Ohsu Background Check: Fill & Download for Free

This is the best question I've seen I'm this topic maybe ever. I also read your comments and noticed you've done a lot of background reading, such as Neurotribes.Probably a good way to find research groups doing work you'd like to participate in is to search for the few existing papers in PubMed or Steve Silberman's bibliography.On the West Coast, Elise Marco at UCSF is studying the neuroscience of sensory processing issues and possible interventions. I've met her and a student or two. If I were looking for a PhD advisor or lab to volunteer in, I'd shortlist her.I don't remember the names of the research group, but OHSU has an ongoing project helping autistics get better healthcare and I believe they have a project focused on women on the spectrum. If you search for Autism Healthcare Toolkit, I think you'll find them.If you find a paper you like, don't just stop by considering the group that wrote it. Check the bibliography for their references. (And you can keep on digging deeper and deeper with modern hyperlinked references. Well, at least if you have library access or the papers you like are open access.)

The best way to help someone with dementia to remember important appointments?When my own mother was around, she would forget appointments and even forget to take her medications. Let me treat each of these separately, but for both, there are two aspects: MOTIVATION and MEMORY.Without the motivation to do something (attend an appointment, swallow a tablet), they will not want to commit it to memory, they will be less likely to remember, and if they do remember (or are reminded), they will be less likely to act (and prepare for or go out for the appointment). Motivation is important and often overlooked. I know this because I overlooked it! Read on.Memory is the obvious aspect. At first, with onset dementia, frequent reminders of the right kind will help. With worsening dementia, no amount / quality of reminding will help. I have a good example of this. Read on.AppointmentsPreparation. With most appointments, there is a need to prepare before hand. Get dressed appropriately. Finish the current meal or snack. Visit the bathroom. Get hold of any paperwork or money required for the appointment. So a reminder is required before the appointment with enough time to prepare and enough detail to know what preparation is required. However, once the preparation is done, a second reminder may be required to actually carry out the appointment (make the call, go outside, whatever is required). So…Act NOW. A second reminder may be required to say, “it’s 3pm, time to step out the door” or, “it’s 3pm, stay in the lounge room near the telephone.”MedicationPreparation. Blister packs, also known as Webster packs, are extremely helpful. These days, pharmacies pre-pack those little medication packs for you, one week ahead of time. Brilliant! But it’s only one third or one quarter of the answer.Knowing what day and time it is. My mother used to doze during the day. Perhaps at 5:30pm, at dusk, she would awaken and think that it was morning time. She would go through her morning and breakfast routines, which would include taking the next morning’s medications. It would be slightly confusing because the previous day’s dinner-time tablets would be still in there. She would either leave the dinner tablets there, or take both. Either way… not a good thing.So having multiple day-and-time clocks around the house, preferably NOT controlled only by batteries, was crucial. However, after a while, with worsening dementia, this stopped working (both because of the “motivation” factor and because of “I forgot to look at the clock” factor).Take the medication NOW. So I bought my mother what I thought was the perfect medication reminder clock. It would announce (according to my simple “programming”), 3 or 4 times a day, in a delightfully flat American accent, “It’s xx o’clock, time to take your morning/afternoon/evening/lunchtime medication”, and it would repeat that sentence about once per minute for (I can’t remember, maybe 10 or 15 minutes) until she either pressed the green button or until the 15th time had completed.This worked for a while, but eventually her dementia worsened. And see my motivation story below.What to do when it went wrong. So, what did my mother do when the Webster pack mysteriously went out of alignment? I expected her to call me about it. Because she was slightly ashamed or embarrassed, and because of the motivation factor (see below), she wouldn’t ever call me about missed or duplicated medication. I assumed that she had everything worked out, until my weekend visit, at which point I’d notice either unopened segments of the Webster pack, or a misalignment of a day. Frustrating for me. So your elderly parent needs a “what to do” plan B that doesn’t make her feel small and silly. Easy to say. Impossible to do.My Motivation StoryOne day I happened to call my Mum (Mom for those of you in America) at around 11:50am. Ten minutes into the conversation, her medication alarm clock went off. I heard it in the background, LOUDLY announcing, with perfect timing, in a wonderful American accent, that it was time for her to take her lunchtime medication (I don’t remember the exact words; it isn’t important to my story).My Mum remained silent for the duration of the alarm. I remember thinking what a clever son I was. I had found and purchased that device, set it up, taught her what it was for, how to acknowledge it to make it stop, what to do. Clever son. So I fully expected that at the end of the alarm’s announcement, she would either excuse herself to take the medication, or mention it to me so that I’d remind her after our call.I was wrong.After the last syllable, she resumed our conversation, without even THINKING about her medication! There was no pause to reflect, no mention of the alarm, no concern about needing a reminder. She treated the alarm like background noise… like people talking at a cocktail party. To her, it simply did not exist.Some background: My Mum had a history of difficulty in swallowing medication. She simply couldn’t do