Archives for February 2016

Traumatic Brain Injury: Drug Shows Promise for Reducing Harmful Brain Inflammation

(MedicalNewsToday) In recent years, researchers have highlighted the potential long-term effects of traumatic brain injury, which include increased risk of dementia and other neurological disorders. Now, a new study has uncovered a drug that shows promise for reducing the brain damage caused by such an injury.

Traumatic brain injury (TBI) is defined as a bump, jolt or blow to the head that interferes with normal brain functioning.

Falls, motor vehicle accidents and assault are some of the most common causes of TBI, and people who play contact sports are particularly at risk.

Symptoms of TBI include headache, dizziness, fatigue, problems with concentration and memory and poor motor control, though how long these symptoms last depends on the severity of injury. In more severe cases, symptoms can last for weeks or months.

Increasingly, studies have suggested that TBIs can have even longer-term effects on the brain. Recent research reported by Medical News Today, for example, found evidence of Alzheimer’s brain plaques in people who had suffered a TBI from 11 months to 17 years previously.

As such, there is more focus than ever on identifying ways to reduce both the short- and long-term effects of brain damage caused by TBI.

In a new study published in PLOS One, lead study author Adam Bachstetter, PhD, assistant professor in the Spinal Cord & Brain Injury Research Center and the Department of Anatomy & Neurobiology at the University of Kentucky, and colleagues reveal how an experimental drug called MW151 could do just that.

MW151 ‘Dampens Down’ Damaging Inflammatory Responses in TBI

Study coauthor Linda Van Eldik, PhD, of the Sanders-Brown Center on Aging and the Department of Anatomy & Neurobiology at Kentucky, explains that after a head injury, the body tells immune cells to respond to the trauma and begin the healing process.

Fast facts about TBI

  • TBI contributes to more than 30% of all injury deaths in the US
  • In 2010, around 2.5 million emergency department visits, hospitalizations or deaths in the US were linked to TBI
  • Between 2006-2010, men were almost three times as likely to die from TBI than women.

Learn more about TBI


“Although these immune cells help repair the injury, they also cause inflammation that may damage the tissue – a sort of double-edged sword,” she adds.

Previously, the researchers found that MW151 blocked the release of harmful chemicals that triggered inflammation in a rodent model of closed head injury – a form of TBI in which the brain knocks against the skull – while maintaining the immune cells that repair brain damage.

Additionally, the researchers found that MW151 was able to reduce cognitive impairment caused by closed head injury.

For the new study, the team tested MW151 against a mouse model of mild fluid percussion injury (mFPI), which represents a more severe form of TBI called diffuse axonal injury (DAI).

In DAI, brain injury occurs over a more widespread area as a result of the brain moving back and forth in the skull. It is most common in shaking injuries or motor vehicle accidents.

When the mouse models were treated with MW151, the researchers found that the drug suppressed levels of a pro-inflammatory cytokine in the brain called interleukin-1 beta (IL-1β), which reduced inflammation without interfering with the brain’s repair process.

Commenting on the findings, Bachstetter says:

“We were delighted to see that MW151 is effective in more than one model of TBI. MW151 appears to dampen down the detrimental inflammatory responses without suppressing the normal functions that the cells need to maintain health.”

Van Eldik believes their findings could have a significant impact on the treatment of TBI, an injury that she says represents a “major unmet clinical need.”

“[…] there is currently no effective therapy to prevent the increased risk of dementia and other neurologic complications, such as post-traumatic epilepsy, neuropsychiatric disorders, and post-concussive symptoms such as headaches, sleep disturbances, memory problems, dizziness, and irritability,” she adds.

“MW151 represents an important next step in the process to help people with TBI, including soldiers, athletes, car accident victims and others.”

The researchers say they hope to begin clinical trials of MW151, assessing its effects in people with TBI, within the next few years.



MW151 inhibited IL-1? Levels after traumatic brain injury with no effect on microglia physiological responses, Adam Bachstetter et al., PLOS One, doi: 10.1371/journal.pone.0149451, published online 12 February 2016.

