Peace of Mind Placements

10/01/2024

We Have Not Forgotten October 1st

Seven years ago today, our community was forever changed. We remember the lives lost and honor the resilience of the brave first responders and survivors. Let's never forget the impact of this tragedy and the sacrifices made by all.

10/01/2024

International Day of Older Persons 2024

The goal of International Day of Older Persons – observed on October 1st – is to celebrate the contributions of seniors and highlight the issues affecting them. It is estimated that the worldwide senior population will reach 1.5 billion by 2050, more than double what it is today. With this increase, it is more important than ever to ensure our seniors have access to the care and resources needed to thrive. Here are a few ways you can help:

Advocate for policies that protect the rights and well-being of seniors.

Volunteer your time to assist seniors through local non-profit organizations.

Raise awareness of the issues affecting older persons by sharing personal experiences.

Educate yourself on the challenges facing seniors.

Another way you can help, is to guide individuals in the state of Nevada looking for housing options and medical care, to Peace of Mind Placements. This company is licensed by the State of Nevada, Department of Public Behavioral Health, Bureau of Healthcare Quality Compliance. We are a voice for the “voiceless” in our communities that are looking for affordable housing and medical care for seniors.
THANK YOU!

Peace of Mind Placements
Rommel Timbal
702)308-5629 Mobile
702)550-2776 Office
702)434-3235 Fax
rommel@myseniorchoice.com

07/28/2024

Day 5 - What Do You Think About This?

Taken from a repost on LinkedIn, from my friend Dr. Delon Canterbury, PharmD, BCGP

Dear Colleagues,
​
What do you do if your patient reports symptoms of a benzodiazepine-induced neurological dysfunction?

This video from Alliance medical director, Alexis Ritvo MD MPH, explores the effects of discontinuing benzodiazepine usage and offers strategies to support patients after this process. It starts with findings from a survey on the effects of benzodiazepine use, highlighting the impact and repercussions of withdrawal, as well as the evidence connecting benzodiazepines to an elevated risk of su***de.

Finally, the presentation examines alternative approaches to supporting patients with benzodiazepine-induced neurological dysfunction (BIND), including alternative medications, lifestyle adjustments, and coping strategies.

https://lnkd.in/gvSGkrVh

07/27/2024

Day 4 - What Do You Think About This?

Your Aging Parents Want To Stay In Their Home, But Here Are Seven Reasons Why It Could Be Tough

By Carol Roth - Fox News

90% of seniors want to age in their own home. That requires serious planning.

Published January 28, 2024 10:00am EST

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Michigan senior living hosts Dolly Parton-themed party to celebrate singer's birthday

The Waltonwood Senior Living home hosted a Dolly Parton birthday celebration in Michigan for the residents.

More than 12,000 people are turning 65 each day in the US. And with that, individuals and families are starting to make considerations on what might be entailed to better manage the aging process.

There is a strong desire from seniors to age in place, meaning staying in their home instead of moving to a dedicated facility. Marc Glickman, CEO of long-term care planning experts BuddyIns, estimated that today, around 75% of seniors are using home care servicesto age in place instead of moving to an assisted living or nursing homes.
An AARP survey showed 90% of individuals 65 and over would prefer to age in place.

However, when it comes to aging in place, there is much to consider that is often overlooked.

1. Home modifications
On the home front, there are many modifications to the home to be made, big and small, to make aging in the home safer. From remodeling or relocation, such as moving an upstairs bedroom downstairs, to small shifts like managing loose electrical cords that could cause tripping, there is an "age-proofing" process that must be done in order to ensure home safety. Review checklists like this one from AARP to consider what’s involved.

2. Personal care issues
Personal care is an underappreciated issue when it comes to aging. Whether it be bathing, dressing or grooming, day-to-day tasks often become more difficult with age. Think through who is going to be there to assist with these tasks. Also, consider a wardrobe that might be more appropriate for mobility issues or if you need to change adult diapers.

