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.

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.”

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

32 Ways to Cope with Grief this Holiday Season

Lots of people are grieving for all kinds of reasons, but it all comes down to loss and loneliness. Loss of a loved one, loss of a friendship, loss of a job, and sheer loneliness as a result of being socially distanced.

Here are some ways to get through the darkest, most dismal holiday season most of us have had to endure.

  1. Take a drive on a country road. Park and out and walk.
  2. If you don’t have a dog, borrow a neighbor’s dog to take on a walk.
  3. Watch a recommended movie or t.v. series that you can get lost in.
  4. Bake cookies or quick breads and distribute them to your neighbors.
  5. If you’ve had a hard time discarding your loved one’s clothes, think about donating them to a homeless shelter, etc.
  6. Start journaling. It’s a wonderful way to express your feelings and get things off your chest.
  7. Write a letter to your loved one and express your love, your sadness, grief, guilt, etc.
  8. Place two chairs facing one another. Sit in one and speak out loud the words you would like to express to your loved one. Tell him or her how much you miss them, or express your anger and guilt, etc.
  9. Watch what you eat. You should definitely enjoy your favorite foods, but don’t use grief as an excuse to overindulge in foods that aren’t good for you.
  10. Splurge on a gift for yourself!
  11. Help out at a shelter or food bank, or make a donation in honor of your loved one.
  12. Don’t overcommit. And don’t over donate. This is so easy to do and lose track of just how much money you are sending an organization, especially if you do it online, which is so easy.
  13. It’s okay to be happy. It’s the holidays! Don’t feel guilty for enjoying yourself. It won’t diminish the love you have in your heart for your loved one.
  14. Read a book that will help identify your feelings and cope more easily with grief. I recommend these two: The Empty Chair: Handling Grief on Holidays and Special Occasions by Ed.D Zonnebelt-Smeenge, Susan J. R.N. and Robert C. De Vries | Sep 1, 2001. The Secret Life of Grief: A Memoir by Tanja Pajevic, 2016, 2016
  15. Give yourself a massage. Refer to the chapter “Self Massage” in my book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.”
  16. Use aromatherapy. Citrus oils are generally refreshing and uplifting for the mind and emotions, relieve stress and anxiety.  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.
  17. Get the sleep that you need.
  18. Make an appointment with a professional therapist if you need help. You can do it virtually from the comfort of your home.
  19. Eat a serving of high-quality protein with every meal and snack
  20. Focus on complex carbohydrates (whole grains, veggies and fruits), and eliminate junk foods (refined carbs).
  21. Enjoy unlimited amounts of fresh veggies.
  22. Eat a good breakfast!
  23. Eat 3 balanced meals and 1-2 snacks/day.
  24. Magnesium, B complex, fish-oil, walnuts, flax seeds, dark leafy greens, and high quality all help reduce stress and uplift mood.
  25. Meditate, light a candle, or find some quiet time for yourself.
  26. Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  27. Exercise! At least take a short walk every day.
  28. Put on a CD, vinyl record or the radio and listen to your favorite music. Dancing as though no one is watching. There is nothing like music or dance to uplift the spirit.
  29. Put on a funny YouTube video and laugh.
  30. Sing your heart out while listening to your favorite showtunes.
  31. Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  32. Do the best you can. Try to relax and enjoy your family and friends, even if you can only meet over Zoom.

It’s easy to drown our troubles in alcohol or recreational drugs. Please be safe. Any of the above 32 ways to engage in self-care will do you a whole lot of good. Alcohol and drugs will not.

Be safe, be well, love yourself. Better times are ahead.

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 online at Target and Walmart, and many other fine independent bookstores, as well as public libraries.

How to prevent and ease tension headaches without drugs

There’s been an increase in the incidence of stress headaches, no matter whether you’re a caregiver, someone who’s lost a job or a loved one, a parent juggling virtual school and a job, or dealing with loneliness and pandemic stress.

If you’re concerned that your headache may be a symptom of COVID-19, Dr. Emad Estemalik, director of the headache section at the Cleveland Clinic, said that although respiratory viruses often involve headaches, if a headache is your only symptom, it’s unlikely that it is related to COVID-19. https://www.news5cleveland.com/news/local-news/having-more-headaches-during-the-pandemic-its-not-just-you

On the other hand, “If you suddenly are short of breath or you have a fever out of the blue and you have an excruciating headache, that’s a different story,” he said.

What is a tension headache?

