Does Intravenous Vitamin C Work for COVID-19?

Doctors are using intravenous vitamin C to treat COVID-19 patients in China and Italy, where clinical trials are being conducted. Doctors in some areas of the U.S. are using it. Although it isn’t standard protocol in hospitals here, you can usually find it in private holistic clinics as an adjunct to other therapies and as an overall health booster.

But if you or a loved one happens to end up in the hospital with COVID-19, based on the few studies that have been documented, I would try my best to get it prescribed ASAP. If you are not able to find a treatment center for IV vitamin C, or are afraid of needles, here is Dr. Magaziner’s COVID-19 wellness recommendations to strengthen your immunity and resistance to the coronavirus: https://drmagaziner.com/news/dr-magaziners-coronavirus-covid-19-wellness-recommendations/

What is IV vitamin C?

A solution of vitamin C is administered intravenously in the arm so that the vitamin C goes directly into the bloodstream. When you take vitamin C supplements, it goes into the stomach and intestines. If the dose is higher than your body needs, you excrete it through urine. No matter how much vitamin C you take via a supplement you will not be able to achieve the blood levels you’d get from intravenous vitamin C.

How does it work?

It’s counter-intuitive, but even though vitamin C is an antioxidant when it is infused into your blood in very high doses it creates free radicals that destroy viruses and bacterial. At the same time, IV vitamin C strengthens the body’s antioxidant protection, which is especially important during an illness because serious infections use up the body’s antioxidants and vitamin very quickly.

Is it safe?

Yes, but it must be administered by a medical professional and few hospitals in the U.S. are prescribing it for COVID-19, so you have to beg for it. It is administered in private clinics as a preventative treatment against COVID-19 and for other illnesses including cancer. https://www.cancer.gov/about-cancer/treatment/cam/hp/vitamin-c-pdq

Intravenous vitamin C keeps people healthier longer.

Covid19 pneumonia is an extremely rapidly developing disease with a high mortality rate. The main pathogenesis is the acute lung injury that causes Acute Respiratory Distress Syndrome (ARDS) and death. Clinical studies and reports demonstrate that a timely administration of high dose IV Vit-C improves the outcome of Covid19 infection.

Since the development of vaccines or antiviral drugs may take a long time to develop, the use of IV Vit-C as a universal agent for ARDS may have benefits for Covid19 and other viral diseases.

Where has IV Vit-C been used successfully?

Recently, it was used in China to treat COVID-19 patients. Data published by the “Expert Group on clinical Treatment of New Corona Virus Disease in Shanghai” (Shanghai, 2019) discusses the use of IV Vit-C as a safe and effective treatment for hospitalized COVID-19 patients. The Chinese facility had 358 COVID -19 patients on March 17th, 2020. Fifty patients with moderate to severe infection were treated with the vitamin C infusion. None of the patients died and all of them improved. Their length of stay at the hospital was 3 to 5 days shorter than the typical 30-day hospital stay of the patients who did not receive the Vitamin-C IV.

Intravenous vitamin-C therapy has a safe track record and is relatively inexpensive. It shortens hospital stays, making it cost effective, and it frees up hospital beds and resources.

A 2020 meta-analysis of 9 existing clinical trials compared a group of people who received an IV infusion with a group of controls. The researchers found that, on average, IV vitamin C shortened the length of mechanical ventilation by 14%. The effect varied from study to study, though, and it was greater when members of the control group needed longer periods of ventilation.

A 2019 meta-analysis found that vitamin C infusions could shorten the length of intensive care unit stays by 7.8% and the need for mechanical ventilation by 18.2%. The study looked at a wide range of medical conditions, but not at COVID-19.

2019 randomized controlled trial looked at people with sepsis and severe acute respiratory failure, which are two complications that people with severe COVID-19 may experience. Participants received either a placebo or a vitamin C infusion. Although vitamin C did not decrease the rate of organ failure or sepsis, fewer people in the vitamin C group died.

What can you do now?

It might be awhile until a safe vaccine against COVID-19 is available. In the meantime, support your immune system with the recommended supplements and eat the color of the rainbow, including lots of fresh berries and vegetables, low-fat healthy protein, legumes, and nuts, and healthy fats (olive and avocado oils).

References

Alberto Boretti, Bimal Krishna Banik. Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome. PharmaNutrition. 2020 Jun; 12: 100190.

Paul S. Anderson. Intravenous ascorbic acid for supportive treatment in hospitalized COVID-19 patients. 12 March 2020. International Society for Orthomolecular Medicine.

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

Keep your cool with healthy summertime smoothies and popsicles.

Mango banana popsicles on ice
Mango banana popsicles on ice with fresh fruits and berries

It’s hot and you’re probably stressed like most of the world. It’s especially important to keep up with your supplement and exercise regimen, and eat well. But that doesn’t mean you shouldn’t enjoy the bounty of summer fruits and delicious smoothies and popsicles.

If you’ve been reading my blog for any length of time, you’ve heard me say repeatedly how important it is to stay hydrated — all year-long. It’s even more important during the summer and now during the pandemic.

Our body is 50-65% water. Drink plenty of water to stay hydrated and to flush out toxins. The brain, which is 70% water, gets dehydrated just like your body. When it is dehydrated, neurotransmission — which is heavily dependent on water — is impaired, resulting in poor memory, concentration and impaired abstract thinking. The next time your mind is muddled, drink a tall glass of water and notice the difference.

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. Coconut water is cooling and helps to replenish electrolytes, which is especially important during and after an illness.

Enjoy these smoothie and popsicle recipes. They provide hydration, vitamins and minerals, and are perfect for kids as well as for folks with dementia and Alzheimer’s who may forget to eat or lose interest in food.

Popsicles

Watermelon and Kiwi–makes 8

4 kiwis, peeled and sliced

3 cups of pureed watermelon

Place kiwi inside the sides of the popsicle molds. Pour in the watermelon. You can make this with other fruits: watermelon and strawberries, etc. Add basil or mint; lemon or lime juice with or without the rind.

For a beautiful popsicle with 3 layers: Add watermelon puree but leave room for 2 more layers. Freeze for 30 minutes. Take out of the freezer and pour in a small amount of coconut milk, the full-fat canned variety. Freeze again. Take out and add pureed kiwi and freeze. This is a treat for the eyes as well as your taste buds.

Strawberries and Cream–makes 8

2 cups of pureed strawberries (leave some chopped for texture)

2 cups cream of vanilla yogurt.

