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Aging Wisely May 2007 - Aging Wisely

Recommended Reading Related to Dementia


Friel McGowin, Diana. (1993). Living in the Labyrinth: A Personal Journey through the Maze of Alzheimer’s. Forest Knolls, CA: Elder Books.

Smith Henderson, Cary. (1998). Partial View: An Alzheimer’s Journal. Southern Methodist University Press.

Mace, Nancy and Rabins, Peter. (1999). The 36-Hour Day. NewYork: Warner Books.

Gosselin, Kim. (2001). Allie Learns about Alzheimer’s Disease. JayJo Books.

Robinson, A., B. Spencer, and L. White. (1998). Understanding Difficult Behaviors: Some Practical Suggestions for Coping with Alzheimer’s Disease and Related Disorders. Ypsilanti, MI: Geriatric Education Center of Michigan, Michigan State University.

Caring for an Alzheimer’s Patient: A Family Guide. American Health Assistance Foundation. 1994, revised 1998. This 34-page booklet discusses the issues involved in caring for an Alzheimer’s patient, including family involvement, tips for creating a safe home environment, and support groups and respite care options for caregivers of

Snyder, Lisa. Speaking our minds: What It’s Like to Have Alzheimer’s, Revised Addition. New York: W. H. Freeman, 2009. ISBN: 1932529500. Seven individuals of various ages and backgrounds express their thoughts and feelings about what it is like to have Alzheimer’s disease, to live with it day to day, and to cope with its impact on their lives.Alzheimer’s patients.

Taylor, Richard. Alzheimer’s from the Inside Out. Health Professions Pr; 1 edition (December 31, 2006). ISBN: 1932529233.The author, who was diagnosed with Alzheimer’s Disease at age 58, shares his experience of living with the disease. Addresses the complex emotions surrounding issues such as the loss of independence, unwanted personality shifts, struggles to communicate, and more.

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Alzheimer’s Fact Sheet


General Facts:

  • Dementia is defined as “a deterioration of intellectual function and other cognitive skills, leading to a decline in the ability to perform activities of daily living” (Merck Manual of Geriatrics). Alzheimer’s Disease (AD) is the most common form of dementia among older people. Other types of dementias include: Lewy Body Disease, Pick’s Disease, Creutzfeldt-Jakob Disease, AIDS related dementia, dementia associated with Parkinson’s or Huntington’s Disease, multi-infarct dementia and others.

  • Scientists think up to 4 million Americans suffer from AD. Risk increases with age, but AD is not a normal part of aging.

  • AD is named after Dr. Alois Alzheimer, a German doctor. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. He found the characteristic amyloid plaques and neurofibrillary tangles considered hallmarks of AD.


  • Not yet fully understood.

  • Probably several factors involved.

  • Risk increases with age.

  • Family history is another risk factor, although in the most common form of AD occurring in late life, no obvious family pattern is seen.

  • Dementia symptoms can be caused by many physical and sometimes reversible factors, making it important to gain a thorough evaluation and rule out other causes.


  • Definitive diagnosis requires observing plaques and tangles in brain tissue, which can be done in autopsy. However, doctors can diagnose AD correctly up to 90% of the time using complete medical history, medical tests to rule out other causes, neuropsychological tests, and brain scans.

  • Symptoms are gradual. Typically, the early stages are characterized by loss of recent memory, inability to learn and retain new information, language problems, mood swings, and personality changes.

  • Course varies widely from person to person. On average, AD patients live from 8-10 years from diagnosis.


  • No current treatment can cure AD. Some drugs may help prevent symptoms from becoming worse (tacrine/Cognex, donepezil/Aricept, rivastigmine/Exelon, galantamine/Reminyl/Namenda).

  • Medicines can also be helpful in controlling behavioral symptoms.

  • Structure and routine help the person with Alzheimer’s. Supportive care can help the person and their caregiver.

  • Research shows that overall healthy lifestyle including exercise, low fat/Mediterranean diet, no smoking and moderate drinking may help prevent Alzheimer’s.

  • A lot of research is being conducted on additional medications, a vaccine, preventative measures such as diet, vitamins, curry, Omega 3s, and better diagnosis and imaging, particularly at early stages.


  • Caregivers are faced with great challenges and stress in caring for a family member or significant other with AD. Aging Wisely can help caregivers prepare and cope.

