
- With Mayo Clinic health education outreach coordinator
Angela Lunde
read biographyclose windowBiography of
Angela Lunde
Angela Lunde is a dementia education specialist in the education core of Mayo Clinic's Alzheimer's Disease Research Center at the Abigail Van Buren Alzheimer's Disease Research Clinic in Rochester, Minn.
Angela Lunde
The transfer of information about dementias, as well as understanding the need for participation in clinical trials, is an essential component of the education core.
Angela is a member of the Alzheimer's Association board of directors and co-chair of the annual Minnesota Dementia Conference. She is a member of the Dementia Behavior Assessment and Response Team (D-BART), a multidisciplinary outreach service assisting professional and family caregivers in understanding and managing difficult behaviors often present in dementia. She facilitates several support groups, including Memory Club, an early-stage education and support series, and more recently, helped to develop and now deliver Healthy Action to Benefit Independence and Thinking (HABIT), a 10-day cognitive rehab and wellness program for people with mild cognitive impairment.
Angela takes a personal interest in understanding the complex changes that take place within relationships and among families when dementia is present. She is particularly interested in providing innovative and accessible ways for people with dementia and their families to receive information and participate in valuable programs that promote well-being.
"Amid a devastating disease, there are tools, therapies, programs and ways to cope, and it is vital that families are connected to these resources," she says.
Latest entries
- Alzheimer's support group gets lift from humor, sharing
May 14, 2013
- As caregivers, support each other without judgment
May 1, 2013
- Alzheimer's individual living in the moment — in happiness
April 16, 2013
- Take the time to find gratitude: You'll be happier, healthier
April 3, 2013
- Gratitude is the one pill everyone should be prescribed
March 19, 2013
Alzheimer's blog
-
April 28, 2010
Long term care: Plan ahead to know your options
By Angela Lunde
Thanks for the recent discussion around the topic of long term care. I completely agree that it's hard to know when or where to start looking. I understand the enormous financial barriers, and that finding adequately staffed and high quality residential care challenging. There are no easy solutions for families. But here are examples of types of care, some thoughts to consider, and resources for you to explore.
Changes that occur over the course of Alzheimer's disease make it almost certain that additional care, including residential care, will be needed. The decision is often heart-wrenching and met with uncertainly, fear and guilt on the part of the family or caregivers involved in the process.
Having said that, I can't stress enough the importance of doing your homework as early as possible (well before your loved one needs long term care) so you can take time to understand the options available. Even if your loved one is in denial, family members can begin to investigate on their own. As the disease progresses and the time to move a loved one is near, it's most often the family (children) that influence the decision the most.
So what exactly is long term care in the context of a person with dementia such as Alzheimer's disease? There are generally 2 types of residential care available: assisted living and nursing homes.
- Assisted living is any group of residential programs not licensed as a nursing home. Definitions of assisted living and the specific regulations differ from state to state. The spectrum of assisted-living services includes options such as congregate housing, residential-care facilities including adult foster care homes and memory care assisted living. Assisted living residences generally provide 24-hour staff, recreational activities, meals, housekeeping, laundry and transportation.
- Memory care assisted living is essentially a step beyond basic assisted living. Residents are in a supervised, sometimes secured locked facility. Meals are provided; activities of daily living including medications are managed by care staff. Memory care assisted living is social, activity-based model of care (vs. medical model of care found in nursing homes). Most persons with dementia can live in a memory care assisted living facility throughout their disease unless there are medical conditions that require the skilled nursing services offered in nursing homes.
- Foster care or board and care homes provide meals and help with some daily activities (such as money management, scheduling transportation, reminders to take medication, laundry and housekeeping). Board and care homes may also be called adult foster care, elder care homes or residential care homes. Some foster homes are also dementia specific and will provide round the clock supervision, assistance with daily care and social activities.
