By Paula Spencer Scott | January 27, 2021 | Health

“You don’t look like you have Alzheimer’s,” people tell Terry Montgomery. “Well, that’s like saying, ‘You don’t look like an alcoholic,’” she says. “I’m just not as cognitively sharp as I used to be.” Montgomery, 63, was diagnosed with young-onset (also called early-onset) Alzheimer’s five years ago.

“I don’t look any different or talk different. I’m not deaf, so you don’t have to shout. I understand English,” adds the retired businesswoman of Duluth, Ga., who’s now on the advisory board of Dementia Action Alliance. “I hate the stigma placed on us because people don’t know any better. Once I met others like me, it took away my fear and phobia.”

People diagnosed with Alzheimer’s or other forms of dementia often hear outdated or simply wrong beliefs about their conditions, says Mayo Clinic behavioral neurologist Dr. Jonathan Graff-Radford. He tackles such myths and more in the new “Mayo Clinic on Alzheimer’s Disease and Other Dementias” (written with Angela Lunde), a complete revision of a 2013 guide by Dr. Ronald C. Petersen. The update adds personal stories from people with dementia and their care partners as well new sections on brain health and living well with cognitive disorders. Among the misconceptions it’s time to toss:

Dementia is a problem for the old

Not exclusively, as Montgomery, who got diagnosed at 58, knows. Almost a quarter-million Americans are living with young-onset Alzheimer’s (developing symptoms before 65), which is why the Mayo book now includes a section on it. Another type, frontotemporal dementia, typically strikes between 40 and 65.”A lot of information focuses on those in their 70s. But people in their forties, fifties, and sixties may still work or have dependents living in the house, with different concerns,” Graff-Radford says.

If you have memory loss, you probably have dementia

It’s more apt to say, if you have memory loss, you’re human. Everybody forgets things; young adults blame sleep or stress and move on. Older adults are more apt to make the leap right to disease.”As folks age, it’s natural to have forgetful moments — losing your keys, trouble connecting a name with a face, coming up with a word on the spot,” Graff-Radford says. “There’s a cognitive spectrum, a wide continuous range with many shifting levels between just ‘normal’ or ‘abnormal.’”“Dementia teaches you to enjoy life.”

About 10% to 15% of cases of mild cognitive impairment (changes in thinking and memory beyond what would be expected by aging alone) transition to dementia every year. Dementia is daily memory loss that impacts the ability to function independently, like cook or balance the checkbook. Even this kind of memory loss can have reversible causes, including medications and sleep apnea.”You don’t go right from memory trouble to dementia,” Graff-Radford says.

Alzheimer’s and dementia are the same thing

“If I tell someone, ‘You have dementia,’ they say, ‘But not Alzheimer’s, right?’” Graff-Radford says. “Or if I say, ‘You have dementia due to Alzheimer’s disease,’ people look confused and ask, ‘What’s the difference?’”

Dementia, he explains, is the umbrella term for a syndrome of memory loss and other cognitive changes that interfere with everyday life. Alzheimer’s is the most common type of dementia. Other types of dementia include frontotemporal degeneration, Lewy body dementia, and vascular cognitive impairment.People with dementia can’t learn new things

Actually, people living with dementia can continue to learn new routines, skills, and habits, Graff-Radford says, thanks to procedural memory, a type of long-term automatic memory that tends to be preserved well into the course of the disease. Motor memory, a.k.a. “muscle memory,” can preserve ingrained abilities (ride a bike, tie a shoe) and through repetition, aid the ability to pick up new ones (painting, dancing, trying new exercises). Dementia doesn’t shut down every thinking skill involved in learning.

People with dementia lose the ability to enjoy themselves

“Nothing could be farther from the truth,” Graff-Radford says. Very few patients are diagnosed so late that there isn’t plenty of their same pre-diagnosis life ahead. “We always ask patients, ‘What are the things that bring you joy?’ It’s critical to try to enjoy usual activities, realizing you may need to make modifications,” says Graff-Radford. A gardener may need to use photos to help remember plantings or a bridge player could have someone else keep score while finding the same pleasure in the activity. ” I’d say dementia teaches you to enjoy life,” adds Montgomery. “All the filters, the things I was afraid of, are removed when you focus on the present moment.”.

