Signs of Alzheimer’s Disease

Drawing face of clock part of test for signs of alzheimers disease

How do I know if my Mom or Dad has signs of Alzheimer’s disease? Making the Decision to Seek Help

Did you know that 1 in 10 adults over the age of 65 will have Alzheimer’s disease? At the beginning the signs may be hard to discern. The early stages could be confused with simple signs of aging.

Quick reference for links mentioned in this article:

Mini Mental State Exam –

Science Alert Video on Phases of Alzheimer’s Disease and Effect on Brain –

Learn More About Alzheimer’s Disease –

Helping Hands ADS Program –


Understanding the Signs of Alzheimer’s Disease

Understanding how Alzheimer’s disease effects the brain is helpful for those that are daily trying to help a loved one make sense of the sometimes incomprehensible. Currently, there is no cure for Alzheimer’s disease but science is learning more and more about the causes and effects. However, armed with information, you do have the ability to maintain a higher quality of life for as long as possible during the progression of the disease.

At Helping Hands Respite Care our Adult Day Services (ADS) program can offer a level of consistency of care that can have a positive impact on not only the participant, but the loved ones bearing the brunt of the responsibilities of care. A regular schedule of stimulating activities and socialization, balanced nutrition, adequate hydration – all under a nurse’s supervision and well-trained care staff, can deliver positive results. Families report that their loved one comes home from the ADS program having experienced a stimulating day that results in a better appetite and better sleep —both beneficial for maintaining a quality of life.

Knowing when to seek care outside the home, or inside is so important. We recognize that all too often the direct family caregiver is reluctant to broach this subject with their loved one and will wait too long to get all of the benefits possible from a program like ADS. If you haven’t already, it may be time to ask your Doctor about an assessment or the Mini-mental exam. Being armed with information about the progression of Alzheimer’s disease will help. Here is a very short video that helps you understand the phases of the disease and how it acts on the brain. If you don’t watch the video right away, you can see our recap of the phases below the image. (Click on the image to watch 3 minute video)

Link to short video that demonstrates the signs of alzheimer's disease and the effect on the brain. picture of a brain.


Phases of Alzheimer’s Decline and how it affects the brain over average 8 to 10 years of the disease progression.
Here is a summary of the phases described in the video:

  • Ability to form new memories- short term,
  • Language processing- such as losing words,
  • Logical thought or ability to grasp concepts. Eg; clocks and calendars,
  • Emotions are heightened and sometimes difficult to control,
  • Senses are affected making it hard for brain to process. Eg; causing confusion or hallucinations,
  • Oldest and most precious memories are being lost,
  • Balance and coordination are affected,
  • Last stage the brain stops life functions like swallowing and breathing


Not every client who attends the ADS program has a diagnosis of Alzheimer’s disease. Some have other forms of dementia or are fighting other diseases such as Parkinson’s. Helping Hands Respite Care has been operating an Adult Day program for well over 30 years. We are proud of our history and continue to look to the future for ways to continue to improve.
If you are interested in learning more about the ADS program for a loved one, PLEASE feel free to reach out to Alison Sarkozy our program supervisor to set up a no obligation exploratory visit.

Repetitive Phone Calling as Dementia Behavior

Senior with dementia displaying repetitive phone calling as dementia behavior

Adult Day Services (ADS) Program Supervisor, Alison Sarkozy shares another great article on the challenges of repetitive phone calling as dementia behavior. This may be effecting some of our senior clients and family who are learning to cope with the ever-changing and disconcerting behaviors related to dementia.

Dementia Behaviors: Repetitive Phone Calling

By Ava M. Stinnett

Whether your loved one has been diagnosed with Alzheimer’s disease or another type of dementia, it’s important to know that confusion, memory loss, and difficulty performing everyday activities are common overlapping symptoms. A healthcare provider may use a simple three-phase model (mild/early, moderate/middle, and severe/late) to describe the progression of the disease. Although symptoms will vary for each person, learning more about how dementia unfolds over several years can guide you as you plan for a loved one’s care.

In the mild to moderate stage, symptoms may include loss of awareness of recent events, personality changes, confusion about surroundings, and repetition of particular actions or behaviors. For example, some people with dementia make phone calls to their loved ones over and over again—particularly in the middle of the night or early morning. This might occur because they forget that they have already called; it’s also possible that they’re feeling insecure, anxious, or even bored and need to be occupied. Still others with dementia call just to make sure someone answers the phone. Medical professionals sometimes call this act of going through the motions of familiar activities “perserveration” (Rosenzweig, 2017).

 On the Receiving End of Repetitive Phone Calling as Dementia Behavior

As a loved one on the receiving end of the phone calls, it can be frustrating or distressing—even more so when your elder calls your neighbors, other relatives, or even physicians when they don’t reach you after several unanswered calls. Additionally, the expense of long distance calls or overage of mobile phone minutes can become problematic. What steps can you take to alleviate this behavior?