University of Kentucky news release, accessed 19 February 2016.

Additional source: CDC, TBI: get the facts, accessed 19 February 2016.

Additional source:, Definitions related to TBI, accessed 19 February 2016.

MediLexicon International Ltd, Bexhill-on-Sea, UK

© 2004-2016 All rights reserved.


Dementia Treatment Delayed Due To Misdiagnosis

(ScienceDaily) Many patients showing signs of dementia are quickly diagnosed with Alzheimer’s disease when they might actually suffer from frontotemporal dementia, delaying the appropriate treatment for them.

“Some people cannot tell frontotemporal dementia from Alzheimer’s disease,” said Joseph Masdeu, M.D., director of the Nantz National Alzheimer Center at Houston Methodist Hospital.

“However, these diseases have different symptoms and treatments. And with advances in neuroimaging, we can see a clear difference in how frontotemporal dementia manifests in the brain.”

alz vs ftd

 Using specialized PET imaging, researchers at Houston Methodist are able to identify accumulations of the protein beta amyloid in the brain of Alzheimer’s patients, shown in yellow in the scan on the left. Beta amyloid is not present in the brains of patients with frontotemporal dementia, as shown in the scan on the right. Credit: Houston Methodist

In Alzheimer’s disease, the accumulation of the protein beta amyloid can induce the excess production of an abnormal form of the important brain protein, tau. In frontotemporal dementia, beta amyloid is not present and a different abnormal form of tau is detected. Houston Methodist Hospital is the only center in Houston offering tau imaging to aid in the diagnosis of frontotemporal dementia.

“A misdiagnosis of Alzheimer’s can prevent a person with frontotemporal dementia from participating in future trials for this group of disorders” Masdeu said.

“And since potential Alzheimer’s treatments would not help a patient with frontotemporal dementia, misdiagnosed patients participating in Alzheimer’s clinical trials can skew that data and prevent the advancement of those treatments.”

Masdeu adds that a good treatment is not yet available for frontotemporal dementia, but that the symptoms can be treated. While memory loss is the primary symptom of Alzheimer’s, patients with frontotemporal dementia begin to be less concerned or organized in their daily activities, say or do inappropriate things that they usually would not, or have difficulty finding the right words.

Frontotemporal dementia is estimated to affect more than 50,000 people in their 50s to 70s annually, whereas Alzheimer’s disease affects more than 5 million people between the ages of 60 and 90 each year.



Houston Methodist. (2016, February 24). Dementia treatment delayed due to misdiagnosis. ScienceDaily. Retrieved February 29, 2016 from

Copyright 2016 ScienceDaily or by third parties, where indicated.


Alzheimer’s Caregiving: Tips for Managing Guilt

(BrightFocus Foundation) Being a caregiver to one with Alzheimer’s can be rough terrain. Ask anyone who has journeyed down the caregiving path, and you will find many examples of an emotional experience, perhaps unlike any other. Chief among the many emotions associated with being a caregiver to one with Alzheimer’s is guilt. It is present in many scenarios of caregiving, such as:

  • You are a long distance caregiver who is able to visit your loved one every few months, and you do what you can from a distance. When in town, you help in ways that are needed, giving the regular caregiver some respite. Though happy to contribute your time, you return home feeling relieved to be getting back to your own routine, and guilty for having a reason to leave.
  • You are a spouse caregiver. You cook, clean, bathe, attend appointments, do laundry, and manage medications. You have been doing this for years. You are tired. You are not as patient as you once were. Feeling stuck in your role, you do not know how much longer you can do this, and feel guilty for wanting out.
  • You live near your loved one with Alzheimer’s, work fulltime, are married, and have school-age children. There are so many demands on your time, you are not available as much as needed to any of your loved ones, and sometimes you take your stress out on them. You feel pulled in multiple directions.
  • You are a paid caregiver who works 10 – 12 hours a day. More and more often, you find yourself losing patience with your care recipient. You have been leaving each day feeling terrible about these moments.

