Aging and Memory Loss: What’s normal, what’s not, and how to seek help (this article appeared in the Daily Camera’s Aging at Altitude Special Section, spring 2022)

Most of us have had “senior moments” where we’ve run into a friend and momentarily forget their name. Or we search the house for eyeglasses that are perched on our head. Or we walk in circles trying to locate our car in the mall parking lot. Those forgetful moments are fairly typical of being a member of the 21st century with a headful of thoughts and responsibilities.

Putting the car keys in the refrigerator might be something you do if you’re distracted, but storing a dozen cans of pineapple in the dishwasher, or forgetting how to drive home are not normal memory slips. These types of forgetfulness could be a sign of cognitive impairment or a dementia. But the latest research is showing that if you treat early signs of mental decline, you can slow down and possibly reverse cognitive decline.

Ilene Naomi Rusk, Ph.D. is a neuropsychologist, functional brain health coach, and director of The Healthy Brain Program at the Brain and Behavior Clinic (2523 Broadway #200, Boulder, CO, 303-938-9244). Dr. Rusk acts like a detective to fully understand the root causes of a person’s psychological and brain health issues. Then she works with the patient and a functional medicine team with personalized diagnostics, and treatment or interventions, from brain training to nutrition guidance.

“It’s good for everyone to have baseline neuropsychological testing in mid-life even if you have no memory issues,” says Rusk. Most people think cognition is memory, but it’s much more than that. It’s memory, learning, attention and focus, visual and spatial skills, and how we absorb information, retain it and then share it. Cognition is also how we process things visually, auditorily, and spatially.”

There are different categories of cognitive health versus cognitive impairment that can clue me into whether or not someone is headed towards dementia, says Rusk.

“Subjective Cognitive Impairment (SCI) is when you notice a change in your cognition and think ‘I’m a little different than I used to be’, but other people can’t tell and it wouldn’t show up on a memory test.

“The next category is Mild Cognitive Impairment (MCI). This is when you notice changes in your thinking and people around you may or may not notice changes. With MCI you might also have some challenges on neuropsychological tests that show empirical changes. This is a staging system,” says Rusk. “With MCI there’s a great opportunity to intervene, and we want to intervene as early as possible because once you have Mild Cognitive Impairment it’s easier to slip into dementia,” she adds.

The best thing is to tell your doctor if you have concerns and then go to see someone to get properly assessed.

“I recommend that people go directly to a neuropsychologist or neurologist after they’ve spoken to their family physician to look for root causes. There are so many prevention strategies and a new functional medicine methodology to approach cognitive decline. Functional Medicine practitioners look at blood sugar control, blood pressure, gut health, latent, mold, infections, inflammatory markers, stress, sleep patterns, chronic loneliness, and trauma. These are all important things when looking at modifiable root causes of cognitive impairment,” says Rusk.

“We no longer think that Alzheimer’s is only a disease of the brain. That’s definitely an endpoint,” she says. “Everything from dental health to herpes is being looked at, and the amyloid theory of Alzheimer’s is even being questioned by some people. I see trauma healing and stress reduction as important interventions. Chronic stress affects so much in our physiology and unhealed trauma leaves physiologic imprints.

 It’s also important to know,” she adds, “that 70% of dementias are of the Alzheimer’s type and 30% of dementias fall into other categories such as Frontal Temporal Dementia, Parkinson’s, Lewy Bodies, etc. getting properly diagnosed is very important.

The brain pathology of Alzheimer’s often starts 20 years before there are clinical signs. “A person goes from no dementia to SCI, MCI, early stages of dementia, mild, moderate, and severe stages,” says Rusk. “My goal is prevention, and my favorite thing to do is talk to young people about brain health. If we can intervene early, the decline can be delayed and even sometimes prevented.”

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: TheCaregiver’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.

Should you move your loved one to a memory care home?

Forgetful senior with dementia

Moving my husband to a memory care home was the hardest thing I’ve ever done. But I knew that if I didn’t, I’d pay dearly with my own deteriorating health. After caring for Morris for 8 years, I was stressed and diagnosed with a serious disease. When I asked my doctor what he would do in my situation, he paused before saying “You need to take care of yourself.”

Morris was mostly able to take care of his personal hygiene, with some help in the shower, etc. But he wasn’t able to drive, and he needed help getting dressed. He could feed himself if I put the food in front of him. He still enjoyed watching movies, although I’m sure he couldn’t follow the plot. He liked being taken out to lunch, but he couldn’t read a menu. In other words, he needed a lot of help. I didn’t feel that he was a danger to himself or to me, but I didn’t leave him alone in the house for more than a quick trip to the grocery store. However, I was burned out and had received a diagnosis that no one ever wants to hear — the kind that requires a lot of self-care, rest, and good nutrition.

So I was relieved to learn that our spot on the waiting list at my chosen memory care home was towards the top of the list. And I was especially glad, thanks to my therapist’s advice, that I had looked for a place the previous year so that in case of an emergency I didn’t have to frantically scramble to find a home for my husband . . . a place where I felt confident that the caregivers would treat him with kindness, compassion, and respect.

