ThirdAge Services

ThirdAge Services Certified Dementia Consultant for families She consults face to face with families in North Texas and via telephone with families nationwide..

Carole Larkin MAG, CMC, CAEd, QDCS, EICS is a Certified personal consultant to families who have a family member who has Alzheimer’s or a related dementia. Her company is called ThirdAge Services LLC, She can be reached at 214-649-1392 or at [email protected].

12/06/2020

Retired!!!! Will be shutting down this facebook account soon. If you want to get in touch with me, you'll need to go to Carole Larkin.

11/20/2020

Retired as of 11/2020
If you need referrals to others that do what I did- just contact me!

The headline is very misleading. The article is clear. Any mask is more protective of you than no mask. Surgical masks a...
05/25/2020

The headline is very misleading. The article is clear. Any mask is more protective of you than no mask. Surgical masks are pretty damn good. Cloth masks are effective too. Reusing a mask is better than not using one at all.You can clean masks and tells you how. My comment: You see pictures of kids with cancer in the hospital during cancer treatment. They are wearing masks. Is this because they don't want to pass on Cancer to the rest of the world? Oops, snarky question-sorry! Just trying to get the attention of all those who don't care about anybody but themselves.
Maskomania: Masks and COVID-19
THE-HOSPITALIST.ORG
Maskomania: Masks and COVID-19
Masks alone are not enough to control COVID-19 and must be coupled with other nonpharmacologic interventions.

Masks alone are not enough to control COVID-19 and must be coupled with other nonpharmacologic interventions.

03/27/2019

I'm on Facebook with Carol Marak talking about legal issues like Medical Powers of Attorney for older adults, especially for those who are alone. Take a look!

Superlative article on the doctors ( on the whole) not addressing guns in the home of a person with a dementia. A traged...
10/15/2018

Superlative article on the doctors ( on the whole) not addressing guns in the home of a person with a dementia. A tragedy just waiting to happen? I think so.

When should doctors broach the topic?

You think Medicare isn't being changed- think again. Proposed changes make the Texas Medical Association think that Doct...
09/18/2018

You think Medicare isn't being changed- think again. Proposed changes make the Texas Medical Association think that Doctors will quit taking Medicare patients in DROVES. Even more than they do now. The Texas Medical Association is begging politicians to STOP the changes. Lookie Here!

https://www.texmed.org/TexasMedicineDetail.aspx?id=48561

Federal lawmakers must hold hearing immediately to stop proposed changes to Medicare that would cause lasting and serious damage to the program and to health care in the United States, Texas Medical Association President Douglas Curran, MD, told two key Texas congressmen today.

09/10/2018
08/29/2018

Man, this really bugs me...

Reliant Rehab To Pay $6.1M After Settling Allegations It Paid Kickbacks 08/24/2018| by Shawn Shinneman|  Share Post Plano-based Reliant Rehabilitation Holdings Inc. will pay the federal government $6.1 million to settle claims the company paid kickbacks to skilled nursing facilities and doctors. Th...

I am a member of the ALCA (Aging Life Care Association) South Central Chapter Conference Committee  putting on this Conf...
08/28/2018

I am a member of the ALCA (Aging Life Care Association) South Central Chapter Conference Committee putting on this Conference. I think that it's gonna be AWESOME!!! Who knew that I'd be this much work? I didn't, until now! Anyways, it's November 9 & 10, 2018.(just before Veteran's day) All are welcome. A bunch of CEU's! Cheap!!!

http://tinyurl.com/y7jd74j6

Aging Life Care™/ geriatric care management is a holistic, clientcentered approach to caring for older adults or others facing ongoing health challenges. Working with families, the expertise of Aging Life Care™ Professionals provides the answers at a time of uncertainty. Their guidance leads fam...

Interesting. Alzheimers as protection against herpes virus. Protection run amuck. Hmmm...
07/12/2018

Interesting. Alzheimers as protection against herpes virus. Protection run amuck. Hmmm...

A new study has found the mechanism by which amyloid beta -- the protein deposited into plaques in the brains of patients with Alzheimer's disease -- protects from the effects of herpes viruses commonly found in the brain.

Now this is an interesting study. I goes against established thinking. Hmmm, what's up with this?
05/18/2018

Now this is an interesting study. I goes against established thinking. Hmmm, what's up with this?

U.K. study shows better fitness, but not cognition

Sad, sad, sad. I see it with people promoting all kinds of craziness that they claim "cures" Alzheimers.
04/26/2018

Sad, sad, sad. I see it with people promoting all kinds of craziness that they claim "cures" Alzheimers.

