What happens to your body when you’re a stressed caregiver?

Woman having a headacheStatistics show the stress of care giving can result in chronic disease for the caregiver and take as many as 10 years off one’s life. In comparison to caregivers of people in all categories, caregivers of Alzheimer’s patients in particular rate their health more poorly, take worse care of themselves, and spend more money on their health care. Feeling more tired and depleted, they evaluate themselves as less healthy, engage in fewer health-promoting behaviors, and use more health services.

Given the demands on caregivers’ time and energy, they may neglect their own self-care by sleeping less, eating too much or too little, not exercising, or not managing their own health problems. Neglect of their own health may worsen pre-existing illnesses or increase vulnerabilities to new stress-related problems.

The Physiology of Stress

Walter Cannon described the fight or flight response in 1929.  Adrenaline is the fight-or-flight hormone: It causes cells, especially muscle cells, to speed up energy production so that the body will be ready to fight a foe or run away. It is needed for short blasts of stress.

  • Pupils dilate to sharpen vision.
  • Heart rate and blood pressure increase to accelerate the delivery of oxygen to fuel the muscles and critical organs.
  • Blood flow is diverted from non-critical areas such as the gastrointestinal tract to the critical areas such as the heart, skeletal muscles and liver.
  • Liver releases glucose and fatty acids into the bloodstream. Glucose is for immediate energy; fat is needed when the fight-or-flight response lasts longer than expected.
  • Bronchial tubes dilate to maximize the exchange of oxygen and carbon dioxide.

Cortisol bolsters us in long-lasting stress situations. But when the body is dealing with chronic stress, the adrenals get “stuck” in the on position and the whole system goes into chronic “fight or flight.”

  • Glucose that is dumped into your bloodstream goes unused, so your body has to produce an enormous amount of insulin to handle it. Eventually, this may result in hypoglycemia or diabetes.
  • Fat that is dumped into your blood also goes unused, so it clogs your arteries, leading to cardiovascular disease.
  • If you drink caffeine, the stress hormone cortisol becomes elevated, which can set you up for countless health problems including: poor quality of sleep, impaired immunity and age-related deterioration.

Adrenal exhaustion–The adrenal glands produce or contribute to the production of about 150 hormones. When they are stressed, they become exhausted. Once the adrenal buffer is gone, you become a prime candidate for asthma, allergy, fibromyalgia, chronic fatigue syndrome, autoimmune disorders, hypoglycemia

Alcohol, caffeine, sugar and salt put added stress on the adrenals.

Stimulate, such as caffeine increase the effects of your body’s own stimulating neurotransmitters: norepinephrine and dopamine, which are similar to adrenaline in their effects. Caffeine and these natural stimulants provide short-term energy, focus and even a lifted mood. But in the long-term, caffeine depletes your stores of norepinephrine and dopamine, leaving you more tired, sluggish and down than you were before the caffeine habit.

Psychological stress can impact cardiovascular function and lead to cardiovascular disease, and possible stroke/heart attack.

Stress and sleep

Adequate sleep repairs your body, sharpens your mind and stabilizes emotions. Lack of sleep triggers the body to increase production of cortisol, which makes it harder to fall asleep and stay in a deep sleep because on some level your body and brain think they need to stay alert for danger.

  • Loss of sleep as a result of caring for a loved one can lead to serious depression.
  • As little as five nights of poor sleep can significantly stress the heart.

Weight gain and insulin resistance

  • Increased cortisol production leads to weight gain. The adrenals increase gluconeogenesis, which provides the body with glucose from protein, rather than carbohydrates. This decreases serotonin and melatonin, which results in poor sleep and leads to food cravings for carbohydrate-rich foods in order to uplift mood, which releases more serotonin and insulin. This leads to more stress and insulin production to regulate glucose, which may lead to fat storage, weight gain and insulin resistance. It becomes a vicious cycle.
  • Insufficient sleep is also associated with lower levels of leptin, a hormone that alerts the brain that it has enough food, as well as higher levels of ghrelin, a biochemical that stimulates appetite. Consequently, poor sleep may result in food cravings.

Exercise

  1. Insufficient sleep may leave us too tired to burn off extra calories with exercise.
  2. When your body is stressed and prepared to fight or run it’s full of stress hormones. If you’re sedentary, those hormones will continue to circulate and cause damage to your body. Vigorous exercise, however, burns off those hormones. Exercise also releases the neurotransmitter serotonin and endorphins, the body’s natural pain relievers.
  3. Doctors from Nottingham Trent University suggest the chemical phenylethylamine is released during exercise and could play a part in uplifting mood as a result of exercise. Phenylethylamine is a naturally produced chemical that has been linked to the regulation of physical energy, mood and attention.

Impact of food on mood and physiology

Hazards of caffeine

  1. Caffeine stresses the adrenal glands and can contribute to anxiety, insomnia, depression, irritability, anxiousness—not good for caregivers. In fact, studies show that those who drink the most coffee often suffer from chronic depression. It depletes the body of B1, biotin, inositol, vitamin C, calcium, potassium, and zinc. It increases thirst because it is dehydrating, over stimulates and weakens the kidneys, pancreas, liver, stomach, intestines, heart, and nervous system.
  2. Can increase production of cortisol, leading to stronger cravings for fat and carbohydrates. This increases blood glucose, release of insulin and fat stored in the abdomen.
  3. Increases dopamine levels, making you feel good until it wears off
  4. May interfere with restful sleep
  5. Try not to drink coffee after 2pm
  6. Simple carbohydrates increase insulin production.

