Why hydration is crucial, especially during the pandemic

Glass of waterAdipsia is the fancy name for the loss of the sense of thirst. As we get older, our sense of thirst diminishes, just as our sense of smell and taste diminish. Chronic dehydration  is one of the most common problems among seniors and the elderly who reside in care facilities.

If you have a loved one at home with dementia or in a care facility it’s important that you learn the signs of dehydration (below) and offer water or another beverage to your patient every hour and throughout the day.

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

Better monitoring of fluid intake is needed at care facilities

Studies have shown that nearly all nursing home residents suffer from inadequate hydration. Additionally, in one study, 25 out of 40 participants suffered from diseases that may have been caused or exacerbated by their being dehydrated.

If your loved one is in a care facility now—during the COVID-19 pandemic–it is more important than ever to try to encourage them to drink. Ask the staff to put signs up in their room as a reminder. It’s especially important if your loved one has dementia and forgets to drink or is not thirsty.

What happens when you are dehydrated?

Your blood begins to thicken, which interferes with normal blood flow and viscosity. This is one of the reasons why, especially during the  pandemic, it’s crucial to stay hydrated. There have been many reports of blood clots and other cardiovascular episodes in patients with COVID-19. The kidneys, liver, pancreas and other organs can be severely affected from dehydration, and severe dehydration can lead to acute pancreatitis in some individuals.

Dehydration can interfere with brain function

This is a good example of what happens when our brains are dehydrated. My mom wasn’t able to walk the last two years of her life, and was dependent upon two private caregivers. She also drank thickened water, which is a disgusting thickened pudding-like liquid that substitutes for water. The reason?  She aspirated water and food into her lungs, which caused her to cough. Sometimes, the result was pneumonia. She may have felt thirsty and not wanted to bother with the thickened water, or maybe she wasn’t thirsty. But she ended up being severely dehydrated on more than one occasion.

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

It’s important to learn the signs of dehydration in everyone, but especially in seniors and young children. The physical symptoms are usually clear:

  • dry lips and sticky or dry mouth
  • no tears when crying
  • dry, papery skin that tents when it is pressed
  • decreased urine output
  • sunken eyes
  • headache
  • lethargy
  • dark urine
  • extreme thirst
  • unable to sweat
  • fast breath rate
  • low blood pressure
  • the mental symptoms are not as obvious, but can result in mental confusion, irritability, delirium
  • extreme cases of dehydration can lead to loss of consciousness, coma, kidney failure, and seizures.

Ways to stay hydrated

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

The rule of thumb is to have 48 to 64 ounces of non-sweetened, non-artificially sweetened drinks. Hydration keeps the body in proper pH (how acidic or alkaline your body is) and protects it from getting dehydrated, which is a cause of inflammation and other kinds of imbalances. Dehydration can also contribute to urinary tract infections (UTIs).

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

The next time your mind is muddled, drink a tall glass of water and notice the difference. Drink plenty of water, fresh juices, and herbal teas to stay hydrated, flush out toxins and enjoy mental clarity. It is especially important now as we head into summer and during the COVID-19 pandemic. But it’s just as important all year round.


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16 ways to help you get through the anxiety and fear of the pandemic

Empire of the sunWe’re all experiencing some level of anxiety during this crazy time. And if you’re a caregiver, you’re dealing with your own stress and the anxiety of the person you are caring for. Watch for a blog next week about calming the person that you care for. Or, search through the archives on this site.

Here are some practical things that really work to help create order and calm.

  1. First thing in the morning when you wake up say an affirmation or prayer. “This will be a beautiful day,” “I will do the best I can,” I am strong and healthy,” ” I can get through this.” “I am strong and confident.”
  2. Create a schedule and try to stick to it. For example:
  • Shower
  • Make breakfast
  • Do an online yoga or cardio class
  • Wash clothes, clean house
  • Clean your office
  • Work on a creative project, i.e. write, knit, paint, etc.
  • Have lunch
  • Walk outside, if the weather permits
  • Etc.

It seems very simplistic, but it helps. And when you check each item off the list it adds to a sense of accomplishment.

3. Include a self-care ritual in your day. Take a bath, call a friend, do a manicure. Wash and style your hair. Whatever makes you feel good.

4. When the negative thoughts start flowing, stop them in their tracks. I heard about this technique recently from a friend, who got it from her therapist. Change the mental dialogue in your head by replacing the worst case scenario you imagine with a best case scenario. Instead of dwelling on doom and gloom, think hopeful thoughts. Of course, this technique only goes so far. If the person you are caring for has mid- to late -stage Alzheimer’s, for instance, hoping for a total recovery isn’t very likely. But you can still think positive thoughts that focus on what you cherish about the person instead of  what you dislike about his or her behavior. Or when you start to panic about what will happen to your loved one if you get sick, replace that thought with a visualization of being strong and healthy.

5. Watch a funny movie or YouTube video. There are tons of movies online, and as of today, March 20, Hulu is currently offering a free 30-day trial. The Metropolitan Opera is offering Free Live Audio Streams. Vocal artists are offering online concerts while you’re stuck at home.

6. You can work out in your living room thanks to fitness studios that are live-streaming workout classes for yoga, meditation, cardio, etc. free during the coronavirus outbreak.

7. Create a ritual of lighting a candle and playing classical music at dinnertime.

8. Use aromatherapy to calm the nerves and uplift the mood. 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. Check online for ways to order aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn.

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

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

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

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

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

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

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

15. Do some volunteer work, unless you are a caregiver. Your spiritual/religious community has things you can do to help others like calling congregants to check-in and see if they need anything. Or donate money to a food bank or emergency assistance organization. It’ll make you feel good.

16. It’s officially spring! Get outside and do some yard work. Plant some seeds for a spring garden and watch as the seeds sprout into nature’s gift of flowers and greens.

Stay positive and healthy. We will get through this together.


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.

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14 Ways to boost your immune system to stave off the VIRUS.

boost your immune systemDear Readers,

This is a crazy time, and there’s a lot of misinformation out there.

I’d like to share time-tested information, and a few new tips I’ve learned from health professionals about ways to boost your immunity . . . and the immunity of the people you lovingly care for.

You’ve heard it a million times: wash your hands, don’t touch your face, stay hydrated and rested, and eat well.

What else should you do?

The mucous membranes—the linings of our nose, throat, sinuses, eustachian tubes, upper respiratory system—-are the body’s first defense against bacteria, viruses and other toxins. Mucous traps the stuff we don’t want inside of us. We sneeze and cough in order to rid ourselves of the “invaders.” We also swallow the invaders. If the good bacteria in our stomach is doing its job, stomach acid will destroy the invaders.  So, you want to keep your mucous membranes hydrated. It’s important they stay moist and lubricated.

