Category Archives: Memory

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

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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-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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Caring for yourself and others with good nutrition

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Mary Collette Rogers interviewed me on her podcast “The Healthy Kitchen Companion.”

Find out more about Mary’s programs around The New Kitchen Way: cookhappylivehealthy.org/blog/

Discover insights and tools for handling the challenges of caregiving, particularly stress. Sobering statistics highlight the need for addressing this topic: In 2017, fully 16 million friends and family provided 18 billion hours of unpaid care for 5½ million Americans with Alzheimer’s. That figure, of course, accounts for just one of many chronic conditions that required the services of caregivers.

Equally important is the need for self-care since it is said that at some point you’ll either be a caregiver or be cared for yourself. Self-care can minimize the need for care from others, or make it possible to provide care to those you love.

In this conversation, Barbra Cohn and Mary Collette Rogers share a wealth of knowledge and strategies for using the power of good nutrition to alleviate the stress of caregiving–whether for yourself or others.

Barbra, author of Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia, provides solid nutritional advice for
** Introducing the Stress Vitamins and minerals, and foods where they can be found
** How neurotransmitters like serotonin improve mood and how to use natural mood boosters in foods to uplift mood
** Why breakfast is the most important meal of the day for caregivers and key breakfast foods
** Barbra’s secret for boosting immunity, staying hydrated and replenishing nutrients drained by stress

Mary Collette, Healthy Kitchen Companion, explores how to ensure that Barbra’s nutritional wisdom doesn’t just get parked at the kitchen door. With The New Kitchen Way, her integrated approach to meal making, you’ll see good nutrition advice actually show up on your table–deliciously and easily. Learn
** About the power of organization and why it works as well in the kitchen as the business world
** How chaos and lack of control are the true culprits that sabotage kitchen fun and success
** How organization alleviates stress when you invite it into your kitchen and meal making
** How the kitchen and meal making can be broken down into just six areas, and
** How the 6 KitchenSmart Strategies easily guide you to get those six areas under control, leaving you relieved and confident about making nourishing meals.

 

 

The Stigma of Having Dementia: To tell or not to tell

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若い女性One of the hardest things about getting a diagnosis of Alzheimer’s disease is deciding when and whom to tell. When my husband was diagnosed with younger-onset Alzheimer’s disease at 60 years old we were afraid that people would treat him differently, and that our friends would write us off.

Although we were excluded from some social events and intimate dinners by friends who didn’t have the patience to listen to the same story repeated over and over, or by those who simply didn’t know how to act around someone with dementia, most of our friends created a warm, caring cocoon that helped us feel safe and loved.

In the beginning, I refrained from telling our children about their dad’s diagnosis for an entire year, hoping to delay their heartache. Our youngest daughter had just gone off to college and we wanted her to have one year in which she could focus on her studies and friends, without worrying about her parents.

I tried my best to cover up my husband’s gaffes, slips of memory, and awkwardness in social situations. Eventually, we withdrew from our old life because of the challenges that accompany dementia, and we socialized only with family and intimate friends. Our world became increasingly smaller as I became lonelier and more isolated.

When I look back at that time I find it naïve to think that divine intervention or a miracle would cure my husband. After all, I thought, why tell people about his diagnosis when perhaps he’ll be cured as a result of taking myriad nutritional supplements and getting healings from alternative practitioners? It can remain our little secret.

It turns out that according to a survey published in the World Alzheimer’s Report 2012: Overcoming the Stigma of Dementia, we weren’t alone in trying to keep my husband’s diagnosis a secret. (We did tell my parents, his brother, and a few very close friends.) Nearly one in four people with dementia (24 percent) who responded to the survey said they hid their diagnosis, citing stigma as the main reason. They expressed concerns that their thoughts and opinions would be discounted and dismissed, and that they would be treated more positively if they did not reveal their diagnosis.

Why worry about stigma when you’ve got so many other worries?