3. Who is in charge?
In addition to personal care, managing everything from food, shelter, financial services, medical needs, transportation and more can become more challenging as we age. If family members are going to be caregivers, be sure to have a meeting and be clear of who is in charge of what tasks and what the "Plan B" is if that person becomes unavailable for some period of time. If specialist contractors are going to be hired with home health or other caregiving services, you need to do your research, as this is an area that can cause additional issues. Be sure to obtain references for any care providers and also consider the impact of having strangers in the house on the person aging. There are additional concerns with hiring helpers. Senior Providers Network elder care expert Scot Cheben, who has also been a primary caregiver himself, warned that hiring the "wrong kind of caregiver could cost you your house." Cheben shared that not all home care companies do background checks and that some companies don’t provide workers’ compensation insurance to their contractors.
He said this varies due to state regulations, but hiring a caregiver that doesn’t have workers’ compensation who then hurts themselves inside the home could sue the homeowner or even sue the hiring person for not following labor laws, so be very aware of what is at risk. Cheben notes that workers’ compensation is state-regulated coverage, and different states have different regulations.

4. Sharing wishes and accessing information

As you make any plans to age in place, be sure to go over what’s important to the aging individual and a full plan of who is doing what. Alongside, there must be emergency plan and end-of-life planning. Using a legacy and wishes planning roadmap like my own Future File system can help a family broach the subject and move through critical but challenging conversations. Having a file ensures there is a common place where everyone who needs it can access to critical information and wishes, whether that be medicines taken, contacts of important service providers and key financial policies, as well as any needed medical or property-related directives.

5. Leveraging technology
Technology is playing a bigger role in our lives, and that is certainly the case with aging. Look into technology that can help with everything from medication management to monitored personal alarms. Tech-powered devices today can help monitor your health and also manage different facets of the home, whether that be a device that automatically shuts off the stove after a certain amount of time. The family care partner can access devices that can be activated remotely or by voice to manage everything from the temperature to the lights. On the personal robot front, Marc Glickman shared that "we are seeing advancements in technology to allow seniors to age in place with ‘companion robots’. Elliq from Intuition Robotics is advanced technology that uses the latest AI to create a custom companion for seniors."

6. Socialization
Isolation is an overlooked issue with aging. You need to make sure that while aging in place, there are enough plans for socialization, whether inside or outside of the home. The National Council on Aging wrote that "the health risks of prolonged isolation are equivalent to smoking 15 ci******es a day."
Personal care is an underappreciated issue when it comes to aging. Whether it be bathing, dressing or grooming, day-to-day tasks often become more difficult with age. Think through who is going to be there to assist with these tasks. Also, consider a wardrobe that might be more appropriate for mobility issues or if you need to change adult diapers. With both socialization and access to other products and services, people aging in place who live in more populated areas may have different considerations than those in less populated areas.

7. Costs
Unfortunately, when it comes to aging, none of this is cheap. Marc Glickman shared on the home care services front that "the cost of these services is increasing due to shortage of quality home care aides. This is why it is critical to budget for these services by considering long-term care insurance or setting aside dedicated assets or income for these needs." There is a lot to consider regarding aging in place, but given how many seniors would prefer this route to aging in a dedicated facility, it’s good to start the planning process early.

07/26/2024

Day 3 - What Do You Think About This?

Andrew Lokenauth

In toxic work cultures, burnout is normalized.

10 years from now, the only people who will remember you worked late is your family.

Burnout is dangerous because it steals the energy you need for tomorrow, to get through today.

You're draining your future self to power your current self.

Burnout sacrifices your well-being for short-term gains.

It happens when you work too hard for too long without taking care of yourself.

Burnout happens when you're physically and emotionally exhausted. You might feel:

1. Sad for no reason
2. Tired all the time
3. Frustrated easily
4. Not excited
5. Anxious

10 Rules for Avoiding Burnout and Protecting Your Focus:

1) Learn to Say "No":

Don't overextend yourself – know your limits and politely decline additional tasks.

Set clear limits on your work hours and stick to them.

Don't let work take over your life.

2) Use Your Time Off

Use your vacation days and sick days when you need them.

They're there for a reason!

Taking time off can help you return to work feeling refreshed and ready to go.

3) Practice Time Management:

Effective time management is key to preventing burnout.

