How would you rate yourself as a caregiver?

It’s been 12 years since my husband passed away from younger-onset Alzheimer’s disease. Even now ask myself if I could have done more for him. I still have guilt, even though I saw a therapist for the last three years of his life who said to me, “If a friend were telling you what you’re telling me, what would you say to her?”

I’d tell her, “You’re doing the best that you can.” My therapist nodded his head and reminded me that I was doing the very best that I knew how, and physically was able to.

I was pragmatic and philosophical about my husband’s Alzheimer’s. I was really good about taking him to his doctor appointments and utilizing every complementary healing modality that was available, such as acupuncture, massage, and even some pretty far-out techniques which I don’t even remember the name of. We hired gentle-touch practitioners, psychic healers, and astrologers. You name it. We tried them all. I even bought an expensive stress-reducing massage bed that emits infrared light and has jade balls that massage the spine by riding from the neck to the ankles.

Did these modalities help? I think so. They certainly helped reduce the stress that we both felt. Did they delay the symptoms of Alzheimer’s? Probably not, but my husband outlived his prognosis by two years, according to his doctor, so I have to believe that a good diet, nutritional supplements, and the support of loving friends and family played a huge role.

Yet, still, I think there were a few things I could have done better. I could have worked harder to acknowledge Morris’s reality. By that I mean I could have done a better job of redirecting him when he got anxious or worried. I realize that it’s easier to say this now, more than a decade after he died. But I wish I had more skill and practice in switching the topic from his obsession about having his car keys taken away, or his discomfort when I’d take him for a ride in the car and he’d complain about every bump in the road.

I wish I had shown him more affection by holding his hand or rubbing his shoulders. I actually told him one day at the breakfast table that I could not have an intimate physical relationship with him anymore because I felt more like his mother than his wife. This is a hard thing for me to admit, and I feel so sad that I said this to him. The reason I’m writing it here is to tell you that you don’t have to be 100% honest with what you express to the loved one you are caring for. It’s okay to withhold things because if your loved one has dementia s/he is already having difficulties processing normal everyday activities. There’s no need to get into a deep philosophical discussion or one in which you have to express what you are going through. Create a time and space for that to happen with a dear friend or a therapist.

If you feel guilty or are unsure of whether you’re doing enough ask yourself these questions:

  • Do you feel that you aren’t doing enough for your care recipient? Make a list of everything you do for the person you care for. Preparing a meal, shopping for groceries, driving to appointments, making a bed, doing laundry, making a phone call, sitting next to the person, even just giving a hug: the list adds up! You are doing a lot more than you think you are!
  • Are you guilty about your negative feelings? Resentment, anger, and grief are all normal. They are just feelings and they aren’t wrong. Feelings are complicated and you are entitled to them. You probably love the person you are caring for but the time you spend is precious and you might rather be outside gardening or hiking or traveling.
  • Do you feel bad about taking time for yourself? Don’t! If you don’t stay well, including eating and sleeping well, there’s a good chance you will get sick. And that is not going to help anyone! Please take some time for yourself. If you are a full-time caregiver, at least take a 15-minute walk every day. Get some respite care. Your local county social services department can most likely provide you with some options for help.
  • Are you feeling inadequate at a caregiver? The Alzheimer’s Association offers free classes on caregiving. “The Savvy Caregiver” is an excellent five-session class for family caregivers. It helps caregivers better understand the changes their loved ones are experiencing, and how to best provide individualized care for their loved ones throughout the progression of Alzheimer’s or dementia.
  • Tips for easing guilt
  • Ask yourself what is bothering you. Talk with a close friend who will not judge you, or with a professional therapist, clergyperson, spiritual teacher, or intuitive guide. Talk about your guilt until you feel your body release the tension that is stored in your muscles and cells.
  • Remember that you are human and not perfect. No one expects you to perform with absolute clarity and grace all the time.
  • You cannot control everything all the time. You are doing the best that you can with the information, strength, and inner resources that you have.
  • Have an “empty chair” dialogue by speaking out loud and pretending that your care partner is in the chair next to you. Express your feelings openly and wholeheartedly. Ask for forgiveness if you feel that you wronged your loved one in any way.
  • Write down your thoughts and feelings. 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.
  • Strong feelings of guilt, remorse, and grief will diminish over time.  If they continue to haunt you, seek professional help.

