Did you know that napping can be an early Alzheimer’s warning sign?

Tired.

Senior sitting and sleeping. 

Researchers at the University of California (several campuses), and University of Sao Paulo recently found that if you need to nap more than usual, and if your nap time is getting longer than it used to be, it might be an early warning sign that you could develop Alzheimer’s disease.

Even if they’ve had a full night’s sleep, many people with Alzheimer’s will sleep a lot during the day. Now, based on this new finding, researchers are considering that examining daytime napping might help predict the future onset of Alzheimer’s disease.

The researchers were concerned about what comes first: sleep changes that play role in the development of Alzheimer’s or if changes in a person’s sleep pattern is indicative of the beginning of Alzheimer’s.

Dr. Lea Grinberg, senior author of the findings, which appear in the journal Alzheimer’s & Dementia, explains that her team found evidence that an entire network of neurons that keeps us awake is wiped out by the accumulation of tau proteins which form tangles that disrupt communication between brain cells.

The researchers studied postmortem brain tissue of 13 deceased Alzheimer’s patients who had donated their brain to research and compared them to others without the disease. They found that in the Alzheimer’s brains the three areas of the brain that keep us awake (the locus coeruleus, the lateral hypothalamic area, and the tuberomammillary nucleus) had lost 75% of their neurons.

Researchers found “considerable amounts of tau inclusions” in the awakening areas of the brain, the study said.

Tau is a protein whose normal function is to stabilize a particular part of the neuron in all species. In the brain of someone with Alzheimer’s, tau acts abnormally and destabilizes the neuron. The build-up of tau protein is one of the main culprits of Alzheimer’s disease.

The researchers said that it’s unclear how long it takes to notice memory loss after sleep pattern changes occur.

Sadly, the study’s lead author Jun Oh said in an article by Maria Cohut published in Medical News August 18, 2019, said that “It’s remarkable because it’s not just a single brain nucleus that’s degenerating, but the whole wakefulness-promoting network. Crucially, this means that the brain has no way to compensate because all of these functionally related cell types are being destroyed at the same time.”

As a result of this study and one in the past, she said, they have received funding to keep looking into changes in sleep patterns before memory loss begins.

The NIH and Rainwater Charitable Foundation are investing $1.4 million per year to this research group to continue their research into other areas of the brain responsible for promoting sleep and the areas that regulate circadian rhythm, as well as sleep pattern changes that occur before memory loss begins.

Until we know more, if napping is a normal part of your routine,  you don’t have to worry about taking a mid-day or mid-morning siesta. But if your pattern has changed, it might be a good idea to make an appointment with your physician to discuss your sleep habits and to rule out other medical conditions.

In the meantime, make sure your sleep hygiene is optimal. Click here for 16 ways to sleep better.

Good night, sleep tight.


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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.

How dehydration can lead to delirium and other health issues

Different drinks in glass jugs on white background. Ideas for summer cocktailsIt’s hot outside and it’s easy to get dehydrated. Our body is 50-65% water. The brain, which is 70% water, gets dehydrated just like your body. When it is dehydrated, neurotransmission—which is heavily dependent on water—is impaired, resulting in poor memory, concentration and impaired abstract thinking.

Dehydration can also result in delirium. Delirium is a mental disturbance that is exhibited by a new or worsening confusion, changes in one’s consciousness or by hallucinations. It has a sudden onset from hours to days. It can be reversed but it’s easier to prevent delirium than to reverse it.

When my mom was admitted to the hospital for a UTI (urinary tract infection), she developed delirium. A psychiatrist called me to report that my mom was exhibiting full-blown dementia. I had just spoken to Mom a day before and she sounded fine. I refused the offer of an antipsychotic drug for her, knowing well the high risk of putting an older adult on those drugs. (see Why you should throw away that antipsychotic drug prescribed for your loved one). As it turned out, my mom was severely dehydrated. After a couple days on a hydrating intravenous solution she returned to her normal self.

It’s important to learn the signs of dehydration in everyone, but especially in seniors and young children. The physical symptoms are usually clear: dry lips and mouth, no tears when crying, decreased urine output, sunken eyes, headache, lethargy, dark urine and extreme thirst. The mental symptoms are not as obvious, but can result in mental confusion, irritability and delirium.

Many older adults often limit their fluid intake because they may be incontinent or fear accidents. Those who have limited mobility may try to avoid another trip to the toilet. Individuals who have aphasia (inability to speak due to dementia or brain damage from  stroke, etc.) may not be able to express their thirst.