How do you know when it’s time to move someone to a long-term facility?

Of course, every situation is unique, especially since no two dementia patients or families are alike. Some families consist of an elderly couple who live by themselves with no family nearby. A person with dementia may live on their own. Or an older parent may be looked after by an adult child or grandchild who lives nearby or in another state. But in every case, it’s vital to have safety measures in place. That may involve moving the person with dementia into a family member’s home or into a long-term care facility. Families that have several siblings — adult children of the affected parent — share the caring responsibility by having the parent rotate throughout the year, staying with each child for a few months at a time.

Here are some indications of when it’s time to make that move

  • The caregiver is burned out and stress is affecting his/her mental, emotional, and physical health.
  • When it becomes obvious that the person being cared for is unable to take care of their basic needs.
  • S/he wanders off and doesn’t know how to get back home.
  • S/he is isolated, lonely, and depressed.
  • Your loved one is angry and verbally or physically abusive.
  • S/he has mobility issues and tends to fall.
  • The person with dementia has Sundowner’s syndrome and gets agitated at the end of the day. This is a sign that they are becoming unable to live alone.

Making the decision to move a loved one into a memory care home is one of the hardest decisions you will ever make. Just remember that when you’re a caregiver for someone with dementia, it’s important to take care of yourself, too. Because if you don’t and you get sick, then who will take care of you?

Take the advice of my therapist and start looking for a home where your loved one will be well cared for. Or have a family meeting and make a caregiving plan that suits everyone. Here are a couple of other blogs that may be helpful. https://barbracohn.com/2019/08/03/the-20-most-important-things-to-consider-when-looking-for-a-memory-care-home/

https://barbracohn.com/2013/04/03/is-it-is-it-time-to-move-your-loved-one-to-a-memory-care-home/

Please be gentle with yourself.

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: TheCaregiver’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 memory care home wants to evict my loved one! What should I do?

Caregiver yelling at man in wheel-chair

Sometimes a person with dementia will act out and strike the person who just happens to walk by, or the person who accidentally walks into their room. Or, the aggressor might bite another person. Aggressive behaviors aren’t that unusual, but sometimes they get out of control. If they continue, the director of the memory care home will give the family a warning, and if the behavior isn’t resolved, the patient may be asked to leave.

Before things get out of control, there are modalities that can be used to help calm things down. Please read Chapter 18 “Aromatherapy” in Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia by Barbra Cohn (see below) on how essential oils can immediately diffuse a tense situation. The book contains 19 other healing modalities that really do work.

In our case, the care facility wanted my husband to leave because he became too needy. Even though the director assured me that the facility would be able to take care of him to the end of his Alzheimer’s journey when I signed the contract for him to move in, that’s not what happened.

After Morris had surgery for a kidney stone, he was unable to walk or toilet by himself. He couldn’t do much of anything anymore. He stopped talking and couldn’t feed himself. The facility where he had been for two years refused to accept him back from the hospital. The hospital discharged him on a Friday afternoon and we had to scramble for a facility that would take him. It was stressful and the new facility was awful. I begged the home where he had been to take him back, and they agreed, but with a big caveat. I had to hire a care person to be with Morris one-on-one because the facility didn’t have the staff to give him the extra care that he needed.

We hired extra care, but the cost became prohibitive. I moved Morris for the third time in four weeks to a different facility that specialized in end-stage Alzheimer’s. It was the perfect decision. He died there two weeks later, after having compassionate end-of-life care.

If things hadn’t gotten so crazy, and my husband hadn’t deteriorated as quickly as he did, I would have called my ombudsman to help me communicate with the first memory care home’s director. Her refusal to take Morris back after his hospitalization was virtually the same as kicking him out, and it was contrary to what was promised when I signed the initial contract: that they’d care for him until the end.

Contact your ombudsman

If you have any similar issues, contact your ombudsman. An ombudsman is someone who advocates for the health, safety, and rights of individuals in long-term facilities (LTC), and ensures that the residents are protected by the standards required under the Nursing Home Reform Law of 1987. Under the federal Older Americans Act, every state is required to have an Ombudsman Program that addresses complaints and advocates for improvements in the long-term care system. 

Unlawful evictions are one of the major complaints that an ombudsman deals with. The ombudsman will

If you can’t resolve a conflict or your concerns with the director of the facility or are uncomfortable, you can contact your ombudsman to:

  • Investigate suspected abuse (mental, physical, and emotional) of your loved one
  • Review inadequate staffing or training that should meet the level of care expected and promised
  • Discuss and resolve grievances that you and the staff have
  • Learn about your options and legal rights

Who can use an Ombudsman?

  • Residents of any nursing home or board and care facility, including assisted living facilities
  • A family member or friend of a nursing home resident
  • A nursing home administrator or employee with a concern about a resident at their facility
  • Any individual or citizen’s group interested in the welfare of residents
  • Individuals and families who are considering long-term care placement

How do I contact my Ombudsman?

Residential care communities must post the area’s ombudsman program contact information and responsibilities. You can also search for your state’s ombudsman by visiting the Elder Care Locator website (eldercare.acl.gov) or contact the Alzheimer’s Foundation of America’s (AFA) Helpline – 866-232-8484.

