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.

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.

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.

Is it okay to leave a person with Alzheimer’s home alone?

Confused woman at home alone

This is a tricky question. The short answer is it depends. It depends on a lot of things. But if you are asking the question, the answer is probably no.

Use this assessment questionnaire. These issues are difficult to think about, let alone deal with. But if you have a sense of unease when thinking about your care partner’s abilities, it’s time to put safety precautions in place.

  • How far along in the disease is the person? If the person is in the moderate phase of dementia, the phase when they need help with basic daily activities such as bathing and brushing their teeth, it’s not safe to leave him or her home alone.
  • Do they get easily confused?
  • Do they get lost walking around the neighborhood or in the house?
  • Do they follow you throughout the house?
  • Could they make a phone call if they need help or become anxious?
  • Do they still cook, make coffee or use the microwave? Do they forget to turn off the stove or oven? If so, they should not be allowed to cook any longer.
  • Are they able to make themselves something to eat? If not, could they find food that has been prepared for them, or are they able to find a snack?
  • Do they wander?
  • Do they recognize dangerous situations such as fire?
  • Are they susceptible to scam phone calls? Are they apt to provide private information?
  • Can the person engage in enjoyable hobbies or activities such as gardening, knitting, wood work?
  • Can they distinguish between a family, friend, neighbor and stranger if someone comes to the door?
  • Is it easy for them to toilet without assistance?
  • If there were an emergency in the house, could they leave and seek shelter?
  • Is there a possibility the person could damage or destroy your personal property if they got highly agitated?

Keep your care partner safe from wandering

There’s nothing more frightening than discovering that your care partner has wandered out of the house and is nowhere to be found. If the weather is very hot or very cold this could turn into an emergency situation. Or if the person needs a medication at a specific time, it could become a matter of life or death.

Here are some ways to reduce this risk.

Never leave your care partner alone in the car, even for a quick stop.

Hide the car keys. I had a neighbor whose husband took the car keys and drove off into an isolated area. Although the car was found, he was never seen again. It was an unspeakable tragedy.

Camouflage the exterior doors with curtains, a poster, or sign that says, “Stop,” or “Do not enter.

Don’t leave shoes, hats, coats, or keys near the exit doors. All are reminders of leaving home.

Inform your neighbors so if they see your care partner wandering around the neighborhood, they can alert you or the police, or gently guide the person home.

Have your care partner carry a photo ID, and wear a medical bracelet. Put labels inside their coat, hat, etc.,

Project Lifesaver is a program offered by police departments. Some police departments offer wristbands at discounted rates or at no charge. To find out or enroll in Project Lifesaver, contact your local police department and ask if they participate. Call Project Lifesaver International Headquarters at (757) 546-5502 or visit the Project Lifesaver website.

Enroll in the MedicAlert https://www.medicalert.org/ and Alzheimer’s Association’s safe-return program. Read about it here: https://www.alz.org/help-support/caregiving/safety/medicalert-with-24-7-wandering-support. For a fee, participants receive an identification bracelet, necklace or clothing tags and access to 24-hour support in case of emergency. You also might have your loved one wear a GPS or other tracking device.

Read Dr. Laura Struble’s excellent article “How to Minimize Wandering in a Senior with Dementia” in which she says it’s important to first observe the person and try to figure out why your care partner is wandering or trying to leave, what they are trying to achieve, and where they want to go. https://www.agingcare.com/articles/help-a-senior-with-dementia-who-wanders-167541.htm

Safety first is always a good motto. It might take a little work and effort to put these safety measures into place, but it will definitely be worth it for your own peace of mind and for the health and safety of your care partner.

Care for the caregiver

If you are the caregiver of someone at home, it’s vital that you take care of yourself and get out of the house, hopefully, for at least a walk every day. During the coronavirus pandemic, you aren’t doing as much as you normally would outside of the house, but try to take a daily walk.

If you’re depressed, learn about 20 natural remedies that can uplift your mood. https://wordpress.com/block-editor/post/barbracohn.com/5720 Or, 20 energy and stress fixes to use now! https://wordpress.com/block-editor/post/barbracohn.com/4998

If you aren’t able to leave your care partner even for a short walk, it’s time to get respite care. When the time came for my husband to need full-time care, I hired someone to be with him husband twice a week so I could get out of the house. Is there a neighbor who would be willing to come in for 30 to 60 minutes twice a week? This might be tougher during the pandemic. But while the weather is still warm, a care person could take your loved one for an outing, sit on the porch with them, or go for a drive.

Be safe. Be well. Take care.

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 your loved one in denial about their Alzheimer’s diagnosis?

After my husband had a heart attack in 1994, a friend told him that he appeared to have one foot in heaven. Morris was more focused on the celestial world and less engaged in his life on earth. He hibernated in his home office, and spent just a handful of hours at his business office each week. He watched too much television, and filled much of his day meditating. His greatest joy was participating in spiritual singing groups.

But I knew something was very wrong. I had an aunt who passed away from Alzheimer’s disease so I was familiar with the symptoms. When Morris started getting lost driving around town, when he departed for a road trip with our son and left behind his suitcase, and when he couldn’t give a friend’s son directions to the high school that Morris had graduated from, I suspected Alzheimer’s.