  1. Turn on the humidifier if you live in a dry climate. If you don’t have one, consider buying one.
  2. Use a Netti pot or Neil Med sinus rinse with Alkalol, an antimicrobial nasal wash. And please use distilled water, not purified water. This helps clear mucous to support healthier nasal passages.
  3. If your sinuses are congested use an ayurvedic oil in your nostril. Sinus Care & Nasal Oils. You can also use a cooking oil such as sesame, olive, or coconut. Just put a couple of drops of oil in each nostril 3 times a day.
  4. Gargle twice a day with warm salt water or oil. There is an email going around that says it will eliminate the virus. Although I don’t have a scientific reference for this, it’s worth a try.  Oil Pulling is an ayurvedic practice of holding and swishing 1-2 teaspoonfuls of herbalized oil in your mouth for 5-10 minutes. This practice is also said to reduce infection from bacteria and viruses.
  5. Drink water. Lots of it. Forget about sodas and juices. You need to stay hydrated in order to flush the toxins out of your body, and that includes the virus. Herbal tea and coconut water are good, also. Have coconut water on hand just in case you get a fever. It provides electrolytes naturally, without getting artificial color or sugars found in Gatorade.
  6. Take Vitamin D3–2-5,000 IU a day, depending on health and body weight. Please read my article Are You Getting Enough Vitamin D? Most people are not getting enough and that puts us in greater risk for getting the flu, and now COVID-19.
  7. Did you know that 70% of your immune system lies in your gut? Probiotics are live bacterial microorganisms that populate the human gastrointestinal tract. They combat the daily bombardment of toxins and pathogens (bacteria, fungus, parasites, and viruses) that enter our digestive system every day through contaminated food and other toxins. Recent studies show that the bacteria in your gut can also affect your mental health, mood and stress levels. Fermented foods such as kombucha, Greek yogurt, kefir, sauerkraut, miso, cottage cheese are probiotics. Probiotic bacteria colonize the digestive tract with good bacteria. Prebiotics are the food and nutrients that feed probiotics. Prebiotic fiber is found in fruits and vegetables such as artichokes, jicama, wild yams, onions and garlic, asparagus, beans, oats, chicory root and Jerusalem artichokes. Prebiotics support mineral absorption, vitamin utilization, and healthy blood sugar levels. Your gut needs both pro- and prebiotics in order to stay healthy and keep you healthy.
  8. Include EFAs (Essential Fatty Acids) in your diet. EPA/DHA from fish, nuts or algae are essential for our brain, nerves and immune system to work efficiently. Under stress, our systems become inflamed so it’s more important now than ever to make sure you’re getting enough. Ways to increase your DHA intake: eat cold-water fish such as wild-caught salmon, sardines and mackerel, at least twice a week. Add flax meal to cereal and baked goods, sprinkle flax oil on your salad, eat a small handful of walnuts at least several times a week.
  9. Take a Multivitamin Mineral for overall added protection. Make sure it is high quality.
  10. Zinc has been shown to inhibit various coronaviruses in a couple of studies. SARS coronavirus, and ZN (2+) inhibits coronavirus.  However, it hasn’t been tested on COVID-19. Still, it is always a good idea to make sure you are taking a zinc supplement, and that doesn’t mean the zinc lozenge. Most people are deficient in zinc. A researcher at the University of Pittsburgh recommends taking 25 mg of zinc morning and evening.
  11. Make sure you’re getting enough Vitamin A. Beta Carotene is the antioxidant of choice for people who are unsure about which vitamin A to take. It is the precursor of vitamin A and can be converted into vitamin A if the body needs it. It gives added protection to the immune system, skin, eyes, and lungs.
  12. Get plenty of Vitamin C-Your body does not manufacture vitamin C on its own, nor does it store it. Since vitamin C is water-soluble, it dissolves in water, and leftover amounts of the vitamin leave your body through urine. That means you need to maintain your vitamin C intake by eating citrus and other fruits and vegetables that are high in vitamin C. Dr. Ed Bauman, founder and president of Bauman College of Nutrition recommends taking a high-quality vitamin C supplement such as Vitamin C with Bioflavonoids: 500 mg. 3-5 x day of Amla (natural vitamin C with bioflavonoids from gooseberry) or 2-4 times that amount of buffered vitamin C from ascorbic acid. Or, take Ascorbyl palmitate. It is a fat-soluble form of vitamin C, which is better absorbed than ascorbic acid, the water-soluble form. It offers all the benefits of ascorbic acid, plus it won’t flush out of the body as quickly as ascorbic acid, and it is able to be stored in cell membranes until the body needs it.
  13. Eat a variety of colored fruits and vegetables. There’s not much left on the grocery store shelves at the moment. But the next time you shop, fill up your cart with fruits and veggies that contain antioxidants and carotenoids to boost your immune system.
  14. Make Healthy Choices

Choose these

  • Water, green tea, herbal teas
  • Nuts & seeds
  • Avocado, olive oil, omega-3 fatty acids
  • Fresh fruits and Veggies
  • Fish, high-quality protein
  • SOUL foods (seasonal, organic, unadulterated, local)
  • Sugar alternatives: stevia, monk fruit, coconut sugar, maple syrup, agave, birch sugar, honey

Avoid these

  • Coffee, soda, artificial sweeteners
  • Chips, cookies, pastries, candy
  • Poor quality fats (hydrogenated,
  • Processed lunch meats
  • Dairy products with rBGH (growth hormones)

Remember this

Whether you’re eating breakfast, lunch, dinner or a snack, always think protein! Protein helps build cells and tissues and supports our strength.

Build your meal around chicken, fish, tofu, cottage cheese or eggs, and then add low-starch vegetables or fruits. The general rule is to eat 3-4 ounces of lean, dense meat or 6 ounces of fish. Women should aim for around 30 grams of protein. Men should aim for around 40 grams of protein. Another rule of thumb is to divide your plate in half. Fill half of the plate with veggies, one quart with a protein, and the other quarter with a whole grain such as quinoa, rice, barley, etc.

Please take care of yourself. And if you are a caregiver, take double care of yourself. You won’t be of help, if you get sick.

All the best to you and your family.