Although some facilities accept state funding (Medicaid), assisted living is ordinarily paid for privately
- Nursing homes provide a full range of skilled care needs, including acute care and long-term care. There are many persons with dementia who live in nursing homes because of coexisting medical conditions or due to insurance, proximity to family, or other logistical reasons. Some nursing homes offer alzheimer special care or memory care units to better meet the special needs of residents with dementia. Special care units are usually a floor or a unit inside a nursing home.
Currently 27 states have legislation requiring nursing homes and assisted living residences to tell exactly what specialized services including memory care they provide. This includes providing written information about trained staff, specialized activities, ability of staff to care for residents with behavioral needs, and what fees they charge.
What kind of care is best for you or your loved one? The Alzheimer's Association CareFinder can be a useful tool and will walk you through the following:
- what types of care are available
- how to recognize good care
- what the Alzheimer's Association recommends
- how to decide what care you need
- how to make sure you've found good care
You can find a link to CareFinder on the Resources tab above.
Once again, there are no easy answers, but another valuable resource I must mention is a local support group. Support group participants can share their firsthand experiences with long term care and offer invaluable insight into their journey. More importantly, they can provide the emotional support families need as they navigate this uncharted and unrequested territory.
34 comments posted
March 22, 2012 11:04 a.m.
My husband has had Alz. for about five years. Lately he has been unable to sleep through the night, often getting up at 3 AM to sit alone in the living room. He has become at times argumentative, combatative, will often leave the table and say he is going out with someone to eat real food. Is the sleep pattern change also called wandering???
- Jean
January 29, 2011 9:30 a.m.
Hello fellow Caregivers, sufferers, professionals. *If you care not to hear a history skip to * What can you do or how can you possibly deal with the news that after being a caregiver for a parent by yourself for 3+ years with no help from family, what kind of help is there if you need it.If you have family less than a mile away, a child within 5 miles and none come to see their mother or grandmother at all or even call. I feel sadly that those who do show up trying not to be forgotten or ticked off that I am the caregiver, POA and Health Care Proxy and make moms decsicions. I can bet when all is said and done $ usage will e an issue.As an FYI,I'm not writing this on a new computer,watch a 60 inch TV, have a new car or any car are mistaken. We live from Govt to govt check, I am on disability for back and other injuries. all that being said, I hope you have read along this far for the big question. *What do you do when the caregiver, after as said 3-4 yearsof doing such, finds out themselves that they most likely have early onset Alzheimers, at age 52? If there is no one who cares about their own mom or grandma, and yourchildand you barely have any kind of relationship, who or how do you plan ahead for a furure. Even the alternates to Alzheimers are grim. It is heartbreaking and scary I'm sure at age 52 all of a sudden, depression or not, start seeing yourself as the person you take care of and swear you would never get like that. what options if any does one have Billy
- Billy
November 24, 2010 4:17 a.m.
Thanks for your great discussion about long term care..
- Buy Advair
November 10, 2010 10:22 a.m.
My husband was diagnosed with AZ two years ago.He is at stage where he is very abusive verbally, refuses to shave and change his clothes. He drools when drinking liquids. He sometimes hears music when it is not there. He constantly loses things and accuses me of stealing them. He took his truck out and has been lost in the city for up to 12 or so hours six times. He was told he could not drive by his physician. His license has been revoked by the state. He still wants to drive and curses me out several times a day because he wants the keys to his truck. I was told that if I gave them back to him again I would be enabling him and he could potentially harm someone and I would become responsible legally. In May I was told that he was between the first and second level of five levels. He thinks that he is above the law because he is a retired military officer. He has threatened to kill me and wants to divorce me. Even though all of the above is going on he can still work puzzles in the paper, loves his ball games and loves to go out to eat etc. He can fix his own breakfast, bathe and dress himself, washes his bed clothing and makes his bed and shop in the grocery store when I take him. Socially he can have good conversation when others are around. He is still ambulatory. He doesn't seem to fit any particular stage or level which leaves me unable to make a decision when to place him or where to place him. This causes me much heartache. I really appreciate your newsletter. Thanks.
