Some Common Drugs May Increase Risk of Dementia

Some common drugs may cause increased risk of dementia.
Some common drugs may cause increased risk of dementia.

Research conducted in 2019 has strengthened the connection between the risk of dementia and a common class of drugs used to treat a variety of symptoms.

Anticholinergics are a type of medication that blocks the action of acetylcholine. That’s a chemical messenger (or “neurotransmitter”) in the brain that help coordinate breathing, digestion, urination and other functions.

Anticholinergics can treat a variety of ailments, including urinary incontinence.

Considerable’s recent article entitled “These common prescription drugs could boost your risk of dementia” reports that anticholinergics include a roster of drugs for depression (such as Paxil), psychosis (such as Thorazine), Parkinson’s disease (such as Cogentin) and bladder disorders (such as Ditropan).

The 2019 study found a nearly 50% increase in chances of dementia in those people who received more than 1,095 daily doses of these drugs in a 10-year period.

The research was published in JAMA Internal Medicine.

The study, sponsored by the University of Nottingham, monitored 284,343 patients age 55 and older between 2004 and 2016. The researchers examined the total standardized daily doses (TSDDs) of anticholinergic drugs during that time period.

The researchers said that this was the equivalent to a senior taking a strong anticholinergic medication daily for at least three years.

Researchers looked at each person’s anticholinergic exposure and found the most frequently prescribed anticholinergic drugs were antidepressants, drugs to treat vertigo, motion sickness or vomiting and an overactive bladder.

The researchers at the University of Nottingham discovered that some other anticholinergic antihistamines and gastrointestinal drugs failed to correspond to a higher incidence of dementia.

The UK study shows a correlation between these specific anticholinergic drugs and increased chances of dementia. However, the researchers cautioned that seniors shouldn’t stop taking any medications without talking with their doctor.

Reference: Considerable (July 1, 2020) “These common prescription drugs could boost your risk of dementia”

 

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Estate Planning Issues Affecting the Sandwich Generation

If you're a member of the Sandwich Generation, make sure your parents and adult children have the necessary estate planning documents in place.
If you’re a member of the Sandwich Generation, make sure your parents and adult children have the necessary estate planning documents in place.

July is National Sandwich Generation Month, a time to honor those who are caring for both their children and their aging parents. This is a particularly stressful time for members of the Sandwich Generation who may not only be parenting their children but also spending the last few months homeschooling them. Older children who have lost their jobs or were unable to return to college after spring break due to the coronavirus may now be living at home. At the same time, members of the Sandwich Generation may be acting as caregivers for parents who are no longer able to look after themselves, or who are at a higher risk for contracting COVID-19.

Some of the stress of caregiving can be alleviated by making sure your aging parents and adult children have legally valid and up-to-date estate planning documents in place, and if they do not, encouraging them to have these important documents prepared. This is a relatively simple step to ensure that there will be no delays or uncertainty if you have to take action in an emergency to make medical and financial decisions for them. If they have the necessary estate planning documents in place, you will have the peace of mind in knowing that you will be able to avoid delays when you need to act quickly to preserve their safety and well-being.

What estate planning documents should you have for any person in your care?

  • A financial power of attorney – This will allow you to pay bills, manage financial accounts, file tax returns, talk to insurance companies, deal with issues related to benefits, hire a caregiver, and sell property on behalf of your parents. A financial power of attorney is also helpful in the event you need to handle financial matters on behalf of your adult child (over the age of eighteen), for example, cashing a paycheck for your child or signing a new lease on your child’s behalf.
  • A medical power of attorney – A medical power of attorney enables you to make health care decisions for your parents, if they are unable to do so themselves.  A medical power of attorney is also important for your children who are 18 or older. Once your child reaches age 18, you no longer have the authority to make medical decisions for your child.
  • A HIPAA Authorization – The Health Information Portability and Accountability Act (HIPAA) requires medical records to be kept private unless an individual consents in writing to sharing of protected health information with a named individual. If you are your parents’ caregiver, they should fill out a HIPAA authorization permitting your parents’ health care providers to keep you informed about their medical conditions and treatments. You should also keep in mind that you are not authorized to receive any medical information regarding a child of yours who is 18 or older. If your adult child wishes you to be involved in his or her health care you need a HIPAA authorization signed by the child allowing you to receive his or her medical information.

