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.

10 Great Gifts for Caregivers

New Year's box with gifts and bows, fir cones, snowflakes and Christmas toy on old boardsIf you’re a caregiver, you have little time for yourself and you’re probably stressed out. You don’t need another pair of pajamas, and you don’t need another coffee mug.

What you desperately need is some time for yourself to relax and rejuvenate, and ways to make your life easier.

When friends and family ask you,” How can I help?” Or, “What do you need?” send them this list. They will appreciate it, and you will definitely appreciate the rewards.

  1. You know how wonderful it feels to have a sparkling clean house. And you probably haven’t had time to do a deep cleaning in a while. Ask your friends and neighbors for recommendations for a good house cleaner or cleaning service. Merry Maids is a national company available in most parts of the U.S. They also have gift cards online to make it convenient for your gift givers.
  2. Wouldn’t it be heavenly to get away for a few hours? It’s important to maintain friends throughout our lives, and even more important when we need to vent or just need a friendly chat or someone to tell you that you’re doing the best that you can. Gift cards to a neighborhood coffee shop or restaurant can help provide an excuse to connect to a friend you haven’t seen in a while. Make a date.
  3. But in order to make a date, you might need a companion to stay with your loved one. Providing TIME to you may be the greatest gift of all. Ask for a time donation, possibly in blocks of time. Two hours a week for a month? Four hours a month? Spread your wishes around. You’re bound to get several “yeses.”
  4. Do you like to sing? Whether you sing in the shower or in a chorus, it’s been well documented that singing reduces stress levels and depression. Group singing boosts oxytocin levels, and creates a feeling of “togetherness.” (Oxytocin is called the “love  hormone” because it is released when mothers breastfeed and when people snuggle up or bond socially. Request a favorite music CD that you like to sing to. Try to include the person you are caring for. Invite neighbors over for a singalong, and make it intergenerational. It’s amazing that people who even have advanced dementia can often remember the words to songs they sang decades ago.
  5. What about dance? You might have two left-feet, but you can dance away your blues without anyone watching in your living room. I always say that dance is what kept me off anti-depressant medication during the 10 years I cared for my husband. I did folk dance, salsa, and contra on a weekly basis. It was well worth the expense of hiring someone to keep my husband company on those evenings. Dance supports the release of endorphins from the brain into the bloodstream. I experienced firsthand a rush of happiness for hours, and sometimes days, after dancing for just a couple hours. Not only does dancing uplift your spirit, it can help you think more clearly. A 21-year-long Einstein Aging Study that was published in the New England Journal of Medicine in 2003 found that dancing is the best form of exercise to help prevent dementia when compared to 11 other activities including swimming, bicycling, and team sports. The study also found that dancing can help slow down cognitive decline. Dancing to music that carries special significance can be a wonderful way to connect with your care partner. Why not ask for a CD of your favorite music and dance in your living room, alone or with your care partner? Or, learn a new dance. Request a DVD to teach you the steps. Or, try a Zumba class. Fitness is a Latin-inspired cardio-dance workout that uses music and choreographed steps to form a fitness party atmosphere. While many of the types of dance and music featured in the program are Latin American inspired, classes can also contain everything from jazz to African beats to country to hip-hop and pop. Attend a Zumba class at your local recreation center or YMCA. They are also available on YouTube videos. And ask for a gift of companion-sitting for your loved one.
  6. House maintenance is often neglected when you have a million caregiving tasks. When is the last time you raked your lawn, pulled weeds, fixed a leaky sink, or had your carpets cleaned? The offer of someone volunteering their time to provide these services or the gift of a handyman service is always appreciated.
  7. Would you like to try a yoga class, either online or at a studio? Ask for a yoga mat, yoga blocks and a yoga strap. That’s all you need to help you release stress, build up endurance, relax muscles, and reduce risk of osteoporosis. Yoga videos are sold on Gaim, and are offered on their website for $11.99 per month after doing a free 2-week trial at https://www.gaia.com/yoga?utm_source=google+paid&utm_medium=cpc&utm_term=gaiam%20yoga&utm_campaign=1-USA-ENGLISH-BRAND-EXCT&utm_content=gaia&ch=br&gclid=Cj0KCQiA5dPuBRCrARIsAJL7oejWgk-kRRzIVjk_nt7xXY3-I5F_cYeHbltpDj4H7vba2QBjnQPwwiMaAqLVEALw_wcB
  8. Everyone loves a home-cooked meal. A personal chef who prepares meals in your home or theirs is an extravagant service. But put the idea out there. You never know . . . . A more affordable option is home-delivered meal kits. Home Chef, Blue Apron, and Green Chef are a few of the meal kit companies that allow you to choose meals that arrive with fresh, pre-measured and prepped ingredients, and instructions on how to create a fast meal.
  9. Massage is a wonderful way to relax and tune out the world. I highly recommend asking for a gift certificate to a spa that offers massage with hot stone and aromatherapy. You will emerge like a new person.
  10. One of the best gifts you could receive is respite care.  Do you have a relative or friend who could stay with your loved one a night or two so you can get away and totally tune out the world? If not, maybe one of they would generously provide you with a professional care service. Just imagine getting away from it all without any responsibilities for 24 or 48 hours.

