Advice From Your Advocates
Advice From Your Advocates
Supporting Loved Ones with Dementia: Expert Tips & Compassionate Strategies
Discover how to transform the journey of dementia care into one filled with compassion and expertise, as renowned geropsychologist, Dr. Natalie Edmonds from Dementia Care Blazers returns to our show to share her valuable insights in a conversation with our host, Elder Law Attorney Bob Mannor. This episode promises to navigate you through the complexities of dementia and offer personalized strategies to uplift the lives of those affected. We unravel the heartwarming power of family-sourced knowledge and its crucial role in managing the challenges dementia may bring, such as a patient's love for Western movies becoming a key to mitigating aggressive behavior.
Dr. Natalie Edmonds illuminates the multifaceted nature of dementia, extending the conversation to include the impact on personality, behavior, and physical capabilities, not just memory. We tackle the less common forms, particularly frontal temporal dementia, highlighting how it can reshape family dynamics. Through transparent discussion, we expose common caregiving pitfalls and reframe our approach, emphasizing understanding and patience over correction – an insight that may just redefine how we support our loved ones.
But it's not all about the challenges. This episode also highlights the empowering elements of caregiving, focusing on the importance of self-care for those who give so much of themselves. We explore practical strategies for managing weighty responsibilities, from seeking help to adopting healthy lifestyles that may mitigate the risk of dementia. By the end of our conversation, you'll be equipped with an understanding of the role of lifestyle and environmental factors in dementia prevention, truly making this an episode that can't be missed by anyone touched by this condition.
Host: Elder Law Attorney Bob Mannor
Guest: Dr. Natalie Edmonds
Executive Producer: Savannah Mekso
Assistant Producer: Samantha Noah
Learn more about Mannor Law Group.
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ABOUT US:
Mannor Law Group helps clients in all matters of estate planning and elder law including special needs planning, veterans’ benefits, Medicaid planning, estate administration, and more. We offer guidance through all stages of life.
We also help families dealing with dementia, Alzheimer’s disease, Parkinson’s disease, and other illnesses that cause memory loss. We take a comprehensive, holistic approach, called Life Care Planning. LEARN MORE...
Welcome back to Advice From your Advocates. I'm Bob Manor. I'm a certified elder law attorney in Michigan and we have a dementia-focused practice. I am so excited today that we have Natalie Edmonds from Dementia Care Blazers Back. She's been on our podcast before. She's a wealth of knowledge and passion about these topics and I'm really excited to have her back because the first time great information and very well received. Welcome back, natalie.
Speaker 2:Oh, thank you so much for having me.
Speaker 1:So, natalie, tell us a little bit more about yourself and the passion you have for helping folks and families that have a loved one with dementia, and specifically about dementia care blazers.
Speaker 2:So I'm a board certified geropsychologist. It means that my foundation training is as a clinical psychologist, but then I went on and got specialty training specifically in geriatrics, and I specialize in helping family members care for a loved one with dementia. So what we do at Dementia Care Blazers is we put out information, training programs and resources and tools that family members can use as they're going through their caregiving journey. Whether their loved one has just been diagnosed with some type of dementia or they're in the end stages, we're here to support them in whatever way can help make their caregiving journey easier. And in addition to that, we do consulting for dementia care facilities long-term care facilities and helping train their staff members, who are often caring for people with dementia but has no formal training in dementia. So we're working to fill in the gaps there as well.
Speaker 1:That's great. I really love that last part about training. It is such a difficult thing and it's a big growth area in business to have assisted livings and memory cares, but it and all can be very well-intentioned. But then we have to make sure that there's structure and process in place to deal with some of these memory issues right. There is. Your average person is not gonna come off the street knowing how to interact with somebody who is asking the same question over and over again, or is likely to get confused and maybe wander off or things like that. So tell us a little bit more about the work that you do with assisted livings or other facilities and how to help them be better at providing care for those with dementia.
