20 Ways to prevent falls in Alzheimer’s patients

Woman falls on slippery bathroom floor.

People with Alzheimer’s and other types of dementia are four to five times more likely to fall than older people who don’t have cognitive impairment. They are also three times more likely to fracture their hip when they fall, which leads to surgery and immobility. The rate of death following a hip fracture for those with Alzheimer’s is also increased.

A person with dementia may have trouble recognizing sight, sound or touch. Their vision may be distorted, not because of an actual eye problem but because of how the brain interprets what it is seeing. They may have problems with depth perception, get confused by patterns or light intensity, and they may lose coordination of movement and physical strength.

Some of these changes are inevitable and irreversible. However, movement and physical activity can go a long way toward fall prevention.

Scott Salus, occupational therapist and co-owner with physical therapist Daniel Basta, of Kind Rehabilitation says, “One of the main things that helps prevent falls is understanding that a fear of falling is one of the best predictors that someone will eventually fall.

“It’s really important to address falls before they happen. Caregivers need to come from an honest and firm place, because the moment someone has their first fall that can be the moment they lose their independence,” he says.

When Salus’ then-65-year-old, physically-fit mother and her boyfriend were moving, he insisted they look into the future to think about mobility issues. Would it be more prudent to live in a ranch than a multi-level home? “You can start the conversation early and plan for an eventuality that may never take place,” he says.

Salus, who specializes in working with patients with dementia and Parkinson’s, says, “The process of fall reduction is a delicate one that includes practicing every-day activities. We

reassure patients that it’s safe to practice pulling up their pants, or going into a shower fully clothed.”

He evaluates if the patient has vertigo when bending to tie their shoes or getting up from a seated position. Have they had a recent surgery or new diagnosis? How do they manage pain? Do they need a commode, or learn to reposition their arms, feet, and legs when toileting or getting out of a chair?

A physical therapy program might include exercises for strength, flexibility, good posture, and gait training. Learning to maintain balance while you’re walking and distracted or multi-tasking is also important, Salus adds.

The Feldenkrais Method® (Awareness Through Movement® and Functional Integration® developed by Moshe Feldenkrais) is another modality that helps prevent falls by teaching individuals to pay closer attention to the way they move.

Al Wadleigh, a Feldenkrais practitioner who teaches privately and at the Longmont Senior Center, starts a chair class by asking the participants to begin with a scan by turning the awareness inward. “Get a sense of how you’re making contact with the chair and with your feet on the floor. How is your weight distributed on the pelvis? Now roll back and forward to sense how your lower back is in relationship to the chair,” he says.

“We go through the lessons—and there are 2,000 of them—to fill out the idea of exploring and sensing what feels good. It’s to figure out, when given a better opportunity and choice, what the nervous system prefers. It’s development learning in order to change habits from old injuries, surgeries, emotions, work, and thoughts that don’t serve us.”

The aim of Feldenkrais is to invigorate your brain and nervous system with new ways of organizing and sensing your movement in the world. “Around age 50 the brain says ‘we’re not using all our neuro-pathways.’ We have fewer to rely on, so we have to neutralize the old habits in order to live life with more vitality,” Wadleigh adds.

He ends the class by asking participants to do a self-inquiry. One person says, “I’ve done the pelvis rock many times but sitting on a chair made it clearer.”

Wadleigh responds that the smaller the movement the more precise it can be. Once you’re aware of what you’re not aware of, you can fill in those parts.”

Another person with Multiple Sclerosis says that one of his feet was dragging that morning. “Now I can lift it up.” He adds, “I feel a centered-ness since doing Feldenkrais, and have better structure. Now when I stand and I’m reaching for something I’m able to move easier. That’s big for me.”

20 Tips for preventing falls

  1. Have adequate lighting throughout the house; place night lights in the bedroom and bathroom.
  2. Limit liquids after dinner to reduce night-time toileting.
  3. Get adequate sleep.
  4. Remove loose area rugs.
  5. Wear gripping socks, sturdy slippers, or shoes in the house.
  6. Avoid unsafe shoes, i.e. flip flops and high-heels.
  7. Place guardrails where needed.
  8. Stand up slowly.
  9. Use a walker or cane for steadiness.
  10. Declutter and remove excess furniture.
  11. Implement an exercise program to support muscle strength, stability, and balance.
  12. Use a “reach stick” to grab out-of-reach items.
  13. Do not use a step ladder.
  14. Eliminate or reduce alcohol and smoking.
  15. Be wary of medications that cause dizziness, sleepiness, and unsteadiness.
  16. Be attentive to pain management.
  17. Be aware of where your pet is to avoid tripping.
  18. Get adequate calcium and vitamin D to maintain bone health.
  19. Maintain a healthy weight.
  20. Get regular vision and hearing check-ups.
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.

Pets can provide people with Alzheimer’s and dementia companionship, comfort and joy

Man resting in garden with his dog

My next door neighbor got an adorable lap dog that loved him to pieces during his struggle with Alzheimer’s. Now that he has passed away, his wife has a loving companion that gets her outside several times a day for walks. And that animal gazes at her with the love that only a dog can give. This was a success story of dog companionship for an elderly couple immersed in navigating the dark Alzheimer’s journey.

Pets can provide loving companionship, emotional therapy, and an excuse for getting out of the house for a walk and chat with other people on the trail. But pets can also pose a hazard when they get in our way or pull hard on a leash.

I have a friend who tripped this winter while walking her dogs. She fell and broke her collarbone. Another friend tripped over her dog in the kitchen and instinctively put her hand out to brace a fall. Unfortunately, she put her hand on a very hot stovetop and got a second-degree burn.

