By Vernon Doucette,
Boston University Photography

Concord residents had a terrific opportunity to learn from one of the nation's leading Alzheimer's researchers last night as Dr Robert Stern, co-director of the Center for the Study of Traumatic Encephalopathy at Boston University's School of Medicine, spoke at the Concord Council on Aging. Stern, an excellent speaker, filled evening with both useful information and hopeful stories.  I knew we were in for a good evening when he started off with what most would consider a professional and political No-No: he told a joke about a man suffering from Alzheimer's Disease. And his point was well-taken: successful Alzheimer's caregivers have to have a sense of humor.

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This past week the Boston Marathon bombings put parts of the city and suburbs on lockdown, providing an unwelcome example of a type of emergency families rarely plan for: terrorism and police actions. Most people who care for elders think often about the elder’s own health crises, and all of us have to plan for blizzards, power outages, and related events. But reassuing a frightened elder during an act of terrorism? Not so much.

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I posted recently about a Johns Hopkins study on aging senior citizens: For Older Adults, Participating in Social Service Activities Can Improve Brain Functions. Today's story is about a man who could be Exhibit A for this point: local hero Al Armenti.

Al is well-known in his home town of Concord MA.  Well into his 90s, he is very active in many social service activities, in his church (First Parish in Concord, a Unitarian Universalist congregation), and in music circles.  He is a combat veteran and has been a peace activist for decades.  Recently, I received an email from Al reporting on his participation in the St Patrick's Day with the Veterans For Peace.  He writes by way of explanation that "As a long-standing member and, because of my age, I was allowed to ride in the back seat of an open convertible."  That's okay, Al, I hope that if I am still fighting the good fight when I'm nearly 100, someone gives me a ride in the parade, too.

Although it seems that Al has been a dedicated member of Veterans For Peace for since the Revolutionary War, his participation is somewhat more recent.  This is not a small commitment: a few days before the parade, Adrian Walker wrote a column in the Boston Globe about VFP's efforts to march in the traditional St Patrick's Day parade:  Antiwar Veterans Group Battles to March in St Patrick's Day Parade.  Al also sent along a video of the event (he appears in the red convertible toward the end).

The picture above at the right is Al playing his mandolin, which he still does in public.  One of his favorite songs is Pete Seegar's humorous My Get Up and Go Has Got Up and Went.  Delivered with a twinkle in his eye and an engaging smile, the song as Al sings it is clearly ironic.  His 'Get Up and Go' is doing just fine.

So here's to you, Mr. Armenti! You aren't old - you have just been young for a very long time!

Congratulations to our own Dr. Deborah Bier, PhD!  The Home Care Association of America, the home care industry's largest trade organization, has asked her to deliver another of her popular series of webinars training professionals and families who are dealing with Alzheimer's Disease and Related Dementia (ADRD). In 2012, Debbie's first webinar was so popular that they immediately asked her to deliver three additional sessions on similar topics. We learned later that her sessions were being downloaded by agencies around the country to use in their training. Quite a compliment to her work, and a demonstration of the high quality we try to deliver at Caring Companion.

Debbie's trainings and webinars are based on a program developed by the Alzheimer's Association of Massachusetts and delivered through the state's Executive Office of Elder Affairs.  We use the approach, called "Habilitation Therapy," in training our caregivers for dementia clients.

Details of the webinar are below. 

Alzheimer's Disease and Related Dementias (ADRD) require a many resources to manage on a daily basis, draining caregiver energy, time, finances and patience. But there are proven methods to make care easier, safer, and more enjoyable for both patient and caregiver. Learn some of these little-known best practices, used successfully by both professional and family caregivers alike.

Deborah Bier, PhD, is the director of care for Caring Companion Homecare in Concord MA and has been a holistic psychotherapist for 25 years. Certified by the Commonwealth of Massachusetts's Office of Elder Affairs and the Massachusetts Alzheimer's Association, she trains dementia caregivers and coaches dementia families. Her particular expertise is in helping multi-generational families apply wellness approaches to managing chronic illness. She holds a doctorate in therapeutic counseling, and is a widely published writer and speaker specializing in health and healing.

Probably the single greatest reason we are called to serve families is to provide care following a fall by an elder. Particularly when people have lived in a home for decades, we see that homes and people have not adapted to the extra care needed to prevent falls. These are preventable events, and families with elders will be well-advised to attend Emerson Hospital's free workshop.