What if my loved one is asked to leave because of aggressive behavior?

First, try to figure out why your loved one is acting out. Does s/he have a urinary tract infection? Is s/he in pain because of a tooth abscess? Have a physician do a complete physical exam to rule out pain. Your loved one may be unable to articulate what is bothering them.

Be on the lookout for bruises, bedsores, stomach upset, missing personal items such as eyeglasses, or anything else that may be the cause of a change in behavior. Is another resident walking into your loved one’s room accidentally? Is loud music being played in the dining room? What about community TV shows? Are they violent, disturbing, or too loud?

Sadly, residents who have behavior issues are often given medications to control their outbursts. Try everything you can before resorting to those. My husband was given a sedating drug at one point and he became catatonic. As soon as I ordered the doctor to take him off the drug, Morris quickly reverted to his usual, pleasant self. When he would start to show agitation, I’d plug in an aromatherapy diffuser with a blend of oils that immediately calmed him down.

Essential oils can 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 loved one’s collar or pillow. Find a fragrance that is pleasing to them.

It’s always in everyone’s best interest to try to solve things amicably. An attorney can help review your contract with the facility, especially when it comes to involuntary transfers and aggressive behavior. But hopefully, the situation won’t get to that point.

All the best to you in the new year,

Barbra

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.


How in the World Will I Pay for Long-term Caregiving?

Financial planning is an important factor in long-term caregiving.

Having a long-term caregiving plan is a must for family caregivers, especially if their loved one has Alzheimer’s disease or other chronic health conditions. In 2018, the Alzheimer’s Association estimated that the total lifetime cost of care for someone with dementia was  $341,840.

When we placed my husband in a memory care home in 2008, it cost roughly $6,000 a month, which covered a private room and extras like a weekly massage. Everything is more expensive today. The Alzheimer’s Association lists the following median costs for long-term care services in 2021. From what I’ve seen, the costs are typically higher on the East and West Coasts and lower in rural towns, and in the Midwest, the South, and western states.

  • Home care: A paid non-medical home health aide is $24 per hour and $960 per week (40 hours of care).
  • Adult day services: $74 per day.
  • Assisted living facilities: $4,300 per month or $51,600.
  • Private room in a nursing home: $290 per day or $105,850 per year.
  • Semi-private room in a nursing home: $225 per day or $93,075 per year. https://www.genworth.com/aging-and-you/finances/cost-of-care.html

What’s the difference between assisted living and a nursing home?

By the time a person with dementia is ready for a care facility, they need lots of assistance so it’s best to consider a home that offers memory care in a locked-down environment. Locked-down isn’t as bad as it sounds. It just means that the residents can’t leave the facility and wander off and get lost. The exterior doors are locked, but residents are usually free to roam the halls and go in and out of their rooms and living areas.

An assisted living home offers some care such as transportation to doctor appointments and help taking medications. And some offer designated living areas for people with dementia. But generally, residents in assisted living facilities are in fairly good health and are able to take care of their personal needs.

A nursing home provides medical care 24 hours a day. Meals are prepared by the staff, residents usually eat in a dining room, or in their own room, and care is provided ranging from help getting dressed and bathing, to rehabilitation from a fall or bone breakage.

People with dementia and Alzheimer’s disease are usually placed in memory care homes that cater to their particular needs. Memory care homes aren’t exactly nursing homes because not everyone with dementia has another physical illness. But the cost is comparable to that of a nursing home because of the amount of hands-on care that is needed, which includes bathing, brushing teeth and getting dressed, toileting, etc.

Consider respite care

Respite care provides short-term relief for primary caregivers. It can be a life savior when you’re at your wit’s end and “just can’t take it anymore.” There’s no need to feel guilty. All caregivers need a break in order to recharge, destress, and take care of their own needs—which is crucial to staying healthy.

Respite care can be provided at home, in a healthcare facility, or at an adult day center. It can be arranged for a few hours or for several days or weeks. For more information about respite care: https://www.nia.nih.gov/health/what-respite-care, https://archrespite.org/respitelocator

Financial help

As soon as you or a loved one is diagnosed with Alzheimer’s, or other dementia or chronic disease, make an appointment to see an elder attorney. They will inform you of your options and help with long-term planning.

For instance, in Colorado, in 2020, one month in a nursing home costs nearly $9,000. That’s more than $100,000 over the course of a year. Many elderly individuals spend down their life savings on nursing home costs so they can eventually qualify for financial assistance

If both spouses are living, and one of them is healthy, the healthy spouse can be left with little money on which to survive. An elder law attorney can help families avoid this unfortunate, but common, scenario.

The Community Spouse Resource Allowance is useful when there is concern the couple has too many assets to receive financial assistance from Medicaid to pay for long-term care. This particular allowance lets the healthy spouse keep a portion of the joint assets, up to $128,640 in 2020.