Ron Briggs felt he'd experienced a medical miracle, and just wanted to share it

These doctor's comments on the different definition of Alzheimer's for researchers are all over the place. Very interest...
04/12/2018

These doctor's comments on the different definition of Alzheimer's for researchers are all over the place. Very interesting reading!

http://tinyurl.com/yak4auxp

A NEW WAY TO DEFINE ALZHEIMER'S!! This could start to ACTUALLY begin to take the stigma out of it! All we have to do is ...
04/10/2018

A NEW WAY TO DEFINE ALZHEIMER'S!! This could start to ACTUALLY begin to take the stigma out of it! All we have to do is make the biological tests available to everyone. That means PET scans or Spinal Taps. Ok, can anyone make those tests affordable, or at least get them covered by Medicare???

https://www.mdedge.com/familypracticenews/article/163073/alzheimers-cognition/alzheimers-biomarkers-not-cognition-will-now?channel=180&utm_source=News_FPN_br_041018_F&utm_medium=email&utm_content=Breaking%20News:%20Biomarkers,%20not%20cognition,%20will%20now%20define%20Alzheimer%27s

This new way of classifying AD may change the way doctors and patients talk about the disease – and, one day, could change treatment.

Now all they have to do is find enough Geriatricians, nurses, social workers and pharmacists in the United States to sta...
04/09/2018

Now all they have to do is find enough Geriatricians, nurses, social workers and pharmacists in the United States to staff it!

Proposal provides 24/7 access to care team, mentors nursing home staff

I say that it is person centered, person driven care. Also, there is no doubt at all that it will be fought out in the c...
04/03/2018

I say that it is person centered, person driven care. Also, there is no doubt at all that it will be fought out in the courtroom, possibly up to and through the supreme court. And so folks, it ain't happenin' any time soon. That, you can take to the bank!

Critics say it’s a disturbing effort to allow withdrawal of basic sustenance from the most vulnerable in society.

As I suspected, computer brain training programs really train people in tasks similar to the exercise they learn to do, ...
03/08/2018

As I suspected, computer brain training programs really train people in tasks similar to the exercise they learn to do, rather than really increase working memory. Better to learn a whole new language or take up a new hobby to really improve working memory.

A significant part of working memory training effects is a result of a fast development of task-specific strategies during training, rather than an increase in working memory capacity.

And you wonder why I've turned into a cynic? Look at the bad behavior from so many sources within health care. Makes me ...
02/27/2018

And you wonder why I've turned into a cynic? Look at the bad behavior from so many sources within health care. Makes me sick and sad.

The week in investigative reporting on health

01/02/2018

"Just the last few years alone have seen some serious breakthroughs in Alzheimer's research," Joseph Jebelli says. His new book is The Pursuit of Memory.

Sadly, nothing seems to stop Dementia from progressing, or prevent it from starting, new research shows. (a Meta Analysi...
12/27/2017

Sadly, nothing seems to stop Dementia from progressing, or prevent it from starting, new research shows. (a Meta Analysis no less). DAMN!!! Not good news!!!

www.medpagetoday.com/neurology/dementia/69970

Little benefit seen in meta-analyses for exercise, 'brain training,' nutrition supplements

You know, usually I read this stuff and go, "it's just more bla, bla, bla. But in this case, I think that there may be s...
12/11/2017

You know, usually I read this stuff and go, "it's just more bla, bla, bla. But in this case, I think that there may be something to this. Why? Because over the years I've noticed an extraordinary proportion of my Alzheimer's clients have an addiction to sweets (read Sugar), whether they are diabetic or not. I've theorized that their addiction to sugar may just be the only way their brains instinctively know how to force insulin to the portions of the brain that need it to keep functioning at the level it used to. Do I have any proof of this? NO! But the theory falls in line with this research perfectly. But then, maybe I'm just looking for self confirmation here! ; < )

Growing evidence from basic science and preclinical studies demonstrates that insulin plays a key role in brain synaptic function viability, vascular function, amyloid/tau regulation, and cerebral glucose metabolism.

12/03/2017

My most memorable Client.