Prioritize your tasks based on their urgency and importance, and use tools like calendars and to-do lists to stay organized.

Avoid multitasking, as it can lead to decreased productivity and increased stress levels.

4) Practice Relaxation Techniques

Relaxation techniques like deep breathing, meditation, and yoga can help reduce stress.

Find a technique that works for you and make it a regular part of your routine.

5) Embrace a Growth Mindset:

A growth mindset will help you view challenges as opportunities for growth, rather than sources of stress.

6) Take Regular Breaks:

A short walk, quick stretch, power nap, or meditation can make a big difference.

Your brain needs these little rest periods to stay sharp.

7) Get Quality Sleep:

Aim for 7-9 hours of restful sleep each night.

Recharge your mind, body and soul.

😎 Eat Healthier:

What you eat affects how you feel.

Fuel your body with nutritious and healthy foods.

9) Stay Active:

Regular exercise boosts energy levels and improves mood.

10) Relax and Unwind:

Make time for hobbies, meditation, or other stress-relieving activities.

♻️ Too many people suffer with burnout, help them by sharing this!


07/25/2024

Day 2 - What Do You Think About This?

Better L.A.T.E. Then Never? A New Category of Dementia Has Been Determined

By Dr Mark Rothman, MD

A new type of dementia is in town. It is called L.A.T.E. It has many similarities with Alzheimer’s Disease. In fact, it overlaps with Alzheimer’s in many cases. Last month an international consortium of dementia researchers published a summary of what we know about L.A.T.E. They also agreed on the name, they proposed standard protocols to use going forward so that research and drug development could happen faster, and they alerted the public and medical community that this new category of dementia is real and needs our attention.

L.A.T.E. is an acronym that stands for:
• Limbic-predominant
• Age-related
• TDP-43
• Encephalopathy

While the name is a tongue-twister, it does point to several of the ways in which L.A.T.E. is either similar or distinct from Alzheimer’s Disease.

Both diseases affect the hippocampus, but in L.A.T.E., the damage is a bit more spread out within the limbic system. This part of the brain controls memory, personality, and behavior. This makes this disease limbic-predominant.

Although both Alzheimer’s and L.A.T.E. are age-related, their age at onset is distinct. The earliest signs of Alzheimer’s tend to appear in the early to mid 70’s. Early symptoms of L.A.T.E. appear in the mid 80’s instead; nearly a decade later.

The hallmark plaques of Alzheimer’s Disease are mainly composed of amyloid-beta. There are plaque-like deposits in the brain tissue of L.A.T.E. patients as well, but the main protein is called TDP-43. I find the distinction encouraging because so far, all the clinical trials that targeted amyloid-beta have failed. We desperately need new targets for drug-development and now we have one. It is also possible that one of the reasons those clinical trials failed is because there were L.A.T.E. patients mixed into the study population. Scientists are trying to figure out how important that may or may not have been.

And lastly, both are slow, progressive diseases that affect memory and one’s ability to care for oneself. In that sense, they are both encephalopathies.

Most of what is known about L.A.T.E. comes from studies of people who died and donated their bodies to science. The findings that pathologists discovered under the microscope were then correlated back with the patient’s symptoms and the natural history of their dementia before they died. From this work it seems that Alzheimer’s and L.A.T.E. can overlap. When one happens without the other, both of the diseases appear to progress slowly, but when they occur together, the symptoms are more severe and the dementia progresses faster.

I can think of many patients who had what looked like Alzheimer’s but their diseases progressed at very different rates. Some developed symptoms and then passed away within 5-7 years. Others were (or are) still alive over 10-15 years later. Is it possible that some had the 2 dementia’s combined while others only had one or the other?

Unfortunately, there’s no way to separate these two dementias’ apart in the clinic. No lab or screening tests exist to do that just yet.

Clearly, we are still in the early innings when it comes to L.A.T.E. The work done by the L.A.T.E. consortium is a significant step forward and will jumpstart several new avenues of research. Given the vast impact that dementia is having across our society, that is welcome news to this geriatrician’s ears.


07/25/2024

Day 1 - What Do You Think About This?