Identifying stigma is important because it:
• Gets in the way of receiving the proper help and care people with dementia need in order to live life optimally
• Leads to stereotyping and discriminating of the elderly and those with dementia
• Damages the fragile self-esteem of people with dementia
• Is a major cause of social isolation for the dementia patient and his or her family
• Is a barrier to the caregiver’s utilization of community services and obtaining support from family and friends
• Reduces the depression and burden for the caregiver

Doctors keep secrets, too. What happens when the doctor doesn’t reveal a diagnosis?

According to a report released March 24, 2015 by the Alzheimer’s Association, just 45 percent of Medicare patients who’d been diagnosed with Alzheimer’s said they were informed of the diagnosis by their doctor. By contrast, more than 90 percent of Medicare patients with cancer said they were told by their doctor.

One reason doctors often cite for not telling patients is the time constraints of a typically short appointment, says Keith Fargo, director of scientific programs at the Alzheimer’s Association. “It’s difficult to disclose a diagnosis of a fatal brain disease in just a few minutes,” he says. (The average length of time a doctor spends with a Medicare patient is just 8 minutes.)

It’s also hard for doctors to tell patients they have a disease that can’t be stopped or even slowed down by a drug or surgery, Fargo says. And, he says, doctors often fear the emotional reaction an Alzheimer’s diagnosis can cause.

However, the Alzheimer’s Association believes that telling the person with Alzheimer’s the truth about his or her diagnosis should be standard practice. Disclosure can be delivered in a sensitive and supportive manner that avoids unnecessary distress. And based on the principles of medical ethics, there is widespread agreement among health care professionals that people have the right to know and understand their diagnosis

Disclosing an Alzheimer’s diagnosis has several benefits:

  • Allows better access to quality medical care and support services
  • Provides an opportunity for people with a diagnosis to participate in decisions about their care, including providing informed consent for current and future treatment plans
  • Enables the patient to get the maximum benefit from available treatments
  • Increases the chance of participating in clinical drug trials

What can you do?

In response to the World Alzheimer’s Report 2012: Overcoming the Stigma of Dementia, the Alzheimer’s Association came up with these tips for coping with stigma created by people living with the disease. Current and former members of the Alzheimer’s Association National Early-Stage Advisory Group developed these tips based on their personal experiences:

  • Be open and direct. Engage others in discussions about Alzheimer’s disease and the need for prevention, better treatment and an eventual cure.
  • Communicate the facts. Sharing accurate information is key to dispelling misconceptions about the disease. Whether a pamphlet or link to online content, offer information to help people better understand Alzheimer’s disease.
    • Seek support and stay connected. It is important to stay engaged in meaningful relationships and activities. Whether family, friends or a support group, a network is critical.
    • Don’t be discouraged. Denial of the disease by others is not reflection of you. If people think that Alzheimer’s disease is normal aging, see it as an education opportunity.
    • Be a part of the solution. Advocate for yourself and millions of others by speaking out and raising awareness. If you have the time and inclination, write letters to your state representatives, and to your newspaper.

If you or a loved one have received a diagnosis of dementia or Alzheimer’s disease I encourage you to not keep it a secret as I did. Be open and share your feelings with your family and friends. Unfortunately, because Alzheimer’s disease is predicted to become an epidemic for the Baby Boomer generation, almost everyone will be touched by it in one way or other. It’s important that we do our best to educate the public and the best place to start is within our circle of family and friends—-because ignorance leads to fear and understanding leads to compassion.

 

What does marijuana do for Alzheimer’s and dementia patients?

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Medical marijuana from the DoctorMy husband passed away eight years ago from younger-onset Alzheimer’s.  Recreational marijuana is now legal in Colorado, but before medical marijuana was legal I’d find a way to obtain it for him to smoke or eat in cookies and brownies. It calmed him down and made him happy. It reduced his anxiety, but it definitely did not help his memory. And that’s not what I was looking for. I just wanted him to feel calmer, and in so doing, it helped me feel more at ease. (Please read Is it a good idea for Alzheimer’s and dementia patients to use marijuana?)

I am not a scientist, but having interpreted studies for the nutritional supplement industry for several decades I can say that it’s possible to find a pro and con study for almost any drug, nutraceutical, herb, vitamin or mineral. Every person is unique, every situation is unique and every environmental factor will influence the outcome of a scientific study in some way. This fact is especially interesting: Because of the federal restrictions, researchers’ only legal source of cannabis for study is a Mississippi farm. But the marijuana plants there are not necessarily identical to those that people get at the dispensary or on the street. Just another indication that studies don’t always demonstrate accurate findings.

