Keep your cool with these 10 summertime eating tips

20bb6fee-b988-4716-bd91-23dff6882655It’s summertime and the livin’ is easy—or at least we’d like it to be. This summer is especially hot all over the world. If you’re tired and stressed out from caregiving, these tips will help you stay cooler in summer. The same information applies to those we care for. . . and for everyone.

According to the ancient Indian system of Ayurveda our body consists of three main elements or doshas—Vatta, Pitta and Kapha. Pitta consists of water and fire. It’s hot, so during summer when the temperature rises we want to eat cooling foods. Eating cooling foods not only keeps us from overheating, it reduces the tendency to get irritable, impatient and angry.  (Chapters 20 and 31 in “Calmer Waters: The Caregiver’s Journey through Alzheimer’s and Dementia” contain more information about ayurveda and nutrition that calms down the nervous system and supports immunity.)

  1. First and foremost, stay hydrated. It’s especially important to make sure you and your loved ones are getting enough liquids because when we forget to drink we can become dehydrated quickly, which leads to other health problems. It’s also crucial to keep the brain hydrated in order to maintain mental alertness. Drink plenty of water and stay away from carbonated and caffeinated drinks. Herbal teas, and fresh fruit or vegetable juices are great in summer. Just remember that fruit juices are high in sugar and calories. Coconut water is cooling and helps to replenish electrolytes, which is especially important during and after an illness.
  2. Enjoy the bounty of summer fruits. Peaches, apricots, cherries, watermelon, cantaloupe, and berries are especially good for helping the body reduce the fiery heat of summer. Juice them or make popsicles with watermelon juice or any other combination including yogurt. These are especially helpful to keep seniors hydrated and for people who have trouble chewing.
  3. According to Ayurveda, some of the recommended summer vegetables include cucumber, green leafy vegetables, green beans, squash, zucchini, asparagus, beets and eggplant. Juice a leafy green with cucumber and beets for a delicious cooling drink.
  4. Sprinkle on the herbs and spices. They’re easy to use and contribute added flavor and antioxidants to your diet. Cooling spices include cardamom, coriander, fennel and tumeric. Cooling herbs include cilantro, mint and dill.
  5. Avoid hot, sour and salty foods including fermented food, red meat, and greasy and spicy food. Excess pitta aggravates the tendency towards heartburn and gastric hyperacidity.
  6. Here’s some good news—Ayurveda recommends ice cream during the hot summer months! So by all means, enjoy! Dementia patients are especially fond of ice cream. If the person you are caring for refuses to eat or eats very little, try serving ice cream. It contains protein, calcium and calories, and it’s easy to serve and eat. If weight gain or cholesterol is a concern, select a dairy-free version of America’s favorite dessert. Rice Cream, Coconut Bliss and Soy Delicious make delicious non-dairy, frozen desserts.
  7. Cooling grains include amaranth, barley, quinoa, rice, tapioca and wheat. Use them in salads mixed with veggies. One of my favorites is quinoa salad. Cook 1 cup of quinoa. (Be sure to rinse it first to remove saponin, a naturally occurring chemical that coats each grain to ward off insects. It has a strong, bitter flavor. And yes, it is a pain to rinse quinoa. First soak it and then place it in a very fine mesh strainer and rinse.)  Sauté onion and zucchini, add a handful of fresh corn cut off the cob, mix with the quinoa. Add fresh tomatoes, black beans, and a dressing made with olive oil and balsamic vinegar. Delicious!
  8. Make your own granola. Once you do, you’ll never go back to buying store-bought granola, which is typically filled with sugar. Plus, it is expensive. Oats, almonds, and coconut are all cooling. First toast 1/2 cup of slivered almonds on a cookie sheet in the oven. Watch carefully so they don’t burn. Add to 4 cups of oats, along with 1/2 cup coconut flakes, 1/4 cup coconut oil, 1/4 cup maple syrup. Add 1/2 tsp of cinnamon, if desired. (Cinnamon is warming, but a little bit won’t hurt.) Stir and bake at 325 degrees for about 20 minutes. Add raisins if desired.
  9. For added protein, top your salads with these cooling legumes: garbanzo, pinto, white beans, azuki beans, and black-eyed peas.
  10. If you eat meat try to avoid beef, chicken, and pork during the hot months and use cooling meats such as buffalo, turkey rabbit or venison instead.

Happy eating. . . and stay cool!

Can depression be a sign of dementia?

Depressed Senior Woman Sitting OutsideDepression can affect our memory, and it can result from not being able to do the things that were once easy for us, as in the case of Alzheimer’s or dementia. Depression can result from a number of factors and it often appears differently in different people

Some people are able to hide the fact that they are terribly depressed. I did. I tried to put on a happy face during my husband’s illness, but inside I often felt as though I was dying. Following the recent suicides of Kate Spade and Anthony Bourdain, we have to remind ourselves that we usually don’t know what is happening inside someone else’s head.

Before my husband was diagnosed with younger-onset Alzheimer’s disease he was withdrawn and depressed. I didn’t know what exactly what was going on, and he was unable to articulate how he felt. I eventually realized that he was depressed because the things that were once effortless for him to do, such as driving around town or figuring out how much tip to leave in a restaurant, had become difficult.

Alzheimer’s and depression often occur simultaneously, which often makes it difficult for physicians to make a diagnosis without further testing. According to James M. Ellison, MD of the Swank Memory Care Center, Christiana Care Health System, approximately half of individuals affected by Alzheimer’s disease will experience clinically significant depressive symptoms at some point.  Depression can occur during any phase of the illness.

Symptoms common to Alzheimer’s and depression

  • Loss of interest in things that were once enjoyable
  • Memory issues
  • Sleeping too much or too little
  • Social withdrawal or isolation
  • Impaired concentration
  • Eating too much or too little
  • Crying, feelings of hopelessness, despair
  • Unmotivated
  • Lack of energy, lethargy, apathy
  • Irritability
  • Thoughts of death or suicide

A case of the chicken or the egg: which came first, Alzheimer’s or depression?

Some health professionals think that depression can put one at greater risk for Alzheimer’s. There is also a belief that depression is a symptom of Alzheimer’s. In any case, physicians feel that a person with dementia who is depressed can experience a quicker cognitive decline and need to rely more on caregivers.

What to do?

8 natural ways to combat depression.

