Is it time to take away the car keys?

Senior woman driving a car in traffic jamDeciding when to take the car keys away from someone with dementia is one of the most heart wrenching tasks that caregivers face. The milestone is a huge blow to the driver, who loses his/her independence, and to the caregiver, who is forced to take on even more responsibility. My husband never forgave me for taking away his car. He reminded me on a weekly basis that he was angry with me.

But according to a study at Florida Atlantic University, Boca Raton, FL, drivers diagnosed with early Alzheimer’s disease may be able to maintain their road skills over the course of a year if they are treated with Memantine.*  The study included 60 otherwise healthy men and women over 60 years of age, who had mild Alzheimer’s disease — defined as a Mini Mental State Examination score of at least 23. Twenty-nine participants completed six months of the program, and 25 completed the 12-month study.

Peter Holland, MD, lead author of the study, said that despite the small group of participants in the study his research team was able to show a statistically significant difference between the drivers who were on memantine and those who were on placebo. In an article written by Ed Susman for MedPage Today, Holland is quoted as saying, “We believe that adding Memantine to the drug regime is effective in delaying driving impairment in subjects with mild Alzheimer’s disease.”

An earlier study done at the University of Michigan in Ann Arbor assessed the driving skills of 17 people with a diagnosis of early stage dementia. Their cars were equipped with special instruments for the two-month study in order to analyze a set of driving behaviors that might be common among drivers with dementia. The memory-impaired individuals were able to drive as safely as the comparison group, but they were more likely to get lost.

Although some people with early stage Alzheimer’s disease are able to drive for a year or two after diagnosis, it’s imperative that caregivers continually assess their skills in order to ensure safety for the driver, passenger(s) and other drivers. If a person with Alzheimer’s disease is in a tragic automobile accident, the consequences can be emotionally, physically and financially catastrophic for the families involved.

When you are concerned about the safety of a memory-impaired driver

Dr. Jason Karlawish, associate director of the Memory Disorders Clinic and fellow of the Center for Bioethics at the University of Pennsylvania, said it helps to give dementia patients’ families some perspective.

“In my practice, I recommend that family members and friends ask themselves a simple question,” he said. “‘Would you let your relative with Alzheimer’s disease drive the grandchildren, or someone else’s grandchildren, to an event?’ If they answer to this is anything less than a simple ‘Yes,’ then it is sensible to consider at least a driving evaluation or even taking away the keys.”

 For caregivers, the question of when to take away the car keys is always a difficult one. Here are some resources that can help.

  • Make an appointment with your doctor and let him or her make the decision. Often the memory-impaired individual will listen more readily to a doctor than to a family member or friend.
  • Contact the Alzheimer’s Association® for help. 24/7 Helpline: 1-800-272-3900 or visit their site that specifically discusses Driving assessment.
  • The University of Michigan Transportation Research Institute and the UM Drive-Ability Program has published an excellent on-line driver evaluation test at: um-saferdriving.org. This is an excellent assessment of driving ability for seniors and those with early stage Alzheimer’s disease. The test can be completely in less than 30 minutes, with or without the help of a caregiver. Based on the answers, a report is instantly issued with health concerns the driver might be experiencing, i.e. reduced visual acuity, and a list of driving skills that might be affected by the health concerns, i.e. turning, yielding, etc. A list of recommendations for safer driving is given, along with a list of ways to modify the driver’s vehicle and other safety tips.
  • When Your Are Concerned: A Handbook for Families, Friends, and Caregivers Worried About the Safety of an Aging Driver (and Help Network) is an 8 chapter handbook available online. aging.state.ny.us/caring/concerned
  • How to Help an Older Driver is a 30-page booklet that provides readers with details of how age and medications affect a person’s driving skills, how to assess an older driver’s skills both through self-screening and by observing various factors, how to help an older driver by ensuring he or she exercises and sees a physician regularly, and what features to look for in choosing a car. It also provides a list of driver refresher courses and offers suggestions for how to help older drivers cope and plan for driving cessation, and how to overcome the fear of losing independence. Finally, it provides contact information for every state department of motor vehicles and lists of useful websites for aging drivers. Funded by AAA Foundation for Traffic Safety. aaafoundation.org

* Memantine is the first in a novel class of Alzheimer’s disease medications acting on the glutamatergic system by blocking NMDA-type glutamate receptors. It was first synthesized by Eli Lilly and Company in 1968. Memantine is marketed under the brands Axura and Akatinol by Merz, Namenda by Forest, Ebixa and Abixa by Lundbeck and Memox by Unipharm. Memantine has been shown to have a modest effect in moderate-to-severe Alzheimer’s disease and in dementia with Lewy bodies. Despite years of research, there is little evidence of effect in mild Alzheimer’s disease. (wikipedia)

If you’d like to read more articles like this, please subscribe to thehealthycaregiverblog.

If you would like to read about tools and techniques that can help you stay strong as a caregiver, reduce stress and support your immunity, read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia

BarbraCohn__

The best gifts for people with Alzheimer’s and dementia

Christmas gift or New Year with blue ribbon and greeting card on wood table on bokeh background. Tiny and Handmade gift box concept.Instead of worrying about what to give a friend or loved one who suffers from Alzheimer’s disease or dementia consider this. What that person really wants more than anything is to just be with you. So here’s a list of things you can do together.