Pets offer numerous benefits

When people interact with pets the physiological response is a lowering of blood pressure and an increase in the neurochemicals associated with relaxation and bonding. These effects can help ameliorate behavioral and psychological symptoms of dementia. Several small studies suggest that the presence of a dog reduces aggression and agitation, and promotes social behavior in people with dementia. One study showed that having aquariums in the dining rooms of memory care homes stimulates residents to eat more and to maintain a healthier weight.1

When a dog is brought to visit memory impaired individuals (either at home or a facility), unexpected and positive reactions occur. Some patients who have refused to speak will talk to the dog, and others who have refused to move might pet the dog.

My daughter often brought her Miniature Schnauzer, Paco, to the memory care home where my husband lived. Paco always brightened the day for Morris and the other residents. He would run around scrounging for crumbs and sniffing the residents’ feet. Some residents reached out to touch him. One lady liked to hold him like a baby. She’d place a napkin on his head, pretending it was a hat. Paco created a bit of a stir, but he brought a smile to everyone’s face, including mine.

The human-animal bond goes beyond the mind and is centered in the heart. It can nurture us in ways that nothing else can. Sometimes a person with memory loss won’t be able to recognize a spouse, but can recognize a beloved pet. Just three days before Morris died a friend visited him with his trained pet therapy dog. Morris was bedridden, dehydrated, and non-communicative, but he opened his eyes and reached out for the dog.

If your loved one is used to being around animals, has had a pet, or if there is an animal that he or she is familiar with, by all means encourage the interaction to continue. It’s an easy, wonderful way to promote ease and happiness among care partners.

If you’re considering getting an animal companion, consider the following pros and cons.

10 Ways an animal companion or pet can help a person with dementia

Pets can:

  • Offer people with dementia unconditional love
  • Help relieve stress and anxiety
  • Help build confidence
  • Encourage laughter
  • Improve self-esteem
  • Help the person reminisce and recall memories
  • Provide an opportunity to get outside and walk
  • Support social activities, i.e. talking about the animal with neighbors, grandchildren, etc.
  • Bring back a sense of fun
  • Provide an opportunity to care for a living being, which in turn promotes empathy.

Things to consider

  • Does the person have the mental capacity to take care of the animals’ needs?
  • If the person has a caregiver, is that caregiver willing to provide the care for animal, including visits to the veterinarian.
  • Not everyone wants to interact with animal. Make sure the person really wants a pet and/or visit from a therapy dog.
  • A stuffed animal, cuddly toy, or robotic toy animal might provide the comfort that the person would get from having a pet. This might be a good option to explore before making a commitment to getting animal.
  • What happens if the person dies? Consider who will take responsibility for the animal.

In the end, you may find that a lower maintenance animal is a better fit. A fish aquarium can provide gentle stimulation, and quiet, relaxing beauty and grace.

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.

Dental hygiene for people with dementia

oral hygiene products

As with any debilitating disease, Alzheimer’s and other dementias pose limitations to what a patient can and can’t do. Good dental hygiene is one of the self-care daily habits that, unfortunately, often fall by the wayside in cognitively impaired individuals.

In the beginning stages of Alzheimer’s, a daily reminder might be all it takes to ensure that a person with dementia continues with their dental hygiene routine. As the disease progresses, the individual might need a more hands-on approach.

Why is dental care for dementia patients important?

It doesn’t matter whether you have dementia or are in tip top shape, dental care is a primary factor in overall health. Maintaining your dental health is much more than having a beautiful smile. Tooth decay and gum disease can affect your heart, your lungs, and your brain.

Periodontal disease has been linked to diabetes, heart disease, and Alzheimer’s disease.

According to the U.S. Centers for Disease Control and Prevention, one out of every two American adults over the age of 30 has some form of gum disease. Oral bacteria can migrate to distant sites in the body. Elderly and immuno-compromised patients, such as those suffering from cancer, diabetes or rheumatoid arthritis, may be especially vulnerable to systemic oral pathogens.

Periodontal disease is also associated with weight loss and wasting, which might contribute to cognitive decline. Gum disease often results in tooth loss, which often leads to problems with chewing, swallowing and food selection. And individuals don’t absorb nutrients from food efficiently if it is not chewed well. Evidence from several studies indicates deterioration in nutritional status in individuals missing teeth.

Certain medications can cause dry mouth

Decongestants, antihistamines, painkillers, diuretics and antidepressants are known to reduce saliva flow. Saliva neutralizes acids produced by bacteria in the mouth and helps protect you from microbes that can multiply and lead to infection and disease. The problem is, salivary glands are less productive as we age. Individuals with dementia also forget to drink when they’re thirsty. It’s important to be alert to cracked lips and dry mouth in your care partner in order to know when an individual is dehydrated.

8 Tips for preventing dry mouth

  • Sip water throughout the day—carry a water bottle.
  • Suck on hard, sour candies.
  • Chew sugarless gum.
  • Avoid or reducing the medications listed above.
  • Use Biotene, Plax, or ACT mouthwash which contain no alcohol.
  • Eat fibrous foods like apples, carrots and celery. They’re mildly abrasive and sweep bacteria and plaque off the teeth.
  • Use a humidifier to keep the membranes moist.
  • Get regular dental check-ups and alert the dentist about dry mouth. The teeth can sometimes be coated with protective substances that protect the teeth from bacteria and plaque.