Marijuana studies vary in quality and the conclusions are frequently conflicting, according to experts on the issue. What we do know is that marijuana contains hundreds of chemical compounds, the most powerful of which are delta-9-tetrahydrocannabinol, or THC, and cannabidiol, or CBD. THC produces the psychoactive effects — the marijuana high. CBD has a role in pain control and also moderates the effect of THC. But many strains of marijuana in use today have high concentrations of THC and little CBD to balance it. The long-term effects of this shift are unknown.

Here are some recent studies showing the effects of marijuana use on cognition, dementia and heart health.

  1. It’s a known fact that high beta-amyloid—the culprit in Alzheimer’s disease—triggers inflammation and nerve cell death. This leads to memory loss and cognitive deficits. A study published in the journal Aging and Mechanisms of Disease (Amyloid proteotoxicity initiates an inflammatory response blocked by cannabinoids) found that the compound THC (tetrahydrocannabinol) reduced beta-amyloid levels and eradicated the inflammatory response to beta-amyloid, preventing nerve cellular death. While clinical trials are needed to confirm the role THC might play in protecting nerve cells against beta-amyloid, the researchers believe their findings shed more light on the role beta-amyloid plays in Alzheimer’s disease, which could pave the way for new treatments.
  2. Another study examined mice with induced symptoms of Alzheimer’s. The laboratory animals were given a combination of THC and CBD.  The animals displayed improved learning and had less evidence of amyloid clumps in their bodies. Other researchers believe that targeting the CB2 receptor could control the activity of microglia, (a type of cell located throughout the brain and spinal cord) preventing the potentially harmful overactivation of the immune system in the brain.
  3. A Harvard study indicates that medical marijuana has a positive impact on executive functioning in adults. The study points out that medical marijuana products themselves may protect against the executive function deficits that affect most recreational marijuana users because of the inherent differences between medical and recreational products. Medical products are usually low in THC, the primary psychoactive constituent of the plant, and high in other cannabinoids, including CBD. CBD is a non-psychoactive component touted for its therapeutic potential, which may also mitigate some of the negative effects of THC. On self-report questionnaires, patients also indicated moderate improvements in quality of sleep and depression. Obviously, individuals with dementia and Alzheimer’s are not  making important decisions, but this study shows how cannabis can help with sleep and mood.
  4. Research presented in March 2017 at the American College of Cardiology’s 66th Annual Scientific Session showed that using marijuana raises the vascular risks of stroke and heart failure, both major risk factors leading to vascular dementia. Research in cell cultures shows that heart muscle cells have cannabis receptors relevant to contractility, or squeezing ability, suggesting that those receptors might be one mechanism through which marijuana use could affect the cardiovascular system. The study drew data from the Nationwide Inpatient Sample, which includes the health records of patients admitted at more than 1,000 hospitals comprising about 20 percent of U.S. medical centers. Researchers extracted records from young and middle-aged patients—age 18-55 years—who were discharged from hospitals in 2009 and 2010, when marijuana use was illegal in most states. Marijuana use was diagnosed in about 1.5 percent (316,000) of more than 20 million health records included in the analysis. Comparing cardiovascular disease rates in these patients to disease rates in patients not reporting marijuana use, researchers found marijuana use was associated with a significantly increased risk for cardiovascular events such as stroke, heart failure, coronary artery disease and sudden cardiac death. Marijuana use was also linked with a variety of factors known to increase cardiovascular risk, such as obesity, high blood pressure, smoking and alcohol use. After researchers adjusted the analysis to account for these factors, marijuana use was independently associated with a 26 percent increase in the risk of stroke and a 10 percent increase in the risk of developing heart failure.

“Even when we corrected for known risk factors, we still found a higher rate of both stroke and heart failure in these patients, so that leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects,” the lead researcher said. “More research will be needed to understand the pathophysiology behind this effect.”