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Sundowner’s Syndrome


aging care

Sundowning or “sundowner’s syndrome” is a commonly used term among professionals working with patients who have Alzheimer’s disease or other dementias. This term describes a pattern of increased behavior problems in the late afternoon and early evening. Persons may exhibit increased confusion, agitation, wandering, hallucinations and general disorientation.

Want more information on terms and conditions related to dementia? Grab our guide to memory loss and dementia here.

While the cause is not definitive, there are likely several factors. Primarily, the person may be tired after daily activities and caregivers may suffer similar weariness which shows through to the care recipient. The change from light to dark and the “internal clock” may also play a role during this time which has traditionally been transitional (i.e. returning from work, or family time in evenings).

Here are some practical tips, compiled from our experience and advice from the Alzheimer’s Association website:

  • Anticipate this problem and schedule accordingly. Try to reduce activities and outings at this time. Plan some quiet, alone time in late afternoons.

  • Keep a routine (always important for a person with dementia). Naps or quiet activities may be helpful during this time (and you may want to avoid naps earlier that might interfere with later sleep).

  • Reassure the person and redirect them when agitated or restless. Do not attempt to argue with them or use “reality therapy”.

  • Examine causes of agitation. Noise or stimulation may increase these behaviors.

  • Identify causes of physical discomfort. If you notice a major change in behavior, a person may be feeling pain or have an underlying infection. Many times, our care managers will note a significant change and when a culture is done, the client has a UTI (urinary tract infection).

  • As a caregiver, get plenty of rest and recognize your need for a break. Your irritation or exhaustion may further exacerbate your care recipient’s behaviors.

  • Consult with a physician knowledgeable about dementia. With problem behaviors, it can be helpful to use the services of a geriatric psychiatrist. Medications may alleviate symptoms.

Aging Wisely’s care managers support many clients with dementia and their family members in this difficult journey. Whether it be for advice and caregiver consultations, referrals to professionals and programs, coordination and oversight, or a full assessment, we’re your resource—for solutions when you need them.

Contact us online or at 727-447-5845 for help or questions.


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Alzheimer’s Quiz


1. Which of the following is TRUE?

a. Alzheimer’s is one type of dementia.

b. Dementia is a form of Alzheimer’s.

c. Dementia is an early stage of Alzheimer’s, but not a later stage.

d. None of the above.


2. Besides Alzheimer’s, which of the following can cause dementia?

a. stroke

b. Parkinson’s disease

c. Brain tumors

d. All of the above.


3. Which of the following is FALSE?

a. People with dementia need supervision.

b. The best thing for people with severe dementia is to provide new challenges and changes to their routine every day.

c. People with severe dementia often lose the ability to perform routine tasks such as buckling a belt.

d. Routine and structure may help the person with dementia function better.


4. TRUE or FALSE. Alzheimer’s is a normal part of aging.


5. Which of the following is not a typical symptom/course of Alzheimer’s?

a. gradual memory loss

b. changes in personality

c. wandering or repetitive movements

d. sudden change in memory or cognition


6. TRUE or FALSE. It is best to reason or argue with a person with Alzheimer’s so that they understand right from wrong.


BONUS: What is the only way to get a 100% definitive diagnosis of Alzheimer’s?

Click Here for the Answers















1. A

2. D

3. B


5. D


BONUS: Autopsy-brain

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10 Warning Signs of Alzheimer’s


1. Memory loss. Forgetting recently learned information is one of the most common early signs of dementia. A person begins to forget more often and is unable to recall the information later.

What’s normal? Forgetting names or appointments occasionally.

2. Difficulty performing familiar tasks. People with dementia often find it hard to plan or complete everyday tasks. Individuals may lose track of the steps involved in preparing a meal, placing a telephone call or playing a game.

What’s normal? Occasionally forgetting why you came into a room or what you planned to say.

3. Problems with language. People with Alzheimer’s disease often forget simple words or substitute unusual words, making their speech or writing hard to understand. They may be unable to find the toothbrush, for example, and instead ask for “that thing for my mouth.”

What’s normal? Sometimes having trouble finding the right word.

4. Disorientation to time and place. People with Alzheimer’s disease can become lost in their own neighborhood, forget where they are and how they got there, and not know how to get back home.

What’s normal? Forgetting the day of the week or where you were going.