Tension headaches are typically caused by muscle contractions in the head and neck. They can be mild, moderate, or intense pain that you may feel in your head and neck or behind your eyes. Often they feel like a tight band around your head. They can be chronic or episodic, once or twice a month. Women are twice as likely as men to have tension headaches, and according to the Cleveland Clinic, chronic headaches affect approximately three percent of people in the U.S and can last more than 15 days a month.

Common causes of headache

  • Allergies and certain foods including MSG, artificial sweeteners, aged cheese, cured meats, salty foods, chocolate, pickled and fermented foods, frozen foods (i.e brain freeze)
  • Alcohol, caffeine, smoking
  • Depression, stress and anxiety
  • Dehydration
  • Eye strain and dry eyes
  • Emotional stress
  • Peri-menopause and pre-menstrual hormone fluctuations
  • Lack of sleep
  • Poor posture, especially looking down at our devices and at our computers for long stretches of time.
  • Cold, flu, or sinus infections
  • Vertebrae misalignment, especially of the atlas and axis
  • Over exercising
  • Hunger, not eating enough or on time
  • Air pollutants such as nitrogen dioxide, particulate matters from wildfires, and benzene from fracking
  • Change in the weather

Ways to prevent and ease a tension headache

According to the National center for Complementary and Integrative Health, these supplements may help prevent tension headaches:

  • Butterbur
  • Coenzyme CoQ10
  • Feverfew
  • Magnesium
  • Vitamin B-12 (riboflavin)

Yoga postures help by increasing circulation to your head. Remember to breathe. For more information about deep breathing as a stress reliever, including two easy breathing exercises, visit: “Support your lungs with deep breathing exercises” https://barbracohn.com/2020/03/26/support-your-lungs-with-deep-breathing-exercises/

More ways to ease a tension headache

  • Dab some lavender essential oil on your temples. Some people report instant relief.
  • Drink at least 6-8 glasses of water each day.
  • Get plenty of sleep. If you have trouble sleeping read this: https://barbracohn.com/2017/10/25/16-ways-to-sleep-better-so-you-can-be-a-better-caregiver/
  • Exercise regularly and walk outside in fresh air.
  • Get an air purifier to clean the air in your house.
  • Set boundaries for yourself. Don’t take on more than you can handle.
  • Support your emotional well being. Avoid movies that elevate cortisol (stress hormone), avoid family arguments, engage socially on facetime or zoom to avoid loneliness. Take a walk with a neighbor with masks on, etc.
  • Get a massage or chiropractic adjustment.
  • Do something soothing for yourself at least once a day. Listen to some classical, religious or meditative music to uplift your spirit. Take an Epsom salt bath with lavender aromatherapy oil. Take time out to read a book. Keep a gratitude journal. Get a dog or cat.

Please make a telehealth appointment with your doctor if your headaches continue and to rule out other illness.

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 online at Target and Walmart, 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.

20 Natural Remedies for Depressed Caregivers (and everyone else)

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

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

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

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

Here are 20+ ways to combat depression

Natural supplements for depression

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

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

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

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

2. Vitamin B complex optimizes cognitive activity and brain function, has a positive effect on memory, learning capacity and attention span, and supports a healthy nervous system and a stable mood. Vitamins B6 and B12, in particular, play a role in the synthesis of serotonin, the neurotransmitter linked to improving memory, lifting mood and regulating sleep.

3. Nervines

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

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

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

Recommended nervines:

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

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

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

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

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

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

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

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

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

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

12. Use aromatherapy oils to immediately diffuse feelings of sadness, depression, anxiety, etc. Lavender oil is the most frequently used fragrance. You can also try bergamot, grapefruit, lemon, orange, clary sage, geranium, rose, and ylang ylang, frankincense, and myrrh. Put the oil in a diffuser or spray bottle to mist your collar or pillow. Check online for ways to order aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn.

13. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.

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

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

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

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

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

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

20. Sleep well by getting to bed before 11:00 pm, eating your last meal before 8pm, turning off your electronic devices, and eliminating light in your bedroom. If you have trouble sleeping consider using a lavender essential oil spray on your pillow or a sachet of lavender inserted into the pillowcase. There are lots of natural sleep aids available at your local health food store, such as melatonin, calcium/magnesium, valerian, hops, etc. Consult with a nutritional consultant about what might work best for you.

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


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

When your loved one has difficulty eating

senior woman eatingMeals can be challenging for someone with Alzheimer’s or another form of dementia, not to mention their caregivers. As the disease progresses, it can become difficult for the person to consume enough calories to maintain a healthy weight. But there are ways to encourage healthy eating. Eventually, toward the end of life, it’s natural for humans, and all animals, to lose the desire for food.

