Our Long-Term Care Journey

April 14th, 2015 by Doris Bersing

Aging in PlaceMaking a life-changing decision on a loved one’s long-term care and considering a nursing home or assisted living facility is never easy and there are many hurdles that must be overcome. For many, this may not be necessary as they will receive the care they require in the comfort of their own home, which is certainly the first option for a large percentage of seniors receiving care.

According to an AARP study 89% of those 65 and older would love to age in place for as long as possible, and there are several important benefits of aging at home, like improved health, routine, independence and the familiar setting. If medically and financially possible, there is no place like home. In-home care can be affordable, when limited in services and in number of hours per day.

For low income seniors, there are several programs, like the In-Home Supportive Services (IHSS) program, the Cash and Counsel program, or if you or your family member is a US veteran, the VA administration for veterans may cover a variety of in home care services in your state. Services that are typically covered by these programs include, health care, personal care, homemaker care, adult day care, transportation, medical equipment and some minor home remodeling.

For those that prefer a group setting, or home care is not appropriate and/or affordable, and the family feels that a nursing home or assisted living facility would be the be the best fit, obviously there are many emotional issues that need to be dealt with. Often there are conflicting emotions raging, including, guilt, anger, sadness and helplessness, when they are no longer able to provide the care that their loved ones now require.

Another area that needs to be navigated when considering a nursing home, is how to pay the bill, which for many American families is financially out of reach even after saving up for a considerable number of years. The same situation arises with home care services; unless the person has savings, equity in their home, or Long Term care Insurance, cost can be an issue. The federal and state governments provide Medicaid/Medical help if the individual meets all financial and medical eligibility guidelines. There is often a grueling task, companies like Senior Planning Services could help you with the Medicaid application process, or you can address your local Medicaid office, often, with the risk of failure quite high.

Last but no least, there are considerations as far as choosing the right nursing home or assisted living facility for mom or dad, to the right in-home care agency that will take into account all personal, cultural, religious and location-based preferences. This accumulation of stress is enough to inundate any sane person, but for the nearly 65 million heroic individuals providing care in the US for a loved one, this is often the best care option for the senior.Having worked for many years as a nursing home placement coordinator for a NJ-based Medicaid planning company, I’d like to share the personal saga of one of our clients which touched me deeply.

Several months ago I was contacted by a woman living in northern New Jersey. Her mom, who resided in central NJ in Ocean County, was suffering from severe dementia and the daughter wanted her admitted to a nursing home in her own area, up in northern NJ, in Bergen County. In addition to her dementia, the elderly woman also had severe behavioral issues.

The family was in the Medicaid application process and their application was in the pending status. Because of her unique needs, our options were quite limited. We needed a nursing home with a secure unit where the residents could not wander out of the unit, since a wander guard would not have been sufficient for this woman. Dementia patients tend to become so confused and lost in their surroundings, that they will try to leave the premises even when wheelchair bound.

The woman, as we mentioned earlier, also had violent tendencies and would sometimes act disrespectfully, hit other residents and caregivers, and needed a nursing facility that was equipped for these needs. These issues made finding the right facility a nightmare.

When we did find one or two, we were turned down, since our Medicaid status was still pending and not all nursing homes were willing to work with Medicaid-pending applicants.

In the meantime, we found placement for the woman in a nursing home in the Ocean County area which was able to provide all of her needs. I had a good working relationship with this facility and, after some cajoling, they accepted her, confident that the Medicaid application would be approved. It didn’t satisfy the requests of the daughter, though, who wanted mom close by.

When the Medicaid application was subsequently approved, we were successful in transferring the woman to a facility closer to her daughter in Bergen County. We were all very excited that it had worked out well for everybody, at last. The daughter thanked me profusely for the effort I had expended in making it happen.

It was heartbreaking when, days later, the woman passed away at the facility…

Conclusion: You know, as professionals, we try to maintain a certain degree of detachment in order to be better able to assist our clients, but at the end of the day… it’s painful. We do develop relationships with the wonderful people whose long-term care is entrusted to us and when they go so quickly, it’s like losing a friend or relative, in a sense.

In collaboration with Benjamin Lamm, a senior advocate.

Cancer: you are not alone

April 9th, 2015 by Doris Bersing

The right teamA diagnosis of cancer is terrifying and often it is a long journey for patients, clinicians, and family members to look at the available options for treatment and care. Cancer patients often feel more comfortable and secure being cared for at home. Many patients want to stay at home so they will not be separated from family, friends, and familiar surroundings. Home care can help patients achieve this desire but cancer care often involves a team approach that includes doctors, nurses, social workers, physical therapists, family members, and others but one size does not fit all and looking for the right team is the key.