I have had so many clients over the 12 years that I have been a personal consultant to families that have a family member with one of the dementias, but one stands out as my most difficult but also most rewarding case. She was 92 years old, and recently passed away from both breast cancer and from her dementia. I was with her for her last 7 years. I would like to tell you of my time with her.
I’ll call her Debby (not her real name, of course). I was called in to the case by the administrator of the family trust, on recommendation from the neurologist that diagnosed her with mid-stage dementia, probably of the Alzheimer’s type. She was rich. I mean stinkin’ filthy rich. She had a Picasso hanging in her living room. It didn’t even have an honored place on the wall. It was just one of her paintings. That’s how rich she was.
Her last husband had died a few years before. Her son lived across the country and visited her every year or two. That was a good thing because even though he claimed that he loved her, the two together were like oil and water. No, worse than that. When they were together, it took no time at all for arguments and agitation to ensue. We’d have to calm her down afterward. UGH!!!
She lived in a condo in the best condo building (at the time) in the most expensive part of Dallas. Attending to her was her husband’s butler, who had stayed on after her husband died. He knew nothing about Alzheimer’s and how to deal with it. I did a lot of teaching/coaching to him over the years, and I think that it took a long time for him to wrap his head around the fact that she really did have a dementia. It wasn’t until her last year of life that he fully came to believe it. His job was as house man, meaning cooking, cleaning, shopping and running errands for her.
Debby had grown up poor in Oklahoma, but over the years had acquired great wealth through her marriages. It didn’t hurt that she was a beauty. I mean a Hollywood Starlet beauty. And in fact, she was a Hollywood Starlet. In the house were pictures of her with Hollywood directors, producers and actors of the era. She was friends with people like Howard Hughes, Frank Sinatra, and many other familiar Hollywood stars of that era.
Over the years, she had learned to be what I call “entitled”. Apparently, everyone kowtowed to her every wish. Now with mid stage Alzheimer’s, the filter was off. She could and did regularly verbally slice you up like so much meat waiting for the butcher’s knife. I mean, she could push every one of your buttons when she wanted to, and she wanted to a lot.
She had the usual mid-stage paranoia, heightened by the fact she had so many possessions to misplace and then accuse others of stealing from her. When I arrived, the local police and fire department departments were so tired of her constant 911 calls that they asked the trust to “so something to stop the calls”.
Ironically, she was really was being scammed and robbed of some of her jewelry by some “new” friends who claimed that they were jewelry appraisers who would take her jewelry to be appraised. She’d forget that it was gone, and it was never seen again. OH BOY! I had to discreetly (as one could never let this information out due to her position in society) stop this from happening again. What did we do? We prevented the scammers from seeing her, calling her or communicating with her in any fashion. They were persistent, but we were vigilant. It took a few months but they finally stopped trying to contact her. On to greener fields I presume.
I knew that I would have to find the world’s best caregiver to contend with this mess. And find her I did. Actually, I transferred her from another one of my clients, who presented no challenge, and was underutilizing her skills. I’ll call the professional caregiver Mary. (Again, not her real name.) Over the years Mary not only endured the verbal slicing and dicing, bur also physical abuse, including kicking, biting, scratching, slapping and punching from Debby. It came at bath time, but at other times as well. Mary took to wearing protective gear and gloves at bath time especially. Through all of this, plus the houseman’s nose being out of joint having to share power with another person in the household, she persisted. She stayed with Debby to the end, and was there when Debby took her last breath. Mary is my hero forever, period.
Probably, the most amazing thing in this saga is, in the last year and a half of Debby’s life, her personality changed completely. It happens to some people with Alzheimer’s or another dementia. Debby became sweet, relatively quiet, thoughtful, in other words, nice. On her deathbed, she used to tell Mary and me that she was so glad that she was friends with us. She said that she had put us in her will (she hadn’t) and that she would split her estate between Mary, me, and her son, (again, not true.). She would tell both Mary and I that we were pretty and that she loved us over and over again. Yes, she kept her verbal abilities, all the way up to the end. I used to get tickled when on her deathbed, she would correct my grammar and pronunciation. And she was mostly right!
I miss her a lot. And Mary was so devastated at her death that she got out of the caregiving field entirely, going back to her previous profession. Mary and I still are friends, and will be going out to lunch together now and then.
No, I will never forget Debby. All the bad and all the good. May she rest in peace.

11/15/2017

Carole Larkin, a geriatric care manager for ThirdAge Services, knows that many caregivers want to “pull their hair out” when giving baths to Alzheimer’s p

10/28/2017

And now the article on lack of caregivers right now. And folks its going to get worse in the future unless we change some things.

The Common Cause of the Abuse of Neudexta and the lack of Real “Person Centered Care in America.

I’m trying to kill 2 birds with one stone here. This article will be 98% fact and 2% my opinion.

FACT:

Marie Marley asked in a comments section of my last article “The True Meaning of Person-Centered Care”, so which of the national chains of Residential Care for seniors are good?”

Marie, I’d love to give you a simple answer, but there really isn’t one. There are way too many other influences on any given Assisted Living/Memory Care/Skilled Nursing Care Facility than just the corporate policy dictating how things should run at the community/facility. Granted, Corporate policy is the foundation and the framework that sets the outside parameters of how the community is run. There is no disputing that.

Large corporations of all types depend on “standardization” to ensure consistency of their product going to the consumer, for maximum efficiency of production of the product at the lowest cost possible. It’s the same “assembly line” model that America has used for well over a century, since the era of industrialization emerged from the pre-industrial era. (Yes, I was a history major in college.) It works the same whether its cars or residents in a community/facility. In order for this model to work, people must be viewed as objects on the assembly line, hence the lack of real person-centered care.