From my friend, Kimberly Preto-Diaz

“I once asked a very successful woman to share her secret with me. She smiled and said to me…

“I started succeeding when I started leaving small fights for small fighters.

I stopped fighting those who gossiped about me…

I stopped fighting with my in laws…

I stopped fighting for attention…

I stopped fighting to meet peoples expectation of me…

I stopped fighting for my rights with inconsiderate people..

I stopped fighting to please everyone…

I stopped fighting to prove they were wrong about me….

I left such fights for those who have nothing else to fight…

And I started fighting for my vision, my dreams, my ideas and my destiny.

The day I gave up on small fights is the day I started becoming successful & so much more content.”

Some fights are not worth your time….. Choose what you fight for wisely.

07/13/2024

Day 47 - Helpful Hint for Our Seniors

Taken from my colleague, Kimberly Preto- Diaz

Have you considered this situation with your “loved one” suffering from dementia?

The issue of fi****ms in the home came up at a recent consultation, so I wanted to share this from the Alzheimer's Association in case anyone else is dealing with a similar situation.

Firearm safety: Fi****ms and other weapons can be found in households across the country. In most situations, their presence creates no problems for responsible gun owners and others in the household.

However, if someone in the home is living with dementia, fi****ms can pose a significant risk for everyone. For example, as the disease progresses, the person may not recognize someone they have known for years and view them as an intruder. With a gun accessible, the result could be disastrous. Even if the person has past experience with guns, their current abilities will be altered because the safe use of fi****ms requires complex cognitive abilities and quick decision-making skills, which may be compromised due to dementia.

Consider the following to help reduce risk:

Locking or disabling a gun may not be enough. People living with dementia sometimes misperceive danger and may do whatever seems necessary to protect themselves, even if no threat exists. These actions can include breaking into gun cabinets, finding ammunition and loading guns. Preventing a gun from firing may not prevent the person living with dementia or others from being harmed.

Consider removing guns from the home to fully protect the family from an accident. Family members sometimes attempt to hide their fi****ms or ammunition to prevent the person living with dementia from accessing them. They may lock the guns in an attic or in the trunk of a car, or keep ammunition outside of the home. These solutions are good first steps, but they do not ensure that the person will not find the gun or appear to be holding a loaded weapon, thereby causing those around the person to react. It is critical that there be an open discussion among family members about all weapons in the home, including antiques, collections, war souvenirs, hunting equipment and decorative pieces.

Just as legal, financial, care and driving plans are best made early in the disease process, it is important to consider current and future gun safety. Put a plan in place for what to do with fi****ms or other weapons immediately, when the person is no longer capable of handling them safely. If there is a history of using fi****ms or other weapons for work or recreation, these conversations can be difficult, as they may threaten key aspects of the person’s identity.

The person may be very attached to their weapons, refusing to part with these weapons. But alternate plans will need to be made for the storage, inheritance or disposal of weapons in order to ensure everyone’s safety.

The following may help as you prepare to discuss fi****ms: Begin with a discussion of who might inherit various pieces. It may be good to talk about providing the inherited pieces to the recipient soon, so that person can provide for upkeep, use the weapon, etc. This can be a way to move to a discussion of safety at home when the responsibility for keeping fi****ms in good working order becomes too difficult or is no longer possible. Consider selling some valuable items that are no longer used to help pay for care. A collection of fi****ms could be considered as part of this discussion. Discuss donating an antique collection so that others can learn about and appreciate them. Include a trusted authority figure that is knowledgeable about the critical safety issues.

Get agreement ahead of time from everyone involved that if that person says that the removal of the weapons from the home must be done as part of keeping family members safe, it will be done. Consider inviting trusted relatives, hunting buddies, etc., to take part in the conversation with the family. If there is no consent to remove the weapons, removal may need to be done against the person’s wishes and should be done while they are out of the house. Take care to also remove reminders of the weapons, including cases, ammunition, racks and holsters.

Address any anger or other emotions that may occur as a result of the change by acknowledging feelings. Redirecting to an activity that can be done together may help reduce feelings of anger or other emotions. If you need assistance removing the guns, your local law enforcement agency may be able to help.

