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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Forgetful senior with dementia

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

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

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

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

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

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

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

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

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

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

Please be gentle with yourself.

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

The memory care home wants to evict my loved one! What should I do?

Caregiver yelling at man in wheel-chair

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

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

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

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

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

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

Contact your ombudsman

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

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

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

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

Who can use an Ombudsman?

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

How do I contact my Ombudsman?

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

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

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

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

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

Essential oils can diffuse feelings of sadness, depression, anxiety, etc. Lavender oil is the most frequently used fragrance. You can also try bergamot, grapefruit, lemon, orange, clary sage, geranium, rose, and ylang-ylang, frankincense, and myrrh. Put the oil in a diffuser or spray bottle to mist your loved one’s collar or pillow. Find a fragrance that is pleasing to them.

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

All the best to you in the new year,

Barbra

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


Is your care partner driving you nuts?

Stressed caregiver

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

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

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

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

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

I’m a little worried about my memory

Woman forgot to pick her granddaughter up from preschool.

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

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

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

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

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

Here’s what I know

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

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

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

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

Signs of cognitive decline

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

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

What happens physically to the normal aging brain?

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

Normal brain aging

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

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

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

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

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

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

Man resting in garden with his dog

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

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

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

Pets offer numerous benefits

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

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

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

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

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

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

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

Pets can:

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

Things to consider

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

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

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

14 ways that caregivers can achieve a healthier, more relaxed 2021

You’re tired, you’re stressed – You and 45 million or so American caregivers, including the 16 million adult family members caring for a someone with Alzheimer’s. So what are you going to do about it? Don’t say that “I don’t have time to take care of myself.” I’ve been there and done that. But I always promised myself that I was not going to be a martyr and sacrifice my health for my husband’s illness. Because if both of us were sick that wasn’t going to help anyone, least of all our children. They were barely adults when my husband was in the throes of Alzheimer’s disease. Our kids needed at least one healthy parent. And whether you are taking care of a spouse, parent or child, there are other people in your life who love and need you, not necessarily to take care of them, but to love and support them emotionally.

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

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

  1. Say a positive affirmation before you get out of bed. “This day is going to be a good one.” “I am grateful for my friends and family.” “I am healthy and full of energy.” “I am strong and competent.” Say something positive to set the tone of the day.
  2. Before you reach for a cup of coffee, drink a glass of hot water with lemon. It hydrates your body and brain, the lemon helps to alkalize the system (yes, it’s counter intuitive), which is usually too acidic, and it helps with regularity.
  3. Ask for help! You don’t have to do it all by yourself. No one is going to think badly of you if you take some time for yourself. If your loved one resents your going out, it’s okay. Don’t become a slave to their wishes and rants. If you can’t leave your loved one alone, please ask a neighbor, friend or home care professional to help at least a couple hours a week. Some social service programs provide free respite care.
  4. Many cities throughout the U.S. offer volunteer snowbusters (volunteers who will shovel your walk and driveway), fix-it volunteers who will help with easy home repairs, and yard maintenance volunteers.
  5. Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  6. Find a walking partner in your neighborhood and try to walk at least once a week (preferably 3 times a week).
  7. Put on a CD, vinyl record or the radio and listen to your favorite music. If your care partner is mobile, ask him/her to dance. There is nothing like music or dance to uplift the spirit.
  8. Find a virtual class online. Yoga, Pilates, Barre fitness, Zumba, Les Mills Bodypump and more are offered through the YMCA for free if you have Silver Sneakers. There are hundreds of other classes available online.
  9. Use essential oils to immediately diffuse feelings of sadness, depression, anxiety, etc. Lavender oil is the most frequently used fragrance. You can also try bergamot, grapefruit, lemon, orange, clary sage, geranium, rose, and ylang ylang, frankincense, and myrrh. Put the oil in a diffuser or spray bottle to mist your collar or pillow. Find a fragrance that is pleasing to your care partner. It’ll help him/her also.
  10. Eat breakfast! It is the meal that you break your fast with. During the night our blood sugar levels drop, so it’s especially important to eat within one hour of arising and by 10am. Eating breakfast restores healthy blood sugar levels, but make sure your breakfast isn’t coffee and a doughnut. Have some protein and a healthy fat such as an omelet and avocado and a piece of whole grain or gluten-free toast. It’ll provide you with the energy you need to get through the morning while maintaining a sense of equilibrium.
  11. Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  12. Include more fruits and veggies in your diet. Veggies are low in calories and high in fiber. Fruits are also high in fiber and like veggies, contain numerous vitamins and minerals. Just like people, fruits and vegetables come in a variety of shapes, sizes and colors. And it’s the colors that identify many of the bioactive substances called phytonutrients that give us antioxidant protection and other special health benefits.
  13. Avoid isolation. Staying connected, especially during the pandemic, is sooooo important! Join an online support group if you don’t have friends and family nearby to listen to your woes and help out. Here are two great ways to make meaningful connections online: https://wordpress.com/post/barbracohn.com/3517
  14. It’s important to get at least 6 hours (preferably 7 or 8) of sleep every night. Of course, this isn’t always possible if you are caring for someone and need to get up at night, or are worried about paying the bills, taking care of the car, getting a new stove, etc. If you can’t get in the hours at night, put your feet up for 10 minutes during the day when your care partner naps. Or take a power nap. It really helps.

