A new article on Medpage regarding delirium (acute confusional state is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior - From Wikipedia) that is important to any elder facing cardiac surgery or potentially any other surgery. We often see our elder clients, when hospitalized, have a severe exacerbation of their dementia or new onset of a confusion and disorientation during the hospitalization and after returning home. Often a delirium is misdiagnosed in the hospital as a dementia and so it is important that a psychiatrist or neurologist test a person who is suspected to have either a rapid onset delirium or a dementia to determine the correct diagnosis. The link to the Medpage article is here.
Just returned from four days at the annual Professional Fiduciary Association of California (PFAC) education conference. Over 500 fiduciaries in attendance and loads of great classes, information and networking! I co-taught a four hour pre-intensive course on Medical Issues of the Elderly, Working with Care Managers & Caregivers, Understanding Advanced Directives, DNRs, POLST forms, and Death & Dying - How to advocate for a "Good Death". An upcoming class I'll be teaching is "What is a Fiduciary" to a group of Senior Peer Counselors on May 14, 2012. I'll also be teaching the Conservator of Person & Estate class for Family Conservators on July 6, 2012 at the Bray Law Library.
As reported in last evening's news, Dick Cheney received a heart transplant. He is expected to remain in the hospital for 1-2 weeks and then be in rehab for more weeks to get back on his feet.
This article reminded me of a recent study that showed that hospitalizations have a significant impact on those over the age of 65. Many people may not realize that hospitalizations can lead to a decline in cognition for elders, whether they have a pre-existing cognitive decline or not. And the longer the hospitalization, the severity of the illness and greater age all contribute to a greater cognitive decline. The authors noted that the medical community needs to figure out how to minimze hospitalizations for the elderly, especially for minor illnesses/injuries.
A daily assessment of elders when residing in their homes, assisted living, or skilled nursing and immediate action taken to have them visit their primary care physician (PCP) when caregivers note anything out of the ordinary would go a long way to avoiding emergency room visits and hospitalizations. A minor cold, flu, or infection if caught early and treated early by the PCP would often times reduce hospitalization days later. Caregivers should note any change in cognition, temperature, or behavior and notifiy the family, fiduciary or physician, rather than waiting until the illness becomes a medical crisis. The link to the article is:
Well, finally starting a blog as recommended by my staff on Fiduciary issues. I'll be covering medical issues related to caring for individuals with one or more of the following diagnoses: dementia, brain injury, stroke, mental health issues, aging, or injuries related to trauma. Additionally, I'll be blogging about investments, bill paying, computer programs related to both and websites/articles/books that might be of assistance to new fiduciaries/family caregivers/conservators that will assist them in caring for an individual with one or more disabilities.
To start off, for anyone caring for someone with any type of dementia (and there are more than 50+ types of dementia) one of the basic books that will aid a caregiver is "The Thirty-Six Hour Day" by Nancy L. Mace. This book covers the causes and types of dementia, intervention strategies for caring for someone with dementia and prevention of dementia, all written in layman's language. The essential guide for anyone involved with or caring for a person with dementia.
Additionally, I read articles weekly on medical issues related to the above diagnoses and will post a short synopsis of the articles and a link to the full text study.