Antidepressants may not work as well with people who have Alzheimer’s and are depressed. Before resorting to antidepressants and other drugs,  try these options:

  1. Provide a safe and calm environment. Light candles at dinner, play classical music, have a vase of fresh flowers on the table.
  2. Get some physical exercise every day; even just a 20 minute walk helps tremendously.
  3. Use 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
  4.  I gave my husband Ginkgo biloba for depression (and also took it myself). It helped right up until he was in late stage Alzheimer’s. One word of advice, not all brands are efficacious, so pick one carefully. Also note that it takes about 6 weeks to notice an effect. This is a typical difference of taking a pharmaceutical versus a natural remedy.
  5. 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.
  6. 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.
  7. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group, or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.
  8. Sleep well by getting to bed before 11:00 pm, eating your last meal before 8pm, turning off your electronic devices, and eliminating light in your bedroom. Studies have indicated that sleep deprivation can increase risk of dementia and Alzheimer’s disease. If you have trouble sleeping consider using a lavender essential oil spray on your pillow or a sachet of lavender inserted into the pillowcase. There are lots of natural sleep aids available at your local health food store, such as melatonin, calcium/magnesium, valerian, hops, etc. Consult with a nutritional consultant about what might work best for you.

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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” 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.

Men: Are you taking care of yourself?

仲の良い父と娘Happy Father’s Day to all men who play a caring role in the life of a child, and kudos for  all that you do. But let me ask you this: Do you take care of yourself? Typically, most men take better care of their cars than themselves. Most men wait until a symptom pops up, and by then the illness or disease has progressed.

I’m not going to give you a lecture about how you should make an appointment tomorrow to get a routine preventative check-up, but hopefully after going through the following list, you’ll see my point.

Take this quiz to see how much you really know about men’s health. 

1) As a man gets older, it’s almost inevitable that he:

  1. loses interest in sex
  2. has a difficult time maintaining an erection
  3. doesn’t need to exercise as much
  4. develops an enlarged prostate

2) To detect prostate cancer early, a man should:

  1. have a colonoscopy
  2. practice a monthly self prostate examination
  3. have a digital rectal exam and PSA blood test
  4. have a sonogram of his prostate every year

3) Impotence can result from:

  1. drinking too much alcohol
  2. recreational drug use (smoking marijuana)
  3. high blood pressure
  4. diabetes
  5. all of the above

4) 75% of prostate cancer occurs in:

  1. Hispanic men
  2. men over 65
  3. men who eat a low-fat diet
  4. men with low testosterone levels

5) The most common cancer among men is:

  1. prostate cancer
  2. lung cancer
  3. skin cancer
  4. colon cancer

6) Which racial/ethnic group is most likely to develop prostate cancer?

  1. Caucasian
  2. Asian
  3. Hispanic
  4. African-American

7) A common risk factor for developing prostate cancer is:

  1. lack of exercise
  2. high fat diet
  3. high testosterone levels
  4. growing older
  5. all of the above

8) What beverage has been found to support prostate health?

  1. beer
  2. green tea
  3. orange juice
  4. red wine

9) What common food has been found to support prostate health?

  1. oranges
  2. tomatoes
  3. beef
  4. cheese

10) Which disease is considered the number one cause of death among American males?

  1. diabetes
  2. prostate cancer
  3. obesity
  4. cardiovascular disease

11) Cardiovascular disease kills far more men and women than cancer.

  1. True
  2. False

12) Eating a diet that includes plenty of pasta, potatoes and white rice can reduce your risk of heart disease.

  1. True
  2. False

13) The heart muscle is totally responsible for maintaining normal blood pressure levels.

  1. True
  2. False

14) Cardiovascular disease is hereditary and cannot be prevented.

  1. True
  2. False

15) CVD starts in the teenage years.

  1. True
  2. False

16) An aspirin a day is the best way to thin the blood, in order to reduce the chance of stroke and heart attack.

  1. True
  2. False

17) High blood cholesterol is the best overall indicator of cardiovascular disease.

  1. True
  2. False

18) Statistics show that the stress of caregiving can result in chronic disease for the caregiver and take as many as ten years off one’s life.


Answers:

1) d

2) g

3) e- all of the above. Not smoking, eating a healthy diet, not overdoing it when it comes to drinking, regular exercise, getting enough sleep, will all help support normal blood flow. Also, Ginkgo biloba extract helps support normal blood flow to the penis

4) b. Simply growing older increases a man’s risk. Seventy-five percent of prostate cancer occurs in men over 65 with only 7% diagnosed in men under 60 years of age.

5) c. Skin cancer is the number one form of cancer in the US. Prostate cancer is the most common cancer among men next to skin cancer and the second leading cause of cancer death in men after lung cancer.

6) d. African-American males have the highest incidence of prostate cancer, a third higher than white males, and African-American males are also twice as likely to die from it.

7) e. Also, men who have higher testosterone levels, or who eat a high fat diet have been shown to have an increased risk of developing prostate cancer.

8) b. Green tea is chock full of antioxidants that have been shown to reduce cancer. Red wine, on the other hand, is a natural preventative against cardiovascular disease.

9) b. Tomatoes contain lycopene, especially potent in the fight against prostate cancer.

10) d. Among major disease groups, heart disease is the leading cause of death within the elderly population.

11) True. Although cancer fears are more common, cardiovascular disease is the chief cause of death and disability in the United States today. It affects close to 60 million Americans and every year more than a million people suffer from new or recurrent heart attacks. In fact,every 20 seconds a person in the United States has a heart attack, and one-third of these attacks leads to death. The American Heart Association calls CVD “the silent epidemic.”

12) False. For years we were told that a heart-healthy diet included foods low in fat and high in carbohydrates, such as fruits, veggies, legumes, grains and other starches. But now experts are saying that overloading on carbohydrates (especially the wrong kind) can make you fat and increase your risk of heart disease. Eating foods with a high glycemic index—such as cookies, cake, candy, bagels, pasta, white rice, refined bread and grains, potatoes and potato chips—raises blood sugar and insulin levels, which in turn stimulates the production of triglycerides (blood fats that raise heart disease risk).

13) False. Your kidneys, blood vessels and heart all control blood pressure. In order to maintain healthy blood pressure and keep blood moving, the walls of your arteries, capillaries and veins need to be flexible and strong. Research has shown that nutrients such as Co-Q10, hawthorne, red wine polyphenols, notoginseng (a cousin of ginseng), and astragalus help strengthen blood flow throughout the entire body, maintaining healthy blood pressure. In addition, EDTA (the main ingredient in Health Freedom Nutrition’s Cardio Clear) removes heavy metals and toxins that interfere with the production of nitric oxide, a major factor in controlling blood pressure.

14) False. Even if there’s heart disease in your family, and even if you have high cholesterol, combining an regular exercise program with and a Mediterranean based diet and healthy lifestyle (no smoking, reduced alcohol consumption) can dramatically reduce your risk of heart attack and stroke.