Conclusion

A lot of clinical research needs to be done in order for the medical community and Alzheimer’s Association to recommend the use of cannabis for Alzheimer’s and dementia.

As with any pharmaceutical, it’s important to understand that no drugs are, as a general rule, 100% safe. But if they can fix something, we take a calculated risk by using them. If cannabis calms down an agitated person, helps with sleep, puts a smile on one’s frozen face, it might be worth trying. If you do decide to give it to an individual with Alzheimer’s, please be cautious. Start with a very small dose in a cookie or brownie and see what the reaction is. Watch for signs of distress and nausea. And hope for some sense of calm and joy.

It helped my husband relax and appear as his old, happy self. But it certainly didn’t help his cognition.

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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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

 

 

 

 

 

 

Do you worry about developing digital dementia?

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Cropped Group of friends standing on table and browsing in their divices in modern roomI recently listened to a lecture about the dangers of digital dementia, and I think it’s an important topic to explore on the healthycaregiverblog. Essentially, it’s a condition that develops overtime after becoming addicted to and overusing digital technology. This includes smart phones, computers, reading devices, and tablets. The term was coined by German neuroscientist Manfred Spitzer and describes how the result of overuse of digital technology is resulting in the breakdown of cognitive abilities, which first appear as something similar to attention disorder.

Our kids are on their phones too much, they play video games for hours, and studies have shown they are having an increasingly harder time concentrating on schoolwork. An article in Psychology Today (Susan Greenfield Ph.D., 7.1.15) says “We know that action video gaming is linked with greater brain volume in the striatum (1) but this may be at the expense of a reduction in hippocampal volume. (2) Although this proposal requires further investigation, previous research has shown that reduced grey matter in the hippocampus is associated with an increased risk for schizophrenia, post-traumatic stress disorder, depression and dementia, amongst other disorders.”

According to the Kaiser Foundation’s shocking report, elementary-age children use entertainment technology for an average of 7.5 hours a day.

  • 75% of these children have televisions in their bedrooms
  • 68% of two-year-olds regularly use tablets
  • 59% have smartphones
  • 44% have game consoles.

While occasional digital screen time may be okay, many parents rely on them for babysitting and some peace and quiet. An ASHA Survey of the U.S. states that:

“…more than half of parents surveyed say they use technology to keep kids ages 0–3 entertained; nearly 50% of parents of children age 8 report they often rely on technology to prevent behavior problems and tantrums.”

However, just because something is common doesn’t mean it’s okay. What exactly should we be worried about?

Spitzer proposes that short-term memory pathways will start to deteriorate from underuse if we overuse technology. I know for my self that I am addicted to checking my email and friends’ Facebook posts. I have also realized that it is more difficult for me to concentrate on reading the newspaper because I can get the nugget of information more quickly online than reading an entire article. I’m just thankful my overuse of technology hasn’t gotten in the way of my love for reading hand-held old-fashioned books.

But what about putting myself at risk for dementia? Should I worry? Should you worry?

YES!

Here’s why: All digital devices emit high levels of blue light and blue light has been proven to increase cortisol levels.  Cortisol is the stress hormone.  Chronically elevated cortisol levels can lead to shrinkage in some brain areas, most notably the hippocampus, which is what is associated with memory and recall. This is the area first affected in Alzheimer’s disease.  Elevated cortisol is also a major contributor to obesity and Type II Diabetes.  It also disrupts our normal circadian rhythm leading to sleep disorders. Over 25,000 articles have been published in scientific journals over the last 30 years about the effects of EMF’s (electromagnetic fields) on human health.

I think we all need to be cognizant of how much time we spend behind the screen–any screen, including TV. Here are some ways to turn of the technology, re-establish healthy social interaction and get healthier at the same time.

Include your family in setting these parameters

  1. Get outside as much as possible. Walk more. Get a dog so you have to go outside and walk. Exposure to natural sun light is much preferred over sitting in front of a digital device that emits blue light.
  2. Limit the time digital technology is used in your home. Set a specific time and limit that time.
  3. Read more, read together.
  4. Enjoy a joint or individual project. Have a game night or an ongoing puzzle set up in the family room.
  5. Make it a strict rule: no phones or TV at the dinner table. That includes at  restaurants.
  6. Learn games on non-electronic formats. For instance, instead of learning how to play chess on a computer, get a chess set and set up the board. Leave it out; don’t put it away. It’ll encourage your family to play more often.
  7. Write a play and then act it out for the family or neighborhood
  8. Learn how to play a musical instrument.
  9. Join a sports team.
  10. Walk a neighbor’s dog or babysit.

