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Caring for older adults with dementia is stressful, especially when they become physically or verbally aggressive, wander away from home, develop paranoia or hallucinations, engage in inappropriate or repetitive behaviors, or refuse to let caregivers help them.

This story also ran on The Washington Post. It can be republished for free.

Upward of 95% of patients experience these neuropsychiatric symptoms of dementia, which tend to fluctuate over time and vary in intensity. Theyre the primary reasons people with dementia end up in assisted living facilities or nursing homes. At some point, families and friends trying to help at home simply cant manage.

When people think about dementia, they usually think about forgetfulness and memory impairment, said Mary Blazek, director of the geriatric psychiatry clinic at the University of Michigan. But its behavioral and psychological disturbances that are most disruptive to patients and caregivers lives. About ‘Navigating Aging’

Navigating Agingfocuses on medical issues and advice associated with aging and end-of-life care, helping Americas 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment,click here.Read More Columns

Now, help is available from a first-of-its-kind website created by prominent experts in this field. It offers free training in a comprehensive approach to managing neuropsychiatric symptoms of dementia a method known as DICE based on several decades of scientific research as well as extensive clinical practice.

The websites goal is to give people tools to better manage often-distressing situations, said Helen Kales, chair of the Department of Psychiatry and Behavioral Sciences at UC Davis Health in Sacramento, California, and one of DICEs creators. Users learn that neuropsychiatric symptoms are caused by changes in the brain that increase peoples vulnerability. Nine video modules and two simulations provide comprehensive information and problem-solving techniques.

More than 16 million unpaid caregivers primarily family members and friends help people with dementia live at home. (An estimated 20% of patients live in institutional settings.) The most common form of dementia, Alzheimers disease, affects nearly 7 million Americans 65 and older.

DICE is also designed to help avoid the knee-jerk prescribing of psychoactive medications that have potentially serious side effects, Kales said. Several medical organizations recommend that non-pharmaceutical approaches to troublesome behaviors be tried before drug therapy, but, in practice, this doesnt routinely happen. Email Sign-Up

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Drugs prescribed for dementia include antipsychotic medications, such as Risperidone, which carry a black-box warning noting an increased risk of sooner-than-expected death in elderly patients; anticonvulsants, such as gabapentin, for which use has been on the rise despite concerns about safety; benzodiazepines, such as Ativan, which are associated with an increased risk of falls and, thus, fractures; and Celexa and other such antidepressants that have limited data supporting their effectiveness in easing dementia symptoms.

DICE is a mnemonic a pattern of letters meant to serve as a memory aid that stands for Describe, Investigate, Create, and Evaluate, the four pillars of this approach. At its core is an assumption people with dementia engage in disturbing behaviors for often-unrecognized reasons that can be addressed once they are understood.

Take an example on the website featuring Jennifer, a 55-year-old caregiver for her mother, Betty, 85, whom she tries to bathe daily in the late afternoon. When Betty resists getting into the tub, Jennifer insists, Lets go! I have things to do. Betty responds by smacking her and shouting, Leave me alone. It hurts.

DICE asks caregivers to step back from the heat of the moment and examine issues from three perspectives: the person with dementia, the caregiver, and the environment. All can contribute to distressing situations and all need to be considered in fashioning a response.

Examining the problem by using a who, what, when, how, why prompt can reveal several potential issues: The patient. Betty has arthritis and may experience pain getting in and out of the tub. She may feel tired and overwhelmed in the late afternoon. The caregiver. Jennifer may become easily frustrated when she encounters resistance adopting a scolding and commanding tone rather than breaking down what Betty needs to do in simple steps. The environment. The bathroom tends to be cold, with overly bright lights, tepid bathwater, and no grab bars around the tub.

Some possible solutions discussed on the website: Offer Betty an over-the-counter pain reliever before her bath. Try baths in the morning, not the afternoon. Relax expectations that shell have a daily bath and offer sponge baths several times a week. Install grab bars around the tub, and make sure the water temperature is comfortable. Use a nicely scented soap and play music to help Betty relax. Speak calmly, making simple statements.

