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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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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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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Note: The following was published in our monthly column "Living and Loving: Elder Care in the 21st Century" in Gate House News' Concord Journal.  We will continue this theme of Alzheimer's and dementia in this blog with periodic articles on the subject.

The weeping elderly woman is pleading. “I want to go home! Please find out why my ride isn’t here!” Exasperated, her daughter snaps at her, “You are already home, mom! I keep telling you, why can’t you remember? You moved in with us last year!” More weeping, snapping, pleading and exasperation follow. Around and around this goes, several times a day. Both women end up beside themselves with frustration, sadness, anger, and fatigue.

While looking at books at their local library, a man suddenly jumps to his feet, announcing loudly to his wife, “I have to go to the bathroom, now!” Five seconds later, he wets his clothing, urine puddling around his feet. “I asked you to go before we left home and you refused! Why can’t you control yourself?! I can’t take you anywhere like this!” she says to him in despair and exhaustion. They are both embarrassed and ashamed, a wedge stands between them and tension hangs thick in the air.

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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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The National Private Duty Association (NPDA) recently asked us to present a webinar for a national audience of both professional and family caregivers to discuss the Habilitation Therapy curriculum recently developed by the Commonwealth of Massachusetts and the Alzheimer's Association.  I was certified in the first class given using this curriculum designed to help people managing Alzheimer's Disease and other related dementias.  The reception to our presenation was so good that the NPDA has asked us to present a series of three more webinars on the topic. We will post details on those as soon as they are scheduled. 

You can watch and listen to our webinar on Habilitation Therapy for Alzheimer's at your convenience.  Fill out the simple registration form to proceed.

Caring Companion Home Care of Concord, MA was selected by the industry's most prominent national trade organization, the National Private Duty Association (NPDA), to deliver a consumer seminar entitled "When Dementia Strikes: Managing Care and Making the Most of Each Day."  It will be delivered as a free webinar on May 16 at 3:30 PM EST.

Alzheimer's Disease and Related Dementias (ADRD) cause grief for families and increasingly complex cases for home care agencies. The Alzheimer's Association and the Commonwealth of Massachusetts have developed an innovative new program to train family and caregivers in the use of Habilitation Therapy to reduce the care challenges in these difficult cases.  Participants will learn about best practices in the industry as the country faces this growing challenge.

"We are truly honored to have been selected to deliver this information, among the roughly 17,000 thousand homecare agencies nationwide," says Caring Companion owner and long-time Concord resident, Jim Reynolds. "We owe this to our Concord office director, Dr. Deborah Bier, who has become a recognized expert on dementia and home care." 

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Capacity is limited. Reserve your Webinar seat now here.

Alzheimer's Disease and Related Dementias (ADRD) cause grief for families and increasingly complex cases for home care agencies. The Alzheimer's Association and the Commonwealth of Massachusetts have developed an innovative new program to train family and caregivers in the use of Habilitation Therapy to reduce the care challenges in these difficult cases. Come learn about best practices in the industry as we face this growing challenge.

Bios of Presenters

Dr. Deborah Bier has been certified to train dementia caregivers and coach dementia families in Habilitation Therapy -- an approach recommended by the Alzheimer's Association that serves as the basis of a cutting-edge program recently developed by the Alzheimer's Association of Massachusetts and the Commonwealth of Massachusetts. As District Director of Caring Companion Home Care, Dr Bier was in the first class certified in this new program. She has a 25-year career as a counselor and agency director helping multi-generational families apply wellness approaches to managing chronic illness.

Jim Reynolds, CEO of Caring Companion Home Care outside Boston MA, has established CCHC as a leader in developing innovative technology and care solutions applied to elder care. CCHC has been praised for their unique proprietary family communications platform as well as its focus on wellness and use of Habilitation Therapy to care for ADRD clients.

After registering you will receive a confirmation email containing information about joining the Webinar.

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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Caring Companion Home Care has adopted and trains our caregivers in habilitation therapy when caring for clients with Alzheimers Disease and related dementias (ADRD). This approach was developed at the Massachusetts Chapter of the Alzheimer's Association, and is considered to be the best standard of care for all types of dementia. Sadly, it is not in as widespread use in all aspects of elder care as it should be.

Habilitation therapy is a comprehensive behavioral approach to caring for people with dementia. It focuses

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By Susanne Liebich (photo at right)

Editor's Note: This program is an excellent example of what we believe here at CCHC: that our clients are first and foremost people with challenges, not full-time patients.  The difference living this point of view is profound, as this article makes abundantly clear.