5. Poor or decreased judgment. Those with Alzheimer’s may dress inappropriately, wearing several layers on a warm day or little clothing in the cold. They may show poor judgment, like giving away large sums of money to telemarketers.

What’s normal? Making a questionable or debatable decision from time to time.

6. Problems with abstract thinking. Someone with Alzheimer’s disease may have unusual difficulty performing complex mental tasks, like forgetting what numbers are for and how they should be used.

What’s normal? Finding it challenging to balance a checkbook.

7. Misplacing things. A person with Alzheimer’s disease may put things in unusual places: an iron in the freezer or a wristwatch in the sugar bowl.

What’s normal? Misplacing keys or a wallet temporarily.

8. Changes in mood or behavior. Someone with Alzheimer’s disease may show rapid mood swings – from calm to tears to anger – for no apparent reason.

What’s normal? Occasionally feeling sad or moody.

9. Changes in personality. The personalities of people with dementia can change dramatically. They may become extremely confused, suspicious, fearful or dependent on a family member.

What’s normal? People’s personalities do change somewhat with age.

10. Loss of initiative. A person with Alzheimer’s disease may become very passive, sitting in front of the TV for hours, sleeping more than usual or not wanting to do usual activities.

What’s normal? Sometimes feeling weary of work or social obligations.

If you recognize any warning signs in yourself or a loved one, the Alzheimer’s Association recommends consulting a doctor. Early diagnosis of Alzheimer’s disease or other disorders causing dementia is an important step to getting appropriate treatment, care and support services.

Everyone forgets a name or misplaces keys occasionally. Many healthy people are less able to remember certain kinds of information as they get older.

The symptoms of Alzheimer’s disease are much more severe than simple memory lapses. If you or someone you know is experiencing Alzheimer symptoms, consult a doctor.


The difference between Alzheimer’s and normal age-related memory changes


Someone with Alzheimer’s disease symptoms

Someone with normal age-related memory changes


Forgets entire experiences

Forgets part of an experience


Rarely remembers later

Often remembers later


Is gradually unable to follow written/spoken directions

Is usually able to follow written/spoken directions


Is gradually unable to use notes as reminders

Is usually able to use notes as reminders


Is gradually unable to care for self

Is usually able to care for self

From: The Alzheimer’s Association,

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Sample Case Management Notes

Is the Time Righ

These sample case notes demonstrate some of the types of situations we deal with as geriatric care managers and some of the interventions we offer elders and caregivers. Geriatric care management can address a wide variety of elder care situations and provide services ranging from professional consulting to patient advocacy, care coordination and geriatric case management. You can click on the links below to pull up the sample case notes from each of these cases to understand more details about the interventions and accomplishments.

Journal Notes – Transitioning from Home to Assisted Living

This client’s family engaged Aging Wisely’s help after finding their mother in deplorable conditions, and assisting her to clean her place. They were concerned about her ongoing ability to live independently and maintain a healthy environment. A neighbor had contacted the housing inspector and these case notes pick up where the geriatric care manager had been contacted by the family to attend this inspection and formulate a plan to begin working with client towards alternative living arrangements in assisted living. The geriatric care manager was successful in a short time in working with the client and family and facilitating a move, and assisting client during the transition.

Journal Notes – Managing Elder Care at Home

These sample journal notes are from a couple who Aging Wisely worked with over a number of years. They lived at home with 24 hour home health care and Aging Wisely assisted their trust officer in ensuring their wellbeing. As the notes illustrate, Aging Wisely can help to monitor in home care, coordinate repair services and protect vulnerable clients, arrange for respite care or alternative placements when needed, and oversee the many issues faced by clients with dementia. The care manager also focuses on quality of life, as shown here in making sure clients had holiday visits and gifts and helping ease their anxieties. Geriatric care management brings together the comprehensive needs of elderly clients, contributing to better results for the elder clients as well as their family members or professional advisors.

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Florida Senior Care – Eldercare Resources


Helping Florida Serve the Geriatric Care Needs of its Senior Citizens

Florida has many great resources for senior care and aging assistance. Over the last century elderly people have been migrating to Florida for its warm weather and healthy senior environment. Many times they are geographically separated from loved ones but wish to stay in Florida, but need some eldercare support to do so. Here at Aging Wisely we hope to continue in this long tradition of serving our nation’s elderly parents, relatives and loved ones.