12 Ways to assist dementia patients with oral hygiene

  • Talk your patient through the steps of brushing, if necessary. Put your hand over their hand that is holding the brush to guide them.
  • We typically brush our teeth in the bathroom. However, if it’s more comfortable for someone to brush while sitting down on a chair or in bed, by all means provide a plastic tub and glass of water for the patient.
  • As dementia progresses, it becomes more difficult for patients to visit their dentist for regular cleanings. It also becomes more difficult for caregivers to help with daily brushing, which is why caregivers must be more diligent in trying other techniques.
  • If a regular toothbrush is hard to hold and manipulate, try an electric toothbrush. Or, provide a toothbrush with a large handle. Some caregivers get creative and put the handle through a tennis ball to give the patient something heftier to hold onto.
  • Don’t use fluoride toothpaste if the patient is inclined to swallow it. If the patient doesn’t like toothpaste, try using baking soda and water, or just plain water.
  • Flossing is very important. See “Does gum disease really cause Alzheimer’s disease?” https://barbracohn.com/?s=flossing&submit=Search. Flexi-Floss, Stim-u-dent-or a tiny brush makes the job a bit easier.
  • If you can trust the patient not to swallow mouthwash, try an anti-plaque mouthwash when brushing is not feasible.
  • Ask your dentist about using a super soft toothbrush or one with a sponge head instead of a bristle head. Foam oral swabs are available at medical supply companies.
  • If your patient wears dentures, make sure to take them out and clean them daily. Use a soft brush to clean the patient’s gums and roof of their mouth when the dentures are removed.
  • Be alert to dental pain which may be exhibited by rubbing of the jaw or cheek, flinching while being shaved or having their face washed, refusing to put dentures back in, moaning, flinching, etc.
  • As mentioned in the above section, eating fibrous foods like apples and celery, and drinking plenty of water can help prevent plaque build-up.
  • It’s important to find a dentist who is patient and knowledgeable about dementia in order to make your patient’s dental visits as pleasant as possible. Let the staff know ahead of time about any concerns. If your patient gets agitated, ask his/her physician for an anti-anxiety medication beforehand. Or, use a homeopathic remedy such as calcarea carbonica or aconite, or an essential oil such as lavender oil to reduce anxiety. For a list of herbal remedies that reduce anxiety see “20 Natural Remedies for Depressed Caregivers (and everyone else).” https://barbracohn.com/category/aromatherapy/

References

  1. Hee Lee, K, Wu, B, and Plassman, B. Cognitive function and oral health—related quality of life in older adults. JAGS. 2013: 61: 1602-1607.

2. Elsig, F, Schimmel, M, Duvernay, E, Giannelli, SV, Graf, CE, Carlier, S, Herrmann, FR, Michel, JP, Gold, G, Zekry, D and Muller, F. Tooth loss, chewing efficiency and cognitive impairment in geriatric patients. Gerodontology. 2013: 1-8.

3. Chalmers, JM, Carter, KD, and Spencer, AJ. Oral diseases and conditions in community-living older adults with and without dementia. Spec Care Dentist. 2003: 23: 7-17.

4. Fabiano, JA. Oral health management in the patient with dementia. Medscape. May 24, 2011.

The truth about eating chocolate

Dark chocolate stack, chips and powder

Americans eat more than 11 pounds of chocolate each year, which is far less than most Europeans, especially the Swiss, who eat 19 pounds a year.

There’s a big difference between eating dark chocolate and milk chocolate. Dark chocolate has the highest percentage of cocoa solids and cocoa butter, as well as sugar and cocoa bean powder. It also contains flavonoids, plant-based compounds that have anti-inflammatory and antioxidant properties the support immunity. Additionally, it contains magnesium, sulfur, calcium, iron, zinc, copper, potassium and manganese, which are essential minerals. Dark chocolate also contains epicatechin and Gallic acids which support the heart, act as an anticarcinogens (anti-cancer), and support brain health and mental clarity.

Milk chocolate contains milk powder, sugar, and a small percentage of cocoa solids and cocoa butter. It has a creamier and sweeter taste. It contains less than 10 percent of cocoa versus the minimum of 35 percent cocoa that dark chocolate contains, which means it doesn’t offer nearly the number of health benefits as dark chocolate.

Nutritionists recommend consuming chocolate products that contain 70% to 80% cocoa. If you just want the pure and simple health benefits, forego the chocolate and take raw cacao capsules. Although I definitely wouldn’t recommend giving your sweetheart a bottle of cacao capsules on Valentine’s Day. Indulge in the good-tasting stuff!