- Joyce
November 3, 2010 1:42 p.m.
I want to thank you guys for this site. My mother has this terrible disease, but fights though it daily. I have a question for those of you involved in relationships with significant others. I have met someone I think may be the one. But recently, I told her that I will not compromise or negotiate with her concerning the future of my mother. My mother will not be put into a nursing home. My mother will not go through this along. My potential significant other does not understand that. What should I do?
- Paul
September 27, 2010 11:54 p.m.
My father has declined over the past 4 years. We knew he had the disease, but he refused to go to the doctor. Earlier this summer, my mother (79) and a fighter, experienced a dvt, sepsis kindney condition, heart failure, and them bled out to less than 2 pints of blood. She spent 6 weeks in the hospital and 3 in rehab while making a remarkable recovery! In home health did wonders for her. All the while, my father called me Jimmy, and thought she was his mother. While my mother (his wife) was in the hospital, I tricked he into going to a facility that did the diagnosis and kept him for 12 days. Last week he tried to wander while making it known he was going home (lived here almost 20 years now). I tried to redirect him back into the home and he started hitting me (I'm 44) and mother became involved ;( They both fell onto the floor breaking mothers pelvis and he is back into the facility that diagnosed him with late stage alzheimers just months before this. My mother at 79 now has a broken pelvis on top of all her other medical problems! We are a our wits end!
- Neil
September 9, 2010 2:50 p.m.
I agree with several comments above regarding the omission of keeping the parent or spouse at home. Perhaps you can address this in a future column. My mother who is in mid stage of alz, is at home with us and we currently employee home health aides from 9AM - 8PM everyday to care for her. We are use my mother's money to pay for the aides but when that runs out we will apply for the community based "Frail Elder Waiver" option to pay for care. I rarely see this program discussed. It almost seems like the system is biased in favor of nursing homes and assissted living. The "at home" option should be included as well. She is getting great care at home by the aides and us, her daughters and keeping her in her home creates less stress for her. This is not for everyone but should be considered especially if close relatives are up for the task.
- Barbara
August 27, 2010 9:47 p.m.
I have been taking care of my Mother in her home for almost four years. She has Lewy Body dementia. I work full time and have the support of two care givers that come to our home. It can be a long process to find someone but being able to keep my Mother at home where she is most comfortable means a lot to me. Staying at home is not for everyone. The stress is sometimes over whelming She doesn't know who I am some days but then neither do I. She is not mean and has developed a sense of humor I never saw or heard before from this sweet, refined, elderly lady. I know the time is coming that it will be impossible for me to keep her at home, until that time we'll just keep laughing at hard spots and holding on to the good thoughts.
- Pat
August 26, 2010 2:53 p.m.
I am a guinea pig when I attend the University of British Columbia Hospital, Alzheimer Research Counsel (I think that is what it is called) and as such think I am heading the same direction as my Mother went back in the 90s. I have read the twenty-five comments of others who have shared their opinions and views but feel I have to put in my two cents. I will not be a burden on my wife nor my children, nor on my pension (CPP). I propose to walk to a distant bridge over the Fraser River and when I get there I will make an important decision: either cross it or jump off it. lol vVuTqL
- Lorne
August 25, 2010 10:35 a.m.
i would much prefer to find a way to die rather than live with alzheimers. both of my parents died of alzheimers, so i know whereof i speak. i will never allow myself to get to that point.
- nicky
August 24, 2010 9:41 p.m.