  1. People with dementia love ice cream. Share a pint of his or her favorite. Bring the toppings and arrange them on a table in little bowls—sprinkles, chocolate chips, chopped fruit, whipped cream, butterscotch or chocolate sauce, etc.
  2. Watch a comedy together. It doesn’t matter if your loved one can follow the plot or not. If you laugh, he or she will probably join in the merriment. Laughter triggers the production of endorphins; the brain chemicals that reduce the sensation of pain and make you feel good.
  3. Bring a dog to visit your loved one. If you don’t have one, borrow one. There’s nothing like a friendly pup to cheer someone up and add some excitement. Listen to music together.
  4. Put on a CD and sing together. Big Band Music is usually a hit with most 70, 80 and 90 year olds. If your loved one is younger, you can try classic rock.
  5. Get out the paint brush, paper and water colors. You don’t have to be an artist or art teacher to have fun with your loved one. Painting and drawing is a great way to share time together, and to even express feelings of frustration, irritation and fear—on paper.
  6. Dance to the music. If your loved one is still mobile help him or her get up and move. The exercise will enhance memories, even if temporarily. A short surge of condensed exercise boosts the compression of memories in both elders in good mental shape as well as those with slight cognitive impairment, according to new research by a team of scientists from UC Irvine’s Center for the Neurobiology of Learning & Memory.http://www.cnlm.uci.edu/
  7. Go for a drive and get some fresh air. Just getting out of the house or memory care home does a body good.
  8. Hold hands, give a foot massage. Use aromatherapy oils (see chapter 18 “Aromatherapy” in The Caregiver’s Journey Through Alzheimer’s and Dementia
  9. Create a book of photos that depict your loved one’s life and share memories without saying “remember when. . .”
  10. Just breathe together and be still in the silence. It’s the greatest gift of all.

Treat yourself to the perfect gift for all caregivers to help you feel healthier and happier, less stressed, sleep better, deal with feelings of guilt and grief and find inner peace. The Caregiver’s Journey Through Alzheimer’s and Dementia

BarbraCohn__

12 quick energy and stress fixes to use throughout the holiday season . . . and all year long

Young ambitious executive enjoying his business success as he stThe holidays are stressful for everyone, but especially for caregivers. Here’s a list of some of my favorite stress relievers and energy boosters.

  1. Breathe! When we are stressed, we tend to hold our breath. Take a 5-minute break and sit down in a comfortable chair. Close your eyes and take a deep breath, in and out. Then focus on your breath and watch how your mind quiets down and your muscles relax. Then remember to breathe throughout the day. Whenever you feel yourself getting anxious or tight, take a deep breath and let it go.
  2. Drink water. We’ve heard it a million times but it’s always good to be reminded. Forget about sodas and limit the wine and alcohol. Staying hydrated, especially at this time of year, is vital to supporting the immune system and reducing inflammation. It’s also important to support healthy cognitive function and memory.
  3. Eat walnuts. A daily dose of about 9 whole walnuts or 1 Tbs. walnut oil helps your blood pressure from spiking during stress. Walnuts contain L-arginine, an amino acid that helps relax blood vessels, which in turn helps reduce hypertension.
  4. Drink green tea. L-Theanine is the main chemical constituent in green tea. It is an ideal nutritional aid for stress because it produces alpha-wave activity that leads to deep relaxation and mental alertness. This is especially important because in order to mitigate stressful situations, it’s important to remain calm and alert. Theanine also stimulates the release of the neurotransmitters GABA, serotonin and dopamine, which help us feel happy, motivated and calm. Green tea extract is available as a nutritional supplement, which might be easier and quicker to take, and it’ll save you a lot of trips to the bathroom.
  5. While we’re on the topic of “green,” be sure to eat green leafy vegetables for vitamin B and magnesium, both of which help your body cope with stress.
  6. Two handfuls of cashews (make that a small handful, please; one ounce of cashews contains 157 calories.) provide the equivalent mood-boosting effect as a therapeutic dose of Prozac because they are one of the highest natural sources of tryptophan, the precursor for serotonin, the feel-good neurotransmitter.
  7. Did someone mention dark chocolate? It reduces cortisol, the stress hormone that causes anxiety symptoms. Just a couple of pieces should do the trick.
  8. Walk around the block. Just getting out into fresh air will instantly relieve stress, and moving your body gets your blood pumping and will clear your mind.
  9. Light candles and play relaxing music while you eat. It will change the mood instantly.
  10. Aromatherapy is a miracle cure for stress and anxiety. Use a wall plug-in to diffuse the aroma of lavender oil to uplift mood, or place a few drops on a handkerchief and tuck it into a shirt pocket or on a pillow. Other oils to try: vetiver, frankincense, myrrh, orange, lemon, bergamot, and grapefruit.
  11. Music is the universal language, and it is also the universal stress reliever. Whether it’s jazz, classical, or hard rock that makes you feel better, by all means, play it loud, play it soft, dance to it, drive to it, go to sleep to it. It will definitely help.
  12. Getting the proper rest is vital to staying healthy and reducing stress. Prepare yourself for a deep night’s sleep by unplugging from electronics at least an hour before bed, taking an Epsom salt bath (put several drops of lavender oil in the water for added relaxation), and making sure the room temperature isn’t too warm.  Good night, sleep tight!