You deserve gifts that will help you, the caregiver. So don’t be shy. When people ask how they might help or what you need or want, send them this list.

Have a happy, restful and peaceful 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 Barnes & NobleBoulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and online at Target and Walmart, and many other fine independent bookstores, as well as public libraries.

What if your dementia patient becomes abusive, aggressive or violent?

Angry, enraged senior woman yelling at a landline office phone, unhappy with customer service provided by the agent on the other side, giving off steam and smokeMy husband Morris was a gentle man. But occasionally, if things didn’t go his way, he would get nasty. Once Alzheimer’s took his brain hostage, he exhibited a darker side. But only when he was frustrated or confused.

Morris spent the last two years of his life in a memory care home. He was popular among the staff because he liked to goof around. When he walked the halls listening to music on his Walkman, he’d have a smile on his face and swagger to the rhythm. But if another resident got in his way, watch out. If it was crowded in the dining room and someone accidentally bumped him, he’d swing his arm out to shoo that person away. When one of his neighbors walked into Morris’s room mistaking it for his own, the two got into a rumble on the bed and fought like school boys. After this happened a couple more times, the neighbor was moved to the opposite side of the facility.

When Morris hit a resident in the dining room, the on-call physician prescribed a depressant to “calm him down.” Morris reacted to the drug by transforming into a zombie who slumped in his chair and slept too many hours during the day. I insisted that he get off the drug and Morris returned to his mostly cheerful self.

I once had a next door neighbor whose wife had Alzheimer’s. She threatened to kill her husband with a knife and then went on to slash a painting hanging in their living room. Was she or Morris responsible for their actions? No. A person with dementia is not responsible for acts of violence because as the disease progresses, neurons in the cortex that are responsible for language, reasoning and social behavior are destroyed. This leads to some Alzheimer’s patients engaging in aggressive or violent behavior such as biting, kicking, spitting, slapping, punching, and/or using foul language.

Research from the National Institutes of Health indicates that up to 96 percent of patients with dementia who were studied over a 10-year-period exhibited aggressive behavior at one time or other. In 2011, CNN Health reported that 5 to 10 percent of Alzheimer’s patients exhibit violent behavior at some point during the course of the disease.

There is usually a reason for aggressive behavior.

What to watch out for

  • Urinary tract infection
  • Pain or stress
  • Loneliness, depression
  • Too much noise or stimulation
  • Boredom
  • Constipation
  • Soiled diaper or underwear
  • Uncomfortable room temperature
  • Physical discomfort (stomach ache, etc)
  • Confusion
  • Anger about loss of freedom (to drive, living independently)
  • Drug reaction or contra-indication
  • Resistance against being told what to do such as bathing
  • Sudden change in routine, environment or caregiver
  • Communication problems
  • Hunger or not liking the food
  • Dehydration

What to do

  1. If your life or the life of the person you care for is in danger, get help immediately!
  2. The Alzheimer’s Association has a 24-hour helpline at 800-272-3900.
  3. Rule out UTIs, pain, discomfort, etc.
  4. Use an essential oil to help calm the person down. When my husband got agitated I’d put a few drops of oil on a cotton pad inside a diffuser and plug it into the wall. He usually calmed down immediately.  The following oils can be used in a diffuser, or put in a bath or fragrance free moisturizer. They can also be sprayed on a pillow or handkerchief. Citrus oils are generally refreshing and uplifting for the mind and emotions, relieve stress and anxiety, and are useful for odor management and appetite support. 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. Tree oils are revitalizing with immune boosting properties, ease respiratory congestion, and are supportive to breathing ease. They are useful for pain relief, skin infections, and odor management, and can relieve nervous exhaustion and depression. Consider: eucalyptus (Eucalytpus citriodora or globulus), pine needle, sandalwood, or Tea Tree.
  5. Reassure your patient by speaking gently and calmly.
  6. Play calming music, i.e. Mozart
  7. Try to distract the person with a TV show, favorite snack (ice cream almost always works), or a walk outside.
  8. Maintain a regular routine.
  9. Make sure the lighting is suitable in the home or facility.
  10. Help the person to maintain as much dignity and independence as possible.
  11. Make sure the person is eating a nutritious low-sugar, low-salt diet, with no or very limited amounts of alcohol and caffeine.