Another allowance, the Minimum Monthly Maintenance Needs Allowance, or MMMNA, lets a healthy spouse retain part of their ill spouse’s monthly income. ps://www.robinsonandhenry.com/colorado/estate-planning/medicaid-planning/?utm_term=&utm_campaign=&utm_source=adwords&utm_medium=ppc&hsa_tgt=&hsa_grp=&hsa_src=x&hsa_net=adwords&hsa_mt=&hsa_ver=3&hsa_ad=&hsa_acc=4376139444&hsa_kw=&hsa_cam=14487629423&gclid=Cj0KCQiAhMOMBhDhARIsAPVml-HXnbFv18MpGCumQd7lKb5xGoJ36cvPNwcdGqRFpgnWq63lYsSAYAkaAnCaEALw_wcB

If you plan to hire an elder attorney, please check reviews and ask for referrals for a competent elder attorney. Unfortunately, the elder attorney I hired made a mess of things for me and my family, and I had to hire an additional attorney to straighten things out.

Other options

• Call 800.827. 1000 or visit http://www.va.gov. In addition to Medicare, the person with dementia may qualify for a number of public programs. These programs provide income support or long-term care services to people who are eligible.

• Contact your local family and senior services office. They can provide you with information about help in the home, long-term care options, legal support, Medicare and Medicaid, public assistance benefits, services, and programs, guidance, and tips on accessing services, caregiver support training, and more.

• Contact your local Alzheimer’s Association for information about services and support groups. They offer classes for caregiving on everything ranging from financial planning to how to get your loved one to take a shower. https://www.alz.org/

Taking time for yourself

Caregivers get burned out if they don’t take some time off to recharge. And in the worst-case scenarios, caregivers end up being sick and having to be taken care of. If you don’t take care of yourself, who will take care of the person you were lovingly taking care of?

Here are links to a couple of articles I posted on this blog about ways that caregivers can achieve more peace and less stress. https://archrespite.org/respitelocator, https://barbracohn.com/2020/06/23/20-natural-remedies-for-depressed-caregivers-and-everyone-else/

Have a safe, satisfying, and stress-free (as much as possible) Thanksgiving. And please take a little respite time for yourself, even if that entails just walking around the block for 30 minutes.


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 care partner driving you nuts?

Stressed caregiver

It’s hard to maintain equanimity and patience when your care recipient is constantly repeating him/herself. Of is following you around the house like a puppy dog. Or is accusing you of “stealing” their wallet, or is getting up several times during the night so you’re unable to get the sleep you need for your own health and in order to take care of them without losing your cool.

When I couldn’t handle my husband’s early stage Alzheimer’s behavior, I’d simply leave the house and walk around the block. But as the disease progresses and it isn’t safe to leave your care partner alone in the house, that’s not always possible.

Here are 16 things that might help you keep your sanity, and your care partner’s too. 

  1.  Simplify communication by asking one question at a time. Break down complex ideas, and give only one choice, i.e. when helping your care partner get dressed simply ask “Do you want to wear the blue or green shirt?” Don’t ask open-ended questions. Ask questions with yes or no answers, if possible.
  2. Before speaking, make sure the television, radio, and music are turned off. Look directly in the eyes of your care partner. Use their name and maintain eye contact.
  3.  Provide a gentle physical touch. Just stroking someone’s arm, shoulders or head can reduce agitation.
  4. Put on soothing music. Or, if your care partner loves dance music (Big Band or Rock n/Roll, Latin), turn up the volume and dance!.
  5. Reduce or avoid use of caffeine, sugar, tobacco and alcohol.
  6. Reduce clutter, noise, and the number of visitors.
  7. Bring out the family photo albums to help the person reminisce about happier times. They may not remember what they ate 30 minutes ago, but chances are they will remember special events from the past.
  8. Go for a walk together, or drive to a park where you can sit together and watch children play, or the ducks swim in a pond.
  9. Schedule a relaxing massage for both of you. It will do you good!
  10. Ice cream works like magic. Go for a drive to your favorite ice cream shop.
  11. If your care partner accuses you of stealing their money, let them keep a small
    amount of money in a wallet. When they make an accusation, simply pull out the
    wallet to show them the money is still in there. In case they hide the wallet
    and you’re unable to find it, have a spare one on hand that looks identical to
    the original one.
  12.  If you need to bring your care partner to an appointment, leave plenty of
    extra time for getting dressed, eating, moving from the house to the car, etc.
    If you feel rushed and stressed, they will pick up on your feelings and start
    mirroring them.
  13. 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.
  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.
  15. Get help! Hire someone to come in a couple of times a week so you can get out of the house. If your budget doesn’t allow it, contact your county’s area agency on aging or senior care services agency for information about respite care.
  16.  When all else fails, maintain your sense of humor. Towards the end of my husband’s
    10-year Alzheimer’s journey, for some reason, we both shared a lot of
    meaningless laughs, probably because the whole damn journey was so exhausting
    for both us and what else was there to do? I had already shed more tears than I
    had in all the years leading up to the diagnosis.

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.

I’m a little worried about my memory

Woman forgot to pick her granddaughter up from preschool.