Blend and freeze.

Coco-Mango–makes 4-6

2 cups pureed mango

1/2 cup canned coconut milk

Optional: Add coconut flakes.

Blend and freeze.

Orange Cream–makes 4-6 popsicles

1 cup orange juice

1 cup vanilla yogurt

Blend together and freeze.

Protein shake recipes

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!

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

The most important supplements you need for protection against COVID-19 and influenza

 

We’re already getting warnings from the CDC and other prominent doctors and scientists that COVID-19 is not going away. Coupled with the influenza threat, which normally starts around October and lasts through March or April, it’s a good idea to start building up your immune system now.

Here are the vital nutritional supplements that health practitioners recommend to protect you from COVID-19 and influenza.

Vitamin D
All the recently published studies are showing that individuals with low levels of vitamin D fared worse from COVID-19 than those with higher levels. Additionally, in a study published April 2020 there is evidence that vitamin D3 supplementation might reduce your risk of influenza and COVID-19 infections and deaths.

The authors of one study recommended that people at risk of influenza and /or COVID-19 consider taking 10,000 IU a day of vitamin D3 for a few weeks to rapidly raise their vitamin D concentrations, followed by 5000 IU a day. For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. https://pubmed.ncbi.nlm.nih.gov/32252338/

Another study advises that older adults, especially those with Parkinson’s disease, should take 2000-5000 IU a day of vitamin D3 which has the potential to slow Parkinson’s while also potentially offering protection against OVID-19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287983/

How does vitamin D help?

Vitamin D supports immunity in two ways: 1) It is necessary for the production of antiviral peptides in the respiratory tract, making the respiratory tract less likely to be infected with a virus. 2) It helps promote a balanced inflammatory immune response.

Researchers at Northwestern University analyzed publicly available patient data from 10 countries and discovered a strong correlation between vitamin D levels and cytokine storm—a hyper-inflammatory condition caused by an overactive immune system — as well as a correlation between vitamin D deficiency and mortality. http://www.sciencedaily.com/releases/2020/05/200507121353.htm

According to Ali Daneshkhah, the study’s first author, “Cytokine storm can severely damage lungs and lead to acute respiratory distress syndrome and death in patients. This is what seems to kill a majority of COVID-19 patients, not the destruction of the lungs by the virus itself. It is the complications from the misdirected fire from the immune system.”

The research team believes that this is where vitamin D plays a major role. Vitamin D enhances our innate immune systems, and prevents our immune systems from becoming dangerously overactive. This means that having healthy levels of vitamin D could protect patients against severe complications, including death from COVID-19.

Lead researcher Vadim Backman said, “ Our analysis shows that it might be as high as cutting the mortality rate in half. It will not prevent a patient from contracting the virus, but it may reduce complications and prevent death in those who are infected.

Getting enough Vitamin D

Vitamin D is made in the skin as a result of exposure to sunlight. The problem is, most of us do not get the sunlight needed for cutaneous vitamin D synthesis.

Vitamin D is actually a hormone that is made in the skin as a result of exposure to sunlight. The problem is, if you live at a latitude of 42 degrees (a line approximately between the northern border of California and Boston) the sun’s rays are too low between November and February for your skin to get the sunlight needed for cutaneous vitamin D synthesis.

If you live at a latitude below 34 degrees north (a line between Lost Angeles and Columbia, South Carolina) your body can make vitamin D from sun exposure yearlong. However, it’s important to expose a large portion of bare skin (like your midriff) to mid-day sun for at least 15 minutes every day. Most people are unable to fit this into their schedule, so vitamin D supplementation is highly recommended, especially since so few foods contain it.

According to Michael Holick, PhD, MD, an internationally recognized expert on vitamin D and director of the Vitamin D, Skin and Bone Research Laboratory at Boston University Medical Center, approximately one billion people throughout the world are deficient in vitamin D.

Blacks, Browns, and other dark skinned individuals are at even higher risk for inadequate levels of vitamin D because their skin isn’t able to absorb as much sunlight. This may be one of the reasons that these populations have fared so poorly in the fight against COVID-19.

Foods that are high in vitamin D

  • Cod liver oil, salmon, tuna, sardines, herring, smoked whitefish, rainbow trout, swordfish
  • Milk and fortified non-dairy drinks (orange juice, coconut, soy, almond, etc.)
  • Fortified cereals
  • Mushrooms are the only food in the produce section that has vitamin D. Portobello, maitake, white button have the highest vitamin D content.

How much should you take?

Dr. Holick says, “I recommend to all of my patients that they should take 2000-3000 IU of vitamin D a day from dietary sources, sensible sun exposure and supplements. I believe that it is important for women to take at least 2000 IU of vitamin D a day. Although many of the studies are association studies there continues to be strong evidence that increasing vitamin D intake has other health benefits besides those for bone health. From my perspective there is no downside to increasing your vitamin D intake to levels I have recommended in “The Vitamin D Solution” which is 1000 IU of vitamin D a day for children and 2000-3000 IU of vitamin D for adults.” https://www.nejm.org/doi/full/10.1056/nejmra070553

If you’re over 60, consider taking at least 3,000 IU daily during the summer, and take 5,000 IU in the winter if you want to increase your protection against COVIC-19 and other respiratory illnesses.

Zinc

Zinc is naturally found in the body and is the second most abundant trace element. It is commonly taken to relieve symptoms of the common cold and influenza. It prevents viral replication and the binding of viruses to cells. However, moderate deficiencies can increase the risk of infection.

How does it help?

Researchers are working on lab studies showing how zinc supplementation can help reduce risk of COVID-19. But we know this: Zinc is thoroughly involved in cell-mediated immunity against any infectious agent such as bacteria and virus. Zinc is one of the major factors that control function and proliferation of neutrophils, natural killer (NK) cells, macrophages, and T and B lymphocytes as well as cytokine production by the immune cells. Zinc also mediates protection from the adverse effect of ROS that are generally produced during inflammatory processes. 

Zinc supplementation might play an important role to COVID-19 patients by adding immune boosting effects with anti-viral drugs.

Foods that are high in zinc

  • Meat
  • Shellfish
  • Legumes—chickpeas, lentils, beans
  • Seeds—pumpkin
  • Nuts —cashews,almonds, pinenuts, peanuts
  • Dairy
  • Eggs

How much should you take?