15) True. Dr. Scoot Calig, M.D., a pediatrician at West Hills Medical Center and an assistant clinical professor at the University of Southern California, Los Angeles, says, “It’s important to keep in mind that the development of cardiovascular disease begins in the teenage years. Studies have shown that by that time, arterial plaque formation is well under way.”  Just another reason to exercise, eat a healthy diet, and take nutritional supplements such as oral EDTA to strengthen the heart and arteries and clear out toxic metals that inhibit the production of nitric oxide.

16) False. For years, aspirin has been prescribed after a heart attack, in order to avoid a subsequent heart attack. And now, a panel of experts is recommending aspirin as a precaution against heart disease for all at-risk, healthy adults over 40. But Alfred Berg, M.D., of the University of Washington, head of the panel says, “Do not assume that an aspirin a day is without risk.” Aspirin can cause intestinal bleeding and hemorrhagic stroke. Herbs such as hawthorne, nattokinase, garlic and Ginkgo biloba have the ability to thin the blood like aspirin, without damaging the esophageal and intestinal linings, or exacerbating ulcers.

17) False. Homocysteine—a by-product of the amino acid methionine— is a more sensitive indicator of cardiovascular health than cholesterol. Too much of it increases injury to arterial walls, as well as accelerates oxidation and accumulation of cholesterol in blood vessel. The good news is that folic acid, and vitamins B6 and B12 help keep homocysteine levels low!

18) True—for men and women! Click here to read 16 Stress-busters to nourish your body, mind and soul

Have a happy Father’s Day, and please take care of your health so you can continue to enjoy life and be a support and friend to everyone who loves you.


For dozens of general health tips and caregiving help read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia  by Barbra Cohn.image

12 ways to protect yourself and loved ones from Elder Abuse

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

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 claimed that she was being held in jail and needed bond money. This family emergency scam has been going on for years.

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.

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

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

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

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

Report abuse

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

Types of abuse

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

Signs of abuse

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

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

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

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

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

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

Human Services provides help with:

  • In-home assessment for abuse, neglect, and/or exploitation
  • Crisis intervention
  • Monthly visits by a case worker, if risk continues
  • Assistance with housing and/or placement to alternative housing
  • Assistance with obtaining benefits
  • Money management
  1. To report suspected abuse in a nursing home or long-term care facility, contact your local Long-Term Care Ombudsman. Each licensed long-term care facility is required to display a poster with the facility’s assigned ombudsman’s name and contact information. If you are a resident or family member of a resident in a facility, call the ombudsman listed on the poster. To learn more about the ombudsman program visit: Long-term care ombudsmen are advocates for residents of nursing homes, board and care homes and assisted living facilities. http://www.ltcombudsman.org
  2. Caregivers (both family and professionals) are most often the abusers of the elderly. Stress and feelings of being overwhelmed may provoke unintentional belligerent feelings. If you feel overwhelmed or frustrated as a caregiver, talk to someone for support.
  3. To speak with an Alzheimer’s Association Care Consultant call: 1-800-272-3900
  4. To find a support group in your area visit http://www.alz.org/apps/findus.asp
  5. To receive support from other caregivers visit https://www.alzconnected.org/
  6. To report an incident or concern of abuse or neglect, call the Alzheimer’s Association (1.800.272.3900) or Eldercare Locator (1.800.677.1116). You’ll be connected to your state or local adult protective services division or to a long-term care ombudsman. You do not need to prove that abuse is occurring — it is up to the professionals to investigate suspicions.
  7. Read more: http://www.alz.org/care/alzheimers-dementia-elder-abuse.asp#ixzz2W9DhCbSL
  8. Keep in contact. Talk with your older friends, neighbors, and relatives. Maintaining communication will help decrease isolation, a risk factor for mistreatment. It will also provide a chance to talk about any problems they may be experiencing.
  9. Join Ageless Alliancea national, non-profit grassroots organization working to 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.

You have a dementia diagnosis, now what?

Senior doctor talking with patient and tablet in officeJune is Alzheimer’s & Brain Awareness Month. It’s a good time to have a physical exam, especially if you are worried about your memory not being as sharp as it used to be or if you’re having trouble coping with daily life. If you’ve noticed that someone close to you is showing signs of withdrawal, depression or confusion, please strongly suggest that he or she make an appointment for an exam, too.

Here’s the scenario of how my husband Morris and I received his diagnosis. I’ve provided a list below it to help you tread water when you feel as though you’re drowning.


There were several indications that something was wrong with my husband two years before he was diagnosed. This tall, good-looking man, a graduate of the Wharton School of Business at the University of Pennsylvania, was having trouble calculating how much tip to leave a waitress. When we went to Spain for our twenty-fifth anniversary, Morris couldn’t figure out how much money the hotel would cost in dollars. This man, who once memorized train and airplane schedules without even trying, followed me around the city like a puppy dog as we boarded a subway or bus en route to tourist attractions.

That following fall—our daughter’s last year in high school—Morris couldn’t give directions to a friend who was taking the SAT at the high school my husband had attended in Denver. I got out the map to help him, but he couldn’t read the map. That was the moment I knew something was very wrong. When he left for a road trip to California with our son and forgot his suitcase, I sat on the stairs and cried. I couldn’t deny it any longer. I had a strong suspicion that Morris had Alzheimer’s disease, and although I pleaded with him for two years to see a neurologist, he refused.

Finally, he agreed. The doctor (I’ll call her “Dr. Fitzgerald”) asked Morris why he had come in. “My wife thinks I might have Alzheimer’s disease,” he said.

“You wouldn’t be able to drive here yourself if you had Alzheimer’s,” she replied.

Nonetheless, Dr. Fitzgerald gave Morris the Mini-Mental State Exam (MMSE, a thirty point questionnaire used to screen cognitive impairment), asking questions such as, “What are the year, season, date, day, and month?” and progressing to more difficult questions that included counting backward from one hundred by serial sevens. I don’t know about you, but I’d probably be slow on the draw to count backward by sevens. At least I’d have to stop and think about it before responding. Morris botched up that question, and he wasn’t able to draw the face of a clock either. The concept of time was already an elusive abstraction.

Dr. Fitzgerald ordered a blood work-up to rule out an organic problem such as hypoactive thyroid—which can cause memory problems—and an MRI scan (magnetic resonance imaging) to rule out a brain tumor. To tell you the truth, I was hoping for a brain tumor because at least you can take the bull by the horns and really go at the darn thing with radiation and a scalpel. Well, there was no brain tumor and his blood panel looked just fine.

