Father in temporary respite care: advice needed

LegacyUser

Hi all,
I would really appreciate your advice on this as I'm struggling to find a better solution.

My father has pretty advanced stage dementia. He can understand a lot of what is said to him and takes things in still, but can't respond or communicate properly anymore and only some sentences he says make sense. He has no problems eating and has kept relatively upbeat considering what he has had to go through. We had him at home for as long as possible but when he became increasingly aggressive- and physically- we had to get him respite care.

He is currently in an excellent respite unit that is run by the HSE. It has a small number of dementia and alzheimers patients and they look after them very well- particularly medically speaking and food wise. They have lovely nurses and carers and a great overall manager and doctors call each day as it is part of a hospital.

Sadly there is just very little stimulation for him there and they don't do much by way of activities. I fear my father may get depressed and go down in health. He has been there for just a couple of weeks and is due to stay there for about 2 months until the nursing home we have chosen has a bed available.

Is 2 months going to be detrimental to his long term health if he stays where he is currently? We are reluctant to move him to another nursing home only to have to move him again and as it is, in our area, the nursing homes that do have beds available, are not much better than the respite centre he is in. They do a few more activities but he prob wouldn't get the same level of medical care.

Any advice please would be welcome.

freshpopcorn

Can ye go and visit him and have friends drop into him?
I know our local hospital( respite/elderly patients) the staff used do there best to have bingo/exercises/art for the patients every so often.
You also could bring your relative away for the day if you wanted.

ringthebells

I just wanted to say that I really empathise with your problem. It isn't easy to find somewhere that ticks all the boxes concerning safety, care, food, and finance when it comes to dementia care.

I think that it is quite hard to tell whether or not 2 months will be detrimental on a long-term basis. Persons who enter long-term care often see a sharp deterioration in their ability to perform activities of daily living, etc, but this is typically seen more keenly in the mild or moderate stages of the disease. Because your father's dementia is already quite advanced you may not see the same sharp downturn and so 2 months may not be too bad, especially when he is going into a more suited care setting at the end of it.

You say you fear he may get depressed but you don't mention his current mental state. He's been in the respite unit for 2 weeks now - how does he seem to be getting on there? How is his mood? You could always ask the care staff how he's settling in.

Participation in activities is really important for people with dementia but sadly many units are understaffed and cannot dedicate as much time to this as is ideal. Can you (and other family members) visit a few times a week to go through some old photo albums, do some art, listen to some music together? These should help in the absence of regularly scheduled activities. If you can leave him a 'care package' of photo albums, magazines, etc that he enjoys then that could help too, and also provide some talking points for chats between him and the care staff.

2 months isn't too long and it sounds like you and your family are doing all you can to help make the transition as smooth as possible. Best of luck with it.

LegacyUser

Thanks for the replies everyone.

He is getting on okay there so far in terms of mood. We are all visiting him often. Last week he had a visitor every day, this week he will have someone about 3 times.. it will vary.

A problem is that there seems to be 'in-fighting' going on between the patients. When I visited him recently, one elderly man there winked at me about my father, saying 'that man is complaining' and my father said to me 'he's only a XXXX, I'm sorry I spent so much time on him'. Then another time I saw an elderly woman patient trying to take a personal wool blanket off another patient and it took that same elderly man to break it up! It is pretty sad place.

The patients just seem to be all unhappy there. I remarked to my father and another patient there that it was very 'homely' (we are always positive of course) and the man replied 'it's clean anyway'.

My father is still quite with it in ways. It must be hard for him to adapt. He had a week there before Christmas after an incident of aggression and when I told him he had to go back to monitor the medication he started to cry.

There is nowhere suitable for him. Not enough is being done in nursing homes or these places as regards activities and that is really, really important for their mental health.

Semele

I used to work in activity provision in care homes, and something really helpful that the family could do is bring in photos of family and of your dad when he was younger, or any items related to his interests/past occupations (military badges, any medals or awards he might have got, travel souvenirs etc). If the home will allow it then stick up the pictures rather than having them put away in an album (maybe make a collage on a cork board if you're not allowed to stick things on the walls). If there are any CDs or films he likes then bring them in, and don't be afraid to stick a polite note on them asking staff to pop them on occasionally.