People who are stressed often crave and overeat sugar and simple carbohydrates, like chips, cookies and white bread or pasta, because those foods provide a fast release of the feel-good chemical serotonin. But eating this way causes a blood-sugar crash a couple of hours later, leaving you tired and moody. The more of these foods that you eat the more you crave. Although these foods are high in calories, they contribute few nutrients and deplete the body of essential vitamins and minerals, raise triglycerides, and contribute to inflammation and excess weight.

  1. Lack of water/fiber can rob the body of nutrients because of problems with digestion and assimilation
  • HFCS and other artificial sweeteners can interfere with your natural production of neurotransmitters. Aspartame (NutraSweet and Equal) competes with tryptophan by blocking its conversion into serotonin. Artificial sweeteners contribute to numerous adverse symptoms, as compiled by the Food and Drug Administration and include everything from menstrual changes, weight gain, and headaches to severe depression, insomnia and anxiety attacks.

High fructose corn syrup (glucose and fructose) can lead to a decrease in leptin production leading your body into thinking it’s hungry so you eat more, especially processed foods. HFCS can lead to insulin resistance and higher levels of triglycerides, as well as obesity, hypertension and cardiovascular disease.

Bad habits, i.e. forgetting to eat, eating on the run, not eating breakfast all contribute to unstable blood sugar and adrenal exhaustion, which makes you grab foods that aren’t good for you, so you end up feeling irritable, moody, and even more stressed.


You get the picture? It’s important to take care of yourself, especially when you are taking care of someone else. I don’t want to overwhelm you with information or preach to you. Here’s a short checklist to help you stay healthy and balanced.

  • Eat a serving of high-quality protein with every meal and snack
  • Focus on complex carbohydrates (whole grains, veggies and fruits), and eliminate junk foods (refined carbs).
  • Enjoy unlimited amounts of fresh veggies.
  • Eat a good breakfast!
  • Eat 3 balanced meals and 1-2 snacks/day.
  • Magnesium, B complex, fish-oil, walnuts, flax seeds, dark leafy greens, and high quality all help reduce stress and uplift mood.
  • Meditate or find some quiet time for yourself
  • Exercise! At least take a short walk everyday.
  • Put on a funny YouTube video and laugh.
  • Use aromatherapy.
  • Do the best you can.

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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.

Calmer Waters: Spring 2019 book signings and events

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Especially for folks in the Denver-metro area: You are warmly invited! Please drop by at a book signing to say hello, or attend the caregiver symposium or conference (or both!) for lots of great information, networking and support. Respite care is available for both events. Click on the links to find out more.

10 New year requirements for all caregivers

You’re tired, you’re stressed–You and 45 million or so American caregivers. So what are you going to do about it? Don’t say that “I don’t have time to take care of myself.” I’ve been there and done that. But I always promised myself that I was not going to be a martyr and sacrifice my health for my husband’s illness. Because if both of us went done that wasn’t going to serve any purpose, least of all our children. They were barely adults when my husband was in the throes of Alzheimer’s disease. They needed at least one healthy parent. And whether you are taking care of a spouse, parent or child, there are other people in your life who love and need you, not necessarily to take care of them, but to love and support them emotionally.

When you are a caregiver, it’s hard to find the time to go to the gym or even take a shower, somedays. But it’s absolutely vital that you take care of yourself or you will end up getting sick and then who will take care of your loved one? Who will take care of YOU?

Here are 10 easy ways to take the edge off your stress and fatigue so you feel some relief.

  • Say a positive affirmation before you get out of bed. “This day is going to be a good one.” “I am grateful for my friends and family.” “I am healthy and full of energy.” “I am strong and competent.” Say something positive to set the tone of the day.
  • Before you reach for a cup of coffee, drink a glass of hot water with lemon. It hydrates your body and brain, the lemon helps to alkalize the system (yes, it’s counter intuitive), which is usually too acidic, and it helps with regularity.
  • Ask for help! You don’t have to do it all by yourself. No one is going to think badly of you if you take some time for yourself. If your loved one resents your going out, it’s okay. Don’t become a slave to their wishes and rants. If you can’t leave your loved one alone, please ask a neighbor, friend or home care professional to help at least a couple hours a week. Some social service programs provide free respite care.
  • Many cities throughout the U.S. offer volunteer snowbusters (volunteers who will shovel your walk and driveway), fix-it volunteers who will help with easy home repairs, and yard maintenance volunteers.
  • Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  • Find a walking partner in your neighborhood and try to walk at least once a week (preferably 3 times a week).
  • Put on a CD, vinyl record or the radio and listen to your favorite music. If your care partner is mobile, ask him/her to dance. There is nothing like music or dance to uplift the spirit.
  • 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.
  • Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  • It’s important to get at least 6 hours (preferably 7 or 8) of sleep every night. Of course, this isn’t always possible if you are caring for someone and need to get up at night, or are worried about paying the bills, taking care of the car, getting a new stove, etc. If you can’t get in the hours at night, put your feet up for 10 minutes during the day when your care partner naps. Or take a power nap. It really helps.

Wishing you and your loved ones a healthy, happy New Year! And remember that “this too shall pass.”

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 energy and stress fixes to use now!

The holidays are stressful for everyone, but especially for caregivers. Here’s a list of some of my favorite stress relievers and energy boosters.