Barbra


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

20 Ways to give your body the nutrition it deserves

Health food fitness. Food sources of omega 3 on dark background top view. Foods high in fatty acids including vegetables, seafood, nut and seeds

Health food fitness. Food sources of omega 3 on dark background top view. Foods high in fatty acids including vegetables, seafood, nut and seeds

It’s National Nutrition Month and a perfect time to think about ways to increase your nutritional intake. By now most folks have forgotten about their New Year’s resolutions to lose weight, eat healthier, become a vegetarian, reduce sugar intake, etc. It doesn’t matter. New Year’s resolutions are made to be broken.

This is a good time to develop a new plan that makes sense. Whether you want to support your brain health, relieve stress and anxiety about caregiving responsibilities, or just want to rev up your energy, stamina and immunity, here are some ways to protect your health and support your mood.

  1. Did you know that 70% of your immune system lies in your gut? Probiotics are live bacterial microorganisms that populate the human gastrointestinal tract. They combat the daily bombardment of toxins and pathogens (bacteria, fungus, parasites, and viruses) that enter our digestive system every day through contaminated food and other toxins. Recent studies show that the bacteria in your gut can also affect your mental health, mood and stress levels. Fermented foods such as kombucha, Greek yogurt, kefir, sauerkraut, miso, cottage cheese are probiotics. Probiotic bacteria colonize the digestive tract with good bacteria. Prebiotics are the food and nutrients that feed probiotics. Prebiotic fiber is found in fruits and vegetables such as artichokes, jicama, wild yams, onions and garlic, asparagus, beans, oats, chicory root and Jerusalem artichokes. Prebiotics support mineral absorption, vitamin utilization, and healthy blood sugar levels. Your gut needs both pro- and prebiotics in order to stay healthy and keep you healthy.
  2. The brain is very sensitive to the food we eat. A new study published in The New England Journal of Medicine (Aug. 8, 2016) evaluated 242 participants, measuring fasting blood sugar and neuro-cognitive functioning. Those with elevated blood sugar, including people who did not have diabetes, had a dramatic increase of developing dementia. Just remember that what is good for your heart is good for your brain. So try eating a Mediterranean based diet of olive oil, fish, and lots of fruits and vegetables, whole grains, beans, and nuts and seeds, with less meat, cheese and sweets.
  3. Drink plenty of water to keep your body hydrated and to flush out toxins. Your brain is 70% water when fully hydrated, and it gets dehydrated just like your body. When it is dehydrated neurotransmission—which is heavily dependent on water—is impaired, resulting in poor memory, concentration and impaired abstract thinking. The next time your mind is muddled, drink a tall glass of water and notice the difference.
  4. Take a complete B-vitamin supplement to make sure you are getting a balanced amount of B vitamins. 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.
  5. Berries are berry good for your health. Blueberries, strawberries, raspberries, cherries, cranberries, as well as some others you may never have heard of, contain unique phytochemicals that may help prevent cancer, heart disease, age-related brain declines, and much more. Blueberries score highest on the Oxygen Radical Absorbance Capacity (ORAC) test—a measurement that rates the total antioxidant score of foods, and many berries, such as raspberries, blackberries, cranberries, and strawberries contain ellagic acid, which preliminary research suggests may help to prevent certain types of cancer. Summer is almost here, so enjoy your berries. They are good for you!
  6. Eat more healthy fats and skip the hydrogenated and trans fats found in doughnuts, potato chips and other pastries and desserts.  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. Eating fish such as wild-caught salmon, sardines and other cold-water fish can protect you against Alzheimer’s disease and other forms of dementia. Numerous studies have shown that elderly people who did not have dementia had high blood levels of docosahexaenoic acid (DHA), an essential fatty acid found in cold-water fish, in comparison to those with dementia, who had on average 30% to 40% lower blood levels of DHA. Ways to increase your DHA intake: eat cold-water fish such as wild-caught salmon, sardines and mackerel, at least twice a week. Add flax meal to cereal and baked goods, sprinkle flax oil on your salad, eat a small handful of walnuts at least several times a week.
  7. 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. My favorite cool weather breakfast is eggs (any way you like them), a side of beans such as black or pinto, and a pile of sautéed greens. When the weather is hot, I prefer home-made granola made with oats, a bit of coconut oil and maple syrup, coconut flakes, and lots of nuts including almonds, walnuts, cashews, and pumpkin seeds. Add chia seeds, flax meal, yogurt and fresh berries and you’ve got a breakfast for champions.
  8. Avoid commercially processed meats and favor grass-fed meats, free-range chickens and eggs fed an organic, non-GMO diet. And limit your meat consumption to no more than twice a week.
  9. Eat like a rabbit to reduce your risk of stroke, dementia, macular degeneration, and other chronic illness. 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. The scientific community has produced a large body of research showing the potential of these super nutrients. Compared with people who eat few fruits and vegetables, populations that consume a large variety and generous amounts of plant foods enjoy longevity and reduced risk of disease. For example, the people of Okinawa have a long life expectancy, numerous centenarians, and a low-risk of age-associated diseases. Their diet is low in calories, fat, sugar, salt, and meat and dairy products. Instead, Okinawans eat fish, tofu, whole grains, and lots of fruit, dark green leafy vegetables, onions, green peppers, sea vegetables and sweet potatoes—which are all dense in phytonutrients and antioxidants. These islanders are known for a low-stress, carefree and relaxed attitude. Their rates of stroke, dementia, cancer and heart disease are also the lowest in the world. For every 100,000 people in Okinawa, 30 have passed their 100th birthday, one of the highest rates in the world.
  10. A cup of Joe will do you good . . . just don’t overdo it and don’t add lots of cream and sugar. Researchers from the University of Scranton found that coffee is the number one source of antioxidants in the U.S. diet. Coffee has been shown to improve mental acuity. In fact, a study published in the Journal of Alzheimer’s Disease (2012) found that people older than 65 who had higher blood levels of caffeine developed Alzheimer’s disease two to four years later than people with lower caffeine levels. The study included 124 people who had mild cognitive impairment (MCI). Typically, 15% of people with MCI will go on to develop full-blown Alzheimer’s disease each year. The study participants who had less than 1,200 ng/ml of caffeine levels in their blood developed Alzheimer’s disease. This is equivalent to drinking several cups of coffee a few hours before their blood was taken. The people whose memory loss did not progress to full-blown Alzheimer’s disease had higher levels of caffeine in their blood. Coffee appeared to be the only source of caffeine for the participants in the study. Some big caveats: if you have high blood pressure limit your coffee intake to 2 cups a day, and avoid drinking it before exercise or physical labor which both naturally raise blood pressure. Coffee acts as a diuretic, depleting the body of necessary fluids, so make sure you drink a glass of water for every cup of coffee you drink. Coffee can raise homocysteine levels, an indicator and risk factor for cardiovascular disease. It can also cause headaches, fatigue, depression, anxiety and drowsiness if a coffee drinker forgoes his or her usual daily dose of caffeine. So be smart and listen to your body.
  11. Drink green tea if you don’t like coffee or are unable to drink it. Scientists have found evidence that green tea extract can help fight everything from glaucoma to prostate cancer and leukemia. Now a research team composed of chemists, biochemists and biophysicists at the University of Michigan has found a new potential benefit of green tea extract: preventing the clumping of proteins associated amyloids in the brain, which is associated with Alzheimer’s disease and other neurodegenerative conditions. The study found that the specific molecule in green tea, ( — )-epigallocatechin-3-gallate, also known as EGCG, prevented aggregate formation and broke down existing aggregate structures in the proteins that contained the metals copper, iron and zinc. At Tohoku University Graduate School of Medicine, researchers tracked the green tea consumption of nearly 14,000 people over age 65 for three years. The participants’ quality of life (measured in day-to-day activities such as getting dressed, walking the dog, and performing household chores) was examined in relation to how much green tea they drank. The authors found that the more green tea participants consumed, the longer they were able to ward off the difficulties associated with old age. The people who drank at least five cups a day were one-third less likely to develop disabilities than those who had less than a cup per day. Those people who averaged three or four cups a day had a 25 percent lower risk. Just remember that while green tea and its extracts are considered safe in small amounts, they do contain caffeine and small amounts of vitamin K, which means it could interfere with drugs that prevent blood clotting. So the next time you feel the need for a cup of coffee or black tea, consider drinking a cup of green tea instead. It just might help you maintain clarity of mind, healthy bones, and cardiovascular health well into your senior years.