As his Alzheimer’s progressed, my husband, had trouble recognizing food items. Morris forgot how to hold a sandwich, and I’d have to place it in his hand. He forgot how to cut his food, so I served it to him already cut into small pieces.

Once when I handed him a sandwich to eat, he asked what it was. I replied, “Chicken salad.” He threw the sandwich across the table and exclaimed, “This chicken is dead!” It was hilarious, and shocking.

But there are ways to encourage your loved one to enjoy food and get good nutrition throughout most of the course of the illness.

Here are some suggestions:

  • Seniors and elders with health issues tend to be hungriest in the morning and eat less as the day progresses. Make a healthy breakfast packed with protein, healthy fat, antioxidants, vitamins and minerals. Eggs, anywhere you like them, served with avocado, toast, beans, and  greens provides everything needed to establish the beginning of a good day. The same goes for caregivers! You need the strength and energy to get through the day, so start it off with a nutrient- rich breakfast.
  • Setting the table–Put as little on the table as possible in order to not confuse the patient or detract for their ability to clearly see what is in front of them. Use a colorful plate mat, and a white plate so the food stands out. And serve colorful foods, which are higher in antioxidants and vitamins and minerals. Think sweet potatoes, winter squash, corn, beets, greens, etc. Root veggies can be pureed and served in a mash, which is easier to chew and swallow.
  • Make sure the environment is clean and pleasing. Put on some favorite music. It can be stimulating or soothing, depending on the mood.
  • Has the patient kept up with their dental appointments? My mother was always fastidious about dental care, visiting her dentist several times a year for cleanings. But at the end of her life, she began to lose teeth, most likely from poor nutrition. Observe your loved one and make sure there are no signs of pain, grimacing, trouble chewing, etc.
  • Sometimes, a person will not remember that they have eaten just a little while before saying, “When is lunch (or dinner)?” Or, “I’m hungry. When are we going to eat?” Leave their plate on the table longer as a visual reminder. You might have to hide food, if they have the tendency to overeat. And if you want to make sure they, as well as you, are eating the best diet possible, refrain from buying cookies, sweets, chips, and crackers, that are filled with empty calories and hydrogenated fats.
  • Provide a meal companion for your loved one. If you can’t eat with him/her, ask a friend to share a meal. Or, if he/she is still able to eat in a restaurant, have a friend make a weekly lunch date and bring them to a quiet restaurant that serves their favorite food.
  • The taste for sweet things is the last one to go. If your loved one doesn’t have any appetite, it’s almost guaranteed that they will enjoy ice cream. There are lots of options on the market to choose from ranging from traditional ice cream to frozen desserts made with cashew cream, coconut cream and soy milk.
  • Make sure the temperature of the food isn’t too hot or too cold, and that the patient is seated comfortably in a room that is neither too hot or cold.

Dysphagia

Dysphagia is any problem with swallowing. This was a major issue for my dear mother, who, at the end, couldn’t eat without the food going into her lungs instead of her stomach. In determining the extent of dysphasia, the patient does a swallow test drinking liquid of various consistency and thickness.

Food and drink categories

  1. Nectar thick, he consistency of nectar, quickly runs off a spoon
  2. Honey thick, the consistency of honey, slowly drips off a spoon
  3. Pudding thick, the consistency of pudding, plops off a spoon

My mom had to drink water that was thickened, which tasted disgusting. As a result, she often refused to drink and once became dehydrated to the point where she was hospitalized.

If your patient is put on a dysphagia diet, experiment and find ways to keep him or her hydrated. Puree their favorite foods, make shakes that are delicious and nutritious. You can puree just about anything and make it taste good with herbs, tomato sauce, etc. Please don’t add salt. Yogurt and puddings are another good option. Read the labels and try to avoid added sugars. Especially watch out for high sugar content in flavored yogurt.

Poor appetite

If your loved one doesn’t want to eat, accept it as the course of the illness. But if they are still walking and reasonably active, rule out contra-indications of newly administered drugs and illness, such as urinary tract infections.

Additionally, your patient might have a poor sense of smell, which will translate into a poor appetite. Try adding more seasoning to the food, but try to avoid salt and use herbs and spices that include antioxidants such as thyme, basil, oregano, cumin, cinnamon, and cardamom.

Laraine Pounds, R.N., an internationally recognized aromatherapist lists aromatherapy essential oils that stimulate appetite in chapter 18 of my book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.”