Yesterday I had my annual wellness exam. It was the first time that my doctor asked me if I had any memory concerns. It made me sit up straight and realize that I am definitely in the age group of people who start showing signs of mild cognitive impairment. I nodded or shook my head in response to her questions and then said, “When I walked into my bedroom the other door I completely forgot why I had gone in there. My little granddaughters were playing hide and seek and when I said, ‘I don’t know why I came in here,’ they looked up at me confused and wondered why I was acting a little strangely.'”

Was I concerned? Yes, a little. I’ve done that before, but this time I was frozen for a few seconds. And actually, lately I’ve noticed that my spelling isn’t as sharp as it used to be. Neither is my long-term memory.

I’m even more concerned because I took the MindCrowd test, a short memory test in which you need to read and memorize 12 pairs of words. https://mindcrowd.org/?gclid=CjwKCAjwo4mIBhBsEiwAKgzXOEWhBjIHYSm0c42NvHNYAb2HDr6sMLfSCYjOc-zYq4D7-5FkW6mSmBoC-OIQAvD_BwE You’re given one word and asked to complete the pair, before the screen moves rather quickly to the next pair. To be honest, I didn’t do very well, and I was a little nervous while I was taking the test. It was more difficult for me than the Mini Mental Exam, which is given to people who are evaluated for Alzheimer’s disease.

As I said to my doctor, I know I don’t have Alzheimer’s disease. I’m kind of an expert on the disease and symptoms because I cared for my husband who had younger-onset Alzheimer’s disease for 10 years. And I wrote a book about our journey. https://www.amazon.com/Calmer-Waters-Caregivers-Alzheimers-Dementia/dp/1681570149/ref=sr_1_2?dchild=1&gclid=CjwKCAjwo4mIBhBsEiwAKgzXOHgn8mAm0UZQiBHyTLv7S_v_CYHJ-ruG_G0MyWUNV9myn59vmJfbvxoCuFAQAvD_BwE&hvadid=241894911837&hvdev=c&hvlocphy=9028817&hvnetw=g&hvqmt=e&hvrand=18354321622967658254&hvtargid=kwd-23474874821&hydadcr=22532_10344436&keywords=calmer+waters&qid=1627596739&sr=8-2

But I, and lots of my girlfriends, are somewhat concerned that we’re developing mild cognitive impairment. Should we be worried?

Here’s what I know

Approximately 12-18% of people age 60 or older are living with Mild Cognitive Impairment (MCI).

Researchers have found that more people with MCI than those without it go on to develop Alzheimer’s disease or a related dementia. An estimated 10 to 20% of people age 65 or older with MCI develop dementia over a one-year period.

MCI is more common in men (19 percent) than in women (14 percent), according to a 2010 study in the Neurology. https://www.nia.nih.gov/news/mild-cognitive-impairment-more-common-older-men-older-women

  • MCI prevalence was higher among people with the APOE e4 gene, a known risk factor for late-onset Alzheimer’s, a form of the disease that usually occurs at age 65 or older.
  • A greater number of years spent in school was significantly associated with decreased MCI prevalence, from 30 percent among participants with less than nine years of education to just 11 percent in those with more than 16 years of education.
  • MCI prevalence was higher in participants who never married, as opposed to those currently or previously married.

Signs of cognitive decline

  • Forgetting appointments and dates.
  • Forgetting recent conversations and events.
  • Feeling increasingly overwhelmed by making decisions and plans.
  • Having a hard time understanding directions or instructions.
  • Losing your sense of direction.
  • Losing the ability to organize tasks.
  • Becoming more impulsive.

I don’t forget appointments, but I do forget events that occurred in the past decade or so. But then again, I’m good at remembering details about many events that others don’t remember. I typically don’t get overwhelmed about making decisions and plans. But then again, I had tons of work this summer and did get a little overwhelmed. I don’t have a hard time understanding directions, unless it’s something like installing a toilet or putting together a new machine, which I will gladly leave for my handyman. I rarely lose my sense of direction, but then again, it’s not as acute as it once was and I do get turned around while hiking sometimes. I never have trouble organizing tasks. In fact, I often multi-task. I am not typically impulsive.

What happens physically to the normal aging brain?

The brain changes more than any other part of the body. Yes, even more than our complexion that withers and wrinkles. Physically, the frontal lobe and hippocampus, the areas involved in higher cognitive function and encoding new memories starts to shrink around age 60 to 70. Fewer synaptic connections are made, which may contribute to slower cognitive processing. White matter, consisting of myelinated nerve fibers that carry nerve signals between brain cells, shrinks, and neurotransmitters that play a role in cognition and memory deceases.

Normal brain aging

  • Difficulty learning something new: Committing new information to memory can take longer.
  • Multitasking: Slowed processing can make planning parallel tasks more difficult.
  • Recalling names and numbers: Strategic memory, which helps with remembering names and numbers, begins to decline at age 20.
  • Remembering appointments: Without cues to recall the information, the brain may put appointments into “storage” and not access them unless something jogs the person’s memory.