If you are a caregiver, and that includes caring for yourself!) here are some helpful guidelines:

  • Encourage and remind your care partner to drink.
  • Drinking healthy fluids is important as eating healthy foods. Water is the top choice, followed by milk, vegetable and fruit juices. Remember that juices contain a lot of sugar, both natural and added, so don’t overdo them. Soups are nourishing and hydrating but be aware of the sodium content. Avoid carbonated and caffeinated drinks which have a diuretic effect.
  • Serve liquids at a temperature that your care partner likes. Not everyone enjoys ice water.
  • Flavor water with lime or lemon.
  • Remind your care partner not to wait until s/he is thirsty. By then s/he is already dehydrated.
  • Serve juicy fruits such as watermelon, which contain lots of water.
  • Offer healthy popsicles as an addition to drinks and to those who refuse water.

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. Dehydration can also contribute to urinary tract infections (UTIs).

The dangers of UTIs

Urinary tract infections are notorious for causing delirium and delusional behavior in the elderly. When younger people get a urinary tract infection, they typically experience painful urination, an urgent need to urinate, lower abdominal pain, back pain on one side, and fever and chills. However, an older adult might not experience those symptoms. As we get older our immune system changes and it responds differently to infection. Instead of pain symptoms, seniors with a UTI may show increased signs of confusion, agitation or withdrawal. In older adults with dementia, these behavioral changes may come across as part of that condition or signs of advanced aging. If the underlying UTI goes unrecognized and untreated for too long, it can spread to the bloodstream and become life-threatening. In fact, I have a dear friend who died from a UTI that quickly became septic.

Always: Keep the patient hydrated since urination can flush out unwanted bacteria from the urinary tract.

The next time your mind is muddled, drink a tall glass of water and notice the difference. Drink plenty of water, fresh juices, and herbal teas to stay hydrated, flush out toxins and enjoy mental clarity—in summer and all year round.

 


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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.

What’s new in Alzheimer’s research?

Photo of real female scientists looking into a microscope, Photo taken behind the glass.June is Alzheimer’s and Brain Awareness Month, so I’ve gathered several new studies that you may find interesting and helpful.

You don’t only avoid holes in your teeth by keeping good oral hygiene, researchers at the University of Bergen have discovered a clear connection between gum disease and Alzheimer´s disease. The researchers have determined that gum disease (gingivitis) plays a decisive role in whether a person develops Alzheimer´s or not.

“We discovered DNA-based proof that the bacteria causing gingivitis can move from the mouth to the brain,” says researcher Piotr Mydel at Broegelmanns Research Laboratory, Department of Clinical Science, University of Bergen (UiB).

The bacteria produces a protein that destroys nerve cells in the brain, which in turn leads to loss of memory and ultimately, Alzheimer´s.

Brush your teeth for better memory

Mydel points out that the bacteria is not causing Alzheimer´s alone, but the presence of these bacteria raise the risk for developing the disease substantially and are also implicated in a more rapid progression of the disease. However, the good news is that this study shows that there are some things you can do yourself to slow down Alzheimer´s.

“Brush your teeth and use floss.” Mydel adds that it is important, if you have established gingivitis and have Alzheimer´s in your family, to go to your dentist regularly and clean your teeth properly.

A new longitudinal study has shown that a nutritional drink* designated a “food for special medical purposes” containing the multinutrient combination Fortasyn Connect® can benefit patients with the earliest stages of Alzheimer’s disease (AD), mild cognitive impairment, who are at risk of progressing to the dementia stage of AD, report scientists in the Journal of Alzheimer’s Disease Reports.

Opioid analgesics were associated with a 30% increase in the risk of pneumonia in persons with Alzheimer’s disease, a recent study from the University of Eastern Finland shows. The risk was most pronounced in the first two months of use. This is the first study to investigate the association between opioids and pneumonia in this population. The results were published in the Journal of Alzheimer’s Disease.

Various clinical trials indicate what effects can be expected from standardized intervention programs on the basis of existing evidence. Little is known about the way in which such programs can be implemented in actual care practice. However, it may be possible to use data from clinical practice to estimate the potential of drug prescriptions to delay or reduce the development of dementia. The goal of the present study was to investigate the relationship between antihypertensive drug use and dementia in elderly persons followed in general practices in Germany.

