Category Archives: Caregiving

The loneliness of caregiving: How to stay socially connected

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Closeup of old woman hands holding mobile phone

Woman with mobile phone

My husband had younger-onset Alzheimer’s disease. The hardest thing for me during the duration of his illness was that I lost my companion. He was the person I made important decisions with. The person I went to movies with, ate dinner with, had interesting conversations with, traveled with, and shared delight with over the accomplishments of our children. He was the one I could complain to if I had a headache, stomach ache, or sore throat, without worrying about being called a hypochondriac or a baby. He was also the person who always cheered me on when I succeeded in achieving my goals.

When it came time to make the decision to move him to a memory care home, I especially missed having him help me decide on which room he’d live in, what type of furniture to buy, and the mattress he would sleep on. When it came time to bury him, it was agonizing for me to choose the plot of land where he would be laid to rest, and where I will be eventually interred.

During my many years of caregiving, I would often hide behind a mask of cheerfulness. It helped. I didn’t feel like a prisoner because I hired people to take my husband out to see a movie. Several of his friends kindly took him to lunch on a regular basis. It takes an effort to maintain friends and to stay socially involved, especially if you no longer work outside the home.

I promised myself that I wouldn’t let my husband’s disease ruin my life. I kept an active calendar filled with dance classes, lunches with friends, and even pursued a certificate in nutrition–all the while he was ill.

But it took planning and some might think I was a bit selfish. But when you look at the grand picture of caregiving, taking care of your personal needs is anything but being selfish. Studies show that 40 to 70 percent of family caregivers experience symptoms of clinical depression. One of the reasons, besides the daily stress, is isolation and loneliness.

Now for the lecture part: If you are a caregiver it is vital that you maintain a social network. Here are some ideas:

  • Stay connected with friends and family either through Facebook or another social media outlet, or by telephone or email, etc.
  • Make a lunch date with a friend at least once a week.
  • Many places of worship offer support for caregivers and families, including social events.
  • Go to a class—any kind of class: knitting, dance, weight training.
  • Join a support group—The Alzheimer’s Association offers classes and workshops for caregivers and for the person with memory loss.
  • Ask your friends and family for respite care. Have someone come over for a couple of hours a week so you can at least get out for a walk or go grocery shopping.
  • Go to the movies with a friend. It’s a great way to escape into another world for a few hours.
  • Call a best friend who is happy to talk; call someone who makes you laugh–laughter is truly the best medicine.
  • Bring your loved one to a Memory Cafe/Alzheimer’s Cafe. The challenges of living with memory loss can sever social connection at a time when it is needed most. Throughout the US and Europe, this casual social meeting is for caregivers and their care partner (the person they are caring for). Memory Cafes offer a way to socialize, explore art, music, poetry and listen to discussions and presentations. A Dutch psychologist opened the firs Memory Cafe in Holland. today there are about 200 Memory Cafes in the U.S.
  • Chat online with other caregivers. The Alzheimer’s Association offers chat rooms and so does the American Cancer Society. Check Elder Care Online for chat room and caregiver forum links. ElderCare Online’s Caregiver Support Network brings together online resources, groups and experts to create a virtual community dedicated to improving quality of life for you and your loved ones.

Is it a good idea for Alzheimer’s and dementia patients to use marijuana?

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Doctor hand holding dry medical cannabis on table close up

Doctor writing a prescription for  medical marijuana

I live in Colorado, one of the few states where medical marijuana is legal, as well as recreational marijuana for adults 21 years or older. Before it was legal, my husband, who suffered from anxiety, stress and depression from Alzheimer’s disease, smoked it in a pipe and ate marijuana cookies and brownies. It calmed him down and, most importantly, put a grin back on his face. He would get happy, and although I did not partake it helped me to relax, too–just because he was happier and more relaxed.

How does marijuana help Alzheimer’s?

Numerous studies show that cannabis helps:

THC, the psychoactive chemical in marijuana, helps reduce agitation and increase weight in people suffering from Alzheimer’s disease. Anxiety is defined as the inability to settle down and includes behaviors such as verbal outbursts, pacing and restlessness, all of which may lead to patient combativeness. Additionally, Alzheimer’s patients often experience weight loss because they stop recognizing when they are hungry.

Clinical studies

Researchers at the Meridian Institute for Aging in New Jersey gave a daily dose of 10 to 20 milligrams of dronabinol (an artificial version of THC marketed under the name Marinol) to 48 patients who had been diagnosed with Alzheimer’s disease and anorexia. After one month, two-thirds of the patients were significantly less agitated, and all of them had gained weight. There were no adverse side effects reported, such as falls, seizures or depression.Study results suggest dronabinol, a synthetic version of THC, the active ingredient in Cannabis sativa L (marijuana), may reduce agitation and lead to weight gain in patients with Alzheimer’s disease,

A 2014 preclinical study published in the Journal of Alzheimer’s Disease found that very small doses of tetrahydrocannabinol (THC), a chemical found in marijuana, can slow the production of beta-amyloid proteins, thought to be a hallmark characteristic and key contributor to the progression of Alzheimer’s. http://www.ncbi.nlm.nih.gov/pubmed/25024327. THC could be a potential therapeutic treatment option for Alzheimer’s disease through multiple functions and pathways. The study is among others to support the effectiveness of THC in prohibiting the growth of toxic amyloid plagues.