This is Caregiver Guilt 
It is Normal. It Has a Purpose.

Guilt can serve a useful purpose. It can propel us to improve our caregiving skills, or make changes in how we juggle our caregiver role with our other responsibilities. Below are five helpful tips for turning the guilt into opportunity.

  1. Check in with yourself, asking, “Why am I feeling this way?” Perhaps you did not handle a stressful moment well with your loved one, losing patience for something insignificant. Can you think of better ways for the next time? Could you use some education to learn better responses for these moments?
  2. Find support. Caregiving is a journey, and you need support along the way. Whether a caregiver buddy, a support group, an online caregiver forum, or a family member or friend, enlist the support of someone who knows and understands what you are going through. They can be a great source of support and education. Explore our helpful resources that provide products, services, and other support for people with Alzheimer’s disease and their families.
  3. Give yourself permission to make mistakes. You are human. Mistakes will happen. Take the opportunity to learn from them.
  4. Find additional help. If the stress of daily caregiving is making you weary and/or impatient, consider additional options for your loved one’s care. Hire a part time caregiver. Enroll your loved one in an adult day center. Ask a family member to cover while you take some time off. In many areas of the country, there are respite options for caregivers. Check with your Area Agency on Aging about local resources. Do not feel guilty for doing this. You need to monitor your own ability to continue this important work, and make appropriate adjustments along the way.
  5. Seek balance. Spending lots of time caregiving and not much else? Being a caregiver for your parent, but not attending the children’s activities? Each change in our responsibilities requires us to re-balance the other responsibilities of our lives. A good balance is important for everyone, especially caregivers.

Kathleen Allen, LCSW, C-ASWCM

BrightFocus is a tax-exempt nonprofit organization under section 501(c)(3) of the Internal Revenue Code of the United States.
Copyright 2016 BrightFocus Foundation. All rights reserved.


What You Can Do to Avoid Caregiver Burnout

(WebMD) As much as you love the person in your life who has Alzheimer’s disease, taking care of them can be stressful.

People with the condition often need help for decades rather than a few months or years, says Mary G. Austrom, PhD, an expert on caregivers and Alzheimer’s disease at the Indiana University School of Medicine. They also need more and more help with basic needs over time.

For caregivers, that stress can build into burnout. It can also make you more likely to get depressed. It helps a lot if you can notice when you start to feel overwhelmed, and then take steps to get back on track. If you do that for yourself, you’ll be better prepared to take care of your loved one.

How to Spot Burnout

When your responsibilities start to overwhelm you, you may feel:

  • More frustrated and impatient
  • Exhausted
  • Teary
  • Discouraged
  • Less hungry or more hungry
  • Less pleasure in things you used to enjoy

You may also notice that you sleep more (or less) than usual, or that you are tempted to use alcohol or other drugs to take the edge off.

If any of these things happen, tell your doctor or the one who is treating the person you’re caring for. They may be able to help, Austrom says.

Go Easy on Your Loved One and Yourself

When your loved one seems to be living in the past or wants to argue with you, or says or does things over and over, remember that that’s the disease talking.

Try not to argue with her, even when you know she’s not right. Also, resist the urge to correct your loved one’s behaviors or word choices, says Marsha Lewis, PhD, dean of the School of Nursing at the University at Buffalo. It’s going to take too much time and energy, and you won’t persuade them. It just add stress to your life.

Give yourself a break. Focus on doing what you can for your loved one. Chances are, you don’t have special training in caregiving, and you probably have lots of other responsibilities, such as your own family and a job.

“Most healthy older adults, when asked about their preferences for care if they can no longer care for themselves, say, ‘I wouldn’t want to be a burden on my children,'” Austrom says. Your parent, partner, or other loved one with the disease wouldn’t want you to wear yourself out. So know your limits and try not to push too far past them, too often.

Find Help

You’re less likely to burn out if you share caregiving tasks with other people, Austrom says. Check with your insurance company to see what services they may cover.