Eating issues are common amongst individuals with dementia. Experiment with these suggestions and see what makes a difference. Sometimes, just sitting next to someone and offering gentle conversation helps.


 

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

10 Great Gifts for Caregivers

New Year's box with gifts and bows, fir cones, snowflakes and Christmas toy on old boardsIf you’re a caregiver, you have little time for yourself and you’re probably stressed out. You don’t need another pair of pajamas, and you don’t need another coffee mug.

What you desperately need is some time for yourself to relax and rejuvenate, and ways to make your life easier.

When friends and family ask you,” How can I help?” Or, “What do you need?” send them this list. They will appreciate it, and you will definitely appreciate the rewards.

  1. You know how wonderful it feels to have a sparkling clean house. And you probably haven’t had time to do a deep cleaning in a while. Ask your friends and neighbors for recommendations for a good house cleaner or cleaning service. Merry Maids is a national company available in most parts of the U.S. They also have gift cards online to make it convenient for your gift givers.
  2. Wouldn’t it be heavenly to get away for a few hours? It’s important to maintain friends throughout our lives, and even more important when we need to vent or just need a friendly chat or someone to tell you that you’re doing the best that you can. Gift cards to a neighborhood coffee shop or restaurant can help provide an excuse to connect to a friend you haven’t seen in a while. Make a date.
  3. But in order to make a date, you might need a companion to stay with your loved one. Providing TIME to you may be the greatest gift of all. Ask for a time donation, possibly in blocks of time. Two hours a week for a month? Four hours a month? Spread your wishes around. You’re bound to get several “yeses.”
  4. Do you like to sing? Whether you sing in the shower or in a chorus, it’s been well documented that singing reduces stress levels and depression. Group singing boosts oxytocin levels, and creates a feeling of “togetherness.” (Oxytocin is called the “love  hormone” because it is released when mothers breastfeed and when people snuggle up or bond socially. Request a favorite music CD that you like to sing to. Try to include the person you are caring for. Invite neighbors over for a singalong, and make it intergenerational. It’s amazing that people who even have advanced dementia can often remember the words to songs they sang decades ago.
  5. What about dance? You might have two left-feet, but you can dance away your blues without anyone watching in your living room. I always say that dance is what kept me off anti-depressant medication during the 10 years I cared for my husband. I did folk dance, salsa, and contra on a weekly basis. It was well worth the expense of hiring someone to keep my husband company on those evenings. Dance supports the release of endorphins from the brain into the bloodstream. I experienced firsthand a rush of happiness for hours, and sometimes days, after dancing for just a couple hours. Not only does dancing uplift your spirit, it can help you think more clearly. A 21-year-long Einstein Aging Study that was published in the New England Journal of Medicine in 2003 found that dancing is the best form of exercise to help prevent dementia when compared to 11 other activities including swimming, bicycling, and team sports. The study also found that dancing can help slow down cognitive decline. Dancing to music that carries special significance can be a wonderful way to connect with your care partner. Why not ask for a CD of your favorite music and dance in your living room, alone or with your care partner? Or, learn a new dance. Request a DVD to teach you the steps. Or, try a Zumba class. Fitness is a Latin-inspired cardio-dance workout that uses music and choreographed steps to form a fitness party atmosphere. While many of the types of dance and music featured in the program are Latin American inspired, classes can also contain everything from jazz to African beats to country to hip-hop and pop. Attend a Zumba class at your local recreation center or YMCA. They are also available on YouTube videos. And ask for a gift of companion-sitting for your loved one.
  6. House maintenance is often neglected when you have a million caregiving tasks. When is the last time you raked your lawn, pulled weeds, fixed a leaky sink, or had your carpets cleaned? The offer of someone volunteering their time to provide these services or the gift of a handyman service is always appreciated.
  7. Would you like to try a yoga class, either online or at a studio? Ask for a yoga mat, yoga blocks and a yoga strap. That’s all you need to help you release stress, build up endurance, relax muscles, and reduce risk of osteoporosis. Yoga videos are sold on Gaim, and are offered on their website for $11.99 per month after doing a free 2-week trial at https://www.gaia.com/yoga?utm_source=google+paid&utm_medium=cpc&utm_term=gaiam%20yoga&utm_campaign=1-USA-ENGLISH-BRAND-EXCT&utm_content=gaia&ch=br&gclid=Cj0KCQiA5dPuBRCrARIsAJL7oejWgk-kRRzIVjk_nt7xXY3-I5F_cYeHbltpDj4H7vba2QBjnQPwwiMaAqLVEALw_wcB
  8. Everyone loves a home-cooked meal. A personal chef who prepares meals in your home or theirs is an extravagant service. But put the idea out there. You never know . . . . A more affordable option is home-delivered meal kits. Home Chef, Blue Apron, and Green Chef are a few of the meal kit companies that allow you to choose meals that arrive with fresh, pre-measured and prepped ingredients, and instructions on how to create a fast meal.
  9. Massage is a wonderful way to relax and tune out the world. I highly recommend asking for a gift certificate to a spa that offers massage with hot stone and aromatherapy. You will emerge like a new person.
  10. One of the best gifts you could receive is respite care.  Do you have a relative or friend who could stay with your loved one a night or two so you can get away and totally tune out the world? If not, maybe one of they would generously provide you with a professional care service. Just imagine getting away from it all without any responsibilities for 24 or 48 hours.