You will enjoy more social interaction, feel happier, healthier and more at peace with yourself and the world around you.

 

  1. Kühn S, Romanowski A, Schilling C, Lorenz R, Mörsen C, Seiferth N, … & Gallinat J. (2011). The neural basis of video gaming. Translational Psychiatry, 1(11), e53
  2. West GL, Drisdelle BL, Konishi K, Jackson J, Jolicoeur P, & Bohbot VD. (2015). Habitual action video game playing is associated with caudate nucleus-dependent navigational strategies. Proceedings of the Royal Society B, 282(1808)

 

 

Can depression be a sign of dementia?

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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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

You have a dementia diagnosis, now what?

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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 Amazon, Barnes 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

 

 

 

 

 

Love doesn’t conquer all: caregiver resentment and frustration

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Senior Couple QuarrellingI recently participated in a caregiver symposium. I spoke to dozens of caregivers who expressed fatigue, frustration, and exasperation. Everyone was stressed and stretched to the limit. I detected little joy. Instead, people appeared resentful. “I didn’t sign up for this,” one man said. Another confided, “I read your book and am taking your advice. I will not let my wife’s illness ruin my life.”

Caregiving only goes one way: it gets harder. And when we don’t really like the person we are caring for or if we feel trapped, it is even more challenging. I was only 48 years old when my beloved husband was diagnosed with Alzheimer’s disease. I knew our lives would never be the same again. . . and they weren’t.

Yes, we had joy. Our young adult children graduated from college and got married. We went on a few trips. We had some funny moments that elicited belly laughs. But the emotions I remember most are the heaviness of grief, despair, depression, guilt, and fear. I didn’t feel resentment, I think, because I have a philosophical outlook that we reap what we sow (as in the law of karma), and that somewhere, somehow in a past life beyond the ethers I had signed up for my caregiving duty. I tried to put on a happy face. But I told my closest friends that I was exhausted and stressed.

I felt shame that after decades of practicing Transcendental Meditation and following a healthy vegetarian lifestyle our lives had come to this. Wasn’t life supposed to be blissful and free of stress? I soon realized that no one gets out of here without going through at least one huge, transformative challenge. Mine was caregiving for my life partner, who was unable to hep me make the big decisions such as finding a smaller house because ours had become unmanageable, or finding a memory care home for him when I wasn’t able to continue physically caring for him.

Guilt? Yes, I still feel guilt even though my therapist often said to me “If a friend told you what you just told me, what would you say to her?”

“I would tell her ‘you are doing the best that you can.'” And I did do the best I could for my husband. I took him to healers and doctors and gave him nutritional supplements that been shown to help support cognition and memory.

But I still feel guilt about running away every chance I got to dance or have lunch with a friend, even though I know I needed the relief time in order to stay healthy and strong so I could carry out my caregiving duties.

When all is said and done, if you are not exactly thrilled about giving countless hours to someone you love or to someone you are obligated to care for because there is no one else, you might as well learn how to be the best caregiver possible. Because when your caregiving is over, you will have another chance to live the life you chose for yourself. So give it your best shot. Here are some ways to ease the burden and to help you feel good about yourself and the person you are caring for.

Lighten the load of caregiving

  • Take care of yourself first. Carve out time every day to go for a walk, do yoga, dance, sing, whatever it takes to help you feel better.
  • Join a support group. I don’t know how I would have maintained my sanity if I hadn’t joined the younger-onset Alzheimer’s support group offered by the Alzheimer’s Association.
  • See a therapist. Mine was a god-send who listened with compassion and gave excellent advice.
  • Sign up for community services such as day programs, senior centers, Meals on Wheels, hotlines, etc.
  • Hire someone to take your “care partner” (the person you care for) out for lunch, to the movies, for a visit to a museum, etc.
  • Ask your friends and neighbors for help mowing the lawn, retrieving the mail, sitting with your “care partner “so you can do errands, etc.
  • Talk to family members and make a plan to share the responsibilities. (more on this in another blog post)
  • Make an appointment with an elder attorney to draw up a contract for you to receive wages, find out how to get social security withheld, etc.
  • Breathe! After I buried my husband I realized that I hadn’t fully breathed in years. I was tight, my lungs were tight and I was holding my breath waiting for the next next emergency to occur.

