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About healthycaregiver

I took care of my husband for 10 years while he had earlier-onset Alzheimer's disease. My experience, along with my expertise as a wellness coach and health writer, prompted me to write a book on how caregivers can maintain their health, increase energy, and experience peace. My book "Calmer Waters: The Caregivers' Journey Through Alzheimer's and Dementia" will be released in June, 2016 by Cardinal Publishing Group. Please follow my blog for caregiving advice and the latest scientific studies on staving off dementia and supporting cognitive function.

The loneliness of caregiving: How to stay socially connected

Closeup of old woman hands holding mobile phone

Woman with mobile phone

My husband had younger-onset Alzheimer’s disease. The hardest thing for me during the duration of his illness was that I lost my companion. He was the person I made important decisions with. The person I went to movies with, ate dinner with, had interesting conversations with, traveled with, and shared delight with over the accomplishments of our children. He was the one I could complain to if I had a headache, stomach ache, or sore throat, without worrying about being called a hypochondriac or a baby. He was also the person who always cheered me on when I succeeded in achieving my goals.

When it came time to make the decision to move him to a memory care home, I especially missed having him help me decide on which room he’d live in, what type of furniture to buy, and the mattress he would sleep on. When it came time to bury him, it was agonizing for me to choose the plot of land where he would be laid to rest, and where I will be eventually interred.

During my many years of caregiving, I would often hide behind a mask of cheerfulness. It helped. I didn’t feel like a prisoner because I hired people to take my husband out to see a movie. Several of his friends kindly took him to lunch on a regular basis. It takes an effort to maintain friends and to stay socially involved, especially if you no longer work outside the home.

I promised myself that I wouldn’t let my husband’s disease ruin my life. I kept an active calendar filled with dance classes, lunches with friends, and even pursued a certificate in nutrition–all the while he was ill.

But it took planning and some might think I was a bit selfish. But when you look at the grand picture of caregiving, taking care of your personal needs is anything but being selfish. Studies show that 40 to 70 percent of family caregivers experience symptoms of clinical depression. One of the reasons, besides the daily stress, is isolation and loneliness.

Now for the lecture part: If you are a caregiver it is vital that you maintain a social network. Here are some ideas:

  • Stay connected with friends and family either through Facebook or another social media outlet, or by telephone or email, etc.
  • Make a lunch date with a friend at least once a week.
  • Many places of worship offer support for caregivers and families, including social events.
  • Go to a class—any kind of class: knitting, dance, weight training.
  • Join a support group—The Alzheimer’s Association offers classes and workshops for caregivers and for the person with memory loss.
  • Ask your friends and family for respite care. Have someone come over for a couple of hours a week so you can at least get out for a walk or go grocery shopping.
  • Go to the movies with a friend. It’s a great way to escape into another world for a few hours.
  • Call a best friend who is happy to talk; call someone who makes you laugh–laughter is truly the best medicine.
  • Bring your loved one to a Memory Cafe/Alzheimer’s Cafe. The challenges of living with memory loss can sever social connection at a time when it is needed most. Throughout the US and Europe, this casual social meeting is for caregivers and their care partner (the person they are caring for). Memory Cafes offer a way to socialize, explore art, music, poetry and listen to discussions and presentations. A Dutch psychologist opened the firs Memory Cafe in Holland. today there are about 200 Memory Cafes in the U.S.
  • Chat online with other caregivers. The Alzheimer’s Association offers chat rooms and so does the American Cancer Society. Check Elder Care Online for chat room and caregiver forum links. ElderCare Online’s Caregiver Support Network brings together online resources, groups and experts to create a virtual community dedicated to improving quality of life for you and your loved ones.

Turmeric does a body good

fresh turmeric roots on wooden table

Fresh turmeric 

 

Tumeric is the spice that gives curry its yellow hue and tang. But it does a lot more than flavor the most popular Indian dish. Several studies have found a protective effect of curcumin in Alzheimer’s disease and dementia, and it’s no surprise. The senior population in rural Indian has one of the lowest rates of Alzheimer’s disease in the world, and scientists believe it is due to the antioxidant and anti-inflammatory properties of turmeric,1,2 and its ability to inhibit the build up of amyloid plaque.3

The buzz about inflammation

Inflammation in the body is a good thing; it is the body’s natural response to a cut or injury. When we cut our finger, white blood cells accumulate at the site in order to prevent infection and promote healing. Inflammation serves a vital role in the body. Inflammation is one of the primary mechanisms selected by nature to maintain the integrity of our body against the thousand environmental attacks that we receive every day, according to Luigi Ferrucci, the scientific director of the National Institute on Aging“Inflammation is part of our maintenance and repair system. Without it, we can’t heal.” (“Inflamed”by Jerome Groopman, The New Yorker, Nov 30, 2015.)

Some researchers believe that a chronic state of low-level inflammation in the body can contribute to or trigger chronic diseases such as arthritis and Alzheimer’s disease. Connecting the dots between causation and manifestation of a disease are sketchy. But there are plenty of studies that back up the anti-inflammatory properties of the turmeric.

Turmeric has numerous health benefits. More than 900 published research papers attest to the anti-cancer activity of curcumin, turmeric’s potent extract. And Diabetes Care, a journal of the American Diabetes Association, published a study about curcumin’s ability to help pre-diabetic patients from developing full-blown diabetes.

A study done by researchers from the University of Melbourne indicated that curcumin might prevent or improve age-related cognitive decline, dementia and mood disorders. The study included 60 adults between 60 and 85 years old. An hour after taking a curcumin supplement (400 mg) the participants experienced a higher attention span and better memory when compared to the participants who took a placebo. After four weeks of taking the supplement, the curcumin group showed improvement in mood, memory, alertness and feelings of well-being. 4

How much to take? You can find dietary supplements in tablet and capsule form at health food stores with curcumin extracts in dosages of 400 to 600 mg. The general advice is to take one dose three times daily or as directed on the product.

