Among the battles faced by families with a loved one with Alzheimer’s disease or dementia is deciding if and when to take them out of their own home to a facility.

In March, Alzheimer’s expert Susan Scanland visited Senior Star at West Park Place Toledo to give a seminar titled, “Seniors: When to Make The Move.” Scanland has given more than 500 such seminars on Alzheimer’s and dementia in more than 40 states in her 30-plus year career. She currently consults at a long-term care center in Scranton, Pennsylvania, where she evaluates residents and can make dementia recommendations for the medical and nursing staff.  

There are a number of reasons it’s hard for both the patient and family to “make the move” from the home to a care center, Scanland said.

“Number one I think is the hesitancy to leave one’s homestead, where one’s been for many years,” she said.  “Number two is often the negative stereotype of community senior living. … Many families fear they are institution-like.”

Scanland, who has spoken at West Park Place several times, said that is often the furthest thing from the truth.

“It’s not the nursing home, but people often have that negative stereotype,” she said, explaining many places offer the ability for a couple to stay under the same roof but still provide the needed care for the partner with Alzheimer’s.

“Very often there are so many emotions when an older person has to put their loved one in a nursing home because they can’t take care of them,” she said. “But they can live together, and contract to bring private-duty nurses in. So a couple can be more independent longer and live together longer than if they were at home.”

The third reason it’s hard to move a loved one from their home into a care center could actually be higher on the list for many families, Scanland admitted.

“Guilt is a huge emotion when it comes to placement,” she said. “So many families have told me that this is the hardest decision they ever had to make in their lives. The problem is, often they’re making it without adequate information. … Often too, there are disagreements between adult children about what to do about mom and dad because there’s a lack of information.”

In her Toledo talk, Scanland said her purpose was simple — to educate about existing options.

“There are reasons why home sweet home may not be as safe or as wise a choice as they think it is,” she said.

Scanland identifies seven areas to consider when determining if it’s indeed time to “make the move” or “kiss the guilt good-bye.”

• Pedestrian and driving risks — Even persons with mild dementia are more likely to makae decisions that can result in them getting hit by a vehicle, Scanland said.

“Having fender benders, getting lost while driving are huge red flags,” she said. Oftentimes, dementia patients may depend on another passenger’s “copiloting” to get them from one place to another while driving, Scanland said.

• Nutrition and hydration — Scanland did house calls on dementia patients for years and would often find freezers full of ice cream and other junk food, with no vegetables. Older people often lose their sense of thirst and don’t get enough to drink, she said.

• Medication mixups — People over 65 are four times more likely to have reactions to medications than younger people, Scanland said. Dementia patients are more likely to confuse medications — blood pressure and diabetes drug mixups can be particularly dangerous, she said.

• Falls — “Often older people think it’s OK if they fall,” Scanland said. “It’s not OK that they fall.” Falls contribute to 16,000 deaths in the elderly each year, she said. One out of three people over the age of 65 are at risk for falling, while half are at risk if over 80 years old, she said. She has seen many cases where dementia patients were lying on the floor for one to two days after falling.

• Elopement (walking/driving away from home) — 75 percent of dementia patients wander from their home at least once, Scanland said.

• Isolation/loneliness — People who get depressed after the age of 65 are at a higher risk of developing Alzheimer’s, Scanland said.

“Just because you have dementia, sitting in front of the TV all day with no social interaction and no people, it’s not good for the brain,” she said.

• Financial exploitation — Scanland called it a silent epidemic, pointing out studies suggest four or five unreported cases of elderly scams to go along each one that is reported.

Kirsten Pickle, executive director of West Park Place, said the program on the seven areas to consider was well received by both seniors and their families.

“I think those things are important because nobody wants to leave their home, but it’s also hard to be objective on reasons why you should,” Pickle said. She said the average age of a West Park Place resident is 86. She pointed out statistics suggesting 80 percent of people over the age of 85 have some form of dementia, even if just mild cases.

“The most important thing that people need to understand is to move them earlier,” Pickle said. “The earlier the move, the easier it is on the senior and the more successful they will be in their new surroundings. … If they move here earlier, they’re usually able to stay here a lot later because they’re settled in so well. If you wait too long, your loved one usually ends up in a nursing home.”

Scanland said the purpose of her visit to Toledo was to replace confusion with information.

“When you look at the facts and gather information, it does take a lot of the guilt out of the equation because then the whole shift can be an incredibly positive experience,” she said.

For more information, visit dementiaconnection.com or call West Park Place at (419) 972-2280.

It’s no secret that music has an undeniable connection to personal memories.

Just one song has the power to call back vivid recollections of everything from that first kiss under the stars to that one late-summer road trip spent racking up miles down Interstate 75.