Researchers found seniors who ate more than 300 grams of cooked mushrooms a week were half as likely to have mild cognitive impairment

Singapore, Singapore – A team from the Department of Psychological Medicine and Department of Biochemistry at the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) has found that seniors who consume more than two standard portions of mushrooms weekly may have 50 per cent reduced odds of having mild cognitive impairment (MCI).

A portion was defined as three quarters of a cup of cooked mushrooms with an average weight of around 150 grams. Two portions would be equivalent to approximately half a plate. While the portion sizes act as a guideline, it was shown that even one small portion of mushrooms a week may still be beneficial to reduce chances of MCI.

Copenhagen, Denmark – A new study suggests that vital exhaustion – which can be perceived as an indicator of psychological distress – is a risk factor for future risk of dementia. Researchers from the Department of Public Health, University of Copenhagen have, in collaboration with the National Research Centre for the Working Environment, and the Danish Dementia Research Centre, shown that being distressed in late midlife is associated with a higher risk of dementia in later life. The findings contribute to our understanding of psychological distress as an important risk factor that should receive more focus when considering prevention initiatives in relation to later dementia.

Psychological distress can be defined as a state of emotional suffering sometimes accompanied by somatic symptoms. Vital exhaustion is operationalized as feelings of unusual fatigue, increased irritability and demoralization and can be considered an indicator of psychological distress. Vital exhaustion is suggested to be a response to unsolvable problems in individuals’ lives, in particular when being incapable of adapting to prolonged exposure to stressors. The physiological stress response, including cardiovascular changes and excessive production of cortisol over a prolonged period, may serve as the mechanism linking psychological distress with an increased risk of dementia.

Morgantown, WV, USA – A research team led by Dr. Kim Innes, a professor in the West Virginia University School of Public Health, has found that a simple meditation or music listening program may alter certain biomarkers of cellular aging and Alzheimer’s Disease in older adults who are experiencing memory loss. Study findings, reported in the Journal of Alzheimer’s Disease, also suggest these changes may be directly related to improvements in memory and cognition, sleep, mood, and quality of life.

Sixty older adults with subjective cognitive decline (SCD), a condition that may represent a preclinical stage of Alzheimer’s disease, participated in the randomized, clinical trial. While SCD has been linked to increased risk for dementia and associated with certain neuropathological changes implicated in Alzheimer’s disease development, including elevated brain levels of beta amyloid, this preclinical period may also provide a critical window for therapeutic intervention.


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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.

 

Grief and Relief: When caregiving ends

GedankenCaregiving for a person with dementia is one of the most difficult things anyone will have to do. The pain and suffering is intense, but the rewards are plenty. Even though the person you are caring for cannot express gratitude, on some level they know and appreciate your sacrifice. They are eternally indebted to you. As Lou Gehrig said in his farewell speech, “When you have a wife (caregiver) who has been a tower of strength and shown more courage than you dreamed exists—that’s the finest I know. So I close in saying that I might have been given a bad break, but I’ve got an awful lot to live for.”

Kim Mooney, the Board President of Conversations on Death, and Director of Community Education for Tru Community Care, Colorado’s first hospice, has said that as caregivers “the sacrifices you made changed the course of your life. As you once again look at finding a new course, you will over time grieve your loved one and what you let go of or stored away. You will also begin to discover the things you learned from giving so much. As you recognize and honor what you did, it will begin to shape the meaning of your life now. Whatever the challenges ahead in rebuilding, that understanding can give you the strength, commitment, and satisfaction to make your life more meaningful than ever.”

So, what’s next? Stop, take a deep breath, and think about your journey: where you came from, what you did, and how you feel. When my husband’s final health crisis was over and after I buried him, I realized that I hadn’t fully breathed for years and that my body was strangled with tension and fatigue. I had meditated, eaten fairly well (besides the times I was too tired to cook and made a dinner out of popcorn and ice cream), danced, exercised, and practiced yoga. All these things helped keep me calm, and brought me back to my “self.” But being on call for years took its toll. And after it was all over, while ensnared in the tentacles of grieving, I felt relief. Relief that I wouldn’t feel the pain of watching Morris lose yet another function. Relief that I wouldn’t have to fill another prescription or talk to a physician about my husband’s condition. Relief that I didn’t have to travel the 15 miles to visit him in the memory care home, where I’d inevitably get depressed. Relief that I could stay home and not have an obligation other than caring for myself.