All of these things will help the care staff know your father as a fully rounded person, rather than just in his current role as just their patient, and will provide starting points for conversation/questions. The more you can give them the more they have to work with, even just in terms of making chat during care tasks more personal and enjoyable. If the home is as good as you say then you're lucky to have found it, so I'd look at what you could do both in terms of these ideas and your own visits before I'd look at moving your dad. All the best!

Goldenlady

Hi OP,
I can completely empathise with you. My mom is in a nursing home for last 14 years. My personal opinion is that its best to leave your dad there until the permanent home is available. it might upset him too much to move again.
In terms of patients fighting, I have seen it all through the years, it just seems to be part of a home that caters for people with dementia. I have had cushions thrown at me, blankets, slaps etc but its just part of it Im afraid. The staff will try prevent this as much as possible.
I believe you are probably feeling a little "guilty" at the moment, its so hard seeing your parent in a home ( I was only 19 when my mom went it & it still hurts me each time I leave the home, 14 years later!)
In terms of activities, I would suggest seeing if there are any volunteers in the area that would come and visit and do activities? If the nursing home allows this. Each place is different. There are groups too that sometimes bring patients out for the day to pass the time away - again my moms condition is different so I don't know too much about dementia.
Sorry I don't have too much to offer, but I hope it all works out x

Maura74

syltprojekt wrote: »

Hi all,
I would really appreciate your advice on this as I'm struggling to find a better solution.

My father has pretty advanced stage dementia. He can understand a lot of what is said to him and takes things in still, but can't respond or communicate properly anymore and only some sentences he says make sense. He has no problems eating and has kept relatively upbeat considering what he has had to go through. We had him at home for as long as possible but when he became increasingly aggressive- and physically- we had to get him respite care.

He is currently in an excellent respite unit that is run by the HSE. It has a small number of dementia and alzheimers patients and they look after them very well- particularly medically speaking and food wise. They have lovely nurses and carers and a great overall manager and doctors call each day as it is part of a hospital.

Sadly there is just very little stimulation for him there and they don't do much by way of activities. I fear my father may get depressed and go down in health. He has been there for just a couple of weeks and is due to stay there for about 2 months until the nursing home we have chosen has a bed available.

Is 2 months going to be detrimental to his long term health if he stays where he is currently? We are reluctant to move him to another nursing home only to have to move him again and as it is, in our area, the nursing homes that do have beds available, are not much better than the respite centre he is in. They do a few more activities but he prob wouldn't get the same level of medical care.

Any advice please would be welcome.

This is the big problem with care home there is no or very little secure outside space for residents and are locked in 24/7, it is also the same in the UK and I have spoken to people from the US that worked in a care home and he knew immediately what I was referring to greedy care home owners.

I have visited a lot of care homes and private ones that charge the earth £1000 a week is not uncommon and they provide little or no activities.

Also what I have seen recently that the residents are soon in wheelchairs as it makes it easier for the home to look after no wonder around the home.

I have seen elderly people been fed by carers and there was no interaction whatsoever with the elderly residents that they were feeding like a child. The carers were talking over them about their nights out.

I have not seen any physically abuse there but was told it has taken place and wrote to the nursing home asking if that happen there but was told that their cares are all vetting before they are employed. To me that means nothing as they probably have not been found out, also the guards can only vet people for the time they have been in Ireland they do not what they done in their own country.

I should mentioned that the carers are not doing anything wrong as they are feeding the people but they were not treating them like adults. This was before Christmas and the people were been wheeled around like they were not humans.

The best thing you can do is make sure that there is enough carers to give your father enough exercises and make impromptu visits both morning and afternoon and stay there all day long that way you will get a good idea how the home operates. Also make sure that you dad has got nothing wrong with him physically as that can be over looked by the home and of course your dad will not tell them the nurse that he maybe suffering from pains etc. And also keep asking if he has had any exercise and asked other residents as that is where I got most information that my relative fell but the home made light of that of course.

When the carers are busy and some of them do not know the resident condition ie they condition is short term memory loss. The carers will go around and tell the resident that activities is taking place in the day-room but of course the resident needs to be taken into that room as they will forget what they have been told and if they are not taken into exercise then they get none.

Please stay with your dad as much as you can as the home will show you how much they are doing when you are there for an hour or so, but when you leave they will get on with their routine work as they got to do that as well. The carers work hard and are doing nothing wrong, but you do not what happens when you are not there especially at night time.