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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.

Preventing Caregiver Burnout with Good Nutrition and Foods that Support Neurotransmitters

Keto diet concept - salmon, avocado, eggs, nuts and seedsWhether 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.

Start your day with an energizing breakfast to stabilize your blood sugar, so your mood stays even and you can perform at your best. When blood sugar is too high or low it’s a signal to the body to store calories, which adds fat around your middle. If you’re nauseous in the morning it means your blood sugar is low.

Eat within one hour upon rising and by 10am, and 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.

Healthy Breakfast with Wholemeal Bread Toast and Poached Egg

Breakfast of Champions

  • Top a bagel or slice of whole wheat break with a fried egg, sliced tomato, avocado, slice of low-fat cheese
  • Bagel topped with hummus, tomato, goat cheese
  • Spread a tablespoon of almond butter on a piece of bread or bagel
  • Yogurt/granola parfait with fresh fruit
  • Sautéed greens (kale or spinach) and onion, and a corn tortilla topped with eggs, beans, sprinkle of cheese, salsa
  • Oatmeal or multi-grain cereal with almonds or walnuts, prunes, cinnamon, flax seed meal, Greek yogurt
  • Spinach mushroom omelet with salsa, berries and wheat toast
  • Whole-grain mini-quiche with ½ cup of berries

Hydrate!

Senior couple staying hydrated after running jogging

Our body is 50-65% water. Drink plenty of water to stay hydrated and to flush out toxins. 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. The next time your mind is muddled, drink a tall glass of water and notice the difference. Choose smoothies, fresh juices, water, herbal teas.

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, poor digestion, poor blood sugar control, drug (prescription and recreational), alcohol and caffeine can deplete them. (Emmons, The Chemistry of Joy, 2006).

 

list of neurotransmitters

Serotonin is necessary for a stable mood.

A deficiency can result in depression, irritability, sudden tears, insomnia, anxiety, or panic attacks, binge eating, carbohydrate craving, an overactive mind, and low tolerance to stress. When chronic stress is combined with nutrient deficiencies because of poor eating habits the risk of mood disorders can increase.

Foods that enhance serotonin: Salmon, Soy, turkey, cheese, eggs, spinach, cottage cheese, nuts, milk, avocado, meat, chocolate

Activities that enhance serotonin: cross crawl movement, as in swimming, hiking, biking

Dopamine keeps us focused and motivated. Dopamine is sometimes referred to as a “gas pedal” neurotransmitter. A deficiency can result in depressed mood, excessive sleeping, eight gain, obesity, lack of energy, addictions. When in balance, dopamine increases alertness, wakefulness, energy. It is depleted by addictions, sugar, cigarettes.

Foods that enhance dopamine: Meat, wild game, eggs, chocolate, blueberries, yoghurt, milk, soy, cheese, seeds and nuts, beans and legumes.

Activities than enhance dopamine: Deep breathing, weight bearing exercise and strength training enhance dopamine.

GABA inhibits nerve cells from firing. Too many carbs and refined foods deplete GABA. Exercise, and being outdoors, paying attention to your personal needs are important.

Passion flower, lemon balm and valerian help support GABA, especially helps you fall asleep.

How to boost your neurotransmitters

  • Focus on complex carbohydrates (whole grains, fruits and veggies) and eliminate junk foods or refined carbs.
  • Eat 3 balanced meals and 1-2 snacks/day. Include a high-quality protein with every meal
  • Unlimited amounts of fresh veggies
  • Eat a good breakfast

Do you lie awake at night?

Lack of sleep triggers the body to increase production of cortisol, the stress hormone, which makes it harder to fall asleep and stay in a deep sleep because on some level your body and brain think they need to stay alert for danger. Although insomnia isn’t considered a disease by itself, it can lead to numerous health problems. Lack of sleep may result in slower reflexes, irritability, fatigue, lack of motivation and depression. Your health, motivation, productivity, mood and energy all depend on getting quality sleep.

Foods that promote sleep

Although it’s not recommended to have a full meal close to bedtime, eating a snack helps maintain blood sugar levels, which helps promote restful sleep.

A cheese slice, or slice of turkey contain tryptophan, an essential amino acid, that promotes sleep. Other foods that might help: Whole grain crackers with nut butter, oatmeal, popcorn, almonds and walnuts. Some fruits (oranges, bananas, tart cherries, kiwis) contain melatonin.