And yet, the final letting go of my role as caregiver was uncomfortable and felt strangely similar to sending my children out into the world. How would I define myself if I were no longer a caregiver? How would I fill up the time I had spent caring for my husband for an entire decade, one fifth of my life? Creating a new identity takes time, practice, and patience. And we are told by grief counselors to not rush things. Do not make a major change in your life, such as moving out of the house you’ve lived in for years, or to another state. But day-by-day, it’s okay to acknowledge that we are not the same person who heard the dreaded words from our loved one’s doctor: “You have dementia, most likely of the Alzheimer’s type.”

As caregivers we take a journey through fire and ice and land on solid ground surrounded by calm waters. Then it’s time to swim to shore and get our bearings. Be patient, be kind to yourself, and set out to discover different activities, small and large, that ease you to calmer waters. Here are some ways to help you get there:

  1. Choose at least one healing modality in this book and integrate it into your life. Dance, do yoga, try journaling, find someone to walk with, etc.
  2. Clean out your closets and drawers.
  3. Wash the garage floor and then paint it.
  4. Take a cooking class.
  5. Join a health club or YMCA.
  6. Take a Zumba® fitness class.
  7. Ride your bike.
  8. Join a hiking club.
  9. Learn how to sew or knit.
  10. Serve food at a community table or sort food at a food bank.
  11. Plant a garden.
  12. Play a musical instrument.
  13. Learn a new language.
  14. Travel! Visit friends and family.
  15. Take long nature walks.
  16. Make it a habit to soak in a bath with Epsom salts.
  17. Get a puppy or kitten.
  18. Volunteer at the Humane Society.
  19. Read to elementary school children.
  20. Join a book club.

My journey to calmer waters

My husband’s illness changed the course of my family’s lives in ways that were unexpected, devastating, and empowering. I developed into a strong matriarch and quickly learned how to take charge of my husband’s care, family business, and my children, without the help of my partner. And not having a partner, with whom I would typically make important decisions with, was one of the hardest things of all about being a partner to someone with Alzheimer’s disease.

Not having a partner, with whom I would typically make important decisions, was one of the hardest things of all about being a partner to someone with Alzheimer’s disease. Deciding where and when to place Morris in a memory care home, figuring out how to finance it, and deciding when to enlist the help of hospice were the kinds of decisions I would have discussed with my husband.

I became a compassionate caregiver, not just for Morris, but for other residents of the memory care home where he lived the last two years of his life. I went through a lot—as all caregivers do—but I’ve come through. I’ve recreated my life, and have learned to look forward with hope, wonder, delight, and inspiration after giving so much of myself to the person I vowed to spend my life with.

There are days that go by without my thinking about Morris. After all, it’s been over eight years since he’s been gone. It’s still hard for me to look at family photos because our family was happy, and a link is missing. I know for my children the hardest thing is that their own children are growing up without knowing their grandfather, who would have loved to be a part of their lives. We will always miss him, but our happy memories fill in the gaps, and we honor him eery year on his yahrzeit the anniversary of a Jewish loved one’s death.

I have a new love in my life and grandchildren to enjoy and cherish. I feel good and I am happy! As my beloved teacher Swami Kaleshwar always said, “Life is short, make it sweet.” I will and I do.


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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.

What are you doing for your brain health?

Brain Nutrition

MIND diet includes salmon, beans, greens, nuts, berries

This week is Brain Health Awareness Week, and I’m reposting this piece so you can evaluate your diet and make improvements to support your brain–and heart health. Here’s to your healthy brain and heart!

Have you heard of the MIND diet? It’s the Mediterranean diet and DASH diet slightly remade and combined to form the MIND diet. (MIND is an acronym that stands for the Mediterranean-DASH intervention for Neurodegenerative Delay.)

In a study published in September 2015 in Alzheimer’s & Dementia, the nutritional epidemiologist Martha Clare Morris and her colleagues at Rush University Medical Center borrowed concepts from the Mediterranean diet and the DASH diet. The result is the MIND diet.

The study followed 923 participantsages 58 to 98 years, for an average 4.5 years, and found the MIND diet lowered Alzheimer’s risk by about 35 percent for people who followed it moderately well and up to 53 percent for those who adhered to it rigorously. While more study is needed to better understand the long-term impact of the diet, Morris’s team’s second paper on the MIND diet notes that it’s superior to the DASH and Mediterranean diets for preventing cognitive decline. But it should be noted that high adherence to all three diets may reduce risk of Alzheimer’s disease.