  12. Herbs or adaptogens can be helpful for increasing energy without stimulation. An adaptogen is a natural substance—usually an herb—that helps the body adapt to stress by producing a calming effect on the whole physiology, and stress is often blamed with being the root cause of many illnesses and diseases. Phytosterols, the plant compounds in the herbs ashwaghanda, gotu kola, passion flower, schizandra, skullcap, rhodiola, and cordyceps have been scientifically shown to support the adrenal glands and healthy blood chemistry, and enhance the body’s ability to resist the ravages of stress. Valerian, Siberian ginseng, kava kava, oat straw, and hops also help reduce stress. These herbs can be taken as a tea or in the form of a nutritional supplement. Culinary herbs also have numerous health benefits. Turmeric, the spice used in Indian cooking, has dozens of studies backing up its ability to reduce inflammation, another major cause of chronic disease, and risk of Alzheimer’s disease. Cinnamon helps to stabilize blood sugar levels, which is vital to healthy aging. Oregano contains antioxidants that offer antibacterial protection. Garlic has been called the natural antibiotic, and ginger root has been used for thousands of years for its anti-inflammatory and anti-microbial effects. The list goes on and on.
  13. Magnesium is the fourth most abundant mineral in your body—which means it is absolutely essential to your healthy blood pressure, cardiovascular health, bone and overall health. In fact, you cannot live without it! Magnesium is involved in more than 300 biochemical reactions, particularly as a catalyst for food metabolism and the release of energy. Yet, only about 25% of Americans meet the Recommended Dietary Allowance (RDA) of 400 mg per day for magnesium. Good sources of magnesium include: dark green, leafy vegetables such as spinach, Swiss chard and kale dark green, legumes, peas and beans (especially soybeans), seeds and nuts (especially almonds, cashews and pumpkin seeds) whole, unrefined grains, including oatmeal and bran, and halibut
  14. Go nuts on Brazil nuts. They are rich in selenium, a potent antioxidant which is concentrated in the thyroid gland. They also contain copper, which helps to support a healthy thyroid. Regardless of whether you have thyroid issues, selenium is a good all-round antioxidant. According to the Institute of Medicine, the tolerable upper intake level (UL) (i.e., the highest level of intake that is known to avoid toxicity) for selenium is 400μcg per day. On average, Brazil nuts have 544 mcg selenium per ounce, but studies indicate that the selenium content may vary widely depending on country of origin, cultivation methods, etc. With that in mind, a good starting point for most folks would be to consume 2 – 3 Brazil nuts per day.
  15. Eat more tomatoes. Recent epidemiological studies have suggested that eating tomatoes and tomato-based food products can reduce the risk of prostate cancer and macular degeneration.  This protective effect has been attributed to carotenoids, which are one of the major classes of phytochemicals in this fruit. The most abundant carotenoid in tomato is lycopene. Cooking tomatoes in olive oil helps you digest and assimilate the lycopene so if you like tomato sauce on your pasta, go for it. Just make sure you are eating a healthy pasta product–think whole grain, quinoa, etc.
  16. Include flax oil, flax meal or flax oil in your diet. They are the best source of lignans. Lignans are compounds that form the building blocks of plant cell walls. They contain phytoestrogens that help regulate the body’s estrogen production. When we eat plant foods the lignan compounds are converted in our intestines by good bacteria to produce a form that the body can assimilate. Enterolactone—the primary lignan metabolite (a substance produced by metabolism) that circulates in our blood—produces weak estrogenic activity. Dozens of reports have revealed that high levels of enterolactone in our blood help to reduce risk of breast, prostate and colon cancers, and cardiovascular disease. Studies have also shown that high levels of lignans can support healthy weight and glucose metabolism, reducing the risk of insulin sensitivity, metabolic syndrome and diabetes. Most plant foods contain small amounts of lignans, but flax seeds are by far the best source. Other good sources include high fiber foods such as whole grains (wheat, barley), sesame seeds, sunflower seeds, cashews, kale, broccoli, carrots, legumes, garlic, asparagus and berries.
  17. Lutein and zeaxanthin reduce eye health risks. What are they? They are antioxidants in the carotenoid family—a group of naturally occurring, fat-soluble pigments found in plants—that play a key role in our the health of our eyes.  Carotenoids are the red, orange and yellow plant pigments that give fruits and vegetables their vivid colors.  All fruits and vegetables contain varying concentrations of carotenoids.  But their colors are often covered up by green chlorophyll contained in the plant. Lutein is found in spinach, kale, collard greens, romaine lettuce, leeks, peas, egg yolks, tomatoes, carrots, marigold flowers, and fruits. Zeaxanthin is found in corn, kale, mustard greens, spinach, egg yolk, orange peppers, collard greens, lycii berry fruit, green algae spirulina and other types of commercially produced algae. Lutein and zeaxanthin accumulate in the macula, the prominent, bright yellow spot in the center of the retina that allows you to clearly distinguish fine detail. And studies are showing that people with macular degeneration—the slow deterioration of the cells in the macula, which affects your central vision, the vision you use for reading, writing, driving and identifying faces—have low concentrations of these two pigments in the macula. So make sure you are eating plenty of the above mentioned fruits and veggies.
  18. Chromium is a first class blood sugar and insulin regulator. Yet, nine out of 10 American diets fall short of this trace mineral, which is essential for the transfer of sugar from the bloodstream to muscle cells, giving them the fuel they need to work.  Chromium is also involved in maintaining cholesterol and triglyceride levels, and supporting healthy muscles.  Chromium levels decrease with age and are often low due to poor diet. Eat more foods that are naturally high in chromium: broccoli, barley, oats, green beans, tomatoes, Romaine lettuce, black pepper, Brewer’s yeast.
  19. Coenzyme Q10, or CoQ10is a vitamin-like compound and an important antioxidant. It exists in every cell of your body and you could not survive without it. CoQ10 is essential in the body’s production of adenosine triphosphate (ATP), which produces energy within the cells and is the basis for normal functioning of all body systems and organs. If you think of the body’s cells as little engines that use oxygen to burn the organic fuels that come from food, you may think of CoQ10 as the part of the engine that provides the spark for this process. No other substance will substitute for CoQ10. Without it there is no spark and therefore no production of energy for the cell. And without energy there is no life! As we age, it becomes more and more difficult for the body to produce enough CoQ10. An 80-year-old person has about half the CoQ10 levels of a 20-year-old.  Body levels of CoQ10 are also influenced by stress, cold, illness, high blood pressure, hormone concentrations, physical activity and prescription drugs, which can deplete CoQ10 levels. Scientists estimate that once levels drop below the 25% deficient level, a variety of health problems can take hold. But your cells’ energy and efficiency can be restored with supplementation and/or by eating eggs, dairy products, meat, and poultry, fatty fish, nuts and seeds, broccoli, cauliflower, and some fruits and vegetables.
  20. Are you getting enough vitamin D? Most people, especially the elderly, are vitamin D deficient.  Researchers have found a correlation between vitamin D deficiency and low mood, depression and worse cognitive performance in older adults. In a recent study, 1618 patients who averaged 73.8 years old were tested for vitamin D deficiency. Those with severe vitamin D deficiency were twice as likely to suffer from depression. Vitamin D is most commonly known for helping the digestive system absorb calcium and phosphorus. In that way it helps the body build and maintain healthy bones. But it does much more. Adequate vitamin D is believed to play a role in the reduction of falls, as well as supporting cardiovascular health, a strong immune system and cognitive function. Also, scientists theorize that one of the reasons that influenza occurs in the wintertime is that we do not manufacture enough vitamin D, and the resulting vitamin D deficiency might promote our susceptibility to the flu virus. Which foods contain vitamin D? Fatty fish such as salmon, trout, tuna and sardines, milk, and fortified cereals provide more than 100 IU per serving. And mushroom is the only food in the produce section that has vitamin D. But you’d have to eat an awful lot of these foods to get the recommended daily dose of vitamin D, which is 2400 IU, according to a study published in the Journal of Nutrition. For instance, you would have to eat at least five servings of salmon a day or drink 20 cups of fortified milk. Play it safe and take a vitamin D dietary supplement. According to a study published in the Journal of Nutrition (March 9, 2009) adults need at least four times the current recommended dose of 600 IU of vitamin D. In 2008 The American Academy of Pediatrics (AAP) doubled its recommended minimum intake for infants, children and teens from 200 IU to 400 IU per day.