  • Small amount of protein
  • Complex carbs
  • Nuts
  • Cottage cheese
  • Chamomile tea, warm milk
  • Fruits

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.

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!

Assortment of healthy protein source and body building food

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.

Happy eating!


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

 

What’s new in Alzheimer’s research?

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

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

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

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

Brush your teeth for better memory

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

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

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

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

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

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

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

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

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

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

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

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


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

 

Grief and Relief: When caregiving ends

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

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

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

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

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

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

My journey to calmer waters

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

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

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

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

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


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

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

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

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

The Physiology of Stress

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

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

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

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

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

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

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

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

Stress and sleep

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

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

Weight gain and insulin resistance

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

Exercise

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

Impact of food on mood and physiology

Hazards of caffeine

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

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

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

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

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


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

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

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

Calmer Waters: Spring 2019 book signings and events

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

Falling in love while caring for your spouse with Alzheimer’s

This is a controversial and delicate topic. Is it possible to judge someone unless we’ve walked in their shoes? Watch the video and let me know what you think.

In the meanwhile, you might want to check out my article “Sexual intimacy between care partners” at The topic of sex is often uncomfortable in the best of relationships in the best of times. The topic is especially prickly when one of the partners has Alzheimer’s disease.

 

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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.

Motivating family members to help

Until age eight, I lived in an extended family house with my parents, brother and me on the top floor, my grandparents on the middle floor, and my aunt, uncle and cousin on the bottom floor. We all took care of each other, no questions asked. It was a close, loving family.

But that was then, this is now. Times have changed. People move away, and families don’t always stick together. I was lucky that my daughter and her newly-wed husband live near me and helped care for my husband (her father) who had Alzheimer’s disease. Every Sunday afternoon they took him out to a movie or to lunch. It gave me a break and it uplifted his spirit. My son, who was in graduate school, came home when he could to take his dad to a football game. And friends took my husband out to lunch on a regular basis.

But I needed extra help so I hired two graduate psychology students. I had promised myself that I wouldn’t become a martyr to my husband’s illness. I took care of myself by pursuing my interests and meeting with friends. Because I had time for myself, I had more energy to be present for my husband. Still, caring for someone with Alzheimer’s disease was a daunting task, as is caring for anyone with a chronic disease.

It really does take a village to provide care for someone with a chronic illness. If you have family that offers to help, you are lucky. Sadly, it’s often the case that one family member bears the brunt of the caregiving, which can lead to conflict and bad feelings.

What can you do to encourage family and friends to help?

  • If your loved one has Alzheimer’s or another form of dementia you are well aware of the difficult task of caregiving. But if your sister or brother, son or daughter, etc. only sees the ill person once in a while they might not realize the full impact of the disease. Try to plan a respite day or weekend by having another family member care for your loved one. This is the best way to help your family realize how much care your loved one needs and what the task requires.
  • Plan a conference call and divvy up the caregiving. If your family is spread out, encourage a rotation of caregiving. In some cases, the ill person stays with a daughter or son for a few months and then moves on to stay with another family member. This eliminates guilt and bad feelings among siblings. The logistics are complicated, but it can work.
  • If it is impossible for others to share in the physical caregiving because of where they live or other circumstances, encourage family members to take on a specific responsibility such as: refilling medications, driving to and/or making doctor appointments, providing meals, researching community assistance programs that include respite care and volunteer programs, setting up automatic bill payments and/or dealing with financial issues, providing a housecleaner or cleaning the house once a month, mowing the lawn, shoveling the snow, etc.
  • Speak your truth. Do you need a night out with friends? Time to go for a walk or to the gym? Say so, and don’t be afraid of offending anyone. The worst that can happen is that your sister or brother, or son or daughter will say “no.”
  • Is it possible for you to get paid for the help you provide? Discuss the options with your financial planner and other family members.
  • Ask a family member to create an online caring community such as “Share The Care” https://sharethecare.org/getting-started/ or “Caring Bridge.”  “Share The Care” is a system that creates a support network among caregivers that lets everyone share responsibilities. “Caring Bridge” https://www.caringbridge.org/how-it-workshelps you create a site that enables you to share updates about your loved one, coordinate help, and get emotional support.
  • It’s a fact of life that you can’t force another family member to help. Even if you do get help, you might be the one who does the disproportionate amount of caregiving. Try to accept it and be grateful that you will not feel guilty for not being there for your loved one. You are appreciated and even if your loved one can no longer communicate, he or she appreciates you and loves you. Just know that you are doing the best that you can . . . and that is all you can do.. 

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.