Use as a cold, flu and congestion remedy
Turmeric has been used as a natural remedy for centuries to help boost immunity and prevent and shorten respiratory illnesses. The next time you get a cold, try adding it to hot water with grated ginger and a teaspoon of honey. It will perk you up and possibly reduce the length of time you are sick. You might also discover that it enhances your memory.

How to get more turmeric into your diet?
1. One way is to drink turmeric tea, which is popular among Okinawans, who are known for their longevity.
• Bring four cups of water to a boil.
• Add one teaspoon of ground turmeric and reduce to a simmer for 10 minutes.
• Strain the tea through a fine sieve into a cup, add honey and/or lemon to taste

2. Sprinkle it on your food—turmeric is especially good added to braised greens. Saute onion in olive oil, add greens of your choice (kale, spinach, Swiss chard), and add 1 tsp of turmeric and a sprinkle of salt.
Add turmeric to eggs, scrambled tofu, soups, potato pancakes, casseroles, rice, etc. You can’t go wrong, and you can’t overdose on turmeric.

Recipes

Golden Milk Recipe

1 cup of almond or coconut milk, ½ t ground turmeric, ½ t ground ginger, ¼ t cardamom and 1 tsp honey. You can also add a pinch of black pepper if you wish. Whisk the ingredients together, strain over a mug

 Ingredients:

• 8 ounces milk (dairy, soy milk, coconut, or nut milk), warmed
• 1⁄2 teaspoon (1⁄4 teaspoon for kids younger than 6) turmeric
• 1⁄4 teaspoon honey

Directions: Combine warm milk and turmeric in a mug and add honey.

Vegetable Curry

  • 1 sweet potato, peeled and cubed
  • 1 medium eggplant, peeled and cubed
  • 2 carrots, chopped,
  • 1 medium onion, chopped
  • 1 Bell pepper, chopped
  • 1 zucchini, sliced
  • 2 cloves garlic, minced
  • 1 15-oz can drained garbanzo beans
  • 1/4 cup cashews
  • 6 Tbs. coconut or olive oil
  • 1 tsp ground turmeric
  • 1 Tbs. curry powder
  • 1 tsp ground cinnamon
  • 1 tsp sea salt
  • 3/4 tsp. cayenne pepper
  • 2 Tbs raisins
  • 1 cup orange juice

Directions

In a large pan or pot saute sweet potato, eggplant, peppers, carrots, onion in six tablespoons oil for 5 minutes.

Add garlic, turmeric, curry powder, cinnamon, salt and pepper and cook for 3 minutes.

Add the garbanzo beans, cashews, zucchini, raisins, and orange juice. Cover and simmer 20 minutes. Serve over rice or quinoa.

Enjoy!

References
1. Chin D1, Huebbe P, Pallauf K, Rimbach G. Neuroprotective properties of curcumin in Alzheimer’s disease–merits and limitations. Curr Med Chem. 2013;20(32):3955-85.
2. Nahar PP1, Slitt AL, Seeram NP. Anti-Inflammatory Effects of Novel Standardized Solid Lipid Curcumin Formulations. J Med Food. 2015 Jul;18(7):786-92. doi: 10.1089/jmf.2014.0053. Epub 2014 Dec 9.
3. Endo H1, Nikaido Y1, Nakadate M1, Ise S1, Konno H2. Structure activity relationship study of curcumin analogues toward the amyloid-beta aggregation inhibitor. Bioorg Med Chem Lett. 2014 Dec 15;24(24):5621-6. doi: 10.1016/j.bmcl.2014.10.076. Epub 2014 Oct 30.
4. Cox KH1, Pipingas A1, Scholey AB2. Investigation of the effects of solid lipid curcumin on cognition and mood in a healthy older population. Journal of Psychopharmacology 2014 Oct 2. pii: 0269881114552744.

 

Is it a good idea for Alzheimer’s and dementia patients to use marijuana?

Doctor hand holding dry medical cannabis on table close up

Doctor writing a prescription for  medical marijuana

I live in Colorado, one of the few states where medical marijuana is legal, as well as recreational marijuana for adults 21 years or older. Before it was legal, my husband, who suffered from anxiety, stress and depression from Alzheimer’s disease, smoked it in a pipe and ate marijuana cookies and brownies. It calmed him down and, most importantly, put a grin back on his face. He would get happy, and although I did not partake it helped me to relax, too–just because he was happier and more relaxed.

How does marijuana help Alzheimer’s?

Numerous studies show that cannabis helps:

THC, the psychoactive chemical in marijuana, helps reduce agitation and increase weight in people suffering from Alzheimer’s disease. Anxiety is defined as the inability to settle down and includes behaviors such as verbal outbursts, pacing and restlessness, all of which may lead to patient combativeness. Additionally, Alzheimer’s patients often experience weight loss because they stop recognizing when they are hungry.

Clinical studies

Researchers at the Meridian Institute for Aging in New Jersey gave a daily dose of 10 to 20 milligrams of dronabinol (an artificial version of THC marketed under the name Marinol) to 48 patients who had been diagnosed with Alzheimer’s disease and anorexia. After one month, two-thirds of the patients were significantly less agitated, and all of them had gained weight. There were no adverse side effects reported, such as falls, seizures or depression.Study results suggest dronabinol, a synthetic version of THC, the active ingredient in Cannabis sativa L (marijuana), may reduce agitation and lead to weight gain in patients with Alzheimer’s disease,

A 2014 preclinical study published in the Journal of Alzheimer’s Disease found that very small doses of tetrahydrocannabinol (THC), a chemical found in marijuana, can slow the production of beta-amyloid proteins, thought to be a hallmark characteristic and key contributor to the progression of Alzheimer’s. http://www.ncbi.nlm.nih.gov/pubmed/25024327. THC could be a potential therapeutic treatment option for Alzheimer’s disease through multiple functions and pathways. The study is among others to support the effectiveness of THC in prohibiting the growth of toxic amyloid plagues.