Ask friends and family to help. Some caregivers use online calendars so the people in their lives can easily sign up to handle tasks. The Alzheimer’s Association offers a “care team calendar” on its web site. You can also use Facebook or other social media to organize your circle of family and friends.

Enroll your loved one in an adult day care program for people with Alzheimer’s. He can visit with others while you take a few hours to run errands or relax.

Find other care for a few weeks. Your loved one may be able to stay for a week or two at a long-term care facility. That will give you a break. Austrom says she’s heard caregivers say these breaks helped them relax and feel more able to handle their loved ones’ needs.

Share some tasks with a home health aide. If you hire someone part time, she can drop in and help with some of the caregiving tasks.

Contact your local Agency on Aging. The agency can point you toward resources such as adult day care programs and home health services. You can find your agency’s contact number through the web sites of the National Association of Area Agencies on Aging or the U.S. Administration on Aging.

Connect With People Who Get It

Find a support group for caregivers in your area. When you go, you can talk to people who know what you’re going through because they’ve been there, too. From them, you may learn new ways to manage your stress and see how they handle their challenges, Austrom says.

You can also try an online support group. The Alzheimer’s Association, for example, has one.

Protect Your Own Health

“Sometimes caregivers, in their zeal to care for their loved ones, will stop taking care of themselves,” Austrom says.

But your loved one is counting on you — and you count, too. Make a point to:

  • Keep up with your own medical care.
  • Exercise daily, even if it’s just a 20-minute walk.
  • Get enough sleep.
  • Spend time with people you like.
  • Consider talking with a counselor about what’s going on and how you’re doing.

Appreciate the Moment

Caregiving can be intense. You’re bound to be busy.  Still, look for chances to do things that you enjoy. These may be moments, rather than tons of time. Even so, they can help restore and renew you.

“Taking time for pleasant events is important,” Austrom says. Make time at least once a week to do something fun with your family or friends, head outdoors, or spend time on a hobby that you love. You’ll come back more ready to step back into your caregiver role.


Reviewed by Neil Lava, MD

View Article Sources

© 2016 WebMD, LLC. All rights reserved.



Mental Activity May Not Stave Off Alzheimer’s Progression

(MedicalNewsToday) New research, published this week in Neurology, confirms that remaining physically and mentally stimulated helps to stave off cognitive decline. However, the underlying brain alterations involved in Alzheimer’s disease do not seem be affected in most individuals.

Over the past few years, evidence has mounted that keeping your mind and body in motion through mid-life and into old age helps keep the brain nimble.

So far, evidence for the role of continued mental activity on Alzheimer’s pathology is not so well documented.

Efforts have been made to ascertain whether lifestyle enrichment minimizes the neurological changes that go hand in hand with Alzheimer’s. The results, so far, have not been definitive.

To date, most of these studies have been cross-sectional. In other words, the studies have not followed the patients as the brain ages, rather, they have dipped into a cross-section of the population at just one point in time.

This makes solid conclusions difficult to draw, because the progression within each individual is not charted.

Research, conducted at the Mayo Clinic in Rochester, MN, sets out to bridge some of these gaps. The team investigated the effects of a number of lifestyle and genetic parameters on the underlying pathophysiology of Alzheimer’s disease over time.

Measuring Changes in Aging Brains

The team, led by Prashanthi Vemuri, used participants from the Mayo Clinic Study of Aging (MCSA). This sample consisted of 393 individuals, all over the age of 70. Of these, 340 were clinically normal and 53 had mild cognitive impairment.

The participants’ brains were measured for a number of Alzheimer’s-specific parameters. Firstly, cerebral amyloidosis was measured; this is the buildup of protein plaques in the brain that are a hallmark of Alzheimer’s disease.

Metabolism of glucose within the brain was also measured, as – in Alzheimer’s – this slows as the disease progresses. Finally, the researchers measured the volume of the hippocampus, an area of the brain involved in memory storage and emotion known to shrink during Alzheimer’s progression.

The volunteers received weekly questionnaires to evaluate levels of mental and physical activity.

