Monthly Archives: April 2019

Grief and Relief: When caregiving ends

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GedankenCaregiving for a person with dementia is one of the most difficult things anyone will have to do. The pain and suffering is intense, but the rewards are plenty. Even though the person you are caring for cannot express gratitude, on some level they know and appreciate your sacrifice. They are eternally indebted to you. As Lou Gehrig said in his farewell speech, “When you have a wife (caregiver) who has been a tower of strength and shown more courage than you dreamed exists—that’s the finest I know. So I close in saying that I might have been given a bad break, but I’ve got an awful lot to live for.”

Kim Mooney, the Board President of Conversations on Death, and Director of Community Education for Tru Community Care, Colorado’s first hospice, has said that as caregivers “the sacrifices you made changed the course of your life. As you once again look at finding a new course, you will over time grieve your loved one and what you let go of or stored away. You will also begin to discover the things you learned from giving so much. As you recognize and honor what you did, it will begin to shape the meaning of your life now. Whatever the challenges ahead in rebuilding, that understanding can give you the strength, commitment, and satisfaction to make your life more meaningful than ever.”

So, what’s next? Stop, take a deep breath, and think about your journey: where you came from, what you did, and how you feel. When my husband’s final health crisis was over and after I buried him, I realized that I hadn’t fully breathed for years and that my body was strangled with tension and fatigue. I had meditated, eaten fairly well (besides the times I was too tired to cook and made a dinner out of popcorn and ice cream), danced, exercised, and practiced yoga. All these things helped keep me calm, and brought me back to my “self.” But being on call for years took its toll. And after it was all over, while ensnared in the tentacles of grieving, I felt relief. Relief that I wouldn’t feel the pain of watching Morris lose yet another function. Relief that I wouldn’t have to fill another prescription or talk to a physician about my husband’s condition. Relief that I didn’t have to travel the 15 miles to visit him in the memory care home, where I’d inevitably get depressed. Relief that I could stay home and not have an obligation other than caring for myself.

And yet, the final letting go of my role as caregiver was uncomfortable and felt strangely similar to sending my children out into the world. How would I define myself if I were no longer a caregiver? How would I fill up the time I had spent caring for my husband for an entire decade, one fifth of my life? Creating a new identity takes time, practice, and patience. And we are told by grief counselors to not rush things. Do not make a major change in your life, such as moving out of the house you’ve lived in for years, or to another state. But day-by-day, it’s okay to acknowledge that we are not the same person who heard the dreaded words from our loved one’s doctor: “You have dementia, most likely of the Alzheimer’s type.”

As caregivers we take a journey through fire and ice and land on solid ground surrounded by calm waters. Then it’s time to swim to shore and get our bearings. Be patient, be kind to yourself, and set out to discover different activities, small and large, that ease you to calmer waters. Here are some ways to help you get there:

  1. Choose at least one healing modality in this book and integrate it into your life. Dance, do yoga, try journaling, find someone to walk with, etc.
  2. Clean out your closets and drawers.
  3. Wash the garage floor and then paint it.
  4. Take a cooking class.
  5. Join a health club or YMCA.
  6. Take a Zumba® fitness class.
  7. Ride your bike.
  8. Join a hiking club.
  9. Learn how to sew or knit.
  10. Serve food at a community table or sort food at a food bank.
  11. Plant a garden.
  12. Play a musical instrument.
  13. Learn a new language.
  14. Travel! Visit friends and family.
  15. Take long nature walks.
  16. Make it a habit to soak in a bath with Epsom salts.
  17. Get a puppy or kitten.
  18. Volunteer at the Humane Society.
  19. Read to elementary school children.
  20. Join a book club.

My journey to calmer waters

My husband’s illness changed the course of my family’s lives in ways that were unexpected, devastating, and empowering. I developed into a strong matriarch and quickly learned how to take charge of my husband’s care, family business, and my children, without the help of my partner. And not having a partner, with whom I would typically make important decisions with, was one of the hardest things of all about being a partner to someone with Alzheimer’s disease.

Not having a partner, with whom I would typically make important decisions, was one of the hardest things of all about being a partner to someone with Alzheimer’s disease. Deciding where and when to place Morris in a memory care home, figuring out how to finance it, and deciding when to enlist the help of hospice were the kinds of decisions I would have discussed with my husband.

I became a compassionate caregiver, not just for Morris, but for other residents of the memory care home where he lived the last two years of his life. I went through a lot—as all caregivers do—but I’ve come through. I’ve recreated my life, and have learned to look forward with hope, wonder, delight, and inspiration after giving so much of myself to the person I vowed to spend my life with.

There are days that go by without my thinking about Morris. After all, it’s been over eight years since he’s been gone. It’s still hard for me to look at family photos because our family was happy, and a link is missing. I know for my children the hardest thing is that their own children are growing up without knowing their grandfather, who would have loved to be a part of their lives. We will always miss him, but our happy memories fill in the gaps, and we honor him eery year on his yahrzeit the anniversary of a Jewish loved one’s death.

I have a new love in my life and grandchildren to enjoy and cherish. I feel good and I am happy! As my beloved teacher Swami Kaleshwar always said, “Life is short, make it sweet.” I will and I do.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Communicating with someone who has dementia

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Confused Senior Man With Adult Daughter At Home

Confused Senior Man With Adult Daughter At Home

It’s difficult communicating with people who have dementia for several reasons. They may have diminished hearing, but most often times they are unable to express themselves because they have forgotten words in addition to losing memories and a sense of self.

Here is a list of tips that come from a caregiver’s guide published by the Aging Services Division of the Denver Regional Council of Governments. The author is unknown.

