Is Palliative Care Right for Your Loved One?

Woman comforting her unwell husband

When most people think about palliative care, they visualize someone who is suffering from pain, advanced cancer, COPD (congestive heart failure), or another fatal illness. Palliative care is specialized medical care for people also facing serious illnesses like dementia. The goal is to support the patient and the family on all levels, including physical, psychological, and spiritual.

What’s the difference between palliative care and hospice care?

Palliative care aims to ease pain and discomfort, reduce stress, and help patients —and their families— have the highest quality of life possible. Hospice care comes into play when a cure is no longer viable or when the treatment negatively outweighs the benefits. You can have palliative care at any stage of illness, along with other treatments.

Typically, with hospice curative medications or aggressive treatments for a patient’s illness are stopped. But not all medications are stopped. Medications that help relieve pain, nausea, anxiety and help a person breathe are an important part of hospice care.

In an article that appeared in Alzheimer’s TODAY (Volume 19, Number 1), Ann Wyatt, MSW, a leader in palliative care for people with dementia, says that people with dementia express their comfort and discomfort through their actions. It’s the caregiver’s responsibility to figure out the cause of the discomfort and help the person become more comfortable.

But that’s tough because dementia may prevent a person from communicating the source of distress. It’s usually not dementia that causes the distress, says Wyatt. (Although from my experience with my husband, his dementia caused frustration, anger, and irritability.)

Wyatt, says, “Most of the time it means that somebody is in pain or has some other discomfort. Dementia just means they can’t explain what it is.”

In a care facility, a resident might be given an antipsychotic drug to manage or misdirect behaviors that are perceived as aggressive. But the behavior might be a reaction to the person’s discomfort of being in a setting where schedules are instilled to provide efficiency and ease for the staff without considering the individual needs. For instance, a person who finds it hard to get up in the morning may exhibit “difficult behaviors” because they are woken early for breakfast or a shower, when they’d rather sleep in.

A personal anecdote

In my husband’s case, another resident occasionally, and mistakenly, walked into his room thinking it was his. My husband would shove him, and sometimes they got into a physical altercation. The situation was resolved when the other man was moved to the opposite side of the facility. This was a good example of palliative care. The caregivers removed the source of discomfort and stress for both residents (and families) by simply moving one resident to another area.

Simple ways to provide palliative care

  • Aromatherapy is a miracle cure for stress and anxiety. Use a wall plug-in to diffuse the aroma of lavender oil to uplift mood, or place a few drops on a handkerchief and tuck it into a shirt pocket or on a pillow. Other oils to try: vetiver, frankincense, myrrh, orange, lemon, bergamot, and grapefruit.
  • Play soothing music, and sing.
  • Speak softly.
  • Read to your loved one.
  • Use dimmed lights and/or battery-operated candles.
  • Beautify the environment with flowers.
  • Massage and/or physical touch is a wonderful way to ease everyone’s tension.

Getting palliative care

A palliative care team helps patients and families find ways to improve their quality of life whether that means moving to a skilled nursing facility or getting good home care. To find palliative care in your area visit https://getpalliativecare.org/howtoget/find-a-palliative-care-team/.

Download the free booklet Palliative Care for People with Dementia at caringkindnyc.org for excellent information about a comfort-focused care approach

For dozens more tools and techniques for reducing stress, uplifting mood, supporting your immune system and finding ways to connect on a spiritual and emotional level with the person you care for, read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.

Keep your cool this holiday season and all year long

The holiday season is stressful for everyone, but especially for caregivers. Here’s a list of my favorite ways to destress any time of the year.