A week later, just as we were investigating the cost of long-term health insurance, Dr. Fitzgerald called to ask Morris to bring in his wife to the follow-up appointment. I’m sorry to say that one of the biggest mistakes I’ve ever made was to schedule that appointment without first buying long-term care insurance. Once you get a diagnosis such as Alzheimer’s, there’s no way you’re going to qualify for long-term care insurance, which could potentially save a family thousands of dollars in catastrophic health care costs.

In the early afternoon of January 3, 2001, Morris and I sat in a dimly lit exam room on wooden frame chairs with hunter green cushions on the seat and back. He wore a sweater woven from various shades of blue and gray that highlighted his eyes. We waited for the doctor to knock on the door, the way they usually do. Morris didn’t appear nervous; probably because he didn’t think there was anything wrong with him. But my stomach was wound tight from anxiety and my lungs were working hard to expel phlegm. It didn’t help that the stale re-circulated air had a metallic odor of fear that was probably generated by patients who had received bad news.

Dr. Fitzgerald finally came in and sat on Morris’s left. She had cropped hair and spoke in a blunt, choppy cadence that matched her no-nonsense appearance. Without much of an introduction, the doctor asked me a few questions about Morris, speaking as if he were invisible.

“How is his driving?” she asked.

“He tends to get lost driving in familiar neighborhoods,” I responded, noting the twitch in Morris’s right cheek. I felt my lungs squeeze, and a high-pitched wheeze escaped from my chest.

“Here is the Mini-Mental State Exam Morris took the last time we met.”

His drawing of a house looked like a dilapidated mine shaft. Without waiting for a response, Dr. Fitzgerald turned to Morris and said, “You have Alzheimer’s disease.” Morris froze and his face turned white, while I burst out crying.


I hope that if you ever get a diagnosis such as Alzheimer’s, Parkinson’s, vascular dementia or a similar devastating disease, your doctor is compassionate and gentle about the delivery of the news that will forever change your life and the lives of your loved ones. I wrote “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia” after caring for my husband for 10 years, in order to help other caregivers feel more confident, happier, healthier, and deal with feelings of guilt and grief.

For hundreds of other caregiving tips, find “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia” on AmazonBarnes and Noble, at other fine book stores, and many libraries.

 

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What can and should you do after getting a diagnosis?

It is understandable that you will have many conflicting feelings such as disbelief, anger, depression, sadness, fear, grief, and shock. You may even feel relieved that you finally know why you are not feeling like yourself. It can be helpful to talk about what you’re feeling and thinking rather than to keep things bottled up inside. In addition to talking with people who are close to you, you can contact the Alzheimer’s Association® at 1.800.272.3900.

You don’t have to tell everyone about your diagnosis if you don’t want to. But if you are still working, or if your boss has questioned your work habits, etc., it’s a good idea to inform him or her of your diagnosis, especially since you might be eligible for  Social Security Disability Insurance.

Your health is more important than ever

Just because you receive a diagnosis doesn’t mean you should give up trying to live a healthy life. You probably still have a lot of years ahead of you, so enjoy them as much as you can. Continue to get daily physical exercise such as walking, biking, hiking, dancing, swimming. Eat a Mediterranean based diet that includes lots of fresh veggies, fruits, nuts,  fish, whole grains, avocado and olive oil.

Stay socially connected as much as possible. It’s normal to feel depressed and it’s okay if you don’t feel like “going out” as much as you used to. But it’s important not to isolate yourself. Keep golfing, bowling, playing cards, as much as you can. Continue to meet with friends for lunch or a movie. If you feel the need to talk, make an appointment with a therapist who specializes in helping people with dementia.

Visit museums, spend time with grandchildren, get a pet (if you don’t already have one), attend an Alzheimer’s Association Memory Cafe. The Alzheimer’s Association’s Memory Cafés offer a fun and relaxed way for people living with early-stage memory loss to get connected with one another through social events that promote interaction and companionship. This is a place where the care partner can receive information while connecting and sharing with other people in similar situations.  Keep busy!

 Legal and Financial Planning for the Future

This is the time to start planning for the future. Taking the time to make decisions about matters that will affect your health care and your finances before you are unable to manage them is one of the most important steps you can take for yourself and your family.

There are many legal and financial documents that will help you formalize your plans and wishes such as:

Durable Power of Attorney

In this document you appoint a person you trust to make legal and financial decisions on your behalf, if you become unable to do so for yourself.

Health Care Proxy

In this document you appoint a person to make medical decisions on your behalf, if you become unable to do so for yourself. It’s important that you speak with the person you appoint about the kind of medical care you would or wouldn’t like so that they can carry out your wishes.

Living Will

Some people also want to make a Living Will in addition to having a Health Care Proxy. In this document, you can state your wishes about end-of-life care.

Last Will & Testament

The purpose of this document is to designate how your assets will be distributed after your death. This will must be completed with the assistance of an attorney.

All the best to you and your families. 

With love,

Barbra Cohn

 

 

 

 

 

Easy ways to calm down crazy full moon behaviors

ヨガThe human body is 55 to 78% water (depending on sex and age) so it makes sense that the gravitational pull of the moon would affect us, right?  Many scientists point out that the biological tide theory doesn’t hold. On The Skeptics Dictionary website Robert Todd Carroll says, “Given the minute and bounded mass of fluid contained within the human body, compared to the enormous and free-flowing mass of ocean water, and given the enormous distance to the moon, the lunar pull on the human body is negligible.”

Theories about the moon’s influence on animal behavior are more widely accepted. Although the topic of whether or not the moon affects human behavior is controversial, there is plenty of anecdotal evidence and some scientific evidence indicating that it does.

I, for one, have a difficult time sleeping around the full moon. And my husband, who suffered from Alzheimer’s disease, exhibited more agitated behavior when the moon was full.

Studies have shown that the lunar cycle has an impact on fertility, menstruation, and birth rate.  Admittance to hospitals and emergency units due to cardiovascular and acute coronary events, arterial hemorrhages in the stomach and esophagus, diarrhea, and urinary retention correlate with moon phases. Other events linked to human behavior, such as traffic accidents, crimes, and suicides, seem to be influenced by the lunar cycle.

In the 1600’s Sr. William Hale, a distinguished British physician and medical biographer, wrote, “The moon has a great influence in all diseases of the brain, especially dementia.” The British Lunacy Act of 1842, which dismissed crazy behavior as being caused by the full moon, built on his theory.  In fact, as recently as 1940 a British soldier who was charged with murder pleaded “moon madness.”

Alan M. Beck of Purdue University conducted a longitudinal study to objectively examine the lunar influence on the frequency, duration, and intensity of behaviors in individuals with Alzheimer’s disease.