Co-author of the study, Neel Nabar, cautions against drawing quick conclusions from the study and says that numerous previous studies have shown that marijuana helps Alzheimer’s patients by reducing anxiety and inflammation, and improving appetite.

In this study, the researchers gave Alzheimer’s-afflicted mice various doses of pharmaceutical cannabinoids, which are 100 to 800 times more potent than marijuana compounds. The treated mice did not perform any better than untreated mice on memory tests, and they had just as much brain plaque formation as the untreated mice.

Can it reduce brain inflammation?

In 2005 researchers from Madrid’s Complutense University and the Cajal Institute published an article in the Journal of Neuroscience showing that  a synthetic cannabinoid appeared to reduce brain inflammation in Alzheimer’s.  Some researchers believe that reduction of this inflammation helps to prevent the mental decline associated with this disease.

Three years later, in March 2008, the Royal Pharmaceutical Society of Great Britain unveiled research showing that cannabis-based treatments could improve memory loss in Alzheimer’s sufferers.   Spanish researchers, this time working with a research team from Israel, found that one of the 400 compounds in the marijuana plant could significantly slow memory problems caused by the disease.  A by-product of their research was the finding that the same drug can also help Type 1 diabetes (formerly known as insulin dependent diabetes).

In observing my husband’s reaction to smoking pot and eating edibles, I can say that neither helped to improve or slow down his memory decline. 

In December 2008, results of a study showing that it’s the anti-inflammatory effect of cannabis that appears to help in Alzheimer’s disease were published.  Scientists continue to debate about the role inflammation of the brain plays in Alzheimer’s, and many researchers believe that it plays an important role in the dementia process.

The question comes up that if reduction of inflammation is all it takes to halt mental decline associated with Alzheimer’s, why doesn’t taking an anti-inflammatory, such as ibuprofen, help the condition?  Supposedly, anti-inflammatory drugs such as these have been shown in tests to help young brains, but not to help older brains.I have not found any such studies, but I do believe, along with numerous researchers, that inflammation is a major culprit in chronic disease.

Turmeric has been shown to be a traditional anti-inflammatory spice that has been found to have a protective effect against Alzheimer’s and dementia. Look for my future post about how turmeric supports memory and helps prevent dementia.

Therapeutic Cannabis Dosage for Alzheimer’s

According to Gary Wenk, Ph.D., author of the December 2008 study and professor of psychology and neuroscience at Ohio State University, “a puff is enough.”  He goes on to say that although this dose would probably have some sort of psychoactive effect strictly medical use is not ruled out.  The drug could be taken before bedtime, Wenk says, and with long-term use, tolerance to these psychoactive effects can develop, so impairment might be minimal with a steady dose anyway.

Don Abrams, M.D., chief of hematology/oncology at San Francisco General Hospital, has studied medical marijuana use in people with HIV for more than a decade. He says, “Cannabis is anti-inflammatory and it is also an antioxidant, and those are two things that we seek in treating neurodegenerative disorders.  It’s there, it’s in nature, if the research does find that it has these benefits, why not take advantage of it?”

Marijuana increases appetite and reduces anxiety

It’s important to note the difference, however, between these findings and the beneficial findings of other studies. Alzheimer’s patients often lose the ability to know whether they are hungry or not, and medical marijuana does help induce appetite. It also reduces anxiety. So, in the end, if you are considering giving your loved one medical marijuana for Alzheimer’s symptoms, be aware that it will probably not help improve memory. But it very well may help increase appetite and reduce anxiety.

My husband ate well until he was in late-stage Alzheimer’s disease. By then, he would not have been able to ingest marijuana in any shape or form. But earlier in the disease process it helped him feel better when everything in his world was being tossed and turned upside down. If you are looking for an antidote to anxiety and depression, consider it for a loved one with Alzheimer’s or dementia. If you prefer not to deal with the nasty odor (some people like it, I don’t) then ask your doctor about the pharmaceutical THC tincture. Or, you can always bake marijuana cookies and brownies. Just make sure they are in a container that is child-proof and hidden from your pets, visitors and children.

Hope for Reversing Alzheimer’s Disease

Group of mature people doing yoga

Seniors practicing yoga for relaxation and flexibility

For dozens of techniques and tools for supporting cognitive health and reducing mental decline check out my book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia” — Available wherever books are sold, including amazon.com and barnesandnoble.com

On the summer solstice, the longest day of the year, there are approximately 17 hours of light. This year it happened to coincide with the Strawberry Moon, the June full moon. It’s a special time for healing and wrapping yourself and your loved ones in a luxurious robe of compassion and kindness. The longest day of the year is also a special day that thousands of Alzheimer’s Association volunteers join together to raise millions of dollars to honor those facing Alzheimer’s disease for educational programs and research.

It’s a particularly appropriate time to learn about a new study that suggests that a drug and lifestyle regimen can reverse mental decline in Alzheimer’s patients and those with mild cognitive impairment. First, it’s important to know that the study only included 10 patients, some with mild cognitive impairment, subjective cognitive impairment or Alzheimer’s disease. The researchers created personalized multi-faceted treatment programs for each patient, including diet changes, exercise, improved sleep, brain stimulation, drugs and vitamins.

The patients were treated for between five and 24 months. All 10 patients showed improvements in thinking and memory, and some were even able to return to work and complete tasks that had become impossible for them as their mental abilities declined, according to United Press International.

