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At the final stage, Alzheimer’s disease begins to affect a person’s physical as well as their mental capacity. At this point, the person will require intensive, round-the-clock caregiving: assistance with dressing, eating, using the bathroom, and other ordinary tasks. The goal at this point is to make sure your loved one is comfortable and that they maintain as much dignity as possible. At this stage, communication becomes difficult, and the person loses the ability to have a conversation. They might need assistance in order to walk, and their muscles might become rigid or possess abnormal reflexes. As the disease progresses they will likely also become unable to control their bladder or to swallow. At this stage, it is important to watch for infections; there is an especially high chance of pneumonia. Due to the extent of your loved one’s needs now, this is the time when you’re most likely to need to move the person to a facility where they can receive the proper care. This is a decision that will require lots of research and education to make sure you’re making the right choice. On this website, we have many different resources to help you find the right Alzheimer’s care solution. Though they have trouble speaking, your loved one is still “there.” They feel emotions such as calmness, fear, and love. They can also still use their senses to perceive you and the world around them – this is their primary way of interacting. Your main focus will be on providing for their physical well-being, but try to find ways to connect with them. You might read to them, look at old photographs, play music they might like, give them some potpourri to smell, or make them a meal they would enjoy. Think about the basic life pleasures that many of us take for granted – these are the kind of things your loved one can take pleasure in at this point. This stage of the disease is one that is difficult for caregivers, both on an emotional level and on a physical level too. As the end of your loved one’s life approaches, you might be feeling sad, relieved, or numb to any feeling at all. These reactions are all normal. Receiving guidance from a bereavement specialist, therapist, clergy member, or other support can help you address these feelings in a healthy way. It is important to confront your grief.
For seniors in delicate health, forgetting to take medication or taking it improperly can have more dire consequences than one might think. The federal government estimates that 10% of hospital admissions are due to taking medication incorrectly, and over 125,000 people die each year as a result of this problem. Almost a quarter of nursing home admissions might be due to seniors having trouble with taking their medication. Unfortunately, this is an alarmingly common problem, with over half of all seniors taking medication incorrectly. Half of those, in turn, make the kind of mistakes that could have serious ramifications! When we consider this information in light of the challenges of seniors with dementia, it’s clear that this is a problem caregivers and family members need to be alert about. There are many devices and solutions available to help keep loved ones on track. One simple remedy is buying a pill dispenser or a similar device. Your local drug store probably carries basic versions that will both organize pills and sound some kind of alarm or another reminder. There are also more elaborate and expensive systems that might, for example, call a designated caregiver if the senior has missed a dose. There are even smartphone apps for this issue. Drug companies themselves are also trying to help, with phone calls to seniors who are taking their products. However, studies have shown that these methods don’t solve the problem. Sometimes this is because the devices are too complicated for seniors to use, or because they are not equipped to handle the typical senior’s complex medication regimen. And these systems often require input from a senior who may no longer be organized or independent enough to do what’s needed. Even if a loved one sets up the system initially, snafus like dead batteries or a malfunction could cause that effort to be useless. For this reason, the best solution is to have a family member or other caregiver help the seniors with managing their prescriptions. A human helper can also address when forgetfulness is not the issue so much as unwillingness or lack of understanding about why a particular medication is important. This can be a particular concern for dementia sufferers who are determined to hang on to control and demonstrate their independence. Ideally, there would be some kind of gadget or gizmo to make this problem go away, but this is one issue that requires a human touch.