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Here’s an excerpt from my book  Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia about breath work, including a simple exercise. Follow the directions for breathing in order to release stress and feel more energized.

by Reverend Shanthi Behl (excerpted from Calmer Waters)

Breath work is the first and easiest to start with. We can deliberately extend, shorten, retain, and otherwise direct the air we breathe in a variety of ways in order to guide the prana. Second, is the mechanism of directed attention, also known as our intention. Where our thoughts go, our prana goes. An integrated pranayama practice utilizes both the breath and our focused attention.

When we say we are tired and have no energy, what we are really saying is that our energy is blocked. We need to breathe to live, and how we breathe can profoundly affect our degree of physical well-being; it can regulate our emotions, and it can deplete, sustain, or increase our experience of aliveness. Prana is constantly fluctuating and moving throughout the universe. According to yoga philosophy, it flows throughout the living body in exquisitely determined whirlpools and currents. The wonderment of the yogic system is asana and pranayama practice which allows our innate energy currents to flow as nature intended.

The following instructions are for sitting, but you can practice this exercise while standing in mountain pose.

• Sit up tall, lengthen the spine, and place the feet flat on the floor. Press the feet into the ground, even as you press the top of the head toward the ceiling.

Relax the hands lightly on the lap and release the shoulders down away from the ears.

• Soften the belly muscles. As you breathe in through the nose, lengthen through the crown of the head.

• As you breathe out through the nose, release the shoulders and press your feet into the floor.

• Continue this practice and turn your awareness to sensations along the spinal column. Feel the upward flow as you breathe in and the downward flow as you breathe out. It is perfectly fine if you feel the opposite movement. The important aspect is to tune into a sense of any movement along the spine. You may not initially feel the movement of your energy. However, by first imagining it, you will later actually feel the upward and downward flows of energy along sushumna, the central core of energy.

 

Why you should throw away that antipsychotic drug prescribed for your loved one

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Elderly woman taking a medicineAccording to Human Rights Watch in an average week, nursing facilities in the United States administer antipsychotic drugs to over 179,000 people who do not have diagnoses for which the drugs are approved. Often, these drugs are dispensed like candy, without free and informed consent. . . without a family member or someone who holds durable power of attorney for the health care resident, to make a decision based on the benefits and risks of taking the medication.

Like my late husband, most of the patients who are given these drugs have some form of dementia or Alzheimer’s.  My husband was in a memory care home for two years. Towards the end of his illness, he was given an antipsychotic drug because his behavior became “difficult.” He was not combative, and he was mostly non-ambulatory. Once, though, while sitting, he swung out his arm and hit a woman who was bothering him. Since I wasn’t there, I don’t know the details. But in general, he was a sweet man up until the end. He did get annoyed, however, by other residents’ behavior. And so he was given a drug to pacify him. After visiting him over a period of a few weeks and noticing the deterioration in his overall wellbeing, including his inability to hold his head up, sit upright, or staying awake most of the day, I demanded that he be taken off a number of drugs. The improvement was dramatic and astounding.

According to the US Government Accountability Office (GAO) analysis, facilities often use antipsychotic drugs to control common symptoms of Alzheimer’s. These drugs are associated with clinically significant adverse effects, including death. Then why are they being prescribed to an extremely vulnerable, frail and “at risk” population? Because disruptive behaviors such as crying out “help me, help me” over a long period of time, or yelling out profanities, or exhibiting aggressive behavior can become a nuisance that caregivers –professional and family–are either not skilled in addressing or are too busy taking care of other patients to be bothered with.

What are the alternatives?