The participants were split into two groups – high and low education. The high education group had 14 years of education or more and the low education group had under 14 years of education.

The Role of Apolipoprotein E in Alzheimer’s

Apolipoprotein E (APOE) is a protein involved in cholesterol metabolism. Importantly, APOE4, a variant of APOE, is the largest known genetic risk factor for Alzheimer’s.

In a previous study, carriers of two APOE4 alleles were shown to have between 10 and 30 times the risk of developing Alzheimer’s by the age of 75, when compared with those without any APOE4 alleles. For this reason, the researchers also investigated the role of APOE on the neurological outcomes.

The current study found that APOE4 played a significant role in the way that mental and physical activity impacted Alzheimer’s etiology. Individuals in the higher education group who carried the APOE4 gene and continued to be mentally active had significantly fewer amyloid plaques than similarly educated individuals carrying the APOE4 gene who had not maintained mental stimulation throughout their lives.

Vemuri said of the results:

“When we looked specifically at the level of lifetime learning, we found that carriers of the APOE4 gene who had higher education and continued to learn through middle age had fewer amyloid deposition on imaging when compared to those who did not continue with intellectual activity in middle age.”

However, for the group as a whole, mental and physical activity, occupation and education had no significant effect on amyloid plaques, glucose metabolism or hippocampus volume.

So, for the 20% of the population who carry the APOE4 gene, higher education and continued mental activity does seem to stave off some of the negative brain changes in Alzheimer’s disease; for the rest of the population, this does not appear to be the case.

The authors recognize that the current study has limitations. For instance, Vemuri says that

“it is possible those who did not continue intellectual activity in middle age did so because they had higher levels of amyloid plaques.”

The team ends the paper with a call for further research on a wider scale.


By Tim Newman

Journal Reference:

Prashanthi Vemuri, Timothy G. Lesnick, Scott A. Przybelski, David S. Knopman, Mary Machulda, Val J. Lowe, Michelle M. Mielke, Rosebud O. Roberts, Jeffrey L. Gunter, Matthew L. Senjem, Yonas E. Geda, Walter A. Rocca, Ronald C. Petersen, and Clifford R. Jack, Jr. Effect of intellectual enrichment on AD biomarker trajectories: Longitudinal imaging study. Neurology, February 24, 2016 DOI: 10.1212/WNL.0000000000002490

MediLexicon International Ltd, Bexhill-on-Sea, UK

© 2004-2016 All rights reserved.


Are Women the Key to Unlocking Alzheimer’s?

(WebMD) Alzheimer’s disease hit the Schafferman siblings hard. Audrey was the first. She was diagnosed at age 65, about 3 years before her younger brother Gene. Audrey died in 2007. Gene would follow 5 years later.

Gene’s daughter, Donna Shore, recalls that the disease looked a lot different in her father than it did in her aunt.

“It seemed like Aunt Audrey went a lot faster than my father did,” says Shore, 58, of Littlestown, PA. She took care of Gene. He was so spry and vibrant that he was able to continue his favorite hobby — dancing — until just a year before his death. The nursing home staff called him “Gene, Gene, the Dancing Machine.”

Shore is especially grateful that her dad never forgot who she was, calling her by her nickname, Sparky, right up until his death.

Audrey’s loss, by contrast, seemed crueler. The unfailingly kind and loving mother and grandmother became paranoid. She accused her daughters of stealing her glasses and her social security checks — when she could remember who her children were.

“I would have to go to the bathroom and cry, because I wasn’t used to my mother talking to me that way,” says Robin Broyles, 62, of Baltimore, MD.

When Audrey began sneaking out of the house and started confusing a closet for the bathroom, the family made the wrenching decision to put her in a nursing home. She died 18 months later.

Though the experience of the disease is highly individual, researchers think what happened in the Schafferman family may be part of a larger pattern, one that puts women in the epicenter of the Alzheimer’s epidemic.

Studies show that by age 65, women have about twice the risk of getting the condition. About 1 in 6 women will get Alzheimer’s after age 65, compared to about 1 in 11 men. About two-thirds of people in the U.S. with the disease are women.