“The magnitude of improvement in these 10 patients is unprecedented, providing additional objective evidence that this programmatic approach to cognitive decline is highly effective,” Dr. Dale Bredesen, a professor at the Buck Institute and the University of California Los Angeles, said in a news release.

I have not seen the study, so I can’t comment on the specifics, but the overall treatment plan sounds as though it includes a healthy lifestyle regimen, which could be applied to anyone who wants to maintain mental acuity, stamina, a stronger immune system and overall physical health. The one caveat with the personalized multi-faceted treatment program in the study is that it is vital that the patient continues and maintains the program. Because as soon as an individual ceased to be regular, the old symptoms returned and the decline was steady.

 

Here is my list of 10 recommendations for maintaining cognitive function and boosting brain power

  1. Drink at least 8-10 glasses of water to keep your body hydrated and to flush out toxins. The brain is 70% water when fully hydrated. When it is dehydrated, neurotransmission—which is heavily dependent on water—is impaired, resulting in poor memory, concentration and impaired abstract thinking.
  2. Ginkgo biloba has been proven in hundreds of studies to help blood circulation to the brain, sharpening mental performance, increasing concentration and short-term memory. A well-known study in The Journal of the American Medical Association showed that supplementation with 40 mg of ginkgo three times a day for one year had a positive effect on patients with Alzheimer’s disease. A placebo-controlled, double-blind, randomized trail of an extract of Ginkgo biloba for dementia. 
  1. Vitamin B complex optimizes cognitive activity and brain function, has a positive effect on memory, learning capacity and attention span, and supports a healthy nervous system and a stable mood. Vitamins B6 and B12, in particular, play a role in the synthesis of serotonin, the neurotransmitter linked to improving memory, lifting mood and regulating sleep.
  2. Omega-3 fatty acids are rich in DHA, the major unsaturated fat in the brain. This long-chain fatty acid provides the necessary fluid quality to the membranes of the nerve cells so that electrical nerve impulses can flow easily along the circuits of the brain. One study found that Alzheimer’s patients given an omega-3-rich supplement experienced a significant improvement in their quality of life.
  3. Eat more blueberries! Their active antioxidants have been shown to protect and restore brain function. One recent study revealed that feeding blueberry extracts to mature mice partially reversed some signs of brain aging.
  4. Avoid alcohol. People who drink too much alcohol often show shrinkage or atrophy of the cerebral cortex, the seat of memory, learning, reasoning, intelligence, and emotions. Reduced cortical thickness in abstinent alcoholics and association with alcoholic behavior
  5. Avoid smoking. Smoking constricts blood vessels, making less blood, oxygen, and nutrients available to the brain. It also replaces oxygen with carbon monoxide, a chemical that damages brain cells.
  6. Incorporate a regular exercise program into your daily routine. An easy way to start is by walking 30 minutes a day at least five times a week. Yoga is wonderful for staving off arthritis pain, maintaining flexibility and for relaxation.
  7. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group, or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.
  8. Sleep well by getting to bed before 11:00 pm, eating your last meal before 8pm, turning off your electronic devices, and eliminating light in your bedroom. Studies have indicated that sleep deprivation can increase risk of dementia and Alzheimer’s disease. If you have trouble sleeping consider using a lavender essential oil spray on your pillow or a sachet of lavender inserted into the pillowcase. There are lots of natural sleep aids available at your local health food store, such as melatonin, calcium/magnesium, valerian, hops, etc. Consult with a nutritional consultant about what might work best for you.

Best of luck with your lifestyle changes and best of health to you and your family.

 

 

 

 

 

Summertime Eating Tips to Help Caregivers Keep Their Cool

Background texture of pink and white rose petals

Rose Petals Make a Delicious Cooling Drink and Jelly

 

It’s summertime and the livin’ is easy—or at least we’d like it to be. If you’re tired and stressed out from caregiving, here are some tips to help you stay cooler in summer.

According to the ancient Indian system of Ayurveda our body consists of three main elements or doshas—Vatta, Pitta and Kapha. Pitta consists of water and fire. It’s hot, so during summer when the temperature rises we want to eat cooling foods. Eating cooling foods not only keeps us from overheating, it reduces the tendency to get irritable, impatient and angry.

  • 1) First and foremost, stay hydrated. It’s especially important to make sure you and your loved ones are getting enough liquids because when we forget to drink we can become dehydrated quickly, which leads to other health problems. It’s also crucial to keep the brain hydrated in order to maintain mental alertness. Drink plenty of water and stay away from carbonated and caffeinated drinks. Herbal teas, and fresh fruit or vegetable juices are great in summer. Just remember that fruit juices are high in sugar and calories.
  • 2) Enjoy the bounty of summer fruits and vegetables. The summer fruits such as peaches, apricots, cherries, watermelon, cantaloupe, and berries are especially good for helping the body reduce the fiery heat of summer. According to Ayurveda, some of the recommended summer vegetables include cucumber, green leafy vegetables, green beans, squash, zucchini, asparagus, beets and eggplant.
  • 3) Sprinkle on the herbs and spices. They’re easy to use and contribute added flavor and antioxidants to your diet. Cooling spices include cardamom, coriander, fennel and tumeric. Cooling herbs include cilantro, mint and dill.
  • 4) Avoid hot, sour and salty foods including fermented food, red meat, and greasy and spicy food. Excess pitta aggravates the tendency towards heartburn and gastric hyperacidity.
  • 5) Here’s some good news—Ayurveda recommends ice cream during the hot summer months! So by all means, enjoy! Dementia patients are especially fond of ice cream. If the person you are caring for refuses to eat or eats very little, try serving ice cream. It contains protein, calcium and calories, and it’s easy to serve and eat. If weight gain or cholesterol is a concern, select a dairy-free version of America’s favorite dessert. Rice Cream, Coconut Bliss and Soy Delicious make delicious non-dairy, frozen desserts.
  • 6) My roses are bursting with fragrance and beauty. Roses are especially cooling and ff you have rose bushes that are free of chemicals, here’s a special treat to make: Rose Petal Jam. It’s fun and easy and the person you are caring for might even like to get into the act. It’s also very cooling and pacifies irritability. Spread it on toast, put a teaspoon on top of a scoop of ice or add it to warm milk for a yummy nightcap. (see recipe below)
  • 7) Make a lassi using a tablespoon of rose petal jam. Or use this delicious recipe to make the classic, cooling Indian-style milkshake.