The recommended daily allowance of zinc will vary according to the age, sex, and health conditions of an individual. For healthy adults, the recommended daily allowance is typically 15–30 mg of elemental zinc. Make sure the supplement contains some copper, which makes the zinc more absorbable. The supplement should contain a ratio of 15 mg of zinc to 1 mg of copper.

Other important supplements

Vitamin C and selenium are antioxidants with lots of studies showing how they help support the immune system.

Selenium

Selenium is an essential trace element obtained from the diet (i.e. fish, meat and cereals) which has been found to affect the severity of a number of viral diseases in animals and humans.

Margaret Rayman, Professor of Nutritional Medicine at the University of Surrey, said: “Given the history of viral infections associated with selenium deficiency, we wondered whether the appearance of COVID-19 in China could possibly be linked to the belt of selenium deficiency that runs from the north-east to the south-west of the country.”

Examining data from provinces and municipalities with more than 200 cases and cities with more than 40 cases, researchers found that areas with high levels of selenium were more likely to recover from the virus. For example, in the city of Enshi in Hubei Province, which has the highest selenium intake in China, the cure rate (percentage of COVID-19 patients declared ‘cured’) was almost three-times higher than the average for all the other cities in Hubei Province. By contrast, in Heilongjiang Province, where selenium intake is among the lowest in the world, the death rate from COVID-19 was almost five-times as high as the average of all the other provinces outside of Hubei.

Most convincingly, the researchers found that the COVID-19 cure rate was significantly associated with selenium status, as measured by the amount of selenium in hair, in 17 cities outside of Hubei. http://www.sciencedaily.com/releases/2020/04/200429105907.htm

How does it help?

Selenium supplementation modulates the inflammatory response in acute respiratory distress syndrome (ARDS) patients by restoring the antioxidant capacity of the lungs, thus improving lung function. When there isn’t enough antioxidant capacity in the lungs because of selenium deficiency, mutations within viruses occur. This makes them even more dangerous and infectious.

Foods that are high in selenium

  • Brazil nuts
  • Tuna
  • Shellfish–oysters
  • Pork chops
  • Beef
  • Chicken
  • Firm Tofu
  • Whole wheat pasta, kamut, oatmeal, brown rice
  • Shrimp
  • Shitake mushrooms

How much should you take?

It’s best to make sure you’re eating foods containing selenium. When taken by mouth: Selenium is LIKELY SAFE for most people when taken by mouth in doses less than 400 mcg daily, short-term. However, selenium is POSSIBLY UNSAFE when taken by mouth in high doses or for a long time. Taking doses above 400 mcg can increase the risk of developing selenium toxicity. Most multi-vitamins contain selenium. Check yours (and yes, you shuld be taking a multi-vitamin. Make sure it contains adequate selenium. The recommended Daily Value (DV) or daily allowance for selenium is 55 mcg per day for adults. During pregnancy, a woman should get 60 mcg, and lactating women should get 70 mcg a day.

Look for my next blog in which I’ll discuss how vitamin C infusions can help keep you from being put on a ventilator if you get COVID-19.


 

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

20 Natural Remedies for Depressed Caregivers (and everyone else)

Forest MeditationLots of us have experienced some form of depression during this pandemic. It may have been fleeting or may have set in for a longer period of time. If you’re a caregiver your “blues” may have cascaded into feelings of anger, resentment, anxiety, and or depression.

If you’re a caregiver you may not feel like it but remember that you are a hero/heroine. You are doing the best you can under duress, whether you’re caregiving during a pandemic or on just an ordinary day during a “normal” year.

Please, if you have suicidal thoughts or just can’t seem to shake the blues, get help.  Call the national suicide prevention lifeline: 1-800-273-8255.  The Lifeline provides 24/7 free and confidential support for people in distress, prevention and crisis resources for you or your loved ones.

Have you considered getting professional help? Like so many things nowadays, you can even get online therapy sessions. Check out his website for in-depth reviews on the best online therapy. https://www.consumersadvocate.org/online-therapy

Here are 20+ ways to combat depression

Natural supplements for depression

  1. St. John’s Wort (Hypericum perforatum) is a flowering plant which is used to make liquid extracts, nutritional supplements, and teas. 
  • It is a safe and effective way to treat mild to moderate depression over long periods of time
  • Is similarly effective as standard antidepressants
  • It has minimal side effects when compared to standard antidepressants
  • Understand that it can take 3-6 weeks until you feel the full benefits.
  • Please consult your health practitioner if you are taking an anti-depressant or other medications before taking St. John’s Wort.

One study done on laboratory animals found that St, John’s wort (Hypericum perforatum) has antidepressant properties similar to standard antidepressants. The antidepressant profile of H. perforatum is closely related to the selective serotonin reuptake inhibitors class of antidepressants.

A Swiss study evaluated 440 patients suffering from mild to moderate depression and treated them with 500 mg. of St. John’s wort for up to one year. Although mild side effects such as upset stomach were reported—which may or may NOT have been related to the treatment—the researchers reported that is a safe and effective way to treat mild to moderate depression over long periods of time. They also found that it is especially suitable for preventing a relapse.

A meta-analysis at the Centre for Complementary Medicine Research, Technische Universitaet Muenchen, Munich, Germany analyzed 29 trials (which included 5,489 patients), comparing St. John’s wort with placebo or standard antidepressants. The evidence suggests that the hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants.

2. 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.

3. Nervines

According to David Hoffmann, a leading herbalist and spokesperson for a return to herbal medicines, a nervine is a plant remedy that has a beneficial effect upon the nervous system in some way.  Nervines are especially useful during times of stress because they have a strong relaxing and calming effect without producing a dulling, “hang-over” side effect.  They also tone and restore the nervous system to a more balanced state.  Some nervines are also anti-spasmodic, meaning they relax the peripheral nerves and the muscle tissue, which in turn has a relaxing effect on the whole system.

The main types of nervines are tonics, relaxants, and stimulants.

  • Nervine Tonics – are fundamental to any long-term change in the individual’s ability to cope with their lives and make changes to their health regimen and lifestyle. They are particularly helpful for strengthening the nervous system and restoring balance. In addition to having a relaxing effect, they appear to have a vaso-dilating action on the blood vessels of the brain.  This increases oxygen availability to brain cells and helps with mental agility and mood.
  • Nervine Relaxants – are especially beneficial for short-term use, for example in treating mild depression or acute anxiety. “This group of nervines are most important in times of stress and confusion, alleviating many of the accompanying symptoms. They should always be used in a broad holistic way, not simply to tranquilize.  Too much tranquilizing, even that achieved through herbal medication, can in time deplete and weigh heavily on the whole nervous system,” says Hoffman.
  • Nervine Stimulants– are used as a restorative “pick-me-up” when the individual needs an energetic boost without that revved up feeling produced by caffeine.