Co-author of the study, Neel Nabar, cautions against drawing quick conclusions from the study and says that numerous previous studies have shown that marijuana helps Alzheimer’s patients by reducing anxiety and inflammation, and improving appetite.

In this study, the researchers gave Alzheimer’s-afflicted mice various doses of pharmaceutical cannabinoids, which are 100 to 800 times more potent than marijuana compounds. The treated mice did not perform any better than untreated mice on memory tests, and they had just as much brain plaque formation as the untreated mice.

Can it reduce brain inflammation?

In 2005 researchers from Madrid’s Complutense University and the Cajal Institute published an article in the Journal of Neuroscience showing that  a synthetic cannabinoid appeared to reduce brain inflammation in Alzheimer’s.  Some researchers believe that reduction of this inflammation helps to prevent the mental decline associated with this disease.

Three years later, in March 2008, the Royal Pharmaceutical Society of Great Britain unveiled research showing that cannabis-based treatments could improve memory loss in Alzheimer’s sufferers.   Spanish researchers, this time working with a research team from Israel, found that one of the 400 compounds in the marijuana plant could significantly slow memory problems caused by the disease.  A by-product of their research was the finding that the same drug can also help Type 1 diabetes (formerly known as insulin dependent diabetes).

In observing my husband’s reaction to smoking pot and eating edibles, I can say that neither helped to improve or slow down his memory decline. 

In December 2008, results of a study showing that it’s the anti-inflammatory effect of cannabis that appears to help in Alzheimer’s disease were published.  Scientists continue to debate about the role inflammation of the brain plays in Alzheimer’s, and many researchers believe that it plays an important role in the dementia process.

The question comes up that if reduction of inflammation is all it takes to halt mental decline associated with Alzheimer’s, why doesn’t taking an anti-inflammatory, such as ibuprofen, help the condition?  Supposedly, anti-inflammatory drugs such as these have been shown in tests to help young brains, but not to help older brains.I have not found any such studies, but I do believe, along with numerous researchers, that inflammation is a major culprit in chronic disease.

Turmeric has been shown to be a traditional anti-inflammatory spice that has been found to have a protective effect against Alzheimer’s and dementia. Look for my future post about how turmeric supports memory and helps prevent dementia.

Therapeutic Cannabis Dosage for Alzheimer’s

According to Gary Wenk, Ph.D., author of the December 2008 study and professor of psychology and neuroscience at Ohio State University, “a puff is enough.”  He goes on to say that although this dose would probably have some sort of psychoactive effect strictly medical use is not ruled out.  The drug could be taken before bedtime, Wenk says, and with long-term use, tolerance to these psychoactive effects can develop, so impairment might be minimal with a steady dose anyway.

Don Abrams, M.D., chief of hematology/oncology at San Francisco General Hospital, has studied medical marijuana use in people with HIV for more than a decade. He says, “Cannabis is anti-inflammatory and it is also an antioxidant, and those are two things that we seek in treating neurodegenerative disorders.  It’s there, it’s in nature, if the research does find that it has these benefits, why not take advantage of it?”

Marijuana increases appetite and reduces anxiety

It’s important to note the difference, however, between these findings and the beneficial findings of other studies. Alzheimer’s patients often lose the ability to know whether they are hungry or not, and medical marijuana does help induce appetite. It also reduces anxiety. So, in the end, if you are considering giving your loved one medical marijuana for Alzheimer’s symptoms, be aware that it will probably not help improve memory. But it very well may help increase appetite and reduce anxiety.

My husband ate well until he was in late-stage Alzheimer’s disease. By then, he would not have been able to ingest marijuana in any shape or form. But earlier in the disease process it helped him feel better when everything in his world was being tossed and turned upside down. If you are looking for an antidote to anxiety and depression, consider it for a loved one with Alzheimer’s or dementia. If you prefer not to deal with the nasty odor (some people like it, I don’t) then ask your doctor about the pharmaceutical THC tincture. Or, you can always bake marijuana cookies and brownies. Just make sure they are in a container that is child-proof and hidden from your pets, visitors and children.

Summertime Eating Tips to Help Caregivers Keep Their Cool

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Background texture of pink and white rose petals

Rose Petals Make a Delicious Cooling Drink and Jelly

 

It’s summertime and the livin’ is easy—or at least we’d like it to be. If you’re tired and stressed out from caregiving, here are some tips to help you stay cooler in summer.

According to the ancient Indian system of Ayurveda our body consists of three main elements or doshas—Vatta, Pitta and Kapha. Pitta consists of water and fire. It’s hot, so during summer when the temperature rises we want to eat cooling foods. Eating cooling foods not only keeps us from overheating, it reduces the tendency to get irritable, impatient and angry.