But other things also impact how each community/facility runs daily and how they treat their residents. Consider the importance of the community’s/facilities management (the Executive Director or Administrator, the Assistant Executive Director or Administrator, the Director of Nursing and Assistant Director of Nursing) in your assessment of the community/facility strengths and weaknesses. The management’s personalities, their compassion, their love and dedication to their job, and finally how willing they are to “buck” the corporation edicts at any given time on any given issue. Still another factor is how full the community/facility is and how big their profits are (yes, even in “non-profit” communities) at any given time.

But of all the other factors, the biggest factor is clearly if they have enough trained, knowledgeable, caring staff (meaning aides, caregivers or whatever they are called in that community/facility).

Now I live in Dallas TX, a BIG city and we have a shortage of aides available to help care for disabled or demented older adults. Here the demand is too high for the pool of people available to satisfy the need. And I am talking for any caregivers, be they good, bad or otherwise. The demand for “good” aides is even higher, as you can well imagine. I don’t even want to think about smaller cities and “rural” America, where there is way less people in the pool.

Here’s who is competing for the same pool of people: hospitals and rehabs, nursing homes, assisted livings and memory care communities, home health companies, home care and personal assistant companies and private employers (think families). Not to mention non-health care related companies like fast food and other restaurants, retail stores, etc. And, except for private employers, the non-health care related companies pay more per hour and sometimes offer health insurance benefits. Now which would you rather do, clean up a spill in aisle 3 or clean up a mess in somebody’s incontinence wear?

Any wonder why there’s a shortage now and a crisis looming in the near future as the baby boomers “mature” into consumers of care?

So how can assisted livings, memory care communities and nursing homes cope with a lack of staff to service their needs?
One way is to make the consumers/residents less “needy”, in this instance, users of less time to need the aide’s attention, so that the aide can help more people per shift. How can you accomplish that? Restrain the residents that are “acting out” and causing a ”ruckus”, which usually demands more than one aide to quieten/calm them down. In the old days, they were physically tied down to their bed or wheelchair. Well, that was outlawed so the industry had to look for another way to solve the problem of “needy/disruptive” residents.

The answer? Chemical restraints to put the residents to sleep so that they are less of a problem. Conveniently, the use of antipsychotic drugs (drugs originally meant to calm people with a mental illness called Psychosis), worked just fine on people with dementia. This use was/is off label, meaning the drug wasn’t developed for them anyway. Never mind the side effects of some of these drugs can harm people with dementia and others, they worked. Well, eventually the Federal Government (FDA, CMS, Medicare) figured this out and have started penalizing communities/facilities for using these drugs in that way. The penalty is taking away money from their reimbursements for the care of the residents. That got the communities/facilities attention. Buy the way, this penalization has just started happening within the last year or two.

Now the communities/facilities backs are against the wall again. What to do? TA DA!!! Neudexta (a drug that is NOT technically classified as an Antipsychotic) is invented and comes on the market. Neudexta is really a combination of Quinine (tonic water) and Dextromethorphan (an ingredient in some cough medicines to help quiet coughing). It was approved by the FDA for a specific condition called Pseudobulbar Affect (PBA). Danny Glover of the Lethal Weapon movies advertises it. Maybe you’ve seen some of the ads. Apparently, it has the same effect as the now penalized antipsychotics on some dementia patients.
Anyways, the federal government hasn’t gotten wind of it yet, and hasn’t addressed it’s use off label yet, hence, no penalties for its use, and fair game for chemically restraining users of aides’ time and energy. Therefore, communities/facilities being able to get by with less staff.

See the connection?

OPINION:

To me, all this dodging the law is just putting Band-Aids on a cut that needs sutures. How about trying to really fix it by making the aides jobs more attractive so that people want to do the job rather than run away from it? Yes, doing that involves money. Lots of it. To raise salaries, to give health care and other benefits and to give significant training to aides.

And there’s the rub.

The general public doesn’t want to do that. Why? Because the prevailing view is that old people are not “worth” it. In academia it’s called “ageism”. Whatever it’s called, it’s basically saying old people (and disabled people including those with dementia) have no value because they are not contributing to the USA’s economy. So, until that attitude changes the real “fix” won’t happen. We’re going to just keep putting on Band-Aids and complaining about lousy care for our elderly family members.

What was it that Pogo (the cartoon character) said?
“We have met the enemy, and he is us”

Carepartners of people with Parkinson's disease, this is for you.http://tinyurl.com/ycnhppy8
10/25/2017

Carepartners of people with Parkinson's disease, this is for you.
http://tinyurl.com/ycnhppy8

Findings suggest that health care providers should routinely ask about driving status and make referrals for testing if necessary.

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13601 Preston Road, Ste E220
Dallas, TX
75240

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