First, talk with your loved one’s healthcare provider to determine whether medication needs to be adjusted or if another type of treatment for dementia is warranted. It might help to get a phone with a number recognition display so that you, other family members, and friends can decide whether or not to answer. Switching ringers off at night is another option. While you may feel guilty about not answering every call, it’s important to try to stop the repetitive calling—for you and for your loved one. Another option, depending on how far the disease has progressed, is to purchase a telephone that has no dial or buttons to place calls; the phone is for incoming calls only. In that case, however, you must first assess the situation to ensure that safety options are available in case of emergency.

If you can, create a pleasant diversion such as taking a walk, looking through a photo album, sorting and folding clothes, or listening to soothing music. Try to redirect by changing the focus from anxious behavior to a favorite pastime such as sanding wood, gardening, or providing a safe environment for cooking or baking. Once you can identify the emotion associated with the behavior (e.g., fear, anxiety, boredom, anger, loneliness), you can react to it instead of to the question or behavior. Taking time to express words of reassurance, understanding, and caring can do wonders to ease the challenges of being a caregiver.


Rosenzweig, A. (2017, May 26). Perseveration in Alzheimer’s and Other Dementia: Getting Stuck. Retrieved from

The Alzheimer’s Association. (2017). Repetition and Alzheimer’s. Retrieved from
The Care Support Services. (2012, January 8). Repetitive behaviors and the frustration they present to the dementia caregiver. Retrieved from

Reflections on Students as Caregivers

Adult in Home Supervisor Jeff Nunham interviewing a prospective student for a job as caregiver.

Is Caregiving a lower case job or a real JOB?

Taking a closer look at our caregiver population we are reflecting on students as caregivers.While we appreciate all of our caregiving staff, currently a large percentage of our caregivers are students who spend less than a year in service to our mission, it is interesting to weigh the benefits of a transient caregiver population. Because we are situated so close to Michigan State University, we find that there is a never-ending supply of students who find the work of caregiving to be a convenient job (note the lower case) which can work well around their class schedule. In the past year we have intentionally reached out to several of the colleges at MSU with the idea of cultivating more students in related fields of study such as Family Studies, Kinesiology, Social Work, and more. We search for those that are looking for a preview of sorts to their ultimate JOB.

Students as Caregivers – Lessons Learned

What we have learned is that it is important to value both those in search of a job or a JOB because the work that we offer can have personal significance in either case. “When I sit with prospective caregivers to discuss the feasibility and consequences of working for Helping Hands Respite Care, I am most mindful of the fact that these people that we are about to launch into our system have no idea of the tremendous impact they may have on the people they are about to serve,” shared Adult In-Home Supervisor Jeff Nunham. “I say to them: The person you serve and their disability will call you up to a larger capacity to help. There is a reciprocal relationship that evolves out of this service. You will experience moments of excruciating truth when the person you are serving will become a mirror to reveal your true self.”

There are some drawbacks to students as caregivers. By definition most are transient, and some even between semesters may be heading home to families in distant cities. We recognize this challenge and are searching for ways to mitigate the absences which might occur between semesters or the conflicts with major university life events such as the “big game” or exam periods.

Nunham frequently reports on the transformative nature of the caregiver work at Helping Hands Respite Care. Many students will come to this work as a means to an end ….a lower case job with hours flexibility that makes room for pursuing and/or completing chosen areas of study – not always within the human services field. “Some of my best days are the ones when I find that a caregiver is making a dramatic change in the course of the educational career path, all because of the things they have learned about themselves while being in service to a family in need of care. Now it is a real JOB!”
Aside from fulfilling our mission to provide quality respite care for families in need, one of the benefits we receive at Helping Hands Respite Care is knowing that we are providing an opportunity for meaningful and sometimes life-changing work for young people in our community.

Volunteer of the Year – Loretta Keaner

At a recent meeting of the Helping Hands Respite Care, our Volunteer of the Year, Loretta Keaner was acknowledged. Loretta started working as a volunteer in January of 2016. Her service to Helping Hands Respite Care has included a weekly commitment to the Adult Day Services program, a monthly commitment to Kate’s Memory Café, and some assistance with our annual family picnic and hosting of The Ability Experience riders from Pi Kappa Phi.

Volunteer of the Year, Loretta, serves the Adult Day Services Program

Alison Sarkozy describes Loretta as a true asset to the Adult Day program. “She is a real go-getter, she always tell it like it is and is not afraid to put our caregiver staff in their place, “shared Alison. “ And, I love it! Anything you ask her to do she will jump right in without hesitation. Loretta is always there for our member/participants providing encouragement and support, and also being a non-judgmental sounding board if the member is working through a tough moment.”