These embody strategies shown to improve neuropsychiatric symptoms associated with dementia: recognizing and addressing underlying medical issues such as pain, infections, or delirium; simplifying the tasks a person with dementia is expected to perform; and establishing daily routines that give structure to the day.

Other important steps: Engage the person in activities that are meaningful to them, including social interactions. Reduce clutter and the potential for overstimulation in the environment. Make sure the person is using hearing or vision aids, if needed. Get them outside and exposed to light.

If safety, psychosis, or major depression are urgent concerns, then consider using psychoactive medications after consulting a physician.

Of course, this isnt a comprehensive list of recommendations. Nor is it prescriptive. What works for one person with dementia may not work for another.

Using DICE is an iterative process that involves creativity and frequent evaluation to assess whether strategies are working, Kales said. If not, new interventions should be tried.

Although this is the first time family caregivers can access the DICE toolkit, the program has been available to health care professionals for a while. Notably, all of Wisconsins dementia care specialists have been trained in DICE over the past few years (every county in that state has a specialist who helps families with dementia).

Its a really pragmatic approach thats put together in a very thoughtful fashion, said Art Walaszek, a professor of psychiatry and medicine at the University of Wisconsin School of Medicine and Public Health whos been involved in that effort.

Other dementia training programs are available, some of which review behavioral and psychiatric symptoms in less depth, and they, too, are increasingly available online. Another valuable resource, Best Programs for Caregiving, launched in March, lists evidence-based programs across the country and their availability. Enter a ZIP code to find information that previously hasnt been assembled in one place. This site, too, is very much worth consulting.

Were eager to hear from readers about questions youd like answered, problems youve been having with your care, and advice you need in dealing with the health care system. Visitkffhealthnews.org/columniststo submit your requests or tips.

Judith Graham: khn.navigatingaging@gmail.com, @judith_graham Related Topics Aging Navigating Aging Caregiving Dementia Nursing Homes Contact Us Submit a Story Tip

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Woman missing for more than 60 years found ‘alive and well’

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Woman missing for more than 60 years found 'alive and well'

A woman in the US who has been missing since 1962 has been found “alive and well”, authorities have said.

Audrey Backeberg left her home in Reedsburg, Wisconsin, in July that year when she was 20 years old, Sauk County Sheriff’s Office said.

Investigators pursued numerous leads over the years but the case eventually went cold.

However, during a review of cold cases earlier this year, a detective reassessed all the case files and evidence, and re-interviewed several witnesses – and found Ms Backeberg.

The 82-year-old was “alive and well” – living outside of the state of Wisconsin, the sheriff’s office said.

Ms Backeberg was married and had two children when she disappeared on 7 July 1962, according to the Wisconsin Missing Persons Advocacy organisation.

She left her home to pick up her salary but never returned, causing her husband to ask family members where she was.

Shortly afterwards their 14-year-old babysitter claimed she and Ms Backeberg had hitchhiked to Wisconsin’s capital city Madison and then caught a bus to Indianapolis, Indiana.

The teenager said when she arrived she became nervous and wanted to go home, while Ms Backeberg refused to return and was last seen walking near a bus stop.

Ms Backeberg’s marriage was troubled and there were allegations of abuse, the Wisconsin Missing Persons Advocacy organisation said, with a criminal complaint having been filed days before she went missing.

Her relatives insisted she would never abandon her children, the organisation added, and her husband passed a polygraph test and maintained his innocence.

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‘We talked for 45 minutes’ – detective

Detective Isaac Hanson, who found Ms Backeberg, said her sister’s Ancestry.com account was vital in helping him locate her address.

“That was pretty key in locating death records, census reports, all kinds of data,” he told local news station WISN.

“So I called the local sheriff’s department, said, ‘Hey, there’s this lady living at this address. Do you guys have somebody, you can just go pop in?’

“Ten minutes later, she called me, and we talked for 45 minutes.”

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‘She sounded happy’

Mr Hanson said Ms Backeberg may have left home due to marital issues, but it was unclear why she had stayed away for so long.

He said he had promised to keep their conversation private.

“I think she just was removed and, you know, moved on from things and kind of did her own thing and led her life,” he said.

“She sounded happy. Confident in her decision. No regrets.”