  • Trouble remembering the right words
  • Repeating words with which they are still familiar
  • Creating new words when they can’t recall the names of people or items
  • Problems with organizing words in a coherent manner
  • Falling back on the language used during childhood
  • Losing their train of thought
  • Speaking less and relying primarily on nonverbal communication and gestures
  • Cursing or using inappropriate words even if they never did so before

The following tips can ease working with persons with dementia

  • Remembering that this person is an adult first and foremost. Keep in mind that they deserve respect and dignity
  • Be calm in your interactions and be aware of your body language. Your family remember is looking to you and your behavior for clues on how to behave him/herself.
  • Speak slowly and in short, simple sentences. Avoid complex directions or dialogue.
  • Avoid arguing with or criticizing the person, even if she is delusional in his/her thinking. Always validate the emotion behind the statement.
  • Indicate by facing your family member and maintaining eye contact that you are listening and trying to understand what is being said.
  • Support your loved one’s attempts to converse even if he or she is having difficulty.
  • Do ot interrupt.
  • Speak in a relaxed and gentle tone of voice.
  • Keep a friendly face toward your loved one when either of you is speaking.
  • Approach the person from the front, identify yourself, and address him or her by name.
  • Only ask one question at a time and allow sufficient time for your family member’s response before you continue.
  • Talk about other people using their names rather than pronouns.
  • Never quiz your loved one, e.g., “Don’t you know who that is? Don’t you remember?”
  • Furnish assistance as needed but avoid finishing your family member’s sentences.
  • Never talk about your loved one as if he or she isn’t there.
  • Draw on your innermost resources to display understanding and thoughtful patience, and try to remain flexible.
  • Rely on nonverbal communication such as pointing and touching to help facilitate understanding.
  • Use lots and lots of touch and praise. compliment frequently to make up for lowered self-esteem due to losses in abilities.

And most importantly, be kind. Put yourself in the other person’s shoes. How would you like to be spoken to and listened to?

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Mushrooms may reduce risk of mild cognitive impairment by 50%

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Mushrooms - morchella mushrooms, boletus mushrooms, oyster mushrooms, on white background.If  you eat golden, oyster, shiitake and/or white button mushrooms, as well as dried and canned mushrooms, you’re in luck! A team from the Department of Psychological Medicine and Department of Biochemistry at the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) has found that seniors who consume more than one and one-half cups of mushrooms weekly may reduce their odds of having mild cognitive impairment (MCI) by 50%. 

What is MCI?

Mild cognitive impairment causes cognitive changes that are serious enough to be noticed by people experiencing them or to other family and friends. The changes are not severe enough to interfere with daily activity. People with MCI that involves memory problems are more likely to develop Alzheimer’s disease or other dementias than people without MCI. Approximately 15-20 percent of people age 65 or older have MCI.

Mushrooms might be a key to reducing MCI

The correlation between eating mushrooms and reducing risk of MCI is surprising and encouraging, according to Assistant Professor Lei Feng, who is from the NUS Department of Psychological Medicine, and the lead author of this work.

The six-year study, which was conducted from 2011 to 2017, collected data from more than 600 Chinese seniors over the age of 60 living in Singapore. The research was carried out with support from the Life Sciences Institute and the Mind Science Centre at NUS, as well as the Singapore Ministry of Health’s National Medical Research Council. The results were published online in the Journal of Alzheimer’s Disease on 12 March 2019.

The researchers found that the compound called ergothioneine (ET), a unique antioxidant and anti-inflammatory which humans are unable to synthesize on their own, is the key to possibly reducing MCI. Ergothioneine is found in liver, kidney, black beans, kidney bean and oat bran. But the highest levels are found in bolete and oyster mushrooms.

Other compounds contained within mushrooms may also be advantageous for decreasing the risk of cognitive decline. Certain hericenones, erinacines, scabronines and dictyophorines may promote the synthesis of nerve growth factors. Bioactive compounds in mushrooms may also protect the brain from neurodegeneration by inhibiting production of beta amyloid and phosphorylated tau, and acetylcholinesterase, the culprits of Alzheimer’s disease.

How much do you need to eat?

In the study, a portion was defined as three quarters of a cup of cooked mushrooms with an average weight of around 150 grams. Two portions would be equivalent to approximately half a plate. While the portion sizes act as a guideline, it was shown that even one small portion of mushrooms a week may still be beneficial to reduce chances of MCI.

An article in Science Daily said this: According to Robert Beelman, professor emeritus of food science and director of the Penn State Center for Plant and Mushroom Products for Health, it’s preliminary, but you can see that countries that have more ergothioneine in their diets, countries like France and Italy, also have lower incidents of neurodegenerative diseases, while people in countries like the United States, which has low amounts of ergothioneine in the diet, have a higher probability of diseases like Parkinson’s Disease and Alzheimer’s,” said Beelman. “Now, whether that’s just a correlation or causative, we don’t know. But, it’s something to look into, especially because the difference between the countries with low rates of neurodegenerative diseases is about 3 milligrams per day, which is about five button mushrooms each day.”

 

Mushroom recipes

Cooking mushrooms does not seem to significantly affect the compounds. Roasted or baked mushrooms are simple to make and delicious, and go well with most foods as a side dish or topping.

Wash and slice musthrooms. Lightly oil shallow baking pan large enough to hold mushrooms in single layer. Add mushrooms and toss with 2 to 3 tablespoons oil. Add garlic; season with salt; roastfor 20 minutes stirring on occasion; mushrooms should be browned. Season with pepper.

For baked mushrooms with parmesan, thyme and lemon simply toss with olive oil, Paremesan cheese, garlic, thyme, lemon zest and lemon juice.

For more mushroom recipes google for mushroom risotto, mushroom gravy, cream of mushroom soup, creamy mushroom pasta, mushroom and barley soup.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.