variety of windows, skylights, and other wall installations -- but with a twist. These portals offer "award winning illusions of nature." Overhead views show clouds and trees, rustling in the wind. Another window might offer a view of an especially pleasant beach, with waves in motion. That is why the designs need energy, appropriately solar energy, to keep the images in motion.
Perhaps most unique, some of the images are designed so as to offer subtle changes triggered to the time of day (or night). Sunlight plays across the images of nature, and shadows move with the sun. The goal is for individuals who are house-, chair- or bed-bound to engage with nature, with the hope the engagement will stimulate mental response and circadian rhythms in the body. The use of this product is not limited to seniors, or even disabled persons.
Thursday, March 24, 2016
We don't use this blog to promote a specific product, so please don't read the following as that. There is some educational value in learning about efforts of world-renowned corporations to provide products for people with special needs. I'd heard Nike had shoes in the works for people with special needs so I wanted to share this article regarding their availability. Nike Expands Shoe Line For People With Special Needs was published in the March 16, 2016 issue of Disability Scoop. "The company was inspired to develop the unique system after hearing from then-16-year-old Matthew Walzer in 2012. Walzer, who has cerebral palsy, requested more accessible footwear so that he would be able to go off to college without needing assistance tying his shoes." According to the story, there are several models of the shoe from which to choose.
Friday, November 13, 2015
Studies have shown that those with deep interest in "fun" have healthier, happier lives as they age. Or at least, that's what I hope the studies show. Along that line, I discovered a new definition for the "Century Club," offered by the Dressage Foundation, for the "exclusive group of horse and rider pairs who perform a dressage test at a recognized [horse] show when their combined ages total 100 years or more."
An issue of The Chronicle of the Horse, in an article titled "Older, Wiser and Still Having Fun," features 24-year old dressage mount Toblerone and 77-year old rider Donna Donaghy. Donna is "not done yet" and she plans to keep on riding and showing as long as she can still throw a leg over the back of her horse.
Monday, March 30, 2015
While driving home from the grocery recently, I happened to catch "Press Play," a TED Radio Hour broadcast on the importance of play. It was such an interesting program that I ended up taking my groceries for another couple of spins around the block so that I wouldn't miss a segment!
One interview was with researcher Dr. Stuart Brown, who described his early work with (and about) criminals, including at least one mass murderer. While no single factor accounted for behavior, he noticed that in some of the worst histories, there was a distinct lack of opportunities for childhood imagination and healthy play. He brought this forward into research with the general population, with observations about the role of play throughout life, even for persons with deep dementia. He and other researchers on the program were convincing, to wit, that play, involving pure fun and engagement with others, stimulates the brain in important ways.
Monday, September 8, 2014
Have you ever considered the similarities between caregiving and improv? Probably not--who would-they certainly seem to be quite dissimilar occupations. Yet when you think about their characteristics, they are quite similar. The website, In the Moment, which is focused on "creative ideas for training staff" lists on the landing page characteristics that apply to both, including being flexible, adaptable, courageous, spontaneous, generous, selfless and trusting.
and within twenty four hours ... was on a plane flying to be with ... family and wait for ... Dad to pass away. During that time of sitting, laughing, thinking, crying and rambling -[she]...realized that the world of Improvisation was very similar to the world of caregiving and Alzheimer's disease and dementia.... [unsure] why the idea hit ... then, maybe it was divine inspiration, maybe someone was telling [her] the reason why [her] ... Dad had Alzheimer's or maybe [she] ...was sleep deprived. Probably all of the above... [Having]... attended a lot of very informative and well executed workshops and trainings... [yet] not a very good learner... [she] remember[s] sitting in a class and listening to the instructor talking about effective communication with persons with dementia."
Then inspiration struck, as she says in her own words "[a]ll I could think of was how tired I was of sitting . If she would just do this improv exercise it would illustrate her point more clearly and get everyone up and moving. Hmmmm...." She wrote grant applications, with this excerpt from her abstract, explaining the parallels
The rules of Improvisation parallel the “ rules “ of Caregiving for a person with Alzheimer’s. Each rule of Improv has exercises, hands on techniques to illustrate points of care. Improv itself teaches characteristics that are essential to the caregiver : listening, validation, accepting others’ realities, problem solving and creativity to name only a few. I see improvisation as another tool for caregivers and for trainers to use to create a better quality of life for each person with Alzheimer’s. I want to clarify that this this is not training of how to do Improvisation. But training that uses Improvisation to teach Alzheimer care.
The "rules" she references can be accessed here. The website also provides information about the 6 week training program, training tips, and other resources. Ultimately, the goal of this project is to "[e]Employ ... theater games with creativity exercises ... [to] provide caregivers with the methods to become better at what they do."
Live in the moment--and enjoy that moment with a family member who has dementia---very good advice indeed.
Tuesday, October 22, 2013
On yesterday's ride over the Blue Mountains between my Law School's campus in Carlisle and the campus in State College, I caught a great public radio program, interviewing folks at a "Memory Cafe."
As anyone involved in care for a person with dementia knows, especially those who are "stuck" at home, it can be a challenge. Both the caregiver and the cared-for person could use a good break now and then.
That's where the concept of Memory Cafes come in -- a place where folks won't judge about how Alzheimer's or similar cognitive impairments might affect the ability to have a traditional conversation. Where canes and walkers are welcome. A place that is warm and friendly. Where people understand -- and can share a laugh, along with good coffee.
From Wisconsin Public Radio, here's a bit of history and a description of a cafe in Appleton, Wisconsin:
“'Memory Cafes' got their start in the Netherlands and are common now both there and in England. They are 'judgment-free zones' for people with mild dementia or memory loss.
About a dozen people gathered last week at a cafe session at a coffee shop in Appleton. John McFadden is a co-coordinator of the memory cafe and plays the ukulele to welcome participants. Betty Ann Nelson came with her husband, Duane. The Nelsons have been married 58 years and have attended several cafe sessions since they began earlier this year."
Some sessions might involve activities, such as a program called "Time Slips" where participants pass around amusing photos and are invited to tell the story. One photo showed nuns on bumper cars at an amusement park, leading a customer to describe them as "Holy Rollers."
For more on the concept, follow the links on Wisconsin Public Radio to listen to this radio account.