Volunteer of the Year Supports Kate’s Memory Cafe

Volunteer of the Year, Loretta Keaner helping out at Kate's Memory Cafe with some balloon volleyball.Katie Donovan spoke of Loretta as her right-hand at making the Memory Café a success. “If there is some lively musical entertainment Loretta will jump up and encourage our visitors to clap along or even dance,” said Katie. “At our last Memory Café we had a mother/daughter duo as entertainment. They spontaneously decided to sing the famous song “My Prayer” ….everyone was transfixed and moved by the beautiful rendition of the song. I am so glad I caught Loretta in the background of the video of the ladies singing ….at one point Loretta slipped into the kitchen to grab a Kleenex to wipe her tears away. That moment of vulnerability just warmed my heart.” Loretta has also provides a very personal gift of service to my Mom at the Memory Café. While Mom attends as my partner in care, she doesn’t see herself as needing any help or support. Loretta treats Mom as a co-volunteer and always make her feel needed and useful. As Mom continues to decline in her own journey with dementia, these moments of competence supplied by Loretta mean so much to me – she can offer Mom something that I simply can’t give as her caregiver and daughter – a simple acknowledgment as a friend.”

Volunteer of the Year Pitches in at Annual Family Picnic

The Annual Family Picnic and Welcoming Event for the 37 plus fraternity brothers from across the nation is an opportunity for more service from Loretta. Putting on the picnic event is a big effort and every volunteer makes it that much easier to give up a Sunday afternoon in July for this event.

We are so thankful that Loretta so generously shares her time and talent.
It was an easy choice to single out Loretta Keaner as our 2017 Volunteer of the Year!

MSU Grant Focus on Caregivers 

MSU logo represents MSU grant focus on caregivers


For the past six months Executive Director, John Stauffer, has been serving as a contributor to an MSU Grant Focus on Caregivers, an important alliance for Helping Hands Respite Care. Called the IMPART Alliance, the group was formed to provide critical and anecdotal information for a $500,000 MSU Research Grant process targeting “personal care attendants, or PCAs,” in our vernacular – caregivers. The grant came from the Michigan Health Endowment Fund in the category of Special Projects and Emerging Ideas Grants. Written by MSU professor Clare Luz in the Department of Family Medicine, the grant outlines a program called Integrated Model for Personal Assistant Research Training (IMPART).Clare Luz, author of MSU Grant Focus on Caregivers

Focus of  MSU Grant About Funding for Training and Service

Major topics being explored through this grant include:
– Creative Ways to Finance PCA Training and Workforce Development
– Exploring Diverse Sources of Funds to Pay for Training and Service for PCAs


Background for this initiative began 6 to 7 years ago with a federal grant that was offered in several states to focus on standardized training for PCAs. The acronym for the program was BTBQ which stood for Better Training, Better Quality. Contrary to most of the participating states in this program, in Michigan the BTBQ training never made it to the implementation phase before the funding ran out.
In Michigan, the reason for the evaporation of funding is because unlike the other participating states, Michigan is a state which does not license many of the care facilities/organizations and as such has no uniform training standards across the state.

In this generation of focus on the training, the IMPART alliance proposes going back to the other states to gather lessons learned from their implementation strategies to inform the research goals going forward in Michigan.

Across the country there is a consensus that there is no way forward in an environment where PCAs being paid at minimum wage creates an effective response for the ever-growing need for Personal Care Attendants. As the Executive Director of a program widely recognized as providing top-shelf training, John Stauffer’s role in the committee is to be a strong voice for the methods of training which are relevant to the target audience and appropriately reflects the reality of training for a new generation of caregivers which includes more and more college-age caregivers.

Legislators Recognize Value of Respite with Action – Consult with IMPART Committee of MSU Grant Focus on Caregivers

The IMPART alliance includes a sub-committee, which John Stauffer also serves on, which is focused on future implementation and needed wage increases across the board. And, currently this sub-committee includes several members who were responsible for input on some new state legislation targeted at immediately raising wages for PCA’s. The conversation began with legislators and lobbyists proposing a $2 an hour wage increase for these care attendants. The proposal was ultimately reduced to $.50 an hour, for budget reasons, and specifically targeted to those providing care for Michigan Community Mental Health (CMH) programs supporting respite care for families with members needing care due to cognitive/physical disabilities.

State Legislation Passed Will Positively Impact Some PCA/Caregivers

The $.50 increase for PCA’s caring for individuals supported by CMH went into effect October 1st. At Helping Hands Respite Care approximately 45% of those we care for draw some funds from CMH. Because Helping Hands Respite Care has a broad mission of caring for individuals from the very young to the oldest, the remainder of our programs may draw funds from Tri-County Office on Aging for our senior programs, the Veteran’s Administration and their benefits for respite care for spouses of those who have been in-service to our nation, and finally families privately paying or using long-term care insurance policies. “The diversity of our service and programs means that there will be some caregivers/PCA’s who will not see an increase in their pay,” commented Stauffer.

Minimum Wage Increase Coming January 2018

“However, there has been preparation for addressing a broader increase across more of our care staff with the coming of a $.35 increase in minimum wage in Michigan beginning January 1st. Current care staff should watch for a letter which outlines how these two increases – the CMH wage increase and the minimum wage increase will be reflected in their paychecks. It should be noted that the language of the CMH wage increase provides the $.50 per hour increase to go both to the direct care agency and the care providers. At Helping Hands Respite Care we prioritize the well-being of the families we serve by making sure that all of the increased funds go directly to caregivers,” concluded Stauffer.