Not only are women more likely to get Alzheimer’s than men, but recent studies suggest the disease does its work more swiftly in women, causing them to decline faster — and farther — than men do, at least in the beginning.

It’s long been thought that the main reason for women’s increased risk was age. Women simply live longer than men do, and Alzheimer’s is a disease of aging. The longer you live, the more likely you are to get it.

But researchers say age alone doesn’t entirely explain the extra risk.

In a recent study, researchers at Duke University looked back at the medical histories — documented by written tests and brain scans — of almost 400 women and men enrolled in a long-running study of brain function. All the study participants were showing early changes in memory and thinking that often, but not always, progress to Alzheimer’s disease.

What the researchers found was striking. Women with early memory changes declined about twice as fast as men did, and they ended up worse off, too.

“Our findings suggest that men and women at risk for Alzheimer’s may be having two very different experiences,” says Katherine Lin, a senior at Duke and lead researcher of the study.

Lin says it’s possible there’s something unique to women’s biology or life experiences that makes them more vulnerable to the disease than men.

“Uncovering those factors should be a high priority for future research,” she says.

The Alzheimer’s Association, a national nonprofit advocacy group, agrees.

In May 2015, the association launched the Women’s Alzheimer’s Research Initiative, or WARI, which will focus on funding studies to tease out what those as-yet-unknown risks may be.

They plan to announce the first round of study grants this spring. It won’t be an easy task, as they have to pick just six to eight projects out of more than 120 applications from 17 countries. Each project will get $250,000 in research funding.

“It’s not just that women are living to be older. There’s something else going on in terms of the biology, the environment, for women compared to men that may make them at greater risk, or if they have some symptoms, change the progression,” says Kristine Yaffe, MD, a professor of psychiatry, neurology and epidemiology at the University of California, San Francisco.

Roberta Diaz Brinton, PhD, is a neuroscientist at the University of Southern California and a leading voice for studying the disease in women. She finds it puzzling that most Alzheimer’s research has been gender-blind, when women are in the majority of people with the disease.

“With AIDS, the AIDS research community did not look across the entire spectrum of everyone who was having sexual intercourse,” Brinton says. Instead, researchers focused on gay men having unprotected sex. “Focus on the people who have the biology,” she says.

New Clues in Women

One of the biggest risk factors for Alzheimer’s disease — in men or women — is a gene that carries instructions for a protein called apolipoprotein E, which ferries cholesterol and beta-amyloid in and out of cells. Beta-amyloid are sticky fragments of proteins that build up in the brains of people who have Alzheimer’s disease.

Inheriting just one copy of the APOE4 gene results in a two to four times greater risk of Alzheimer’s disease. Inheriting two copies raises the risk nearly 15 times.

That higher risk doesn’t appear to be shared equally by men and women. A 2014 study of more than 8,000 people found that APOE4 had a stronger effect in women. For healthy men, having one copy of the gene only slightly increased the risk of memory problems compared to other men. For women, a single copy nearly doubled their risk of the brain changes and eventual Alzheimer’s compared to other women.

Other studies have questioned whether lifestyle factors and experiences particular to women may be playing a role. Women are more likely than men to get depression, which increases the risk for Alzheimer’s disease.

Education, it turns out, has a powerful connection with brain health. The more education a person has, the lower their risk for getting Alzheimer’s, leading researchers to wonder whether knowledge and learning may build the brain up, almost like a muscle, making it harder for the disease to wear it away. Historically, women haven’t been as well-educated as men.

Exercise protects the brain from Alzheimer’s, and studies have shown that at least in the past, women haven’t been as physically active over the course of their lives as men are.Even surgery is riskier for women.A little confusion can be normal after general anesthesia, and most people recover from the experience with no lasting problems. But some people never quite recover, and older adults are known to be particularly vulnerable to long-term effects after surgery.Researchers at Oregon Health & Science University found that men and women who’d been put to sleep for surgery did worse on tests of thinking and memory compared to similar adults who didn’t have surgery. But the declines were bigger and more rapid for women. Women also had more brain shrinkage on MRI scans after anesthesia than men did.The more procedures a person had, the bigger the brain problems after surgery. And it didn’t seem to matter what anesthesia drug doctors used.