  1. Breathe! When we are stressed, we tend to hold our breath. Take a 5-minute break and sit down in a comfortable chair. Close your eyes and take a deep breath, in and out. Then focus on your breath and watch how your mind quiets down and your muscles relax. Then remember to breathe throughout the day. Whenever you feel yourself getting anxious or tight, take a deep breath and let it go.
  2. Drink water. We’ve heard it a million times but it’s always good to be reminded. Forget about sodas and limit the wine and alcohol. Staying hydrated, especially at this time of year, is vital to supporting the immune system and reducing inflammation. It’s also important to support healthy cognitive function and memory.
  3. Eat walnuts. A daily dose of about 9 whole walnuts or 1 Tbs. walnut oil helps your blood pressure from spiking during stress. Walnuts contain L-arginine, an amino acid that helps relax blood vessels, which in turn helps reduce hypertension.
  4. Drink green tea. L-Theanine is the main chemical constituent in green tea. It is an ideal nutritional aid for stress because it produces alpha-wave activity that leads to deep relaxation and mental alertness. This is especially important because to mitigate stressful situations, it’s important to remain calm and alert. Theanine also stimulates the release of the neurotransmitters GABA, serotonin, and dopamine, which help us feel happy, motivated, and calm. Green tea extract is available as a nutritional supplement, which might be easier and quicker to take, and it’ll save you a lot of trips to the bathroom.
  5. While we’re on the topic of “green,” be sure to eat green leafy vegetables for vitamin B and magnesium, both of which help your body cope with stress.
  6. Two handfuls of cashews (make that a small handful, please; one ounce of cashews contains 157 calories.) provide the equivalent mood-boosting effect as a therapeutic dose of Prozac because they are one of the highest natural sources of tryptophan, the precursor for serotonin, the feel-good neurotransmitter.
  7. Did someone mention dark chocolate? It reduces cortisol, the stress hormone that causes anxiety symptoms. Just a couple of pieces should do the trick.
  8. Walk around the block. Just getting out into fresh air will instantly relieve stress, and moving your body gets your blood pumping and will clear your mind.
  9. Light candles and play relaxing music while you eat. It will change the mood instantly.
  10. Aromatherapy is a miracle cure for stress and anxiety. Use a wall plug-in to diffuse the aroma of lavender oil to uplift mood, or place a few drops on a handkerchief and tuck it into a shirt pocket or on a pillow. Other oils to try: vetiver, frankincense, myrrh, orange, lemon, bergamot, and grapefruit.
  11. Music is the universal language, and it is also the universal stress reliever. Whether it’s jazz, classical, or hard rock that makes you feel better, by all means, play it loud, play it soft, dance to it, drive to it, go to sleep to it. It will definitely help.
  12. Getting the proper rest is vital to staying healthy and reducing stress. Prepare yourself for a deep night’s sleep by unplugging from electronics at least an hour before bed, taking an Epsom salt bath (put several drops of lavender oil in the water for added relaxation), and making sure the room temperature isn’t too warm.  Good night, sleep tight!

If you, or someone you care about, tend to suffer from stress, anxiety, or depression, these recommendations might just “take the edge off” and improve your quality of life … without the risk of side effects. May the holiday season begin!

Have a safe, healthy, and fun holiday season, and many blessings for a year filled with ease and peace.

For dozens more tools and techniques for reducing stress, uplifting mood, supporting your immune system and finding ways to connect on a spiritual and emotional level with the person you care for, read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.

The 10 things you must do after getting a dementia diagnosis.

A walk through the park

It’s a shock to receive a dire prognosis. The day I listened to the doctor tell my husband that he had Alzheimer’s remains as one of those pivotal, earth-shaking moments that changed the course of my family’s life.

I’ve been hearing about more and more people, young and old, who are getting an Alzheimer’s diagnosis. It’s okay to cry, to throw a tantrum, and to feel numb. I remember calling my parents in disbelief and saying that my life wasn’t supposed to turn out this way. I was only 48 years old. I lost my spouse at 58. Now at 71, I look back and see how far I’ve come. Ten years of navigating the Alzheimer’s world, taking care of my husband, having him live in a memory care home, and seeing it through until the end, definitely took a toll on me — physically and emotionally. I still tear up when I think about it.

Whether you are the caregiver or the person who has dementia, the important thing to tell yourself is that you will get through this. But there are things you must do — starting today — to help yourself and your loved one(s).

  • Get in touch with your local Alzheimer’s Association. https://www.alz.org/ They are a godsend and do amazing work helping caregivers and people with dementia, and funding research. Check out their education programs such as “Managing Money: A Caregiver’s Guide to Finances” https://training.alz.org/products/4355/managing-money-a-caregivers-guide-to-finances?_gl=1*ec354i*_ga*MTkxNzM3NzMxOS4xNzAzMDk3NDQ5*_ga_9JTEWVX24V*MTcwMzA5NzQ0OC4xLjEuMTcwMzA5NzU4MS4xOC4wLjA. Or, “Living with Alzheimer’s: For People with Alzheimer’s Disease.”
  • Make an appointment with an elder attorney to figure out how to best plan for the future. (http://National Academy of Elder Law Attorneys). As soon as possible, designate who will be your powers of attorney, including durable general power of attorney and medical power of attorney. Put a lot of thought into it. You want to make sure the people you put your trust in are people you know will have your best interests and wishes in mind.
  • Consult with a professional about long-term care Medicaid to see if you qualify and what you might do to qualify if you currently don’t. Making these plans while you or your loved one are still able to is a great gift.
  • Enlist family members and neighbors who you can count on to be helpful. Designate someone as an emergency contact. Share your contact information with them and let them know you might need their help at some point.
  • Share your feelings with your closest friends and family. Don’t do what I did and try to keep the diagnosis a secret. That became a huge stressor for me.
  • Consider adult daycare programs that provide care, companionship, and supervision during the day. To find out more about centers where you live, contact your local aging information and assistance provider or Area Agency on Aging (AAA). For help connecting to these agencies, contact the Eldercare Locator at 1-800-677-1116 or https://eldercare.acl.gov.
    The National Adult Day Services Association is a good source for general information about adult daycare centers, programs, and associations. Call 1-877-745-1440 or visit http://www.nadsa.org.
  • Schedule a weekly walk with a friend or neighbor. The exercise and socialization will do you good.
  • Remove area rugs from the house and other items that may pose a fall risk. And make sure there is sufficient lighting in the house.
  • Do everything you can to reduce stress. Have a family meeting in which everyone can participate in the sharing of care. It’s important to divvy up tasks because there will be plenty of them in the long, fraught Alzheimer’s journey. Even if someone lives across the country, that person can share the responsibility of calling in prescription drugs, ordering food to be delivered, setting up appointments, etc.
  • Stay engaged in activities that you’ve always enjoyed. Dance, sing in a choir, play an instrument, garden, play a sport or cards. Alzheimer’s and other dementias are not contagious. Enjoy your life the best way you can by staying engaged in your favorite activities for as long as possible.