Soak in an Epsom salt bath and put in a few drops of lavender oil.
Soak in an Epsom salt bath and sprinkle in a few drops of lavender oil.
  1. Start the day with an affirmation. Before you get out of bed say something such as: “I am happy for the beautiful day.” I am grateful for my family and friends.” “I am cherished.” Make it yours, make it sincere. It’s amazing how it can set a positive tone of the day.
  2. Breathe! When we are stressed we tend to hold our breath. Take a 5-minute break and sit down in a comfortable chair. Close your eyes and take a deep breath, in and out. Then focus on your breath and watch how your mind quiets down and your muscles relax. Then remember to breathe throughout the day. Whenever you feel yourself getting anxious or tight, take a deep breath and let it go.
  3. Drink water. We’ve heard it a million times but it’s always good to be reminded. Forget about sodas and limit the wine and alcohol. Staying hydrated, especially at this time of year, is vital to supporting the immune system and reducing inflammation. It’s also important to support healthy cognitive function and memory.
  4. Make lists, including a meal plan for the week. It helps eliminate the last hour panic of “what am I going to make for dinner?” and unhealthy last-minute food decisions like ordering pizza.
  5. “Me time” is important! Get respite care if your loved one needs full-time attention. Ask a neighbor, relative or friend to come over for an hour or two so you can take a walk, go to the gym, or meet a friend for lunch or coffee.
  6. Eat walnuts. A daily dose of about 9 whole walnuts or 1 Tbs. walnut oil helps your blood pressure from spiking during stress. Walnuts contain L-arginine, an amino acid that helps relax blood vessels, which in turn helps reduce hypertension.
  7. Drink green tea. L-Theanine is the main chemical constituent in green tea. It is an ideal nutritional aid for stress because it produces alpha-wave activity that leads to deep relaxation and mental alertness. This is especially important because in order to mitigate stressful situations, it’s important to remain calm and alert. Theanine also stimulates the release of the neurotransmitters GABA, serotonin and dopamine, which help us feel happy, motivated and calm. Green tea extract is available as a nutritional supplement, which might be easier and quicker to take, and it’ll save you a lot of trips to the bathroom.
  8. While we’re on the topic of “green,” be sure to eat green leafy vegetables for vitamin B and magnesium, both of which help your body cope with stress.
  9. Two handfuls of cashews (make that a small handful, please; one ounce of cashews contains 157 calories.) provide a mood-boosting effect because they are one of the highest natural sources of tryptophan, the precursor for serotonin, the feel-good neurotransmitter.
  10. Did someone mention dark chocolate? It reduces cortisol, the stress hormone that causes anxiety symptoms. Just a couple of pieces should do the trick.
  11. Stretch! It’s important for everyone, not just runners and athletes. Stretching keeps your muscles flexible, strong and healthy. Without it, muscles tighten and weaken, which puts you at risk for joint pain and strain.
  12. Walk around the block. Just getting out into fresh air will instantly relieve stress, and moving your body gets your blood pumping and will clear your mind.
  13. Light candles and play relaxing music while you eat. It will change the mood instantly.
  14. Aromatherapy is a miracle cure for stress and anxiety. Use a wall plug-in to diffuse the aroma of lavender oil to uplift mood, or place a few drops on a handkerchief and tuck it into a shirt pocket or on a pillow. Other oils to try: vetiver, frankincense, myrrh, orange, lemon, bergamot, and grapefruit.
  15. Sit down, close the door and meditate. If you don’t have a mantra use the word OM. Repeat it silently and when you realize you are not saying it, then gently come back to it. Do it for 10 to 20 minutes every day and yoyu will notice that you are much more relaxed.
  16. Music is the universal language, and it is also the universal stress reliever. Whether it’s jazz, classical, or hard rock that makes you feel better, by all means, play it loud, play it soft, dance to it, drive to it, go to sleep to it. It will definitely help.
  17. Take a multi-vitamin mineral supplement to help with stress, energy and immune support.
  18. Warm up with warming herbs and spices such as ginger, turmeric, cumin, oregano, cayenne, black pepper, cardamon, garlic.
  19. Take an Epsom salt bath and put in a few drops of lavender oil. Light some candles, turn down the lights, put on some music, and relax!
  20. Getting the proper rest is vital to staying healthy and reducing stress. Prepare yourself for a deep night’s sleep by unplugging from electronics at least an hour before bed, taking an Epsom salt bath (put several drops of lavender oil in the water for added relaxation), and making sure the room temperature isn’t too warm.  Good night, sleep tight!

If you, or someone you care about, tend to suffer from stress, anxiety, or depression, these recommendations might just “take the edge off” and improve your quality of life … without the risk of side effects. May the holiday season begin!

Best wishes for a happy, safe and relatively stress-free holiday season!

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

The best gifts for people with Alzheimer’s and dementia

Christmas gift or New Year with blue ribbon and greeting card on wood table on bokeh background. Tiny and Handmade gift box concept.Instead of worrying about what to give a friend or loved one who suffers from Alzheimer’s disease or dementia consider this. What that person really wants more than anything is to just be with you. So here’s a list of things you can do together.