I have actually phone the care home on a summer evening and was told that my relative was in bed at 6pm as the 'little ones' gets tired and are put to bed. Grrrrrrr

Also check the medication that you dad is on and then research the medication on the internet.
I know what I will be doing when my time comes, I will do exactly what Terry Pratchett will be doing.

Maura74

Semele wrote: »

I used to work in activity provision in care homes, and something really helpful that the family could do is bring in photos of family and of your dad when he was younger, or any items related to his interests/past occupations (military badges, any medals or awards he might have got, travel souvenirs etc). If the home will allow it then stick up the pictures rather than having them put away in an album (maybe make a collage on a cork board if you're not allowed to stick things on the walls). If there are any CDs or films he likes then bring them in, and don't be afraid to stick a polite note on them asking staff to pop them on occasionally.

All of these things will help the care staff know your father as a fully rounded person, rather than just in his current role as just their patient, and will provide starting points for conversation/questions. The more you can give them the more they have to work with, even just in terms of making chat during care tasks more personal and enjoyable. If the home is as good as you say then you're lucky to have found it, so I'd look at what you could do both in terms of these ideas and your own visits before I'd look at moving your dad. All the best!

Also put a large photo up on the wall one when he was young as that will remind the staff that you dad was a real person with a life before he became ill.

LegacyUser

I've been through this with my mother who also had dementia. After experiencing a few different homes, my advice to you is to leave your father where he is. If the lack of stimulation is your biggest concern then you're laughing. When you put a loved one with dementia into care, their physical care is a big worry. In one home my mum was in briefly, we had to kick up a fuss over their slowness to change her nappy and wash her. Only they knew we were there breathing down their necks god knows what other corners they might've cut.

In terms of stimulation what are you expecting from a home? Your father's never going to receive the 1:1 attention he got at home. Is a man with a guitar in the day room playing oldies or bingo really going to make a big difference? Budgets are being cut and even if the staff work with the patients, there's still work to be done. With your father being in a new environment the best people to try and keep his spirits up are his own family.

Very few people want to go into a nursing home. Especially if they've got dementia and don't understand what's happening. Even if that home in the bed became available now and your father moved into it today, you'd still be encountering the same problems. It takes a while for people to settle into homes. Some people go down when they go into these homes so that's the biggest issue I foresee for you.

Maura74

People think this condition is only related to old age, but in fact, it can happen to anyone the guy in the link is only 57 and that is not supposed to be old. People are supposed to be living longer nowadays.

http://www.bbc.co.uk/news/health-25329442

I feel the problem is that society are genotophobia and hopefuls that will change in due course.

I agree it is a dreadful condition and needs more funding from the government and also care home should have more on the spot inspections.

Governments are not in a hurry to find what causes this condition becasue care homes have become a big industry also creating employment for local people also the economy is not equip for lots of people to live beyond a certain age.

ringthebells

963258711245 wrote: »

In terms of stimulation what are you expecting from a home? Your father's never going to receive the 1:1 attention he got at home. Is a man with a guitar in the day room playing oldies or bingo really going to make a big difference?

Just my two cents - although I agree that physical care and safety is absolutely of the utmost importance when choosing care, activities such as listening to music, reminiscing, games, gardening, socialisation with others and generally being in a stimulating environment have been shown to help persons with dementia to express emotions and aid in retaining and even replenishing cognitive abilities. I think a lack of stimulation is a pretty worthwhile thing to worry about, especially since OP seems to be quite happy with the physical care and safety of his/her father. I do agree that it's probably best to leave the father where he is for the time being and instead try to visit as much as possible.

LegacyUser

I agree with you to a certain extent but I've yet to encounter a home which offers these things to any great extent. The best one I met (which is a HSE one) brings in people to do sessions with the residents but that's getting cut back because of the budgetary constraints. The OP's saying the other home isn't much better anyway so I think they should leave the father where he is. Visit often and do stimulating things with their father is the best option for now.

LegacyUser

Thanks everyone.

I think you're right and we're going to leave him where he is. They have really excellent nurses and carers there, a fantastic manager, and we know he is getting the best of care there.

Regards the lack of activities, which was my only concern here, as I thought that it might leave him to be more down over time, etc. I have to accept that it isn't available there.