It is crucial for your parents to put these estate planning documents in place before they develop any cognitive loss that would prevent them from having the capacity to sign a legal document. If they develop dementia, for example, and are not able to understand the objective or content of a power of attorney or other document, they will be legally unable to execute the document. In that case, you will have to go to a court and ask to be appointed your parents’ guardian to manage their health care and financial affairs.

It is also important that these documents be put in place by your adult child, regardless of any health conditions, because once your child is a legal adult, you can no longer automatically act on your child’s behalf. The worst case scenario is that your adult child is unconcious or in an accident and you are unable to quickly get information from your child’s health care providers.

Members of the Sandwich Generation do not always remember to take steps to lighten their load. But one important step that can make things easier for you as a caregiver is to make sure that your parents and adult children have the necessary estate planning documents in place so that you can quickly make decisions on their behalf if you are called upon to do so.

For more information see https://galligan-law.com/everyone-needs-an-estate-plan/

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How Can Caregivers Find Time for Self-Care?

Family caregivers need to take time out for self care.
Family caregivers need to take time out for self care.

It’s not uncommon for a caregiver to start their journey in a crisis when a family member gets a devastating diagnosis—like Alzheimer’s, cancer, or heart disease—that causes physical or cognitive restrictions on independent daily living.

Considerable’s recent article entitled “How family caregivers can use a Monday routine to reinvent self-care” reports that more than 34 million Americans are caring for a loved one over the age of 50.

Although many caregivers take on their role willingly, they may be forfeiting much needed time for self-care. These sacrifices can accumulate over time, since most caregivers spend an average of four years and 80-160 hours a month in their caregiving role. For individuals taking care of a person with dementia or Alzheimer’s, it can be double that with additional stress.

Creating a routine can give calm to caregivers. A program that is based on a healthy weekly routine is Caregiver Monday, part of The Monday Campaign’s nonprofit public health initiative.

Most caregivers have their regular routines drastically changed, when caring for a family member, This gives caregivers a feeling of a loss of control. When added to the inability to control the disease or disability that impacts loved ones, caregivers can suddenly feel overwhelmed with increased anxiety and chronic stress. This psychological state is called loss of locus of control and has two paths: (i) internal locus of control; and (ii) external locus of control. Caregivers can’t gain external locus of control over the situation or disease, but they can increase internal locus of control—that’s the response they have to these situations. Creating a new routine is part of reestablishing internal locus of control.

A routine can help caregivers cope with change, focus on healthy habits and decrease their stress. It can also help restore balance in a caregiver’s life. Monday gives us a natural refresh point, because it’s part of our cultural DNA. Monday is the start of the work week and the school week, so it makes sense that caregivers can use Monday as the start of a sustainable effort towards improved self-care.

Caregiver Monday provides self-care practices and promotion, and focuses on physical, emotional and social health behavioral change, by helping caregivers commit to weekly efforts. A 2019 survey of 1,000 adult Americans conducted by Data Decisions Group for The Monday Campaigns found that 64% of respondents said if they begin on Monday with a positive frame of mind, they’re more apt to remain positive for the rest of the week. Those surveyed reported they were also more likely to start exercise routines, eat healthier and make doctor’s appointments on Mondays.

Here are three ideas to begin a Caregiver Monday routine. Instead of the Monday blues, caregivers can use Monday as their personal “Fun Day,” to focus on themselves. Caregivers can:

  • Follow Caregiver Monday on Facebook, Twitter, or Instagram for ideas every week on finding self-care practices.
  • Get involved with the caregiving community on these social sites to feel less alone.
  • Ask friends and family to assist with respite care to get a self-care break.

Even with the disruption and the distress, caregivers can use Monday to have a little fun. You can don your favorite color on Mondays or watch YouTube videos of baby animals (a scientific study shows that this can have a positive effect on mood and productivity). Most importantly, thank yourself with little self-care activities and be grateful you can be there for your family member every day.

For more information on issues of concern for the elderly see  https://galligan-law.com/elder-financial-abuse-is-increasing/.

Reference: Considerable (May 11, 2020) “How family caregivers can use a Monday routine to reinvent self-care”

 

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