  • 1) First and foremost, stay hydrated. It’s especially important to make sure you and your loved ones are getting enough liquids because when we forget to drink we can become dehydrated quickly, which leads to other health problems. It’s also crucial to keep the brain hydrated in order to maintain mental alertness. Drink plenty of water and stay away from carbonated and caffeinated drinks. Herbal teas, and fresh fruit or vegetable juices are great in summer. Just remember that fruit juices are high in sugar and calories.
  • 2) Enjoy the bounty of summer fruits and vegetables. The summer fruits such as peaches, apricots, cherries, watermelon, cantaloupe, and berries are especially good for helping the body reduce the fiery heat of summer. According to Ayurveda, some of the recommended summer vegetables include cucumber, green leafy vegetables, green beans, squash, zucchini, asparagus, beets and eggplant.
  • 3) Sprinkle on the herbs and spices. They’re easy to use and contribute added flavor and antioxidants to your diet. Cooling spices include cardamom, coriander, fennel and tumeric. Cooling herbs include cilantro, mint and dill.
  • 4) Avoid hot, sour and salty foods including fermented food, red meat, and greasy and spicy food. Excess pitta aggravates the tendency towards heartburn and gastric hyperacidity.
  • 5) Here’s some good news—Ayurveda recommends ice cream during the hot summer months! So by all means, enjoy! Dementia patients are especially fond of ice cream. If the person you are caring for refuses to eat or eats very little, try serving ice cream. It contains protein, calcium and calories, and it’s easy to serve and eat. If weight gain or cholesterol is a concern, select a dairy-free version of America’s favorite dessert. Rice Cream, Coconut Bliss and Soy Delicious make delicious non-dairy, frozen desserts.
  • 6) My roses are bursting with fragrance and beauty. Roses are especially cooling and ff you have rose bushes that are free of chemicals, here’s a special treat to make: Rose Petal Jam. It’s fun and easy and the person you are caring for might even like to get into the act. It’s also very cooling and pacifies irritability. Spread it on toast, put a teaspoon on top of a scoop of ice or add it to warm milk for a yummy nightcap. (see recipe below)
  • 7) Make a lassi using a tablespoon of rose petal jam. Or use this delicious recipe to make the classic, cooling Indian-style milkshake.

Rose Petal Jam

Ingredients

  • ◦ 1 cup fresh rose petals (must never have been sprayed with any chemicals)
  • ◦ 3/4 cup water
  • ◦ 1 lemon, juice of (1/4 cup)
  • ◦ 2 1/2 cups sugar or evaporated cane juice crystals
  • ◦ 1 package pectin
  • ◦ 3/4 cup water

Directions

  1. Puree rose petals, 3/4 cup water and lemon juice in blender until smooth.
  2. Slowly add sugar.
  3. Blend till all sugar has dissolved; (leave in blender) Stir 1 package pectin into 3/4 cup water, bring to a boil, and boil hard for 1 minute. Pour mixture into blender with rose petal mixture until well blended.
  4. Do this very quickly – it sets up FAST!! Pour into small, sterilized jelly jars.
  5. Let set for 6 hours, till firm.
  6. Will keep one month in refrigerator.
  7. Freezes well.

 

Rose Water Lassi

  • 2 1⁄2 cups plain yogurt
  • 1/2-teaspoon fine sugar
  • ¼ tsp of ground cardamom
  • 2 teaspoons pure rosewater
  • 3⁄4 cups Ice water
  • 1 cup Ice cube cracked
  • Fragrant rose petals for garnish

Blend the yogurt, sugar, cardamom, rose water and iced water in a blender for 2 minutes. Add the ice and process for another 2 minutes. Pour the lassi into tall, refrigerated glasses and garnish with rose petals. Chill out and enjoy!

Protecting Yourself and Loved Ones from Elder Abuse

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Stop Elder Abuse Sign

Stop Elder Abuse Sign, An American road stop sign with words Elder Abuse with stormy sky background

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

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

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

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

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

Report abuse

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

Types of abuse

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

Signs of abuse

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

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

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

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

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

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

Human Services provides help with:

  • In-home assessment for abuse, neglect, and/or exploitation
  • Crisis intervention
  • Monthly visits by a case worker, if risk continues
  • Assistance with housing and/or placement to alternative housing
  • Assistance with obtaining benefits
  • Money management
  1. To report suspected abuse in a nursing home or long-term care facility, contact your local Long-Term Care Ombudsman. Each licensed long-term care facility is required to display a poster with the facility’s assigned ombudsman’s name and contact information. If you are a resident or family member of a resident in a facility, call the ombudsman listed on the poster. To learn more about the ombudsman program visit: Long-term care ombudsmen are advocates for residents of nursing homes, board and care homes and assisted living facilities. http://www.ltcombudsman.org
  2. Caregivers (both family and professionals) are most often the abusers of the elderly. Stress and feelings of being overwhelmed may provoke unintentional belligerent feelings. If you feel overwhelmed or frustrated as a caregiver, talk to someone for support.
  3. To speak with an Alzheimer’s Association Care Consultant call: 1-800-272-3900
  4. To find a support group in your area visit http://www.alz.org/apps/findus.asp
  5. To receive support from other caregivers visit https://www.alzconnected.org/
  6. To report an incident or concern of abuse or neglect, call the Alzheimer’s Association (1.800.272.3900) or Eldercare Locator (1.800.677.1116). You’ll be connected to your state or local adult protective services division or to a long-term care ombudsman. You do not need to prove that abuse is occurring — it is up to the professionals to investigate suspicions.
  7. Read more: http://www.alz.org/care/alzheimers-dementia-elder-abuse.asp#ixzz2W9DhCbSL
  8. Keep in contact. Talk with your older friends, neighbors, and relatives. Maintaining communication will help decrease isolation, a risk factor for mistreatment. It will also provide a chance to talk about any problems they may be experiencing.
  9. Join Ageless Alliance, a national, non-profit grassroots organization working to to promote aging with dignity and eliminate elder abuse, neglect and exploitation through Awareness, Advocacy and Action. Based at the Center of Excellence on Elder Abuse and Neglect at the University of California, Irvine, Ageless Alliance is a grassroots campaign to give a voice to those who have been affected by elder abuse and abuse of adults with disabilities.
  10. Plan ahead to protect against financial exploitation. Download a handout on ways to protect yourself or a loved one. http://www.ncea.aoa.gov/Resources/Publication/docs/NCEA_ProtectYourself_web508.pdf
  11. Be aware of the possibility of abuse. Look around and take note of what may be happening with your older neighbors and acquaintances. Do they seem lately to be withdrawn, nervous, fearful, sad, or anxious, especially around certain people, when they have not seemed so in the past?
  12. Contact your local Area Agency on Aging (AAA) office to identify local programs and sources of support, such as Meals on Wheels. These programs help elders to maintain health, well-being, and independence—a good defense against abuse. See the Eldercare Locator, www.eldercare.gov Welcome to the Eldercare Locator, a public service of the U.S. Administration on Aging connecting you to services for older adults and their families.You can also reach us at 1-800-677-1116.

When the Patient has Trouble Eating

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99f56ed5-402e-4a79-87fc-038e8b868a49

Three delicious and nutritous protein shakes

Find more food and nutrition tips in my new book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”–available wherever books are sold.

Elderly people, people who are ill, and especially people with dementia, sometimes have eating difficulties, which can arise for a number of reasons.

  • Some medications affect taste and decrease appetite.
  • Eating might be one of the few things that a person with Alzheimer’s or dementia still has control over. The memory loss individual might refuse food simply because it’s a way of exerting personal power.
  • A new diet that is introduced due to a health concern such as diabetes, or the introduction of pureed food might cause an individual to refuse food.
  • Depression can result in a lack of interest in food.
  • The sense of taste is the last one to go, but it might be diminished along with the sense of smell.
  • Inactivity can cause loss of appetite, so try to engage the memory loss person in some sort of physical activity. Even a stroll around the block helps.

End-stage Alzheimer’s patients almost always have trouble eating, and ultimately most have trouble swallowing. But if the person you are caring for is losing weight for no particular reason and is still mobile, it is a concern that needs to be addressed. Please consult with your physician when there is any question about weight loss and refusal to eat.

12 Tips for Getting Someone to Eat

  1. Finger foods might be easier to manage than a fork and knife.
  2. Eliminate foods that present a choking risk (hotdogs, chicken or fish that contain bones, etc.)
  3. Provide several small meals throughout the day instead of three large meals.
  4. Make the food tasty by including salt, herbs and spices.
  5. Dementia patients love ice cream. If cholesterol is an issue, substitute a dairy ice cream with a non-dairy frozen dessert such as Rice Dream®, Coconut Bliss or Soy Dream.
  6. Offer healthy snacks throughout the day, such as cheese and apple slices, nut butter on apple slices, smoothies, and diced fresh fruit.
  7. Create a soothing ambience by placing flowers and candles on the table, and playing soft classical music.
  8. Make sure to keep the patient hydrated, especially during the hot summer months.
  9. Provide a comfortable place to eat. If the patient has a bad back, it might be necessary to put a cushion on the chair.
  10. Do a happy, engaging activity before mealtime. Have the memory loss person help set the table or peel vegetables, if possible. Painting, listening to music, playing an instrument, or going for a walk might be all it takes to work up an appetite.
  11. It might be hard for the person to differentiate foods on a plate, especially if they are the same color. Use contrasting colors. For example, serve beets and carrots on white instead of white mashed potatoes on a white plate.
  12. Aromatherapy
  • Bergamot is the flavoring used in Earl Grey Tea. If your patient likes to drink tea, this might be an easy solution. Or, have the person smell bergamot oil, which is used for depression.
  • Citrus oils such as orange, lemon and lime along with ylang-ylang can help alleviate depression.
  • Peppermint and Spearmint are energizing and might stimulate appetite.