Morris thought I was ridiculous and refused to see a doctor. It took two more years before he finally agreed. After ruling out metabolic diseases, depression, nutritional deficiencies, and a brain tumor, the diagnosis was quick and clear. Yet, Morris continued to disbelieve that the doctor said he wouldn’t be able to drive in a couple of years.

There’s actually a term for denial of diagnosis. Anosonosia is the medical term for a person who lacks the insight of awareness to understand their own condition. A person with Alzheimer’s can refuse to believe that they have the disease because their brain isn’t fully capable of understanding the illness. Or the person might be in denial because of the stigma attached to having dementia or Alzheimer’s.

How can you help your loved one?

  1. Don’t keep reminding the person of their diagnosis. Instead, be supportive and allow him/her to do as much as they are capable of without taking over for them.
  2. They most likely feel depressed or bewildered or scared, or all of the above. Be a friend and let them know you are there for them.
  3. Listen to their rants, their feelings, their fears. And know that their outbursts of anger are not personal, although that’s difficult. Usually the person closest to the patient is the one that is subjected to the most anger and frustration. Your loved one is scared of how their world is falling apart. You are probably just as scared. Join a support group. The Alzheimer’s Association near you offers support groups for both the person with dementia and for family members. It is a god-send. https://www.alz.org/
  4. Encourage your loved one to do things that will reduce symptoms of the disease. Exercise, socialize (which may be difficult during the pandemic), listen to music, plant a garden, do art projects. There are dozens of ideas to reduce stress for both the patient and the caregiver in my book “Calmer Waters: The Caregiver’s Journey Through Dementia.” https://www.amazon.com/Calmer-Waters-Caregivers-Alzheimers-Dementia/dp/1681570149/ref=sr_1_1?s=books&ie=UTF8&qid=1543875890&sr=1-1&keywords=calmer+waters
  5. Pharmaceuticals for Alzheimer’s help to slow down the progression of the disease. Encourage your loved one to take what the doctor has prescribed.
  6. Although there is no magic bullet, natural supplements also help. Read: “5 Things that Help Dementia that your Doctor Probably Hasn’t Mentioned.” https://wordpress.com/block-editor/post/barbracohn.com/5277
  7. Focus on eating a Mediterranean diet that includes fish, lots of fresh vegetables and fruit, nuts, and healthy fats—olive oil. https://wordpress.com/block-editor/post/barbracohn.com/5170
  8. Help your loved one decrease use of cigarettes and alcohol.
  9. Emphasize a structured routine including getting to bed on time.
  10. Beautiful and simplify the environment with uplifting music and fresh flowers.

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.

Activities for people who have Alzheimer’s disease and other dementias

sea stones painted by the children on the beach

During the early stages of Alzheimer’s, your loved one might continue to enjoy their favorite activities. But as the disease progresses, he or she will probably withdraw from activity.

If you’re a caregiver taking care of someone at home, this is when things become challenging. How do you keep your loved one engaged without getting stressed and frustrated?

I hired someone to take my husband out a couple times a week for a drive, walk, movie, ice cream, etc. If you can afford it, and can ensure safety measures during the pandemic, respite care can help ease the boredom of watching TV all day. And it can help you get out of the house to do errands, go to doctor appointments, or just take a walk.

Whether you’re a full-time caregiver or occasionally drop in to visit a friend or loved one with Alzheimer’s, here are some activities to try.

*Fold towels, washcloths and hand towels, socks.

*Sort coins.

*Paint with water.

*Make potholders with a child’s loom.

*Rake leaves.

*Weed flower beds.

*Sort through junk mail, open and tear it up.

*Play bingo.

*Go for a ride.

*Play with Play-Doh https://playdoh.hasbro.com/en-us, clay or Kinetic Sand. https://kineticsand.com/

*Dust and polish the furniture.

*Cut out photos from magazines and make a collage.

*Create an “art gallery” with photos, prints, or original artwork.

*Listen to audio books.

*Watch funny YouTube videos of babies, kittens, puppies, etc.

*Color in coloring books.

*Plant an inside herb garden.

*Lace cards.

*Set up a bird feeder outside the window.

*Set up an aquarium.

*Use rubber stamps to make cards for children in the hospital, etc.

*Look for rocks and then paint them.

*Collect seashells (if you live near a beach), and string them and/or paint them.

Art Therapy

Read about how one caregiver heped her mother make paper paper flowers and find a purpose: https://barbracohn.com/2017/09/26/need-something-to-help-your-loved-one-find-a-purpose-how-one-caregiver-discovered-that-art-therapy-can-be-rewarding-and-stress-reducing-for-herself-and-her-mom/

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

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

  1. Making an Inside/Outside Box

Materials:

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

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

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

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

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

  1. Daily or Weekly Mandalas

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

Materials:

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

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

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

  1. Color-Texture-Pattern Feelings Portrait

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

Materials:

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

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

Materials:

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

Materials:

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

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

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

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

6. Process: Breath Drawing

Materials:

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

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

For more information on activities for people living with Alzheimer’s visit the Alzheimer’s Association’s website: https://www.alz.org/help-support/caregiving/daily-care/activities?gclid=CjwKCAjwzIH7BRAbEiwAoDxxTqQOIQhxq3c2b-k5u12ZU9oZixTf9PAfWpl3X-AGcE2eU9GKGRYxyxoCeRQQAvD_BwE