Rose Petal Jam

Ingredients

  • ◦ 1 cup fresh rose petals (must never have been sprayed with any chemicals)
  • ◦ 3/4 cup water
  • ◦ 1 lemon, juice of (1/4 cup)
  • ◦ 2 1/2 cups sugar or evaporated cane juice crystals
  • ◦ 1 package pectin
  • ◦ 3/4 cup water

Directions

  1. Puree rose petals, 3/4 cup water and lemon juice in blender until smooth.
  2. Slowly add sugar.
  3. Blend till all sugar has dissolved; (leave in blender) Stir 1 package pectin into 3/4 cup water, bring to a boil, and boil hard for 1 minute. Pour mixture into blender with rose petal mixture until well blended.
  4. Do this very quickly – it sets up FAST!! Pour into small, sterilized jelly jars.
  5. Let set for 6 hours, till firm.
  6. Will keep one month in refrigerator.
  7. Freezes well.

 

Rose Water Lassi

  • 2 1⁄2 cups plain yogurt
  • 1/2-teaspoon fine sugar
  • ¼ tsp of ground cardamom
  • 2 teaspoons pure rosewater
  • 3⁄4 cups Ice water
  • 1 cup Ice cube cracked
  • Fragrant rose petals for garnish

Blend the yogurt, sugar, cardamom, rose water and iced water in a blender for 2 minutes. Add the ice and process for another 2 minutes. Pour the lassi into tall, refrigerated glasses and garnish with rose petals. Chill out and enjoy!

Protecting Yourself and Loved Ones from Elder Abuse

Stop Elder Abuse Sign

Stop Elder Abuse Sign, An American road stop sign with words Elder Abuse with stormy sky background

World Elder Abuse Awareness Day is June 15th and according to the World Health Organization elder abuse is a violation of human rights and a significant cause of illness, injury, loss of productivity, isolation, and despair. It touches people across all socioeconomic groups, cultures, and races. But only about one in five cases is ever reported. People with dementia are particularly vulnerable because they are unable to recognize that they are being abused or to report it.

My friend’s mother lived in Florida where she had round-the-clock nursing care in her own home. At the end of her life she suffered from dementia and was frail and bed-ridden. When Cheryl (name has been changed) went for a visit, she discovered that her mother had been cruelly beaten, and even though her two caregivers were women, it was apparent there she had been sexually abused. The poor woman’s genital area was swollen and bruised.

Physical abuse is not the only type of abuse targeted at the elderly. I know of two families who lost their inheritance because of financial fraud and theft. In one family the elderly father was cared for by a young woman who convinced him to marry her in order to be the beneficiary of his estate. The man’s family was unable to get a penny or access to the family home they had grown up in. Another elderly man assigned a trustee to overlook his financial affairs. The trustee stole his money and even though one of his adult children is a lawyer, the family was unable to recover a penny of their inheritance.

We’ve all heard of telephone scams in which a caller claims he is a jailed grandson who pleads with his grandparents to send bail money, or the IRS scam where the caller threatens severe consequences if the senior doesn’t pay tardy taxes.

These types of occurrences are all too common, especially in under staffed, under funded nursing homes.

Report abuse

Abuse can occur anywhere: at home, in nursing homes, and memory care homes. If you suspect abuse don’t hesitate to report it. You do not have to prove anything. It is up to the professional staff to investigate your suspicions, and put the proper safety measures in place.

Types of abuse

  • Physical–causing pain or injury
  • Neglect–failure to provide food, shelter, clothing, medical and other necessities required to provide a safe, nurturing environment
  • Emotional and Psychological—Verbal assaults, harassment, threats, intimidation
  • Confinement –restraining or isolating the person
  • Financial—Scams, misuse or withholding of the person’s financial resources to the disadvantage of the elderly person, and to the advantage of another person.
  • Deprivation—Denying the person medication, medical care, food, shelter or physical assistance
  • Sexual abuse –Any sexual activity, including fondling, when the person is unable to understand, unwilling to consent, or threatened or physically forced

Signs of abuse

  • Bruises, pressure marks, broken bones, abrasions and burns
  • Bruises around the breasts and genital area could indicate sexual abuse
  • Poor hygiene, bed sores, unattended medical needs, unusual weight loss
  • Sudden withdrawal from normal activities, unexpected depression, and a sudden change in alertness can be an indicator of emotional abuse. However, these symptoms can be the result of a progression of dementia or other disease.
  • Sudden changes in financial situation can be a result of exploitation.
  • Aggressive behavior from a caregiver or from the person being cared for can result in verbal or emotional abuse on either end.

Caregivers also are the recipients of abuse from the person they care for. If a caregiver feels physically threatened it’s important to get help in providing safe care for the person being cared for, possibly in a facility.

What can you do to protect yourself and your loved ones?

Report suspected mistreatment to your community’s Human Services Adult Protection agency and/or law enforcement office. Even if a situation has already been investigated, if you believe circumstances are getting worse, continue to speak out.