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

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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.

32 Ways to Cope with Grief this Holiday Season

Lots of people are grieving for all kinds of reasons, but it all comes down to loss and loneliness. Loss of a loved one, loss of a friendship, loss of a job, and sheer loneliness as a result of being socially distanced.

Here are some ways to get through the darkest, most dismal holiday season most of us have had to endure.

  1. Take a drive on a country road. Park and out and walk.
  2. If you don’t have a dog, borrow a neighbor’s dog to take on a walk.
  3. Watch a recommended movie or t.v. series that you can get lost in.
  4. Bake cookies or quick breads and distribute them to your neighbors.
  5. If you’ve had a hard time discarding your loved one’s clothes, think about donating them to a homeless shelter, etc.
  6. Start journaling. It’s a wonderful way to express your feelings and get things off your chest.
  7. Write a letter to your loved one and express your love, your sadness, grief, guilt, etc.
  8. Place two chairs facing one another. Sit in one and speak out loud the words you would like to express to your loved one. Tell him or her how much you miss them, or express your anger and guilt, etc.
  9. Watch what you eat. You should definitely enjoy your favorite foods, but don’t use grief as an excuse to overindulge in foods that aren’t good for you.
  10. Splurge on a gift for yourself!
  11. Help out at a shelter or food bank, or make a donation in honor of your loved one.
  12. Don’t overcommit. And don’t over donate. This is so easy to do and lose track of just how much money you are sending an organization, especially if you do it online, which is so easy.
  13. It’s okay to be happy. It’s the holidays! Don’t feel guilty for enjoying yourself. It won’t diminish the love you have in your heart for your loved one.
  14. Read a book that will help identify your feelings and cope more easily with grief. I recommend these two: The Empty Chair: Handling Grief on Holidays and Special Occasions by Ed.D Zonnebelt-Smeenge, Susan J. R.N. and Robert C. De Vries | Sep 1, 2001. The Secret Life of Grief: A Memoir by Tanja Pajevic, 2016, 2016
  15. Give yourself a massage. Refer to the chapter “Self Massage” in my book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.”
  16. Use aromatherapy. Citrus oils are generally refreshing and uplifting for the mind and emotions, relieve stress and anxiety.  Consider: bergamot, grapefruit, lemon, and orange. Floral oils are often used as a personal fragrance and are useful to relieve anxiety, depression, and irritability. These oils are useful as an inhaler, in a body lotion, and for the bath. Consider: clary sage, geranium, lavender, rose, and ylang ylang.
  17. Get the sleep that you need.
  18. Make an appointment with a professional therapist if you need help. You can do it virtually from the comfort of your home.
  19. Eat a serving of high-quality protein with every meal and snack
  20. Focus on complex carbohydrates (whole grains, veggies and fruits), and eliminate junk foods (refined carbs).
  21. Enjoy unlimited amounts of fresh veggies.
  22. Eat a good breakfast!
  23. Eat 3 balanced meals and 1-2 snacks/day.
  24. Magnesium, B complex, fish-oil, walnuts, flax seeds, dark leafy greens, and high quality all help reduce stress and uplift mood.
  25. Meditate, light a candle, or find some quiet time for yourself.
  26. Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  27. Exercise! At least take a short walk every day.
  28. Put on a CD, vinyl record or the radio and listen to your favorite music. Dancing as though no one is watching. There is nothing like music or dance to uplift the spirit.
  29. Put on a funny YouTube video and laugh.
  30. Sing your heart out while listening to your favorite showtunes.
  31. Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  32. Do the best you can. Try to relax and enjoy your family and friends, even if you can only meet over Zoom.

It’s easy to drown our troubles in alcohol or recreational drugs. Please be safe. Any of the above 32 ways to engage in self-care will do you a whole lot of good. Alcohol and drugs will not.

Be safe, be well, love yourself. Better times are ahead.

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 online at Target and Walmart, and many other fine independent bookstores, as well as public libraries.

15 Ways to Instantly Diffuse Anger

Young woman doing upward dog stretch, yoga.

Whether you’ve been caring for a loved one with dementia for a month or more than a decade, you’ve probably felt anger. Anger about having to listen to your care partner ask you for the hundredth time what’s for dinner, even though they have already eaten. Anger about having to downsize your world because you don’t have time to enjoy your previous social life. Anger about having to leave your career because you need to care for someone at home. The list goes on and on.Caregiving for someone with dementia is so hard. Some doctors think of caregivers as hidden patients because they are more likely to suffer from health problems stemming for stress, anxiety, anger, depression, and the inability to take good care of themselves.