More than one million people living in the US are diagnosed with cancer each year – one million people, just like you, who will embark upon a journey of treatment, recuperation, and rehabilitation. It can feel, at times, like a lonely journey, and cancer survivors are often struck by the feelings of isolation and helplessness that are so prevalent during their diagnosis and treatment. However, it is important to know that you are not alone; we are here to share your journey.

There have been some huge developments in the world of cancer research in recent years; from new drugs to the discovery of what causes certain types of cancer, the medical profession is forging ahead in the field of research and pharmaceuticals. However, this news often comes as little comfort to those who may recently have been diagnosed with cancer – your first thoughts will probably be towards your own recovery, and the help available to you, rather than scientific progress, and that is absolutely where your mind should be.

Cancer: where can you turn?

Support comes in a variety of forms, from financial and medical assistance, to help with traveling to and from work, or daily tasks, such as shopping, cooking, or household chores. Where should you turn for support? The obvious answer is often friends and family, and it is those closest to you who will often be there to pick up the pieces following a cancer diagnosis; their dedicated rallying is invaluable at this time, so never be afraid to accept, or ask, for help. Living Well supports a team approach when caring for cancer patients at home.

If you are without a local network of friends and family, or have found it difficult to approach anyone for help, there are a host of organizations that are dedicated to helping those in your shoes. Charities such as The American Cancer Society, The American Association for Cancer Research, and The Cancer Research Institute provide invaluable information and services, including advice on your diagnosis and treatment options, financial guidance, manned helplines, and details on support groups and health services that are local to you; wherever you are, their aim is to connect you with somebody who will listen.

Assisted living: there is somewhere else to turn

There may come a time during your treatment or recuperation when assisted living is suggested, or even prescribed, by a health care professional. While the phrase may conjure images you may not wish to associate with your own situation, assisted living can help to quell worries of living alone, help you to cope with daily tasks, support you during times of loneliness and isolation, and assist you in accessing support. Assisted living can be the supportive environment that you need, allowing you to channel all of your energy into recovery. Whether provided on a temporary or permanent basis, assisted living often becomes a vital lifeline to those experiencing physical or mental changes, and can make recovery much easier when a person’s home no longer has suitable amenities to facilitate treatment.

The most important thing to remember following any diagnosis, particularly that of cancer, is that you are not alone; whether you are being comforted and supported by family, assisted by a dedicated charity, or cared for by home care staff or an assisted living complex, never be afraid to lean on those around you.

Identity and Dementia: Where Do I Go?

March 23rd, 2015 by Doris Bersing
Frankly I do not give a damn...

Frankly I do not give a damn…

Most of us spend a big part of our life searching for meaning, trying to find our identity, and although Thomas Szasz said in The Second Sin (1973) said “…the self is not something one finds, it is something one creates…” we set ourselves for the pursuit of that elusive identity and our meaning as human beings. What is life all about and overall what is our role in life? What do we really live for? Who are we?

We pass many of our prime years looking for our identity, fighting for one, trying to assert one if we are ever given a glimpse of it, wrestling to have our needs met and to have our dreams come true. That search for identity comes sometimes in a puzzle of circumstances, challenges and exploits, and like the overprotected Nemo, we need to swim the oceans of uncertainty and grow until finding ourselves

Through the journey in search of our identity, we attempt to unfold our potential, our desires, and to adjust at the best of our abilities to the challenges of daily life. We build our life upon joys, shadows, and sorrows and fill that life with the mementos and the facts we carve in our memory, those we gathered throughout our journey but one-day, zas! You are diagnosed with dementia. There you are, all of the sudden lost, confused and soon to be stripped, if not of your identity, at least, officially, of your mind.

I know, hopefully, we all have been lost in our minds out of excitement, passion, or love and yet, after the diagnoses you will not be lost in your mind, anymore, since now, your are losing yours. Of course, we could discuss what really mind is, there is so much more to the mind than the cognitive aspect of it and yet for any purpose is THAT mind the one holding your memories, mementos, treasures, pains, and joys that is ready to go with the wind. Well in reality, with the plaques and tangles created in your brain, in a certain time you will not even remember the time of diagnosis. Just as Clark Gable stated while playing Rhett Butler in Gone with the Wind, stated, you may well say: Frankly, my dear, I don’t give a damn….” But he clock is ticking.