He examined wandering, anxiety, physical aggression, and verbal confrontation. His study concluded that individuals with Alzheimer’s disease did, in fact, exhibit significantly more erratic behaviors during periods of the full moon, and that these behaviors were of greater duration during that time. The objective analysis that a lunar influence on behavior in Alzheimer’s individuals exists validates a long-standing belief held by many healthcare providers.

If you’re a caregiver for someone with dementia, you’ve probably seen some odd behavior in your loved one around the full moon. And if you have trouble sleeping or feel restless or anxious during the full-moon, you’ve personally noticed the effects.

Here are some ways to calm the nerves and odd behaviors during the full moon or anytime.

From Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia--“Aromatherapy” chapter 18 by Laraine Kyle Pounds, RN, MSN, BSN, CMT.

Aromatherapy can be a resource of comfort to you and your care partner by providing an easy, natural way to reduce stress and anxiety and uplift mood. The following oils can be used in a diffuser, or put in a bath or fragrance free moisturizer. They can also be sprayed on a pillow or handkerchief.

Citrus oils are generally refreshing and uplifting for the mind and emotions, relieve stress and anxiety, and are useful for odor management and appetite support. Consider: bergamot, grapefruit, lemon, and orange.

Floral oils are often used as a personal fragrance and are useful to relieve anxiety, depression, and irritability. These oils are useful as an inhaler, in a body lotion, and for the bath. Consider: clary sage, geranium, lavender, rose, and ylang ylang.

Tree oils are revitalizing with immune boosting properties, ease respiratory congestion, and are supportive to breathing ease. They are useful for pain relief, skin infections, and odor management, and can relieve nervous exhaustion and depression. Consider: eucalyptus (Eucalytpus citriodora or globulus), pine needle, sandalwood, or Tea Tree.


Herbal remedies (from chapter 31, Nutritional Support for Caregivers, in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”

A nervine is a plant remedy that has a beneficial effect upon the nervous system.  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 particularly helpful for strengthening the nervous system and restoring balance. In addition to having a relaxing effect, they 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 tranquillize.  Too much tranquilizing, even that achieved through herbal medication, can in time deplete and weigh heavily on the whole nervous system,” says renown herbalist David Hoffman.
  • Nervine Stimulants– are used as a restorative “pick-me-up” when you need an energetic boost without that revved up feeling produced by caffeine.

Recommended nervines:

  • Passion flower- helps soothe anxiety, insomnia, tension headaches, muscle aches and spasms, pain, hyperactivity, epilepsy, and helps alleviate anger and lower blood pressure.
  • Skullcap – is antispasmodic and relaxing and is recommended to relieve headaches, mood swings, insomnia, premenstrual syndrome, and nervous tension and exhaustion.

The next time you’re feeling nervous, agitated, restless or hyped up, calm your nerves with a nervine herb or aromatherapy. If your loved one has Alzheimer’s or dementia and is on medication, please check with the physician to make sure they do not interact with the nervine herbs.  Use pure essential aromatherapy oils to lower risk of allergy.

If all else fails, you can always go outside and howl at the moon.

 

Studies showing we are affected by the full moon

1. More babies are born around the full moon. A study in Kyoto, Japan looked at 1007 natural births and found there was significant increase in births when the moon was closest to the earth. Results of this study suggest that the gravitational pull of the Moon has an  influence on the frequency of births.

2. Do you have trouble sleeping around the full moon? Sleep researcher Christian Cajochen at the Psychiatric Hospital of the University of Basel in Switzerland conducted a four-year lab study to see if he could show that it is physiologically true that many people have difficulty sleeping during the full moon.  His researchers monitored the brain activity, eye movements and hormone secretions of 33 volunteers in the lab while the participants slept. All the participants were healthy, good sleepers, and did not take any drugs or medication.Unexpectedly, the scientists found “the lunar cycle seems to influence human sleep, even when one does not see the moon and is not aware of the actual moon phase,” Cajochen said. After reviewing their data, the scientists found during the time of the full moon, brain activity related to deep sleep dropped by 30 percent. People also took five minutes longer on average to fall asleep, and they slept for 20 minutes less overall on full-moon nights. The volunteers felt as though their sleep was poorer when the moon was full, and they showed diminished levels of melatonin, a hormone known to regulate sleep and wake cycles. “It took me more than four years until I decided to publish the results, because I did not believe it myself,” Cajochen told LiveScience. “I was really skeptical about the finding, and I would love to see a replication.”


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” 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.

Love doesn’t conquer all: caregiver resentment and frustration

Senior Couple QuarrellingI recently participated in a caregiver symposium. I spoke to dozens of caregivers who expressed fatigue, frustration, and exasperation. Everyone was stressed and stretched to the limit. I detected little joy. Instead, people appeared resentful. “I didn’t sign up for this,” one man said. Another confided, “I read your book and am taking your advice. I will not let my wife’s illness ruin my life.”

Caregiving only goes one way: it gets harder. And when we don’t really like the person we are caring for or if we feel trapped, it is even more challenging. I was only 48 years old when my beloved husband was diagnosed with Alzheimer’s disease. I knew our lives would never be the same again. . . and they weren’t.

Yes, we had joy. Our young adult children graduated from college and got married. We went on a few trips. We had some funny moments that elicited belly laughs. But the emotions I remember most are the heaviness of grief, despair, depression, guilt, and fear. I didn’t feel resentment, I think, because I have a philosophical outlook that we reap what we sow (as in the law of karma), and that somewhere, somehow in a past life beyond the ethers I had signed up for my caregiving duty. I tried to put on a happy face. But I told my closest friends that I was exhausted and stressed.

I felt shame that after decades of practicing Transcendental Meditation and following a healthy vegetarian lifestyle our lives had come to this. Wasn’t life supposed to be blissful and free of stress? I soon realized that no one gets out of here without going through at least one huge, transformative challenge. Mine was caregiving for my life partner, who was unable to hep me make the big decisions such as finding a smaller house because ours had become unmanageable, or finding a memory care home for him when I wasn’t able to continue physically caring for him.

Guilt? Yes, I still feel guilt even though my therapist often said to me “If a friend told you what you just told me, what would you say to her?”

“I would tell her ‘you are doing the best that you can.'” And I did do the best I could for my husband. I took him to healers and doctors and gave him nutritional supplements that been shown to help support cognition and memory.

But I still feel guilt about running away every chance I got to dance or have lunch with a friend, even though I know I needed the relief time in order to stay healthy and strong so I could carry out my caregiving duties.

When all is said and done, if you are not exactly thrilled about giving countless hours to someone you love or to someone you are obligated to care for because there is no one else, you might as well learn how to be the best caregiver possible. Because when your caregiving is over, you will have another chance to live the life you chose for yourself. So give it your best shot. Here are some ways to ease the burden and to help you feel good about yourself and the person you are caring for.