If you or others experience abuse or neglect in a community setting:

Adult Protective Services (APS) is there to help. The APS mission is to ensure the safety and well-being of elders and dependent adults. Unfortunately, it is estimated that millions of U.S. elders, from all walks of life, face abuse and neglect every year. Anyone can be victimized. However, there are things you can do to help protect yourself from abuse and neglect…

Human Services provides help with:

  • In-home assessment for abuse, neglect, and/or exploitation
  • Crisis intervention
  • Monthly visits by a case worker, if risk continues
  • Assistance with housing and/or placement to alternative housing
  • Assistance with obtaining benefits
  • Money management
  1. To report suspected abuse in a nursing home or long-term care facility, contact your local Long-Term Care Ombudsman. Each licensed long-term care facility is required to display a poster with the facility’s assigned ombudsman’s name and contact information. If you are a resident or family member of a resident in a facility, call the ombudsman listed on the poster. To learn more about the ombudsman program visit: Long-term care ombudsmen are advocates for residents of nursing homes, board and care homes and assisted living facilities. http://www.ltcombudsman.org
  2. Caregivers (both family and professionals) are most often the abusers of the elderly. Stress and feelings of being overwhelmed may provoke unintentional belligerent feelings. If you feel overwhelmed or frustrated as a caregiver, talk to someone for support.
  3. To speak with an Alzheimer’s Association Care Consultant call: 1-800-272-3900
  4. To find a support group in your area visit http://www.alz.org/apps/findus.asp
  5. To receive support from other caregivers visit https://www.alzconnected.org/
  6. To report an incident or concern of abuse or neglect, call the Alzheimer’s Association (1.800.272.3900) or Eldercare Locator (1.800.677.1116). You’ll be connected to your state or local adult protective services division or to a long-term care ombudsman. You do not need to prove that abuse is occurring — it is up to the professionals to investigate suspicions.
  7. Read more: http://www.alz.org/care/alzheimers-dementia-elder-abuse.asp#ixzz2W9DhCbSL
  8. Keep in contact. Talk with your older friends, neighbors, and relatives. Maintaining communication will help decrease isolation, a risk factor for mistreatment. It will also provide a chance to talk about any problems they may be experiencing.
  9. Join Ageless Alliancea national, non-profit grassroots organization working to to promote aging with dignity and eliminate elder abuse, neglect and exploitation through Awareness, Advocacy and Action. Based at the Center of Excellence on Elder Abuse and Neglect at the University of California, Irvine, Ageless Alliance is a grassroots campaign to give a voice to those who have been affected by elder abuse and abuse of adults with disabilities.
  10. Plan ahead to protect against financial exploitation. Download a handout on ways to protect yourself or a loved one. http://www.ncea.aoa.gov/Resources/Publication/docs/NCEA_ProtectYourself_web508.pdf
  11. Be aware of the possibility of abuse. Look around and take note of what may be happening with your older neighbors and acquaintances. Do they seem lately to be withdrawn, nervous, fearful, sad, or anxious, especially around certain people, when they have not seemed so in the past?
  12. Contact your local Area Agency on Aging (AAA) office to identify local programs and sources of support, such as Meals on Wheels. These programs help elders to maintain health, well-being, and independence—a good defense against abuse. See the Eldercare Locator, www.eldercare.gov Welcome to the Eldercare Locator, a public service of the U.S. Administration on Aging connecting you to services for older adults and their families.You can also reach us at 1-800-677-1116.

When the Patient has Trouble Eating

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Three delicious and nutritous protein shakes

Find more food and nutrition tips in my new book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”–available wherever books are sold.

Elderly people, people who are ill, and especially people with dementia, sometimes have eating difficulties, which can arise for a number of reasons.

  • Some medications affect taste and decrease appetite.
  • Eating might be one of the few things that a person with Alzheimer’s or dementia still has control over. The memory loss individual might refuse food simply because it’s a way of exerting personal power.
  • A new diet that is introduced due to a health concern such as diabetes, or the introduction of pureed food might cause an individual to refuse food.
  • Depression can result in a lack of interest in food.
  • The sense of taste is the last one to go, but it might be diminished along with the sense of smell.
  • Inactivity can cause loss of appetite, so try to engage the memory loss person in some sort of physical activity. Even a stroll around the block helps.

End-stage Alzheimer’s patients almost always have trouble eating, and ultimately most have trouble swallowing. But if the person you are caring for is losing weight for no particular reason and is still mobile, it is a concern that needs to be addressed. Please consult with your physician when there is any question about weight loss and refusal to eat.

12 Tips for Getting Someone to Eat

  1. Finger foods might be easier to manage than a fork and knife.
  2. Eliminate foods that present a choking risk (hotdogs, chicken or fish that contain bones, etc.)
  3. Provide several small meals throughout the day instead of three large meals.
  4. Make the food tasty by including salt, herbs and spices.
  5. Dementia patients love ice cream. If cholesterol is an issue, substitute a dairy ice cream with a non-dairy frozen dessert such as Rice Dream®, Coconut Bliss or Soy Dream.
  6. Offer healthy snacks throughout the day, such as cheese and apple slices, nut butter on apple slices, smoothies, and diced fresh fruit.
  7. Create a soothing ambience by placing flowers and candles on the table, and playing soft classical music.
  8. Make sure to keep the patient hydrated, especially during the hot summer months.
  9. Provide a comfortable place to eat. If the patient has a bad back, it might be necessary to put a cushion on the chair.
  10. Do a happy, engaging activity before mealtime. Have the memory loss person help set the table or peel vegetables, if possible. Painting, listening to music, playing an instrument, or going for a walk might be all it takes to work up an appetite.
  11. It might be hard for the person to differentiate foods on a plate, especially if they are the same color. Use contrasting colors. For example, serve beets and carrots on white instead of white mashed potatoes on a white plate.
  12. Aromatherapy
  • Bergamot is the flavoring used in Earl Grey Tea. If your patient likes to drink tea, this might be an easy solution. Or, have the person smell bergamot oil, which is used for depression.
  • Citrus oils such as orange, lemon and lime along with ylang-ylang can help alleviate depression.
  • Peppermint and Spearmint are energizing and might stimulate appetite.