Ms. Lund, yourcomments included: "There are generally 2 types of residential care available: assisted living and nursing homes." I do not understand why you did not mention the option of home care. I fully realize that is not an option for everyone for many reasons. However, it IS an option for some persons, in some circumstances, depending on the Alzheimer's patient. My wife is in the advanced stages (Stages 5-6) of Alzheimer's. I am my wife's full time caregiver; I obtain limited (5-10 hours per week) relief so that I may shop, run errands, etc. I am also assisted, for brief periods of time, by family members. This arrangement, IN OUR CASE, is the only one I would consider. My wife is happier, I am happier, and it is the way it should be, in my opinion. My longer term review indicates that when more intense medical service is required, it can be provided in our home. Again, I repeat, this option is not for everyone. However it is working for me and my wife and is the only one I would consider, given our circumstances, my excellent health and my wife's symptoms. It is definitely an option.
- Marv
August 12, 2010 2:52 p.m.
Very informative!!! For help with your search for an assisted living facility check out silvercensus.com!
- Assisted Living Homes
August 3, 2010 12:45 p.m.
My mother is in a nursing home with stage two dementia. They have said that medicare will not pay due to the fact she can't remember tasks in her speech class. she gets around to well for other kinds of class for that. Please help we have to pay now is there some other thing we can do?
- Rosemary
July 14, 2010 1:11 p.m.
Sherly please note. My husband was given Ativan after kidney surgery. I found it caused hallucinations. In reference to Ativan caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug. If this drug is injected into a vein, seizures, blurred vision, mental/mood changes (e.g., hallucinations, agitation, confusion. Before using this medication, tell your doctor your medical history, especially of: glaucoma (open-angle), kidney disease, liver disease, personal or family history of regular use/abuse of drugs/alcohol, breathing problems (e.g., asthma, chronic obstructive pulmonary disease-COPD). If taken oral then it may have the opposite effect on the elderly, causing mental/mood changes, sleeping problems, increase in sexual interest, or hallucinations. I don't understand why they administer it to the ederly. I had a friend who's mother was given it in her final hours and she became aggressive and they did not know about the affects of this drug.
- Sharon
July 14, 2010 8:12 a.m.
There are both compainies and people who come into one's home and provide care. I have done this for many years and am employeed simply upon a referal basis. I have been told by families that this type of care is a god sent.
- Corrine
July 3, 2010 2:44 p.m.
Don't forget to contact the Veteran's Administration if the situation applies in your case. VA Homes are available to those who qualify.
- Fairy
July 1, 2010 11:41 p.m.
I just wanted to respond to a couple of the comments made. My mom began with some typical Alzheimer's symptoms. My mom wanted to deny it, but I so much wish she would have shared more with me when she could. She began to get extremely angry, accusing, paranoid, and suspicious. She was not the sweet woman I knew. I was able to take her to psychiatrist for evaluation. She was initially put on Aricept, and then later Risperdal. The Risperdal made all the difference in the world with the symptoms I mentioned. The Alzheimers has progressed, and she has continued to deteriorate, but she is so sweet. She has been in a nursing home for two years now, but I am thankful that she still knows me and is so loving.
- Gwen
June 28, 2010 6:03 p.m.
i mother is 73 yrs and she has demntia alzhimers and she sometimes gets so angrey and mad that she turns red in the face why is that and dose this mean i need to take her to dr or what i get scared when this happens
- jo
June 8, 2010 7:32 p.m.
Sue -- Thanks for the site and I will check it out. My husband has so many other medical problems that even for a neighbor to come sit with him for a few hours scares them away. Plus he has become so awfully mean. The complete opposite of who he used to be. He really needs nursing care and I'm not an RN, only training I've had is EMT, but I'm sure getting an education now. He has taken Aricept for 4 yrs. and Namenda for 2 yrs. He is also on Paxil but they recently added Ativan. He's just becoming so mean. And now he's stopped taking baths and shaving. That's a major chore for me to get him to clean up. The internet and my email have become my social life anymore. If I talk on the phone he turns the TV volume up so high you can't talk. I have congestive heart failure but have it under control. However, the stress of caring for him is beginning to take its toll on me. The Drs. don't like this and say the time is here for me to make a decision about alternative care forhim.