If you, or someone you care about, tend to suffer from stress, anxiety, or depression, these recommendations might just “take the edge off” and improve your quality of life … without the risk of side effects. May the holiday season begin!

For dozens more tools and techniques for reducing stress, uplifting mood, supporting your immune system, and finding ways to connect on a spiritual and emotional level with the person you care for, read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.

BarbraCohn__

The 10 best ways to observe National Alzheimer’s Awareness Month

Ribbons of awarenessIt’s November, which means it’s time to enjoy your Thanksgiving with family and friends.

  1. It’s also time to do your brain a favor and take advantage of the free cognitive exam as part of Medicare’s Yearly Wellness Exam. Despite clear signs that their memory and thinking abilities have gone downhill, researchers have found that more than half of seniors with these symptoms haven’t seen a doctor about them. University of Michigan researchers and their colleagues say their findings suggest that as many as 1.8 million Americans over the age of 70 with dementia are not evaluated for cognitive symptoms by a medical provider, which in some patients can lead to a failure to uncover modifiable causes of thinking or memory impairment.

The study, published in Neurology, the medical journal of the American Academy of Neurology, documents a clear lack of clinical testing for seniors with signs of cognitive problems.“Early evaluation and identification of people with dementia may help them receive care earlier,” says study author Vikas Kotagal, M.D., M.S., who sees patients at the University of Michigan Health System and is an assistant professor in the U-M Medical School’s Department of Neurology. “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.”

For instance, knowing that a stroke or vascular issues in the brain caused dementia means patients can work to control risk factors like blood pressure that might otherwise cause it to keep worsening. If your physician suspects Alzheimer’s disease, there are drugs that can help delay the onset of full-blown dementia, and the possibility of placement in a memory care facility, which can help offset the catastrophic cost of the disease.

If you’ve had Part B for longer than 12 months, you can get the free Medicare Annual Wellness Exam to develop or update a personalized plan to prevent disease and disability based on your current health and risk factors. The exam includes:
• A review of your medical and family history
• Developing or updating a list of current providers and prescriptions
• Height, weight, blood pressure, and other routine measurements
• Detection of any cognitive impairment
• Personalized health advice
• A list of risk factors and treatment options for you
• A screening schedule (like a checklist) for appropriate preventive services. Get details about coverage for screenings, shots, and other preventive services.
This visit is covered once every 12 months (11 full months must have passed since the last visit).

2. Combat stress by playing relaxing music, dancing, using an aromatherapy diffuser, taking an Epsom salt bath, turning off electronics at least an hour before bed, etc. Health professionals agree that stress can lead to chronic illness. And in the case of caregiving, it can actually take years off your life.

3. Become a savvy caregiver. The Alzheimer’s Association has chapters throughout the U.S. and offer free classes ranging from how to make financial plans to learning about the latest research in dementia care. Check out their Education and Resource Center.

4. Maintain healthy weight. Women with a thick waistline are at increased risk for dementia. As if you don’t have enough to worry about. A 32-year-long study by Swedish researchers, which was recently published in the scientific journal Neurology, found that women who gain weight around their middle and live to at least 70 years old are at twice the risk for developing dementia.

Medical research has already established a link between fat around your middle and a higher risk of dying prematurely from heart attack or stroke. But this new research provides even more incentive for reducing calories obtained from refined carbohydrates such as breads, pastries, cookies, candy, ice cream and pasta.

The research included almost 1,500 women between the ages of 38 and 60 and was started at the end of the 1960s. Thirty-two years later a follow-up found that 161 women with the average age of 75, had developed dementia. This study shows that women who had a pear-shape figure, broader around the waist than hips, had more than twice the risk of developing dementia when they got old.

What is Metabolic Syndrome?

Also called Syndrome X, it’s caused by a diet filled with refined carbohydrates. The cycle goes like this: you eat a bagel with some orange juice and coffee for breakfast. Have an apple mid-morning. A salad with a piece of French bread for lunch. A handful of M & Ms mid-afternoon, pasta and salad for dinner, and some popcorn later while you’re watching TV. Doesn’t sound too terrible. But the thing is, these foods are mostly simple carbohydrates, which means your digestive system converts them into glucose, which causes your blood sugar to rise quickly. Your pancreas responds by pumping out insulin to convert the glucose into quick energy.

The problem is, the more carbohydrates you eat, the more your body pumps out insulin to deal with all the extra blood sugar. Eventually your body becomes overwhelmed by the amount of insulin and sluggish in response to it. Before you know it, you’ve developed insulin resistance, meaning your cells have lost their sensitivity to the hormone and require even more of it to maintain normal glucose levels. When blood sugar and insulin levels go up, Metabolic Syndrome (Syndrome X) and weight gain result.

What can you do about it?

If you tend to grow love handles around your middle, do something now to protect your heart and brain.