Speaker 2:Yeah, this is such an important topic because to me, like in Arizona, assisted living facilities, like the small group home assisted living facilities, about 45% of the residents who live in those facilities have Alzheimer's disease or some other type of dementia. However, hardly any of the staff have training in dementia care or if they do.
Speaker 2:It might be they watched a video during their first week or two of orientation and they assume that's enough. I think, if. But we all like to say, like the facilities like to say oh, we have dementia care training, we have dementia care training, but as soon as somebody places their loved one in the facility and they start to have some challenging behavior situations, the staff's on the phone with a family member saying if they can't calm down or if they don't stop trying to get out, we're gonna have to discharge them. And like, I think this is absolutely ridiculous If you are accepting people who have dementia, which most facilities have to if they want to stay in business you're accepting people who have some sort of dementia, then it's your responsibility to actually know how to care for people with dementia.
Speaker 2:Everybody says they care. Very few people actually know how to provide that care. So, for instance, one of the things that we do is that we have a consulting package. That is, a care facility was dealing with, you know, a group of people who have dementia, or even one specific person who has dementia and didn't know what they to do. They could consult with us, let us know what the challenges are, let us know what's going on, what's the specific behavior, and we would help them through figuring out, okay, what's the unmet need, what might they be trying to communicate? Here's something you can try.
Speaker 2:And I think the other important piece is when we're talking about facilities and family members, sometimes it feels like they're against one another for some reason, as if when the family member places the loved one, like they're no longer involved in care, and I think that is a dangerous thing and it's not recommended and like so, teaching the facilities what information to gather from the family, upfront and throughout to the course of their stay. What were their nicknames? They responded well to. What were the topics of conversation? They responded well to what were triggers to avoid. Tell me about the challenges you faced when you were caring for them at home that prompted you wanting to place them now, and what did you find worked and what didn't work. So it's like really just training care facilities. It's nothing magic or super, some super trick that nobody is sharing. It's just the basics, but where a lot of facilities are just missing those basics.
Speaker 1:I love that last part that you have, and I have a quick example.
Speaker 1:This is something, a story, that I love to tell, just cause I thought it worked out so well.
Speaker 1:We had a particularly difficult client that could get show some aggression, which is very difficult because we of course want to protect the caregivers.
Speaker 1:This was a large man and could cause some trouble if you got aggressive, and so they weren't really sure what to do. And my team were able to spend some time with the family and they found out that he really enjoyed Western movies. And so what we found out was, as soon as we turned on a Western movie, even if he was being aggressive, even if he was yelling, he would immediately calm down, sit down and watch that Western movie. And so we got picked up a cheap VCR and we had all these old video tapes of Western movies and we trained the staff to, whenever he seemed to be starting that trigger or starting to get aggressive, just put on the movie, and it worked like a charm every time and then sustained him for the rest of his life. And it's just one of those things that you say talk to the family. The family's not out of the caregiving anymore. They might not be doing the hands-on care anymore, but they need to be involved. I think that's fantastic.
Speaker 2:Yes, and I love that example and that story because I like to say, a person with dementia who's pleasantly engaged in an activity can't at the same time be engaged in one of these disruptive or difficult behaviors. So if we can work ahead of time in what are pleasant activities they enjoy, what are things that are enticing to them, that take their interest and we started to plan some days and make sure they had time to do those things we could reduce challenging situations just by that tip alone.
Speaker 1:So now, are you geographically limited in where you can give this consultation? Can you do this from anywhere, or are you limited in geography?
Speaker 2:We can do this anywhere.
Speaker 1:That's what I thought. That's great. This is a great service. I would highly recommend it because it can make such a big, important transition. And so you know, a lot of facilities are spending a whole lot of time on marketing and filling their rooms and making sure that they have their beds filled, and they have a bed filled and they want to empty it and with a little bit of adjustment and maybe a little bit of consultation, they can do a better job and be better trained for the next time. I think this could be a very good and profitable consultation for any organization that deals with patients and residents with dementia.