To diagnose Alzheimer’s, get ‘the Alzheimer’s test’

There’s no single diagnostic test for Alzheimer’s — not yet. (No, those brief cognitive screens that ask you to draw a clock can’t tell you if you have dementia.)

At Mayo, as elsewhere, doctors evaluate possible dementia by considering symptoms, medical history and relatives’ perceptions. Mayo staffers also perform several kinds of neurological tests to check cognitive functions and typically use blood tests and brain imaging to rule out other causes.

“There have been a lot of breakthroughs recently in terms of tests to measure the toxic proteins that build up in the brain through PET scans and spinal fluid, or now plasma as well,” Graff-Radford says. Given that Alzheimer’s starts in the brain 15 or more years before symptoms appear, these biomarker tests may one day identify the disease much earlier.

Dementia makes people more violent

Aggression is far from universal. “Everyone’s journey is very different, with symptoms that depend on them as individuals, on the setting they’re in, and on the anatomy of the disease,” Graff-Radford says.

As “Mike,” a 52-year-old Mayo patient quoted in the book, says, “Please remember that dementia is a disease, not a personality trait.”

Nothing can be done about it — so why find out?

The sooner a diagnosis is made, the more opportunity for treatment, Graff-Radford says.

Current therapies, including medications, can’t reverse symptoms but may slow progression. Coexisting conditions that may make dementia worse, from vitamin deficiencies to sleep apnea, can be treated.

While cognitive changes are still mild, a person can also plan for how and where they’d like to live as symptoms progress. Many of Graff-Radford’s patients choose to emphasize relationships and cultivating a sense of life purpose, he adds.

Far from being an exercise in futility, finding out the cause for concerning symptoms is “empowering,” Graff-Radford says. “Having dementia is just one part of who I am. It does not define me,” says “Dale,” another Mayo patient. “I can enjoy today and what I have now.”

Paula Spencer Scott is the author of more than a dozen books, including Surviving Alzheimer’s: Practical Tips and Soul-Saving Wisdom for Caregivers, a series of interactive journals and health/family guides with doctors at Harvard, UCLA and Duke. Her latest is When Your Aging Parent Needs Help with Dr. Leslie Kernisan. A longtime journalist and former Woman’s Day columnist, she’s also an Alzheimer’s, caregiving, and brain-health educator.

Originally appeared on nextavenue.org

by Vanessa Perez

KALISPELL, Mont. — Millions of COVID-19 vaccines have made their way around the country to people in the 1A and 1B group. But it’s not the same story at for residents at Immanuel Living in Kalispell.

The facility says a timeline showed they would get their first shipment from CVS in late December, and the second one was scheduled for mid to late January.

But it’s almost mid-January, and officials say residents won’t get their first vaccination doses until Saturday.

Immanuel Lutheran says the delay has something to do with CVS’s mile radius cap.

“A gentleman from CVS told me there were 102 buildings that they had contracted with that were 75 miles in their furthest CVS, and so I think we fell through their planning cracks,” Immanuel Living chief operating officer Carla Wilton said.

We reached out to CVS and haven’t heard back yet.

The Flathead City-County health officer says since pharmacies are a federal partner. The department doesn’t have much information.

“They’re literally requisitioning the vaccine right from the feds,” Flathead City-County Health Department chief health officer Joe Russell said.

Wilton says long-term care residents at The Retreat at Buffalo Hill and Skilled Care Center will be vaccinated first.

A group of four CVS workers will go from room to room and vaccinate the residents. She says there will also be a common room for staff to get their vaccinations.

The assisted and independent living residents and staff will be vaccinated the following Saturday.

“It’s been frustrating getting the clinic scheduled, for sure. It felt like it took longer than it should have,” Wilton said.