Interesting health facts about chocolate

  1. Chocolate is an aphrodisiac. Legend has it that the Aztec emperor Montezuma was said to consume large amounts of the cocoa bean to fuel his libido. Today, scientists attribute the aphrodisiac qualities of chocolate to two chemicals: 1) tryptophan, which is a building block of serotonin, a brain chemical involved in sexual arousal. And, 2) phenylethylamine, a stimulant related to amphetamine, that is released in the brain when people fall in love. What about you? Do you experience a heightened sense of arousal after eating dark chocolate?
  2. Chocolate contains good-for-you antioxidants Chocolate comes from the cacao bean, which thrives in hot, rainy climates in South America, Africa and Indonesia. Similar to grapes, the local soil and climate affects the taste of the harvested beans. When you buy a chocolate bar that has the percentage number on the bar wrapper, that represents the weight that comes from the cacao bean content, according to Robert L. Wolke, author of What Einstein Told His Cook: Kitchen Science Explained. The higher the number, the lower the percentage of sugar and the more bitter and complex the flavor, he says. And the higher the number the more antioxidants.
  3. Cacao is rich in magnesium, sulfur, calcium, iron, zinc, copper, potassium and manganese, all essential minerals . . . and antioxidants that support immune health.
  4. Chocolate reduces your risk of Type 2 Diabetes Researchers discovered that the flavanols in chocolate have beneficial effects on insulin resistance, a risk factor for Type 2 diabetes. In a 30-year-long study of 953 men and women from the Maine-Syracuse Longitudinal Study (MSLS), researchers found that the individuals who never or rarely ate chocolate had a significantly higher chance of developing Type 2 diabetes after five years when compared to individuals who ate chocolate more than once a week. Habitual chocolate intake and type 2 diabetes mellitus in the Maine-Syracuse Longitudinal Study: (1975-2010): Prospective observations.
  5. Protects you from heart disease A 2012 report published in the American Journal of Clinical Nutrition found that dark chocolate has a beneficial effect on blood pressure, vascular dilation and cholesterol levels, and can play a role in reducing metabolic precursors that lead to diabetes and eventually to heart disease. However, a study published in October 2016 (John Wiley & Sons, Ltd.) found that out of 32 cocoa product samples analyzed, the cocoa flavanol dose must be about 900 mg or above to decrease blood pressure, and contain 100 mg of epicatechin. So if you want to eat chocolate for health benefits, be sure to check the ingredient label. The aim of the study was to review the effect of cocoa flavanols on cardiovascular health, with emphasis on the doses ingested, and to analyze a range of cocoa products for content of these compounds. PubMed was searched from 2010 to locate systematic reviews (SR) on clinical effects of chocolate consumption.
  6. Supports mental function. A recent analysis of several studies on the effects of cocoa polyphenols on cognition in healthy adults found that they enhanced memory and executive function. https://pubmed.ncbi.nlm.nih.gov/31933112/ In an earlier study carried out by the University of L’Aquila in Italy, 90 elderly participants with mild cognitive impairment (MCI) drank cocoa containing high, medium or low levels of flavonoids. At the end of the eight-week study researchers found improvements in the motor response, working memory, task switching, and verbal memory in the participants who drank cocoa with a higher flavanol content. (Hypertension, Aug. 14, 2012) Alzheimer’s and dementia patients are especially fond of sweets because the taste of sweetness is the last taste to disappear. Another study which evaluated the effect of cocoa flavonoids on cognitive function, blood pressure control and metabolic function in the elderly also found positive results. https://pubmed.ncbi.nlm.nih.gov/25733639/ So if your loved one has Alzheimer’s or dementia, indulge him/her in chocolate. Just remember not to overdo it and make sure to include good dental hygiene in your loved one’s daily regimen.
  7. Helps you think better after a sleepless night. The next time you have a bad night’s sleep, instead of indulging in a cup of Joe drink hot chocolate. Sleep deprivation is a risk factor for cardiovascular disease, and scientists have found that flavanol-rich chocolate counteracted vascular impairment after sleep deprivation and restored working memory performance. Their theory is that the study’s participants had improved cognitive performance because of the effects of cocoa flavonoids on blood pressure and blood flow.Flavanol-rich chocolate acutely improves arterial function and working memory performance counteracting the effects of sleep deprivation in healthy individuals.
  8. Makes you feel gooood Scientists have discovered why chocolate uplifts your mood. Serotonin is the neurotransmitter responsible for keeping us happy, and cacao stops the amino acid tryptophan from breaking down. Since tryptophan is one of the amino acids that make serotonin this, in turn, limits the breakdown of serotonin. https://pubmed.ncbi.nlm.nih.gov/25733639/

On Valentine’s Day celebrate with your loved one by enjoy a steaming cup of delicious hot chocolate made with whole milk or rice or flax milk. Or indulge in a dark chocolate truffle, candy bar or chocolate ice cream. It’ll boost your spirit and your immunity. Just be careful not to overdo it because the calories can add up quickly.

This is what I’m making on Valentine’s Day. Substitute coconut sugar or raw sugar, if you like.  This recipe is easier than you’d think, so don’t let the word souffle scare you off. It’s well worth the time and little effort it takes.

Chocolate Souffle

Ingredients

  • 1⁄3 cup sugar, plus additional for sprinkling
  • 5 ounces bittersweet chocolate chips
  • 3 large egg yolks, at room temperature
  • 6 large egg whites
  • 1⁄8 tablespoon butter

Directions

  • Preheat oven to 375°F.
  • Measure out sugar, chocolate and separate eggs.
  • Butter soufflé dish entirely and then add sugar (additional) coating the entire dish.
  • Melt chocolate in a double boiler, or directly on the stove.
  • Add yolks to chocolate (this will harden the chocolate so don’t be alarmed).
  • Beat egg whites with a pinch of salt. Slowly add sugar, a little at a time. Beat until egg whites hold stiff peaks.
  • Fold white mixture into chocolate slowly and stir until smooth.
  • Pour into large soufflé dish or 4 ramekins and run the end of your thumb around inside to remove any extra batter.
  • Bake until puffed and crusted on top but still jiggly in center, 20 to 25 minutes.
  • Serve immediately with whipped cream or ice cream.

This recipe has become one of my new favorites.