 

Protein shake recipes

Protein shakes are nutritious, filling, and nourishing. Use ingredients of your choice without relying on the sugary nutrition drinks that are generously handed out in institutions.

My favorite delicious and easy-to-make shakes

Banana Berry Shake

  • 1 frozen banana
  • ¼ cup sliced strawberries
  • 8 ounces of milk or non-dairy drink such as soy, almond, or coconut milk
  • 1 scoop of whey protein powder
  • Blend together until smooth.

Berry Sunrise Shake

  • 1/3 cup frozen blueberries
  • 3 medium strawberries
  • 8 ounces of orange juice
  • 1 scoop of whey protein powder
  • Blend together until smooth.

Chocolate, Banana, Peanut Butter Protein Shake

  • 1 banana
  • 2 Tablespoons peanut butter
  • 1-cup almond, soy or coconut milk
  • 1 scoop chocolate protein powder
  • 3-5 ice cubes
  • Blend together until smooth

Enjoy!

Is it really important to eat a good breakfast?

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For more information on the importance of good nutrition to prevent caregiver burn-out, including recipes, read my new book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”—available June 1, 2016 where all books are sold.

Yes! It is absolutely important to eat a good breakfast, and here’s why. This is true for everyone, but especially important for caregivers. It’s recommended that we eat within one hour after waking to stabilize our blood sugar—which has dropped during sleep—so that your mood stays even and you can perform at your best.  If not, you’ll be more apt to reach for a bagel or doughnut or another cup of coffee. After loading up on carbs and empty calories (lacking in nutrition), it’s typical to feel hungry again within a couple hours. And every time our blood sugar crashes, it’s a signal to the body to store calories. The same goes for a hungry body. If you don’t eat breakfast, your blood sugar will be low, and this too is a signal to the body to store calories, which adds fat around your middle.

One of the most critical things you can do for your health and your mood is to keep your glucose levels stable. And that means it’s important to include a healthy protein with breakfast. 

Low blood sugar impairs your concentration and judgment, leaves you tired and fuzzy-headed, and sometimes makes you irritable. These symptoms often disappear after you eat something and your blood sugar rises. Part of the solution is emphasizing a diet rich in protein and non-starchy, high-fiber vegetables. Both protein and fiber help stabilize blood-sugar and insulin levels, which helps to prevent mood swings.

Some things to be aware of

What if you feel hungrier after breakfast? Your body has adapted to not eating breakfast or to eating a poor breakfast. Try eating less at night, or if you eat breakfast at 8am and get hungry at 10am, have a snack that contains protein, such as a protein shake, a small handful of nuts, yoghurt and fruit, or cottage cheese and fruit. You don’t want to get ravenous before lunch and then make a poor food choice.

What if you’re nauseous in the morning but you’re not pregnant? This might be an indication that your blood sugar is too low, and it’s important that you eat!

I need my caffeine fix! Is that bad? Studies show that those who drink the most coffee often suffer from chronic depression because caffeine depletes the body of B vitamins—crucial for dealing with the stress of caregiving —, vitamin C, calcium, potassium and zinc. Caffeine increases thirst because it dehydrates the body, and it overstimulates and weakens the kidneys, pancreas, liver, nervous system, stomach and intestines.

According to the Mayo Clinic, 2-3 cups of coffee can spike systolic pressure up to 13 points and diastolic pressure up to 14 points. If you have high blood pressure, limit your coffee intake to 3 cups a day, and avoid drinking it before exercise or physical labor, which both naturally raise blood pressure.

On the other hand, studies have show that caffeine can delay Alzheimer’s disease in people who are at risk. A study published in the Journal of Alzheimer’s Disease (2012) found that people older than 65 who had higher blood levels of caffeine developed Alzheimer’s disease 2-4 years later than people with lower caffeine levels. The study included 124 people who had mild cognitive impairment (MCI). Typically, 15% of people with MCI will go on to develop full-blown Alzheimer’s disease each year.

The study participants who had less than 1,2000 ng/ml of caffeine levels in their blood developed Alzheimer’s. This is equivalent to drinking several cups of coffee a few hours before their blood was taken. The people whose memory loss did not progress to full-blown Alzheimer’s had higher levels of caffeine in their blood. Coffee appeared to be the only source of caffeine for the participants in the study.

So monitor how you feel after you drink coffee. A safer choice might be a cup of chai or green tea, which has numerous heath benefits, including antioxidant protection.

Breakfasts of Champions

Instead of eating a bowl of cornflakes with a banana and low-fat milk, have a 2-egg omelet, slice of whole grain toast, a cup of fresh fruit and a cup of steamed greens such as kale. Then notice the difference in how you feel. You’ll have more stamina, less anxiety and depression, and will able to get through the whole day more easily.