I’m still working–on forgiving myself for not being the perfect caregiver. I’m not overwhelmed by it, and I’ve recreated a wonderful, fulfilling life for myself. But I remember my therapist’s words, “You’re doing the best that you can.” I know I did, and that just has to be good enough.

The Alzheimer’s Association offers programs especially designed to benefit people caring for a family member or friend living with dementia by providing more understanding and tools to help navigate the journey. For more information contact 800-272-3900, alz.org.

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.

Cataract surgery reduces dementia risk

It seems that almost all my friends are needing cataract surgery. And that’s probably a good thing. Because studies are indicating that cataracts increase your risk of developing dementia.

What is cataract surgery?

Nine in ten people develop cataracts by the time they’re 65, and an estimated 2 million (mostly older) Americans get cataract surgery every year.

A cataract is an opacification or clouding of the natural lens of the eye. The surgery involves the removal of the lens and replacement with an intraocular lens or artificial replacement for the lens of your eye. It’s considered one of the safest, most effective, and most common procedures performed today.

Research shows a link between vision loss and dementia

A recent study in JAMA Internal Medicine analyzed the relationship between cataract surgery and the risk of developing dementia. The researchers discovered that people who had cataract surgery had a 29 percent lower risk of developing dementia when compared to people who didn’t have the surgery. https://pubmed.ncbi.nlm.nih.gov/34870676/

The research also found that glaucoma did not affect the risk of dementia.

How does cataract removal protect brain health?

  • Cataracts can reduce vision, which may lead to depression. Depression is a risk factor for dementia.
  • One study found that the integrity of the eye is essential for the structure and function of the brain. “Cataract patients often present with accelerated age-related decreases in brain function, but the underlying mechanisms are still unclear.” https://pubmed.ncbi.nlm.nih.gov/29548900/ Vision impairment can lead to reduced sensory input to the brain, and this leads to less brain stimulation and loss of brain function.
  • People who have vision loss may be less engaged in physical activity and social interaction. This can lead to an increased risk of dementia.

Ways to help prevent cataracts

  • Eat a Mediterranean-based diet including foods that are high in vitamin C, vitamin E, lutein and zeaxanthin. Low levels of lutein and zeaxanthin are associated with cataracts, whereas higher levels help to reduce the risk of developing cataracts.
  • Lutein and zeaxanthin are carotenoids and are found in spinach, Swiss chard, kale, parsley, pistachios, green peas, egg yolks, sweet corn, and red grapes. They are best absorbed when eaten with a healthy fat such as olive oil or avocado.
  • Wear sunglasses to protect your eyes from UV rays.
  • Quit smoking. Smoking increases the free radicals superoxide and hydroxyl radicals that damage the lipids and proteins in the eyes. This causes deposits to form on the lens of the eyes and leads to cataract formation.
  • Maintain healthy blood sugar levels. People with diabetes are more likely to develop cataracts.
  • Restrict consumption of alcohol, which can increase the risk of cataracts by increasing the body’s inflammatory response, free radical production in the eyes, and dehydration. Dehydration affects the proteins in the lens of your eyes.
  • Get regular eye exams.

Get more bang for your buck

If your eye doctor is suggesting that you have surgery to remove cataracts, do it sooner than later. Because cataract surgery will not only sharpen your vision, it may very well sharpen your mind.

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.


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.

How to increase GABA, your brain’s calming chemical

Everyone is stressed out these days. But caregivers are dealing with pandemic stress on top of normal caregiving stress. And if you live in the West, you may be dealing with the stress of being evacuated because of wildfires, or smoke that is hampering your ability to breathe. Ask yourself this:

Are you feeling stressed and burned out?

Are you unable to relax or loosen up?

Do you feel stiff? Are your muscles tense?