Chocolate zucchini bread

Ingredients

  • 2 cups grated zucchini
  • 2 eggs
  • 1/2 cup unsweetened applesauce
  • 1/2 cup maple syrup (add 3/4 cup if you like it sweet, I don’t)
  • 1 tsp baking soda
  • 1 tsp baking powder
  • 1/2 tsp salt
  • 1/3 cup unsweetened cocoa or cacao powder
  • 2 cups flour of your choice. I use 1 cup almond meal and 1 cup whole wheat
  • 1/2 cup semi-sweet chocolate chips

Directions

  • Preheat oven to 350 degrees. Spray loaf pan with oil or rub with butter.
  • In a large bowl mix egg, applesauce, maple syrup, baking soda and baking powder and salt.
  • Add cocoa powder and whisk until well combined.
  • Add flour and mix until combined. Add 1/4 cup of chocolate chips.
  • Pour batter into pan and sprinkle remaining chips on top.
  • Bake 40-50 minutes or until inserted toothpick comes out clean. Be careful not to hit a melted chocolate chip.
  • Let cool before slicing.

Yay chocolate! Have a very happy Valentine’s Day!

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.

What if the Alzheimer’s patient gets cancer?

As if it weren’t bad enough to endure Alzheimer’s disease, when the patient gets a cancer diagnosis things go from bad to worse for the patient and the caregiver. Here’s what’s really interesting though. Studies show that individuals with Alzheimer’s have a lower risk of cancer and that cancer patients have a lower risk of Alzheimer’s.

In the Framingham Heart Study (FHS) Offspring cohort from 1999-2005, 2,043 participants (54% of them women) without dementia were given neuropsychological tests of memory and executive functioning, in addition to brain MRIs. The cohort consisted mainly of highly-educated, white, healthy middle-aged adults.

There were 252 participants with a previous history of cancer, and 1,7791 without a previous history of cancer. Those with invasive cancers, including the largest sub-types of prostate and breast cancer, actually had better executive function, but not memory function, and larger frontal brain volumes when compared to their peers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659723/

In a previous prospective analysis including 1,274 members of the original FHS cohort, cancer survivors were found to have a 33% decreased risk of developing probable Alzheimer’s disease. https://pubmed.ncbi.nlm.nih.gov/22411920/

So, should you breathe a sigh of relief? It’s unclear because the researchers lacked information on the type of cancer treatments the patients received. They didn’t take into consideration whether the patients were getting chemo or hormonal therapy. They also concluded that they had insufficient evidence because the group of individuals were mainly white, well-educated and healthy middle-aged adults. But it does offer hope that if you have or had cancer, your chances of getting AD is and vice versa is less.

What if you’re caring for someone with Alzheimer’s disease who gets diagnosed with cancer?

There are two important questions to ponder in this situation.

  1. What stage Alzheimer’s is the patient in?
  2. What stage and type is the cancer?

Many factors come into play here: age of the patient, the stage of Alzheimer’s, and the cancer prognosis. It’s a tough one. If the person is in the earlier stages of Alzheimer’s, they might be able to understand the treatment and be willing to go through it. If you are their caregiver, be prepared to go to all doctor appointments with them. Take notes, have the doctor make eye contact with the patient and explain and repeat things in simple language, if necessary. Provide the information in a quiet space without distractions. If your loved one is admitted to the hospital, provide the staff with information about their cognitive needs.

If your loved one has advanced Alzheimer’s you’d have to consider whether putting the patient through cancer treatment is something that the patient would want to do. They will be confused, possibly terrified, and suffer greatly from side effects. Also, a person with late-stage Alzheimer’s doesn’t have a lot of quality of life. Is it worth it?

If the cancer is widespread it could result in pain and discomfort for the patient. Or it might be a slow-growing cancer such as prostate, that can be treated without invasive surgeries or treatments.

It can be difficult to know what is best for the patient. If you are faced with a situation such as this, or another difficult diagnosis, get help from a professional social worker or therapist. Have a family conference, but know there might be conflicts that arise when not everyone is on board.

And remember, you are doing the best that you can do. Take care of yourself and remember to breathe. “This too shall pass.”

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.

Is there a link between radon exposure and Alzheimer’s disease?

January is National Radon Action Month and if you haven’t tested for radon in your home in the past year, this is a good reminder to put it on your to-do list. Radon is a naturally occurring, invisible, odorless gas that decays into radioactive particles. Radon exposure is the second leading cause of lung cancer after smoking. It’s estimated that about 20,000 lung cancer deaths each year are caused by radon exposure. I’m just learning that It is also linked to neurodegenerative diseases.

My husband spent many hours each day in his basement office. When we put our house up for sale, we had to do a radon mitigation after discovering that we had high radon levels. Now I’m wondering if his Alzheimer’s disease was caused by the radon. In a systematic review of the topic, ten studies have been related to multiple sclerosis (MS), two related to motor neuron disease, in particular ALS, and three were related to both Alzheimer’s disease and Parkinson’s disease. https://pubmed.ncbi.nlm.nih.gov/33066046/

I’ve also just learned that the average radon level in a home in Colorado, where I live, is equivalent to every person in the home having 200 chest X-rays a year. That’s scary!

The Journal of Alzheimer’s Disease published an article concluding that ionizing radiation is a risk factor for Alzheimer’s. Inhaling radon gas, can damage tissue in the nasal cavity and hippocampus that, overtime, results in Alzheimer’s.

The researchers did an extensive study of ionizing radiation exposure of the population in the U.S. and compared that with 2013 death rates by states provided by the Alzheimer’s Association. They found that radon background ionizing radiation was significantly correlated with AD death rate in 50 states and the District of Columbia.

Signs and symptoms of radon exposure and possible lung cancer from radon

  • Persistent cough
  • Hoarseness
  • Wheezing
  • Shortness of breath
  • Coughing up blood
  • Chest pain
  • Frequent infections like bronchitis and pneumonia
  • Loss of appetite
  • Weight loss
  • Fatigue

What can you do?