Lighten the load of caregiving

  • Take care of yourself first. Carve out time every day to go for a walk, do yoga, dance, sing, whatever it takes to help you feel better.
  • Join a support group. I don’t know how I would have maintained my sanity if I hadn’t joined the younger-onset Alzheimer’s support group offered by the Alzheimer’s Association.
  • See a therapist. Mine was a god-send who listened with compassion and gave excellent advice.
  • Sign up for community services such as day programs, senior centers, Meals on Wheels, hotlines, etc.
  • Hire someone to take your “care partner” (the person you care for) out for lunch, to the movies, for a visit to a museum, etc.
  • Ask your friends and neighbors for help mowing the lawn, retrieving the mail, sitting with your “care partner “so you can do errands, etc.
  • Talk to family members and make a plan to share the responsibilities. (more on this in another blog post)
  • Make an appointment with an elder attorney to draw up a contract for you to receive wages, find out how to get social security withheld, etc.
  • Breathe! After I buried my husband I realized that I hadn’t fully breathed in years. I was tight, my lungs were tight and I was holding my breath waiting for the next next emergency to occur.

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Here’s an excerpt from my book  Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia about breath work, including a simple exercise. Follow the directions for breathing in order to release stress and feel more energized.

by Reverend Shanthi Behl (excerpted from Calmer Waters)

Breath work is the first and easiest to start with. We can deliberately extend, shorten, retain, and otherwise direct the air we breathe in a variety of ways in order to guide the prana. Second, is the mechanism of directed attention, also known as our intention. Where our thoughts go, our prana goes. An integrated pranayama practice utilizes both the breath and our focused attention.

When we say we are tired and have no energy, what we are really saying is that our energy is blocked. We need to breathe to live, and how we breathe can profoundly affect our degree of physical well-being; it can regulate our emotions, and it can deplete, sustain, or increase our experience of aliveness. Prana is constantly fluctuating and moving throughout the universe. According to yoga philosophy, it flows throughout the living body in exquisitely determined whirlpools and currents. The wonderment of the yogic system is asana and pranayama practice which allows our innate energy currents to flow as nature intended.

The following instructions are for sitting, but you can practice this exercise while standing in mountain pose.

• Sit up tall, lengthen the spine, and place the feet flat on the floor. Press the feet into the ground, even as you press the top of the head toward the ceiling.

Relax the hands lightly on the lap and release the shoulders down away from the ears.

• Soften the belly muscles. As you breathe in through the nose, lengthen through the crown of the head.

• As you breathe out through the nose, release the shoulders and press your feet into the floor.

• Continue this practice and turn your awareness to sensations along the spinal column. Feel the upward flow as you breathe in and the downward flow as you breathe out. It is perfectly fine if you feel the opposite movement. The important aspect is to tune into a sense of any movement along the spine. You may not initially feel the movement of your energy. However, by first imagining it, you will later actually feel the upward and downward flows of energy along sushumna, the central core of energy.

 

The Truth about Caregiver Guilt

Concept of accusation guilty unhappy businesswoman personCaregivers can often feel guilty when taking care of a terminally ill family member. Am I doing enough? Did I make the right decision? What if… what if…? Here are ways to recognize your feelings, tips for accepting them, and ways to forgive yourself.


For dozens of tools and techniques to help caregivers feel happier, healthier, more confident, deal with feelings of guilt and find inner peace read “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”

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Some philosophers and psychologists believe guilt is mental and emotional anguish that is culturally imposed on us. Tibetans and Native Americans don’t even have a word for guilt, which might mean that it isn’t a basic human emotion. Yet, Jews and Christians are very adept at feeling guilty over trivial mistakes, as well as serious blunders.

The first time I felt guilt was when my brother was born. I’m two years older than he, and in 1954 the hospital rules didn’t allow siblings to visit newborns. My Uncle Irv placed me on his shoulders so I could see my mother, who waved to me from the window of her hospital room. I was angry with her for leaving me and I refused to look at her. She waved like the beautiful lady in the fancy red car that passed me by in the Memorial Day parade. But I wouldn’t look at her. The memory is a black and white movie that has replayed itself throughout my life, with the film always breaking at the point when I sullenly turn my head away.

For years afterwards, I would awaken in the night feeling guilty that I didn’t look at her. When I was four years old, I fell out of bed onto the wooden floor of the bedroom I shared with my brother because I was having a bad dream. I don’t recall the dream, but I  remember the ache inside my chest that has always been associated with not doing what my mother wanted me, or expected me, to do.

Over the years, up until my early fifties, I’d have a physical sensation that felt like sand paper or grains of sand inside the skin of my hands that would migrate to the skin and muscles of my arms and torso. Sometimes it felt like my arms and hands were paralyzed or had grown in size. It was hard to move, and the uneasiness of guilt was always associated with the sensation. I recently realized that I haven’t felt those sensations in a very long time.

Maybe I lost those sensations because the guilt of my childhood was replaced by the guilt I felt over placing my husband in a memory care home. I could have taken care of him until the end of his life, but I was drowning in misery and I promised myself I wouldn’t sacrifice everything for this illness. I prayed for his release and my relief, and knew that if I had taken care of him until the end, my own health would have suffered.

I tried to help my husband fight Alzheimer’s by bringing him to healers, holy people, and complementary medicine practitioners. I fed him an organic, whole-foods diet and gave him nutritional supplements, in addition to the prescribed pharmaceutical drugs. I ordered Memantine from Europe before it was FDA approved and prescribed as part of the Alzheimer’s drug protocol by U.S. physicians.

I did all this until I finally realized that my husband needed to take the solitary journey of being a victim of Alzheimer’s disease. Some call it fate and others call it karma. Whatever we name it, no matter how much we are loved and in close communion with family and friends, we have to travel the delicate path of life on our own. When we succumb to illness and disease, it becomes especially painful for others to helplessly stand by and watch, after doing everything humanly possible to assist.

There was always one more “magic bullet” for my husband Morris to try, and yet when I felt the possibility of divine intervention weaken, I began to give up hope and let destiny take its course. The first couple of years after Morris’s passing, the guilt—and grief—would unexpectedly grab me, wrapping its tentacles around my chest. It would twist the insides of my stomach, making it impossible to eat. It would swell into a lump in my throat or tighten a band  around my head, destroying my serenity for an hour or two —or an entire day.