Photos are a good idea, and we did that even at home, putting up pictures from when he was younger for himself, etc, showing him old pics, etc. but even though he didn't respond too much to pictures then he may do now that he is away from home and as it has been said here, it would be good for the carers to see them too- particularly in the new home.

Horrible seeing the state of things in Ireland. I really don't want that to be the case, and the centre he is in now is excellent, as were carers, and others, but in the main, looking back on the history of things as the condition developed, there were just so many unnecessary problems and so much added worry that should not be there. And this is with everyone doing their maximum to look after things.

I feel like Ireland is still like a third world country in some regards. I wouldn't wish dementia on anyone.

Thanks everyone for the replies. It was really helpful to get perspective on this and wish you all the best yourselves.

Maura74

This is one of many abuses that thankfully has been exposed and why relative family should keep up visiting love ones in care homes.

Why are these kind of people employed to look after vulnerable people by care home owners is beyond me. :mad: Why are people so uncivilized. :mad:

http://www.mirror.co.uk/news/uk-news/hillcroft-nursing-home-abuse-care-3009455

OP leave your dad in the respite unit as you are happy with how it is run by HSE.

Big Bag of Chips

Warning issued to Maura74 for Breach of Forum Charter. Most of your posts on this thread fall into the "discussion" rather than "advice" category.

Posters are reminded that Personal Issues is an advice forum. Engaging in general discussion or posting links to various news articles does not actually offer any advice to the OP, and could encourage other posters to get dragged into off-topic discussion, which also would not be helpful to any poster who comes here looking for advice on their own personal issue.

Ham Sambo

The one good thing that you and you family can get from this right now is that your Dad appears to be quite happy in his own world at the moment, however the nursing home are obliged to provide some sort of stimulus for the residents in their care, perhaps you should have a chat with the director of nursing who is in charge of your Dads nursing home. Best of luck.

LegacyUser

OP I have worked as staff in a (new) nursing home recently in a dementia ward. The staff were so good, tons of medical and nursing care, there wasn't a mark on any of the clients bodies even though they were all incontinent, naturally. They all had skn as good as my own. In fact they were all putting on weight cos of the big dinners!

The staff all were very fond of the patients, and even though I was only there a few weeks I started getting very attached to people myself, its impossible not to. Maybe its the "Irish Nurse" thing, but you do tend to see your Mammy/Daddy in everyone you take care of.

The door was locked - if not the clients would say "I'll be off home now so" and trot off onto the main road. And it has to be said there was little to do. There was a day centre in the home which was brilliant, but it was not for people with dementia - it was for residents in other wings who were more with it.

HIQA came and were pissed off at the lack of activities - we would put on the TV or radio mainly. For example there was a lady who was completely unresponsive. She used to be an opera singer so we would always have Lyric on for her. But after a certain point of dementia you wonder what activities would really be suitable. In early dementia maybe things like simple jigsaws and things would be absorbing, but company seems to be the best thing.

Also remember that its not a nurses/care assistants job to do activities. I'm a nurse and wouldn't have a clue! (Not to mention wouldn't have time!) I have ZERO training in stimulating dementia patients mentally. They have to bring in someone to do it. Occupational therapists and the like. I think there wasn't much budget for Occ Health in the home, and thats why it didn't happen much. Same thing with Physio, for example. Only in hospitals would you get Physio every day/every second day.

LegacyUser

Hi OP.

Really empathise with your situation at the moment. Your dad having dementia mutual be difficult to deal with without having to worry about other issues.

The best advice I could offer would to be to contact your local primary care social work team who can assist and advise you about long term care off your dad.

Maura74

syltprojekt wrote: »

Hi all,
I would really appreciate your advice on this as I'm struggling to find a better solution.

My father has pretty advanced stage dementia. He can understand a lot of what is said to him and takes things in still, but can't respond or communicate properly anymore and only some sentences he says make sense. He has no problems eating and has kept relatively upbeat considering what he has had to go through. We had him at home for as long as possible but when he became increasingly aggressive- and physically- we had to get him respite care.