Be well, be heathy, and please subscribe to my blog for more articles filled with information on how you can support your health and the health of your loved ones.


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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.

When your loved one has difficulty eating

senior woman eatingMeals can be challenging for someone with Alzheimer’s or another form of dementia, not to mention their caregivers. As the disease progresses, it can become difficult for the person to consume enough calories to maintain a healthy weight. But there are ways to encourage healthy eating. Eventually, toward the end of life, it’s natural for humans, and all animals, to lose the desire for food.

As his Alzheimer’s progressed, my husband, had trouble recognizing food items. Morris forgot how to hold a sandwich, and I’d have to place it in his hand. He forgot how to cut his food, so I served it to him already cut into small pieces.

Once when I handed him a sandwich to eat, he asked what it was. I replied, “Chicken salad.” He threw the sandwich across the table and exclaimed, “This chicken is dead!” It was hilarious, and shocking.

But there are ways to encourage your loved one to enjoy food and get good nutrition throughout most of the course of the illness.

Here are some suggestions:

  • Seniors and elders with health issues tend to be hungriest in the morning and eat less as the day progresses. Make a healthy breakfast packed with protein, healthy fat, antioxidants, vitamins and minerals. Eggs, anywhere you like them, served with avocado, toast, beans, and  greens provides everything needed to establish the beginning of a good day. The same goes for caregivers! You need the strength and energy to get through the day, so start it off with a nutrient- rich breakfast.
  • Setting the table–Put as little on the table as possible in order to not confuse the patient or detract for their ability to clearly see what is in front of them. Use a colorful plate mat, and a white plate so the food stands out. And serve colorful foods, which are higher in antioxidants and vitamins and minerals. Think sweet potatoes, winter squash, corn, beets, greens, etc. Root veggies can be pureed and served in a mash, which is easier to chew and swallow.
  • Make sure the environment is clean and pleasing. Put on some favorite music. It can be stimulating or soothing, depending on the mood.
  • Has the patient kept up with their dental appointments? My mother was always fastidious about dental care, visiting her dentist several times a year for cleanings. But at the end of her life, she began to lose teeth, most likely from poor nutrition. Observe your loved one and make sure there are no signs of pain, grimacing, trouble chewing, etc.
  • Sometimes, a person will not remember that they have eaten just a little while before saying, “When is lunch (or dinner)?” Or, “I’m hungry. When are we going to eat?” Leave their plate on the table longer as a visual reminder. You might have to hide food, if they have the tendency to overeat. And if you want to make sure they, as well as you, are eating the best diet possible, refrain from buying cookies, sweets, chips, and crackers, that are filled with empty calories and hydrogenated fats.
  • Provide a meal companion for your loved one. If you can’t eat with him/her, ask a friend to share a meal. Or, if he/she is still able to eat in a restaurant, have a friend make a weekly lunch date and bring them to a quiet restaurant that serves their favorite food.
  • The taste for sweet things is the last one to go. If your loved one doesn’t have any appetite, it’s almost guaranteed that they will enjoy ice cream. There are lots of options on the market to choose from ranging from traditional ice cream to frozen desserts made with cashew cream, coconut cream and soy milk.
  • Make sure the temperature of the food isn’t too hot or too cold, and that the patient is seated comfortably in a room that is neither too hot or cold.