Laws around selling or transferring fi****ms vary from state to state. It is important to familiarize yourself with applicable laws in your state.

07/12/2024

Day 46 - Helpful Hint for Our Seniors

Hello everyone, my name is Rommel Timbal. I wanted to promote the concept of pharmacoequity through my friend, Delon Canterbury’s community deprescribing webinar happening on Thursday, July 18, 2024, from 3pm PT to 4:30PT.

Taken from Delon’s post on LinkedIn:

“I am thrilled to announce our first Deprescribing Community Awareness Event hosted in partnership with The AME Zion Heal, Duke Clinical and Translational Institute and GeriatRx! We are on a mission to drive conversations around medication safety, polypharmacy, and prescribing cascades with the help of our Amazing Pastors and Parishioners helping to champion the Deprescribing Mission in a primarily Black demographic here in Durham and surrounding areas! Let's Deprescribe 1 million meds!

I am eternally grateful for the church leaders that have greenlighted our efforts and have fostered engagement among members using our personal experiences and anecdotes to highlight how we all can combat the use of inappropriate medications in older adults. This is a passion project come to life and is the crux of why I created GeriatRx, so the fact that we can pilot this amazing intervention and test our methods is surreal!

Big Thanks to my Co-PI Dr. Julius Wilder, AME Zion Heal, Kenisha Bethea, Dr. Elvin Price from VCU who has graciously donated PGx testing kits for our parishioners. I am honored to share the stage with Elder Orlando Dowdy and Dr. Wilder for this interactive webinar next Thursday July 18th, at 6 PM EST. Thanks Dr. Emily Reeve for allowing us to use the rPATD questionnaire!! Special Shoutout and Thanks to the US Deprescribing Research Network (USDeN) for providing us with the grant to kickstart this project and help dive into what pharmacoequity may look like!”

07/11/2024

Day 45 - Helpful Hint for Our Seniors

Taken from the CMS Website

CMS is pleased to announce the launch of the Guiding an Improved Dementia Experience (GUIDE) Model – the first model of its kind to reach and provide support for people with and their . Through the Guiding an Improved Dementia Experience (GUIDE) Model, nearly 400 participating organizations building Dementia Care Programs are serving hundreds of thousands of people nationwide: https://lnkd.in/eUNJ-B-w.

Participating organizations represent a wide range of health care providers, including large academic medical centers, small group practices, community-based organizations, health systems, hospice agencies, telehealth organizations, and other practices.

For more information, visit the GUIDE Model webpage: go.cms.gov/GUIDE.

Secure .gov websites use HTTPSA lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

07/10/2024

Day 44 - Helpful Hint for Our Seniors

Parkinson’s Disease VS Lewy Body Dementia

Parkinson’s Disease (PD) and Lewy Body Dementia (LBD) are both neurodegenerative disorders that can have significant impacts on individuals and their families. Having studied and researched these conditions extensively, I find the comparison between Parkinson’s Disease and Lewy Body Dementia to present an opportunity to have a compelling discussion.

On one hand, Parkinson’s Disease primarily manifests with movement-related symptoms such as tremors, rigidity, and bradykinesia. These motor symptoms can significantly affect a person's mobility and ability to perform daily tasks, leading to a decline in quality of life. In contrast, Lewy Body Dementia presents with a broader range of cognitive and psychiatric symptoms. Individuals with LBD may experience visual hallucinations, fluctuations in cognition, and REM sleep behavior disorder. This can make care partnering particularly challenging.

The pathology of these conditions differs. Lewy Body Dementia is characterized by the presence of abnormal protein deposits called Lewy bodies in the brain. These protein aggregates are also found in Parkinson’s Disease, but to a lesser extent. Understanding these neuropathological differences is crucial for accurate diagnosis and appropriate management of both conditions.

I am reminded of the importance of interdisciplinary collaboration in addressing the multifaceted needs of individuals experiencing neurodegenerative disorders. Healthcare professionals, care partners, and researchers must work together to provide comprehensive care, support, and resources. This will improve the quality of life for those affected by these conditions.