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Can I Get Paid as a Caregiver?

(AARP) En español | Most caregiving starts out as a labor of love, but it can quickly grow into an expensive obligation. In these economically insecure times, caregivers are struggling with heavy financial responsibilities, especially if they’ve had to quit their jobs to provide care.

I’m often asked by caregivers whether they can be paid for the work they do. Unfortunately, I’m not able to give a simple answer. A qualified “maybe” comes closest to reality. There are, however, several options to explore.

State Programs

Some states have programs that help people pay for the caregiver of their choice, and in certain circumstances that can be a family member. These programs — called, variously, “consumer-directed,” “participant-directed,” “cash and counseling” or other titles — differ enormously depending on where you live. Most have income and other eligibility requirements that the care recipient must meet, and strict rules often apply as to who can be paid for the caregiving. For information about what’s available in your state, contact your local Medicaid or aging services department or go to the National Resource Center for Participant-Directed Services.

But be aware that there are waiting lists for these programs and that states have been cutting back on them because of budgetary pressures.

Veterans’ Benefits

A law passed in 2010 provides a monthly stipend to primary caregivers of veterans injured in military conflict after 9/11. Other benefits to caregivers include travel expenses, access to health care insurance, mental health services and respite care of 30 days a year. For more information, call 1-877-222-VETS (8387). Caregivers of veterans of other wars may be eligible for the VA’s Aid and Attendance Pension Benefit. In addition, some state programs are specially designated for veterans.

Long-term Care Insurance

If your family member has long-term care insurance, it may cover some home care. Some policies permit family members to be paid, although they may exclude people who live in the same household. Ask your family member’s insurance agent to explain this benefit and its conditions.

Caregiver Contracts

If none of these options apply to you, all is not lost, especially if the person you are caring for has some savings or other assets. For example, a parent may be willing to work out a caregiver contract and pay a son or daughter for the care he or she provides. Consult an elder care lawyer to make sure that the contract meets tax requirements, deals with inheritances and is approved by all other interested parties (siblings, for example). Be mindful of the emotional pitfalls in this arrangement.

Other Options

If you are facing financial hardship because of a caregiving situation, here are some other options to consider:

  • Look into finding work you can do at home, or find a job that allows you the flexibility you need to be a caregiver.
  • Hold a family meeting with siblings and others to discuss ways you can all share the financial burden.

Remember, your financial and emotional health should remain a top priority so you can continue to provide the kind of care your loved one needs.


Copyright 2016 AARP


Can’t Take Being an Alzheimer’s Caregiver Anymore?

( Watching your once mentally sharp parent decline before your eyes. The parent’s uncontrollable anger and outbursts. The devastation of memory loss. Worrying that your parent will wander away from home and never come back. When you are taking care of a parent with Alzheimer’s, you are trying to cope with your own grief over their illnesses, help them with their feelings of loss, keep them safe, make your immediate family reasonably content and work at your job. You are wearing out, but caregiver guilt won’t let you say – enough!

Listen to Your Own Needs

Most of us, when we have a vulnerable loved one, want to take care of them. We aren’t excited about having strangers take over the care of our loved ones, and our loved ones normally aren’t excited about that idea, either.

However, outside care eventually becomes a necessity for many. When we are talking about elder care, often people jump immediately to the “nursing home” solution, since in days past, that was pretty much the only choice people had once someone couldn’t stay at home, or with family. Things have changed now, but that doesn’t mean it is easy.

With more options for care comes more confusion. When is in-home help enough? Is assisted living the best option? And what about nursing homes? Are they the nightmares of the past?