Many caregivers are proud of the fact that they’re helping their loved one and doing what they can to keep that person home with the family. But no one claims that caring for a loved one with Alzheimer’s disease is easy. Taking on this heroic task is without a doubt exhausting: mentally, physically, emotionally, and financially. Most caregivers report feeling high levels of emotional stress, and many are just simply worn out physically. For this reason, all caregivers should consider the option of respite care. Respite care is offered at assisted living and similar facilities. A loved one can check into the facility temporarily and there get the expert care they need, allowing caregivers some time to recharge. This can be for as long as a week or two, or as short as an afternoon, giving you the chance to get some important errands done. Rather than frantically doing a search for a respite care facility when you’re at the end of your rope and in a panic, it’s best to start your research before you think you need it, while caregiving still seems manageable. Talk to senior homes and adult daycare programs in your area to learn about the different options available. Respite care might be a good change not just for you, but for your loved one as well. They may enjoy the chance to interact with the other seniors that they meet in their temporary home. Many facilities will hold entertaining events, or run fun activities that are specially designed for their particular ability level. Some Alzheimer’s patients may have some trouble with being in a new environment. However, they do have the capability to get used to being in a new place if you make taking a break a regular routine. How do you know when making use of respite care might be a good idea? Pay attention to your emotions and your body to recognize burnout. These include having trouble sleeping, exhaustion, anxiety, depression, social withdrawal, and anger. Your body will often warn you when you’re getting in over your head, so be mindful of any health problems that crop up. Respite care is not a cop-out, and you are not abandoning your loved one. Rather, you are taking a break to prevent your own burnout. By taking advantage of the respite care option, you are strengthening your ability to provide the best possible care for your loved one. Consider that if you ignore your stress, you may create bigger problems down the line that will result in you giving up caregiving permanently. You can always run much further if you start and stop, rather than push through past the point of exhaustion. Contact us for more information about the respite care options at Raya’s Paradise.
A recent Forbes article confirmed what many of us already know, “people often have trouble making plans with their loved ones as they age, which can leave families unprepared to deal with unexpected circumstances.” Over and over, Raya’s Paradise works with families whose aging parents experience a sudden accident or illness. They then scramble to identify the best option; often failing to thoroughly think through due to time constraints and fears.  “Families must start now to have peace of mind later” the article continues.
Chief Operating Officer and Social Worker of Raya’s Paradise, Monica Westphaln, recommends that the first step is finding a good time to talk to an aging parent. Westphaln advises, “make sure you listen to what they want rather than bringing them a plan.” By taking the time to listen to the needs of an aging parent, Westphaln adds, “you can take preferences into account to help create an individual plan for care.” Involving a loved one in the process ensures that “independence and dignity are simultaneously preserved.” Including a loved one in the conversation assures a loved one they are “important to the family” and enables you to “continue the conversations.” Starting early conversations further reduces stress on families. Westphaln notes, in an event of crisis, families can feel confident that the actions taken are “aligned with the wants and needs of your parent.”
Raya’s Paradise trained team members and clinical professionals are available to provide continuing education to families as needs progress. Those who have joined the Raya’s Paradise family have recognized Raya’s for creating an accessible network of professionals who assist with guidance and direction throughout the aging process.
Published by Staff On January 10, 2019 Author: By Eric Heinz Raya’s Paradise With assistance for hospice, dementia, Alzheimer’s disease and independent living care, Raya’s Paradise plans to open its doors by 2020 after years of going through planning processes. Moti Gamburd, the CEO of Raya’s Paradise, said he acquired the land about five years ago but that it’s been a long process to get the project started. They had to go through San Clemente’s planning process as well as the California Coastal Commission for permitting. Raya’s was required by the commission to remove trees to make an ocean-view corridor for residents, as well as other mandates. He got the final approvals from the Coastal Commission last year. Raya’s Paradise will be located on the 100 block of Avenida Calafia, next to the San Clemente Inn. There will be 24-hour care and an assisted-living unit, providing independent living as well as end-of-life care. Gamburd said he was inspired by his mother, who immigrated to the U.S. from Russia and Israel, to enter the assisted-living industry. “In 1991, my mom, who is a nurse, came to the United States and took care of an old lady,” Gamburd said. “Because she has experience in the geriatric work, she said if I can take care of one lady, why can’t I take care of six ladies?” In California, one home can hold up to six people at one time who are not dependents of the title holder. “At that time, while I was in school, my father got very ill, and I kind of started to help her, and I started to fall in love with this field,” Gamburd said, adding that Raya’s has added six retirement-living facilities in California. Monica Westphaln, the COO of Raya’s, was working for a competitor in 2011 when Gamburd decided to try to join forces with her. “She kind of opened my eyes and showed me how much better it would be to build in a larger community,” Gamburd said. “Eventually, we landed on (San Clemente). We hired an architect from San Clemente.”