Professionals will offer all what they have. They talk and teach how to calm you down, how to deal with your mood swings and your challenging behaviors but do they really know what we are going through, what you are going through? Do they know that you are going through the tunnel, in and out of the darkness, the uncertainty with the challenge of living an existential tale of the here and now, for which, you did not sign up and for which, effectively you have never practiced. Then come the drugs, the optimism, the clinical trials, the walking to fund more research, hopefully before it is too late for you. Looking now for a different meaning. There is so much that is done, said, so much still to do and yet nobody really knows what you are going through.

We try and theorize about the phenomenon, the neurological, psychological, emotional, and practical side of it, even the spiritual side of it. Needless to say, we appreciate all the nice legitimate attempts people make writing new books about breakthrough treatments and findings; they present lectures, write articles about you but what if you could really explain how it is to know that your life is slipping away, fading away? What if you had a voice? What if they found a cure?

I wish I could be more helpful, but I really do not know how it is, all is in my best efforts to explain a phenomenon, I can only observe and witness with powerlessness, compassion and horror. I do not have dementia and I wonder if I had it how I would feel? What would it be like? Again, I do not know but if I could, if I were you, I would not like to go there. That said, I hope I would react calmly and with patience for myself, although I doubt it but let the journey continue and keep on swimming.

For now, I find some solace and motivation to keep ‘on swimming in Thoreau’s wisdom:

“…I went to the woods because I wished to live deliberately… only the essential facts of life, and see if I could not learn what it had to teach, and not, when I came to die, discover that I had not lived. ~Henry David Thoreau, 1854

Can your diet reduce the risk of Alzheimer’s disease?

March 15th, 2015 by Doris Bersing

Diet and Alzheimer's disease


Alzheimer’s is an incurable health condition that is directly linked to the brain. It materializes in older people, and it manifests in different ways from person to person. One of the most common symptoms is loss of memory and difficulty remembering facts, actions, names of people, etc.

Scientifically speaking, Alzheimer’s disease  (AD) is the result of dying brain cells, as well as the disparity between brain cell connectors. Even though there’s no cure for this ailment, there are ways to lower the odds and even delay the manifestation of AD.

A healthy diet, particularly for the brain, consists of essential foods like:

  • Fresh fruit
  • Whole grains
  • Vegetables
  • Lean protein

Thus far, there haven’t been any studied performed on Alzheimer’s and dieting, yet physicians strongly believe that there’s a connection between combating/preventing the manifestation of the illness and a healthy eating plan. For the brain to function properly it needs to be fed with adequate foodstuff. Key nutrients are needed for an improved brain functions, and we must admit that a balanced diet can help. Eating healthy automatically keeps the body in better shape. This may delay the onset of Alzheimer’s disease, although there’s no guarantee and these are mere claims based on what the body needs to remain in good health.

Obesity & the brain

Being overweight is bad for your heart, joints, and others organs. The chances of developing dementia or Alzheimer’s disease later in life are increased in people who are or were obese in their younger years. This claim comes as a result of a study performed back in 2009. There seems to be an increasing connection between Alzheimer’s and obesity; apparently, early-life and environmental elements and genetics may be associated with dementia.

It’s really important to have healthy circulation in order to remain in good health. Brain cells demand a good blood flow in order to deliver oxygen and other nutrients to the brain. When the arteries are clogged with unhealthy fats as a result of bad food, the blood required for the brain may be blocked or restricted. The Alzheimer’s Association emphasizes on the importance of a proper diet, and it warns people that foods high in saturated fats and cholesterol might lead to dementia later in life. Rather than opt for saturated fats, people should opt for monounsaturated fats to strengthen their heart and arteries, such as omega-3s and omega-6s.

Essential nutrients

Omega-3 fatty acids are brain-healthy fats. Excellent food sources of this nutrient can be found in salmon and tuna, but also in vegetarian sources such as leafy greens and avocados. The Alzheimer’s Association advises people to include sources of food rich in vitamin E and antioxidants too into their diet to ward off the materialization of dementia. Some of the best sources are strawberries, blueberries, and oranges.

Challenges in older adults

Adhering to a well-balanced diet plan can often pose a challenge to older people. Seniors in particular, may have difficulty with swallowing and chewing, and these actions may lead to malnutrition. If you find it difficult to consume certain food types that are fundamental for your health, make sure to ask for advice from a nutritionist or physician. He will recommend nutritional supplements, vitamins and shakes you can add into your diet to stay healthy and keep dementia away for as long as possible. For proper brain health, some other vitamins you might want to add to your diet plan are vitamin C, E, B12 and folate.  Look at Supplemented.co.uk for some of these products recommended by our author Edward Francis..

Limiting sodium and sugar

Both salt and sugar are common ingredients we use during the food preparation process. However, these are not good for the health and they must be reduced from our diets. An increased amount of sodium may boost the risk of a stroke in people with hypertension. Sugar on the other hand, contributes to increased blood glucose and weight gain, which may lead to diabetes. According to a report found in the Mayo Clinic, diabetes has been linked to Alzheimer’s.