Speaker 2:Yeah, Thanks, Bob. So when you submit to us a challenging situation that you want feedback on, we will respond to you within 48 hours, usually with a video response.
Speaker 1:So I wanted to mention we have a couple people in our office that are trainers for the certified dementia practitioner and we can do that for folks, but this goes beyond a lot of that. Seems to be a very popular designation lately and it's nice. I certainly am not going to say you shouldn't become have your staff become certified dementia practitioners, but this goes above and beyond, because this is more specific to the specific needs of your residents and getting the general basis knowledge of being a dementia practitioner is great, but sometimes you need it to be a little bit more specific to what the needs of your specific organization are.
Speaker 2:Exactly. I mean, I think it's pretty. I don't think any of us would expect that after going through a training program we have all the answers for every situation and in all kinds of fields and outside of dementia. Just having another perspective, who's not in there emotionally, can be helpful to figure out. Okay, let's try this approach, let's try this approach. So yeah, I think it's great, thank you.
Speaker 1:You had mentioned something in one of your answers earlier and you said Alzheimer's or another type of dementia, and that's something that I think a lot of folks don't quite understand. So can you talk about the different types of dementia and that dementia is really more of a category rather than a specific diagnosis?
Speaker 2:Yeah, this is definitely the most common question I get from family caregivers. So the way I like to explain it is dementia is a category, exactly like you said, and you can think about it just like the. Cancer is a category, and cancer isn't the exact diagnosis. There are many different types of cancer. Is it lung cancer, breast cancer, brain cancer, skin cancer? The same thing is true with dementia. So when we hear dementia, it's a category, but it doesn't tell you exactly the type. Is it Alzheimer's disease, lewy body dementia, frontal, temporal dementia, vascular dementia? So we use the word dementia because there are many different types and a lot of times people don't know specifically what type they might have. But when you hear the word dementia, it means the person is having problems with their thinking and daily functioning that is beyond what would be expected for their age and can't be explained by any other condition, and so that's the way you can think about it as well. It's like kind of dementia, cancer, different types of cancer, different types of dementia.
Speaker 1:And I know a lot of doctors and medical personnel are a bit reluctant to give a specific diagnosis and often they'll say generalized dementia or something like that. I always encourage families to try to get a more specific diagnosis because it tells us a lot more things about what do we need to be prepared for, what is the trajectory of the disease, how do we need to adjust our care plan and our financial plan and other things like that. And it is I think in the medical industry there is a bit of reluctance to try to get that specific diagnosis, but I strongly encourage families to request that from their doctors.
Speaker 2:Yeah, there's lots of reasons why it can be difficult to get the specific diagnosis. The Alzheimer's Association a couple of years ago came out with a survey where primary care providers, many of them, report not being comfortable making a diagnosis.
Speaker 2:And so that's part of the one challenge. The other challenge is that it can be hard to find specialty providers. So if somebody comes, especially if they're younger or their clinical presentation is not quite typical, they would need specialty evaluation from a neurologist and a neuropsychologist. And sometimes we don't have access to those individuals and then we're facing just the stigma even among healthcare providers, where they feel like, well, what's the point in getting tested or getting the diagnosis? There's nothing we can do about it. And that's also a reason why many people I think it's like 72% of people right now who have dementia don't have an official diagnosis of any type.
Speaker 1:So when we get into that, that leads to my next question about some of the surprising symptoms of what can be dementia, and so I think a lot of times we have an idea in our mind of what dementia looks like, but what are some of the surprising symptoms that could very well be dementia?
Speaker 2:So I love this question because I think that a lot of people, when they think about dementia, they are picturing an older adult who maybe looks frail, sitting in a wheelchair or using a walker, not really engaged in the community, and who has memory impairment. But that's not how most people with dementia look. That might be how they look in later stages of the disease and I think that most of what we see online and in movies is always that later stage, like the moderate to severe stages, but not everybody with dementia looks the same. I think a lot of people are surprised to hear that you don't even need to have memory impairment to have dementia.