OP light is very therapeutic for people with this condition.

http://www.best-alzheimers-products.com/light-therapy-for-alzheimers.html

Having this treatment would probably be less expensive for HSE and I feel more beneficial for your dad as some drugs for aggression are very strong and indeed some are now are classed not appropriate for elderly people on the manufactures instructions. Please see website for Alzheimer’s it is a very good site with lots of information also you can register and interact with others and it has load of useful advice regarding how others are coping with this dreadful condition. I have looked at the Irish Alzheimer’s website it also has a lots of useful information on it as well but I could not find a talking point facility on it.
http://forum.alzheimers.org.uk/blog.php

http://www.alzheimer.ie/Living-with-dementia/I-am-a-carer.aspx

He is currently in an excellent respite unit that is run by the HSE. It has a small number of dementia and alzheimers patients and they look after them very well- particularly medically speaking and food wise. They have lovely nurses and carers and a great overall manager and doctors call each day as it is part of a hospital.

OP your dad is lucky that he has got you to look out for him. You know him more than anyone else. A lot of elderly people are wards of court and if the relative with that piece of paper from the court has not got the best interest for their love ones care that the court has given s/he control over that can sometimes be disaster for that person.

One care home that I have been in Ireland, I unfortunately had a love one moved from that care home with the help of local TD and you would not believe how difficult that was even with the help of Mary Harney T.D., then Minister for Health and Children at that time. After lengthy correspondence HSE confirmed that that I highlighted issues that needed to change in that very expensive home and this was brought to the attention care home manager. Therefore it’s up to you to see things that are not correct for your dad otherwise how they will know what they are doing and or the environment is not beneficial for him. Your dad will be more incline to tell you, or you will see what is not conducive for him, as you know him more than any of the carers when he first arrive at a different place to reside in.

These homes are usually situation outside cities, towns and villages therefore lots of fields around them surely it would not be too much of a problem to incorporate an acre or two around the contiguous area of the home to make ‘secure areas’ (gardens) for residents and staff. It cannot be good for mobile residents to be locked in continuously. Surely resident needs sun for vitamin ‘D’ and able to wander around in ‘secure outside areas’.

I would be wonderful if care institutions (I am reluctant to call them homes as they are no way near the home the love one left and worse still when care is lacking also) to have this facilities it the link below for residents and staff alike this would be wonderful as happy employees make it much better for residents that are looking after residents. Also I feel it is better than physio for elderly people and may be less expensive for HSE.

http://www.woking-homes.co.uk/accommodation-and-facilities.aspx?ID=22

I feel with some others posters where dad is now is better where he is as in my opinion private institution are run for profit and in my opinion care should not run for profit but others may disagree.

Sadly there is just very little stimulation for him there and they don't do much by way of activities. I fear my father may get depressed and go down in health. He has been there for just a couple of weeks and is due to stay there for about 2 months until the nursing home we have chosen has a bed available.

Is 2 months going to be detrimental to his long term health if he stays where he is currently? We are reluctant to move him to another nursing home only to have to move him again and as it is, in our area, the nursing homes that do have beds available, are not much better than the respite centre he is in. They do a few more activities but he prob wouldn't get the same level of medical care.

Any advice please would be welcome.

Unfortunately stimulation is an ongoing problem for a lots of care institutions and I feel that should not be case. Care institution (especially private ones should employ someone for that purpose alone).

Have a look at the report OP from hiqu and see what they have picked up when inspection are these places.

http://www.hiqa.ie/social-care/find-a-centre/inspection-reports?field_report_type_centre_value_many_to_one=reportolderpeoples

Hope the above makes sense for you.

LegacyUser

In the earlier stages of my mother's dementia I used to try so many things to try and stop her from slipping away from me. Now I just laugh bitterly at some of them and wonder what on earth was I smoking. That is why I asked the question of what it was you wanted in my first post. It is true that in the early stages of dementia doing thing with sufferers helps. Sadly that phase passes and the families of sufferers are slower to notice this. There comes a stage where enjoyable activities become the equivalent of deciphering quantum physics. When a sufferer gets to the stage where they need full-time care, they are quite often at the stage where they're "happy" to just sit there in their own worlds. My mother was very advanced by the time she went into the home so this happened to her under her own roof.

Your father's dementia may be at the stage where he doesn't need as much stimulation as you think. Your comment about the photographs reminds me of myself and my delusion. Photos stimulate regular people. They don't stimulate dementia sufferers. They think differently.

