The following article was originally published in the Fall 2005 Quarterly Newsletter produced by Premier Homecare Services. This post is part of the blog’s “Newsletter Series” .

Finding care doesn’t have
to be a stressful process

At home is where we feel most comfortable. Many of our memories with friends and family are in the home and time and time again we hear that home is where seniors wish to remain. If you or your loved one is not yet ready to move out into a retirement community or long-term care facility, home care assistance is a helpful and serious option to consider.

There are many decisions to be made when assisting your loved one in determining what care options are the best for everyone involved.

Communicating with home care agencies/providers can sometimes be a long and frustrating process, but it doesn’t have to be. Here are some suggestions to help make finding the right provider easier. Being prepared with the right questions and attitude can help smooth the transition to home care for yourself or a parent.

Tips on dealing with
a home care agency:

• Have a diary/notebook handy. Write down a list of questions to ask each home care agency so that you can do a comparison across the board. Ask yourself: What are the priorities for having home care? What are our preferences for care? What is a realistic price range? Are they available 24/7 for emergencies?
• Record the name of the person you were speaking with, note your impressions. Did they answer your questions appropriately? Were they helpful and friendly? Did they offer to send you additional information or resources on their services or did they direct you to their website?
• Ask your questions and prepare to invest time in getting your questions answered. Take notes.
• Be specific about your situation, your concerns and priorities for care. Typically the more details you can communicate, the easier it is for the home care provider to understand what would be the best way to assist you.
• Meeting for an interview or an assessment is beneficial; this gives you an opportunity to ask questions in more detail, and for the provider to clarify their services. A good home care company should also ensure they are personalizing the services to each situation, what we call a care plan. Will they be available 24/7 to fill emergency schedules if needed? You can invite other family members or power’s of attorney to be present. Involve your parent in the decision making if possible.
• Share a laugh, you are not alone! Many people are in similar situations, and having a positive outlook makes the transition easier for everyone.

Other Blog Articles in
the “Newsletter Series”:

Shaping Cultural Views towards Dying and Grief (Feb. 25, 2010)
Coming Home after Hospitalization: What to Expect (Dec. 3, 2010)

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By: Will Oud, B.Sc.

Will Oud is a Research Assistant in Behavioural Neurology for the Brain Health Clinics, Rotman Research Institute, Baycrest (Toronto, ON).

Forecasting Canada’s
Brain Health & Dementia Risk

A decade into the new millennium and it is well understood that Canada’s demographic landscape is changing – our most elderly population cohort is growing immensely. Advances in science, healthcare technology and medicine, along with better lifestyle choices, have resulted in individuals living longer lives and maintaining better physical health throughout their later years. Along with this will come the inevitable implications of an older population.

An impressive study recently commissioned by the Alzheimer’s Society of Canada – appropriately titled, “Rising Tide” – examines the impending tsunami-like impact of dementia on Canadian society. The study’s results are truly alarming. It estimates that about 500,000 Canadians are living with dementia today, already crowning it as the most significant cause of disability in those aged 65 and over. This number is expected to more than double in the next 30 years, increasing the number of those inflicted to 1,125,200 people by 2038. Such a dramatic increase represents not only a serious health concern but also a crippling economic burden for Canadian society. It is clear that we must begin addressing the issue now.

What Brain Health Means to You and I

Many of us will come to accept that living into our 70’s, 80’s, 90’s or beyond will eventually mean sacrificing some of our physical independence due to unpreventable physical frailty. We may need to employ services like homecare for the added assistance required in maintaining a certain level of personal independence. While for most this is an acceptable compromise in exchange for an extended lifespan, amongst our biggest unresolved fears and one most difficult to comprehend is the potential loss of our mental faculties.

Losing the ability to think for ourselves, to decide on the direction of our own lives as a result of the senility caused by a degraded brain, is not a comfortable concept even for the most stout of heart. For anyone who has witnessed the devastating effects of dementia on another – whether in a family member, friend, or as in my case with clients – the experience can become a very potent alarm, signalling the importance of educating ourselves of this health risk.