Sauk County Sheriff’s Office said Ms Backeberg made the choice to leave and her disappearance “was not the result of any criminal activity or foul play”.

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Sports

Jets-Blues Game 7 preview: Key players to watch, final score predictions

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Jets-Blues Game 7 preview: Key players to watch, final score predictions

It all comes down to this. The Presidents’ Trophy-winning Winnipeg Jets host the St. Louis Blues in the 200th Game 7 in Stanley Cup playoffs history Sunday (7 p.m. ET, TBS).

One team will advance to the second round, while the other will get an early start to the offseason — and try to fix what went wrong.

For the Blues, this is the club’s 19th all-time Game 7, the most of any non-Original Six team. They have gone 10-8 in Games 7s, with the most recent one being the 2019 Stanley Cup Final against the Boston Bruins, which they won 4-1.

This version of the Jets has much less Game 7 history on which to draw; their only Game 7 was a second-round victory over the Nashville Predators in 2018.

Who wins this one? We’ve gathered the ESPN hockey family to identify the key players to watch in the contest — as well as their final score predictions.

Who is the one key player you’ll be watching in Jets-Blues?

Ryan S. Clark, NHL reporter: If he plays, it’s Mark Scheifele. The hit in Game 5 from Brayden Schenn and/or Radek Faksa generated quite a bit of conversation about what is arguably the most physically demanding series in the first round. Scheifele’s play this season and this series prior to the hit reinforces what makes him a legit top-line center in this league. We saw how the Jets maneuvered around his absence for the final two periods of Game 5, while Game 6 proved why they need contributions from everyone if he can’t go.

But again, that’s if Scheifele plays. He skated Saturday in a tracksuit, with Scott Arniel saying the center will be a game-time decision Sunday.

Arda Öcal, NHL broadcaster: Connor Hellebuyck is the obvious answer here for me because he’s been “Vezina” at home (especially Game 2) and “Vezina from Temu” on the road.

Hellebuyck has allowed four or more goals in seven straight road playoff games, which ties the second longest such streak in Stanley Cup playoff history. But Game 7 is at home. The pressure is on but he’s in comfortable confines, surrounded by a “Whiteout.” Which version of Hellebuyck do we get Sunday night?

Kristen Shilton, NHL reporter: Connor Hellebuyck, of course. Has there been a Jekyll/Hyde performance like this in recent years?

The Vezina finalist can play lights-out at home and like a fish out of water on the road. Does that trend continue in Game 7? What version of the goalie shows up for this one?

But as a bonus, I’ll toss Pavel Buchnevich into this equation. He’s been driving the Blues’ offense, and if Hellebuyck is on his A-game then St. Louis is going to need Buchnevich to channel his hat trick energy from Game 3 to help the Blues pull off a stunning road win.

Greg Wyshynski, NHL reporter: Jordan Binnington renewed his title as one of the NHL’s most clutch goaltenders with his 31-save performance in Team Canada’s 4 Nations Face-Off championship win over the U.S. — including six saves in overtime. He first earned it in 2019, backstopping the Blues to the Stanley Cup with Game 7 wins over Dallas and Boston.

Now he’s got a chance to reestablish those credentials.

Binnington had a 0.82 goals-against average and a .968 save percentage in those prior Game 7s. While Hellebuyck has been terrible in St. Louis, Binnington hasn’t been much better in Winnipeg, generating an .861 save percentage and a 3.44 goals-against average and giving up four goals in two of the three games. But as 4 Nations showed, Binnington can meet the moment. (Although this time, Kyle Connor will actually be in the lineup for the opposition. Not that we’re bitter or anything.)


The final score will be _____.

Clark: 4-3 Jets. There have been a few themes in this series. The first being that offense hasn’t been an issue — the teams have combined to score more than six goals in all but one game. The second is that the home team has won every game; I say that continues, and the Jets advance.

Öcal: 6-5 Jets. Hellebyuck doesn’t have his best game, but the Jets outscore that challenge, and Kyle Connor scores another third-period goal in this series to win it.