It might be helpful to understand why you are feeling angry. You may not be aware of lingering feelings that fuel the fire. But there are ways to diffuse anger, which is one of the culprits that contribute to caregiver stress, depression, and poor health.

Are you resentful?

This is a common feeling that many caregivers share, especially if you are the eldest daughter and are caring for a parent. And it’s no wonder. Do your siblings step in to help with an ailing parent? Has your career advancement been put on hold? Is caring for a spouse destroying your dreams of travel or retirement.

I was only 48 when my husband was diagnosed with younger-onset Alzheimer’s disease. And damn right I was resentful. Our youngest was just starting college and we were empty nesters. It was the time in our life that we were supposed to have more freedom. My parents were getting older and had numerous health issues. I was part of a caregiver sandwich. Not the one where you care for a spouse and children at home simultaneously, I had to fly back and forth to tend to my parents’ while caring for my husband. It was hard and exhausting, and I was resentful. I complained to my best friend that my life wasn’t supposed to be like this.

Are you frustrated?

Have you tried various modalities to help your loved one “get better” and not seen any improvement?

Are you exhausted?

It’s no wonder. You need to take care of yourself. Exhaustion and burnout can bring feelings of anger to the surface. Please read: Preventing Caregiver Burnout with Good Nutrition and Foods that Support Neurotransmitters. https://wordpress.com/post/barbracohn.com/5204

Do you feel guilty?

It’s been years since my husband passed away. But I still feel guilty about the times I got angry or the times I went out to enjoy myself. My therapist used to say to me: “If someone told you the story you’re telling me now, what would you say to them?” I’d say, “You’re doing the best that you can.” That’s the right answer. You are doing the best that you can, and I have to remind myself, even now, that I did the best that I could. (Maybe I need more therapy to totally release those feelings of guilt.)

If you fly off the handle when your loved one annoys you or when you haven’t gotten enough sleep, try some of these anger diffusers for immediate relief.

  • Take a deep breath. Breathe in for 4 counts, hold for 4 counts, and release for 4 counts. Repeat twice more.
  • Make sure your loved one is safe and take a brief walk outside. If the weather is bad, walk up and down the stairs. If you can go outside, engage your loved one in an activity or have them watch television. Or just walk away from the situation and go into another room.
  • Put on some uplifting music. “Happy” by Pharrell Williams will definitely make you happy, I guarantee!
  • Call your best friend to vent.
  • Keep a book of inspirational quotes on your night table. Grab it and read a page. Sit there a moment and breathe.
  • Do jumping jacks or a few yoga postures. Corpse pose, legs up the wall, down dog. It doesn’t matter. Choose a few and do them.
  • Don’t lash out at your care partner. Rather than regret hurtful words, respond with an “I” statement or divert his/her attention. “I know you’re upset. I feel frustrated, too, etc.”
  • Use humor. Make a joke, put on a funny YouTube video.
  • Take yourself, your care partner, and your dog (if you have one) for a walk.
  • The British custom of making a cup of tea really works. Make a cup of green tea for added relaxation.
  • Use lavender oil to calm you down. Either put it in a wall plug-in diffuser or spritz your collar or a tissue that you can put inside a shirt pocket.  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.
  • Break open a dark chocolate bar and share it with your care partner. It reduces cortisol, the stress hormone that causes anxiety symptoms. Just a couple of pieces should do the trick.
  • Go into a quiet room and meditate.
  • Light a candle and put on some relaxing music.
  • Drink a tall glass of water, make an energy-boosting smoothie, or hot cocoa.

For more ways to destress, boost your energy and calm down, read “20 energy and stress fixes to use now!” https://wordpress.com/post/barbracohn.com/4998

If you continue to have anger issues, it might be good to speak to a therapist. It definitely helps to belong to a support group. To find an Alzheimer’s (and other dementias) support group in your area call 800-272-3900 or visit: https://www.alz.org/help-support/community/support-groups gclid=Cj0KCQiA7qP9BRCLARIsABDaZzhho3nQIye6hhfVM3umD7WeqWOeanDCfVcfmbF8Ld9MN5cGdPOAyCAaAjC7EALw_wcB

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

How to increase GABA, your brain’s calming chemical

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

Are you feeling stressed and burned out?

Are you unable to relax or loosen up?

Do you feel stiff? Are your muscles tense?

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

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

What is GABA?

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

GABA also:

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

What are neurotransmitters?

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

What depletes GABA?

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

A GABA deficiency often results in:

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

5 Ways to Boost GABA

  1. Eat these foods

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

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

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

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

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

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

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

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

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

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

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

How to boost all your neurotransmitters

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

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

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

Recommended Reading

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