It is fundamental to emphasize that healthy food doesn’t cure Alzheimer’s disease. But it certainly helps delay the developing process. As long as the body is maintained in a healthy condition, the brain feels healthy too; and this certainly helps keep dementia away.

Elderly Care and Gardening

March 10th, 2015 by Doris Bersing

Elderly Care and Gardening in Green HousesElderly Gardening

Most elderly people are concerned about being confined to an environment that does not feel like home. As family members age, they often dread the prospect of being taken to an institution that will not cater to their needs and will diminish their happiness. Robert Jones [1] suggests adjusting the house environment to the needs of the elders in a way they still can do their gardening as they please.

Green House Concept

The green house concept has been successfully used to provide elderly care on a long term basis in a nurturing and sustainable environment. Just like with gardening green houses, the elderly are assured of living in an environment that is designed to enable them to thrive and enjoy life.

Green house care ensures that elderly members of society are given the opportunity to lead an active life and participate as much as much as they can in a communally hospitable setting. This has positively transformed how aging residents are cared for and improves the quality of life in their golden years.

The positive effects of green house living are evident in how the elderly are able to thrive in an interactive and vibrant setting. Green houses for gardening purposes give gardeners or farmers access to structures within which they can regulate atmospheric conditions.

Growing Seasonal Plants

The sizes of green houses vary and range from small to extensive structures. They arise from the investment of resources through which gardeners can control conditions and grow different species of plants. When you grow plants in a green house, you are able to extend the season during which they grow.

Your green house enables you to start planting earlier than you would be able to do if you were growing crops conventionally outdoors. When the season ends, your plants in the green house will be able to last for a longer time than those that are outside.

Your ability to extend the season is based on how you control factors such as light, temperature and humidity inside the green house. You select the amount and quality of natural lighting that you require for your plants along with the materials for your structure.

Wider Variety and Protection

Green houses also enable you to grow more plants than you would typically be able to outside. The environment in a green house can be adjusted for the purpose of growing a variety of plants. Green houses are designed as enclosures that provide plants with protection from pests and predators.

Unlike plants that are exposed to all manner of pests and predators while outside, the green house will ensure that they do not gain entry. During rainy conditions, you can continue to care for plants regardless of how much rainfall there may be.

Gardening All Year Long

Your gardening will not be affected by outdoor conditions because you will be able to carry on with your activities according to the conditions you have set in your green house. Gardeners who grow plants in green houses have much more time each day to work on their gardens.

The installation of green houses gives you the opportunity to supply your own food and grow plants comfortably without any restrictions. Gardeners use their green houses to provide the right environment for growing their plants.

[1] Robert Jones is a professional writer whose work has been featured in various publications. Learn more about potting sheds by visiting his website.


Link between vitamin D and Alzheimer’s disease

March 9th, 2015 by Doris Bersing

AD and Vitamin DMost people are aware of Alzheimer’s disease and may even know someone who has it. It has to be a horrible ailment for all those involved. Sufferers tend to have memory problems and it can affect their thinking. Consequently, it is normal to see behavioral changes. Sufferers can become upset very easily; they are also prone to bouts of paranoia and develop suspicious personalities. This is understandable as the memory loss affects everything in daily life and means reliance on others for the facts in any situation. As the disease progresses poor judgement becomes an increasingly common issue.

Alzheimer’s disease – causes and connection to vitamin D

Unfortunately, despite many studies and research programs it is not yet known what causes Alzheimer’s. Physicians seem to agree that your age, family history and genetics play a large part in the equation. More recent research has also shown that vitamin D is active within your brain. Many receptors have been found in the brain specifically for vitamin D. Receptors are located on a cell’s surface and wait to receive chemical signals. When a signal is attached to a cell, it tells the cell what to do, whether that is how to act or simply to die. It is therefore highly likely that vitamin D has an effect on the way you think, learn and act.

This is borne out by the many studies performed. These indicate that those with lower levels of vitamin D in their blood are more likely to suffer from Alzheimer’s. Vitamin D is very important to the body; the brain relies on these receptors of vitamin D to protect it from harm.

Observational studies on Alzheimer’s and Vitamin D

The current problem is that most research has been done via observational studies, these make the link between vitamin D and Alzheimer’s by testing those with Alzheimer’s and confirming that the level of vitamin D is lower in those affected than in those who are not. Mental tests designed to show how well the brain is working have been performed on a broad spectrum of people also show that those with low levels of vitamin D do not do as well as those who have higher levels.