In an effort to enable those suffering from cognitive diseases like Alzheimer’s and dementia to reconnect with the world through memories triggered by their favorite songs, several local nursing homes are implementing the “Music & Memory” program.

Founded in 2010 by Dan Cohen, “Music & Memory” is a non-profit organization that provides personalized music to the elderly through digital music platforms in order to improve the overall quality of life.

The organization teaches nursing home staff, as well as family caregivers, how to create personalized playlists for residents on digital music devices like Apple iPods.

“Music means so much to everyone’s lives,” said Katie Gulgin, administrator with Otterbein Senior Lifestyle Choices. “One song to me may not mean the same thing to another person. It’s about finding those songs that mean something special to someone.”

According to the “Music & Memory” website, songs associated with important personal events can trigger memory of the physical experience connected to the music. As a result, the music can often calm “chaotic brain activity” and enable the listener to “focus on the present moment and regain a connection to others.”

Each of Otterbein’s locations throughout Ohio – including its Perrysburg and Monclova communities – completed “Music & Memory” certification training as of March 5.

The Perrysburg site, located at 3529 Rivers Edge Drive, has already begun testing the effects of “Music & Memory” on one of its residents.

Gulgin said the resident – a woman who suffers from “severe dementia” – has communication limitations but has become more vocal and responsive since beginning the therapy.

“It’s something her son puts on for her,” she said. “When she’s feeling agitated, it calms her down; or, if she’s having trouble eating, it helps her eat better.”

Gulgin said Otterbein is still trying to work out how each of the individual facilities is going to implement “Music & Memory” into its activity regimen.

The smaller facilities may be able to provide enough iPods for each resident, while the larger, more traditional facilities might only allow access to the devices when an activity professional is on site.

“We should have a good portion of our facilities using the program by mid year,” Gulgin said.

Administrators with Foundation Park Alzheimer’s Care Center completed their “Music & Memory” training March 19 and are preparing to train the rest of the staff in the coming weeks.

Kathy Kuhlman, social service director with Foundation Park, said the facility currently only has 10 iPods, but is seeking donations to help obtain a music player for each of the 125 residents housed in the extended-care facility.

“We want to expand access to activities for residents who are normally unable to take part in (traditional) activities while, at the same time, decreasing negative behaviors and mood outbreaks,” Kuhlman said.

Kuhlman said Foundation Park has already decided which residents will receive the first 10 iPods and staff is in the process of contacting residents’ loved ones to obtain information about their favorite music.

“When residents hear the music they listened to at a younger age, it brightens their days,” she said.

On Dec. 15, 2014 the state Controlling Board approved a request by the Ohio Department of Aging (ODA) for the Office of the State Long-Term Care Ombudsman to use protection funds to contract with Music & Memory, Inc. to allow Ohio nursing homes to become “Music & Memory” certified.

According to a news release from the ODA, the funding will be used to underwrite costs associated with training and certification, equip the state’s regional long-term care ombudsman programs to support the expansion, and provide start-up kits and supplies for participating facilities.

No funds are paid directly to the nursing homes.

To learn more about “Music & Memory^” in Ohio, visit www.aging.ohio.gov/services/music-memory/.

As the mind and body age, we commonly think it is time to slow down and do less. However, the opposite is true.

It’s important to exercise both the mind and body to maintain mental function, reduce the risk of disease, stay physically active and maintain flexibility and balance.

There are options for individuals of all health and fitness levels to begin or maintain an exercise regimen.

If you don’t currently have a fitness plan, or begin to experience challenges with your current routine, it’s important to consult with your physician. Have a discussion about your goals and current challenges so you can work together to develop a plan that will work for your lifestyle.

There are four important focus areas for staying active as we age:

• Aerobic exercises are fundamental for a healthy heart. Try walking or biking with a friend, swimming or low-impact group fitness classes that will elevate your heart rate but are relatively easy on your joints.

• Strength training produces dramatic results but is also important to prevent muscle loss as we age. Lifting light weights can help to maintain strength in the arms, legs and core.

• Stretching and balance exercises can help relieve some symptoms of arthritis and prevent falls. Try a yoga class or tai chi. The classes provide added benefits of peace and relaxation to help manage stress.

• Stimulating the brain is important to help prevent the loss of mental function and some forms of dementia. Crossword puzzles, word games, Sudoku, conversations with friends and family, learning new skills and traveling are all ways to keep your mind active.

It’s important to set yourself up for success, both to maintain a high quality of life and to achieve measurable results with your personalized fitness program.

• Make exercise a regular part of your day. You’ll be less likely to stop if it’s a part of your everyday routine, like brushing your teeth. If you are interrupted for travel, illness or injury, you’ll find it easier to start up again when you’re ready.

• Stick with it. If you can maintain your exercise routine or physical activity for at least six months, it’s a good sign that you are on the way to making physical activity a regular habit and way of life.