Speaker 1:Right.
Speaker 2:So, like you can have perfectly fine memory and still have dementia, you could have good language abilities and still have dementia. There's many different ways dementia presents itself, depending on the type, and so that's surprising for people to hear Sometimes. What's also surprising is that dementia can change a person's personality and behavior and their interests in what they do, and so that can be a way that it shows up that people don't really realize, and dementia can even change somebody's gait and walking, like how they move about their body. So those are some things that I see don't get a lot of attention.
Speaker 1:You know, and that's those are the sometimes those are the types that can be even more difficult, because if you don't have memory loss and you don't have loss of speech so, for example, frontal temporal dementia it can be where the person has the lack, lacked the ability to, or loses the ability to make good decisions and sometimes loses any kind of impulse control. And that can be very difficult for a family, because that's their dad, that's their mom, and now it can ruin relationships, things like that, because they don't understand. Oh, this is actually dementia. This is not, this is not this person just being a bad dad or a bad mom. It could simply be that they now have this type of dementia that has gotten rid of any ability to what they say executive decision making.
Speaker 2:Yeah, their executive functioning could be low and so their it's part of executive functioning is decision making.
Speaker 2:So somebody might be making poor decisions, it might be impulsive and do behaviors that maybe they wouldn't normally do and the family might think they're just being, you know, a jerk or something.
Speaker 2:Or if that the family member had a strained relation, like a strained, tense relationship, with that family member, and then and maybe that family member had made some bad decisions in the past that were still kind of hurtful to the family, but then they get this diagnosis on top so it exacerbates it, they might think, well, they've always been this way, they've always been me, and so that's why it's really important to get an assessment. And what's also really heartbreaking is when other family members who are not as involved in care don't understand that dementia can look different. And so when they visit you know the couple times a year they might visit and the person seems to have a decent conversation or they remember certain things they start to think that the primary caregiver is like being dramatic or making things up or lying, when they just aren't around and they don't understand how dementia can really show itself. So it's really hard for that primary caregiver.
Speaker 1:Yeah, and the family dynamic is always so difficult when there's one or two family members that are really stepping up and you know being involved daily. And then the outsiders come in and if they don't see it, it's not as obvious to them, or things like that. It can cause a real strain and families, which is difficult. You know, that's one of the common mistakes I think that we make. We could spend hours on the question of common mistakes that can be made when dealing with a loved one with dementia, but give us some ideas of just some of the common things. That really is probably the wrong direction to go when you have a loved one with dementia.
Speaker 2:I'd say some of the biggies would be reminding the person they have dementia. Just family members or even healthcare providers think that reminding the person they have dementia is somehow going to change their behavior. But if anything, it's going to make the relationship more strained, tense, and the person with dementia might not even believe you. So there's really not nothing good coming from reminding them. Correcting them when they do things wrong is also not recommended, unless their safety is an issue or their safety is at risk. We could just let them do things wrong and not have to correct every single thing they do. That's going to hurt the relationship and make it harder for them to want to accept your help in the future.
Speaker 2:Highlighting their need for help. They're going to need so much help, especially as the condition declines. So whatever we can do without drawing much attention to it like, for example, if they need help cutting up their chicken and now you're always having to lean over and do that for them well, now, every time you cook the chicken meal, everybody gets their chicken served cut up. It's not like done specifically for them or you're highlighting the fact that they need the help. I think that's really important and then a really big one would be. Sometimes we try to get the person with dementia to understand what we understand, to get them to do something we want them to do.