Other ideas

  • Whole-grain mini-quiche with 1/2 cup berries
  • Oatmeal with prunes or raisins, walnuts or almonds, and cinnamon, whole milk
  • Multigrain hot cereal, Greek yoghurt and fresh fruit, almonds
  • Eggs with beans, salsa, and a side of greens
  • Bagel with hummus, tomato and goat cheese
  • Smoothie with greens, fruit, protein and flax

Recipe for Gluten-free Flax Meal Muffins

  •  ¾ cup brown rice flour
  • ¾ cup buckwheat flour
  • ½ cup ground flaxseed
  • ½ cup date sugar (or sweetener of your choice)
  • 1 tsp baking soda
  • ½ tsp ground cinnamon
  • ¼ tsp ground nutmeg
  • ¼ tsp salt
  • ½ cup raisins
  • 2 eggs
  • ¼ cup oil of your choice (I used grape seed oil)
  • 1/2 cup unsweetened applesauce
  • 1 cup buttermilk or coconut milk

Preheat oven to 375º. Line a 12-cup muffin tin with unbleached paper liners and set aside. In a large bowl, whisk together brown rice flour, buckwheat flour, flaxseed, sweetener, baking soda, cinnamon, nutmeg, salt and raisins.

In a second large bowl, whisk together eggs, oil, applesauce and buttermilk. Add flour mixture to buttermilk mixture and stir until just combined.

Spoon batter into prepared muffin tins and bake until golden brown and a toothpick inserted in the center of a muffin comes out clean, about 30 minutes. Cool muffins in pan for 5 minutes before transferring to a wire rack to finish cooling.

Recipe for overnight oatmeal made in a slow cooker

  • 2 cups old fashioned rolled oats –do not use the instant oats. (serves 4)
  • 1 3/4 cups water

or

  • 1 cup steel cut oats (serves2)
  • 4 cups water
  • Mix oats and water in slow cooker and set for 8-9 hours. These recipes work in a 1 1/2 – 2 1/2 quart capacity slow cooker.

The possibilities of things to add are endless. Some ideas: maple syrup, honey, butter, milk, coconut milk, brown sugar, raisins, dried apricots, prunes, dried cherries, dried coconut, fresh fruit, cinnamon, ginger, almond butter, apple butter, chia seeds, chopped walnuts or almonds, flax meal, etc.

Try some of these recipe and let me know how you feel. Have a great breakfast, and a great day!

 

 

 

Why you should see a doctor if you’re worried about your memory

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I’ve done it. You’ve probably done it, too.  Forgetting where you parked your car is not uncommon. Once I parked in a four level garage at a mall and walked up and down the stairwell with my then-teenaged daughter, who couldn’t find the car either. I ended up calling security and had the guard drive me through the parking garage until I found the car. That was a bit embarrassing. But forgetting where you parked or the name of a familiar face are common age-related memory lapses. I’ve always been lousy at remembering names of people I know, characters from novels, and the names of movies and actors. That doesn’t mean I’m losing it. My explanation, although it might not be scientific, is that I have so many facts and information stored in my brain that my memory is discretionary.

But if you have difficulty recognizing a relative, find your missing keys in the refrigerator, or get lost driving in the town you’ve lived in for years, you should make an appointment with your health care provider. Because if you do have cognitive impairment, the sooner you get help the better.

One of the first signs that my husband (who died from early-onset Alzheimer’s disease) was having memory lapses was that he started getting lost while driving the car in our home town. That scared him, and it scared me. I finally got him to agree to see a doctor, two years after I suspected that something was wrong.

There are lots of reasons to see a doctor if you or your loved one suspects that you are having cognitive difficulties.

  • Individuals who start to forget things or get confused can become depressed, anxious, angry, and/or frustrated because they don’t understand why their thoughts aren’t clear or why they are having difficulty performing certain tasks that were always easy. My philosophy is that knowledge is power. It’s better to know what is happening than to be left in the dark. A consultation with a health professional can help explain what is going on.
  • According to researchers at the University of Michigan, more than half of older adults with signs of memory loss never see a doctor about it. Although there is still no certain way to prevent or forestall most cognitive diseases, knowing that someone has serious memory problems can alert family members and friends to a need for changes in the person’s living arrangements that can be health-or even life-saving. Early evaluation and identification of people with dementia may help them receive care earlier,” says study author Vikas Kotagal, M.D., M.S. “It can help families make plans for care, help with day-to-day tasks including observed medication administration, and watch for future problems that can occur. In some instances, these interventions could substantially improve the person’s quality of life.”
  • If driving becomes difficult it’s important to get an evaluation from your local Driver Motor Vehicle department because of liability and safety issues. This is a very touchy subject and was one of the most difficult thresholds for my husband and me to cross through. He continually blamed me for being the ogre who took away his car keys. But it’s important to know that if a caregiver, spouse or other significant family member knows that a loved one has a diagnosis of Alzheimer’s or other dementia, that family member could be held responsible in case of an accident. If, god-forbid, someone is killed, the repercussions could be emotionally, physically and financially disastrous.