Guilt came in layers, piled up like the blankets I tossed from my bed one by one during a cold winter’s night. The blankets came off as my temperature rose and drops of sweat pooled between my breasts. I shook off the feelings of guilt in a similar way when I heard my therapist’s words in the back of my mind reminding me that I did more than I could do; when I remembered that I’m a mere mortal who breaks and cries when I can’t move one more inch beyond the confines of this physical body; when my heart had expanded to the point where it can’t expand anymore, so it has to contract in order to plow through the walls of pain and deal with the guilt.

Why do I still feel guilt? I feel guilt about not being the perfect wife before Morris got sick. This man adored me and I didn’t reciprocate with a passion that matched his. I feel guilt because I’m alive and he’s not. (Survivor’s guilt is commonly felt by those who share in a tragic event in which the cherished partner dies, leaving the other one to live and put back the pieces of the life they once shared.) I feel guilt about the times I could have spent with Morris watching television or taking a walk instead of running out to be with friends or to dance. Feeling guilt for doing anything to get away from his asking me the same question over and over again, or so I wouldn’t have to watch the man who once stood tall and proud, stoop and stumble like a man way beyond his years.

I hear the therapist’s voice in my head asking, “What would you say to someone who just told you all this?” I’d say, “But you did the absolute best that you could do.” And then I feel better. It’s okay. I’m okay. I really did the best I knew how, and Morris lived longer than his prognosis because of it.

Now, almost eight years after his passing, the guilt appears much less frequently. It hovers momentarily like a hummingbird poking its beak into honeysuckle and hollyhock. The guilt is diluted and flavorless like cream that’s been frozen without added fruit or chocolate chips. It’s a color without pigment, a touch without pressure, a sound without notes. The guilt I feel now is background noise; not noticed until I turn off the other sounds in my world or mindlessly drive my car on a dark, damp day, which is unusual in sunny Colorado. The guilt now appears in various shades of dirty white and brown. It doesn’t reach inside my heart with its claw like it used to. The battle is over, and almost, but not quite, won.

Why do you feel guilty?

  • Do you feel that you aren’t doing enough for your care recipient? Make a list of everything you do for the person you care for. Preparing a meal, shopping for groceries, driving to appointments, making a bed, doing laundry, making a phone call, sitting next to the person, even just giving a hug: the list adds up! You are doing a lot more than you think you are!
  • Are you guilty about your negative feelings? Resentment, anger, grief are all normal. They are just feelings and they aren’t wrong. Feelings are complicated and you are entitled to them. You probably love the person you are caring for but the time you spend is precious and you might rather be outside gardening or hiking or traveling.
  • Do you feel badly about taking time for yourself? Don’t! If you don’t stay well, including eating and sleeping well, there’s a good chance you will get sick. And that is not going to help anyone! Please take some time for yourself. If you are a full-time caregiver, at least take a 15 minute walk every day. Get some respite care. Your local  county social services department can most likely provide you with some options for help.
  • Are you feeling inadequate at a caregiver? The Alzheimer’s Association offers free classes on caregiving. “The Savvy Caregiver” is an excellent five-session class for family caregivers. It helps caregivers better understand the changes their loved ones are experience, and how to best provide individualized care for their loved ones throughout the progression of Alzheimer’s or dementia.

Tips for easing guilt

  • Ask yourself what is bothering you. Talk with a close friend who will not judge you, or with a professional therapist, clergy person, spiritual teacher, or intuitive guide. Talk about your guilt until you feel your body release the tension that is stored in your muscles and cells.
  • Remember that you are human and not perfect. No one expects you to perform with absolute clarity and grace all the time.
  • You cannot control everything all the time. You are doing the best that you can with the information, strength, and inner resources that you have.
  • Have an “empty chair” dialogue by speaking out loud and pretending that your care partner is in the chair next to you. Express your feelings openly and wholeheartedly. Ask for forgiveness if you feel that you wronged your loved one in any way.
  • Write down your thoughts and feelings. Journaling is a wonderful, inexpensive way to release your concerns and worries on paper. It’s available when your therapist and best friend are not, and you can do it anywhere at your leisure.
  • Strong feelings of guilt, remorse, and grief will diminish over time.  If they continue to haunt you, seek professional help.

 

Why you should throw away that antipsychotic drug prescribed for your loved one

Elderly woman taking a medicineAccording to Human Rights Watch in an average week, nursing facilities in the United States administer antipsychotic drugs to over 179,000 people who do not have diagnoses for which the drugs are approved. Often, these drugs are dispensed like candy, without free and informed consent. . . without a family member or someone who holds durable power of attorney for the health care resident, to make a decision based on the benefits and risks of taking the medication.

Like my late husband, most of the patients who are given these drugs have some form of dementia or Alzheimer’s.  My husband was in a memory care home for two years. Towards the end of his illness, he was given an antipsychotic drug because his behavior became “difficult.” He was not combative, and he was mostly non-ambulatory. Once, though, while sitting, he swung out his arm and hit a woman who was bothering him. Since I wasn’t there, I don’t know the details. But in general, he was a sweet man up until the end. He did get annoyed, however, by other residents’ behavior. And so he was given a drug to pacify him. After visiting him over a period of a few weeks and noticing the deterioration in his overall wellbeing, including his inability to hold his head up, sit upright, or staying awake most of the day, I demanded that he be taken off a number of drugs. The improvement was dramatic and astounding.

According to the US Government Accountability Office (GAO) analysis, facilities often use antipsychotic drugs to control common symptoms of Alzheimer’s. These drugs are associated with clinically significant adverse effects, including death. Then why are they being prescribed to an extremely vulnerable, frail and “at risk” population? Because disruptive behaviors such as crying out “help me, help me” over a long period of time, or yelling out profanities, or exhibiting aggressive behavior can become a nuisance that caregivers –professional and family–are either not skilled in addressing or are too busy taking care of other patients to be bothered with.

What are the alternatives?

First:

  • Eliminate noise and disruption.
  • Make sure the patient does not have a urinary tract infection.
  • Evaluate physical needs. Is s/he thirsty, hungry, constipated, etc?
  • Encourage the patient to verbalize feelings and needs, if possible.
  • Limit or reduce caffeine.
  • Reduce external stimuli (loud TV or radio, etc.).
  • Dim the lighting.
  • Avoid confrontation and use a soft, sweet speaking voice.
  • Provide companionship.
  • Identify events or issues that trigger behaviors.

Once you know the patient is safe and free from pain due to an infection, create a calm and beautiful environment.