The healing power of dance… I stand here to vouch for its validity.  And in particular, I want to tell you about a technique called Dance for Parkinson’s Disease developed by Mark Morris Dance Group in 2001. This technique is not about therapy, yet it is therapeutic. It is not about exercise, yet for most, it is a wonderful workout using the whole body in different ways. Dance for Parkinson’s Disease is a pedagogy that integrates ballet with imagery, balance, mobility exercises, expression and enjoyment of the art dance. It’s about creating something aesthetically beautiful and creative with the body. It’s about appreciating dance for dance’s sake in a group setting and to explore the range of physical and creative possibilities that are still very much open to individuals with Parkinson’s.

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Download a flyer for this web conference here

Caring Companion Home Care of Concord, MA and the nonprofit National Private Duty Association (NPDA) will host a consumer education web conference entitled Depression and Older Adults – What Every Caregiver Should Know on March 13, 2012, at 8 p.m. EST. The live and interactive program will provide advice on how family caregivers can work with professionals to identify this condition and develop an effective plan of care for a loved one with depression. Caregivers will learn how to identify key issues and problems, locate needed experts and resources, and outline a plan to provide the best care for a parent. The event is free of charge and anyone can participate.

“Unrecognized, untreated depression is widespread among elders, who may present somewhat different symptoms, and who may need different types of treatment than younger people,” said Deborah Bier, PhD, director of the Concord office of Caring Companion. Bier holds a doctorate in therapeutic counseling, and has spent more than 20 years working with people of all ages with physical, cognitive and emotional disabilities. “Effective treatment can bring about an amazing improvement in quality of life and ability to function. This webinar is the type of increased public education and awareness that’s sorely needed.”

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March 31, 2012 - Sponsored by the Metrowest Alzheimer's Partnership

Where do families turn when they realize that a parent’s memory is fading? Dealing with the emotions surrounding the onset of Alzheimer’s disease, which is the most feared illness in the U.S. after cancer, is difficult. The MetroWest Alzheimer Partnership, in collaboration with the Alzheimer’s Association, is hosting an educational program that is free and open to the public on Saturday, March 31st at Whitney Place in Natick.

Concrete help for families can be elusive as they struggle to provide daily caregiving, research local resources such as residential and day programs, and find local support networks. Especially difficult for families is when their loved one starts to exhibit some of the troubling behavior commonly associated with Alzheimer’s disease.

The event features nationally recognized Alzheimer expert, Paul Raia, Ph.D (above right).

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On Day 4 without power following our recent late-October snowstorm, a woman in her 90s slowly rolled into a municipally-run emergency shelter at a nearby metro-west Boston town.  Leaning heavily on her walker, she looked at the shelter manager wearily and said, "I'm cold. I want to sleep here tonight."  Her caregiver interjected quickly, "I have to get back home,” eyeing the exit.

The shelter manager quizzed them about the elder's ability to function independently.  How much care was needed, and what type?  It turns out that the caregiver came 3-4 days a week; the senior was a bit confused, not fully independent in several of the activities of daily living, nor could she manage her own medications safely. Just not handling her medications independently was enough of a deal breaker, according to the manager. "I'm sorry, but this shelter cannot accommodate you," said the manager. "You'll have to find somewhere else to stay."

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Thanks to The Concord Journal for publishing a story about us in in today's edition.  It's about how our Dr. Deborah Bier has become certified to teach the Alzheimer's Association's home care giver training course, and how vital it is to have trained caregivers for such patients.  Read it here online.

You want your loved one with Alzheimer's Disease or related dementias (ADRD) to be cared for at home by someone experienced in meeting their needs, right?  Someone trained specifically to care for those with dementia.  Of course!

But does experience really mean that home caregivers are offering the care that's truly right for people with such diseases?  All too often, the answer is: NO.  Caring for dementia patients is specialized and requires training for a set of skills all-too-often missing in the homecare setting.

Did you know that dementia-specific training is not included in home health aide or nursing assistant certifications? "While many home care aides have experience with dementia patients, few are actually adequately equipped to do so," said Deborah Bier, PhD, the director of Caring Companion Home Care's metrowest Boston, MA office located in Concord, MA. "As a result, many don't know or use the best, most proven approaches -- the very ones that dementia patients and their families most benefit from."  The result can be challenging behaviors difficult or even impossible to manage in the home setting. But proper training for homecare workers can help make the difference between patients being able to stay comfortably (and less expensively) at home or being institutionalized.

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