Recommended nervines:

  • Passion flower- is beneficial for anxiety, insomnia, tension headaches, muscle aches and spasms, pain, hyperactivity, epilepsy, and to alleviate anger and help lower blood pressure.
  • Skullcap – is antispasmodic and relaxing and is recommended to relieve headaches, mood swings, insomnia, premenstrual syndrome, and nervous tension and exhaustion.
  • Blue Vervain – is a nervine herb that may help when you’re feeling overwhelmed and stressed, and just want to relax. It promotes relaxation and calmness.
  • Hops – the female flower from the top of the humulus lupulus creeping vine, does a lot more than make your beer taste good! It may reduce occasional stress, nervousness and restlessness.
  • Valerian – is the most researched herb for sleep. Interestingly, the word valerian is derived from the Latin verb valere, which means to be strong or healthy. It may provide relief of occasional sleeplessness and promote relaxation.
  • Catnip is a milder nervine that may soothe and promote a calming feeling and reduce irritability.

4. Support serotonin levels. Omega 3 fatty acids are rich in DHA, the major unsaturated fat in the brain. Your brain is 60% fat and depends on the fat you ingest from food. Healthy fats found in cold-water fish such as salmon, mackerel, sardines, and in olive oil, walnuts, flax and avocado will improve your mood. It is important to cook with a healthy fat such as olive oil, walnut or avocado in order to feed your brain! Canola oil, peanut oil, and safflower are not able to provide you with the fat your brain needs.

As a nutrition educator, I also like to recommend foods that increase the “happy” neurotransmitter serotonin. Whole grains, sweet potatoes, brown rice, oatmeal, buckwheat, millet, quinoa, support your brain’s ability to process more serotonin.

5. Drink water. Your brain needs to stay hydrated. Make sure you drink at least six tall glasses of water every day. When my mom went into the hospital for severe dehydration, among other things, she began hallucinating. A psychiatrist called to tell me “your mom has full-blown dementia.” I said, “No she doesn’t,”  and refused to allow the doctor to prescribe an anti-psychotic prescription. Sure enough, several days later my mom sounded completely normal. Her body had been dehydrated, as well as her brain. The simple habit of drinking water is sometimes all we need to maintain mood and mental health.

6. The Canadian Network for Mood and Anxiety Treatments published a report in the “Canadian Journal of Psychiatry” in 2016 with this conclusion: For the management of mild to moderate depression it says exercise, light therapy, St. John’s wort, omega-3 fatty acids, SAM-e, and yoga are recommended as first- or second-line treatments.

7. A recently published study in the “Journal of Clinical Medicine” concluded that individuals who engaged in a meditative movement practice of Tai Chi, Qigong, or Yoga showed significantly improved treatment remission rates. The researchers conclude that emphasizing the therapeutic effects of meditative movements for treating MDD (Major Depressive Disorder) is critical because it may provide a useful alternative to existing mainstream treatments (drug therapy and psychotherapy) for MDD. Given the fact that meditative movements are safe and easily accessible, clinicians may consider recommending meditative movements for symptomatic management in this population.

8. Music is the universal language as well as one of the most common ways to affect mood.  My husband was never without head phones as he listened to music and wandered through the halls of the memory care home where he lived the last two years of his life. Music made him happy. It makes toddlers spin until they’re dizzy, teens hand bang until their necks get sore, and adults drum their car’s steering wheel. Music also helps decrease anxiety and improves functioning of depressed individuals as found in a meta-analysis that concluded music therapy provides short-term beneficial effects for people with depression. 

9. Dance! I was feeling pretty low the other day. My body hurt and I was lonely. I made myself get off the couch and stream a zumba class on my desktop. Within 30 minutes I felt like a new person.

10. Create a calm environment. Light candles at dinner, play classical music, have a vase of fresh flowers on the table.

11. Take a walk in a green environment, if possible. Forest bathing provides physiological and psychological benefits and there’s plenty of research to back it up.

12. Use aromatherapy oils to immediately diffuse feelings of sadness, depression, anxiety, etc. Lavender oil is the most frequently used fragrance. You can also try bergamot, grapefruit, lemon, orange, clary sage, geranium, rose, and ylang ylang, frankincense, and myrrh. Put the oil in a diffuser or spray bottle to mist your collar or pillow. Check online for ways to order aromatherapy oils. 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.

13. 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.

14. If you’re lucky to have a caring partner, give each other a massage. It’s a wonderful way to tune out the world and relax. Or do a self massage with warm oil. Olive or coconut works perfectly.

15. Avoid an excess of alcohol, caffeine and sugar. These will just make you feel more jittery in the long run, and add extra calories.

16. Avoid listening to the news before bed. When the coronavirus outbreak first occurred, I found myself glued to the news and I suffered the price. My sleep was restless and I had nightmares. Limit yourself to tuning in 2 or 3 times a day at most, for a limited period of time. Don’t keep the TV or radio on all day, and certainly not while you’re eating or before bed.

17. Limit your social media time, too. There are a lot of scary things on Facebook, etc. While it’s important to stay informed, too much information can overwhelm us and make us even more frightened.

18. Stay in close contact with family and friends. Reach out to those you haven’t been in touch with for a while. Laugh about old times.

19. Watch a comedy or funny You tube videos (cats, dogs, babies) that will make you laugh. Even when we’re depressed, we can laugh. And laughter is the very best medicine.

20. 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. 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.

“Surround yourself with people who are only going to lift you higher.” anonymous


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

How to protect your loved ones from elder abuse during the coronavirus lockdown

senior man covering his face with his hands. Depression and anxiety Copy space.World Elder Abuse Awareness Day is June 15. 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.

This year during the coronavirus lockdown, there have been massive increases in reports of elder abuse  ranging from financial scams to incidents of family violence.

The most vulnerable

Aging adults are highly susceptible to the deadly effects of COVID-19. Just knowing this, amps up anxiety levels and depressive symptoms in aging adults who might be isolated, lonely, and alienated from their families. Isolation and loneliness make the elderly even more vulnerable to scams, and to abuse by caregivers, neighbors, family and financial advisors.

Adults with mental disabilities and/or dementia who live in care facilities are exclusively cared for by staff who may not be in communication with family members. Family members have been restricted from entering the facilities in order to manage the spread of the virus. Consequently, family members are unable to see first-hand whether their loved one is being well cared for.