Dysphagia

Dysphagia is any problem with swallowing. This was a major issue for my dear mother, who, at the end, couldn’t eat without the food going into her lungs instead of her stomach. In determining the extent of dysphasia, the patient does a swallow test drinking liquid of various consistency and thickness.

Food and drink categories

  1. Nectar thick, he consistency of nectar, quickly runs off a spoon
  2. Honey thick, the consistency of honey, slowly drips off a spoon
  3. Pudding thick, the consistency of pudding, plops off a spoon

My mom had to drink water that was thickened, which tasted disgusting. As a result, she often refused to drink and once became dehydrated to the point where she was hospitalized.

If your patient is put on a dysphagia diet, experiment and find ways to keep him or her hydrated. Puree their favorite foods, make shakes that are delicious and nutritious. You can puree just about anything and make it taste good with herbs, tomato sauce, etc. Please don’t add salt. Yogurt and puddings are another good option. Read the labels and try to avoid added sugars. Especially watch out for high sugar content in flavored yogurt.

Poor appetite

If your loved one doesn’t want to eat, accept it as the course of the illness. But if they are still walking and reasonably active, rule out contra-indications of newly administered drugs and illness, such as urinary tract infections.

Additionally, your patient might have a poor sense of smell, which will translate into a poor appetite. Try adding more seasoning to the food, but try to avoid salt and use herbs and spices that include antioxidants such as thyme, basil, oregano, cumin, cinnamon, and cardamom.

Laraine Pounds, R.N., an internationally recognized aromatherapist lists aromatherapy essential oils that stimulate appetite in chapter 18 of my book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.”

Eating issues are common amongst individuals with dementia. Experiment with these suggestions and see what makes a difference. Sometimes, just sitting next to someone and offering gentle conversation helps.


 

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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.

30 Tips for Coping with Holiday Grief

candle lightThe holidays can bring up all sorts of emotions: joy, anxiety, depression and grief, especially if you’re missing a loved one, or if a loved one is a shadow of their former self.

You are entitled to feel any and all emotions as they arise. If you’re at a holiday party and the tears well up, simply excuse yourself until you’re ready to rejoin the group. If you’re overcome with fatigue and grief and simply can’t make it to a party, it’s okay. Make yourself a bowl of popcorn and watch a movie or read a book. But keep in mind that socializing might do you a world of good. The most important thing is that you do what’s best for YOU. So whatever you need to do in order to get through the holiday season, do it in a healthy way. Please don’t rely on alcohol or drugs to numb your feelings.

Here are some suggestions for feeling your emotions and feeling your best, while remembering your loved ones during the holidays and beyond.

  1. Be honest with yourself and with others. Tell them what you’d like to do and what you’d prefer not to do.
  2. Create a new tradition in honor of your loved one, i.e. if you typically hosted a dinner, set a place setting and serve your loved one’s favorite dish.
  3. Decide where you want to spend the holidays. Maybe go to a new place or take a trip with another widow or widower whom you met in a support group.
  4. If you’ve had a hard time discarding your loved one’s clothes, think about donating them to a homeless shelter, etc.
  5. Start journaling. It’s a wonderful way to express your feelings and get things off your chest.
  6. Write a letter to your loved one and express your love, your sadness, grief, guilt, etc.
  7. 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.
  8. 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.
  9. Splurge on a gift for yourself!
  10. Help out at a shelter or food bank, or make a donation in honor of your loved one.
  11. Don’t overcommit. You don’t need to make the holiday meal, if you’re not up to it.
  12. 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.
  13. 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
  14. Get a massage.
  15. 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.
  16. Get the sleep that you need.
  17. Make an appointment with a professional therapist if you need help.
  18. Eat a serving of high-quality protein with every meal and snack
  19. Focus on complex carbohydrates (whole grains, veggies and fruits), and eliminate junk foods (refined carbs).
  20. Enjoy unlimited amounts of fresh veggies.
  21. Eat a good breakfast!
  22. Eat 3 balanced meals and 1-2 snacks/day.
  23. Magnesium, B complex, fish-oil, walnuts, flax seeds, dark leafy greens, and high quality all help reduce stress and uplift mood.
  24. Meditate, light a candle, or find some quiet time for yourself.
  25. Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  26. Exercise! At least take a short walk every day.
  27. 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.
  28. Put on a funny YouTube video and laugh.
  29. Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  30. Do the best you can. Try to relax and enjoy your family and friends.

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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.

A Vegetarian Holiday Feast

Homemade apple pie with nuts and pumpkin seeds.I’ve been a vegetarian since 1971—my entire adult life. I’ve never had a problem eating Thanksgiving dinner. I just avoid the turkey and make a veggie dish containing protein. The benefit is that, although tryptophan—the essential amino acid in turkey—won’t be surging through my body to promote serotonin, the feel-good neurotransmitter—I will be getting more antioxidants and fiber than most people enjoying the holiday feast.

Whether you eat turkey or not, are a vegetarian or not, here are some great veggie dishes worth trying. I’ve listed them in order from appetizer, salad, muffins, entree, side dishes, and dessert to make a complete vegetarian Thanksgiving/holiday feast.

These two appetizer recipes are a throwback to the 70s. They are still delicious! Serve before your feast, while you are busy in the kitchen with final preparations. All recipes are gluten-free except for the pumpernickel dip, which can be made gluten-free if the dip is put into a bowl or gluten-free hollowed out bread.

Appetizers

Artichoke Dip

  • 1 can artichokes, drained and cut into small pieces.
  • 1 cup mayonnaise
  • 1 cup Parmesan cheese
  • 1/4 tsp garlic powder

Directions

  1. Blend all ingredients together.
  2. Sprinkle paprika on top. Bake at 350 for 20 minutes.
  3. Serve with crackers, veggies, etc.

Pumpernickel dip

  • 3 cups sour cream (1 large container) or plain Greek yogurt
  • 3 cups mayonnaise
  • 4 tsps dried dill weed
  • 1 tsp. salt (or to taste)
  • 1 tsp. celery seed
  • 4 Tbs. dried onion flakes
  • 4 Tbs dried parsley flakes

Directions

  1. Blend together and refrigerate overnight or for several hours so flavors blend.
  2. Scoop out the center of a round pumpernickel or sour dough bread. Fill with the dip.
  3. Serve with raw veggies that can be dipped into the bread.