Testing for radon is easy and inexpensive. Kansas State University National Radon Program Services offers low-cost test kits online. To order a test kit from KSU, go to sosradon.org. Kits can also be found at local hardware and home improvement stores.

If you find radon in your home, A properly installed radon mitigation system will harmlessly disperse the radon gas, making your home dramatically safer. The best part is that these mitigation systems are affordable to install and require minimal maintenance over their lifespan.

I’m ordering a radon testing kit ASAP. This is something that’s easy to do and can help prevent serious diseases. Please get one for your home, too.

Take care and stay safe.

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.

14 ways that caregivers can achieve a healthier, more relaxed 2021

You’re tired, you’re stressed – You and 45 million or so American caregivers, including the 16 million adult family members caring for a someone with Alzheimer’s. So what are you going to do about it? Don’t say that “I don’t have time to take care of myself.” I’ve been there and done that. But I always promised myself that I was not going to be a martyr and sacrifice my health for my husband’s illness. Because if both of us were sick that wasn’t going to help anyone, least of all our children. They were barely adults when my husband was in the throes of Alzheimer’s disease. Our kids needed at least one healthy parent. And whether you are taking care of a spouse, parent or child, there are other people in your life who love and need you, not necessarily to take care of them, but to love and support them emotionally.

When you’re a caregiver, it’s hard to find the time to get the exercise you need or even take a shower, somedays. But it’s absolutely vital that you take care of yourself or you’ll end up getting sick and then who will take care of your loved one? Who will take care of YOU?

14 easy ways to take the edge off your stress and fatigue so you feel some relief.

  1. Say a positive affirmation before you get out of bed. “This day is going to be a good one.” “I am grateful for my friends and family.” “I am healthy and full of energy.” “I am strong and competent.” Say something positive to set the tone of the day.
  2. Before you reach for a cup of coffee, drink a glass of hot water with lemon. It hydrates your body and brain, the lemon helps to alkalize the system (yes, it’s counter intuitive), which is usually too acidic, and it helps with regularity.
  3. Ask for help! You don’t have to do it all by yourself. No one is going to think badly of you if you take some time for yourself. If your loved one resents your going out, it’s okay. Don’t become a slave to their wishes and rants. If you can’t leave your loved one alone, please ask a neighbor, friend or home care professional to help at least a couple hours a week. Some social service programs provide free respite care.
  4. Many cities throughout the U.S. offer volunteer snowbusters (volunteers who will shovel your walk and driveway), fix-it volunteers who will help with easy home repairs, and yard maintenance volunteers.
  5. Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  6. Find a walking partner in your neighborhood and try to walk at least once a week (preferably 3 times a week).
  7. Put on a CD, vinyl record or the radio and listen to your favorite music. If your care partner is mobile, ask him/her to dance. There is nothing like music or dance to uplift the spirit.
  8. Find a virtual class online. Yoga, Pilates, Barre fitness, Zumba, Les Mills Bodypump and more are offered through the YMCA for free if you have Silver Sneakers. There are hundreds of other classes available online.
  9. Use essential 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. Find a fragrance that is pleasing to your care partner. It’ll help him/her also.
  10. Eat breakfast! It is the meal that you break your fast with. During the night our blood sugar levels drop, so it’s especially important to eat within one hour of arising and by 10am. Eating breakfast restores healthy blood sugar levels, but make sure your breakfast isn’t coffee and a doughnut. Have some protein and a healthy fat such as an omelet and avocado and a piece of whole grain or gluten-free toast. It’ll provide you with the energy you need to get through the morning while maintaining a sense of equilibrium.
  11. Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  12. Include more fruits and veggies in your diet. Veggies are low in calories and high in fiber. Fruits are also high in fiber and like veggies, contain numerous vitamins and minerals. Just like people, fruits and vegetables come in a variety of shapes, sizes and colors. And it’s the colors that identify many of the bioactive substances called phytonutrients that give us antioxidant protection and other special health benefits.
  13. Avoid isolation. Staying connected, especially during the pandemic, is sooooo important! Join an online support group if you don’t have friends and family nearby to listen to your woes and help out. Here are two great ways to make meaningful connections online: https://wordpress.com/post/barbracohn.com/3517
  14. It’s important to get at least 6 hours (preferably 7 or 8) of sleep every night. Of course, this isn’t always possible if you are caring for someone and need to get up at night, or are worried about paying the bills, taking care of the car, getting a new stove, etc. If you can’t get in the hours at night, put your feet up for 10 minutes during the day when your care partner naps. Or take a power nap. It really helps.

Wishing you and your loved ones a healthy, happy New Year! And remember that “this too shall pass.”

image

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 best gifts for your Alzheimer’s loved one

Instead of worrying about what to give a friend or loved one who suffers from Alzheimer’s disease or dementia consider this. What that person really wants more than anything is to just be with you.

But this holiday season is going to be very different. If your loved one is in a memory care home, you probably won’t be able to visit them. If you can stand outside their window you could play their favorite music on your phone, or if you’re a musician you could sing or play an instrument. Or, eat a favorite dessert together, even if it’s through glass, and it’s not freezing cold.

Here’s a general list of gifts for dementia and Alzheimer’s patients, no matter where they live. Of course, the stage of the disease will determine the gift that is most appropriate.