  1. People with dementia love ice cream. Share a pint of his or her favorite. Bring the toppings and arrange them on a table in little bowls—sprinkles, chocolate chips, chopped fruit, whipped cream, butterscotch or chocolate sauce, etc.
  2. Watch a comedy together. It doesn’t matter if your loved one can follow the plot or not. If you laugh, he or she will probably join in the merriment. Laughter triggers the production of endorphins; the brain chemicals that reduce the sensation of pain and make you feel good.
  3. Bring a dog to visit your loved one. If you don’t have one, borrow one. There’s nothing like a friendly pup to cheer someone up and add some excitement. Listen to music together.
  4. Put on a CD and sing together. Big Band Music is usually a hit with most 70, 80 and 90 year olds. If your loved one is younger, you can try classic rock.
  5. Get out the paint brush, paper and water colors. You don’t have to be an artist or art teacher to have fun with your loved one. Painting and drawing is a great way to share time together, and to even express feelings of frustration, irritation and fear—on paper.
  6. Dance to the music. If your loved one is still mobile help him or her get up and move. The exercise will enhance memories, even if temporarily. A short surge of condensed exercise boosts the compression of memories in both elders in good mental shape as well as those with slight cognitive impairment, according to new research by a team of scientists from UC Irvine’s Center for the Neurobiology of Learning & Memory.http://www.cnlm.uci.edu/
  7. Go for a drive and get some fresh air. Just getting out of the house or memory care home does a body good.
  8. Hold hands, give a foot massage. Use aromatherapy oils (see chapter 18 “Aromatherapy” in The Caregiver’s Journey Through Alzheimer’s and Dementia
  9. Create a book of photos that depict your loved one’s life and share memories without saying “remember when. . .”
  10. Just breathe together and be still in the silence. It’s the greatest gift of all.

Treat yourself to the perfect gift for all caregivers to help you feel healthier and happier, less stressed, sleep better, deal with feelings of guilt and grief and find inner peace. The Caregiver’s Journey Through Alzheimer’s and Dementia

BarbraCohn__

15 self-care strategies to reduce holiday stress

Hand writing text caption inspiration showing Self Care. Business concept for Taking caring for own Health Written on sticky note paper, wooden background with folded pink paper meaning thinkingIt’s National Family Caregivers Month and the perfect time to consider how you can reduce the stress of the holidays by taking better care of yourself.

  1. First, pat yourself on the back. If you are a caregiver you’re doing an incredible service of giving of yourself and your time. Whether your care recipient verbally expresses appreciation or not, know that you are a bright light in that person’s life and in the world.
  2. Before getting out of bed in the morning repeat an affirmation several times to set the tone of the day. Some ideas: “Today is going to be a good day,” “I am a loving, kind person,” “I am grateful for my family and friends.”
  3. It’s especially important to eat well at this time of year when colds and flues are rampant and the stress of the holidays taxes the immune system. Focus on warming foods such as soups and stews, mineral and bone broths, and ginger tea. Citrus fruits are in season and offer vitamin C, important for immune support. The winter squashes offer beta carotene and vitamin A, which are also excellent antioxidants. Please listen to my interview with Mary Collete Rogers on her podcast “The Healthy Kitchen Companion” for ideas about how to include healthy foods into your diet and how to organize your kitchen. Caring for yourself and others with good nutrition.
  4. Make a food plan for the week and bring a shopping list with you so you don’t have to make a repeat run to the grocery store.
  5. Calm yourself with calming foods. Studies show an association between the levels of the neurotransmitter serotonin and mood. The good news is you can naturally increase your serotonin levels with food such as these: sweet potatoes, brown rice, oatmeal, amaranth, buckwheat, millet and quinoa allow your brain to process more serotonin. 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. Leafy greens, such as spinach, kale, collard greens, are high in folic acid, a B vitamin. Low levels are linked to depression. Bananas contain vitamin B6. They are high in potassium, an important electrolyte for a happy and calm mind.
  6. Reduce stress by supporting your adrenal glands with supportive supplements. The adrenal glands sit on top of your kidneys and produce adrenaline and cortisol, the stress hormones. If you press on your kidneys and they hurt, there’s a good chance your adrenals are working overtime due to stress. Stress may hit us as a headache, backache, insomnia, anxiety, irritability, respiratory, illness, or the flu.  If we really become overwhelmed, stress may accumulate to the point where our entire immune system is compromised and we end up fighting a serious illness. The good news is that adaptogens and nervines —two categories of herbs—can help your body adapt to stress, creating a state of homeostasis.

Recommended adaptogens:

  • Ashwagandha – is an Ayurvedic herb that has also been called “Indian ginseng.” It raises energy levels, enhances immunity, helps the body cope with stress, and reduces the stress hormone cortisol.
  • Cordyceps – is a revered Chinese nourishing tonic used to build strength and stamina, support the immune system, combat fatigue and the effects of aging, and invigorate the elderly and those weakened after serious illness.
  • Gotu kola – is an important brain and nervous system restorative in Ayurvedic medicine. It is also used as a mild diuretic and for insomnia and gastric complaints.
  • Rhodiola – also called golden root, stimulates and protects the immune system by supporting the adrenal hormones. It boosts immunity, improves concentration and stress resistance, and increases physical performance and uplifts mood.  It is also a remedy for sleep difficulties, poor appetite, irritability, hypertension, headaches, and fatigue from intense physical or intellectual strain.

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.

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

The next time you’re feeling nervous, agitated, restless or hyped up, calm your nerves with a nervine herb. If you want to rejuvenate your adrenal glands and boost your entire immune system, take an adaptogen.  You’ll have more energy, feel happier and less stressed, and your overall health will improve too!