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Hospice is not a place. Hospice is a “concept of care” designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments.1 The goal of hospice care is to provide patients with comfort and dignity at the end of life with a special emphasis on controlling pain and discomfort and managing symptoms. The focus is on compassionate caring not curing. Hospice care neither hastens nor prolongs life, but this specialized service has been shown to increase quality of life. Hospice is covered by Medicare and Medicaid and most private insurance companies to eligible patients referred by a physician. Hospice services include care by professionals and volunteers and medication, equipment, and medical supplies. Families have no out-of-pocket expenses other than the cost of room and board. The patient and family are at the center of hospice care. The hospice team works with the patient and family to develop a personalized plan of care that respects the individual’s end-of-life wishes. A multi-disciplinary team of physicians, nurses, home health aides, social workers, therapists, spiritual counselors, bereavement counselors, and volunteers provides expert and compassionate care that is available 24 hours a day, 7 days a week. Physicians and nurses are specially trained to address pain and manage symptoms. The team works closely with family members to provide feeding, bathing, turning, administering medications, and monitoring changes in a patient’s condition. Some hospice providers provide alternative therapies such as Pet Therapy or Music Therapy. Spiritual counselors, therapists, and social workers help patients and families with emotional and spiritual concerns and provide bereavement support to family members after a loved one has died. Most people choose hospice care in their own homes, but hospice care is also available in hospitals, nursing homes, and residential care communities for the elderly such as assisted living communities and board and care homes. In 2011, 66.0% of hospice patients received care in the place they call “home,” including private residences (41.5%), skilled nursing facilities (17.2%), and residential communities (7.3%).2 When hospice care is not an option at home, nursing homes, freestanding hospice facilities, and residential care communities like board and care homes are places for families to turn for short-term respite or longer term care at the end of life. The Board and Care model, which provides residential care for fewer residents in a private home, offers a home-away-from-home in an intimate environment that provides a home-like routine and a place for family to gather. Board and Care homes can offer temporary hospice to residents and families who request it. These homes typically work with a number of hospice organizations to provide families with choice for high quality care. The board and care staff coordinate care with the hospice staff and they may provide bedside comfort tailored to the resident’s needs and preferences, such as soft music, reading, and aromatherapy. “Choosing a hospice to care for yourself or a loved one in the final months or even days of life is an important and stressful process,” said J. Donald Schumacher NHPCO president and CEO. “Each hospice offers unique services and partners with specific community providers – so it’s important to contact the hospices in your area and ask them questions to find the one with the services and support that are right for you.”3 For additional information on hospice and how to select a quality hospice provider, families may turn to online resources found at the National Hospice and Palliative Care Organization (www.nhpco.org) and the Hospice Foundation of America (www.hospicefoundation.org). References: 1Hospice Foundation of America. www.hospicefoundation.org. 2Facts and Figures: Hospice Care in America. 2013 Edition. National Hospice and Palliative Care Organization. www.nhpco.org. 3Choosing a Quality Hospice. National Hospice and Palliative Care Organization. www.nhpco.org.   Trina Duke, Master of Science in Gerontology Concierge Gerontology Services
Our mother absolutly loved her time at Raya’s Paradise. The facility, staff and management were absolutly excellent in their care of our beloved Margerat .feels at home away from home. Our caring staff provides personalized attention to each resident including bathing, dressing, medication supervision, diabetes control, and incontinence management. W West Hollywood, California — 04-10-2018 — Raya’s Paradise was certified as a great workplace today by the independent analysts at Great Place to Work®. Raya’s Paradise earned this credential based on extensive ratings provided by its employees in anonymous surveys. A summary of these ratings can be found here. “We are thrilled to see the results of our efforts to maintain a great company culture,” said CEO Mot Gamburd. “We want our employees to be passionate about their work, represent our core values, and most importantly, feel fulfilled in their work with us and our clients.” “We applaud Raya’s Paradise for seeking certification and releasing its employees’ feedback,” said Kim Peters, Executive Vice President of Great Place to Work’s Certification Program. “These ratings measure its capacity to earn its own employees’ trust and create a great workplace – critical metrics that anyone considering working for or doing business with Raya’s Paradise should take into account as an indicator of high performance.” “According to our study, 92 percent of Raya’s Paradise employees say it is a great workplace,” says Sarah Lewis-Kulin, Vice President of Great Place to Work Certification & List Production. Raya’s Paradise employees completed 64 surveys, resulting in a 90 percent confidence level and a margin of error of ± 2.51. ### About Great Place to Work® Great Place to Work® is the global authority on high-trust, high-performance workplace cultures. Through proprietary assessment tools, advisory services, and certification programs, including Best Workplaces lists and workplace reviews, Great Place to Work® provides the benchmarks, framework, and expertise needed to create, sustain, and recognize outstanding workplace cultures. In the United States, Great Place to Work® produces the annual Fortune “100 Best Companies to Work For®” list and a series of Great Place to Work® Best Workplaces lists including lists for Millennials, Women, Diversity, Small and Medium Companies and over a half dozen different industry lists.