  • A soft bathrobe or blanket in a color they love
  • A CD with their favorite music
  • A digital photo frame.
  • Non-skid slipper socks.
  • Books in large print or audio books if the person is still able to follow and/or read.
  • Poker chips that can be sorted and counted.
  • Non-toxic modeling clay or PlayDoh
  • Water-based paints, brushes and paper
  • An aquarium, if someone else can take the responsibility to feed the fish
  • A terrarium or beautiful plant
  • Easy puzzles, word search books, etc.
  • Plastic nuts and bolts sets
  • Weighted blanket
  • Doll or stuffed animal

If your loved one lives with you and you are the primary caregiver, here are activities to do together.

  1. People with dementia love ice cream. Share a pint of his or her favorite. Bring the toppings and arrange them on a table in little bowls—sprinkles, chocolate chips, chopped fruit, whipped cream, butterscotch or chocolate sauce, etc.
  2. Watch a comedy together. It doesn’t matter if your loved one can follow the plot or not. If you laugh, he or she will probably join in the merriment. Laughter triggers the production of endorphins; the brain chemicals that reduce the sensation of pain and make you feel good.
  3. Listen to music together. Put on a CD and sing together. Big Band Music is usually a hit with most 70, 80 and 90 year olds. If your loved one is younger, you can try classic rock.
  4. Get out the paint brush, paper and water colors. You don’t have to be an artist or art teacher to have fun with your loved one. Painting and drawing is a great way to share time together, and to even express feelings of frustration, irritation and fear—on paper.
  5. Dance to the music. If your loved one is still mobile help him or her get up and move. The exercise will enhance memories, even if temporarily. A short surge of condensed exercise boosts the compression of memories in both elders in good mental shape as well as those with slight cognitive impairment, according to new research by a team of scientists from UC Irvine’s Center for the Neurobiology of Learning & Memory.http://www.cnlm.uci.edu/ If the person is in a wheel chair, move his or her arms to the rhythm.
  6. Go for a drive and get some fresh air. Just getting out of the house does a body good and uplifts the spirit.
  7. Hold hands, give a foot massage. Use aromatherapy oils (see chapter 18 “Aromatherapy” in The Caregiver’s Journey Through Alzheimer’s and Dementia
  8. Create a book of photos that depict your loved one’s life and share memories without saying “remember when. . .”
  9. Share a special meal together and set the mood with candles and music.
  10. Just breathe together and be still in the silence. It’s the greatest gift of all.

Whatever you do, I wish you and your loved ones a peaceful holiday season. Be safe, wear a mask whenever you leave the house, and please be careful.

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.


28 ways to practice gratitude and uplift your spirit this Thanksgiving and holiday season

This will be a different kind of Thanksgiving and holiday season, for sure. It’ll be quiet. It might bring up anxiety about staying healthy or being alone. If you’re at home caring for someone with Alzheimer’s or other dementia, the holidays will be riddled with their typical challenges. If your loved one is in a memory care home, it will be sad because you might not be able to visit. However, this season will also allow us to pause in order to count our blessings and welcome unknown and unseen blessings.

In his book “Upward Spiral,” neuroscientist Alex Korb, M.D. explains that practicing gratitude is one of many pathways to an upward spiral to happiness.

Be grateful. Make a list of things that uplift you and that you’re grateful for. Keep a gratitude book and write about your favorite people and things. A job that you like, a special person, a pet, a warm and safe home, good food, a favorite book or TV show, a park where you walk, your health, a fragrant candle, a neighbor who helps out by shoveling your sidewalk, raking the leaves, or picking up groceries.

Before you get out of bed say an affirmation such as “I’m grateful for my strength and health.” “Today is going to be a good day.” “I have the power to change my attitude.” “I am happy to be alive.”

Write uplifting quotes, blessings, Bible verses, words of wisdom or other religious quotes in a blank book specifically designated as your “happy” book.

If you’ve lost a loved one in the past year, create an alter in your house in remembrance of them. Put up their picture, place a candle on the alter with some incense or food they loved. Be creative. Put on their favorite music. Sit and contemplate all the gifts that person brought to your life.

If you have leftover guilt, pain or regrets about your relationship, have a conversation with that person. Ask for forgiveness and give your forgiveness back. You might shed some tears, but it’ll open your heart to the possibility of healing.

15 ways to connect with your at-home care partner and uplift both of your moods.

  • Put on some music and dance. If your care partner doesn’t walk, hold their hands and gently sway to the music.
  • Look at photo albums together.
  • Make a collage with family photos or pictures cut from a magazine.
  • Make colorful paper chains to decorate the house.
  • Plan a family zoom party. If you have a musician in the family have a sing-along.
  • Try an intergenerational activity like a story chain. One person starts the story and hands it off to the next. It’s a little like the game telephone.
  • Do a puzzle, do board games.
  • Get out some watercolors and paper.
  • Borrow a neighbor’s dog, if you don’t have one and go for a walk.
  • If there’s snow on the ground, bring enough inside to cover a tray. Use food coloring to make designs.
  • Make and/or decorate a gingerbread house.
  • Bake gingerbread and eat it warm with whipped cream.
  • Make and decorate cookies. Then bring them to a neighbor.
  • Read to your care partner.
  • Give your care partner a massage.

If your loved one is in a care facility

  • Try to connect on Facetime or Zoom. Even if your care partner can’t see you very well, hopefully hearing your voice will help you to connect emotionally.
  • Drop off a basket filled with special treats and flowers.
  • Send a CD of favorite music.
  • Fill a memory box with small, special mementos.
  • Puzzles and coloring books help with fine motor skills and uplift the mood.
  • Seniors who loved to dress up will appreciate glittery and colorful costume jewelry.
  • A favorite book on tape might trigger memories and put a smile on one’s face.
  • Provide an aromatherapy diffuser that plugs in the wall, with an uplifting aromatherapy oil.