What Should You Do?

  1. Make an appointment with your general physician and express your concerns. Your doctor will ask you some questions such as: how are you sleeping at night? How often do you drink alcohol? Are you sedentary? Do you exercise? Are you depressed? What is your typical diet? Your doctor might do a blood panel to determine if you have any organic markers such as low thyroid or anemia that could affect your energy and memory.
    2. Your doctor might give you a brief memory assessment or refer you to a memory clinic for further evaluation. The MMSE (Mini-Mental State Exam,http://www.mountsinai.on.ca/care/psych/on-call-resources/on-call-resourc…) is an eight-minute test that has been used since 1975. According to neurologists, the 10-12 minute MoCA (Montreal Cognitive Assessment,http://www.mocatest.org/about/), used since 1996, is more discerning.

Don’t delay. Make an appointment if you or your loved one has memory concerns.

10 Signs of Alzheimer’s Disease
1. Memory loss that disrupts daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality

Reference
Kotagal V, Langa KM, Plassman BL, Fisher GG, Giordani BJ, Wallace RB, Burke JR, Steffens DC, Kabeto M, Albin RL, Foster NL. Factors associated with cognitive evaluations in the United States. Neurology. 2015 Jan 6;84(1):64-71.

 

 

Seniors get a free cognitive exam as part of Medicare’s yearly wellness exam

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Take advantage of this free cognitive exam. If you are a senior, it could make a huge difference in your overall well-being.

Despite clear signs that their memory and thinking abilities have gone downhill, more than half of seniors with these symptoms haven’t seen a doctor about them, a new study finds. 1

University of Michigan researchers and their colleagues say their findings suggest that as many as 1.8 million Americans over the age of 70 with dementia are not evaluated for cognitive symptoms by a medical provider, which in some patients can lead to a failure to uncover modifiable causes of thinking or memory impairment. 1

The study, published online in Neurology, the medical journal of the American Academy of Neurology, documents a clear lack of clinical testing for seniors with signs of cognitive problems.

“Early evaluation and identification of people with dementia may help them receive care earlier,” says study author Vikas Kotagal, M.D., M.S., who sees patients at the University of Michigan Health System and is an assistant professor in the U-M Medical School’s Department of Neurology. “It can help families make plans for care, help with day-to-day tasks including observed medication administration, and watch for future problems that can occur. In some instances, these interventions could substantially improve the person’s quality of life.”

For instance, knowing that a stroke or vascular issues in the brain caused dementia means patients can work to control risk factors like blood pressure that might otherwise cause it to keep worsening. If your physician suspects Alzheimer’s disease, there are drugs that can help delay the onset of full-blown dementia, and the possibility of placement in a memory care facility, which can help offset the catastrophic cost of the disease.

If you’ve had Part B for longer than 12 months, you can get the free Medicare Annual Wellness Exam to develop or update a personalized plan to prevent disease and disability based on your current health and risk factors. The exam includes:
• A review of your medical and family history
• Developing or updating a list of current providers and prescriptions
• Height, weight, blood pressure, and other routine measurements
• Detection of any cognitive impairment
• Personalized health advice
• A list of risk factors and treatment options for you
• A screening schedule (like a checklist) for appropriate preventive services. Get details about coverage for screenings, shots, and other preventive services.
This visit is covered once every 12 months (11 full months must have passed since the last visit).

Don’t delay. Call and make an appointment today. It’s free for all people with Medicare, and it’s to your and your family’s benefit.

Reference

  1. In addition to Kotagal, the study’s authors include Kenneth Langa, M.D., Ph.D., who holds professorships in both the U-M Medical School and Institute for Social Research; U-M neurologist Roger Albin, M.D., U-M neuropsychologist Bruno Giordani, Ph.D. and U-M researcher Mohamed Kabeto, M.S. Authors from other institutions are Brenda Plassman, Ph.D. of Duke University, who directs the ADAMS study from which the data on dementia patients was obtained; and James Burke, M.D., Ph.D., Gwenith G. Fisher, PhD, Robert B. Wallace, MD, MS, David C. Steffens, MD, MH and Norman L. Foster, MD. Langa is a member of the U-M Institute for Healthcare Policy and Innovation.
    The study was supported by the University of Michigan, the National Institute on Aging (AG027010, AG009740, and AG007137), and University of Utah. Reference: Neurology,doi/10.1212/WNL.0000000000001096

 

 

Vitamin E Slows Functional Decline in Patients with Alzheimer’s

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Vitamin E Slows Functional Decline in Patients with Alzheimer’s.

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First we heard that it helps and then not long ago we heard that vitamin E does not help prevent Alzheimer’s disease.1 The newest research suggests that a daily dose of 2000 IU per day of vitamin E might help to slow functional decline for patients with mild to moderate Alzheimer’s, and that it could help reduce the amount of care these patients require by two hours a day.