A news story recently reported that a son was shocked to learn that his father was severely dehydrated, hadn’t eaten for days, and was left in a dirty diaper for more than a couple days. The response he got from the facility was that they were short of staff because so many people were out sick.

Also, people who have diminished eye sight or hearing, or are confined to a wheel chair are vulnerable. My friend’s father who has macular degeneration and is hearing impaired was scammed out of thousands of dollars by a caller who claimed that she was his niece. She said that she was being held in jail and needed bond money. This type of family emergency scam has been going on for years via telephone calls.

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, underfunded nursing homes.

Verify an emergency

If someone calls or sends a message claiming to be a family member or a friend desperate for money:

  • Resist the urge to act immediately, no matter how dramatic the story is.
  • Verify the person’s identity by asking questions that a stranger couldn’t possibly answer.
  • Call a phone number for your family member or friend that you know to be genuine.
  • Check the story out with someone else in your family or circle of friends, even if you’ve been told to keep it a secret.
  • Don’t wire money — or send a check or money order by overnight delivery or courier.
  • Report possible fraud at ftc.gov/complaint or by calling 1-877-FTC-HELP.
  •  Report COVID-19 related scams to the National Center for Disaster Fraud (1-866-720-5721)

 

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.

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.

If you suspect abuse, call the police or 911 immediately if you someone you know is in immediate or threatening danger.

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:

Report suspected abuse or exploitation to the local Adult Protective Services or Long-Term Care Ombudsman Program .

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 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.

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

Why hydration is crucial, especially during the pandemic

Glass of waterAdipsia is the fancy name for the loss of the sense of thirst. As we get older, our sense of thirst diminishes, just as our sense of smell and taste diminish. Chronic dehydration  is one of the most common problems among seniors and the elderly who reside in care facilities.

If you have a loved one at home with dementia or in a care facility it’s important that you learn the signs of dehydration (below) and offer water or another beverage to your patient every hour and throughout the day.

Many older adults often limit their fluid intake because they may be incontinent or fear accidents. Those who have limited mobility may try to avoid another trip to the toilet. Individuals who have aphasia (inability to speak due to dementia or brain damage from  stroke, etc.) may not be able to express their thirst.

Better monitoring of fluid intake is needed at care facilities

Studies have shown that nearly all nursing home residents suffer from inadequate hydration. Additionally, in one study, 25 out of 40 participants suffered from diseases that may have been caused or exacerbated by their being dehydrated.

If your loved one is in a care facility now—during the COVID-19 pandemic–it is more important than ever to try to encourage them to drink. Ask the staff to put signs up in their room as a reminder. It’s especially important if your loved one has dementia and forgets to drink or is not thirsty.

What happens when you are dehydrated?

Your blood begins to thicken, which interferes with normal blood flow and viscosity. This is one of the reasons why, especially during the  pandemic, it’s crucial to stay hydrated. There have been many reports of blood clots and other cardiovascular episodes in patients with COVID-19. The kidneys, liver, pancreas and other organs can be severely affected from dehydration, and severe dehydration can lead to acute pancreatitis in some individuals.

Dehydration can interfere with brain function

This is a good example of what happens when our brains are dehydrated. My mom wasn’t able to walk the last two years of her life, and was dependent upon two private caregivers. She also drank thickened water, which is a disgusting thickened pudding-like liquid that substitutes for water. The reason?  She aspirated water and food into her lungs, which caused her to cough. Sometimes, the result was pneumonia. She may have felt thirsty and not wanted to bother with the thickened water, or maybe she wasn’t thirsty. But she ended up being severely dehydrated on more than one occasion.

When Mom was admitted to the hospital for a UTI (urinary tract infection), she developed delirium. A psychiatrist called me to report that my mom was exhibiting full-blown dementia. I had just spoken to Mom a day before and she sounded fine. I refused the offer of an antipsychotic drug for her, knowing well the high risk of putting an older adult on those drugs. (see Why you should throw away that antipsychotic drug prescribed for your loved one). As it turned out, my mom was severely dehydrated. After a couple days on a hydrating intravenous solution she returned to her normal self.

It’s important to learn the signs of dehydration in everyone, but especially in seniors and young children. The physical symptoms are usually clear:

  • dry lips and sticky or dry mouth
  • no tears when crying
  • dry, papery skin that tents when it is pressed
  • decreased urine output
  • sunken eyes
  • headache
  • lethargy
  • dark urine
  • extreme thirst
  • unable to sweat
  • fast breath rate
  • low blood pressure
  • the mental symptoms are not as obvious, but can result in mental confusion, irritability, delirium
  • extreme cases of dehydration can lead to loss of consciousness, coma, kidney failure, and seizures.

Ways to stay hydrated

If you are a caregiver (and that includes caring for yourself!) here are some helpful guidelines:

The rule of thumb is to have 48 to 64 ounces of non-sweetened, non-artificially sweetened drinks. Hydration keeps the body in proper pH (how acidic or alkaline your body is) and protects it from getting dehydrated, which is a cause of inflammation and other kinds of imbalances. Dehydration can also contribute to urinary tract infections (UTIs).

  • Encourage and remind your care partner to drink.
  • Drinking healthy fluids is important as eating healthy foods. Water is the top choice, followed by herbal teas, milk, vegetable and fruit juices. Remember that juices contain a lot of sugar, both natural and added, so don’t overdo them. Soups are nourishing and hydrating but be aware of the sodium content. Avoid carbonated and caffeinated drinks which have a diuretic effect.
  • Serve liquids at a temperature that your care partner likes. Not everyone enjoys ice water.
  • Flavor water with lime or lemon.
  • Remind your care partner not to wait until s/he is thirsty. By then s/he is already dehydrated.
  • Serve juicy fruits such as watermelon, which contain lots of water.
  • Offer healthy popsicles as an addition to drinks and to those who refuse water.
  • Smoothies and shakes are nourishing and filling.

The next time your mind is muddled, drink a tall glass of water and notice the difference. Drink plenty of water, fresh juices, and herbal teas to stay hydrated, flush out toxins and enjoy mental clarity. It is especially important now as we head into summer and during the COVID-19 pandemic. But it’s just as important all year round.


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Does dementia increase a person’s risk of getting Coronavirus?

Elderly woman looking sad out the window.Although dementia in itself doesn’t increase one’s risk, there are other factors that might contribute to a person’s increased risk.