You deserve gifts that will help you, the caregiver. So don’t be shy. When people ask how they might help or what you need or want, send them this list.

Have a happy, restful and peaceful Thanksgiving!


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

What if your dementia patient becomes abusive, aggressive or violent?

Angry, enraged senior woman yelling at a landline office phone, unhappy with customer service provided by the agent on the other side, giving off steam and smokeMy husband Morris was a gentle man. But occasionally, if things didn’t go his way, he would get nasty. Once Alzheimer’s took his brain hostage, he exhibited a darker side. But only when he was frustrated or confused.

Morris spent the last two years of his life in a memory care home. He was popular among the staff because he liked to goof around. When he walked the halls listening to music on his Walkman, he’d have a smile on his face and swagger to the rhythm. But if another resident got in his way, watch out. If it was crowded in the dining room and someone accidentally bumped him, he’d swing his arm out to shoo that person away. When one of his neighbors walked into Morris’s room mistaking it for his own, the two got into a rumble on the bed and fought like school boys. After this happened a couple more times, the neighbor was moved to the opposite side of the facility.

When Morris hit a resident in the dining room, the on-call physician prescribed a depressant to “calm him down.” Morris reacted to the drug by transforming into a zombie who slumped in his chair and slept too many hours during the day. I insisted that he get off the drug and Morris returned to his mostly cheerful self.

I once had a next door neighbor whose wife had Alzheimer’s. She threatened to kill her husband with a knife and then went on to slash a painting hanging in their living room. Was she or Morris responsible for their actions? No. A person with dementia is not responsible for acts of violence because as the disease progresses, neurons in the cortex that are responsible for language, reasoning and social behavior are destroyed. This leads to some Alzheimer’s patients engaging in aggressive or violent behavior such as biting, kicking, spitting, slapping, punching, and/or using foul language.

Research from the National Institutes of Health indicates that up to 96 percent of patients with dementia who were studied over a 10-year-period exhibited aggressive behavior at one time or other. In 2011, CNN Health reported that 5 to 10 percent of Alzheimer’s patients exhibit violent behavior at some point during the course of the disease.

There is usually a reason for aggressive behavior.

What to watch out for

  • Urinary tract infection
  • Pain or stress
  • Loneliness, depression
  • Too much noise or stimulation
  • Boredom
  • Constipation
  • Soiled diaper or underwear
  • Uncomfortable room temperature
  • Physical discomfort (stomach ache, etc)
  • Confusion
  • Anger about loss of freedom (to drive, living independently)
  • Drug reaction or contra-indication
  • Resistance against being told what to do such as bathing
  • Sudden change in routine, environment or caregiver
  • Communication problems
  • Hunger or not liking the food
  • Dehydration

What to do

  1. If your life or the life of the person you care for is in danger, get help immediately!
  2. The Alzheimer’s Association has a 24-hour helpline at 800-272-3900.
  3. Rule out UTIs, pain, discomfort, etc.
  4. Use an essential oil to help calm the person down. When my husband got agitated I’d put a few drops of oil on a cotton pad inside a diffuser and plug it into the wall. He usually calmed down immediately.  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.
  5. Reassure your patient by speaking gently and calmly.
  6. Play calming music, i.e. Mozart
  7. Try to distract the person with a TV show, favorite snack (ice cream almost always works), or a walk outside.
  8. Maintain a regular routine.
  9. Make sure the lighting is suitable in the home or facility.
  10. Help the person to maintain as much dignity and independence as possible.
  11. Make sure the person is eating a nutritious low-sugar, low-salt diet, with no or very limited amounts of alcohol and caffeine.

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