7. Move! Exercise is vital to staying healthy and strong. The days you feel “stuck” or stiff are the days it’s most important to put on your walking shoes, sunglasses, and a hat, and go for a walk. Chat with/walk with a friend or with your pet dog

8. Take a bath. Hydrotherapy has been used for thousands of years as a healing modality throughout the world to relieve stress, release aches and stiffness, and refresh the mind and emotions. For an added benefit, add Epsom salts and/or essential oil.

9. Dance is an amazing healing aid that can instantly enhance your mood and create joy. Put on your favorite Motown, R & B or salsa music and dance in your living room as though no one is watching. A twenty-one-year long Einstein Aging Study, completed in 2001, found that dancing is the best physical activity to help prevent dementia when compared to eleven other activities including team sports, swimming, and bicycling. The study was summarized in an article that appeared in the New England Journal of Medicine in 2003.

10.Breathe deeply. Most of us breathe shallow breaths that restrict oxygen flow to the lungs and throughout the body, resulting in fatigue and depletion of our vital energy. Breathing is not only free, but it will set you free. Try this simple exercise: Sit on a chair with your back straight and focus on your breath. Take a deep breath, and then let it go, exhaling all the stale air out of your lungs. Continue for several minutes. Notice any sensations in your body. Eventually your body and thoughts will settle down, and you’ll emerge feeling more relaxed. Try to do this at least five minutes on a regular basis.

11. Stay hydrated! It’s important to keep your brain hydrated as well as the body. Have non-caffeinated, unsweetened beverages throughout the day, particularly water and tea. The rule of thumb is to have 48 to 64 ounces of non-sweetened, non-artificially sweetened drinks. Hydration keeps the body in proper pH (how acidic or alkaline your body is) and protects it from getting dehydrated, which is a cause of inflammation and other kinds of imbalances.

12. Meditate, pray, take a walk in nature. Take a walk around the block, even for 15 minutes.

13. Listen to some classical music, meditative music, religious music, etc.

14. Use aromatherapy essential oils such as lavender for an instant relaxing effect.

  • Use essential oils (lemon, peppermint, lavender, frankincense, bergamot, thyme, sandalwood, vetiver, myrrh) to boost immunity. 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

15. Practice good sleep hygiene. It’s hard to function at your best and to stay healthy when you aren’t sleeping well. Here’s a quick reminder of how to improve your sleep.

Don’t drink caffeine after 1:00 pm. Limit your fluid intake after dinner so you don’t have to pee during the night. Turn off all electronics at least 30 minutes before bed. Cool your bedroom, but make sure you don’t feel. Or, warm your bed with a heating pad. Get black out curtains. Eat a banana; it contains potassium and magnesium which help reduce risk of muscle cramps. Or, have a protein snack such as a slice or cheese or tsp of peanut butter on a cracker to help maintain balanced blood sugar. For more suggestions read 16 ways to sleep better . . . so you can be a better caregiver. 

Best wishes for a happy, safe and relatively stress-free holiday season!


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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.

 

Have you tried any of these natural ways to combat depression?

St. John's Wort capsulesOctober 11 is National Depression Screening Day. If you are feeling overwhelmed, depressed or have a hard time getting out of bed in the morning because you don’t want to face the world it’s time to evaluate your emotional health. You can take an anonymous screening online here: Select a state to find a screening.

If you are suicidal please 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.


If you have mild to moderate depression, there are a number of proven natural supplements and modalities that can help.

While I cared for my husband who had younger-onset Alzheimer’s disease, I lived behind a persona of forced cheerfulness because I didn’t want anyone to know that my private world was being deconstructed bit by bit. I went through bouts of depression and grieving periods. I took the supplement St. John’s wort, danced and meditated. I met with girlfriends and did yoga. I also used essential oils and tried to eat well. It all helped.

I gave St John’s wort to my husband, too, until he was in late-stage Alzheimer’s disease. By then he needed a pharmaceutical anti-depressant. But the St. John’s wort worked well for mild to moderate depression.

  1. Here’s what we know about St. John’s wort
  • 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

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. 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.

3. 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.

4. 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.

5. 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.

6. 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. 

Other natural ways to combat depression

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

8. Get some physical exercise every day; even just a 20 minute walk helps tremendously.

9. Use 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

10. 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.

11. 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.

12. 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.

Can depression be a sign of dementia?

Depressed Senior Woman Sitting OutsideDepression can affect our memory, and it can result from not being able to do the things that were once easy for us, as in the case of Alzheimer’s or dementia. Depression can result from a number of factors and it often appears differently in different people

Some people are able to hide the fact that they are terribly depressed. I did. I tried to put on a happy face during my husband’s illness, but inside I often felt as though I was dying. Following the recent suicides of Kate Spade and Anthony Bourdain, we have to remind ourselves that we usually don’t know what is happening inside someone else’s head.

Before my husband was diagnosed with younger-onset Alzheimer’s disease he was withdrawn and depressed. I didn’t know what exactly what was going on, and he was unable to articulate how he felt. I eventually realized that he was depressed because the things that were once effortless for him to do, such as driving around town or figuring out how much tip to leave in a restaurant, had become difficult.

Alzheimer’s and depression often occur simultaneously, which often makes it difficult for physicians to make a diagnosis without further testing. According to James M. Ellison, MD of the Swank Memory Care Center, Christiana Care Health System, approximately half of individuals affected by Alzheimer’s disease will experience clinically significant depressive symptoms at some point.  Depression can occur during any phase of the illness.