Exploring the similarities and differences between Parkinson’s Disease and Lewy Body Dementia has deepened my understanding of the complexities inherent in neurodegenerative disorders. This reflection underscores the need for ongoing research, education, and advocacy to enhance the care and support available to individuals and families impacted by these challenging conditions.

07/09/2024

Day 43 - Helpful Hint for Our Seniors

Many thanks to Assisting Hands of Potomac on sharing this article in LinkedIn.

A Guide to Parkinson’s Disease Treatment

Parkinson’s disease may develop in older adults at various points in their lives. The way the disorder affects seniors is as different as the individuals themselves. However, Parkinson’s symptoms do progress, which necessitates the assistance of a caregiver at some point. Having a guide for reference provides a little enlightenment as to what lies ahead.

INFORMATION

When planning to care for a senior loved one diagnosed with Parkinson’s, allow yourself the opportunity to learn about the wealth of information available. Learn the underlying cause of the disorder and the medical interventions used to offer relief from its symptoms. Familiarize yourself with the physical, emotional, and cognitive symptoms that appear as the disease progresses, and learn about the techniques needed to address each one. The main objective is to ensure your loved one enjoys an optimal quality of life.

Many seniors in the early stages of Parkinson’s are able to live on their own, but they may need a bit of help with the everyday tasks of life, such as exercising and preparing nutritious meals. Aging adults who require assistance with the tasks of daily living can benefit from reliable home care service. Families trust that home care or PCA agencies to provide the high-quality care their elderly loved ones need and deserve. Our caregivers are trained to help seniors prevent serious illnesses and encourage them to make healthier decisions as they age.

CARE TEAM

Before the symptoms progress dramatically, sit down with the rest of the family and discuss how each member might contribute to your loved one’s care. Some may volunteer to run errands, while other family members might be willing to attend healthcare appointments. One or two family members may have the ability to step in and provide daily assistance, should the primary caregiver become ill, have an emergency, or simply need to take a break. Having a team encourages ongoing communication among family members.

DIET

Seniors with Parkinson’s must maintain a healthy diet that provides the right nutrients while preventing unhealthy weight gain. Meals should consist of an abundance of fruits and vegetables. In addition to providing vitamins and minerals, produce contains a wealth of antioxidants that protect cells from free radical damage.

Protein is necessary to provide the fuel needed for cell, connective tissue, and muscle regeneration. However, too much protein interferes with the ability of dopamine supplements to alleviate symptoms. Thus, seniors may need to limit their protein intake to a specific time of day.

As Parkinson’s progresses, seniors often demonstrate swallowing difficulty. The texture and consistency of foods must then be altered to make eating easier.

Living with serious health conditions can make it challenging for seniors to age in place. However, they can maintain a higher quality of life with the help of professional live-in care. Seniors can benefit from assistance with meal prep, bathing, transportation to the doctor’s office, medication reminders, and much more.

EXERCISE

Seniors with Parkinson’s need to exercise regularly. The regimen must include exercises that enhance flexibility while increasing strength and balance. Cycling, swimming, and walking are some of the activities recommended for boosting strength and endurance. Tai chi is an ideal activity that enables seniors with Parkinson’s to maintain balance. You can also use the Pilipino martial arts of Arnis, to help individuals deal with the dyskinesia associated with Parkinson’s Disease.

PROFESSIONAL CONSULTATIONS

Occupational and physical therapists often customize workout schedules for older adults with Parkinson’s to address the symptoms while increasing function and mobility. However, it is not unusual for the disease process to cause fatigue and overheating during physical activity. Recognize the symptoms and encourage your loved one to take breaks as needed.

In time, seniors with Parkinson’s experience rigidity, stiffness, slowed movements, and balance and walking difficulties. Therapists can help caregivers better understand the symptoms and how to help their loved ones handle them.

Caring for a loved one with Parkinson’s can be extremely challenging, and a compassionate professional caregiver can be a wonderful source of support. If your senior loved one has been diagnosed with a serious condition and needs help with tasks like meal prep, transportation, medication reminders, bathing, and grooming, reach out to a local homecare agency that families can trust. Also ask this local homecare agency if they offer comprehensive care for seniors with dementia, Alzheimer’s, and Parkinson’s.