 

Most studies of vitamin E, including this new one, have focused on alpha-tocopherol, a synthetic form of vitamin E. This is extremely significant because in its natural form vitamin E consists of many compounds—including d-alpha tocopherol, high gamma tocopherol, mixed tocopherols and tocotrienols—that have been proven safe and beneficial. If the natural form of vitamin E had been used in this study, the outcome might have been even better. And if it had been used in the countless studies done over the years, many of which were negative, the results might have come out very different.

 

In the current study, researchers followed 613 patients with mild to moderate Alzheimer’s disease, all of whom were taking an acetylcholinesterase inhibitor (Aricept, Exelon, Razadyne). Of these patients, 155 received 20 mg a day of memantine – a class of drugs used to treat Alzheimer’s – while 152 patients received 2,000 international units a day (IU/day) of vitamin E, 154 received a combination of both and 152 took a placebo. The patients who took the vitamin E had a 19% reduction in their functional decline, compared with the patients who received the placebo. The researchers said that this was equivalent to approximately 6.2 months in time over the 2.3 year follow-up period.

 

They also noted that memantine and a combination of both memantine and vitamin E demonstrated no clinical benefit for the patients.

The researchers pointed out that functional decline as a result of Alzheimer’s disease is increasingly recognized as having a significant impact on a patient quality of life, as well as putting a strain on social and economic costs. But they said their findings suggest that vitamin E could combat these factors.

 

What you should know

Vitamin E is naturally found in a variety of foods including eggs, fortified cereals, meat, nuts, poultry, some fruits and vegetables (green, leafy vegetables, avocados, asparagus, kiwi, broccoli, pumpkin, sweet potato, mangos, tomatoes, papayas), wheat germ, sunflower and safflower oils.

 

Taking a high dosage of alpha-tocopherol alone has been shown to deplete the body of other forms of vitamin E, which are much more powerful antioxidants and have been proven to have unique health properties. And taking a single form of vitamin E, such as synthetic alpha-tocopherol, denies the very fact that nature offers seven different forms of tocopherols and tocotrienols for a reason.

 

In order to get the full protective benefits of vitamin E, it’s important to make sure you’re taking a supplement that contains a full spectrum of vitamin E compounds—including d-alpha tocopherol, high gamma tocopherol, mixed tocopherols and tocotrienols.

 

The bottom line is this: Based on the large body of scientific evidence that’s been published over the past several decades, we should all be taking a wholesome full spectrum vitamin E … because full spectrum vitamin E is safe and good for your heart, your brain, your overall health, and as a protectant against cancer and degenerative diseases.

 

References

  1. Isaac MG, Quinn R, Tabet N. “Vitamin E for Alzheimer’s disease and mild cognitive impairment.” Cochrane Database Syst Rev. 2008 Jul 16;(3):CD002854. doi: 10.1002/14651858.CD002854.pub2.
  2. Dysken Mw, et al. “Effect of vitamin E and memantine on functional decline in Alzheimer disease: the TEAM-AD VA cooperative randomized trial.” JAMA. 2014 Jan 1;311(1):33-44. doi: 10.1001/jama.2013.282834.

10 Stress-relieving Holiday Tips for Caregivers

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  1. Drink a glass of water every other hour to keep hydrated. Staying hydrated helps support immunity, and reduces stress and irritability. It’s important to remember that your brain needs water, too. A dehydrated brain doesn’t think clearly, which can contribute to stress and anxiety.
  2. Include a protein with every snack. It’s difficult to stay away from sweets this time of year. But including a protein with every snack helps maintain healthy blood sugar levels. Try apple slices smeared with almond butter or topped with a cheese slice. A small handful of almonds or walnuts and a couple of dates satisfy the sweet tooth and provides vitamins, minerals and protein.
  3. Plug in an aromatherapy diffuser and inhale the relaxing scent of lavender, nernoli (orange blossom) or any scent you like.
  4. Pour some Epsom salt into a hot bath, light a candle, put on soothing music, and soak away your stress and anxiety.
  5. Turn off the TV, phone, iPad, computer, and other electronic devices an hour before bed. Instead, listen to relaxing music while sipping a cup of chamomile tea.
  6. Journaling is a wonderful, inexpensive way to release your concerns and worries on paper. It’s available when your therapist and best friend are not, and you can do it anywhere at your leisure.
  7. Move your body. Exercise is one of the very best stress relievers. You don’t have to buy a special outfit or go to a gym. Put on a pair of walking shoes and make a habit of walking 1/2 hour every day. If it’s too cold outside, put on your favorite dance music and move as though no one is watching.
  8. Fill half of you plate with green leafy vegetables. They contain magnesium, “the mood mineral,” which supports healthy blood sugar and blood pressure, decreases food cravings, and nourishes and calms the nervous system.
  9. Laugh to reduce anxiety and produce endorphins, the feel-good hormone. Look at funny family photos, reminisce with a high school friend, or watch a comedy. Whatever tickles your funny bone will definitely lift your spirits.
  10. Aim to be in bed before 10pm and make a habit of going to bed and rising at the same time every time. You’ll sleep better and have more energy and resilience.