I welcome you to my Brain Health Series on the Premier Homecare Services Blog. I hope that with this first entry you will become convinced we should all begin paying more attention to this topic of brain health.

Shattering Traditional Modes
of Thinking about the Brain

In the not so distant past, the accepted concept of the adult nervous system was that it was a fixed static entity both in terms of function and structure. Remember hearing the expression, “You can’t teach an old dog new tricks”? Contrary to this ingrained maxim, many years of groundbreaking research – the work of many brilliant minds – has begun to offer a different way of thinking about the brain. We now view the brain as a very dynamic organ constantly changing both in function and in structure.

Evidence of Functional Change (Synaptic Plasticity)

Back in the middle of the 20^th century, neuropsychologist Donald Hebb posited a theory, which has been summarized as, “[brain] cells that fire together, wire together”. This means that if a neuron (the cells which make up our nervous system and act by stimulating each other in a pathway) continually causes a neighboring neuron to fire, a metabolic change will take place that can, over time, strengthen the connection between the two. Neuroscientists like Michael Merzenich have applied this theory and observed significant functional rewiring of the cortex of primate and human brains, experimentally demonstrating that this theorized functional change occurs.

Evidence of Structural Change (Neurogenesis)

We used to think that the growth of new neurons was not possible after our childhood years. If someone were to experience brain injury there wasn’t much that could be done with them other than to help them cope with what functions remained because we believed that brain cells could not regenerate and the damage was permanent. We now know that through a process called neurogenesis, the development of new neurons is very much a possibility. Psychologist Elizabeth Gould has conducted pioneering research in this area of neuroscience. She has shown that the generation of neurons in the adult brains of monkeys does indeed occur. These newly created neurons arise from neural stem cells and migrate not only to the hippocampus – a part of the brain important for memory – but to the associative areas of the cortex that are important for higher cognitive function.

Until recently and most likely because of the traditional model of the static brain, the most focus on brain health has been given to the stages of older age and what happens in advanced brain failure like Alzheimer’s disease. Armed with this fresh knowledge regarding a more dynamic brain, we may begin to adopt a more holistic approach to brain health and focus on the greater process of brain aging. By turning our attention to what we can do in the areas of prevention, early intervention, and rehabilitation, we may be able to strengthen Canada’s brain health and reduce the burden of dementia on future generations.

Strengthening Brain Health – Strategies
for Slowing the Progression of Disease

Many scientists are actively searching for effective methods of promoting positive changes in our brains. The hope is to find solutions for preventing or slowing the loss of brain tissue during aging and disease progression, or for minimizing the impact of such losses. Much of the research that has shown noteworthy promise is in healthy lifestyle choices like physical activity, nutrition, the exercise of mental activity, and choice of environment. According to the Alzheimer’s Society, promoting brain health through lifestyle choices may be the most effective way of reducing the risk of Alzheimer’s disease and for slowing down its progression.

Through this blog series – Brain Health by Will Oud – I will take a critical look at contemporary research involving lifestyle choices and their potential effects on healthy brain aging and the prevention of disease. I’ll begin to sift through what advice is supported by valid research and what claims the literature just doesn’t back up. Follow-up four weeks from now for the next addition to the series.

By: James Watson & Joanne Bunton

When you work within the homecare business you become accustomed to the story of families or individuals facing a crisis – a loved one becoming ill or injuring themselves by a fall – and suddenly they don’t know where to turn for help when they need it most. Everyday our offices across Canada receive calls from families facing this precise situation.

It is not always easy to plan ahead for something you cannot anticipate. Even when you can see the need, planning ahead can be very difficult. Consider the example of deciding on whether to plan for moving into a long-term care home versus a retirement home, or to forget that altogether and plan to remain independent in your own home. Each option one has a unique set of advantages, disadvantages and decisions that must be made. An individual’s situation will change over time and thus their needs and preferences too. One of the purposes of the Premier Homecare Services blog is to provide you with information that can help your family and you anticipate and plan for these unforeseen circumstances.