Does the patient have any underlying conditions such as high blood pressure, diabetes, auto-immune disease, lung diseases including asthma and COPD, cancer? All of these increase risk of serious symptoms associated with the COVID-19 virus.

If a person with dementia is living at home, s/he may be at increased risk if they forget to wash their hands or socially distance. And, of course, as we are all well aware of, patients in care  facilities are at higher risk simply for the fact they are communally living together. Caregivers come in and out of the facility, go to their homes, and may be interact with others. See Should you move a family member back home from a care facility?

What can you do?

  • If your loved one is living at home and can still read, place sticky notes around the house  (refrigerator, bathroom, kitchen sink) in appropriate places to remind him/her to wash their hands.
  • Call often to check in. Use Zoom or Skype, Facetime, if the person can manage technology. Amazon’s new Portal, which is like a large iPad that is kept plugged in, is an easy device. Check it out: It’s a smart, hands-free video calling device with Alexa built-in.
  • Make sure your loved one has adequate food. If s/he can still prepare meals, drop off their groceries. If they have trouble in the kitchen, bring home-cooked meals or make arrangements with an organization such as Meals on Wheels that can deliver foods.
  • If you have to go inside the person’s home, make sure you have on a mask and gloves, and maintain physical distance as much as possible.
  • A person with dementia is probably not keeping a clean, tidy home, which is important to health and wellness. Try to clean around the person. Have him or her sit in front of the TV or at the kitchen table, while you vacuum and clean the bathroom. Then move him/her to another room in order to clean the kitchen.
  • The main thing is to stay in daily contact. Have the grandkids write notes and draw pictures to send in the mail. If you live in the same town, visit from the lawn and have your loved one sit on the front or back porch.
  • Set up a daily schedule for your loved one. Keep it posted on the fridge. For example: 8:00–wake up, toilet, brush teeth, shower. 8:30 Take meds, eat breakfast. 9:30 Do fitness routine, etc. Do 10 sit-to-stands while watching TV. Walk through the house for 10 minutes a couple times a day.
  • It’s important to protect our loved ones physically but to engage them socially to prevent loneliness and to keep them mentally stimulated. Here’s a great way for seniors whose dementia is minimal.

Well Connected (formerly called Senior Center Without Walls), is a telephone-based national program that offers free weekly activities, education, friendly conversation, classes, support groups, and presentations to individuals 60 years or older anywhere in the United States for English and Spanish speakers. There are activities occurring throughout the day, every day 10:00 am-8:00 pm, Mountain Time, depending on the day. Sessions run between 30 minutes to one hour.

Play a game, write a poem, go on a virtual tour, meditate, share a gratitude, get support, and most importantly, connect and engage with others every day. Well Connected is a community consisting of participants, staff, facilitators, presenters, and other volunteers who care about each other and who value being connected. All groups are accessible by phone and many are accessible online.

Well Connected offers 75 different programs. People can join a particular group, call in the same time each week, hear the same voices on a regular basis and make friends. This has a positive impact on their emotional and physical life. “The gratitude activity, which is offered twice a day, is especially popular and well attended,” says Wade, Social Call director (see below). “Participants share something they are grateful for. This allows for an increase in social connectedness. We also have fun and intellectual programs that help individuals feel valued, stimulated and engaged, and sometimes we invite presenters from the outside in.”

Wade pointed out that Well Connected, is not just for people with mobility concerns. We get folks who are active, people who are married and individuals in a co-housing situation. Anyone can feel lonely, she says. “We take a survey every year and the results indicate that 85% of our participants feel more intellectually stimulated and  socially connected. And on a daily basis, we get calls of gratitude from participants who say, ‘this program saved my live,’” says Wade.

Well Connected also offers a program called Social Call, in which volunteers call participants for a weekly phone visit. For more information, email coviaconnections@covia.org or call 877-797-7299.

Well Connected is an award-winning program of Covia, formerly called Episcopal Senior Communities. For more information: To register call 1-877-797-7299,  https://covia.org/services/well-connected/


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

Should you move a family member back home from a care facility?

I'll have to learn to walk againAccording to the New York Times (April 17, 2020), about a fifth of U.S. virus deaths are linked to nursing homes and other long-term care facilities. That’s about 7,000 people.

It’s an extremely difficult time for families who have a loved one in a care facility. You’re not able to visit, and you and your loved one might be missing the physical touch that we as humans crave.  You might be too overwhelmed with caring for others at home to make the drive to the care facility, only to be allowed to peer through a window and touch hands separated by glass.

Two of my friends recently lost a parent who was in a nursing facility. Their parents didn’t die from Covid-19. One died from Alzheimer’s (yes, Alzheimer’s is a fatal disease) and the other had dementia and was recovering from a broken pelvis. Neither friend was able to get to the facility in time to say good-bye, partly because of the imposed lock-down on these facilities.

You might be worried that your loved one will contract Covid-19. What should you do?

Should you move your loved one home?

  • Consider why you moved your loved one to a care facility in the first place. Are you able to safely care for him/her at home?
  • How is your health? Have you been sick? Do you have a chronic condition that prevents you from taking on added stress?
  • Are you overwhelmed caring for children who are doing online schooling?
  • Are you working from home?
  • Is your loved one mobile? Continent? Can you bathe and dress him/her? Do they need a two-person transfer?
  • Can you hire in-home care? This option comes with the risk of having an outsider who has possibly been exposed to Covid-19 come into your home.
  • A person with dementia might have compounded anxiety during the pandemic. Anxiety increases when a person with dementia has their routine disrupted. The individual may not be able to understand what is going on, but pick up on the stress of those around him/her. Would you have the patience and time to devote to caring for such an individual?
  • Be honest with yourself, and consider your own health, psychology and emotional well-being.

If moving your loved one is out of the questions, consider these tips from The Alzheimer’s Association.

If your loved one is in a care facility:

By now, almost all care facilities are not allowing visitors through the door. 

  • Check with the facility regarding their procedures for managing COVID-19 risk. Ensure they have your emergency contact information and the information of another family member or friend as a backup.
  • Do not visit your family member if you have any signs or symptoms of illness.
  • Depending on the situation in your local area, facilities may limit or not allow visitors. This is to protect the residents but it can be difficult if you are unable to see your family member.
  • If visitation is not allowed, ask the facility how you can have contact with your family member. Options include telephone calls, video chats or even emails to check in.
  • If your family member is unable to engage in calls or video chats, ask the facility how you can keep in touch with facility staff in order to get updates.