- Sheryl
May 31, 2010 2:27 p.m.
To Sheryl, Nicholas & No name given: Please check out this website---www.alzheimerspouse.com for help in your situation. I've found it helpful.
- Sue
May 13, 2010 10:45 a.m.
The problem with Adult Day Care facilities is that there aren't enough of them and there are only a limited number of patients they can accomodate. There is usally a waiting list and some programs have a fee that isn't covered by all entities. Having someone at home without adequate support becomes a life sentence for the caregiver and puts them at risk for their own safety and health. My father-in-law tried to keep Mom at home for as long as he could. She became an escape artist and could open any lock on the door. Her internal clock became very confused and she would get up in the middle of the night, get dressed and want to go out to lunch, etc. One night she opened the front door and was found wandering on a major road heading toward the woods near the highway. Dad's health was become compromised and that was the factor that decided that staying at home was no longer an option and that she needed a more secure environment. Even with us living in the same town, family are not there with the patient 24/7, it becomes very stressful and depressing for the caregiver who sees no end in sight to the nightmare they suddenly find themselves in. The person you love is slipping away or is gone and this stranger is very difficult for you to deal with. No one can deal with this situation without some personal repercussions in their own life.
- Diane
May 12, 2010 9:46 a.m.
There is a great Website www.silvercensus.com that allows you to see virtual tour and pictures of assisted living communitues, Independent living communitues and so much more. They also have 24/7 Care Managers that can assist you with placement for Free! You can call anytime 1-888-776-1311. They were great Help to me when I needed help and information for my Aunt. It's a great Website to get information.
- Maria
May 7, 2010 6:04 p.m.
to Nicholas and Cheryl: I also have no help, but you have to take control,my wife refused all help and hates me. I had her taken by the police when she took a knife after me. I had to tell them she was a threat to herself, they took her to the hosp. and the County put her on a 72 hour hold {they had to pay for it, the county because they ordered it.} Since she came home she stays in control because of meds prescribed for her Aricept and An Antideppresent. and I tell her often the rules I make must be followed or she will go back.. I have to treat her like this to survive. I love her very much But I must take care of me first, or I can't take care of her, if I am not healthy
- Robert
May 6, 2010 6:26 p.m.
My husband is in year 5 of fighting this disease. He still denies there is anything wrong. He gets very beligerent and angry and can be difficult to manage. He outweighs me by over 100 lbs. so I can't handle him at all. The local Alzheimer group gave him a scholarship to adult day care for 2 days a week. I could not get him to go. Would not get in car. I need a break from the 24/7 I spend with him. I find myself as a person slowly slipping away from me and resenting having to spend all my time with this mean man. He is not the man I married 50 yrs. ago. There is no help getting sitters to stay with him unless I pay as much as $15/hr. Being on Social Security I can't afford that, not and pay for his meds too. I have to take him everywhere I go as I can't leave him home alone. Takes me twice as long to grocery shop. We have no family in this area. I would love to have some kind of life for me again. To go to beauty shop he hates to wait for me and acts like a 5 yr. old. He regresses more each month. I agree with Nicholas. HELP.
- Sheryl
May 6, 2010 5:57 p.m.
I find it hard to find people that choose to keep their spouse or parent at home. The cost and care is no more than a nursing home and the one on one compared to 13 to 1 has to make a difference. We need to look at the oriental and older cultures in the european world to see the alternatives. My husband has had 4 strokes and has alz as well and with a calm and assertive enviorement here at home he is a happy person. May not know where he is and the day he is in however he is calm and can be kept quiet and at peace. Oh we have outburst, but with a good effort and support system it can work. We have 9 children and we are alone in our needs. So it is not coming from the family as they are on a track we were on at one time. They are there if I go down it is all in place and that is what makes my job so okey with this man I have been with forever and ever. Or society needs to pull closer together not ship us out.
- Charlene
Share on:


34 comments posted