Planning Ahead for Your Funeral

With the woman I have chosen to interview in this article, it is inevitable that we will all require the services of her line of work at one point in time. A licensed Funeral Director, Joanne Bunton will commonly refer to herself as a “Community Outreach Co-ordinator”. She works with Ward Funeral Homes, advocating in her community that you should look to planning your funeral arrangements now, lest more headaches arise in the future. Below, I asked her to shed some light on the topic:

Q: Why Advance Planning?

A: When you plan your funeral in advance, you spare your family from having to make complex decisions at an especially demanding time. As well, you give yourself the ability to make those important choices at your leisure, giving them the time and consideration they deserve – and your family will not have to “second guess” what you might have wanted. There are several options available to help you personalize the funeral service. We can show you how contemporary funeral services allow you to create an event that is most appropriate for both you and your loved ones.

Q: What details are you certain to cover when you sit down with someone?

A: The extent to which people plan in advance and the amount of detail they ask us to keep on file varies from one person to the next. We provide a wide range of options including service details, a comprehensive selection of caskets, cremation urns, burial vaults, stationery and monuments and markers. We’ll discuss the kind of funeral you think would be most appropriate, discuss your options related to burial, cremation or entombment, and guide you through the choice of merchandise. Once those things are known, we are able to explain the costs involved. We’ll also record the “Vital Statistics” information such as your name, address, date of birth, place of birth, Social Insurance Number, occupation and your parent’s names and places of birth.

Q: Does the advance planning incorporate pre-financing for the funeral?

A: Advance Planning does not necessarily mean you have to pre-finance. If you do choose to prepay your arrangements, you can protect yourself against future price increases and spare your family the possibility of unexpected expenses. In fact, effective July 1^st of this year, the tax on a funeral and related cemetery services will increase from 5% to 13%. As we make people aware of this, we’ve noted a marked increase in the number choosing to pre-finance their arrangements in order to avoid the additional 8% tax. The principal and all interest remain on deposit until the time of need to cover the increase in cost due to inflation. Any excess funds will be refunded to your estate and all money is guaranteed, safe and secure. Should you relocate, the pre-paid funds are transferrable to another funeral service provider. Pre-paying your funeral eases the financial burden that can surround unprepared families and friends at the time of loss.

Q: Beyond simply planning and financing the funeral service, what other related things should someone anticipate?

A: During the advance planning discussions, we are often asked about Powers of Attorney, Wills, Living Wills, Organ Donation, Memorial Donations, Estate Settlement, Canada Pension Plan Benefits and other matters unique to each individual situation. You should definitely anticipate leaving with a more secure and settled state of mind knowing that you have done a good thing not only for yourself, but for those you love and care for.

Ward Funeral Homes – http://www.wardfuneralhome.com/

Related Blog Articles about Planning Ahead:

• My Parents Need Help, Where do I Begin? (Feb. 12, 2009)
• Where do I Begin? – Homecare (Feb. 26, 2009)
• Homecare: Questions You Might Ask (Feb. 26, 2009)
• Where do I Begin? – Retirement Homes (Mar. 12, 2009)
• Where do I Begin? – Moving Solutions (Mar. 26, 2009)

Other Informative Blog Articles:

• Veterans Independence Program (May 7, 2009)
• Q&A with Dr. Michael Gordon (July 2, 2009)
• Anticipating the Flu Season & H1N1 (Sept. 1, 2009)
• Coming Home after Hospitalization: What to Expect (Dec. 3, 2009)
• A Palliative Care Story, by Jane Teasdale (Jan. 28, 2010)
• Regulatory Changes to the Live-in Caregiver Program (Mar. 25, 2010)

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