Whilst research has discovered the importance of vitamin D there have not yet been enough studies. It is not yet clear whether vitamin D supplements assist in treatment, prevent the disease from occurring or both. Only more research can provide the answer to this.

Studies performed on the connection of Vitamin D to Alzheimer’s disease

Caution also needs to be applied to these results as it is possible that those with Alzheimer’s to stay inside more and therefore have less exposure to the sun. The sun is an excellent source of vitamin D and a lack of exposure would mean lower vitamin D levels. It is possible that the low vitamin D levels are a result of the disease rather than the other way around.

There have been several important research projects over the last few years and all of them feature vitamin D. One of the largest studies was completed in Denmark over a period of thirty years. It monitored vitamin D levels at the beginning of the study and whether or not they developed Alzheimer’s after 30 years. Australia completed a study in 2011 assessing whether high doses of vitamin D affected sufferers or if low doses made a difference. France has also performed a study; in 2012 they studied the affect on memory and thinking in people with Alzheimer’s when taking vitamin D and memantine. This was compared to just taking vitamin D and just taking memantine. Most improvements were seen by taking both supplements.

One of Living Well contributors, Edward Francis has found,  research is clearly the answer. More studies and wider research projects will provide better results and assist in isolating the cause and treating or preventing this life destroying disease. Meanwhile we can be certain that vitamin D plays a part and ensuring you get an adequate amount daily will do no harm. On the contrary, the body needs this vitamin to function properly. It is important to expose yourself to the sun more, although stay away from damaging UV rays because you don’t want to do damage to your skin. Another related issue is the quality of the supplements or the quality of Vitamin D you take. In regards to this aspect, Edward Francis  and European Nuique.recommend doing your own research.

Home Safety for an Alzheimer’s and Parkinson’s Relative Aging-in-Place

February 4th, 2015 by Doris Bersing

age in placeWhoever said there is no place like home really nailed it. Whether you are visiting Hawaii or you are on top of Everest, you will always have a tingling pricking of nostalgia for sweet home. If a relative is suffering from debilitating effects of Alzheimer’s and Parkinson’s, this is a poignant fact to always remember.

Averting Strain to Family Relationships

Most families suffer restrained relations once the advanced effects of the disease start emerging. Dementia is the most traumatizing effect due to possible hazards if your aging relative is at your place.

Forgetfulness and mobility problems require specialized attention but if your elderly dad refuses to go to a nursing home, you should not force him. Instead, take cautionary steps to ensure they age in place surrounded by love and comfort; isn’t that what you would also love if in the same situation?

Creating the Ideal Aging-in-Place Residence

Indeed, you are in luck because there are experts who can help you make any complex renovations depending on your home’s design. Take a look at how you can easily accommodate your ailing relative:

  • Increase lighting: Alzheimer’s and Parkinson’s eventually affect vision judgement and according to the Alzheimer’s Association, it is crucial to ensure all areas in the house have adequate illumination to help your loved one move around. Before implementing this, you should compare Texas electric rates in order to get the cheapest plan to offset the increase in lighting fixtures.
  • Enhance quality of lighting: While you need more lighting in the house, you should also minimize glares, shadows and reflections that cause distraction and curtail mobility. Moreover, you must avoid sudden changes in light in all rooms and instead apply uniform lighting to help your loved one adapt with time.
  • Age-in-place structural adjustment: According to the National Association of Builders (NAB), this is the fastest growing new segment in home remodelling. You can hire a contractor to create structures such as ramps to enable wheelchair movements, secure steps and handrails across the building, and install grab bars in your toilet and bathrooms among other features.
  • Safety devices: Modern technology has birthed amazing gadgetry that you can use to keep your loved one safe even when away. For instance, touch and voice applications in lamps, TV, interior door among other appliances will help make life easy and safer. They will not have to attempt tinkering with electric appliances, as it is dangerous in their state.
  • Monitoring technology: Motion detectors are important around the house in case your loved one wanders outside without your knowledge. Video cameras can also monitor their movements and in turn ensure they are safe all the time.
  • Automatic switch off in appliances: Home electric appliances should also have automatic sensors in case your relative forgets all about the sandwich he left in the oven. This will give you peace of mind knowing nothing will go wrong.

Other simple techniques include removal of cluttering and old rugs in the house that can lead to tripping. More importantly make sure your loved one has assistance at all times lest he try to carry out risky tasks.

—In collaboration with Mark Harrison. Mark is a construction consultant in Texas who has previously worked in both government and private sector as an energy auditor. If in Texas, he urges homeowners to compare Texas electric rates to enjoy cost-saving.