What if the care facility has or had Covid-19 incidences?

  • Ask the facility about their quarantine procedures. What is your level of confidence that CDC guidelines are being followed?
  • How many people in the facility have been impacted by COVID-19? Are those affected staff, residents or both?
  • Is your family member able to follow social distancing procedures (with or without help)?
    • In some cases, the person may not be able to walk or move about on their own. This could help maintain social distancing.
  • Does the facility have and use personal protective equipment?
  • How many staff members interact with your family member on a regular basis? Is the facility able to limit the number of staff who work with your family member?
  • Is the facility adequately staffed to provide the level of care your family member requires?

The Centers for Disease Control has issued these guidelines for nursing home visitation in the wake of the COVID-19 outbreak:

Limiting Visitation: For facilities that are in counties, or counties adjacent to other counties where a COVID-19 case has occurred, we recommend limiting visitation (except in certain situations as indicated above). For example, a daughter who visits her mother every Monday, would cease these visits, and limit her visits to only those situations when her mom has a significant issue. Also, during the visit, the daughter would limit her contact with her mother and only meet with her in her room or a place the facility has specifically dedicated for visits.

Facilities should actively screen and restrict visitation by those who meet the following criteria: 1. Signs or symptoms of a respiratory infection, such as fever, cough, shortness of breath, or sore throat. 2. In the last 14 days, has had contact with someone with a confirmed diagnosis of COVID19, or under investigation for COVID-19, or are ill with respiratory illness. 3. International travel within the last 14 days to countries with sustained community transmission. 4. Residing in a community where community-based spread of COVID-19 is occurring.

Be kind to yourself, and try not to feel guilty about not being able to visit your loved one. Caregiver guilt is complicated, but you are probably doing the best that you can.

This pandemic lock-down is unprecedented. Hopefully, the restrictions will lift soon and you’ll be able to be with your loved one again. Until then, take extra good care of yourself.


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

Gardening as therapy for caregivers and their care partners

Senior couple gardening in the garden

Clipping vegetables and watering flowers can do wonders for the soul and have a profound effect on a stressed physiology. Horticultural therapy is a health-care specialty that uses gardening to promote physical and emotional health by creating a peaceful oasis amid the challenges of Alzheimer’s disease, or any other caregiving situation.

Therapy gardens encourage memory-impaired people and their caregivers to take a moment to smell the roses and perform tasks that magically momentarily take away their cares and worries. You might already being working in the garden, which is a natural balm for these anxiety-filled days.

If you are caregiving for a loved one at home, gardening is a great opportunity for you and your care partner to spend time outdoors, connect through memories that might arise, and de-stress. You’ll also gain the satisfaction of accomplishing something that will, hopefully, provide you with beauty, sweet scents, and/or food!

Here are some ways to include your care partner so that you both benefit—from the “Horticulture Therapy by horticulurual therapist Pam Catlin, chapter 17 in my book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.


Throughout the ages people have connected over food and the garden setting provides an abundance of taste experiences through edible flowers, herbs, and vegetables.  Not all non-poisonous flowers are tasty or have a pleasing texture, however.  Some tried and true edible flowers are nasturtiums, lavender, day lilies, roses, tulips, pansies and violas.  The flowers can be used in salads, baking, decorating cakes and so much more. In caring for these flowers, chemical pesticides must be avoided.

Herbs and vegetables are a great addition to a garden and they provide another taste experience for the gardener.  Examples of easy to grow herbs are basil, chives, mint, oregano, parsley and rosemary.  Some are even perennials that will come back each year. These herbs might be enjoyed by being mixed into plain yogurt or softened cream cheese to create an easy dip to spread on a cracker.  When selecting vegetables, keep in mind that all of the solanaceous family (tomatoes and eggplant) have toxic foliage.  With close supervision, they can still be planted as most gardeners love a beautiful ripe tomato.

For those who have retained their olfactory senses, just running hands over herb plants provides a fragrance to inhale and enjoy.  Scented geraniums, grown for their foliage and not their bloom, date back to Victorian times and are now available in most nurseries in a variety of fragrances including but not limited to citrus, chocolate and rose. Particularly fragrant flowers to include in your garden are sweet alyssum, heliotrope, pansies and cosmos.

When selecting plants to stimulate the visual senses, it is important to remember that bright colors such as reds, pinks and yellows are more easily seen by older eyes than subtle, pastel colors or white.   Don’t forget interesting leaf patterns when looking for visual stimuli.  Unusual leaf patterns and colors can be found in coleus, Rex begonias and some grasses, such as zebra grass.

Consider adding some auditory elements to the garden.  Wind chimes near the patio door can assist in orienting an individual to the door’s location.  Grasses, trees, plants with seed pods, water features and bird feeders can all add a variety of pleasant sounds to the garden.

As the other senses fade, tactile stimulation becomes an important part of the gardening experience.  Selections that are surprisingly soft to the touch are dusty miller, African fountain grass and lamb’s ears.  Smooth skinned succulents provide tactile interest and can be grown indoors and (weather permitting) outdoors.  Placing plants with texture near the edges of containers or beds is an invitation to garden visitors to touch and feel as they move through the outdoor space.  If the gardener with cognitive issues is not responsive to the stimuli when touching with their fingers try running a fuzzy leaf across the cheek.  The apple of the cheek is filled with tiny nerve endings that will often be more receptive than the nerve endings in older fingers.

What you need to set up a therapy garden in your yard or porch

As the person with memory loss advances in his or her disease process, physical balance tends to become a challenge. an effective way to create a safe gardening experience is to elevate the growing areas either through raised beds or large ports. For those able to stand for short periods of time, a variety of planter heights would be ideal to support gardening while standing or sitting. rEcommended dimensions for planter height is 2′ – 2 1/2′ for sitting or 3′ – 3 1/2′ for standing. Acceptable dimensions for widths are 2′ if accessible from only one side or 4/ if accessible from all sides.

If the gardener has limited reach, avoid building materials such as bricks or block as it would be difficult to reach the soil to plant. It’s a good idea to measure what would be comfortable for the user before constructing the garden. Growing in pots or raised beds requires good planting mixes (combination of peat moss, topsoil and sand or perlite or a good quality soilless mix), regular fertilizing and plants that are no taller than 3′.