Do you have a hard time falling asleep because your mind keeps racing?

If you answered yes, you could use of a boost of GABA.

What is GABA?

Gamma-Aminobutyric acid (GABA) is an amino acid that is produced in the brain and acts as a neurotransmitter, communicating information throughout your brain and body. GABA inhibits nerve cells from firing, and helps us to feel balanced, calm and relaxed.

GABA also:

  • Reduces mental and physical stress
  • Reduces anxiety
  • Eases muscle tension
  • Creates a calm mood
  • Supports balanced blood pressure
  • Promotes restful sleep
  • Regulates muscle tone
  • Uplifts mood

What are neurotransmitters?

Neurotransmitters are the brain chemicals that communicate information throughout your brain and body. The brain uses neurotransmitters to tell your heart to beat, your lungs to breathe, and your stomach to digest. They can also affect mood, sleep, concentration, weight, and can cause adverse symptoms when they are out of balance. Neurotransmitter levels can be depleted many ways. It is estimated that 86% of Americans have suboptimal neurotransmitter levels. Stress, poor diet–protein deficiency, poor digestion, poor blood sugar control, drug (prescription and recreational), alcohol and caffeine can deplete them. (Emmons, The Chemistry of Joy, 2006).

What depletes GABA?

Too many carbs and refined foods, and certain drugs and medications deplete GABA. If you rely on tobacco, marijuana, alcohol, Valium, sweets or starch, you probably have a GABA imbalance

A GABA deficiency often results in:

  • High anxiety, panic, worry
  • “Monkey mind” or a racing mind.
  • Difficulty falling and staying asleep

5 Ways to Boost GABA

  1. Eat these foods

The best foods for helping your body produce GABA, according to a May 2018 review published in Nutrients, include:

  • Cruciferous vegetables (broccoli, cabbage, cauliflower, Brussels sprouts)
  • Soy beans
  • Adzuki beans
  • Mushrooms
  • Spinach
  • Tomatoes
  • Buckwheat
  • Peas
  • Chestnuts
  • Sweet potatoes
  • Sprouted grains
  • Rice (specifically brown rice)
  • White tea

Fermented foods including kefir, yogurt, tempeh, sauerkraut, kimchi, and pickles help increase GABA levels. These foods may also boost GABA: whole grains, fava beans, soy, lentils, and other beans; nuts including walnuts, almonds, and sunflower seeds; fish including shrimp and halibut; citrus, tomatoes, berries, potatoes, and cocoa.

2. Meditation and yoga have a positive effect on GABA levels.

3. Passion flower, lemon balm and valerian help support GABA, and help you fall asleep if your mind is on overdrive. Infuse them in hot water for a soothing herbal tea.

4. Nutritional supplements support GABA. Make sure you let your physician know which supplements you take, since some may interfere with medications.

L-theanine is a relaxing amino acid found in green tea. It’s available as a nutritional supplement, or get it by drinking green tea.

Magnesium is the most important mineral for the heart, It supports healthy blood pressure, decreases food cravings, balanced blood sugar, nourishes and calms the nervous system, and protects the body from damage of stress. Besides food, Epsom salt baths are another way of getting magnesium–absorbed through the skin. Magnesium is found in dark, leafy greens, dark chocolate, avocados, nuts, legumes, tofu, seeds, whole grains, bananas, and some fatty fish.

Taurine is an amino acid that activates GABA receptors and encourages the release of GABA. It is found in dairy food, shellfish, and the dark meat of turkey and chicken. It is also taken as a dietary supplement.

GABA is available in amino acid from as a dietary supplement. It is questionable, however, if it is able to cross the brain barrier.

5. Exercise, and being outdoors, paying attention to your personal needs are important.

How to boost all your neurotransmitters

  • Eat a serving of high-quality protein with every meal and snack. Focus on complex carbohydrates, and eliminate junk foods (refined carbs).
  • Enjoy unlimited amounts of fresh veggies.
  • Eat a good breakfast!
  • Eat 3 balanced meals and 1-2 healthy snacks per day.