Salad

Green salad with “cutie” mandarin oranges—serves 4-6

  • 1 or 2 heads of Butterhead lettuce
  • 3 mandarin sectioned oranges or 1 can of mandarin oranges, drained
  • 1/2 cup slivered almonds
  • 2 Tbs sugar
  • 1 cup celery, diced
  • sliced red onion (optional)

Dressing

  • 1/4 cup red wine vinegar
  • 1/2 cup olive oil
  • 1 tsp sugar
  • salt and pepper to taste
  • 1/8 tsp red pepper flakes

Directions

  1. In a large bowl, combine the lettuce, oranges, and sliced onions.
  2. Heat sugar and almonds in a pan over medium heat until sugar melts and coats almonds; stir and heat until almonds are slightly brown.
  3. Turn onto plate and cool for 10 minutes.
  4. Combine remaining ingredients in a jar with a tight fitting lid; shake vigorously.
  5. Pour salad dressing over lettuce mixture; toss.
  6. Sprinkle with sugared almonds.

Muffins

Gluten-free Flax Meal Muffins

  •  ¾ cup brown rice flour
  • ¾ cup buckwheat flour
  • ½ cup ground flaxseed
  • ½ cup date sugar (or sweetener of your choice)
  • 1 tsp baking soda
  • ½ tsp ground cinnamon
  • ¼ tsp ground nutmeg
  • ¼ tsp salt
  • ½ cup raisins
  • 2 eggs
  • ¼ cup oil of your choice (coconut, avocado, etc.)
  • 1/2 cup unsweetened applesauce
  • 1 cup buttermilk or coconut milk

Directions

  1. Preheat oven to 375º. Line a 12-cup muffin tin with unbleached paper liners and set aside.
  2. In a large bowl, whisk together brown rice flour, buckwheat flour, flaxseed, sweetener, baking soda, cinnamon, nutmeg, salt and raisins.
  3. In a second large bowl, whisk together eggs, oil, applesauce and buttermilk. Add flour mixture to buttermilk mixture and stir until just combined.
  4. Spoon batter into prepared muffin tins and bake until golden brown and a toothpick inserted in the center of a muffin comes out clean, about 30 minutes.
  5. Cool muffins in pan for 5 minutes before transferring to a wire rack to finish cooling.

Entree

Kale Slab Pie (adapted from a recipe by Arthi Subramaniam)  serves 12

  • 3 bunches of kale—tear the leaves off the stems, or 2 pounds of Swiss chard
  • 1/3 cup olive oil
  • 2 medium onions, finely chopped
  • 1 bunch scallion, chopped
  • 1/2 cup chopped fresh dill
  • 1/2 cup chopped fresh mint
  • 1 tsp red pepper flakes
  • Freshly ground pepper to taste (divided)
  • 3 cups water
  • 2 cups coarsely ground cornmeal (polenta style)
  • 1 cup feta cheese, crumbled
  • 1 cup shredded mozzarella cheese
  • 1 cup pomegranate seeds for garnish

Directions

  1. Blanch kale leaves in salted boiled water for about 4 minutes. Transfer wilted greens to a bowl of cold water. Drain and squeeze out moisture. Chop and set aside.
  2. Heat 4 Tbs of olive oil over medium heat in a skillet, add onion. Cook, stirring until tender, about 8 minutes.
  3. Add scallions and cook for another 2 minutes. Stir in kale, dill and mint. Add red pepper flakes, and salt and pepper to taste, and combine well. (I don’t add salt because I think there’s another salt in the cheese.) Remove from heat and let kale mixture cool.
  4. Preheat oven to 350 degrees and grease a 13-by-9pinch rectangular pan with remaining oil (1 Tbs plus 1 tsp.)
  5. In a medium saucepan, bring water to a boil. Gently and slowly add polenta and 1-2 tsp. of salt. Stir continuously so it doesn’t lump until thick. Spread in the pan, like a crust.
  6. Add feta and mozzarella cheese to kale mixture; lightly combine well. Spread evenly over the polenta crust. Cover the dish with foil, loosely, and bake 30 minutes. Remove foil and bake an additional 15-20 minutes, until top is slightly brown. Remove from oven and allow to sit for 30 minutes. Garnish with the pomegranate seeds. Allow the slab pie to “rest” for about 30 minutes before serving.

Veggie side dish

Roasted Cauliflower  serves 6

  • 2 heads cauliflower cut into florets
  • 1/2 cup olive oil
  • 1 tsp dried thyme
  • 1/2 tsp salt
  • 1/2 tsp pepper
  • 2 Tbs pine nuts
  • 1/2 cup raisins soaked in hot water

Directions

  • Preheat oven to 450 degrees.
  • In a large bowl, toss cauliflower, 1/4 cup olive oil, curry powder, salt and pepper. Spread onto a pan and roast for 10 minutes. Toss and then roast another 10 minutes until slightly golden, about 2 minutes.
  • Toast the pine nuts in a toaster oven, making sure to keep an eye on them so they don’t burn. Drain the raisins. Toss the cauliflower with the pine nuts and cauliflower.

Side dish

Butternut Squash Risotto serves 4

  • 1 butternut squash baked and scooped
  • 2 Tbs olive oil
  • 1 tsp salt
  • 1/2 tsp black pepper
  • 6 cup of vegetable stock or water
  • 6 Tbs unsalted butter
  • 2 large shallots, minced
  • 1 1/2 cups of Arborio rice
  • 1/2 cup of white wine
  • 1 tsp saffron threads
  • 1 cup of grated parmesan
  • Heat oven to 450 degrees. Peel squash and cut into cubes, discarding stringy center and seeds. Toss with olive oil and salt and pepper. Place on baking sheet and roast 30 minutes. Set aside.

Directions

  1. Heat stock and simmer.
  2. In a large pot, melt butter and add shallots for 10 minutes. Add rice and coat with butter.
  3. Add wine and cook 2 minutes.
  4. Add 2 full ladles of stock to rice plus saffron, 1 tsp. salt and 1/2 tsp pepper. Stir and simmer until stock is absorbed. Continue to add stock until almost all is used, cooking about 30 minutes.
  5. Turn off heat and add squash and Parmesan cheese.

For dessert enjoy apple pie, pumpkin pie or simple baked apples with ice cream.