  • Limit the amount of carbohydrates you eat
  • Include a high-quality protein with every meal, such as salmon or chicken
  • Exercise regularly
  • Add whole foods to your diet instead of highly processed foods, including brown rice, quinoa, and whole oats, 5-9 servings of fruits and vegetables, cottage cheese, eggs
  • Take nutritional supplements proven to support healthy glucose levels: Bitter melon Momordica charantia), cinnamon, green tea extract, Salacia reticulata, Banaba leaf, chromium

5. Get regular dental check-ups. It’s hard to determine which comes first, Alzheimer’s disease or inflamed gums, but they seem to go hand in hand. A recent study done at the College of Dentistry, NYU, New York, NY proposes that chronic periodontitis might contribute to the onset and progression of Alzheimer’s disease. Inflammation and Alzheimer’s disease

And in the famous Nun Study, one of the first documented studies of Alzheimer’s in a specific population, the researchers found that the participants with the fewest teeth had a higher incidence of dementia. In fact, the researchers concluded that having very few teeth -one to nine-might be a predictor of dementia late in life

How to prevent gum disease

Frequent dental visits may become necessary to ensure a thorough cleaning of the teeth, roots and gums.

Supplementation with vitamin C is important in order to try to maintain healthy gum tissue.

Lycopene may be effective in treating and preventing gingivitis. Lycopene is the carotenoid which makes tomatoes red. It is a popular supplement for supporting prostate and cardiovascular health, and helps prevent macular degeneration and other types of cancer. A recent study compared just taking lycopene as a supplement to a combination treatment of taking lycopene and root scaling and planing in patients with gingivitis. The groups that were treated demonstrated significant reductions in gingivitis, but the group that received both lycopene and prophylaxis showed a statistically significant reduction in symptoms.The results presented in this study suggest that lycopene shows great promise as a treatment for gingivitis.

Gingivitis vs. Periodontitis

Gingivitis (gum inflammation) usually precedes periodontitis (gum disease). The gums can become swollen and red, and they may bleed while brushing your teeth. Although the gums may be irritated, the teeth are still firmly planted in their sockets, and at this stage, no bone or other tissue damage has occurred.

When gingivitis is left untreated, it can advance to periodontitis, which is an infection caused by bacteria under the gum tissue. The gums can pull away from the tooth, bone can be lost, and the teeth may loosen or even fall out.

Warning signs of periodontal disease

  • Bad breath or bad taste that won’t go away
  • Red or swollen gums
  • Tender or bleeding gums
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Gums that have pulled away from your teeth
  • Any change in the way your teeth fit together when you bite
  • Any change in the fit of partial dentures

6. Buy a new pair of walking shoes and a comfortable workout outfit. You deserve it! You also owe it to yourself to move your body. For years, health professionals have been preaching about the importance of exercise to cardiovascular and overall health. “Whatever is good for the heart is good for the brain.” The latest study of older adults at increased risk for Alzheimer’s disease is the first evidence that physical activity may protect against cognitive decline and the onset of dementia symptoms in people who carry the genetic marker for Alzheimer’s.

The hippocampus, the brain region responsible for memory and spatial orientation, normally loses some volume as we age. But overtime, people with an increased genetic risk for Alzheimer’s disease experience greater atrophy in that area of the brain, which means they experience greater memory loss and cognitive dysfunction.

The good news is that Dr. J. Carson Smith, a kinesiology researcher in the University of Maryland School of Public Health, and his colleagues found clear evidence that being physically active has the potential to help protect the hippocampus in people at increased risk for Alzheimer’s disease. This is especially significant because if you know that exercise can help delay the onset of the disease and if you engage in an exercise regimen it could extend your longevity and ability to take care of yourself. This, in turn, would reduce the financial burden of needing a caregiver and other medical intervention.

Dr. Smith and colleagues tracked four groups of healthy older adults ages 65-89, who had normal cognitive abilities, over an 18-month period and measured the volume of their hippocampus (using structural magnetic resonance imaging or MRI) at the beginning and end of that time period. The groups were classified both for low or high Alzheimer’s risk (based on the absence or presence of the apolipoprotein E epsilon 4 allele) and for low or high physical activity levels.

Of all four groups studied, only those at high genetic risk for Alzheimer’s who did not exercise experienced a decrease in hippocampal volume (3%) over the 18-month period. All other groups, including those at high risk for Alzheimer’s but who were physically active, maintained the volume of their hippocampus.

Whether you are at high risk for Alzheimer’s or not, it’s never too late or too early to start a daily exercise regimen. If you are sedentary start walking 30 minutes three days a walk, and go from there. Park your car at the opposite end of the parking lot, from where you need to go. Get a walking buddy, or get a dog. Whatever you do, be serious about being physically active. It could have a huge impact on your life and the lives of your loved ones.

7. Sleep more soundly. There are plenty of studies linking poor sleep to a host of physical and psychological ailments: poor immunity, elevated levels of cortisol and insulin, weight gain, diabetes, cardiovascular disease and even Alzheimer’s disease. And irritability, foggy thinking and anxiety, depression and low energy can directly impact your ability to care for another person, do household chores and get in the way of your interpersonal relationships. Discover ways why Good sleep hygiene is the first step to improving your sleep.

8. Include turmeric in your diet. Turmeric is what gives curry its yellow hue and tang. But it does a lot more than flavor the most popular Indian dish. Turmeric has numerous health benefits. 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, and its ability to inhibit the build up of amyloid plaque.

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.

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.

How to get more turmeric into your diet?

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

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, soups, potato pancakes, casseroles. You can’t go wrong, and you can’t overdose on turmeric.

Use as a cold, flu and congestion remedy
Turmeric has been used as a natural remedy for centuries to help prevent and cure 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 helps your memory.

