Exciting New Research On Dementia

Dr. Sarang Kim

Would you have thought that the number one concern facing people with dementia and their carers was social stigma? Researcher Dr. Sarang Kim from ANU conducted a national survey on people’s attitudes to dementia which showed that the general public have negative views and wish to avoid people living with dementia. Dr. Kim was the recipient of the 2016 Alzheimer’s Australia Hazel Hawke Research Grant in Dementia Care and has concentrated her research on the social effects on a person with dementia.

Following the survey Dr.Kim is developing a Dementia Stigma Reduction Program (DESeRvE), which is based on the idea that contact with people living with the condition and education is the best way to reduce stigma. She will use frequently asked questions about people living with dementia sourced from focus groups to have short video clips produced. They will feature people with dementia and their carers answering the questions. Dr. Kim is hopeful that this ‘virtual contact’ and education will help to reduce the level of stigma.

Many of my clients are people living with dementia who reach a stage where they need the level of care provided in an aged care facility. I have noticed that my services as an Aged Care Placement Consultant are being called upon more often by young people with dementia. Most of these clients are in their fifties or sixties and have been living with the condition for about ten years, so the onset was quite young.

Hope for a reduction in the effects of dementia is being offered by the research undertaken by Dr Rebecca Nisbet from the Queensland Brain Institute, who has discovered a feasible treatment. “One of the main causes of Alzheimer’s disease and frontotemporal dementia, two of the most common forms of dementia, is the aggregation of the protein tau within neurons. In our study we generated an antibody specific for tau (RN2N), and investigated its efficacy in clearing tau in a mouse model of frontotemporal dementia,” Dr Nisbet said.

Dr. Nisbet went on to explain that the presence of a blood–brain barrier has historically made delivery of treatment drugs to the brain difficult, but she had found that by using ultrasound, which transiently opens the barrier, that RN2N could be delivered resulting in improvements to memory. Alzheimer’s Australia also provided funding for this important research project, which still has several years to go before it could be offered as a treatment to humans.

 

Senior Forums on Aged Care in Melbourne

Reporting on an aged care forum held recently with seniors in the eastern suburbs of Melbourne facilitated by Aged Care Minister, Ken Wyatt AM, and Member for Chisholm, Julia Banks MP, Ms Banks said “In the electorate of Chisholm, residents aged 65 and over make up 16 per cent of the population and this is set to grow to more than 25 per cent by 2050.”

She made reference to the Aged Care Diversity Framework that was released by the federal government in December as a perfect example how barriers that may exist to accessing appropriate aged care can be eliminated. She spoke of the diverse backgrounds of her electorate saying
“We have welcomed a large number of people from culturally and linguistically diverse backgrounds who contribute so much to the fabric of our local community. We are committed to ensuring that all Australians have access to safe, quality and respectful care and that the diversity of race, religion, language, sexuality and gender is reflected in the care options available.”

With three aged care action plans being drafted under the Diversity Framework, designed to help guarantee equity of access to care, Mr. Wyatt once again stated that people are living longer than ever before and his vision for ageing and aged care was unwavering.  He further stated the government’s aim is to consistently deliver quality aged care that is accessible, affordable and sustainable and that forums like this helps the government understand what is working and what needs to be improved.

Aged care is currently somewhat of a mixed bag and, as an Aged Care Consultant,  I constantly seek the best options for my clients moving into aged care facilities.  Thankfully the standards are lifting across the board and the government’s reforms will hopefully enshrine the best possible standards of care for our elderly Australians.

Reference: Department of Health Media Hub

New Laws for Advance Care Directives In Victoria

This month new laws were passed in Victoria which legalise advance care directives under the “The Medical Treatment Planning and Decisions Act”. I highly recommend that my clients and any elderly person take advantage of this new legislation, as it will give them peace of mind should they need health intervention at a time when they are unable to give the decision for treatment themselves.

Under the Act Victorians can:

  • Create a legally binding advance care directive where they can specify treatment they consent to or refuse.
  • Also create a values directive where they state the values they hold that may affect medical treatment, for example, religious views.
  • Also appoint a medical treatment decision maker, a trusted person who can make medical decisions on their behalf if they are unable to make decisions, adhering to the values stated in the values directive.
  • To help a person make decisions they can also appoint a support person who can assist by gathering and interpreting information and help in communicating decisions.