So what do I think? Am I developing MCI? I certainly hope not, and I really don’t think so. I spend a lot of time using my cognitive skills. I’m a writer, and am at my best while sitting at the computer writing words. But my memory is definitely not what it used to be, nor is it as good as my mother’s was when she was well into her 80s. But I take ginkgo, phosphatidylserine, B vitamins, and Lion’s mane mushroom, and I know they help because when I don’t take them, my mind is fuzzy. I’m not going to worry, because worrying does no good but add stress. But I will continue to eat a plant-based Mediterranean diet, which is proven to stave off premature aging, and try to get enough sleep and exercise

P.S. I repeated the MindCrowd test and scored really well!

P.P.S. No, I never forgot to pick up my granddaughter from preschool. 🙂

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.

If you suspect that you or a loved one has Alzheimer’s, you need to read this.

June is Alzheimer’s and Brain Awareness Month. If you suspect that you or a loved one might have Alzheimer’s disease, here’s what you need to know.

After decades of not making progress with pharmaceuticals for Alzheimer’s disease, researchers are finally coming up with some promising results. There’s a brand new blood test for the disease that you can take instead of going through a series of expensive and sometimes painful tests. And there’s a brand new drug that delays cognitive decline in early stage Alzheimer’s. We still don’t have a cure, but there are a number of clinical trials that someone diagnosed with Alzheimer’s can enroll in.

Why it’s important to get diagnosed early

For a full explanation, click here to read a blog I posted August, 20202. https://barbracohn.com/blog/page/2/

Here are the bullet points:

  • Cognitive problems can be caused by a number of physical conditions.
  • Cognitive symptoms may be reversible.
  • An early diagnosis is empowering as far as estate planning, and end-of-life planning, etc.
  • An early diagnosis is easier for the physician to make when the patient is able to answer questions.
  • Family and loved ones might be confused by particular behaviors which will be explained.
  • An early diagnosis allows individuals to take advantage of support groups, and caregivers to learn ways to better manage medications, the environment, etc.
  • Getting an early diagnosis provides the opportunity to enroll in a clinical trial.
  • The patient can prioritize what is important to them while they are still able to make decisions.

What new tests are available to detect Alzheimer’s?

PrecivityAD is the first blood test for Alzheimer’s to be cleared for widespread use and one of a new generation of such assays that could enable early detection of the leading neurodegenerative disease—perhaps decades before the onset of the first symptoms. The test uses mass spectrometry to detect specific types of beta-amyloid, the protein fragment that is the culprit in Alzheimer’s disease. As plaques in the brain build up, levels of beta-amyloid decline in the surrounding fluid. The levels can be measured in spinal fluid samples. The new blood test can determine where beta-amyloid concentrations are significantly lower. PrecivityAd is designed to be used for people 60 to 91 years old with early signs of cognitive impairment.

How it works

  • Your doctor orders the PrecivityAd blood test and schedules a blood draw appointment.
  • Your blood sample is sent to the lab for analysis by mass spectrometry.
  • Your doctor receives the report and discusses the results with you.

How much does it cost?

The test costs $1,250. Since it is new and is not currently covered by private insurance, Medicare or Medicaid, patients must pay out-of-pocket for the test. A six-month interest-free payment plan is available, and a financial assistance program is available for patients who medically and financially qualify. The assistance program can bring the costs down to between $25 and $400 for eligible patients.

Other causes for memory issues

One benefit of the PrecivityADTM blood test is that if Alzheimer’s markers
are not detected, additional costly tests may be avoidable and your physician can explore other causes for memory and cognitive issues. Other causes for memory issues include: hypothyroidism, head trauma or injury, certain medications or a combination of medications, emotional disorders, depression, strokes, amnesia, alcoholism, vitamin B012 deficiency, hydrocephalus, brain tumors, and other brain diseases.

New drug for delaying symptoms

The FDA recently approved a new drug for Alzheimer’s. Aducanumab isn’t a cure, but it’s the first drug to get this far in an approval process that actually modifies the underlying pathology of the disease, and helps delay cognitive decline in early stage Alzheimer’s. Read about it in my last post. https://wordpress.com/post/barbracohn.com/6470

Clinical research studies for people with early symptomatic Alzheimer’s

The objective of a clinical research study is to answer questions about the safety and effectiveness of potential new medications. These studies have to be completed before a new treatment is offered to the public. There are currently more than 3000,000 clinical studies taking place throughout the world.

For those who are qualified, taking part in research studies offers several benefits:

  • Getting actively involved in their own health care
  • Having access to potentially new research treatments 
  • Having access to expert medical care for the condition being studied, since investigators are often specialists in the disease area being studied
  • Helping others by contributing to medical research

One way to find information about clinical trials is by searching this website: http://www.clinicaltrials.gov. ClinicalTrials.gov is an interactive online database, managed by the National Library of Medicine. It provides information about both federally and privately supported clinical research. ClinicalTrials.gov is updated regularly and offers information on each trial’s purpose, who is qualified to participate, locations, and phone numbers to call for more information.

The Alzheimer’s Association also has a service called TrialMatch that provides customized lists of clinical studies based on user-provider information. The free, easy-to-use platform allows you to see which studies are a good fit for you or a family member.
Visit TrialMatch
. You can also call 800.272.3900 or email TrialMatch@alz.org to get started. You’re under no obligation to participate. You can reach out to researchers directly to sign up, or let researchers know that you are open to being contacted with more information about their study. You can also browse available clinical studies by location and type, or sign up to be notified when new studies are posted that are relevant to you.