9. Is it time to move your loved one to a memory care home? If your loved one has Alzheimer’s or another form of dementia and it is getting difficult to provide a safe environment for him/her, please take the time NOW, before a crisis arises, is the time to investigate the memory care homes in your area. A good place to start is by calling the county’s senior social services office, or by speaking with an ombudsman who is knowledgeable about the pros and cons of the local memory care homes. Signs that it’s time to make the big move.

10. Evaluate your driving. Play it safe. If you or a loved one has dementia, please park you car for good. Don’t take a risk of getting lost or worse, injuring yourself or someone else.

November is the perfect time to incorporate a new health regimen into your daily routine. Start today and get a head start at the beginning of the holiday season to maintain healthy weight, strengthen your immunity to flues and colds, and protect your mental health and memory.

HAPPY THANKSGIVING!!!!

 

For more information on how you can reduce stress and boost your happiness and health, read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.

BarbraCohn__

Is it forgetfulness, dementia or Alzheimer’s?

Senior Woman Comforting Depressed Husband Sitting On Bench

At one time or another, most of us have forgotten where we put our keys, our phone, glasses, or even parked our car. Have you ever walked into a room and forgotten why you went in? Sure. Run into an acquaintance and forgotten the person’s name? Yes, and it’s embarrassing.

It doesn’t mean you have dementia or Alzheimer’s. I call memory blips “brain farts.” They become more common as we age because our brains form fewer connections so the memory is not as strong as it once was. Also, the speed at which our brain processes stored facts, figures and names becomes slower. Recall becomes slower. (One trick I have for bringing up a person’s forgotten name is to go through the alphabet. It almost always works.)

Forgetfulness can be a normal part of the aging process, or it could be triggered by these physical conditions:

  • insomnia, or lack of sleep (for help in this area read 16 ways to sleep better)
  • thyroid condition
  • drug interactions
  • too much caffeine and/or alcohol
  • stress (Read 16 Stress busters)
  • vitamin B12 deficiency
  • UTIs –urinary tract infections
  • dehydration (please remember to drink at least 6 glasses of water every day)
  • depression and/or mood disorders

The best way to rule out memory problems is to have a full physical exam including a blood panel. Please make an appointment with your doctor to discuss your concerns. Sometimes a memory issue can be cleared up by just getting more sleep or by taking a vitamin B complex supplement.

But if you find yourself putting your keys or your phone in strange places like the refrigerator, getting lost in the city you’ve lived in for decades, or forgetting how to scramble your eggs, this could be indicative of a more serious problem.

Dementia or Alzheimer’s? 

Dementia is the name for an umbrella of  brain disorders with the primary symptoms being memory loss, inability to think clearly or to express oneself, difficulty making decisions and solving problems, and trouble controlling emotions. The term dementia usually refers to degenerative conditions of the brain that result from trauma, as in the brain injuries found in athletes, but more commonly it is used to refer to conditions related to a disease.

Dementia is a major symptom of these diseases:

Alzheimer’s disease is the most common neurocognitive disorder and affects almost 6 million Americans. The number of Americans with Alzheimer’s disease is expected to nearly triple over the next generation. In the early stage of the disease, people with the disease will find it difficult to remember recent events such as what they had for dinner the night before, or even just a few hours ago. They will most likely be depressed because they can’t manage things as well as they used to. An active person might lose interest in things that used to excite them. And the person might forget names of people near and dear. As the disease progresses, emotional behavior will change, the ability to communicate will be impaired and confusion will take over. Everyday tasks such as bathing will become a challenge. Later, physical changes will occur such as the inability to walk or talk and eventually swallow, which often leads to death.

Frontotemporal dementia often emerges around the age of 60 years, but it can appear in people who are in their 20s. It involves a loss of nerve cells and affects behavior, language and movement.

Dementia with Lewy bodies can resemble those of Alzheimer’s disease, but there may also be sleep disturbances, visual hallucinations, and an unsteady walking pattern. Lewy bodies are collections of protein that develop inside nerve cells and prevent them from functioning properly.

Creutzfeldt-Jakob disease represents a number of brain diseases that cause problems throughout the body. They are thought to be triggered by prion proteins. A prion is neither a virus nor a bacterium, but it can cause a disease. Types of Creutzfeldt-Jakob disease (CJD) include bovine spongiform encephalopathy (BSE), or “mad cow disease.” Symptoms include rapid memory, behavior, and movement changes. It is a rare and fatal condition.

CTE–Chronic Traumatic Encephalopathy is a progressive degenerative disease which afflicts the brain of people who have suffered repeated concussions and traumatic brain injuries, such as athletes in contact sports such as football. s

Huntington’s disease is a genetic disorder that results from a defect on chromosome 4. It can lead to mood changes, abnormal movements, and depression. The person may experience an ongoing decline in thinking and reasoning skills. There could be slurred speech and problems with coordination. It tends to appear between the ages of 30 and 50 years.

Parkinson’s disease is a motor system disorder. The hallmark signs include trembling, especially tremor in the hands. It can also involve depression and behavioral changes. In the later stages, the individual may have difficulty speaking and sleep disturbances.

Vascular dementia, also known as post-stroke dementia, can appear after a stroke, when there is bleeding or vessel blockage in the brain. It affects a person’s thinking and physical movements. Early symptoms may include an inability to organize, plan, or make decisions.

Preventing dementia

Although there is no cure yet, there are measures you can take NOW to stave off brain and mental decline. Click here to read 8 Ways to Train Your Brain.