it. Try as she might, she would sip and sip and sip water, throw her head back and try to get it down. Invariably, she would bite into the bitter tablet or pill, scrunch up her face in disgust and swallow it down… often with a “chaser” of a piece of bread or fruit (when she could still remember). So compared to other seniors with dementia, my Mum had even LESS motivation to take her medication because she couldn’t swallow (which does matter for some medications) and she was sensitive to bitter taste. But even for someone who CAN swallow tablets without any problems, it’s not their favourite activity. It reminds them of their poor health. It is unpleasant. And when people talk to them about it, the conversation invariably makes them feel stupid, old, small, incompetent, sick, and so on.You see my point? For you and I, the motivation for taking tablets is to get better (or to not get worse, perhaps) but for someone with dementia, that long-term objective is forgotten and/or irrelevant. Like a child, if it’s not pleasant, it’s EVEN HARDER to remember and act upon.The solutionSo my Mum’s physician, who was obviously more clever or at least more experienced than I was, placed all critical medication into the dinnertime (evening) “slot” of the day, and we organized a daily nursing visit for weekdays (when I wouldn’t be visiting).And my backup strategy was to call her to remind her. But not JUST to remind her. To engage her in conversation, genuinely talk about her day, tell her about my day. And then to pause and ask her to go fetch the medication so that I could talk her through it and solve any problems.At once stage I had a webcam in the room where she had her telephone, that I could use to view her actually following through my instructions. That was before the days of seniors video phones, which make it so much easier.One of the seniors video phone users that I know is called daily by her daughter to check on hydration compliance. The loving daughter actually watches her mother drink water periodically from a water bottle during their conversation. It works for both of them! The daughter ensures that her mother complies with hydration requirements. Her mother loves the daily call, and doesn’t at all mind drinking the water because it’s part of the routine. The MOTIVATION is the call from the daughter. She gets to see the daughter, and sometimes the grandkids. The daughter is extremely careful not to make a big deal out of the water drinking, but at the same time, she insists strongly that her mother fetch the water bottle at the start of the call. By linking the two events (call from loving daughter and having to drink water), the motivation goes up and, of course, the chance of dehydration goes down.What about appointments?The simple answer is to call your elderly parent once at preparation time and once at “act now” time, preferably with video (to their seniors video phone) so that there is no chance that they will forget and so that you can watch the “compliance”, while treating them to some “motivation therapy” (having a great time talking to them and showing them your family, or photos from your computer).Younger seniors with less-advanced dementia can use one of the many iPad apps or seniors tablets to remind them… but from my experience, such devices and apps lack the motivation factor (of a son/daughter calling, with video, to say “hi”) and are too easy to ignore, forget, put off, put away, drop, misplace, leave off charge, leave out of Wi-Fi range, and so on.Recruit family membersIf you have no time yourself, then recruit other family members to call your elderly parent (preferably with video) to attend appointments. It’s FAR better than an electronic calendar, for one more BIG reason: Social isolation.Let me explain.Social isolation and loneliness are linked to poor sleep, depression, dementia, high blood pressure and morbidity. As a health risk, social isoation is worse for you than smoking cigarettes! (If you ask me, I’ll post a link to the study or studies that compare the death rates of both).Conversely, social engagement is VITAL. Particularly FACE-TO-FACE conversation.Face-to-face social engagement is good for seniorsTwo medical studies (by Prof Alan Teo at OHSU) showed that in-person face-to-face conversation, OR Skype-based face-to-face conversation, specifically with family and friends, at LEAST 3 times per week, reduces social isolation and HALVES depression risk. In the studies, it was shown that regular telephone conversation (without face-to-face / video contact) did not derive any measurable benefits.One other medical study (by Prof Hiroko Dodge at OHSU) showed that increased social engagement, via daily face-to-face video calls, actually INCREASED cognitive function in those with dementia and those at risk of dementia. The results were so strong that OHSU was funded for two 5-year follow-on studies to quantify the longer term effects, in terms of slowing dementia onset and progression. I apologize if I have misquoted or understated this research. Once again, I can link to each of the studies within comments if required. I have learned not to include links within my Quora answers because such answers often get reported and deleted.So my point is, if you can’t visit 3 times per week, having a simple video call DOES work, and will help in two ways: 1. It lets you initiate and check on compliance (to medication, hydration and/or appointments) in a way that’s foolproof and provides motivation compared to simple alarms/tablets; and 2. It provides valuable face-to-face conversation, which increases social engagement, which exercises the brain in so many more ways than puzzles or simple telephone calls, resulting in a likely better form of cognitive exercise that shows great promise, and in line with medical studies.SummaryDepending on the stage of dementia, you’ll likely need a different approach to ensure compliance with appointments. Remember to think amount motivation, observation (ensuring compliance) and the reminder itself, as well as a fallback strategy. And consider the importance of social engagement for those with worsening dementia or those at risk.