Symptoms common to Alzheimer’s and depression

  • Loss of interest in things that were once enjoyable
  • Memory issues
  • Sleeping too much or too little
  • Social withdrawal or isolation
  • Impaired concentration
  • Eating too much or too little
  • Crying, feelings of hopelessness, despair
  • Unmotivated
  • Lack of energy, lethargy, apathy
  • Irritability
  • Thoughts of death or suicide

A case of the chicken or the egg: which came first, Alzheimer’s or depression?

Some health professionals think that depression can put one at greater risk for Alzheimer’s. There is also a belief that depression is a symptom of Alzheimer’s. In any case, physicians feel that a person with dementia who is depressed can experience a quicker cognitive decline and need to rely more on caregivers.

What to do?

8 natural ways to combat depression.

Antidepressants may not work as well with people who have Alzheimer’s and are depressed. Before resorting to antidepressants and other drugs,  try these options:

  1. Provide a safe and calm environment. Light candles at dinner, play classical music, have a vase of fresh flowers on the table.
  2. Get some physical exercise every day; even just a 20 minute walk helps tremendously.
  3. Use 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
  4.  I gave my husband Ginkgo biloba for depression (and also took it myself). It helped right up until he was in late stage Alzheimer’s. One word of advice, not all brands are efficacious, so pick one carefully. Also note that it takes about 6 weeks to notice an effect. This is a typical difference of taking a pharmaceutical versus a natural remedy.
  5. 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.
  6. Omega-3 fatty acids are rich in DHA, the major unsaturated fat in the brain. This long-chain fatty acid provides the necessary fluid quality to the membranes of the nerve cells so that electrical nerve impulses can flow easily along the circuits of the brain. One study found that Alzheimer’s patients given an omega-3-rich supplement experienced a significant improvement in their quality of life.
  7. 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.
  8. 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. Studies have indicated that sleep deprivation can increase risk of dementia and Alzheimer’s disease. 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.

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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” 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.

Men: Are you taking care of yourself?

仲の良い父と娘Happy Father’s Day to all men who play a caring role in the life of a child, and kudos for  all that you do. But let me ask you this: Do you take care of yourself? Typically, most men take better care of their cars than themselves. Most men wait until a symptom pops up, and by then the illness or disease has progressed.

I’m not going to give you a lecture about how you should make an appointment tomorrow to get a routine preventative check-up, but hopefully after going through the following list, you’ll see my point.

Take this quiz to see how much you really know about men’s health. 

1) As a man gets older, it’s almost inevitable that he:

  1. loses interest in sex
  2. has a difficult time maintaining an erection
  3. doesn’t need to exercise as much
  4. develops an enlarged prostate

2) To detect prostate cancer early, a man should:

  1. have a colonoscopy
  2. practice a monthly self prostate examination
  3. have a digital rectal exam and PSA blood test
  4. have a sonogram of his prostate every year

3) Impotence can result from:

  1. drinking too much alcohol
  2. recreational drug use (smoking marijuana)
  3. high blood pressure
  4. diabetes
  5. all of the above

4) 75% of prostate cancer occurs in:

  1. Hispanic men
  2. men over 65
  3. men who eat a low-fat diet
  4. men with low testosterone levels

5) The most common cancer among men is:

  1. prostate cancer
  2. lung cancer
  3. skin cancer
  4. colon cancer

6) Which racial/ethnic group is most likely to develop prostate cancer?

  1. Caucasian
  2. Asian
  3. Hispanic
  4. African-American

7) A common risk factor for developing prostate cancer is:

  1. lack of exercise
  2. high fat diet
  3. high testosterone levels
  4. growing older
  5. all of the above

8) What beverage has been found to support prostate health?

  1. beer
  2. green tea
  3. orange juice
  4. red wine

9) What common food has been found to support prostate health?

  1. oranges
  2. tomatoes
  3. beef
  4. cheese

10) Which disease is considered the number one cause of death among American males?

  1. diabetes
  2. prostate cancer
  3. obesity
  4. cardiovascular disease

11) Cardiovascular disease kills far more men and women than cancer.

  1. True
  2. False

12) Eating a diet that includes plenty of pasta, potatoes and white rice can reduce your risk of heart disease.

  1. True
  2. False

13) The heart muscle is totally responsible for maintaining normal blood pressure levels.

  1. True
  2. False

14) Cardiovascular disease is hereditary and cannot be prevented.

  1. True
  2. False

15) CVD starts in the teenage years.

  1. True
  2. False

16) An aspirin a day is the best way to thin the blood, in order to reduce the chance of stroke and heart attack.

  1. True
  2. False

17) High blood cholesterol is the best overall indicator of cardiovascular disease.

  1. True
  2. False

18) Statistics show that the stress of caregiving can result in chronic disease for the caregiver and take as many as ten years off one’s life.


Answers:

1) d

2) g

3) e- all of the above. Not smoking, eating a healthy diet, not overdoing it when it comes to drinking, regular exercise, getting enough sleep, will all help support normal blood flow. Also, Ginkgo biloba extract helps support normal blood flow to the penis

4) b. Simply growing older increases a man’s risk. Seventy-five percent of prostate cancer occurs in men over 65 with only 7% diagnosed in men under 60 years of age.

5) c. Skin cancer is the number one form of cancer in the US. Prostate cancer is the most common cancer among men next to skin cancer and the second leading cause of cancer death in men after lung cancer.