Additionally, 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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
  7. 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.
  8. 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.
  9. 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.
  10. 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.

For more information on how you can reduce stress and boost your happiness and health, read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.

BarbraCohn__

 

A UTI, fall or a cold can lead to cognitive decline and even death in a person with Alzheimer’s disease

Dementia disease and a loss of brain function and memories

November is Alzheimer’s Awareness Month 

People with Alzheimer’s who get even a mild respiratory or gastrointestinal infection, or a bump or bruise are at risk for having a significant, permanent memory loss, according to a report that was published in the September 8, 2009 issue of the journal Neurology. These patients can have high levels of tumor necrosis factor—alpha (TNF-a)—a protein that is linked to inflammation and is associated with memory loss and cognitive decline.

In the study, which was done at the Clinical Neurosciences Research Division at the University of Southampton, United Kingdom, 222 Alzheimer’s patients were followed for six months. Of those, 110 people had an infection or injury that resulted in inflammation. These individuals had twice the memory loss during that period of time as the individuals who did not have an illness or injury. Researchers attribute the memory loss to inflammation. In patients whose TNF-a levels were high to begin with, an infection increased their memory loss to 10 times more than those who had low TNF-a levels.

Clive Holmes, PhD, lead researcher, said that this population should be vaccinated against the flu, and infections and injuries should be treated as soon as possible.

It is not uncommon for an elderly person to die from a urinary tract infection, especially someone who has dementia. Even a mild cold can develop into a serious pneumonia and lead to death in an elderly person. My husband developed a kidney stone, and died six weeks later. He progressed from a person in mid- to late-stage Alzheimer’s to someone in the final stage of Alzheimer’s, unable to walk or talk.

Tips for keeping you and your loved one healthy and safe

  • Inoculate against flu, pneumonia and shingles
  • Boost immunity with zinc, vitamin D and vitamin C
  • Prevent falls and accidents (recommended: Complete Guide to Alzheimer’s Proofing Your Home by Mark L. Warner
  • Reduce systemic inflammation with a curcumin (turmeric extract) supplement
  • Use a humidifier to moisturize nasal passages and mucous membranes to help keep them healthy
  • Engage in gentle exercise to reduce inflammation
  • Keep hydrated by drinking at least 6-8 glasses of water each day
  • Reduce risk of urinary tract infections with D-Mannose powder and cranberry extract 
  • Use essential oils (lemon, peppermint, lavender, frankincense, bergamot, thyme, sandalwood, vetiver, myrrh) to boost immunity. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn
  • Eat yogurt. 70% of your immune system lies in your gut. Probiotics are live bacterial microorganisms that populate the human gastrointestinal tract. They combat the daily bombardment of toxins and pathogens (bacteria, fungus, parasites, and viruses) that enter our digestive system every day through contaminated food and other toxins. Recent studies show that the bacteria in your gut can also affect your mental health, mood and stress levels. Fermented foods such as kombucha, Greek yogurt, kefir, sauerkraut, miso, cottage cheese are probiotics. Probiotic bacteria colonize the digestive tract with good bacteria. Prebiotics are the food and nutrients that feed probiotics. Prebiotic fiber is found in fruits and vegetables such as artichokes, jicama, wild yams, onions and garlic, asparagus, beans, oats, chicory root and Jerusalem artichokes. Prebiotics support mineral absorption, vitamin utilization, and healthy blood sugar levels. Your gut needs both pro- and prebiotics in order to stay healthy and keep you healthy.
  • Drink mineral broth. It helps alkalinize the body and warm the system. It also helps counter the negative effects of stress. Have it as a bowl of soup or sip it throughout the day. Use your vegetables scraps or chop 2 cups yams, 1 medium potato, 1 cup zucchini, 1 cup cabbage, 1 cup green beans, 2 cups celery, 1 cup onions. Add herbs, garlic, parsley–anything you like. Place in a large pot, cover with water, bring to a boil, turn down to a simmer, and cover for 3-5 hours. For more information read chapter  31 “Nutrition” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn

BarbraCohn__

16 ways to sleep better . . . so you can be a better caregiver

Woman sleeping on a comfortable bed in the clouds

We’ve all had those sleepless nights in which we toss and turn, look at the clock and feel stressed that we aren’t going to get enough sleep. When you are caring for someone else–whether it’s a toddler, sick relative or someone with Alzheimer’s or dementia, it’s even more important to get a good night’s sleep.

There are plenty of studies linking poor sleep to a host of physical and psychological ailments: poor immunity, elevated levels of cortisol and insulin, weight gain, diabetes, cardiovascular disease and even Alzheimer’s disease. And irritability, foggy thinking and anxiety, depression and low energy can directly impact your ability to care for another person, do household chores and get in the way of your interpersonal relationships.

Here is a list of things to try when you are stressed, your mind is on overload, or when you’ve just had too much stimulation and can’t fall asleep or stay asleep.

Good sleep hygiene is the first step to improving your sleep.