Speaker 2:So for example, like I need you to take a shower because you haven't showered in three days or three weeks and you're starting to see stink and it's not great for your skin. And you know. We try to get them to understand from our perspective and that rarely works. Instead, you just want to focus on the ending you want. So, instead of trying to focus on their understanding of what you need, focus on the ending that you want them to do. So when we focus on the ending, it's like they'll need to understand our reasoning or why it's important to us. We just need to figure out what would get them to do the thing, what would make it enticing? How can we present it in a way that would make sense in their mind to want to go forward with the activity?
Speaker 1:That's great. I can think of so many examples. One would be and this is something I'm working with families on practically every day, or at least multiple times per week of the family feeling that they have to logically, rationally, convince their parent or their spouse of the thing that we need to do, like get rid of the car or stop driving. The thing about that is, if it is, say, one of the issues, one of the types of dementia that does have memory loss, even if you somehow could get through and have that person understand the rational, logical argument, as opposed to giving an incentive towards the end result oh, you don't like spending more time with me, I'll drive you to the store when you need to go to the store. That's the result, as opposed to the doctor said you shouldn't be driving, you could get in a car accident, you could not.
Speaker 1:Those are all logical, rational reasons, but the reality is that even if you somehow could get through to them, they're not going to remember that the next day. That rational, logical argument is going to fail most of the time when we're trying, and I have so many families that will say okay, I understand your plan, bob. We probably need to institute this plan. I got to go convince my parent of it and I try to explain to them. Okay, but you will remember. You know that even if you are able to do that, they won't necessarily remember that tomorrow. Yes, so it's just an important part of it.
Speaker 2:It's very important and that's a great example, and it can go two ways. So, even if they can't remember that, you'll remind why they can't do something over time, like when you remind them, hey, you can't drive anymore, you're not safe. And of course a lot of people are going to have a hard time hearing that. What ends up happening is they start to remember the general feeling they get when you're around. So, even though they don't remember, you told them they couldn't drive or you reminded them, they know that every time you come around for some reason, they just don't feel very good and so that makes it. It's going to make it harder for you to be able to help them with anything in the future.
Speaker 2:But if somebody does have memory impairment, you can use that to your advantage. Sometimes family members will try and approach and it works. But then the person asks again can I drive, can I drive, Can I drive? And family members sometimes put pressure on themselves, like they keep asking, and I'm like but did it work the way that you responded the first time? Oh yeah, that worked fine. Well, we could just keep using it because they're not remembering, so like, in some ways, bad memory we can use to our advantage. We don't have to come up with a bunch of different responses. But we it's like sometimes we have this faulty assumption that because they can't remember, we can just kind of say whatever we want to say, but over time they'll remember how they feel with you.
Speaker 1:You said something there that was an insight for me that I'm going to use from now on. That was fantastic. What you said was that if you're constantly having to have tough conversations, then now they have a memory of that feeling. They're not going to remember those tough conversations. They're going to remember that feeling and then they might have bad feelings towards you gone, going because you constantly are having that tough conversation, as opposed to making it a positive to say I just want to spend more time with you, I like I, I spending time with you, that's why I want to drive you to the grocery store or whatever.
Speaker 1:And now you've created that, that record and history of positive feelings when we see you, and that I never. That's an insight I never thought of before, and so that's a, I think, a really effective way to say okay, when we're having to deal with these tough issues, if there's a way, for certainly we don't want to have that difficult, sometimes negative, conversation over and over again, because that's going to create a difficulty for you and your relationship from for probably some time, and so, but if we can flip that switch and say no, we're going to make all of those conversations have a positive feeling, having to have an uplifting feeling that's going to help you with that relationship. They're going to be excited to see you rather than anxious to see you, because they've had that negative conversation so many times that now they have anxiety just by seeing you. That's fantastic. I had never heard of it that way before.
Speaker 2:Yeah, awesome.
Speaker 1:Okay, so you know we've been talking about this from the different types of dementia. I want you to spend a little bit of time talking about the symptoms, the typical symptoms for Alzheimer's, because that is the most common type of dementia, correct?