These days, many large pots are lightweight and easy to move andn place prior to filling with soil mix. Pots can be placed on rolling saucers, provided the wheels have brakes, or on pavers to help raise

Successful Plants

There are a number of tried and true plants that are safe for the garden.  For cool weather gardening, calendulas, pansies/violas, and stock add bright color.  Cool season vegetables are broccoli, cabbage, cauliflower, kale, lettuce, peas, radishes and spinach. Suggested plants for the warm season shade garden are coleus, impatiens, begonias and mint.  Good plants for warm season sunny locations would be alyssum, dusty miller, geraniums, marigolds, purple cup flower, petunias, portulaca, snapdragons, zinnias, most herbs other than mint and most vegetables other than those mentioned for cool season planting.   Bush varieties of squashes and cucumbers are best suited for raised beds and pots, as are some varieties of tomatoes.

A piece of advice when creating a garden space is to start small.  The primary purpose of this growing area is to provide peace of mind and an avenue of connection for the person with memory loss and those providing care, not food production.  A garden that provides a balance of physical activity and just being in nature is a perfect addition.


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

Easy art projects to do with your care partner when you’re both going nuts

Brush point in watercolor paint closeup

If you’re a caregiver taking care of someone at home, you probably feel like pulling your hair out. It’s tough, especially if you or your care partner, or both of you are experiencing anxiety or stress.

Here are a few things you can do by yourself and with your care partner.

“Art Exercises for Caregivers” by Meg Carlson, chapter 11 in my book Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.

  1. Making an Inside/Outside Box

Materials:

  • Boxes-shoe box, tea box, metal tin, etc.
  • Mixed media-crayons, paint, markers, glue, feathers, felt, rocks,

Decorating a box allows the artist to reflect his/her persona or face that is shown to the outside world on the outside of the box. Decorating the inside of the box is an opportunity to express the internal feelings and conflicts that are private or feel too big to find words to express. Use whatever materials that are available to decorate the outside of the box, and then the inside of the box to express these feelings.

Outside Box: How do you experience being around others with your loved one? What do you share with the outside world about your process/how do you share?

Inside Box: What is really going on inside of you each day? What isn’t shared with others that have an impact on you?

What has this process, or your imagery expressed to you? What kinds of responses are you having?

  1. Daily or Weekly Mandalas

A mandala is a circular image. It begins with a circle drawn on a page. It can be any size and any media can be used.

Materials:

  • Paper: Bristol, Watercolor, or mixed media (6×6 is a great size)
  • It is small enough to be done in a brief sitting, and large enough to have room for several images or areas of focus.

Pencils, markers, watercolor, colored pencil, pastels, or crayons are all great.

A version of mandala exists in many spiritual traditions (rose windows in Cathedrals, Navajo and Tibetan sand paintings, Buddhist imagery, etc.) Mandalas can be used to support focusing attention, as a self check-in tool, to express emotions in a contained space (circle), for establishing a sacred space, and to aid in mindfulness and mediation. Carl Jung, through his own art process, came to realize that mandala paintings enabled him to identify dysfunctional emotional patterns and work towards integration and wholeness. 

  1. Color-Texture-Pattern Feelings Portrait

         This process is about awareness of how much is going on in each of us at any given moment. It is an opportunity to just GET IT OUT through color, movement, and expression. The imagery is usually abstract. It is the process of expressing that is beneficial here, not the finished product. Feelings are difficult to have, and when they are expressed visually they can be difficult to look at. But that is okay. If you use this process, when you are finished, take a moment to witness it like a loving friend. Then just set it aside. If your image invites a redo or edit, you can come back to it and work with it, even tear it up and re-create it. If not, let it go. The materials will support you to express emotions and that is their purpose sometimes …. to help you create something that is not necessarily pretty, but honest. That is their gift to you.

Materials:

  • Small to medium paper, mixed media paper is sturdy. Taped to surface is best. When you prep ask yourself, What size is my expression today? That will tell you what paper size to use.
  • Pencils, markers, watercolor, colored pencil, pastels, or crayons are all great.
  • This can be done between 5 and 25 minutes. It is simply the process of choosing colors and making textures and patterns that express the layers of feeling present. Let the speed and movement be an extension of your expression. It will be unique every time.
  1. Two Inch Window Drawing

The goal is to work with detail and discernment to create a bird’s eye view. Another way to use this tool is one of magnification, to zoom in to one aspect of something larger; examples could be to feel a single sensation, filling a small (contained) space with just what is magnified. Used as a daily or coping practice it may serve to redirect concentration or focus energy and attention, provide containment while titrating an intense sensation. They take between 1-10 minutes to complete. Think Macro and Micro… what would be most helpful, to step back or lean in?

Materials:

    • Paper: Bristol, watercolor, or mixed media (2×2 or 4×4)
    • Card stock scraps come in several colors, and can usually be found at craft stores.
    • This drawing is small enough to be done in a brief sitting, and can even be a single set of colors.
  1. Process: Journey Drawing

Materials:

  • Paper: Bristol, watercolor, or mixed media (6×6 or larger)
  • Collage materials, or a material you enjoy (fabric, craft papers, natural materials, etc.)
  • Chalk/oil pastels, pencil, watercolor

Where are you in this journey? Emotionally … physically . . .personally . . . socially? Is there stuckness . . . is there movement? What colors, shapes, textures represent where you are right now? What colors feel supportive of your journey or give you strength? What emotions are present for you about your current life, about being a caregiver? Can you think of any supportive guides/helpers that you have met along the way? How has your identity or personality been challenged or changed in this process? Who in your life is accepting these changes, who in your life are having difficulty accepting the changes?

What has this process, or your imagery expressed to you? If you had a chance to respond to it, what kinds of responses are you having? Are you in a different place in your journey than you assumed/thought/hoped? What are the qualities of where you feel you are in your journey as a caregiver? As you have moved through different stages, what has each stage offered you?

Lastly, choose a color that feels strengthening, a color that will help you move into the next stage of your journey. Now create a final piece of you drawing that will offer you strength and power when you look at it.  Be one of the helpers for yourself in this moment of your journey.

6. Process: Breath Drawing

Materials:

  • Oil pastels or chalk pastels
  • Large paper
  • Your breath
    With one color in each hand, draw your breath. Notice the qualities of your in breath (short, stunted, deep, long, interrupted, fast, shallow) and allow your hands and the colors to express it. Same with the exhale. What are the qualities present in your out breath? Move each hand/arm in a circular motion with the expression, notice how the lines change over time. Notice similarities and any shifts. Follow your own breath with soft awareness.

What has this process, or your imagery expressed to you? What kinds of responses are you having?


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