My 2020 Thanksgiving prayer

I am grateful for being loved and loving. I am grateful that I’ve stayed healthy this year. I am grateful to authors who share their beautiful imaginations, I am grateful to my parents who, many years ago, let me go west to college, where I’ve lived in the Rocky Mountains ever since. I am grateful for my beautiful environment, my comfortable home, my book club, and my writing groups. I am grateful for being able to eat organic food and drink pristine spring water. I am grateful that I live in a place where intelligent people question authority. I am grateful that I have healthy children who are contributing members to society. I am grateful for being blessed with four gorgeous, delicious and healthy grandchildren.

I am so grateful to be alive, and for so much more.

May your Thanksgiving be filled with good health, friendship, hope and ease.

Amen.

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.

15 Ways to Instantly Diffuse Anger

Young woman doing upward dog stretch, yoga.

Whether you’ve been caring for a loved one with dementia for a month or more than a decade, you’ve probably felt anger. Anger about having to listen to your care partner ask you for the hundredth time what’s for dinner, even though they have already eaten. Anger about having to downsize your world because you don’t have time to enjoy your previous social life. Anger about having to leave your career because you need to care for someone at home. The list goes on and on.Caregiving for someone with dementia is so hard. Some doctors think of caregivers as hidden patients because they are more likely to suffer from health problems stemming for stress, anxiety, anger, depression, and the inability to take good care of themselves.

It might be helpful to understand why you are feeling angry. You may not be aware of lingering feelings that fuel the fire. But there are ways to diffuse anger, which is one of the culprits that contribute to caregiver stress, depression, and poor health.

Are you resentful?

This is a common feeling that many caregivers share, especially if you are the eldest daughter and are caring for a parent. And it’s no wonder. Do your siblings step in to help with an ailing parent? Has your career advancement been put on hold? Is caring for a spouse destroying your dreams of travel or retirement.

I was only 48 when my husband was diagnosed with younger-onset Alzheimer’s disease. And damn right I was resentful. Our youngest was just starting college and we were empty nesters. It was the time in our life that we were supposed to have more freedom. My parents were getting older and had numerous health issues. I was part of a caregiver sandwich. Not the one where you care for a spouse and children at home simultaneously, I had to fly back and forth to tend to my parents’ while caring for my husband. It was hard and exhausting, and I was resentful. I complained to my best friend that my life wasn’t supposed to be like this.

Are you frustrated?

Have you tried various modalities to help your loved one “get better” and not seen any improvement?

Are you exhausted?

It’s no wonder. You need to take care of yourself. Exhaustion and burnout can bring feelings of anger to the surface. Please read: Preventing Caregiver Burnout with Good Nutrition and Foods that Support Neurotransmitters. https://wordpress.com/post/barbracohn.com/5204

Do you feel guilty?

It’s been years since my husband passed away. But I still feel guilty about the times I got angry or the times I went out to enjoy myself. My therapist used to say to me: “If someone told you the story you’re telling me now, what would you say to them?” I’d say, “You’re doing the best that you can.” That’s the right answer. You are doing the best that you can, and I have to remind myself, even now, that I did the best that I could. (Maybe I need more therapy to totally release those feelings of guilt.)

If you fly off the handle when your loved one annoys you or when you haven’t gotten enough sleep, try some of these anger diffusers for immediate relief.

  • Take a deep breath. Breathe in for 4 counts, hold for 4 counts, and release for 4 counts. Repeat twice more.
  • Make sure your loved one is safe and take a brief walk outside. If the weather is bad, walk up and down the stairs. If you can go outside, engage your loved one in an activity or have them watch television. Or just walk away from the situation and go into another room.
  • Put on some uplifting music. “Happy” by Pharrell Williams will definitely make you happy, I guarantee!
  • Call your best friend to vent.
  • Keep a book of inspirational quotes on your night table. Grab it and read a page. Sit there a moment and breathe.
  • Do jumping jacks or a few yoga postures. Corpse pose, legs up the wall, down dog. It doesn’t matter. Choose a few and do them.
  • Don’t lash out at your care partner. Rather than regret hurtful words, respond with an “I” statement or divert his/her attention. “I know you’re upset. I feel frustrated, too, etc.”
  • Use humor. Make a joke, put on a funny YouTube video.
  • Take yourself, your care partner, and your dog (if you have one) for a walk.
  • The British custom of making a cup of tea really works. Make a cup of green tea for added relaxation.
  • Use lavender oil to calm you down. Either put it in a wall plug-in diffuser or spritz your collar or a tissue that you can put inside a shirt pocket.  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.
  • Break open a dark chocolate bar and share it with your care partner. It reduces cortisol, the stress hormone that causes anxiety symptoms. Just a couple of pieces should do the trick.
  • Go into a quiet room and meditate.
  • Light a candle and put on some relaxing music.
  • Drink a tall glass of water, make an energy-boosting smoothie, or hot cocoa.

For more ways to destress, boost your energy and calm down, read “20 energy and stress fixes to use now!” https://wordpress.com/post/barbracohn.com/4998

If you continue to have anger issues, it might be good to speak to a therapist. It definitely helps to belong to a support group. To find an Alzheimer’s (and other dementias) support group in your area call 800-272-3900 or visit: https://www.alz.org/help-support/community/support-groups gclid=Cj0KCQiA7qP9BRCLARIsABDaZzhho3nQIye6hhfVM3umD7WeqWOeanDCfVcfmbF8Ld9MN5cGdPOAyCAaAjC7EALw_wcB

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.