Food to eat on the MIND Diet

  • Green leafy vegetables: a minimum of 6 servings a week (kale, Swiss chard, spinach, collard, etc.)
  • Nuts: a minimum of 5 servings a week (walnuts, pistachios, almonds, cashews, etc)
  • Berries: a minimum of 2 servings a week
  • Beans: a minimum of 3 servings a week (garbanzo, red, black, kidney, white, pinto, etc.)
  • Whole grains: a minimum of 3 servings a day (millet, oats, brown rice, quinoa, wheat berries, etc.)
  • Fish: at least 1 serving a week
  • Poultry (like chicken or turkey): at least twice a week
  • Olive oil as the primary oil used
  • Wine: no more than 1 glass a day

Foods to limit or avoid

  • Red meat: no more than 4 servings a week
  • Butter and margarine: no more than 1 tablespoon (tbsp) daily
  • Cheese: no more than 1 serving a week
  • Sweets: no more than 5 servings a week
  • Fried or fast food: no more than 1 serving a week

To summarize the MIND DIET—

On a daily basis you eat at least three servings of whole grains, a salad and another vegetable, along with drinking a glass of wine. The jury is still out on whether a little alcohol consumption is better for the brain than none at all. I just heard a panel of researchers and neuroscientist address this issue. If you don’t consumer alcohol, there is certainly no reason for you to start now. But if you do, limit your consumption to one glass of wine a day.)

It’s advised that on most days you should snack on nuts, and every other day eat half a cup of beans. At least twice a week eat poultry and a half-cup serving of berries (blueberries are best), and eat fish at least weekly. Olive oil is the preferred cooking oil.

What is the DASH diet?

The healthy DASH diet plan was developed to lower blood pressure without medication in research sponsored by the US National Institutes of Health, Dietary Approaches to Stop Hypertension. The first DASH diet research showed that it could lower blood pressure as well as the first line blood pressure medications, even with a sodium intake of 3300 mg/day!  Since then, numerous studies have shown that the DASH diet reduces the risk of many diseases, including some kinds of cancer, stroke, heart disease, heart failure, kidney stones, and diabetes. It has been proven to be an effective way to lose weight and become healthier at the same time.

The DASH diet eating plan is a diet rich in fruits, vegetables, low-fat or non-fat dairy. It also includes mostly whole grains; lean meats, fish and poultry; nuts and beans. It is high fiber and low to moderate in fat. It is a plan that follows US guidelines for sodium content, along with vitamins and minerals. In addition to lowering blood pressure, the DASH eating plan lowers cholesterol and makes it easy to lose weight. It is a healthy way of eating, designed to be flexible enough to meet the lifestyle and food preferences of most people.

How is it different from the Mediterranean diet? It can be considered to be an Americanized version of the Mediterranean diet, and to be easier to follow, since it has more specific guidelines. But if you love tabouli, hummus, and olives, you might prefer the Mediterranean diet.

Although there are similarities among all three diets, the MIND diet is the only one that encourages the consumption of foods that have been found to promote cognitive health.

There is a saying that “what’s good for your heart is good for your brain.” So please start switching over to the MIND diet while eliminating foods high in calories and low in nutrients. You will feel better and your brain will stay healthier longer.


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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.

What does end-stage Alzheimer’s and dementia look like?

Brain disease with memory loss due to Dementia and Alzheimer’s illness

Nine years after my husband Morris was diagnosed with Alzheimer’s disease he developed a kidney stone. At that point he was still walking, but shuffling and sometimes losing his balance. He was speaking, although he often didn’t make any sense. He was laughing–sometimes. And he usually knew his family and friends. It was difficult for him to eat and he often didn’t know what he was eating. But mostly he fed himself.

The day he went to the emergency for severe pain from a kidney stone, Morris was propelled on a downward spiral into end-stage Alzheimer’s. He died six weeks later. In just a matter of days my husband lost his ability to walk, toilet, speak and eat by himself. He needed to be lifted out of bed into a wheel chair and spoon fed. The memory care home he had lived in for two years wouldn’t accept him back because he was no longer ambulatory.

Morris was released from the hospital on a Friday afternoon to a rehabilitation center for physical therapy, which attempted to help he walk–which he never did again. At the rehab center he didn’t sleep at night. The floor attendant kept him in a wheel chair in the hall so he wouldn’t get out of bed and fall. They ended up putting his mattress on the floor because he did fall out and required stitches on his forehead. He’d go days without sleep and my son-in-law predicted that the lack of sleep would get him in the end.