Wilton says 179 Immanuel Lutheran residents have signed up to be vaccinated so far. They’ve had one resident say no.

Click here to watch the news feature and read the full article.

Some people get scared off by the term “estate planning” because they think it sounds like something only the wealthy need to do. Truth is, one of the greatest gifts you can make for your loved ones is leaving instructions for both your wishes after you die and for if you can’t make health or financial decisions while you’re alive.

As Krueger said: “It’s not always all about money. It’s about planning to make things easier for the transfer of your assets and to reflect what’s important to you should anything happen.”

Below are a few tips from “Friends Talk Money” co-hosts Krueger (co-host of “MoneyTrack” on public television and founder of Wealthramp.com, Terry Savage (nationally syndicated personal finance columnist and the author of “The Savage Truth on Money”) and me (editor of Next Avenue’s Money & Policy channel). You can hear the entire “Friends Talk Money” podcast episode below or wherever you get your podcasts.

First things first: the importance of having a will.

This document will let your loved ones know where you’d like many of your assets to go upon your death. It’s essential to have a will whether you’re married or single or whether you’re a parent, grandparent or childless.

Your life insurance policies, Individual Retirement Accounts and 401(k) accounts will automatically go to whomever you name as beneficiaries. (Side note: be sure you’ve named your beneficiaries and that your choices are up to date.)

Savage strongly urges hiring an estate lawyer to prepare a will and possibly a revocable living trust — more on the latter shortly. “Estate planning is a not a DIY project,” she said.

1-Bedroom, 1-Bathroom with Den Apartment

Former Villa’s model apartment becomes newest Life Plan Community option

The former Villas Model / Sales Center is currently being renovated and will be available this fall, becoming the newest apartment with a Life Plan Community option at Buffalo Hill Terrace. The Camas includes a Traditional Entrance contract option, like the Villas, which entitles you to future health care discounts on campus.

The Camas is a 800 sq ft-1 bedroom, 1 bath with den floor plan. It includes a bright, daylight living room and den, with a spacious kitchen. The bathroom includes granite countertops with double sinks and a frameless glass walk-in shower. WiFi, telephone and TV are included, along with a reserved carport. It is located within Buffalo Hill Terrace with easy access to the Fitness Center, Art Studio and elevators.

Renovations include:

• Large walk-in closet
• Remodeled bathroom with double sink with granite countertops
• Beautiful kitchen with granite countertops
• Double-door refrigerator
• Electric range
• Dishwasher
• Garbage Disposal
• Espresso Color Scheme
• Bright and spacious den
• Stacked Washer/Dryer

Discover independent living in Kalispell for seniors.
Ask a question and start a conversation. Call 406-752-9625 or complete the information request form.

August 24, 2020- Flathead Beacon, Immanuel Living Breaks Ground on New Facilities

August 17, 2020 Daily Interlake Article, Immanuel Lutheran Breaks Ground on The Cottages at Buffalo Hill

The Cottages at Buffalo Hill

Corner of Crestline Ave and Buffalo Hill Drive (185 Crestline Ave)

Press Release

For more information, contact:
Tracy Bridges, Director of Marketing & Community Relations
tbridges@ilcorp.org
406-752-9625

Subject: Immanuel Living Breaks Ground on The Cottages at Buffalo Hill Adding a New Housing Option for those 55+ 

KALISPELL – Immanuel Living held a ground breaking ceremony on Wednesday, August 12th at noon to celebrate an expansion to add the Cottages at Buffalo Hill, a new housing development for adults 55 and over. This single family home development adds a new option for those seeking an independent lifestyle without the hassles of home maintenance. Immanuel Living’s Life Plan Community guarantees future access to healthcare on campus and offers residents a continuum of housing services as they age. The Cottages at Buffalo Hill is the latest addition in a multiple-phase campus expansion and redevelopment project which kicked off in 2015.