 

Protein shake recipes

Protein shakes are nutritious, filling, and nourishing. Use ingredients of your choice without relying on the sugary nutrition drinks that are generously handed out in institutions.

My favorite delicious and easy-to-make shakes

Banana Berry Shake

  • 1 frozen banana
  • ¼ cup sliced strawberries
  • 8 ounces of milk or non-dairy drink such as soy, almond, or coconut milk
  • 1 scoop of whey protein powder
  • Blend together until smooth.

Berry Sunrise Shake

  • 1/3 cup frozen blueberries
  • 3 medium strawberries
  • 8 ounces of orange juice
  • 1 scoop of whey protein powder
  • Blend together until smooth.

Chocolate, Banana, Peanut Butter Protein Shake

  • 1 banana
  • 2 Tablespoons peanut butter
  • 1-cup almond, soy or coconut milk
  • 1 scoop chocolate protein powder
  • 3-5 ice cubes
  • Blend together until smooth

Enjoy!

Is it really important to eat a good breakfast?

For more information on the importance of good nutrition to prevent caregiver burn-out, including recipes, read my new book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”—available June 1, 2016 where all books are sold.

Yes! It is absolutely important to eat a good breakfast, and here’s why. This is true for everyone, but especially important for caregivers. It’s recommended that we eat within one hour after waking to stabilize our blood sugar—which has dropped during sleep—so that your mood stays even and you can perform at your best.  If not, you’ll be more apt to reach for a bagel or doughnut or another cup of coffee. After loading up on carbs and empty calories (lacking in nutrition), it’s typical to feel hungry again within a couple hours. And every time our blood sugar crashes, it’s a signal to the body to store calories. The same goes for a hungry body. If you don’t eat breakfast, your blood sugar will be low, and this too is a signal to the body to store calories, which adds fat around your middle.

One of the most critical things you can do for your health and your mood is to keep your glucose levels stable. And that means it’s important to include a healthy protein with breakfast. 

Low blood sugar impairs your concentration and judgment, leaves you tired and fuzzy-headed, and sometimes makes you irritable. These symptoms often disappear after you eat something and your blood sugar rises. Part of the solution is emphasizing a diet rich in protein and non-starchy, high-fiber vegetables. Both protein and fiber help stabilize blood-sugar and insulin levels, which helps to prevent mood swings.

Some things to be aware of

What if you feel hungrier after breakfast? Your body has adapted to not eating breakfast or to eating a poor breakfast. Try eating less at night, or if you eat breakfast at 8am and get hungry at 10am, have a snack that contains protein, such as a protein shake, a small handful of nuts, yoghurt and fruit, or cottage cheese and fruit. You don’t want to get ravenous before lunch and then make a poor food choice.

What if you’re nauseous in the morning but you’re not pregnant? This might be an indication that your blood sugar is too low, and it’s important that you eat!

I need my caffeine fix! Is that bad? Studies show that those who drink the most coffee often suffer from chronic depression because caffeine depletes the body of B vitamins—crucial for dealing with the stress of caregiving —, vitamin C, calcium, potassium and zinc. Caffeine increases thirst because it dehydrates the body, and it overstimulates and weakens the kidneys, pancreas, liver, nervous system, stomach and intestines.

According to the Mayo Clinic, 2-3 cups of coffee can spike systolic pressure up to 13 points and diastolic pressure up to 14 points. If you have high blood pressure, limit your coffee intake to 3 cups a day, and avoid drinking it before exercise or physical labor, which both naturally raise blood pressure.

On the other hand, studies have show that caffeine can delay Alzheimer’s disease in people who are at risk. A study published in the Journal of Alzheimer’s Disease (2012) found that people older than 65 who had higher blood levels of caffeine developed Alzheimer’s disease 2-4 years later than people with lower caffeine levels. The study included 124 people who had mild cognitive impairment (MCI). Typically, 15% of people with MCI will go on to develop full-blown Alzheimer’s disease each year.

The study participants who had less than 1,2000 ng/ml of caffeine levels in their blood developed Alzheimer’s. This is equivalent to drinking several cups of coffee a few hours before their blood was taken. The people whose memory loss did not progress to full-blown Alzheimer’s had higher levels of caffeine in their blood. Coffee appeared to be the only source of caffeine for the participants in the study.

So monitor how you feel after you drink coffee. A safer choice might be a cup of chai or green tea, which has numerous heath benefits, including antioxidant protection.

Breakfasts of Champions

Instead of eating a bowl of cornflakes with a banana and low-fat milk, have a 2-egg omelet, slice of whole grain toast, a cup of fresh fruit and a cup of steamed greens such as kale. Then notice the difference in how you feel. You’ll have more stamina, less anxiety and depression, and will able to get through the whole day more easily.