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.

New drug cites a 22% reduction in cognitive decline in early stage Alzheimer’s.

The FDA hasn’t approved a new drug for Alzheimer’s disease in more than 17 years. It looks like that is about to change. Aducanumab isn’t a cure by any means, but it’s the first drug to get this far in an approval process that actually modifies the underlying pathology of Alzheimer’s, and helps delay cognitive decline in early stage Alzheimer’s.

How does Aducanumab work?

Amyloid-beta is a protein that is normally present in the brain. In the Alzheimer’s brain the abnormal levels of the protein clump together to form amyloid plaques. Researchers think that these clumps lead to brain cell death.

Aducanumab is a monoclonal antibody that targets amyloid-beta.

Researchers developed it using Neurimmune’s proprietary Reverse Translational Medicine Platform. Neurimmune scientists discovered Aducanumab with a team of researchers at the University of Zurich. The human antibody targets the aggregated amyloid-beta. Through this interaction, Aducanumab could reduce the number of amyloid plaques present in the brain. This ultimately may slow neurodegeneration and disease progression.

Aducanumab in clinical trials

In 2007, Neurimmune licensed the exclusive rights to Biogen, which sponsored several clinical trials investigating Aducanumab in humans. Together, Neurimmune’s and Biogen’s scientists published a study in Nature 2016 that described how one year of monthly intravenous infusions of Aducanumab reduces brain beta amyloid in a dose- and time-dependent manner in patients with pre-dementia or mild Alzheimer’s disease. 1https://www.nature.com/articles/nature19323

The history of the clinical trials of Aducanumab is confusing. If you want to read the details about the trials continue reading. If you want the bottom line , scroll down and read from *But Biogen reversed course and decided to continue the trials.

On March 21, 2019, the manufacturer (Biogen) announced it had ended two Phase 3 clinical trials of Aducanumab for Alzheimer’s. The drug had failed a “futility analysis,” which means a clinical trial is stopped when the interim results suggest that it is unlikely to achieve statistical significance.1

But then just five months later, Biogen announced that they were applying for FDA marketing approval. They explained that data gathered in the three months between the start of the futility analysis and the decision to end the trial hadn’t been used in the original analysis. After adding the additional three months of data, they realized that a subset of patients who had been given higher doses saw significant benefits on measures of cognition and function, including memory, orientation and language. Those patients also saw benefits in daily living activities.2

The OptumRx Pipeline Surveillance team observed that despite the positive reported outcomes, Aducanumab has only demonstrated a statistically significant improvement in one of the two pivotal trials. Further, in the one positive trial, the reported improvements were small, and the true clinical relevance of the findings remain uncertain.

Researchers have completed three Phase 1 trials. These were assessing Aducanumab in healthy volunteers (NCT02782975) and in Alzheimer’s disease patients in the U.S. (NCT01397539) and Japan (NCT02434718).

A fourth, randomized, double-blind, and placebo-controlled Phase 1 trial (NCT01677572), PRIME, enrolled 192 pre-dementia and mild Alzheimer’s patients at 32 sites in the U.S. The goal was to assess the safety and effect of different aducanumab doses versus a placebo on amyloid plaques. Researchers measured this with positron emission tomography imaging.

Interim results from the first 165 patients showed that all doses of Aducanumab (given as monthly infusions into the bloodstream) significantly reduced amyloid plaques in the brain in a time- and dose-dependent manner. During the first year, 40 patients from both groups discontinued treatment. Little to no change was apparent in the placebo group after one year. The greatest reduction was present at higher doses. Aducanumab also appeared to slow the rate of cognitive decline. Researchers measured this as a change in the clinical dementia rating sum of boxes (CDR-SB) and the mini-mental state examination (MMSE).

They presented results from a long-term extension of the PRIME trial at the 2017 Clinical Trials on Alzheimer’s Disease meeting. In total, 143 patients from the initial trial opted to continue in the long-term extension study, where all patients received Aducanumab. This included data from patients who had been on Aducanumab for up to three years. During this time, patients who received Aducanumab continued to experience a time- and dose-dependent reduction in amyloid plaque levels.

Biogen also began two large-scale randomized, double-blind, and placebo-controlled Phase 3 clinical trials in people with early-stage Alzheimer’s disease. The first trial, called ENGAGE (NCT02477800), aimed to enroll 1,350 patients at 187 sites in North America, Australia, Europe, and Asia. The second trial, called EMERGE (NCT02484547), also sought to enroll the same number of patients at 194 sites in North America, Europe, and Asia.

The goal of both trials was to assess the efficacy of Aducanumab, given once a month at low and high doses by infusion into the bloodstream. Researchers measured the effectiveness of the treatment by changes from the start of the study in the CDR-SB, MMSE, Alzheimer’s disease assessment scale-cognitive subscale 13 items (ADAS-Cog 13), and Alzheimer’s disease cooperative study-activities of daily living inventory mild cognitive impairment version (ADCS-ADL-MCI) scores over a 78-week period. They had expected to complete the trials in 2022.