Complex carbohydrates, such as sweet potatoes, brown rice or oatmeal, allow your brain to gradually process more serotonin, the neurotransmitter that keeps us happy. Eating protein and healthy omega-3 fats, found in fish, walnuts and flax, will also improve mood. B vitamins, which are abundant in fresh leafy greens and in chemical-free, pasture-raised meat, are another important factor because they’re needed for serotonin production.

For more information about how to prevent caregiver burnout and ways to boost your neurotransmitters, visit: https://barbracohn.com/2019/07/03/preventing-caregiver-burnout-with-good-nutrition-and-foods-that-support-neurotransmitters/

Recommended Reading

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

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

Confused woman at home alone

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

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

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

Keep your care partner safe from wandering

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

Here are some ways to reduce this risk.

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

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

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

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

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

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

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

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

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

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

Care for the caregiver

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

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

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

Be safe. Be well. Take care.

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

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

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

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

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

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

How can you help your loved one?

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

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

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

sea stones painted by the children on the beach

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

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

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

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

*Fold towels, washcloths and hand towels, socks.

*Sort coins.

*Paint with water.

*Make potholders with a child’s loom.

*Rake leaves.

*Weed flower beds.

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

*Play bingo.

*Go for a ride.

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

*Dust and polish the furniture.

*Cut out photos from magazines and make a collage.

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

*Listen to audio books.

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

*Color in coloring books.

*Plant an inside herb garden.

*Lace cards.

*Set up a bird feeder outside the window.

*Set up an aquarium.

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

*Look for rocks and then paint them.

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

Art Therapy

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

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

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

  1. Making an Inside/Outside Box

Materials:

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

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

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

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

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

  1. Daily or Weekly Mandalas

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

Materials:

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

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

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

  1. Color-Texture-Pattern Feelings Portrait

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

Materials:

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

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

Materials:

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

Materials:

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

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

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

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

6. Process: Breath Drawing

Materials:

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

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

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

Why it’s important to get an early diagnosis when cognitive problems appear

Doctor talking with patient

There were several indications that something was wrong with my husband two years before he was diagnosed. This tall, good-looking man, a graduate of the Wharton School of Business at the University of Pennsylvania, was having trouble calculating how much tip to leave a waitress. When we went to Spain for our twenty-fifth anniversary, Morris couldn’t figure out how much money the hotel would cost in dollars. This man, who once memorized trains and airplane schedules without even trying, followed me around the city like a puppy dog as we boarded a subway or bus enroute to tourist attractions.

That following fall — our daughter’s last year in high school — Morris couldn’t give directions to a friend who was taking the SAT at the high school my husband had attended. I got out the map to help him, but he couldn’t read the map. That was the moment I knew something was very wrong. When he left for a road trip to California without our son and forgot his suitcase, I sat on the stairs and cried. I couldn’t deny it any longer. I had a strong suspicion that Morris had Alzheimer’s disease, and although I pleaded with him for two years to see a neurologist, he refused.

What if he had gotten an early diagnosis? Would it have helped?

There’s no way to know for sure, but probably it would have. Because as soon as he started taking Aricept he stopped getting lost driving around our small city. And I started giving him nutritional supplements, which also seemed to help. Read “5 Things that Help Dementia that your Doctor Probably Hasn’t Mentioned.” https://barbracohn.com/2019/09/25/5-things-that-help-dementia-that-your-doctor-probably-hasnt-mentioned/

Professionals, both researchers and physicians and the Alzheimer’s Association, recommend that an early, accurate diagnosis is the key to living a less stressful life for both the patient and the family.

Here’s why:

  1. Cognitive problems can be caused by a number of physical conditions other than Alzheimer’s disease, vascular cognitive impairment, Lewy Bodies dementia and Frontotemporal dementia (FTD). These include thyroid problems, hydrocephalus, a brain tumor, and even depression. When my mother was severely dehydrated and hospitalized with a urinary tract infection (UTI), a psychiatrist called to tell me that she had full-blown dementia. “No she doesn’t,” I said. And sure enough, after being put on an IV saline drip Mom regained her full mental capacity. Memory problems can result from dehydration, severe diabetes and some forms of Parkinson’s disease, traumatic brain injury, HIV, and Huntington’s disease.