I moved Morris back to his original memory care home on the condition that I had to hire outside help. The rehab facility was understaffed and the food provided little nutrition. The first night I left him there I felt as though I was leaving him to the “wolves.”

When I first placed him in the memory care home two years previous to this time, I was promised that my husband could stay there throughout the course of his illness. So if you are planning to place a loved one in a home, read the contract very carefully.  After he was back at the home for a couple weeks I had to move him again because it was costing way too much at this point to pay the monthly bill of $6,000 dollars plus an additional hourly fee for the outside care agency. Morris lived only two more weeks in an end-stage hospice facility. The staff was top notch and compassionate and I’m grateful that I moved him there.

End-stage Alzheimer’s is not pretty.

It includes:

  • incontinence
  • difficulty eating and swallowing
  • loss of speech
  • inability to walk and get out of bed
  • total assistance with personal care
  • not recognizing family members—but not all the time
  • secondary illnesses
  • sleep issues or sleeping most of the time

What can you do?

  1. Make sure you have all your loved one’s legal and financial papers in place well before this stage. (durable power of attorney, will, trust, advance directives, DNR-do not resuscitate, etc., final arrangements-cremation or burial, memorial service, etc.)
  2. Ask family and friends for support, and be specific. Do you need help with yard maintenance or with walking your dog?
  3. Do you need someone to shovel the driveway or sidewalk if you are spending a lot of time with your loved one?
  4. Ask someone at your place of worship to set up a meal-train or to set up a CaringBridge account to keep friends and family abreast of the current situation.
  5. AFA–Alzheimer’s Foundation of America’s licensed social workers are available Monday through Friday, from 9am to 9 pm EST, and Saturdays from 9am to 1pm EST, via AFA’s National Toll-free helpline–866-232-8484. They are also available by e-mail, chat and Skype.
  6. The Alzheimer’s Association Helpline is open 24/7-800-272-3900.
  7. Hospital chaplains console families and help in times of grief and the difficult period of waiting for a loved one to recover or pass.
  8. Hospice offers support to the patient by providing personal services that include bathing, and palliative care. Hospice also offers grief counseling to families.
  9. It is important that as a caregiver you take care of yourself. On days that I was too exhausted to make dinner, I would heat a pan with a bit of olive oil, saute pre-washed spinach, and pour over a couple of eggs for a healthy, quick meal. Protein is important and so are greens that contain the stress-reducing nutrients vitamin B and magnesium. If you have difficulty eating because of nerves and emotions or time limitations, make yourself a protein shake with berries and/or a banana, a scoop of protein powder and liquid of your choice.
  10. 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.

Blessings to you, your family and your loved one.

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__

Significant study points to MIND diet for improving brain health and preventing Alzheimer’s disease

Brain Nutrition

MIND diet includes salmon, beans, greens, nuts, berries

 

Have you heard of the MIND diet? It’s the Mediterranean diet and DASH diet slightly remade and combined to form the MIND diet. (MIND is an acronym that stands for the Mediterranean-DASH intervention for Neurodegenerative Delay.)

In a study published in September 2015 in Alzheimer’s & Dementia, the nutritional epidemiologist Martha Clare Morris and her colleagues at Rush University Medical Center borrowed concepts from the Mediterranean diet and the DASH diet. The result is the MIND diet.

The study followed 923 participantsages 58 to 98 years, for an average 4.5 years, and found the MIND diet lowered Alzheimer’s risk by about 35 percent for people who followed it moderately well and up to 53 percent for those who adhered to it rigorously. While more study is needed to better understand the long-term impact of the diet, Morris’s team’s second paper on the MIND diet notes that it’s superior to the DASH and Mediterranean diets for preventing cognitive decline. But it should be noted that high adherence to all three diets may reduce risk of Alzheimer’s disease.

Food to eat on the MIND Diet

  • Green leafy vegetables: a minimum of 6 servings a week (kale, Swiss chard, spinach, collard, etc.)
  • Nuts: a minimum of 5 servings a week (walnuts, pistachios, almonds, cashews, etc)
  • Berries: a minimum of 2 servings a week
  • Beans: a minimum of 3 servings a week (garbanzo, red, black, kidney, white, pinto, etc.)
  • Whole grains: a minimum of 3 servings a day (millet, oats, brown rice, quinoa, wheat berries, etc.)
  • Fish: at least 1 serving a week
  • Poultry (like chicken or turkey): at least twice a week
  • Olive oil as the primary oil used
  • Wine: no more than 1 glass a day