The HSE home where my mother is living brings in outsiders to do activities with the residents. I sat in on one of them and came away thinking that it was probably a waste of money. Very few of the residents got anything out of it at all. The person who worked in a dementia ward explained it very clearly and I found myself nodding in agreement. A few years ago I would've been horrified but now that I have seen it with my own two eyes I understand. Don't underestimate the hit that HSE budgets have taken because of the cutbacks. Perhaps the unit did have people come in to do activities with the patients but that had to go when they were revising their figures.

That is why I believe you are lucky to have your father in the unit he is in. He is getting the best of care and he may not need as much stimulation as you believe he needs. Go visit him and tell him all the gossip. That will do far more for him than anything anyone can organise for him in the unit.

Maura74

OP, stimulation I feel is very important for your dad, maybe not board’s games as he would need someone with him to help, but certainly music is known to have an effect on the brain and does not need anyone to be with him for that stimulation. http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=760

Also no one knows what cause the condition and apparently there are 100 different diseases that can cause it. Therefore no one knows what memories people have left or that they can understand what going on around them.

Go and be with your dad as often as possible as that is the best therapy for him. He will obviously be distress if he has to go into a new home and who would not be in his circumstances. Imagine a well person been put into a home with lots of strangers with different condition all lumped in together and staff are busy doing their tasks and have not much time for you that would be stressful for anyone let alone a very sick person.
Also stress exacerbate conditions and indeed stress does that to a well person never mind a person a very sick person with this condition. I also feel that it depends on the person personality with this condition as well as the challenges they had in life and how it affect them. Photos are good also as it can be enjoyable for both of you go through them together.

I agree with other poster residents in care home get a raw deal for what they are charged, but hopefully if relatives makes complaints to government for funding and also make sure your loves one is not been-over looked in the care home is the way to go.

amtc

My nana has advanced vascular dementia - she is 88. Is cared for at home by my aunt.

I recently spent some time with them, and was struck by something. Everything from am to pm was asking her was she ok (they have carers every day or showers etc. in Aus, not here)...but I said to my aunt that the level o pressure asking her every five minutes was she ok would be too much attention for me, She also calls out all night, but I sat up one night (within hearing) an when no-one answered she got herself up for the bathroom. Doctor said it was kind of like 'controlled crying' for a baby. My nana once said 'i I scream until I make myself sick will you come..'

Not easy, I just hope I never get there.

LegacyUser

Ham Sambo wrote: »

The one good thing that you and you family can get from this right now is that your Dad appears to be quite happy in his own world at the moment, however the nursing home are obliged to provide some sort of stimulus for the residents in their care, perhaps you should have a chat with the director of nursing who is in charge of your Dads nursing home. Best of luck.

Thanks Ham Sambo,

He is currently in a unit which is part of a hospital- he is going to be there until the nursing home we have found for him have a bed available. The stimulus that they have in the unit at the moment seems to be just the tv and prayer times. And the prayer times are so damn depressing. I don't even want to think about them.

The nursing home we have chosen for him have a specific dementia unit and they said they do activities appropriate for people with dementia. Things like hand massage and sonas therapy.

There was a home that I visited that had received great HIQA reports but on visiting I wouldn't trust them. The owner seemed fake, and most of the residents were in bed. Didn't see many nurses on the ground either. You really do need to do a lot of research at every single point.

Maura74

amtc wrote: »

My nana has advanced vascular dementia - she is 88. Is cared for at home by my aunt.

I recently spent some time with them, and was struck by something. Everything from am to pm was asking her was she ok (they have carers every day or showers etc. in Aus, not here)...but I said to my aunt that the level o pressure asking her every five minutes was she ok would be too much attention for me, She also calls out all night, but I sat up one night (within hearing) an when no-one answered she got herself up for the bathroom. Doctor said it was kind of like 'controlled crying' for a baby. My nana once said 'i I scream until I make myself sick will you come..'

Not easy, I just hope I never get there.

amtc, your nana may have been suffering from what is describe in the link below.

http://www.webmd.com/alzheimers/managing-care-13/manage-sundowning

Regarding your nana ablutions, I also have found this a problem in care homes when the person with the condition as no one to look-out for s/he.
Also, teeth hygiene is a big problem, apparently which also can bring on Alzheimer as researchers are now finding. Dental treatment is very expensive and maybe that is causing such a lot of mental problems.

http://www.medicalnewstoday.com/articles/264164.php

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=138