Baked apples

Ingredients

  • 3 pounds apples peeled, cored, sliced (Honeycrisp, Gala, or Granny Smith, or a mixture of 2 or all 3)
  • 1/2 cup light brown sugar
  • 2 teaspoon ground cinnamon
  • 1/2 teaspoon ground nutmeg
  • 1/4 teaspoon ground cloves
  • 1/8 teaspoon salt
  • lemon juice from 1/2 a lemon
  • 1 teaspoon vanilla extract
  • 2 tablespoons unsalted butter

 

Directions

  1. Preheat the oven to 350 degrees.
  2. Peel the apples, cut and remove the core and cut into slices about 1/3-1/2 an inch thick.
  3. Put the apples to a large bowl and add the light brown sugar, cinnamon, nutmeg, cloves, salt, lemon juice and vanilla extract. Stir to combine. Spoon the apples into a 2 quart baking dish.
  4. Cut the butter into small squares, and place over the apples.
  5. Bake for 30 minutes, stirring after the apples have baked for 15 minutes. This prevents apples on the top from drying. Bake until the apples are tender and soft.
  6. Remove and serve with a scoop of vanilla ice cream on top. Serve warm.

Have a safe and wonderful Thanksgiving!

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

Just because I’m having trouble with my short-term memory doesn’t make it OK to exclude me from discussions about me

Just because your loved one has dementia, please treat him or her as a thinking, feeling person who has feelings. Don’t disregard them or exclude them from conversation.

Dealing with Dementia

I’m writing this post recognizing that I’m really kinda angry. I know I can get a little “righteous” but I’m seeing families work around their loved ones instead of with them.

I know often, it’s easier to to just do things for someone. Please imagine how you would feel if you suddenly found yourself on the outside when choices about your health and finances were made for you?

Maybe you had a discussion about the topic, but for someone with short-term memory loss they won’t remember that, so are there other ways to help include and remind them of the discussion and decisions made? A notebook, email or texts?

I’m working with a new client and she told me she went to the bank to get a copy of her last statement and her son and POA had changed her statements to paperless. She knows she can’t recall the amount…

View original post 322 more words

How dehydration can lead to delirium and other health issues

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

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

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

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

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

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

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

The rule of thumb is to have 48 to 64 ounces of non-sweetened, non-artificially sweetened drinks. Hydration keeps the body in proper pH (how acidic or alkaline your body is) and protects it from getting dehydrated, which is a cause of inflammation and other kinds of imbalances. Dehydration can also contribute to urinary tract infections (UTIs).

The dangers of UTIs

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

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

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

 


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

Keep your cool with these 10 summertime eating tips

Colorful smoothies in bottles, detox summer diet fresh drink for breakfast or snack.It’s summertime and the livin’ is easy—or at least we’d like it to be. This summer is especially hot all over the world. If you’re tired and stressed out from caregiving, these tips will help you stay cooler in summer. The same information applies to those we care for. . . and for everyone.

According to the ancient Indian system of Ayurveda our body consists of three main elements or doshas—Vatta, Pitta and Kapha. Pitta consists of water and fire. It’s hot, so during summer when the temperature rises we want to eat cooling foods. Eating cooling foods not only keeps us from overheating, it reduces the tendency to get irritable, impatient and angry.  (Chapters 20 and 31 in “Calmer Waters: The Caregiver’s Journey through Alzheimer’s and Dementia” contain more information about ayurveda and nutrition that calms down the nervous system and supports immunity.)

  1. First and foremost, stay hydrated. It’s especially important to make sure you and your loved ones are getting enough liquids because when we forget to drink we can become dehydrated quickly, which leads to other health problems. It’s also crucial to keep the brain hydrated in order to maintain mental alertness. Drink plenty of water and stay away from carbonated and caffeinated drinks. Herbal teas, and fresh fruit or vegetable juices are great in summer. Just remember that fruit juices are high in sugar and calories. Coconut water is cooling and helps to replenish electrolytes, which is especially important during and after an illness.
  2. Enjoy the bounty of summer fruits. Peaches, apricots, cherries, watermelon, cantaloupe, and berries are especially good for helping the body reduce the fiery heat of summer. Juice them or make popsicles with watermelon juice or any other combination including yogurt. These are especially helpful to keep seniors hydrated and for people who have trouble chewing.
  3. According to Ayurveda, some of the recommended summer vegetables include cucumber, green leafy vegetables, green beans, squash, zucchini, asparagus, beets and eggplant. Juice a leafy green with cucumber and beets for a delicious cooling drink.
  4. Sprinkle on the herbs and spices. They’re easy to use and contribute added flavor and antioxidants to your diet. Cooling spices include cardamom, coriander, fennel and tumeric. Cooling herbs include cilantro, mint and dill.
  5. Avoid hot, sour and salty foods including fermented food, red meat, and greasy and spicy food. Excess pitta aggravates the tendency towards heartburn and gastric hyperacidity.
  6. Here’s some good news—Ayurveda recommends ice cream during the hot summer months! So by all means, enjoy! Dementia patients are especially fond of ice cream. If the person you are caring for refuses to eat or eats very little, try serving ice cream. It contains protein, calcium and calories, and it’s easy to serve and eat. If weight gain or cholesterol is a concern, select a dairy-free version of America’s favorite dessert. Rice Cream, Coconut Bliss and Soy Delicious make delicious non-dairy, frozen desserts.
  7. Cooling grains include amaranth, barley, quinoa, rice, tapioca and wheat. Use them in salads mixed with veggies. One of my favorites is quinoa salad. Cook 1 cup of quinoa. (Be sure to rinse it first to remove saponin, a naturally occurring chemical that coats each grain to ward off insects. It has a strong, bitter flavor. And yes, it is a pain to rinse quinoa. First soak it and then place it in a very fine mesh strainer and rinse.)  Sauté onion and zucchini, add a handful of fresh corn cut off the cob, mix with the quinoa. Add fresh tomatoes, black beans, and a dressing made with olive oil and balsamic vinegar. Delicious!
  8. Make your own granola. Once you do, you’ll never go back to buying store-bought granola, which is typically filled with sugar. Plus, it is expensive. Oats, almonds, and coconut are all cooling. First toast 1/2 cup of slivered almonds on a cookie sheet in the oven. Watch carefully so they don’t burn. Add to 4 cups of oats, along with 1/2 cup coconut flakes, 1/4 cup coconut oil, 1/4 cup maple syrup. Add 1/2 tsp of cinnamon, if desired. (Cinnamon is warming, but a little bit won’t hurt.) Stir and bake at 325 degrees for about 20 minutes. Add raisins if desired.
  9. For added protein, top your salads with these cooling legumes: garbanzo, pinto, white beans, azuki beans, and black-eyed peas.
  10. If you eat meat try to avoid beef, chicken, and pork during the hot months and use cooling meats such as buffalo, turkey rabbit or venison instead.

Happy eating. . . and stay cool!


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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.