A study in ‘The Gerontologist’ states that, “approximately one-third of 65-year-olds are single.” That’s a 50% increase since 1980 according to the U.S. Census. Aging with family and friends has been shown to result in improved health of seniors, including lower chances of cognitive impairment, and hospitalization. Research shows that socialization, companionship and hobby-building has great benefits for seniors: older adults who are surrounded by others are at a decreased risk of both cardiovascular and cognitive decline. For some seniors, moving into an Assisted Living Community is the first step they can take to help maintain or increase the quality of life as they grow older. In reputable communities, experts in the field of long-term care help coordinate between activities to create communities where older adults are able to create new memories with one another. Residents take on scheduled group hobbies such as yoga, cooking, and artistry while pursing passions both new and old. Assisted Living Communities can act as a hub for seniors to connect and make new friends. Our advice for making friends in a community? Participate and try out all the opportunities that are available. The goal is to foster an natural feeling of community with residents similar in age and circumstances.
Can the right foods reduce or even reverse Alzheimer’s symptoms? Certified Nutrition Specialist, Amy Berger thinks so. Berger believes that Alzheimer’s is caused by a glucose shortage in the brain, causing brain neurons to degenerate, and leading to the all-too-familiar Alzheimer’s symptoms like memory loss and behavioral changes. In her book, “The Alzheimer’s Antidote: Using a Low-Carb, High-Fat Diet to Fight Alzheimer’s Disease, Memory Loss, and Cognitive Decline”, Berger presents a nutritional and lifestyle intervention approach she claims is designed to combat Alzheimer’s disease. Berger’s research suggests that an effective way to treat Alzheimer’s is through diet and lifestyle changes that improve energy generation in the brain and that a food-based solution to achieve measurable improvements is as simple as a low-carb, high-fat diet. At Raya’s Paradise, we are always looking to improve and enhance our residents’ lives. Our certified nutritionists design our healthy living menus so as to help minimize the “metabolic dysregulations” that contribute to Alzheimer’s symptoms. We serve three daily meals that are rich in healthy, unprocessed fats and include micronutrient packed vegetables – beneficial for a healthy life and proven through research to help reduce, and even prevent Alzheimer’s and dementia symptoms.
Dementias are degenerative disorders that develop primarily in the nervous system and selectively damage particular areas of the brain. Some dementias, like Alzheimer’s disease affect all areas of the brain simultaneously, while others, such as frontotemporal dementia, affect the parts of the brain involved in controlling one’s communications and emotions. Still others are caused by vascular disease, brain trauma, or chronic alcohol abuse (Korsakoff’s syndrome) By 2030, 20% of U.S. population will be older than 65 years of age – about 50 million people. Dementia affects 1% to 6% of those older than 65, and between 10% and 20% of those older than 80 years of age. In the next 30 years, estimated 10-20 million seniors in U.S. will have mild to severe forms of dementia. Seniors with history of moderate traumatic brain injury (TBI) have a 2-3 times greater risk of developing Alzheimer’s disease – those with a severe TBI have a 4-5 times greater risk. Even healthy seniors are at risk for falls and head trauma, so any fall to the head, however minor, should be seen by a medical professional and documented. Alzheimer’s disease accounts for 65% of all dementias. There is no direct diagnosis of Alzheimer’s – and while PET scans and other imaging techniques are being studied, none have yet been able to show the presence of Alzheimer’s disease. Alzheimer’s onset often surprises families because vision, movement, and sensation remain untouched while a senior’s memories begin to slowly decrease. Recent memories are affected first, leading to “senior moments” that appear innocent because all other memories, including those from decades ago, remain intact. Eventually those remote memories begin to fade, and lastly the senior’s “crystallized” memories, such as family member’s names and faces, are compromised.   By David L. Raffle, PhD Clinical and Forensic Neuropsychologist www.RaffleBrainInstitute.com