Speaker 2:It is the most common type. That's what we hear most about gets the most research funding.
Speaker 1:So so tell me some of the symptoms of Alzheimer's dementia.
Speaker 2:So the classic homework feature is going to be memory loss. So that's why a lot of people assume people with dementia should have memory loss. Because of this common type Alzheimer's disease does present with memory loss, and a lot of times the changes can be subtle. When somebody has Alzheimer's disease it's not like all of a sudden they wake up one day and something's off and you know something is wrong. That can be true, and vascular dementia not so much in Alzheimer's disease, and so sometimes by the time family members start to recognize I think this is more than just a bad day or bad night's sleep or a lot of stress. A lot of times that person's probably approaching the middle stages of the disease moderate stages by the time they actually go forward to get an assessment. But the classic homework feature is going to be like slow, gradual memory loss.
Speaker 1:So this is a difficult question we were talking earlier about. This could go in so many different directions, but can you give us some hallmarks of good care, for you know, my question I asked you earlier is are there best types of care for dementia? That's such an open-ended question so I'm altering it a little bit to say what are some hallmarks of good care for someone that has dementia in any form?
Speaker 2:The most important thing that I can say is that whoever is giving care so if you are giving care or partnering in their care, the most important thing that person can do is make sure they're taking care of themselves. Like I know for so many big-hearted people giving care, they put all their attention on the person with dementia. But I've worked with more than a handful of cases where the actual caregiver is the one who winds up in the hospital and now we need emergency care and coverage, you know, for their person with dementia because their own health deteriorated so much. And so I think it's making sure we don't buy in to any myths or lies that somehow doing something for ourselves and prioritizing our own appointments and our own health is somehow selfish. Everything you do that's good for you and your health is going to have a positive benefit on your person with dementia, and if you're not prioritizing your own health and your own needs, it's going to have a negative impact with somebody who has dementia. Now, this doesn't mean that we're off at the spa every day and that we're able to get, you know, nine hours of sleep every night.
Speaker 2:Caregiving comes with many big demands. That's going to like not make some of those things possible. But it starts with how we talk to ourselves, what we think in our mind, making sure we get to those doctor's appointments that we need to get to being okay asking for help, like sometimes people will ask me at what point should I allow help? Or start looking for help, like how do I know when I need it? And I'm like we can get help without needing it. We can get help now, knowing that this journey is long, you're going to need things as the disease progresses. We could just start accepting help now. We can look at it as not a sign of weakness. So for me it's just like rewiring our brain from how we've been thinking for decades of our life.
Speaker 1:I think this is especially true when it's the spouse is the caregiver. And so then I hear things like well, you know, my family helps on. I said that's great, I'm so glad that you have such a loving family, but how many hours of a day are they coming up? Well, you know, they're coming over every day for an hour or two. That means that you're a full-time caregiver, another 22 hours out of the day, and you're also 89 or 75 or whatever, and you're not getting any younger either.
Speaker 1:It's so difficult for a spouse in particular to accept that that they don't have to give up all of their stress and all of their sleep and all of their, you know, in order to provide the care for it, because that's not going to work long term. You know, we hear that statistic over and over again, that it's the caregiver spouse that dies first more often than not, and that's we've seen it in our own office. It's true. So often, and it's often we're putting so much stress on the caregiver that you know it's great if we can have that caregiver, keep somebody in their home, things like that. But we've got to provide that proper support. Give them breaks, give them respite, give them time off Maybe.
Speaker 1:I was in court yesterday and lawyers have this rule that they can't solicit clients. So I would have loved to go up to this lovely woman and tell her I can help you, but I'm not allowed to do that under the ethics rules, Because she was talking to the judge about how difficult it was and how she'd love to take a weekend off and that she can't. And you know there's resources for that, there's options for that, but she, you know she's not aware of them, and so it's one of those things. If you don't get to take a weekend off every once in a while, or maybe even take a week off and go visit the grandkids, then it's going to be very difficult for you to maintain that level of caregiving for the length of time that the person with dementia might need it, that your spouse might need it.