Below you’ll find a list of links and senior care resources we believe important to not only helping Florida seniors care for themselves but also nationwide and international citizens looking to make Florida their home and families at a distance concerned about elderly loved ones living in Florida.

Aging Wisely is your Florida Senior Care Resource Expert.
Click here to schedule a time to talk with a geriatric care manager about senior care resources to help you!

Below you can find resources dealing with Alzheimer’s, Florida Caregivers, Geriatric Care Management, Florida Prescription Drug Information, along with Housing and Legal Issues. If you’re trying to make the best healthcare choices, we offer specialized Medicaid and Medicare advocacy and analysis.

The following links are great resources as you navigate your senior care journey, but we know it can be confusing to figure this all out alone! We encourage you to contact us at 727-447-5845 for a personal needs analysis or reach out online for further information on Florida eldercare, healthcare or geriatric care management.

ALZHEIMER’S – Alzheimer’s Association

Alzheimer’s Specialty Home Care in Florida

CAREGIVERS – Solutions to caregiving situations, managing stress and making decisions – Family Caregiver Alliance, a non-profit organization for family caregivers and the professionals with whom they work (provides research, education, awareness, advocacy) Florida home caregivers’ blog offers a wide array of information for family and professional senior caregivers. – Information & Resources for Caregivers – Online community for elder caregivers

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CARE MANAGEMENT – National Association of Professional Geriatric Care Managers, information on the field of care management and links to geriatric care managers throughout the U.S. and in other areas of Florida.

Signs You Might Need a Geriatric Care Manager

Benefits of a Geriatric Care Management Assessment

DRUG INFORMATION -This website offers comprehensive information on patient assistance programs and prescription drug information. – Medicare’s official site – Allows you to make weekly medicine schedules, including pictures of medicines – Institute for Safe Medication Practices, a nonprofit organization educating professionals and consumers on safe medication practices – FDA safety information and adverse event reporting program

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ELDER CARE/SENIOR ISSUES – EasyLiving, Inc. provides home health care and senior home care services in Pinellas County, Florida. – The Eldercare Locator has a listing of government and local eldercare services (good place to find contact information, but will not offer recommendations). – Searchable listings of various benefits programs that help seniors pay for costs of food, utilities, prescription drugs, etc. – Administration on Aging, created by the Older Americans Act – is an online community that connects people caring for elderly parents to other caregivers, personalized information and local resources.– Aging Wisely’s weekly blog posts cover the most current topics in aging, caregiver questions and insights from our eldercare experts. Leave us a comment or question you’d like answered!

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HEALTH ISSUES – National Institute of Health – Caring Connections from the National Hospice Foundation, information on end of life care and downloadable state-specific advance directives. – American Academy of Family Physicians’ patient information site, search for useful articles/topics related to seniors and family health – Florida Health & Human Services: Agency for Health Care Administration (state surveys of nursing homes, home health and other eldercare and healthcare organizations, healthcare regulation information and state updates) – American Parkinson’s Disease Association. The Information and Referral Center-West Coast of Florida can be contacted at 727-328-6246.

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HOUSING – Previously called the American Association of Homes & Services for the Aging

Guide to Choosing the Best Assisted Living– Tips for choosing a care facility for seniors from our eldercare experts who know the inside scoop on care facilities

Florida Health Finder-Facility Locator – A listing of all regulated Florida health entities such as nursing homes, assisted living facilities and home health agencies, managed by Florida’s Agency for Healthcare Administration.

Senior Citizen Housing Information– U.S. Department of Housing and Urban Development’s information for seniors on housing assistance and various programs

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LEGAL ISSUES – National Academy of Elder Law Attorneys – assists lawyers, bar organizations and others who work with older clients and their families – resource of information, education, networking and assistance – National Senior Citizens Law Center – advocates nationwide to promote independence and well being of low-income elderly individuals and persons wit disabilities, with particular emphasis on women and racial and ethic minorities

Ask us for a referral to a local Florida elder law or estate planning attorney!

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MEDICARE AND MEDICAID – The official U.S. government site for Medicare information. Includes search tools for helpful contacts, Medicare personal plan finders, nursing home information and frequently asked questions. – Center for Medicare Advocacy – Centers for Medicare and Medicaid Services – information for consumers and professional regarding Medicare and Medicaid

Florida Health Finder’s Medicaid information – Florida Agency for Healthcare Administration’s portal for Florida Medicaid information and key contacts.