The company halted the trials because an independent data monitoring committee found that they were unlikely to meet their primary objective. This was based on initial data from the trials and not on safety concerns. Follow-up visits and closing-out activities for both trials are now complete.

The Phase 2 EVOLVE trial (NCT03639987) began in late 2018 to evaluate the safety of continued dosing of Aducanumab in participants with mild cognitive impairment due to Alzheimer’s disease or with mild Alzheimer’s disease dementia. This trial also was halted in March 2019 as a result of the committee’s findings.

*But Biogen reversed course and decided to continue the trials.

later analysis based on additional follow-up data, showed that EMERGE met its primary goal. Patients receiving the highest dose of Aducanumab experienced a significant reduction in the progression of cognitive and functional impairments. Although ENGAGE failed to meet its primary goal, Biogen stated that data from the sub-group of patients who had sufficient exposure to the medication also showed significant benefits. These and other supportive findings formed the basis of the company’s BLA (Biologics License Application) submitted to the FDA requesting the approval of Aducanumab for the treatment of Alzheimer’s disease.

In August 2020, Aducanumab was granted priority review by the FDA, meaning that the agency plans to expedite the review process to determine whether they will approve the medication. 

Are there any negative side effects from taking Aducanumab?

Researchers said a majority of the test subjects taking Aducanumab showed no negative side effects. In some cases, however, patients experienced swelling in the brain called “amyloid-related imaging abnormalities” (ARIA) and headache.

How is the drug administered?

Intravenous doses of Aducanumab are given about 4 weeks apart over approximately 52 weeks for a total of 14 doses. Qualifying patients can continue into the long-term extension at a dose approximately 4 weeks apart for up to an additional 112 doses.

When will Aducanumab become available?
The FDA process for reviewing applications for approval, called New Drug Applications or NDAs, usually takes around 10 months. Biogen has said the Aducanumab application has about 4,500 files with more than 2.5 million pages of data and information. Biogen believes a decision will be made by June 7, 2021. Though the FDA would continue to monitor the effects of the drug, to ensure no unexpected side effects from prolonged usage, after approval the drug can be made available widely. People with Alzheimer’s disease may have a new medication to take soon.

How much will it cost?

Aducanumab is expensive, with the annual cost projected to be around $50,000 for the recommended dosage, based on one infusion per month. Even if the drug is approved by the FDA, the Centers for Medicaid and Medicare Services can determine for themselves how much Medicaid and Medicare will cover Aducanumab if the cost is high. PET brain scans to detect amyloid beta plaques would probably be necessary to determine aducanumab coverage, and those are expensive as well.

Where can I buy it?

I ordered Memantine for my husband from Europe before it was available in the U.S. India manufacturers provide many of the drugs sold in the U.S. I found this website for an Indian Pharmaceutical company which sells Aducanumab throughout the world. https://indianpharmanetwork.co.in/buy-aducanumab.php

The problem, of course, with buying Aducanumab from an Indian pharmacy is that you’d have to find a doctor who is willing to administer it intravenously. Since it is expected to be approved this summer, it’s probably more prudent to wait until you can get it prescribed by your doctor. But keep in mind that you might be able to save money by ordering it from India even after it is approved by the FDA.

Although Aducanumab isn’t a cure for Alzheimer’s, it is the first drug that is showing some promise for providing more time to individuals with this insidious disease.

References

  1. The Lancet. A resurrection of aducanumab for Alzheimer’s disease. Published December 4, 2019. Accessed January 7, 2020.
  2. Bio Space. Biogen Alzheimer’s Plans Met with Hope, Some Skepticism. Published: December 6, 2019. Accessed January 7, 2020.

20 Ways to prevent falls in Alzheimer’s patients

Woman falls on slippery bathroom floor.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

20 Tips for preventing falls

  1. Have adequate lighting throughout the house; place night lights in the bedroom and bathroom.
  2. Limit liquids after dinner to reduce night-time toileting.
  3. Get adequate sleep.
  4. Remove loose area rugs.
  5. Wear gripping socks, sturdy slippers, or shoes in the house.
  6. Avoid unsafe shoes, i.e. flip flops and high-heels.
  7. Place guardrails where needed.
  8. Stand up slowly.
  9. Use a walker or cane for steadiness.
  10. Declutter and remove excess furniture.
  11. Implement an exercise program to support muscle strength, stability, and balance.
  12. Use a “reach stick” to grab out-of-reach items.
  13. Do not use a step ladder.
  14. Eliminate or reduce alcohol and smoking.
  15. Be wary of medications that cause dizziness, sleepiness, and unsteadiness.
  16. Be attentive to pain management.
  17. Be aware of where your pet is to avoid tripping.
  18. Get adequate calcium and vitamin D to maintain bone health.
  19. Maintain a healthy weight.
  20. Get regular vision and hearing check-ups.
Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

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

Man resting in garden with his dog

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

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

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

Pets offer numerous benefits

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

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

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

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

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

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

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

Pets can:

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

Things to consider

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

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

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