Speaker 2:Exactly, and I work with the Careblazers in my program like one of the big things is getting comfortable asking for help. A lot of people feel uncomfortable asking for help but I'm like, well, you're already uncomfortable doing everything on your own, so we might as well be uncomfortable and give yourself a little bit of chance at getting some extra help. And then for people who are really hesitant, especially when it comes to hands-on help with their loved one with dementia, we can accept help in all kinds of ways. But I have my Careblazers take a list. I have them go through a typical day. Write down everything that you do Grocery shot, pick up medicines, order refills, go to the bank, take out the trash, cut the yard grass in the yard, make the bed all of these things. Write down everything you're doing.
Speaker 2:Now, on that list, what absolutely has to be done by you only and the majority of them do not have to be done by that person only. So in the beginning stages, especially if you're having a little bit of difficulty or finding somebody who's comfortable giving care for your loved one with dementia, well, maybe we can have them do the grocery shopping. Or if the person, maybe there's a resource or a tool out there that exists that could do the grocery shopping for you. So it's like starting to retrain their brain on getting help in caregiving doesn't actually have to be only in the caregiving task. It could be in so many different other things.
Speaker 1:That's great.
Speaker 1:So there does come a time for lots of folks where the best answer and I know sometimes culturally we don't think this, we see this in movies and various things but the best, absolute best answer for this person, for the spouse, for the family, is to get care outside of the home.
Speaker 1:And I'm a big advocate for this because I think that sometimes not being in your home, lonely and alone for 24 hours a day without hardly any input or people, especially input from people your age, it gets lonely, it can exacerbate the memory loss. So I think one of the things is, if we're not going to look at an assisted living or memory care or a nursing home or things like that, we need to have other input, like going to the senior center or having some kind of a day setting that we might look at so that we get that stimuli, we get that interaction with others. But when it comes to that and we finally make that decision which is often, in my view, the absolute right decision to get care outside of the home, either an assisted living, independent living, any of these options what are some of the factors that we should look at that would be most important to evaluate those options.
Speaker 2:I think it's going to depend on your particular situation. So, for example, I have some care blazers who it was very important for them that the location of the facility be super close by so that they can go visit often. For other people they were trying to do long distance caregiving and so location of the facility wasn't that important, but they wanted to make sure that the staff members there were super trained in being able to care for somebody with dementia. So location, the training of the staff, the price of the facility we have to be realistic in what people are looking for. But I recently just did a survey with my audience so not a scientific study, but just like a survey to my audience and I asked them what was the most important factor when you were looking for a care facility that you were wanting to know, and it was staff training, and confidence came out on top far beyond anything else.
Speaker 2:Now, the first thing they looked for when they were touring a facility was the cleanliness. That's the first thing that stood out was just the cleanliness of the facility. But when we boiled it down to like if you had to fit somebody your loved one in a care facility, what was the most important thing. It really was a staff training and knowledge. So I think being able to find out truly what their staff's knowledge and training is don't let them get away with. Oh, we have dementia training.
Speaker 2:Okay, really, what is that? Was it just like a one week training session? Is it just a piece of paper? I mean, is it just two people and they're not even on staff anymore? I also think the family member knows the reasons they're looking for placement and the common challenges that their loved one is having. So asking the facility, what would you do if my husband kept asking to go home and wanted to go home and it was the middle of the night? How would you handle that situation? Hear their response and see what they would say. You'll start to get a really good idea on what their treatment approaches are.
Speaker 1:Yeah, that's great. I'm gonna end on a more positive note. You had mentioned this earlier to me when we were talking privately about that. How does lifestyle and environment play into preventing dementia? A lot of us are worried about it because, especially those that work in this field, we think, okay, boy, that's a tough life and is there something I can do to make it less likely that I'm going to have to experience that life? So how does lifestyle and environment play into preventing dementia?