That Promise You Made

Hindsight can make us pretty smart. Sometimes, when our parents are younger and healthier, we make promises: “I promise I’ll never put you in a nursing home.” We should not tell our parents we’ll never put them in a nursing home, since we have no idea what the future will bring. Also, that promise just underscores their view of the old style nursing homes, which were truly depressing places.

Unfortunately, there are still areas of the country where nursing homes are far from excellent, and our whole nation has a long way to go before most homes are what they should be. But we are talking about your reality here. We are talking about what is happening right now.

You may have made a promise that you could need to break. If that’s so, remember that by caring for your parent for as long as you have has honored the spirit of the promise (I snitched that phrase from a terrific hospice chaplain). The idea is that you’ve done all you can to keep your elders safe and to help them through some tough times. However, times have gotten tougher than you expected, and you must look for other options. That’s okay.

Don’t Make the Promise if You Haven’t Already Done So

If you haven’t made the fateful promise, but your parents want you to do so, simply say, “I love you very much and will do everything I can to take care of you. We don’t know what the future holds, but I’ll do my best, always, to care for you in the best way I can.” Repeat as needed.

Back to Options

The first place I recommend people check for help is their state website. Since each state is different, it’s hard to give one answer as to what help is available in your community. By going to your state Web site (just type in the state name and scroll down until you find the official site), you should find some help. If you type “aging” into the search box of your state site, you’ll find your state’s version of the National Family Caregiver Support Program (NFCSP). Click that link and check in with these people. They will know what your state and community have available. They will also offer emotional support.

Many states have some federally funded hours of in-home care that go to waste because people don’t know about them. The NFCSP folks should be able to point you to the organization in your area that would administer this help.

Click on any site that looks useful under this state aging help category. You may find quite a lot of help – or not much.

In-home care agency care can be expensive, but it’s flexible. You may find an agency that can help your loved one, at least for awhile so you have a break from constant care, and then you can look for more permanent help. The main idea is that you need to get some relief.

Assisted living centers often have memory units, which generally offer good care to folks with dementia who are not having a lot of other physical problems. Assisted living is expensive. Expect that most of your elder’s money will go for their care, if they need outside help. Unless people are wealthy, long-term diseases like Alzheimer’s can eat up most of your parents’ assets. You’ll have to accept that reality and so will they.

Your own health is expensive, too. If you get physically or mentally sick, you aren’t going to be able to care for your loved ones well, if at all. You may have to explain this to your elders (and to yourself) repeatedly. But believe me, it’s true. If you are coming to the end of your rope with caregiving, you need to get help. Guilt isn’t an option. Your sense of guilt will only contribute to your parents’ feeling of insecurity. So, please work on your own feelings about outside help. Think of this as giving more care, not about you caring less.

Assume as upbeat an attitude as you can, and start looking at assisted living facilities. Treat it as an adventure, even if your elders are complaining. Do your best to detach from their complaining and look anyway. Try to be cheerful but firm about any help you seek.

Nursing homes are for the sickest people. They, too, are expensive. Most people who spend a long time in a home end up spending all of their money and most of their other assets. They then go on Medicaid, which is the government help for the poor. A good nursing home should not give lesser care to someone on lower paying Medicaid than to someone who is on what they call “private pay.”

When my loved ones moved to a local nursing home, I watched the staff closely. This was an exceptionally good home, to be sure, but I’ll say that I never, ever saw any difference in care based on how the home got paid. Nursing homes are all supposed to be this way. If you see a home that discriminates, report this home to your state ombudsman.

Back to Your Own Needs

When you’ve had enough, you’ve had enough. No one who is burned out is able to do his or her best to care for another person. Don’t let this happen to you. Get help before you are at the stage where your loved one needs more attention and help than you can give.

When caring for a parent with Alzheimer’s becomes too much for you, you are at risk for depression and other health problems. You may even put your loved one at risk because you can’t watch after him or her safely. Do it now before you completely break down. Do it for your family and yourself.


By Carol Bradley Bursack

Elder care author, columnist and speaker Carol Bradley Bursack is an contributing editor and moderator of the community forum. Read her full biography

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