Foods to limit or avoid

  • Red meat: no more than 4 servings a week
  • Butter and margarine: no more than 1 tablespoon (tbsp) daily
  • Cheese: no more than 1 serving a week
  • Sweets: no more than 5 servings a week
  • Fried or fast food: no more than 1 serving a week

To summarize the MIND DIET—

On a daily basis you eat at least three servings of whole grains, a salad and another vegetable, along with drinking a glass of wine. The jury is still out on whether a little alcohol consumption is better for the brain than none at all. I just heard a panel of researchers and neuroscientist address this issue. If you don’t consumer alcohol, there is certainly no reason for you to start now. But if you do, limit your consumption to one glass of wine a day.)

It’s advised that on most days you should snack on nuts, and every other day eat half a cup of beans. At least twice a week eat poultry and a half-cup serving of berries (blueberries are best), and eat fish at least weekly. Olive oil is the preferred cooking oil.

What is the DASH diet?

The healthy DASH diet plan was developed to lower blood pressure without medication in research sponsored by the US National Institutes of Health, Dietary Approaches to Stop Hypertension. The first DASH diet research showed that it could lower blood pressure as well as the first line blood pressure medications, even with a sodium intake of 3300 mg/day!  Since then, numerous studies have shown that the DASH diet reduces the risk of many diseases, including some kinds of cancer, stroke, heart disease, heart failure, kidney stones, and diabetes. It has been proven to be an effective way to lose weight and become healthier at the same time.

The DASH diet eating plan is a diet rich in fruits, vegetables, low-fat or non-fat dairy. It also includes mostly whole grains; lean meats, fish and poultry; nuts and beans. It is high fiber and low to moderate in fat. It is a plan that follows US guidelines for sodium content, along with vitamins and minerals. In addition to lowering blood pressure, the DASH eating plan lowers cholesterol and makes it easy to lose weight. It is a healthy way of eating, designed to be flexible enough to meet the lifestyle and food preferences of most people.

How is it different from the Mediterranean diet? It can be considered to be an Americanized version of the Mediterranean diet, and to be easier to follow, since it has more specific guidelines. But if you love tabouli, hummus, and olives, you might prefer the Mediterranean diet.

Although there are similarities among all three diets, the MIND diet is the only one that encourages the consumption of foods that have been found to promote cognitive health.

There is a saying that “what’s good for your heart is good for your brain.” So please start switching over to the MIND diet while eliminating foods high in calories and low in nutrients. You will feel better and your brain will stay healthier longer.


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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 had your blueberries today? They are proven to improve cognition in older adults.

Blueberry smoothie in a glass jar with a straw and sprig of mintIf you’ve ever had the pleasure of picking wild blueberries or strawberries, you’ve experienced the incredible burst of fragrance and flavor offered by each berry. It is easy to get the impression that something that good MUST be incredibly good for you. That might not be a reliable test of healthfulness but, in this case, it happens to be so. Blueberries, as well as strawberries, raspberries, cherries, cranberries and other berries all have remarkable health benefits.

New studies reveal that eating blueberries every day make a significant difference in  cognition in older adults.

A double-blind controlled trial in which 13 men and 24 women, between 60 and 75 years old, ate the equivalent of one cup of fresh blueberries every day for 90 days or a blueberry placebo had an interesting result. The group that ate blueberries showed significantly fewer repetition errors in the California Verbal Learning test.*  These findings show that the addition of easily achievable quantities of blueberry to the diets of older adults can improve some aspects of cognition.

*The California Verbal Learning test is one of the most widely used neuropsychological tests in North America. It is a relatively new approach to clinical psychology and computer science. It is a measure of episodic verbal learning and memory, which demonstrates sensitivity to a range of clinical conditions.

A second study found enhanced neural activation after 16 weeks of daily blueberry supplementation in older adults with mild cognitive impairment at risk for dementia. The researchers concluded that these data demonstrate, for the first time, enhanced neural response during a working memory challenge in blueberry-treated older adults with cognitive decline and are consistent with prior trials showing neurocognitive benefit with blueberry supplementation in this at-risk population.

What’s so special about blueberries?

You’re already familiar with antioxidants, which include vitamins, minerals, herbs, and other nutrients that protect us from free radical damage. Phytochemicals fall under the category of antioxidants, but more specifically, they are compounds found in plants that have been recognized for their potential to fight and protect us from disease. More than 900 different phytochemicals have been identified as components of food, and many more phytochemicals continue to be discovered, it seems, on a weekly basis. It is estimated that there may be more than 100 different phytochemicals in just one serving of vegetables—which is one of the reasons health experts urge us to eat at least five to eight servings of fruit and vegetables each day.