Speaker 2:It's a huge role. So when we think about the dementias, there are about 2% of all dementias are due to pure genetic factors. Unluck of the draw, no matter if they were the healthiest person in the world, if they have these rare genetic mutations, they're going to develop Alzheimer's disease, no matter what. For all other cases, genetics plays about 50% of the role and lifestyle factors play the other 50%, and so we have a lot of say. We have a lot of power in being able to reduce our own dementia risk.
Speaker 2:Now, by the time somebody shows clinical symptoms of any type of dementia, the brain changes have been happening decades prior. So right now our brains are changing, even if we're not showing clinical symptoms. So what we do right now is really important, and the classic common lifestyle factors to prioritize are going to be a healthy diet. So people might have heard of, like the mind diet, the Mediterranean diet for neurodegenerative diseases. That would be something that people want to prioritize as far as eating. Getting good exercise ideally about 150 minutes of moderate intensity exercise a week is going to help reduce your risk Not smoking, avoiding excess alcohol use. If you have hearing loss, making sure you are wearing hearing aids or whatever corrective devices you are prescribed because hearing loss is a risk factor for dementia.
Speaker 1:That's really interesting.
Speaker 2:Oh yeah, it's a big one. I forget the exact, I can't remember if it's 4% or 8% of all dementia cases could totally be wiped out if people wore their hearing aids.
Speaker 1:Wow.
Speaker 2:When they needed to. Yeah, it was a study that came out last year, but a study that came out this year in February in JAMA the journal talked about. They looked at brain pathology of people. So when we're thinking about Alzheimer's disease, they look for beta amyloid and tangles and what they found is that people who had the biological markers in their brain of Alzheimer's disease, but they had the healthy lifestyle, their cognition, they had a better cognitive abilities than people who did not have healthy lifestyles. So even though if you looked at both of the brain somebody who had Alzheimer's disease and somebody who didn't and you opened it up and they looked the same, the people who had the lifestyle healthy lifestyle factors were functioning better in their day-to-day life and had better cognitive functioning than the people who did it. So even if you had these biological markers, it's not a guarantee that you are going to develop dementia and that's why these lifestyle factors are important to do now. But unfortunately a lot of us don't do these things until we start to show the clinical manifestation of the problem.
Speaker 1:You mentioned activity and food. What about stress and anxiety?
Speaker 2:Yes, so that's another good point. We want to do whatever we can to manage getting good sleep as much as possible is going to be important. Managing stress is going to be important. If you have anxiety or even depression, that's going to be important. Dementia, any specific type of dementia is. There's a lot of lookalikes, so people who have poor sleep, especially in old age, they can look like they have dementia. People with severe anxiety, depression, high stress levels it can look like they have dementia and they might not have it at all. That's why dementia is technically a condition of exclusion. We have to exclude everything else before we actually say this is what it is and so, yeah, we want to manage those things as much as possible.
Speaker 1:Excellent. You're just a wealth of advice and information. I always enjoy talking to you. Natalie Edmonds from Care Lasers Did I say that right?
Speaker 2:You got it, care, blazers.
Speaker 1:Care Blazers, and so thank you so much for joining us.
Speaker 2:Thank you, Bob, for having me. We're going to flip this script and have you come on and share all your wealth of knowledge with all of our Care Blazers soon.
Speaker 1:That would be great. So if you enjoyed this presentation which I can't imagine that you didn't if you're at all interested in this topic, please remember to subscribe. We're going to be available on any podcast station, any of the places that you listen to podcasts. You can also go to our website and listen or watch it there at manorlawgroupcom. But we appreciate our listeners and please feel free to subscribe so that you hear about the next options and next topics that we cover. Thanks so much. Thanks for listening. To learn more, visit manorlawgroupcom.