Certain medications can affect mental clarity and balance. Be sure to ask your pharmacist about drug contraindications, and interactions with natural supplements. Alcohol abuse and binge drinking can destroy brain cells that are critical for memory, thinking, and decision making and mimic or lead to dementia.

2. Cognitive symptoms may be reversible. There are a number of holistic doctors who claim that their protocol can treat the root cause of cognitive decline and Alzheimer’s disease. Please read my blog ” Significant study points to MIND diet for improving brain health and preventing Alzheimer’s disease.” https://barbracohn.com/2018/11/09/significant-study-points-to-mind-diet-for-improving-brain-health-and-preventing-alzheimers-disease/

Dale Bredesen, MD, a physician scientist in the Department of Pharmacology at UCLA who’s published more than 220 papers on Alzheimer’s, has spent 30 years looking at the root causes of the neurodegenerative phenomenon in hopes of eradicating it. In 2018, Bredesen published the case studies of more than 100 patients in cognitive decline in the Journal of Alzheimer’s Disease & Parkinsonism. https://www.omicsonline.org/open-access/reversal-of-cognitive-decline-100-patients-2161-0460-1000450.pdf

In her editorial in the Lancet Neurology, published in May 2020, Joanna Hellmuth, MD, of the UCSF Memory and Aging Center, said the “Bredesen protocol” – named by neurologist Dale Bredesen, MD – has reeled in patients and their families seeking hope outside of the physician’s office for a disease that is currently incurable.

The Bredesen protocol is propounded in his 2017 bestseller The End of Alzheimer’s Program and can be accessed for $1,399, which includes protocol assessments, lab tests and contact with practitioners, who provide the regimen for additional fees. Online support and cognitive games are available for an additional monthly charge. This protocol is timely, costly and requires steadfastness. But if you have the time and means, it’s probably worth a try.

3. An early diagnosis is empowering. Before the disease has progressed to the point where decision making is difficult, the patient can be included in financial and estate planning, creating end-of-life wishes and durable power of attorney decisions, etc.

4. An early diagnosis is easier for the physician to make when the patient is able to answer questions. Later in the progression of the disease, the patient isn’t able to make observations or answer accurately.

5. Family and loved ones who might be confused by particular behaviors such as anger, depression, disinterest, can better understand why their parent or spouse or significant other is behaving the way they are. This helps to preserve the person’s dignity rather than have someone close to them yell at them, treat them poorly, or want to distance them self, etc.

6. Individuals diagnosed early can take advantage of support groups, and caregivers can learn ways to better manage medications, and learn strategies for coping with unexpected and unusual behaviors and the ordinary progression of the disease. The Alzheimer’s Association was a godsend for me. I was able to connect with other caregivers who knew exactly what I was going through. I could talk about what was happening all day with my best friend, but there was no way she would be able to fully understand the stress of caregiving and the grief of losing a partner to Alzheimer’s. https://www.alz.org/alzheimers-dementia/research_progress/clinical-trials/about-clinical-trials

7. Getting an early diagnosis provides the opportunity to possibly enroll in a clinical trial. TrialMatch is a clinical trial matching service for Alzheimer’s and other dementias. It is a free, easy-to-use service that connects individuals living with AD, caregivers, and healthy volunteers with current research studies. Their continuously updated database of AD clinical studies includes hundreds of pharmacological and non-pharmacological studies being conducted at sites throughout the U.S. and online.

8. An early diagnosis allows the patient to prioritize what is important to them, whether it’s creating a masterpiece or traveling the world. There is still time at this point in the disease to enjoy a happy, satisfying life.

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

20 Natural Remedies for Depressed Caregivers (and everyone else)

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

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

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

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

Here are 20+ ways to combat depression

Natural supplements for depression

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

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

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

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

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

3. Nervines

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

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

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

Recommended nervines:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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