Researchers have known for a long time that the phytochemicals in plants protect them from disease. But it wasn’t until 1980 when The National Cancer Institute began evaluating phytochemicals for their safety, efficacy and potential for preventing and treating human diseases that health experts recommended that we increase our consumption of fruit and vegetables as a valuable way to ward off illness and disease.

Blueberries come out on top

In a test that measures the antioxidant potency of a variety of foods—the Oxygen Radical Absorbance Capacity (ORAC) test—blueberries came out on top.  This tiny, magnificent berry contains a huge serving of antioxidants that have been demonstrated to benefit numerous health conditions, including the prevention of oxidative and inflammatory stress on the lining of blood vessels and red blood cells. Berry anthocyanins also improve neuronal and cognitive brain functions, ocular health as well as protect genomic DNA integrity.

Berries as Smart Nutrients

In a landmark study in 1999, researchers at Tufts University discovered just how powerful this berry is by feeding old rats the equivalent of one cup of blueberries a day. The results were dramatic. The old rats that were fed the blueberries:

  • learned faster than the young rats
  • were more coordinated
  • showed improved motor skills
  • outperformed the young rats in memory tests

In one test, 6-month-old rats were able to run on a rod an average of 14 seconds, when compared to old rats, which fell off after six seconds. But remarkably, the old rats that were fed a blueberry supplement could stay on the rod for 10 seconds. Although the rats didn’t become young again, their skills improved tremendously. When the researchers examined the rats’ brains, they found that the brain neurons of the rats that ate the blueberries were able to communicate better.

The study was significant because the researchers discovered blueberry’s potential for reversing some age-related impairments in both memory and motor coordination. The researchers concluded that these findings suggest that, in addition to their known beneficial effects on cancer and heart disease, phytochemicals present in antioxidant-rich foods may be beneficial in reversing the course of neuronal and behavioral aging.

An earlier study done by researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University published research showing that nutritional antioxidants, such as the polyphenols found in blueberries, can reverse age-related declines in brain function, namely the cognitive and motor deficits associated with Alzheimer’s and Parkinson’s disease. Since then, hundreds of studies have been done showing that all kinds of berries exert a protective effect against oxidation—a principal cause of cellular damage and death—which ultimately results in illness and disease.

 Protects against brain damage

Among blueberry varieties, wild or lowbush blueberries contain the highest antioxidant power and were shown to protect laboratory animals from brain damage from an induced stroke, after they ate blueberries for six weeks. The researchers concluded that this study suggests that inclusion of blueberries in the diet may improve ischemic stroke outcomes.

Conclusion

There are thousands of health-promoting phytochemicals in plants—which is why it’s so important to eat a wide variety of colorful fruits and vegetables every day. Berries contain numerous phytochemicals (including anthocyanins, lutein, carotenoids, ellagic acid, chlorogenic acid, and caffeic acid) that have potent antioxidant and inflammatory effects—that have specifically been shown to protect us from numerous health ailments and diseases.

But most Americans do not meet the Recommended Daily Allowance of five to eight fruits and vegetables a day. The good news is that taking a daily nutritional supplement containing a mixture of berry extracts is an excellent way to get a variety of unique phytochemicals, and cover your antioxidant protection needs.

Berry good for you recipes

Berry Smoothie

Ingredients

  • 2 frozen bananas
  • 4-5 strawberries
  • 1/2 cup of blueberries
  • 1/2 cup of raspberries
  • 1 tsp. of maple syrup or stevia (optional)

Blend in a food processor or blender. About 500 calories (if you use the maple syrup) and 0 fat

Serves: 1-2

 Two berry crisp

Ingredients

  • 1 pint blueberries
  • 1 pint strawberries, hulled, sliced
  • 2 cups sugar-free granola
  • 2 TB coconut oil

Preparation:

Preheat oven to 375°. Toss prepared berries in an 8-inch square glass baking dish. Blend coconut oil with the granola and sprinkle the mixture over the berries.Cover dish with foil and bake for 30 minutes. Remove foil and bake another 10 minutes, until topping is browned. Serve warm or at room temperature, with ice cream or whipped topping.

Serves 6-8

Enjoy!


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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-Helpin 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.