The advance care directive and values directive are to be made whilst the person is able to make decisions and requires two witnesses, one of which must be a medical practitioner. A person cannot refuse palliative care as part of an instructional directive but can include statements about palliative care in their values directive, such as it is more important for them to remain lucid than completely pain-free at the end of their life. A treating physician must adhere to the advance care directive or gain a decision from the appointed medical treatment decision maker prior to treatment if their patient is unable to make decisions. This applies whether it is a temporary situation or permanent. There are some extenuating circumstances, such as an emergency, where this may not be required.

More information is available here.

You can read more about my services as an Aged Care Placement Specialist on my website.

 

Scientific Anti-Ageing Research May Reverse Need For Aged Care

In our rapidly changing society we could go from the present situation where aged care facilities are the biggest construction growth sector to not needing aged care facilities at all! With the recent news that Australian scientists have helped turn back the body clock for elderly mice and their hope of producing an anti-ageing pill for humans, everything could change. Their findings were reported in the Cell journal and Sydney Morning Herald this week

In a five-year study where the elderly mice became as fit and as strong as the younger ones, scientists from Harvard, Massachusetts Institute of Technology and the University of New South Wales fed a compound to elderly mice that increased muscular blood flow, enhanced physical performance and endurance.  The compound called nicotinamide mononucleotide (NMN) is a form of vitamin B3 that is naturally produced by the body.

The study’s lead author Dr Abhirup Das, anti-ageing researcher at the University of NSW, explained that “NMN can make the old cells healthy, and it can increase capillaries and blood flow.”  This is very important, because as people age, their body largely stops building capillaries and blood flow slows down. Cells are starved of oxygen and nutrients, resulting in weakness and frailty. The best way to slow this process is by exercising but the body’s response to exercise declines with age.  This is where the compound comes in; it is virtually exercise in a pill.

Past attempts at producing an anti-ageing pill failed as the compounds used had to pass through the digestive system, which broke it down before it could be effective. The MNM compound converts to something called NAD+ which doesn’t go through the digestive system. Human trials have shown that this compound is safe for consumption. Later this year more human trials will test its effectiveness in the human body.

Currently I am immersed in helping elderly people and their families to find the most suitable and comfortable residence for their golden years when it’s apparent they need a higher level of care than their present circumstance provides. I take great care to investigate the best possibilities for my clients and sometimes even negotiate a better deal for them in their selected aged care facility.  However, I would happily give away my career if this pill becomes widely available and reverses the effects of ageing. It would be wonderful to see my clients and other elderly people enjoying a younger, fit body to carry them through their later years, staying at home and remaining independent.

 

Meeting Residents’ Expectations in Aged Care Homes

Featured

One of the biggest challenges for providers of Aged Care Facilities is meeting the expectations of residents and their families. From my perspective, as an Aged Care Placement Consultant, I perceive that many families expect their loved ones to receive one on one attention 24/7.  Of course, this is unrealistic as sometimes the other residents will need the attention of the staff. This can’t be helped in accommodation where there are a number of residents with varying levels of care needs to be met.

Clients always ask me about staff ratios, which has become a hot topic in aged care. This is a difficult question to answer since the introduction of Ageing In Place, because most Aged Care Homes now have a mixture of high and low needs and staff numbers are rostered according to care needs and work load at any given time. The most helpful question to ask of an Aged Care Facility is the availability of Registered Nurses on each shift, including overnight, as well as the availability of Doctors on weekends and overnight.
The quality of food is the other big issue in Aged Care Homes and I understand why it’s so important. Apart from the nutritional value, food plays a major role in the daily life of a resident. The anticipation of meals is an important focus and having a good feed leaves them satisfied. Everyone enters a home anticipating the food will be up to standard and palatable; some are disappointed at the quality, while others find the meals delicious.