First:

  • Eliminate noise and disruption.
  • Make sure the patient does not have a urinary tract infection.
  • Evaluate physical needs. Is s/he thirsty, hungry, constipated, etc?
  • Encourage the patient to verbalize feelings and needs, if possible.
  • Limit or reduce caffeine.
  • Reduce external stimuli (loud TV or radio, etc.).
  • Dim the lighting.
  • Avoid confrontation and use a soft, sweet speaking voice.
  • Provide companionship.
  • Identify events or issues that trigger behaviors.

Once you know the patient is safe and free from pain due to an infection, create a calm and beautiful environment.

Creating a beautiful space

  • Maintain a clean environment without clutter.
  • Enjoy a vase of fresh flowers.
  • Burn incense to clear and purify the air, unless the smoke or odor is irritating.
  • Paint the walls a color that rejuvenates the spirit. For instance, green is healing and relaxing, red restores vitality in people who are depressed, and purple is powerful for those who need spiritual and emotional healing.
  • Gather gemstones. They exert healing effects. Lithium quartz is said to ease tension and stress, and keep nightmares at bay. Pink Calcite promotes compassion, healing, and universal love. Amethyst is for protection, purification, and spiritual/divine connection.
  • Listening to calming sounds can relax a tense body within minutes. Consider a wind chime, water fountain, or a CD of singing birds, ocean waves, or falling rain.]
  • Use essential oils or aromatherapy to have a specific effect on the body, mind, and spirit. (See Aromatherapy, Chapter 18 in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.”)
  • Create an outdoor sacred space with river rocks, a koi or lily pond, a flowering tree or shrub, pampas grass, colored sand—the possibilities are endless.
  • Include religious symbols, chakra symbols, animal totems, prayer flags, angel statues, rainbow banners, and lamps with colored bulbs.

Herbal remedies

  • A nervine is a plant remedy that has a beneficial effect upon the nervous system.  Nervines are especially useful during times of stress because they have a strong relaxing and calming effect without producing a dulling, “hang-over” side effect.  They also tone and restore the nervous system to a more balanced state.  Some nervines are also anti-spasmodic, meaning they relax the peripheral nerves and the muscle tissue, which in turn has a relaxing effect on the whole system.
  • The main types of nervines are tonics, relaxants, and stimulants.
  • Nervine Tonics – are particularly helpful for strengthening the nervous system and restoring balance. In addition to having a relaxing effect, they have a vaso-dilating action on the blood vessels of the brain.  This increases oxygen availability to brain cells and helps with mental agility and mood.
  • Nervine Relaxants – are especially beneficial for short-term use, for example in treating mild depression or acute anxiety. “This group of nervines are most important in times of stress and confusion, alleviating many of the accompanying symptoms. They should always be used in a broad holistic way, not simply to tranquillize.  Too much tranquilizing, even that achieved through herbal medication, can in time deplete and weigh heavily on the whole nervous system,” says renown herbalist David Hoffman.
  • Nervine Stimulants– are used as a restorative “pick-me-up” when you need an energetic boost without that revved up feeling produced by caffeine.
  • Recommended nervines:
  • Passion flower- helps soothe anxiety, insomnia, tension headaches, muscle aches and spasms, pain, hyperactivity, epilepsy, and helps alleviate anger and 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 your loved one is  feeling nervous, agitated, restless or hyped up, try calming him/her with a nervine herb or aromatherapy. If your loved one is on medication, please check with the physician to make sure the drugs do not interact with the nervine herbs.

Other ways to help a person with dementia relax and feel calm without the use of antipsychotic drugs.

  • Aromatherapy
  • Music
  • Pet therapy
  • Horticulture therapy
  • Color therapy

For detailed information on all of the above, read  “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”

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12 tips to encourage your Alzheimer’s patient to eat

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Seniorin mit BetreuerinIt seems that ice cream is the favorite food of most Alzheimer’s patients. It was certainly my husband’s. Sometimes it was the only thing that he found appealing. It’s no wonder: ice cream is cold, slippery and delicious! However, there are lots of healthy frozen desserts available that are low in fat and calories that contain little or no cholesterol. Try Rice Dream®, Coconut Bliss, Soy Dream, or Halo Top. If you have a food processor, puree frozen strawberries or bananas. You won’t even miss the sugar and cream.