This new phase of development adds two patio homes, a total of four residences with attached garages and covered front porches. The homes are all two bedroom, two bathroom floor plans ranging from 1,300 sf to 1,550 sf, the largest design includes a bonus sun-room.

Residents of The Cottages will have access to all of the amenities and services at Buffalo Hill Terrace including: multiple dining venues, The Wooden Nickel Bistro and Lounge, a fitness studio, exercise room, pool, hot tub, and an auditorium and chapel.

“As Baby Boomers retire they are looking for new, more modern options and as the area leader in senior living it is important to offer new solutions,” said Jason Cronk, CEO of Immanuel Living.

Cronk says the Cottages will feel like home with everything from fireplaces to granite countertops, and more, but will include enhanced services like a dining plan, transportation and shopping deliveries to make life just a little easier.

“Offering single family homes really completes Immanuel Living’s housing offerings and will attract those who are downsizing from the family home. This allows them to move to a fresh, new living space and puts a plan in place for their future needs. At the same time, they won’t have the worry of selling a home or downsizing at an inconvenient time,” said Cronk.

MMW Architects of Missoula, has created the design and construction plans for the expansion. Local firms JD Builders and Davidson Construction will be used to complete the site work and build.

The Cottages at Buffalo Hill will be located on the corner of Crestline Avenue and Buffalo Hill Drive in Kalispell offering neighborhood views of Buffalo Hill Golf Course. Construction of the project begins Thursday with the removal of a house original to the property.

I lose my glasses, forget actors’ names, repeat stories to my kids. None of these slips are red-flag symptoms of Alzheimer’s. Nevertheless, I’ve had a battery of cognitive assessments, from memory screens to genetic tests and brain scans.

Why? Because the science of brain health is advancing rapidly. Given my distressing family history of dementia, I prefer to err on the side of “knowledge is power,” rather than “ignorance is bliss.”

Earlier this year, to my surprise, the U.S. Preventive Services Task Force (USPSTF) chose not to recommend cognitive screening for asymptomatic older adults, saying the “evidence is insufficient to assess the balance of benefits and harms.” While evidence of harms of cognitive screening is limited, USPSTF says, some studies have shown “higher stress, greater depression and lower quality of life in persons aware of a diagnosis of cognitive impairment.”

Once I discovered the growing body of evidence that it’s possible to reduce some risks of Alzheimer’s or delay onset, I had to know: Where do I stand?

I worry the net effect of this recommendation might be for people to think dementia testing is pointless — when its upside, underscored both by my own experience and experts’ insights — is huge.

Lifechanging, even.

“Cognitive screening” typically refers to brief tests like Mini-Cog, MMSE, MIS, and MoCA — the kind where you draw a clock face, recall words or count backwards by sevens to evaluate thinking skills. They’re part of Medicare’s annual wellness visit. The Self-Administered Gerocognitive Exam (SAGE) is a similar self-administered screen. Increasingly, people without symptoms also get other, prevention-focused tests — again, to assess status rather than to diagnose — including more detailed neurocognitive evaluations, physicals, labs and brain imaging (CT, MRI, PET).

I’ve had them all. Sadly, comprehensive testing isn’t financially or logistically feasible for everyone today. (My expensive scans, for example, were for a study I’m enrolled in.) Here’s why testing should be made more accessible and available:

To Get Clarity About Your Dementia Risks

Really: I’m no hypochondriac or test fanatic. But it’s one thing to hear of general risks and another to know your individual status. Once I discovered the growing body of evidence that it’s possible to reduce some risks of Alzheimer’s or delay onset, much the way doctors now assess cardiac risk factors for heart disease and stroke, I had to know: Where do I stand?

My mental slips made me nervous as I underwent cognitive performance tests during a brain-health educational program I attended, again at the University of Texas-Dallas Center for Brain Health and at Weill Cornell Medicine’s Alzheimer’s Prevention Clinic, where I’m enrolled in two studies.