Earlier in my career when I worked in Aged Care Facilities I was amused that it was often the people who had lived alone surviving on toast or crumpets who complained the most about the food. I would hear the complaints the Chef received and they were often contradictory, some thought the soup too hot, some too cold, some found the gravy too thick, some too thin. I realised how difficult it was to deliver meals for such a large and diverse population, also taking into account medical conditions, and still please everyone. I can assure you there are many residents who do enjoy their food.

In my experience, the people who choose to enter Residential Aged Care and embrace their new lifestyle thrive and are mostly content. And, like anything else, those who look for the bad will always find it and will probably never be happy.

Aged Care Future Planning Paid Off

Caroline and Billy

Last week I wrote a blog about future planning for aged care. For Billy and Caroline it paid off. With my help they planned for the day they would move to an aged care facility. Caroline and Billy received an offer from their chosen facility last week, and have gladly accepted it.

Initially they were hesitant to consider moving from their home, despite encouragement to plan for this from both their family and doctor. When I was referred to them in April/May last year they decided to explore the possibilities with my help. Caroline had concerns for the short term that she may need to go to hospital and her husband Billy cannot be left on his own. In the long term they wanted to be together and share a suite. I recommended they get their financials in order so they would be prepared, and referred them to a Financial Planner.  We decided to begin searching in their local area for suitable accommodation.

They continued to manage reasonably well at home with services and assistance from their family until late last year when Caroline needed hospitalisation for a few days. Interim care was arranged for Billy at home but when Caroline had complications and had to stay in hospital longer, I found emergency respite for Billy in one of the homes we had initially visited.  The family were very pleased with the care Billy received but for Caroline it was not the facility where she wanted to spend the rest of her life.

Once Caroline and Billy returned home, she called a family meeting, which I attended, and informed her family that she had decided that it was time for her and Billy to make the transition to permanent residential care. She felt that, should there be another crisis, she did not want this undue pressure put on her family again. They had decided on Kew Gardens Aged Care, so I contacted the facility and asked for their application to be moved from waiting to urgent. Within two months a suite became available. They chose the Kew Gardens aged care facility because it is right across the road from their present home and they already have friends residing there.  Set on the edge of beautiful Kew Gardens, it is aptly named and has a pleasing outlook. They will move shortly. I am so pleased that this transition will be far less stressful for them ,due to their taking action and forward planning. I was happy to assist them in their planning and take pride in doing the best for my clients.

Future Plan Is The Best Way To Care For Parents on The “Tightrope of Aging”

Modern facility lounge

Making the decision to move from the home that you know and in which you have invested so much of yourself is always difficult, no matter at what stage of life you make it.  When you are elderly and no longer capable of caring for yourself it is even more so. There are so many emotional reactions to the idea – reluctance to leave the comfort of your own home, sadness at leaving behind friends or family, fear of an unknown environment, not wanting to be a burden and shame at no longer being able to care for yourself. A book called “Holding the Net: Caring for My Mother on the Tightrope of Aging” by Melanie P Merriman published late last year explores the difficulties faced by two daughters whose ageing mother is fiercely independent and does not want “to be a burden” to her children. They enter a tug of war where their mother fights for her independence whilst they fight for her safety.

The ultimate conclusion Melanie draws is that the discussion about her mother’s future needs and the best way to meet them should have been held early on and a future plan decided upon with all parties in agreement. She realised too late that trying to adhere to her mother’s desire “not to be a burden” actually caused the problems that did become burdensome to Melanie and her sister.

Being at the coalface of this type of situation myself, as an Aged Care Placement Specialist, I often see how difficult the decision to move a parent to an aged care facility can be. Trying to find a suitable place at short notice when a parent has a serious fall or their health seriously deteriorates is very stressful. I strongly advocate that families discuss their elderly parent’s future needs with them in an honest and open way before a crisis occurs. Setting up a future plan for elderly parents in which they feel empowered and involved in the decision making will reduce a great deal of stress if the time comes when they need the added level of care that an aged care facility can provide.

With the depth of knowledge I have of the different aged care facilities, current legislation and the processes involved, I have been able to assist people to set up their future plans. It is always my pleasure to help people find the best option for their later years, where they will feel at home and enjoy their lifestyle.