Getting adequate nutrition and even the sheer act of eating can be a challenge for both patients and caregivers. Here’s a list of ways to create a tranquil setting, and some easy-to-eat foods to uplift mood and support immunity for everyone.

  1. Play classical or another type of relaxing music. My husband loved to listen to Nina Simone’s jazzy voice while he ate. Whatever the preference is, play the music softly to create an inviting atmosphere. If your loved one lives in a memory care home, the other residents will probably appreciate the music, as well.
  2. Light a candle. Set the table with a table cloth and vase of flowers. Beauty, color and light always create a magical, calming effect.
  3. Aromatherapy oils including peppermint and spearmint are energizing and might stimulate appetite.
  4. Make the chair as comfortable as possible, especially if the person has a bad back. Place a cushion on the seat and back, if necessary.
  5. Use soft lighting. Replace glaring light bulbs with a warmer color light bulb, or install a dimmer.
  6. It might be hard for the person to differentiate foods on a plate, especially if they are the same color. Use contrasting colors. For example, serve beets and carrots on white instead of white mashed potatoes on a white plate.
  7. If your patient has trouble using a fork and knife, serve finger foods. Sandwiches cut in quarters or even eighths, pieces of fruit rather than whole fruits, baked potatoes cut into chunks, etc. are easier to manage.
  8. Use herbs and spices to flavor foods instead of salt. Herbs and spices have healing benefits. For instance, basil can relieve gas and soothe stomach upsets. Cinnamon has a tranquilizing effect that helps reduce anxiety and stress. It also helps regulate blood sugar. Dill soothes the digestive tract and reduces heartburn. Mint promotes digestion and boosts mental alertness.
  9. Puree soups such as split pea, potato/leek. cauliflower, and vegetable, and serve with a wide straw, if necessary. This relieves the chore of chewing and helps hydrate as well as nourish the patient.

One of my all-time favorite recipes is for Indian kicheree, also called a “meal in a pot.”

This traditional soup is wonderful during times of stress, stomach upset, and any time the appetite is diminished due to sickness or stress.

Kicheree

4 Tbs organic Basmati rice

4 Tbs mung dal or red lentils

4 1/2 cups water (more or less, depending on whether you like it soupy or thick)

2 tsp grated fresh ginger

2 Tbs fresh lemon juice

1 cup assorted veggies cut bite-sized (zucchini, yam, carrot, cauliflower, broccoli, etc.)

1 tsp ground coriander seed

1 tsp ground cumin seed

1/4 tsp turmeric

salt and pepper to taste

Combine the rice, dal ginger, veggies and water in pot. Add the spices. Bring to a boil over medium heat; then lower to a simmer for 45-50 minutes. Add water if it gets too thick. Remove from the stove. Add the lemon juice, salt and pepper.

10. Protein shakes are nutritious, filling, and nourishing. Use ingredients of your choice without relying on the sugary nutrition drinks that are generously handed out in institutions. Bananas, strawberries, blueberries, kale, spinach, peanut butter, coconut milk, almond milk, hemp milk, soy milk, and cow’s milk are some of the popular ingredients to try. Protein powders are concentrated sources of protein from animal or plant foods, such as dairy, eggs, rice or peas. The most popular include whey, casein, egg, pea, hemp, brown rice, and mixed plant proteins.

11. Offer healthy snacks throughout the day such as cheese and apple slices, nut butter on apples slices, fresh fruit, humus and carrot sticks.

12. Eggs are my favorite “go to” food for protein. They are easy to eat, can be made in a variety of ways and contain 13 essential vitamins and minerals! Vitamin D for bone health and immune function, lutein and zeaxanthin, antioxidants important for reducing the risk of cataracts and macular degeneration, vitamins B 12 and B6, thiamin, riboflavin, folate, choline, vitamin E, vitamin A, iron, zinc and more. Add pureed veggies for extra vitamins and minerals. Devil eggs are always a hit as a delicious and highly nutritious snack.

For hundreds of other caregiving tips, read “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia”

 

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