6) d. African-American males have the highest incidence of prostate cancer, a third higher than white males, and African-American males are also twice as likely to die from it.

7) e. Also, men who have higher testosterone levels, or who eat a high fat diet have been shown to have an increased risk of developing prostate cancer.

8) b. Green tea is chock full of antioxidants that have been shown to reduce cancer. Red wine, on the other hand, is a natural preventative against cardiovascular disease.

9) b. Tomatoes contain lycopene, especially potent in the fight against prostate cancer.

10) d. Among major disease groups, heart disease is the leading cause of death within the elderly population.

11) True. Although cancer fears are more common, cardiovascular disease is the chief cause of death and disability in the United States today. It affects close to 60 million Americans and every year more than a million people suffer from new or recurrent heart attacks. In fact,every 20 seconds a person in the United States has a heart attack, and one-third of these attacks leads to death. The American Heart Association calls CVD “the silent epidemic.”

12) False. For years we were told that a heart-healthy diet included foods low in fat and high in carbohydrates, such as fruits, veggies, legumes, grains and other starches. But now experts are saying that overloading on carbohydrates (especially the wrong kind) can make you fat and increase your risk of heart disease. Eating foods with a high glycemic index—such as cookies, cake, candy, bagels, pasta, white rice, refined bread and grains, potatoes and potato chips—raises blood sugar and insulin levels, which in turn stimulates the production of triglycerides (blood fats that raise heart disease risk).

13) False. Your kidneys, blood vessels and heart all control blood pressure. In order to maintain healthy blood pressure and keep blood moving, the walls of your arteries, capillaries and veins need to be flexible and strong. Research has shown that nutrients such as Co-Q10, hawthorne, red wine polyphenols, notoginseng (a cousin of ginseng), and astragalus help strengthen blood flow throughout the entire body, maintaining healthy blood pressure. In addition, EDTA (the main ingredient in Health Freedom Nutrition’s Cardio Clear) removes heavy metals and toxins that interfere with the production of nitric oxide, a major factor in controlling blood pressure.

14) False. Even if there’s heart disease in your family, and even if you have high cholesterol, combining an regular exercise program with and a Mediterranean based diet and healthy lifestyle (no smoking, reduced alcohol consumption) can dramatically reduce your risk of heart attack and stroke.

15) True. Dr. Scoot Calig, M.D., a pediatrician at West Hills Medical Center and an assistant clinical professor at the University of Southern California, Los Angeles, says, “It’s important to keep in mind that the development of cardiovascular disease begins in the teenage years. Studies have shown that by that time, arterial plaque formation is well under way.”  Just another reason to exercise, eat a healthy diet, and take nutritional supplements such as oral EDTA to strengthen the heart and arteries and clear out toxic metals that inhibit the production of nitric oxide.

16) False. For years, aspirin has been prescribed after a heart attack, in order to avoid a subsequent heart attack. And now, a panel of experts is recommending aspirin as a precaution against heart disease for all at-risk, healthy adults over 40. But Alfred Berg, M.D., of the University of Washington, head of the panel says, “Do not assume that an aspirin a day is without risk.” Aspirin can cause intestinal bleeding and hemorrhagic stroke. Herbs such as hawthorne, nattokinase, garlic and Ginkgo biloba have the ability to thin the blood like aspirin, without damaging the esophageal and intestinal linings, or exacerbating ulcers.

17) False. Homocysteine—a by-product of the amino acid methionine— is a more sensitive indicator of cardiovascular health than cholesterol. Too much of it increases injury to arterial walls, as well as accelerates oxidation and accumulation of cholesterol in blood vessel. The good news is that folic acid, and vitamins B6 and B12 help keep homocysteine levels low!

18) True—for men and women! Click here to read 16 Stress-busters to nourish your body, mind and soul

Have a happy Father’s Day, and please take care of your health so you can continue to enjoy life and be a support and friend to everyone who loves you.


For dozens of general health tips and caregiving help read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia  by Barbra Cohn.image

You have a dementia diagnosis, now what?

Senior doctor talking with patient and tablet in officeJune is Alzheimer’s & Brain Awareness Month. It’s a good time to have a physical exam, especially if you are worried about your memory not being as sharp as it used to be or if you’re having trouble coping with daily life. If you’ve noticed that someone close to you is showing signs of withdrawal, depression or confusion, please strongly suggest that he or she make an appointment for an exam, too.

Here’s the scenario of how my husband Morris and I received his diagnosis. I’ve provided a list below it to help you tread water when you feel as though you’re drowning.


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 train and airplane schedules without even trying, followed me around the city like a puppy dog as we boarded a subway or bus en route 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 in Denver. 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 with 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.

Finally, he agreed. The doctor (I’ll call her “Dr. Fitzgerald”) asked Morris why he had come in. “My wife thinks I might have Alzheimer’s disease,” he said.

“You wouldn’t be able to drive here yourself if you had Alzheimer’s,” she replied.

Nonetheless, Dr. Fitzgerald gave Morris the Mini-Mental State Exam (MMSE, a thirty point questionnaire used to screen cognitive impairment), asking questions such as, “What are the year, season, date, day, and month?” and progressing to more difficult questions that included counting backward from one hundred by serial sevens. I don’t know about you, but I’d probably be slow on the draw to count backward by sevens. At least I’d have to stop and think about it before responding. Morris botched up that question, and he wasn’t able to draw the face of a clock either. The concept of time was already an elusive abstraction.