Creating a beautiful space

  • Maintain a clean environment without clutter.
  • Enjoy a vase of fresh flowers.
  • Burn incense to clear and purify the air, unless the smoke or odor is irritating.
  • Paint the walls a color that rejuvenates the spirit. For instance, green is healing and relaxing, red restores vitality in people who are depressed, and purple is powerful for those who need spiritual and emotional healing.
  • Gather gemstones. They exert healing effects. Lithium quartz is said to ease tension and stress, and keep nightmares at bay. Pink Calcite promotes compassion, healing, and universal love. Amethyst is for protection, purification, and spiritual/divine connection.
  • Listening to calming sounds can relax a tense body within minutes. Consider a wind chime, water fountain, or a CD of singing birds, ocean waves, or falling rain.]
  • Use essential oils or aromatherapy to have a specific effect on the body, mind, and spirit. (See Aromatherapy, Chapter 18 in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.”)
  • Create an outdoor sacred space with river rocks, a koi or lily pond, a flowering tree or shrub, pampas grass, colored sand—the possibilities are endless.
  • Include religious symbols, chakra symbols, animal totems, prayer flags, angel statues, rainbow banners, and lamps with colored bulbs.

Herbal remedies

  • A nervine is a plant remedy that has a beneficial effect upon the nervous system.  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 particularly helpful for strengthening the nervous system and restoring balance. In addition to having a relaxing effect, they 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 tranquillize.  Too much tranquilizing, even that achieved through herbal medication, can in time deplete and weigh heavily on the whole nervous system,” says renown herbalist David Hoffman.
  • Nervine Stimulants– are used as a restorative “pick-me-up” when you need an energetic boost without that revved up feeling produced by caffeine.
  • Recommended nervines:
  • Passion flower- helps soothe anxiety, insomnia, tension headaches, muscle aches and spasms, pain, hyperactivity, epilepsy, and helps alleviate anger and lower blood pressure.
  • Skullcap – is antispasmodic and relaxing and is recommended to relieve headaches, mood swings, insomnia, premenstrual syndrome, and nervous tension and exhaustion.
  • The next time your loved one is  feeling nervous, agitated, restless or hyped up, try calming him/her with a nervine herb or aromatherapy. If your loved one is on medication, please check with the physician to make sure the drugs do not interact with the nervine herbs.

Other ways to help a person with dementia relax and feel calm without the use of antipsychotic drugs.

  • Aromatherapy
  • Music
  • Pet therapy
  • Horticulture therapy
  • Color therapy

For detailed information on all of the above, read  “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”

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12 tips to encourage your Alzheimer’s patient to eat

Seniorin mit BetreuerinIt seems that ice cream is the favorite food of most Alzheimer’s patients. It was certainly my husband’s. Sometimes it was the only thing that he found appealing. It’s no wonder: ice cream is cold, slippery and delicious! However, there are lots of healthy frozen desserts available that are low in fat and calories that contain little or no cholesterol. Try Rice Dream®, Coconut Bliss, Soy Dream, or Halo Top. If you have a food processor, puree frozen strawberries or bananas. You won’t even miss the sugar and cream.

Getting adequate nutrition and even the sheer act of eating can be a challenge for both patients and caregivers. Here’s a list of ways to create a tranquil setting, and some easy-to-eat foods to uplift mood and support immunity for everyone.

  1. Play classical or another type of relaxing music. My husband loved to listen to Nina Simone’s jazzy voice while he ate. Whatever the preference is, play the music softly to create an inviting atmosphere. If your loved one lives in a memory care home, the other residents will probably appreciate the music, as well.
  2. Light a candle. Set the table with a table cloth and vase of flowers. Beauty, color and light always create a magical, calming effect.
  3. Aromatherapy oils including peppermint and spearmint are energizing and might stimulate appetite.
  4. Make the chair as comfortable as possible, especially if the person has a bad back. Place a cushion on the seat and back, if necessary.
  5. Use soft lighting. Replace glaring light bulbs with a warmer color light bulb, or install a dimmer.
  6. It might be hard for the person to differentiate foods on a plate, especially if they are the same color. Use contrasting colors. For example, serve beets and carrots on white instead of white mashed potatoes on a white plate.
  7. If your patient has trouble using a fork and knife, serve finger foods. Sandwiches cut in quarters or even eighths, pieces of fruit rather than whole fruits, baked potatoes cut into chunks, etc. are easier to manage.
  8. Use herbs and spices to flavor foods instead of salt. Herbs and spices have healing benefits. For instance, basil can relieve gas and soothe stomach upsets. Cinnamon has a tranquilizing effect that helps reduce anxiety and stress. It also helps regulate blood sugar. Dill soothes the digestive tract and reduces heartburn. Mint promotes digestion and boosts mental alertness.
  9. Puree soups such as split pea, potato/leek. cauliflower, and vegetable, and serve with a wide straw, if necessary. This relieves the chore of chewing and helps hydrate as well as nourish the patient.

One of my all-time favorite recipes is for Indian kicheree, also called a “meal in a pot.”

This traditional soup is wonderful during times of stress, stomach upset, and any time the appetite is diminished due to sickness or stress.

Kicheree

4 Tbs organic Basmati rice

4 Tbs mung dal or red lentils

4 1/2 cups water (more or less, depending on whether you like it soupy or thick)

2 tsp grated fresh ginger

2 Tbs fresh lemon juice

1 cup assorted veggies cut bite-sized (zucchini, yam, carrot, cauliflower, broccoli, etc.)

1 tsp ground coriander seed

1 tsp ground cumin seed

1/4 tsp turmeric

salt and pepper to taste

Combine the rice, dal ginger, veggies and water in pot. Add the spices. Bring to a boil over medium heat; then lower to a simmer for 45-50 minutes. Add water if it gets too thick. Remove from the stove. Add the lemon juice, salt and pepper.

10. Protein shakes are nutritious, filling, and nourishing. Use ingredients of your choice without relying on the sugary nutrition drinks that are generously handed out in institutions. Bananas, strawberries, blueberries, kale, spinach, peanut butter, coconut milk, almond milk, hemp milk, soy milk, and cow’s milk are some of the popular ingredients to try. Protein powders are concentrated sources of protein from animal or plant foods, such as dairy, eggs, rice or peas. The most popular include whey, casein, egg, pea, hemp, brown rice, and mixed plant proteins.

11. Offer healthy snacks throughout the day such as cheese and apple slices, nut butter on apples slices, fresh fruit, humus and carrot sticks.

12. Eggs are my favorite “go to” food for protein. They are easy to eat, can be made in a variety of ways and contain 13 essential vitamins and minerals! Vitamin D for bone health and immune function, lutein and zeaxanthin, antioxidants important for reducing the risk of cataracts and macular degeneration, vitamins B 12 and B6, thiamin, riboflavin, folate, choline, vitamin E, vitamin A, iron, zinc and more. Add pureed veggies for extra vitamins and minerals. Devil eggs are always a hit as a delicious and highly nutritious snack.

For hundreds of other caregiving tips, read “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”

 

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