• Make it fun. Exercise doesn’t have to be an exhausting, sweaty chore to dread. Try a new sport, go dancing or visit walking trails in the Metroparks of the Toledo Area system. If you enjoy what you are doing, you’re more likely to look forward to your workout and stick with it.

• Use the buddy system. Exercising with a friend helps you both be accountable and gives you someone with whom to try new things and laugh!

Roseanna Mosiniak is a certified personal trainer and certified group fitness instructor at ProMedica Wildwood Athletic Club, where she specializes in senior fitness. For more information, visit www.wildwoodathleticclub.org or call (419) 539-0235.

Every 13 seconds, an older adult is rushed to an emergency department because of a fall. In fact, so many older adults are falling that it’s now the leading cause of accidental death among the elderly. However, most of these accidents can be prevented.

From 2000-12, Ohioans aged 65 and older experienced a 167 percent increase in the number of fatal falls, according to the Ohio Department of Health (ODH). On average, about three older Ohioans suffered fatal falls each day in 2012. The ODH reports falls among older adults cost the state and its residents $646 million in 2012.

The costs can be psychological, too. As a physical medicine and rehabilitation physician at The Ohio State University Wexner Medical Center, I’ve seen that patients who have fallen before often develop a fear of falling, which puts them at an even higher risk of falling again.

There are many reasons why patients fall, including vision or medication problems, or even conditions like diabetes and low blood pressure.

That’s why it’s so important for doctors to assess patients from head-to-toe, examining their history of falls and medical history, along with testing their gait and balance.

The following tips may help reduce the risk of falling at home:

• Remove clutter to create clear paths for walking in the home.
• Remove throw rugs or use double-sided tape to keep rugs from slipping.
• Install handrails and lights on staircases.
• Install grab bars inside and outside the shower and by the toilet.
• Use nonslip mats in the bathtub and on shower floors.
• Extend the chain on ceiling fans to make them easily reachable.
• Get up slowly and turn on a light before walking across the room.
• Wear shoes both inside and outside the house. Avoid wearing slippers.

Falling is not an inevitability that comes with age.

There are steps doctors, patients and caretakers can take to help prevent falls.

Dr. Joe Rosenthal is a physical medicine and rehabilitation physician at The Ohio State University Wexner Medical Center.

George Burns — who lived to be 100 years old — used to say, “If I knew I was going to live this long, I would have taken better care of myself!”

It’s true that some individuals are blessed with good genes. For the rest of us who might be concerned with quality of life as we age, exercise is one of the keys.

Muscle mass decreases as we age. Beginning in the fourth decade of life, adults lose 3-5 percent of muscle mass per decade, and the decline increases to 1-2 percent each year after age 50. Muscle keeps us strong; it burns calories and helps us maintain our weight, and it is also an essential contributor to our balance and bone strength.

The good news is that muscle mass can increase at any age in response to exercise. In an important study of strength training and older adults conducted with 100 male and female residents of a nursing home in Boston (average age 87), subjects lifted weights with their legs three times a week for 10 weeks. At the end of the study, there was an increase in thigh mass of 2.7 percent, walking speed increased 12 percent, and leg strength increased 113 percent. In a similar study of adults 65-79 years old, subjects who lifted weights three times a week for three months increased their walking endurance by 38 percent (from 25 minutes to 34 minutes) without appreciable increases in mass.

Additionally, the literature is voluminous with evidence defining geriatric improvements in cardiovascular, musculoskeletal and neurological health. The inclusion of carefully constructed exercise regimens may slow down the osteoporotic process. Additional studies show a reduction in hip fractures in women who undertake regular exercise regimens. The factors leading to this reduction are improved strength, proprioception and maintaining of greater bone density.

The rate of hip fractures increases dramatically within the geriatric population. Therapeutic exercise may reduce this risk. The evidence supports improved strength and endurance. Additionally, all therapeutic exercise regimens must include activities that sharpen proprioceptive skills, as most hip fractures are fall-related. Your fall risk can be estimated by your physical therapists.

While exercise cannot vaccinate against or eradicate dementia, evidence suggests therapeutic exercise can slow the rate of or reduce the onset of dementia while promoting mental health improvements.

Set an appointment with your physician to determine your capabilities to proceed with an exercise regimen. The physician may in turn refer you to physical therapy for balance assessment. The physical therapist will prescribe specific therapeutic exercise, which is capable of improving functional strength, endurance, balance and range of motion. The physician and physical therapist may also refer you to an exercise physiologist, who will consider your current physical status and issue a specific exercise prescription.

All of these services are available through Mercy. To find a physician, call (419) 251-4000.

Burton Rogers Jr. is regional administrative director for Mercy Sports Medicine.