Falling - Don't let it happen to you or someone you love

People familiar with Alzheimer's Disease and related dementias listened with interest last month as NPR reported recently (Alzheimer's 'Epidemic' Now A Deadlier Threat To Elderly) on the Alzheimer's Association release of statisitcs showing that Alzheimer's death rates are soaring, even as death rates from other diseases decline. The 68% increase in Alzheimer's deaths between 2000-2010 does mask some good news: other health factors like heart diseaes, which typically kill at earlier ages, are declining - leaving longer-living patients vulnerable to Alzheimer's as they age. Paradoxically, however, the only disease with a rising death rate and with no effective treatment and no cure or vaccine receives scant funding for research into solutions.

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People concerned about elder care and resources for senior citizens living in Concord should attend Saturday's Healthy Concord Community Forum at the Harvey Wheeler Center, 9:30am - 12:30pm. This is a chance to alter the resources and emphasis the Town places on issues of elders and elder care.

Back in the fall, the Town of Concord embarked on a healthy community planning project to assess the physical, mental, emotional, and spiritual health and overall well-being of the community. The project has worked to identify Concord’s existing assets and resources, define residents’ needs, and determine opportunities for improvement. The focus of the Healthy Communities effort has been on local issues that affect health and quality of life, such as:

• Public health concerns such as heart disease, substance abuse & air quality
• Housing and education
• Youth development
• Access to health/medical care
• Child care and elder care
• Recreation
• A clean and healthy environment
• A safe environment
• Arts and cultural pursuits
• Transportation

For more information contact Jill Block, Healthy Concord Coordinator at This email address is being protected from spambots. You need JavaScript enabled to view it. or Susan Rask, Public Health Director at This email address is being protected from spambots. You need JavaScript enabled to view it. . Register by e-mail to This email address is being protected from spambots. You need JavaScript enabled to view it. . Please specify if childcare is needed.

Last chance is TODAY! Local residents can support Meals on Wheels by bidding on some terrific restaurants and other contributions available until 10PM EST tonight. March for Meals is a national campaign sponsored by the Meals on Wheels Association of America to raise awareness about senior hunger, recruit volunteer Meals on Wheels drivers and raise needed funds. This month the March for Meals online auction, with gift cards to restaurants, grocery stores, coffee shops and other food-related businesses as well as Red Sox tickets. Place your bids here.

Minuteman Senior Services is a non-profit organization that has been helping elders and their family caregivers in Massachusetts locate appropriate eldercare assistance since 1975. Their mission is to help seniors and people with disabilities live in the setting of their choice by engaging community resources and supporting caregivers. Over 22,000 people each year turn to them for help. Caring Companion Home Care has worked with Minuteman in a variety of capacities for years, including as an approved home care agency in their publicly-funded program for low-income seniors. Through the Executive Office of Elder Affairs, Caring Companion Director of Care Dr Deborah Bier was trained in pilot program with the Massachusetts Alzheimers Association for Rehabilitation Therapy, and we now use this as the basis for all our Alzheimer's training for our caregivers and client families.

Yesterday I attended a presentation by Dr Gregory Martin, Chief Medical Officer of Emerson Hospital in Concord MA.  Dr Martin highlighted, with justifiable pride, a recent program by Emerson to reduce their already-low rate of hospital infection. Anyone familiar with current elder care issues at hospitals knows the concern that the facilities can be a petri dish of infection, and with frail elders and compromised immune systems, the risk of becoming sicker in a place designed for healing is one of the frustrating ironies in today's health care world.

As a home care agency owner, I was particularly interested in his remarks about reducing infection for clients with catheters, since so many of our clients have them. 

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Earlier this week I attended a meeting of the New England Health Information Management Systems Socitey (NEHIMSS) about use of mobile technology in health care, including home care. The session, delivered by Dr Fernando Martinez, focused on hospital systems and issues of security and cost as well as quality of care. But I was again struck by the importance of the data collected by home care workers and the potential to improve health outcomes, reduce cost, raise patient quality of life, and lower the stress of family caregivers if the data is documented and followed by either an educated lay person (family member or non-medical case worker), so that earlier intervention can eliminate hospital stays.