To make an Alzheimer’s patient’s life easier, you need to consider safety, health, independence and quality-of-life:SafetyWalking safety: Stairs, paths and doors: People with dementia can forget to take adequate care in and around the home. Ensure that paths to and from doors are level (not bumpy). Install stair rails. Consider installing ramps instead of, or beside, stairs. Think about escape during an emergency (such as fire) and choose appropriate locks, latches and doors.Cooking safety: Cooking can become dangerous. It becomes easier to burn oneself on the stove top or while using the oven. At some stage, consider disabling the oven and stove top and teach the patient to prepare and re-heat food using the microwave oven. At a further stage, even this will be too dangerous and difficult, and delivered hot meals may be required, if available in your area.Security: Consider installing a monitored alarm system, complete with smoke / CO2 monitoring and security cameras that you can monitor on your mobile phone. Some Smart Home systems enable you to monitor activity in and around the house, so that you can check on movements, visitors, and whether/when doors have been open/shut and locked/unlocked.HealthDiet: Dementia patients tend to neglect their diet. Like a child, they may either migrate towards foods that are high in sugar content and fat, or they may revert towards the diet they remember from their childhood. Also, as pointed out previously, food preparation can become dangerous. Consider home delivery of prepared meals that are either already hot or can be reheated safely in a microwave oven, if that is still safe.Exercise: Dementia patients tend to neglect exercise. Encourage exercise by involving them in group exercise activities, encouraging walking, and instilling regular (good) habits such as a morning walk to the coffee shop or to buy a newspaper, fruit or milk.Blood pressure: Regular visits to their doctor are important. Make sure that the doctor keeps an eye on blood pressure. It may be convenient for you to purchase a home blood-pressure machine so that blood pressure can be monitored more often.Medication: It’s extraordinarily hard to push a dementia patient to take their medication correctly and regularly. There’s little incentive. Consider products such as medication blister-packs, medication dispensers and monitors. I found that a telephone call, around the times of taking medication, was great motivation because most older people are lonely and love receiving phone calls… even if one of the purposes of the call is to encourage them to take medication and monitor the outcome (over the phone and using the security cameras described earlier).Face-to-face contact: Social isolation and loneliness are linked to poor sleep, high blood pressure, dementia, depression, reducing functionality and morbidity. However, recent OHSU studies show that only face-to-face conversation, specifically with family and friends, 3 times per week (or better still, daily), reduces social isolation, halves depression risk and actually improves cognitive ability after just 6 weeks. Although new studies are measuring the longer term impact, it’s clear that face-to-face conversation is one of the best forms of brain exercise available. The best news is that Skype-based contact also works! Get them a simple tablet, or if they’re beyond learning a new device, get them a seniors video phone designed for someone with dementia or a disability.Smoking: Smoking is implicated as a risk factor for dementia.IndependenceLabels and instructions: Create labels / instructions for appliances that are still in use but may be forgotten, such as the microwave oven.TV remote: Get a simple, 6-button remote control that only does volume up/down, power on/off and channel up/down. There are both learning remotes and universal remote, as well as remote that are both learning and universal. In contrast, the standard remote control that comes with most televisions has black buttons on a black background, has 40 or more buttons, and is terribly difficult and fiddly to use even for someone without dementia.Showering assistance and other support: Bring services into their home, if you can afford to, in order to try to keep them living in their own home for as long as possible (but not past the point where it becomes unsafe or undignified).Preparing for the move: At some point, transition into an aged care facility is likely to be needed. Have that discussion earlier than you need to. Place them in a couple of different facilities for short periods of respite while you’re away on your vacations. That way, when the move is really needed, you’ll both be ready!Decisions are important: Even if you think a decision is obvious, or that they might choose incorrectly, it’s important to ask and help them feel like they are in control of their destiny. Which is better: To live 10% longer (or with 10% less risk), or to enjoy the thrill of preparing one’s own meal occasionally with the risk of something going wrong? OK that’s maybe a bad example or poorly worded, but you get my point: Self-esteem and independence go hand-in-hand, and sometimes we need to give up a little control. Sometimes. I hope this makes sense and I wish I could think of a more concrete example. Oh, “going for walks alone in the park” could be an example, where one needs to balance risk versus independence?Quality of LifeVisits should be fun: Don’t make the mistake of using every visit to do things for them (paperwork, mail, washing, cleaning, shopping, cooking, tidying, gardening). Sure, if you enjoy these activites, do them for or with them. I found myself starting to dislike visits, so I found a simple solution: Make the visits fun for ME as well! I took my elderly Mum to visits to restaurants, coffee shops, art galleries and walks in the park. I brought a friend or partner with me when I could. Suddenly, the visits became fun… and my mother saw it in me too, so she also had more fun. The tasks? I paid for someone to do gardening and cleaning. I did the paperwork and mail in my own time, and simplified or automated as much as possible. Shopping was done online, with home delivery. I was OK with tidying up. This was the biggest single change I made (the change in my own attitude, to make visits fun). Once my mother was in an aged care facility, of course, there was practically nothing left for me to do anyway, but I was already in the habit of taking her (out of the facility) to go visit fun places and do fun things, rather than just sitting in the facility watching the clock like I see many other visitors/relatives do.I hope this helps. Remember that carer’s fatigue (caregiver’s fatigue) is a real thing. Look after your own mental health and give yourself little rewards, little breaks and variety during your caregiving!Best wishes and good luck.