Medicaid Fact Sheet– The latest Medicare numbers and an overview of the various parts of Medicare, presented in a clear, concise manner.

Medicare Under 65 – Overview of information and resources for people under age 65 who may qualify for Medicare coverage, such as those with disabilities.

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ADDITIONAL INFORMATION & RESOURCES – Department of Veteran’s Affairs – Social Security Administration and Social Security Online – National Center on Elder Abuse – The state of Florida’s official web portal, with a wide variety of information and links on government services. Contains specific sections on elders ans retirement in Florida with links to various senior services and information for older adults in Florida.

For more information about how you and your family can prepare for eldercare, contact us at 727-447-5845 and get your copy of our Essential Eldercare Checklist.

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Florida Disaster Preparedness for Seniors


Disaster Preparedness for Senior Citizens

Between the months of June and November hurricanes and tropical storms are very common. Hurricanes and tropical storms are formed when several different weather conditions occur simultaneously. A hurricane is a tropical cyclone with winds exceeding 74 mph, originating in the tropical regions of the Atlantic Ocean, Caribbean Sea, or the Gulf of Mexico. A tropical storm is a lesser form of a hurricane.

Aging Wisely’s care managers can provide a home visit and assessment to help determine if your loved ones are prepared for hurricane season. We complete a checklist, discuss options and evacuation and help coordinate their plan. We see this process as not only preparedness, but a time for education.


Below is a checklist to help seniors prepare for nature’s disasters. Additionally, every individual should have a plan for emergency evacuation. For individuals who need assistance evacuating, contact the county emergency service to register for assistance (however, it is important to use county services and especially special needs shelters as a backup plan should other plans fail, these services are not designed to meet all residents needs and may be very uncomfortable and challenging for elders with medical and care needs):

Pinellas County – (727) 464-3800

Hillsborough County – (813) 272-5900

Pasco County – (727) 847-8959


1. _____ Important medical, family contact and insurance information, safe and secure

2. _____ Water (2-week supply at home, 3-day supply if evacuating – 1 gallon per person, per day)

3. _____ Food (2-week supply of nonperishable food at home, 3-day supply if evacuating)

4. _____ Non-electric can-opener

5. _____ Battery powered radio

6. _____ Flashlights

7. _____ Extra batteries

8. _____ Two-week supply of prescription medication & list inc. dosages and allergies

9. _____ Mosquito repellant

10. _____ First Aid Kit

11. _____ Water purification kit (tablets, plain chlorine and iodine)

12. _____ Pre-moistened towelettes

13. _____ Antibacterial wipes and/or hand sanitizer

14. _____ Walker, wheelchair, and other medical equipment (talk to medical equipment company prior to determine needs for battery or electric powered devices, register with the power company if electricity required for Oxygen or special needs)

If you evacuate, also take:

15. _____ Bedding

16. _____ Extra clothing and shoes

17. _____ Eyeglasses

18. _____ Folding chair or cot

19. _____ Extra hearing aid batteries

20. _____ Walker, wheelchair, and other medical equipment

21. _____ Important papers (in a waterproof container)

a. _____Driver’s license

b. _____ Special medical information

c. _____ Medical insurance and Medicare cards

d. _____ Insurance policies

e. _____ Family and physician contact numbers

f. _____ List of style and serial numbers of medical devices, i.e. pacemaker

Precious commodities before and after a storm:

22. _____ Cash, Ice, Charcoal, Wooden Matches, Grill

Click hereResources:

For evacuation zones and shelter information in Pinellas county:

For Pasco County, visit:

Hillsborough County evacuation levels are available at: Red Cross provides information and checklists for individuals with special needs and how to be prepared for disasters. Go to their “Disaster Services” and click on “Be Prepared” to find the information specific to persons with special needs.

Contact Aging Wisely at 727-447-5845 for assistance with hurricane planning or other eldercare planning needs. We offer a special hurricane season planning package.

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Payment Concerns
Not sure how you are going to pay for elder care?

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Aging in Place
How to keep a loved one safe at home, and when it may be time to consider assisted living.

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Mission Statement

Our goal is to enable every individual we work with to live the most fulfilling life possible, with utmost dignity, focusing on their physical, mental, spiritual, family and financial wellbeing.