Thankfully, I aced them. Imaging showed no brain shrinkage or amyloid plaques, both dementia precursors. Yet, other testing revealed a number of modifiable risk factors setting me up for worsening future scores, including high homocysteine (an amino acid linked to dementia that’s remedied with B vitamins), a thyroid condition, sub-optimal cholesterol and a sad fat-to-muscle ratio.

To Motivate Behavior Improvements

There’s nothing like proof of weakness to motivate behavior change. For the first time in my life, I joined a gym and hired a trainer and began brain-beneficial high-intensity interval training. (Just walking — my old exercise — wasn’t enough, I learned.) I became even more vigilant about my Mediterranean diet, took prescribed supplements, learned “brain breaks” like mindfulness and more.

Two years on, my improved cognitive scores and lower cholesterol keep me going. As does finding myself in stronger shape at 60 than I was at 40. (True, I gained several pounds…but of muscle.)

I now run every choice I make through the lens of my brain health: Is this helping or harming?

For someone else, testing might raise urgency about lousy sleep, hypertension, poor glucose control or stress. Swiss researchers have suggested that having “motivational reserve” — motivation to improve one’s cognitive health — may even have a protective effect on the course of mild cognitive impairment.

To Establish a Cognitive Baseline

Would knowing my cognitive status also be a useful comparison to future changes? I asked this of some geriatricians. Absolutely, Dr. Howard Fillit, who’s also a neuroscientist and founding executive director of the Alzheimer’s Drug Discovery Foundation, told me.

“Data shows that fifty percent of people with Alzheimer’s aren’t diagnosed until the moderate stage,” he said. “People say, ‘There’s nothing you can do.’ That’s where I really go nuts.”

The sooner cognitive symptoms are noted, the sooner that any reversible explanations (like polypharmacy, low B12 or depression) can be considered. The sooner helpful medical care can begin, too; if not medication (the current crop is unimpressive), then joining clinical trials, putting memory supports in place or managing other conditions differently. For example, Fillit’s own father, a meticulous diabetic, repeatedly landed in the hospital before anyone realized he was misdosing insulin due to mild cognitive dysfunction.

To Help My Family

Some say they’ll worry about their cognitive status down the line. Not a great plan, said Dr. Leslie Kernisan, geriatrician and founder of Better Health While Aging, an educational site on health and caregiving. “There’s a gray area when people around you are worried before you are. You’re putting yourself and others at risk, but refusing to go to the doctor, mismanaging money, continuing to drive and ferociously resisting help.”

An average of two years of this turmoil ensue between family noticing symptoms and diagnosis, according to Fillit. By then, it’s usually too late to competently take part in detailed, dementia-specific advance planning.

“If you want to spare your family the norm, get evaluated,” Kernisan said.

To Ease Anxiety

Finally, many avoid cognitive testing due to a fear of finding out. I don’t get it. Research isn’t finding increased anxiety or depression from cognitive testing, as the USPSTF noted. Many people find relief in getting clarity, one way or the other. Anyway, most of us are the worried well: 97% of those 65-74 and 83% of those 75-84 don’t have Alzheimer’s.

Worth remembering: None of these tests can definitively say if you have, or will get, Alzheimer’s. Not even testing for the APOE-4 gene variant that carries a higher Alzheimer’s risk. Yes, I welcomed this controversial test, too. Though curious, I knew it doesn’t predict anything; it’s just another bit of useful data to inform choices and plans.

Like so many, I’ve experienced dementia’s dreadfulness up close, as it haunted five beloved relatives and upended our lives. Keeping a sharp proactive eye on this specter feels far less stressful than letting it sneak up on me unawares.

(Next Avenue invites opinion pieces that reflect a range of perspectives. Doing so helps our readers learn about views from a multitude of experts.)

By Paula Spencer Scott
Paula Spencer Scott is the author of Surviving Alzheimer’s: Practical Tips and Soul-Saving Wisdom for Caregivers and Like Mother, Like Daughter. A longtime journalist, she’s also an Alzheimer’s and caregiving educator.@PSpencerScott