Other ideas

  • Whole-grain mini-quiche with 1/2 cup berries
  • Oatmeal with prunes or raisins, walnuts or almonds, and cinnamon, whole milk
  • Multigrain hot cereal, Greek yoghurt and fresh fruit, almonds
  • Eggs with beans, salsa, and a side of greens
  • Bagel with hummus, tomato and goat cheese
  • Smoothie with greens, fruit, protein and flax

Recipe for Gluten-free Flax Meal Muffins

  •  ¾ cup brown rice flour
  • ¾ cup buckwheat flour
  • ½ cup ground flaxseed
  • ½ cup date sugar (or sweetener of your choice)
  • 1 tsp baking soda
  • ½ tsp ground cinnamon
  • ¼ tsp ground nutmeg
  • ¼ tsp salt
  • ½ cup raisins
  • 2 eggs
  • ¼ cup oil of your choice (I used grape seed oil)
  • 1/2 cup unsweetened applesauce
  • 1 cup buttermilk or coconut milk

Preheat oven to 375º. Line a 12-cup muffin tin with unbleached paper liners and set aside. In a large bowl, whisk together brown rice flour, buckwheat flour, flaxseed, sweetener, baking soda, cinnamon, nutmeg, salt and raisins.

In a second large bowl, whisk together eggs, oil, applesauce and buttermilk. Add flour mixture to buttermilk mixture and stir until just combined.

Spoon batter into prepared muffin tins and bake until golden brown and a toothpick inserted in the center of a muffin comes out clean, about 30 minutes. Cool muffins in pan for 5 minutes before transferring to a wire rack to finish cooling.

Recipe for overnight oatmeal made in a slow cooker

  • 2 cups old fashioned rolled oats –do not use the instant oats. (serves 4)
  • 1 3/4 cups water

or

  • 1 cup steel cut oats (serves2)
  • 4 cups water
  • Mix oats and water in slow cooker and set for 8-9 hours. These recipes work in a 1 1/2 – 2 1/2 quart capacity slow cooker.

The possibilities of things to add are endless. Some ideas: maple syrup, honey, butter, milk, coconut milk, brown sugar, raisins, dried apricots, prunes, dried cherries, dried coconut, fresh fruit, cinnamon, ginger, almond butter, apple butter, chia seeds, chopped walnuts or almonds, flax meal, etc.

Try some of these recipe and let me know how you feel. Have a great breakfast, and a great day!

 

 

 

Colorado First: Healing waters

Source: Colorado First: Healing waters

Why you should see a doctor if you’re worried about your memory

I’ve done it. You’ve probably done it, too.  Forgetting where you parked your car is not uncommon. Once I parked in a four level garage at a mall and walked up and down the stairwell with my then-teenaged daughter, who couldn’t find the car either. I ended up calling security and had the guard drive me through the parking garage until I found the car. That was a bit embarrassing. But forgetting where you parked or the name of a familiar face are common age-related memory lapses. I’ve always been lousy at remembering names of people I know, characters from novels, and the names of movies and actors. That doesn’t mean I’m losing it. My explanation, although it might not be scientific, is that I have so many facts and information stored in my brain that my memory is discretionary.

But if you have difficulty recognizing a relative, find your missing keys in the refrigerator, or get lost driving in the town you’ve lived in for years, you should make an appointment with your health care provider. Because if you do have cognitive impairment, the sooner you get help the better.

One of the first signs that my husband (who died from early-onset Alzheimer’s disease) was having memory lapses was that he started getting lost while driving the car in our home town. That scared him, and it scared me. I finally got him to agree to see a doctor, two years after I suspected that something was wrong.

There are lots of reasons to see a doctor if you or your loved one suspects that you are having cognitive difficulties.

  • Individuals who start to forget things or get confused can become depressed, anxious, angry, and/or frustrated because they don’t understand why their thoughts aren’t clear or why they are having difficulty performing certain tasks that were always easy. My philosophy is that knowledge is power. It’s better to know what is happening than to be left in the dark. A consultation with a health professional can help explain what is going on.
  • According to researchers at the University of Michigan, more than half of older adults with signs of memory loss never see a doctor about it. Although there is still no certain way to prevent or forestall most cognitive diseases, knowing that someone has serious memory problems can alert family members and friends to a need for changes in the person’s living arrangements that can be health-or even life-saving. Early evaluation and identification of people with dementia may help them receive care earlier,” says study author Vikas Kotagal, M.D., M.S. “It can help families make plans for care, help with day-to-day tasks including observed medication administration, and watch for future problems that can occur. In some instances, these interventions could substantially improve the person’s quality of life.”
  • If driving becomes difficult it’s important to get an evaluation from your local Driver Motor Vehicle department because of liability and safety issues. This is a very touchy subject and was one of the most difficult thresholds for my husband and me to cross through. He continually blamed me for being the ogre who took away his car keys. But it’s important to know that if a caregiver, spouse or other significant family member knows that a loved one has a diagnosis of Alzheimer’s or other dementia, that family member could be held responsible in case of an accident. If, god-forbid, someone is killed, the repercussions could be emotionally, physically and financially disastrous.

What Should You Do?

  1. Make an appointment with your general physician and express your concerns. Your doctor will ask you some questions such as: how are you sleeping at night? How often do you drink alcohol? Are you sedentary? Do you exercise? Are you depressed? What is your typical diet? Your doctor might do a blood panel to determine if you have any organic markers such as low thyroid or anemia that could affect your energy and memory.
    2. Your doctor might give you a brief memory assessment or refer you to a memory clinic for further evaluation. The MMSE (Mini-Mental State Exam,http://www.mountsinai.on.ca/care/psych/on-call-resources/on-call-resourc…) is an eight-minute test that has been used since 1975. According to neurologists, the 10-12 minute MoCA (Montreal Cognitive Assessment,http://www.mocatest.org/about/), used since 1996, is more discerning.

Don’t delay. Make an appointment if you or your loved one has memory concerns.

10 Signs of Alzheimer’s Disease
1. Memory loss that disrupts daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality

Reference
Kotagal V, Langa KM, Plassman BL, Fisher GG, Giordani BJ, Wallace RB, Burke JR, Steffens DC, Kabeto M, Albin RL, Foster NL. Factors associated with cognitive evaluations in the United States. Neurology. 2015 Jan 6;84(1):64-71.