  1. Refrain from drinking caffeine after 1:00 pm.
  2. If you need to visit the bathroom during the night, limit your fluid intake after dinner.
  3. Do not resort to alcohol to help you sleep. It usually impairs sleep, and you might wake up with a headache.
  4. Try valerian, passion-flower or skullcap herbal tea at least a couple of hours before bedtime.
  5. A cup of warm milk with a small pinch of cardamom, coriander, cinnamon, turmeric and cumin, and an 1/8 of a tsp of ghee is a tasty and relaxing bedtime drink. The calcium in the milk is a muscle relaxant and the Indian spices help induce relaxation. Experiment to see which spices you like.
  6. Turn off all electronics at least 30 minutes before bedtime. This is difficult for most people so it will take some effort. Instead, listen to soothing music or read a relaxing book.
  7. Do not watch the news or listen to the radio with current news before bed. World and political events can be upsetting and unsettling.
  8. Make your bed as comfortable as possible. Cotton sheets are usually more comfortable than synthetic. Is it time to replace your mattress? When is the last time you turned it over?
  9. A cool bedroom is usually more conducive to sleep than an overheated room. On the other hand, feeling cold will not help you sleep, either. If you feel cold at bedtime, warm up some neck wraps in the microwave and place them in your bed so it’s toasty when you get in. Then when you feel warm and are starting to fall asleep you can throw them on the floor. Or, warm up your bed with a heating pad. One of my favorite thing to do is to put on pajamas that have been heated in the clothes dryer for 5 minutes.
  10. Get black out curtains. It’s easier to sleep when there is no light coming through the windows.
  11. Eat a banana. Bananas contain potassium and magnesium that help reduce risk of muscle cramps. These two minerals also support heart health and cognitive function.
  12. A drop in blood sugar during the night can cause us to wake up. Although it’s better to not go to sleep on a full stomach, a small protein snack such as a slice of cheese or smear of peanut butter on a cracker can help maintain balanced blood sugar.
  13. Exercise during the day to get your heart pumping and to maintain overall health. Just don’t do it too close to bedtime because you will get energized.
  14. Go to sleep when you get sleepy but make sure it’s before 11:00. According to Ayurveda, the ancient Indian healthcare system, it’s best to be in bed by 10:00.
  15. Melatonin supplements help some people, but you might have to experiment with the dosage. I like Natural Vitality’s Natural Calm, a powdered calcium supplement that you put in water or juice. I also like the homeopathic remedy Hyland’s Calms Forte.
  16. Use ear plugs if it’s noisy in your neighborhood. Again, you might need to experiment in order to find the product you find is most comfortable.

As a caregiver you probably think of yourself last. But it’s crucial that you take care of yourself because if you don’t, it will be able to take care of your loved one(s). So take the time to experiment. Promise yourself that you will put an emphasis on trying to improve your sleep. You will notice a difference right away, and so will everyone in your life.

Good night, sleep tight!


“Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn contains a treasure trove of information on how to stay connected with your loved one, keep calm, improve immunity, reduce stress and feel happier and healthier. Plus, it includes 20 healing modalities that the caregiver can do alone or with their loved one. Available wherever fine books are sold and on Amazon.

BarbraCohn__

 

 

Dealing with a loved one’s things after their death

 

Wohnungsauflösung

I confess. I am attached to my material possessions. It’s very important to me that I live in a beautiful environment and that means being surrounded by beautiful things. I have had the good fortune to inherit lovely things from my deceased in-laws. Their various art collections grace my walls and I enjoy them. But actually, at this stage in my life I would prefer to live more simply in a small, uncluttered home where I don’t need an alarm system to provide peace of mind that my beautiful things will be forever guarded and safe.

Now that my mother has passed away I have more beautiful things. But this time around, as I weathered the storms of her many health crises I was able to think about the things I would like to keep and visualize what it would actually be like to clear out her apartment. I contemplated the reality of having to face the thankless task of going through her top drawer and disposing of her most intimate things: eye glasses, hearing aids, medications, bras, and underwear. I think this exercise helped me to get through the actual tasks required after she died.

Creating a safe space for family

I invited my adult children, my brother’s wife and their daughters, my mother’s sister and husband, and a few cousins to my mother’s apartment the day after she was buried. Since everyone lived at least a thousand miles away, the “farewell party” had to be expedient. Most people were flying home that afternoon.

I asked everyone to browse through the things I had laid out on the couch and the many items, including a collection of paper weight and Lladro figurines, that were displayed in two large glass showcases. Next, we took turns choosing what we would like to take home as a remembrance of our mother, sister, grandmother, and cousin. It worked beautifully because my mother’s family happens to be one of the most “normal” families I know. No one fights, everyone gets a long–usually. And that’s how it went without petty arguing or bickering.

But my mother had a will in which she specifically indicated that I, the only daughter, was to inherit her jewelry. A couple of years before she passed, we went through her jewelry together and picked out pieces for her granddaughters and daughter-in-law. And then I found four small pinky size rings with various precious stones that were perfect for her four little great granddaughters. The will made this task easy.

Many years ago, when my mother-in-law died it wasn’t as easy. One family member got greedy which led to some bitter feelings. The key is to make a plan ahead of time. Encourage your loved ones to designate in a will who they want to inherit valuable and sentimental items.