Shilton: 5-4 Jets. The Jets have been too good on home ice to let this one slip away. That’s not to say a St. Louis win would be surprising, but even if Hellebuyck is off, Winnipeg’s offense should be able to provide enough buffer that the Jets can squeak through with a narrow victory to advance.

Wyshynski: 5-3 Jets. The Jets would be toast if this game were played in St. Louis because it’s a demonstrable fact that Hellebuyck is a disaster on the road in the playoffs. He’s slightly below replacement at home in the postseason, but Winnipeg will take that considering his three removals on the road.

The Blues are first in the playoffs in 5-on-5 offense and goals-for percentage at home. But Winnipeg is second in both categories. Hellebuyck calms down, and the offense gets ratcheted up at home, especially now that Nikolaj Ehlers has a game under his belt, having not played since April 12 due to a foot injury.

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Environment

Meet Bodo – the 35 mph electric golf cart that thinks it’s a G-Wagen

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Meet Bodo – the 35 mph electric golf cart that thinks it's a G-Wagen

With a fully-enclosed, G-Wagen-inspired body and an 80 mile electric range, the Bodo G-Wagon golf cart is the NEV you need when you decide it’s time to get serous one-upping the rest of the Palm Beach country clubbers.

If you love the look of the $230,000 Mercedes-Benz G580 off-roader, but think the 579 hp, 6,800 lb. electric 4×4 is probably overkill for occasional trips to the golf course and country club, this G-Wagen-inspired golf cart might be just what you’re looking for.

The shiny black 2024 Bodo G-Wagon sold at Mecum Auctions last month for $31,900, which seems like it might not be a lot of money to the sort of person who decides to take a flyer on a goofy, limited-use EV that ships with real, metal doors, power windows, heating and air conditioning, fully digital instrument cluster and infotainment, and a “posh,” caramel leather interior.

It even has windshield wipers, power steering, and a rear-seat entertainment system that’s built into the front headrests!

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It’s really nice in there

Under the hood, the Bodo packs a 15 kW (20 hp) electric motor drawing power from a 10 kWh li-ion battery that won’t deliver a scorching 0-60 mph time (it only goes 35), but will deliver you and your buddies from one end of any golf course in North America and back several times over, thanks to the G-Wagon’s 80 mile range.

The official Mecum Auctions listing goes into a bit more detail, and I’ve included it here, in case it gets deleted after a while and you’re just finding this for the first time in 2027:

Be the envy of any country club or golf community showing up with this 2024 Bodo G-Wagon Golf Cart. Perhaps more appropriately known as an E-Wagon, this baby G-Wagon is powered by a 15kW motor with a 10kWh lithium battery. Boasting an 80-mile range and a 35 MPH top speed, the Bodo is an enclosed, luxury golf cart that pampers occupants with heating and air conditioning, rear-seat entertainment, power windows, power locks and a posh, caramel-colored interior. With the Bodo fitted with power steering and 4-wheel power disc brakes with brake boost, drivers will think they’re in a full-size G-Wagon, thanks to the multiscreen entertainment cluster, the rearview camera, windshield wipers, turn signals, running lights and so much more.

Finished in black with the right amount of brightwork, the overall vibe is one of jaw-dropping, smile-inducing fun. While the Bodo would be an excellent choice for any golf community, it should also prove to be hugely popular around a race track or car condo community as well, or maybe even a neighborhood with its own airplane runways. Over the past decade in particular, the demand for unique, luxury golf carts has been on the rise, and understandably so. The number of luxury communities with specific interests in sports, aero and auto has also been on the rise, with people buying homes in these exclusive locations to better engage with like-minded people. All too often a golf cart is the perfect way to get around these gated neighborhoods, and this one is enclosed, comes with the amenities of a full-size car and is infinitely more stylish.

MECUM AUCTIONS

You can check out a few more photos of the 2024 Bodo G-Wagon golf cart that sold at Mecum, below – and if you want one for yourself, you’re in luck! I found this brand-new 2025 “G600 E-Wagon” (in white) for $23,900 at Gulf Carts in Santa Rosa Beach, Florida. Head on down to the comments and let us know if you buy it.

SOURCE | LOTS MORE PHOTOS: Mecum Auctions.


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