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Karen Tannenholz works in our office, and last summer she faced the kind of sudden medical emergency we help many people through. Stressed families often imagine their circumstances are unique, but Karen’s story reveals threads common among many: feelings of growing confusion, helplessness, stress, anger, and even humor are all normal. Ultimately, deeper appreciation of each other can emerge as we navigate together through some of life’s most difficult passages. To hear Karen’s story, click 'Read More' below:

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Hats off to Mary Baum, Nancy Crowley, and the team at Concord Park for their terrific PhotoVoice project! I attended the open on Thursday November 29, and it was very impressive. We had previously blogged about this project (see our post from October 31). The emotional power of the images and the descriptions reveal a lesson we always emphasize to the families of our clients and to our caregivers when we conduct training: although reasoning and language ability may decline, the emotional experience of people with dementia remains vivid. This is why it is so important to “meet them where they are.” Absent safety concerns, the immediate facts are irrelevant, but the emotional life of the person are real.

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Readers and others often ask us how to start conversations with parents about planning for the parents’ potential care needs and other aspects related to their declining capabilities. As we approach the holiday season, this is an especially good time to have these conversations – key family members who may be available only during holidays are often present, and it may be easier, even given holiday activity, to find some time for a quiet conversation. In hopes of facilitating a successful discussion this holiday season, we offer a few thoughts about what needs to be discussed, and how to conduct a conversation with an elder family member to plan for a time when he or she may not be able to manage independently.

First, as you approach the conversation, you will typically find best success if you think of it as

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Concord Park in West Concord, MA announced the opening of The PhotoVoice Project, a distinctive exhibit featuring the photographs and writing of older adults living with memory loss (see video below for a view of last year's exhibit in a sister community in Hopkinton, MA).

The Opening Reception for the exhibit is Thursday, November 29, 2012 from 4:00-7:00pm at Concord Park located at 68 Commonwealth Avenue, Concord. The public is invited to attend to view the works and will have an opportunity to meet the artists.

The PhotoVoice Project was developed by several researchers at the University of Michigan to enable individuals with disabilities to identify, represent and articulate aspects of their lives by working with cameras to capture images of interest and then giving meaning to those images through words.

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Massachusetts Alzheimer's Association
Greater Concord MA "End Alzheimer’s" Kickoff

Tuesday, August 7, 5:30 pm - 6:45pm
Concord Council on Aging
Harvey Wheeler Community Center
1276 Main Street
Concord, MA 01742

Friday the 13th was our lucky day -- on Friday July 13, 2012, anyway.

Public Radio International, producer of such popular shows as Marketplace, called to request that I appear on To the Point, "a fast-paced, news based one-hour daily national program that focuses on the hot-button issues of the day, co-produced by KCRW and Public Radio International." The show was devoted to "Home Care and Our Aging Population."

This was our third opportunity for national exposure within a month, including an opinion piece on CNN.com and a series of national webinars requested by the National Private Duty Association.  The show examined both the costs of home care and people's attitudes toward old age. The most interesting question, I thought, was

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We were delighted to learn recently that CNN.com published a piece I had submitted on the unintended consequences of the Obama administration's intention to change the Fair Labor Standards Act regarding overtime for home care workers.  Leaving aside for the moment the merits of the adminstration's proposal and the cautions I was raising as it is considered, it was a milestone for our agency to be on the national stage debating a piece of legislation this important.

Most of the reader comments indicated that people thought I was concerned about the home care agency's profits, but the fact is that the law, if passed, would not affect our profit by a single dollar. That is because Massachusetts already has an overtime provision, so we pay overtime to everyone who works more than 40 hours. What those readers do not realize is this:

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A recent blog post addressed how to conduct difficult conversations with an elder whose skills may be declining, but who is still  clear-minded enough to reason. Today we discuss territory where you often must act more independently, because Alzheimer’s Disease and Related Dementia (ADRD) has compromised your loved one’s ability to choose wisely. This is thorny territory.

This situation reinforces the importance of our focus from last column: Start these conversations before they are needed. By the time Alzheimer’s or dementia strike, elders are at risk of making decisions that put them in danger they do not recognize.  Advanced age and even the appearance of dementia are not a license to remove all sense of independence from the elder, but the family must be willing to

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Last weekend I attended the Aging in America 2012 conference in Washington, DC, and I had a chance to speak to a several large home care franchisors and a few networks of assisted living facilities who are considering adopting our software. While I was in Washington, I also arranged with the National Private Duty Association (NPDA) to give a webinar on family web portals and what features they can or should provide.  And in an unexpected and pleasant surprise, NPDA also invited me and Debbie Bier to give a webinar on Alzheimer's training for consumers.  All of that activity made for an exciting week and weekend!

As one would expect for a Washington DC conference,

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