10 tips for making a difficult, emotional process a little easier

  • Consider how much time you have. Do you need to vacate the apartment or house in one week or one year? Personally, I am glad that I had a time limit of one week. Even though the job was exhausting, I’m glad to have it behind me. Dragging it out month after month would seem to me to be even more exhausting, both physically and emotionally.
  • Get help! My aunt, her daughter and my partner, who stayed with me for the entire week, helped tremendously. I could not have done it without them. After everyone pulled out the items they wanted, it was easy for my helpers to go through things and determine if they could be sold or if they should be donated.
  • Find a non-profit agency such as Goodwill to pick up a truckload of furniture. I was shocked when several very nice pieces of furniture were rejected because of a stain or slight crack. These non-profit groups have become very picky, so be sure to ask on the phone if they will accept imperfect furniture pieces. Set a time for pick-up and ask if the items need to be disassembled before pick-up.
  • Bring miscellaneous items such as pots and pans, dishes, books directly to a non-profit organization in order to clear the space for when the bigger items are picked up, if you have the time and energy.
  • Nursing homes and continuum care facilities sometimes have a “store” on the premises that accepts used items. They often are eager to accept artwork and medical supplies such as wheel chairs, walkers, commodes, etc. If not, give these to someone in need. You might even find a neighbor on the same floor as where your loved one lived.
  • Take photos of photos to save money and space. My parents kept dozens of photo albums from their many trips. I shipped home some albums that included family life cycle events and gatherings. My brother, however, wanted all the travel albums. Instead of spending a fortune on shipping heavy albums, I removed the photos and put them in shoe boxes. My daughter took photos of the special family photos to archive.
  • Keep important papers: insurance policies, birth certificates, car titles, etc.
  • Don’t stop and read every letter or card that you ever sent your loved one. Box them up and bring them home to read when you aren’t as emotional.
  • Do not flush medications down the toilet! They get into the water supply. Boulder County’s website says: Pour liquid medications over cat litter or other absorbent material, and seal it in a plastic bag before placing it in the trash. Fill pill containers with household glue, remove all personal information from the container, and place it in the trash after the glue has dried. Cut trans-dermal patches into small strips, place them in a container, and add glue or mix them with coffee grounds or used cat litter. In some areas, you can bring medications to the fire or police station.
  • Don’t feel guilty about getting rid of stuff. The objects meant a lot to your loved one. But your memories are not contained in the favorite necklace your dad gave to your mom. Your dad’s favorite golf clubs that he won several trophies with don’t hold the same meaning for you. Your spouse’s slippers are old and ratty and it’s time to get rid of them. As we reminisce and go through our loved one’s material possessions, it is a good time to start downsizing our household and to think about our own mortality and how we want to live the rest of our life. The memories of celebrating your loved one’s life will always be held close to your heart. As you go through their items, remember the saying “You can’t take it with you.” It might just help, at least a little.

“Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn contains a treasure trove of information on how to stay connected with your loved one, keep calm, improve immunity, reduce stress and feel happier and healthier. Plus, it includes 20 healing modalities that the caregiver can do alone or with their loved one. Available wherever fine books are sold and on AmazonBarbraCohn__

What special item will you keep when your loved one dies?

Green shirt with long sleeves

Of course, I kept the recipe boxes that contain the directions for the foods my mother loved and made for us: noodle kugel, apple pie, Mandelbrot, eggplant Parmesan, and sour cream coffee cake. When I look at her handwritten recipe cards I can almost feel her gentle touch. What is it about someone’s handwriting that seems to reach out and explain exactly how they feel at the moment they wrote the line? If the curve of a letter such as B or C swings too far to the right the person is said to be very generous. If the letters are straight and stiff and lean toward the left, the person is supposedly self-centered. My mother’s handwriting speaks to me of kindness and femininity and I find myself luxuriating in her handwritten notes until my eyes well up with longing for her or even for just a taste of her eggplant or the banging of her pots in the kitchen.

When I was clearing out my mother’s apartment this past August, a mint green, cotton button-down shirt with three-quarter length sleeves begged me to take it home. It looks like my mother in her younger years when she was passionately interested in health matters. Mom was one of the first New Age people to juice carrots, eat granola and take nutritional supplements, and she was overly interested in her friends’ and family member’s health issues. It made perfect sense. She loved the color green, the color associated with health. And green perfectly highlighted her green cat eyes, dark brown hair, and fair complexion.

The cotton green shirt is crumpled now. It rests in the ironing basket where it will stay until I’m able to caress it, iron the wrinkles out, and hang it in a place where I can look at it without weeping for my mother. The green shirt will hide in the bottom of the basket under clothes eager to be worn, until I am ready to wrap myself in it and feel comfort, not the grief that accompanies the inexplicable feeling that a daughter feels when she has lost her first friend, her best cheerleader, and her devoted goddess who implored the moon and stars to enchant her girl’s life. When I finally iron the green shirt, it will hang limply reminding me of the voice that I can hear as clearly as if my mother were standing next to me, reminding me of who I am and where I came from.


“Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn contains a treasure trove of information on how to stay connected with your loved one, keep calm, improve immunity, reduce stress and feel happier and healthier. Plus, it includes 20 healing modalities that the caregiver can do alone or with their loved one. Available wherever fine books are sold and on AmazonBarbraCohn__

World Alzheimer’s Month eBook Sale & Giveaway Now through September 30!

AlzAuthors

September is World Alzheimer’s Month, the international campaign by Alzheimer’s Disease International (ADI) to raise awareness and challenge the stigma that surrounds Alzheimer’s and other dementias. In recognition of  this event, AlzAuthors has put together an eBook sale and giveaway!

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