Dr. Fitzgerald ordered a blood work-up to rule out an organic problem such as hypoactive thyroid—which can cause memory problems—and an MRI scan (magnetic resonance imaging) to rule out a brain tumor. To tell you the truth, I was hoping for a brain tumor because at least you can take the bull by the horns and really go at the darn thing with radiation and a scalpel. Well, there was no brain tumor and his blood panel looked just fine.

A week later, just as we were investigating the cost of long-term health insurance, Dr. Fitzgerald called to ask Morris to bring in his wife to the follow-up appointment. I’m sorry to say that one of the biggest mistakes I’ve ever made was to schedule that appointment without first buying long-term care insurance. Once you get a diagnosis such as Alzheimer’s, there’s no way you’re going to qualify for long-term care insurance, which could potentially save a family thousands of dollars in catastrophic health care costs.

In the early afternoon of January 3, 2001, Morris and I sat in a dimly lit exam room on wooden frame chairs with hunter green cushions on the seat and back. He wore a sweater woven from various shades of blue and gray that highlighted his eyes. We waited for the doctor to knock on the door, the way they usually do. Morris didn’t appear nervous; probably because he didn’t think there was anything wrong with him. But my stomach was wound tight from anxiety and my lungs were working hard to expel phlegm. It didn’t help that the stale re-circulated air had a metallic odor of fear that was probably generated by patients who had received bad news.

Dr. Fitzgerald finally came in and sat on Morris’s left. She had cropped hair and spoke in a blunt, choppy cadence that matched her no-nonsense appearance. Without much of an introduction, the doctor asked me a few questions about Morris, speaking as if he were invisible.

“How is his driving?” she asked.

“He tends to get lost driving in familiar neighborhoods,” I responded, noting the twitch in Morris’s right cheek. I felt my lungs squeeze, and a high-pitched wheeze escaped from my chest.

“Here is the Mini-Mental State Exam Morris took the last time we met.”

His drawing of a house looked like a dilapidated mine shaft. Without waiting for a response, Dr. Fitzgerald turned to Morris and said, “You have Alzheimer’s disease.” Morris froze and his face turned white, while I burst out crying.


I hope that if you ever get a diagnosis such as Alzheimer’s, Parkinson’s, vascular dementia or a similar devastating disease, your doctor is compassionate and gentle about the delivery of the news that will forever change your life and the lives of your loved ones. I wrote “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia” after caring for my husband for 10 years, in order to help other caregivers feel more confident, happier, healthier, and deal with feelings of guilt and grief.

For hundreds of other caregiving tips, find “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia” on AmazonBarnes and Noble, at other fine book stores, and many libraries.

 

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What can and should you do after getting a diagnosis?

It is understandable that you will have many conflicting feelings such as disbelief, anger, depression, sadness, fear, grief, and shock. You may even feel relieved that you finally know why you are not feeling like yourself. It can be helpful to talk about what you’re feeling and thinking rather than to keep things bottled up inside. In addition to talking with people who are close to you, you can contact the Alzheimer’s Association® at 1.800.272.3900.

You don’t have to tell everyone about your diagnosis if you don’t want to. But if you are still working, or if your boss has questioned your work habits, etc., it’s a good idea to inform him or her of your diagnosis, especially since you might be eligible for  Social Security Disability Insurance.

Your health is more important than ever

Just because you receive a diagnosis doesn’t mean you should give up trying to live a healthy life. You probably still have a lot of years ahead of you, so enjoy them as much as you can. Continue to get daily physical exercise such as walking, biking, hiking, dancing, swimming. Eat a Mediterranean based diet that includes lots of fresh veggies, fruits, nuts,  fish, whole grains, avocado and olive oil.

Stay socially connected as much as possible. It’s normal to feel depressed and it’s okay if you don’t feel like “going out” as much as you used to. But it’s important not to isolate yourself. Keep golfing, bowling, playing cards, as much as you can. Continue to meet with friends for lunch or a movie. If you feel the need to talk, make an appointment with a therapist who specializes in helping people with dementia.

Visit museums, spend time with grandchildren, get a pet (if you don’t already have one), attend an Alzheimer’s Association Memory Cafe. The Alzheimer’s Association’s Memory Cafés offer a fun and relaxed way for people living with early-stage memory loss to get connected with one another through social events that promote interaction and companionship. This is a place where the care partner can receive information while connecting and sharing with other people in similar situations.  Keep busy!

 Legal and Financial Planning for the Future

This is the time to start planning for the future. Taking the time to make decisions about matters that will affect your health care and your finances before you are unable to manage them is one of the most important steps you can take for yourself and your family.

There are many legal and financial documents that will help you formalize your plans and wishes such as:

Durable Power of Attorney

In this document you appoint a person you trust to make legal and financial decisions on your behalf, if you become unable to do so for yourself.

Health Care Proxy

In this document you appoint a person to make medical decisions on your behalf, if you become unable to do so for yourself. It’s important that you speak with the person you appoint about the kind of medical care you would or wouldn’t like so that they can carry out your wishes.

Living Will

Some people also want to make a Living Will in addition to having a Health Care Proxy. In this document, you can state your wishes about end-of-life care.

Last Will & Testament

The purpose of this document is to designate how your assets will be distributed after your death. This will must be completed with the assistance of an attorney.

All the best to you and your families. 

With love,

Barbra Cohn