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 review of the science: how you can reduce your risk of dementia NOW by getting flu, pneumonia, and shingles vaccines

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Almost 10% of U.S. adults over 65 have dementia, and another 22% have mild cognitive impairment. However, research is showing that if you treat early signs of mental decline, you may be able to slow down and possibly reverse cognitive decline.

Ilene Naomi Rusk, Ph.D., a Canadian neuropsychologist, functional brain health coach, Founder, and Director of The Healthy Brain Program at the Brain and Behavior Clinic in Boulder, strives to understand the root causes of a person’s psychological and brain health issues. She and a functional medicine team provide a neuropsychological diagnosis and treatment protocol for each patient, from brain training to nutrition. “It’s important to look at the whole person including lifestyle—stress resilience, mood, sleep, nutrition, exercise—and assess a person’s vascular and metabolic risks,” she says.

“We use the same cognitive training used in the FINGER study (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) and other studies which found that if you target several lifestyle and physiological factors simultaneously you can reduce your risk of getting dementia. Those include having a healthy gut microbiome, eating more fruits and vegetables, and sleeping well without sleep apnea. Physical activity is important because it increases brain-body communication, is good for strength and coordination, helps circulation, clears toxins, and improves oxygenation of your brain. 

“We need to be challenged every day,” Dr. Rusk adds. “Read new books, learn new crafts, and stretch ourselves so our brains create new neural connections. Social engagement is also one of the pillars shown to protect against dementia. Loneliness is a huge risk factor because it leads to depression and depression can shrink the hippocampus the same way Alzheimer’s does.”

Dr. Elliot Good, DNP, a nurse practitioner and owner of Amavi Integrative Mental Wellness in Niwot is board-certified in psychiatric mental health and adult geriatric primary care. Amavi offers a multidisciplinary approach to treating all types of memory disorders. The team of professionals uses psychotherapy, medications, and care coordination with other physicians to help patients manage their condition and maintain a high quality of life. Dr. Good emphasizes there’s no cookie-cutter approach to help everyone. “A comprehensive plan may include a medication and/or a neurological assessment plan depending on a person’s risk factors so we know where to target our efforts.

“First, we target things to help prevent dementia like exercise, diet, and sleep. We assess hearing and visual impairment, medication load, and alcohol abuse to optimize your well-being as you age. Secondary prevention assesses underlying issues that contribute to dementia such as hypertension, vascular changes in the brain, diabetes, vitamin D and vitamin B deficiencies, depression, social isolation, and anxiety. Then we try to get those things under control.

We have a neuropsychologist who uses the ACTIVE Study approach based on the study done by the National Institute of Aging for early dementia. It was designed to focus on memory, reasoning, and visual processing speed, the three areas that we tend to lose earliest in our 60s, and the things that lead to not being able to live independently. The people in the study saw an immediate improvement over five years, like remembering to take medication and being less likely to have an auto accident or to stop driving.

What can you do now?

  1. Get a flu and pneumonia vaccine. Get a flu and pneumonia vaccine. Research released at the 2020 Alzheimer’s Association’s International Conference found that over a period of years, at least one flu vaccination was associated with a 17% reduction in Alzheimer’s incidence. More frequent flu vaccination was associated with an additional 13% reduction in Alzheimer’s incidence. Vaccination against pneumonia between ages 65 and 75 reduced Alzheimer’s risk by up to 40% depending on individual genes. Interestingly, individuals with dementia have a higher risk of dying (6-fold) after infections than those without dementia (3-fold). The shingles vaccine also reduces risk of Alzheimer’s since there is a link between viruses and neurodegeneration.http://Lehrer S, Rheinstein PH. Vaccination Reduces Risk of Alzheimer’s Disease, Parkinson’s Disease and Other Neurodegenerative Disorders. Discov Med. 2022 Sep-Oct;34(172):97-101. PMID: 36281030; PMCID: PMC9608336.
  2. Eat a whole foods diet. Evidence from observational studies and randomized controlled trials suggest Mediterranean diet, the DASH diet, and the MIND diet help to reduce cognitive decline. The DASH diet emphasizes vegetables, fruits, low or fat-free dairy products, whole grains, fish, poultry seeds, nuts and vegetables, and limits salt, sweets, and red meats. The Mediterranean diet includes little red meat and emphasizes whole grains, fruits and vegetables, fish and healthy fats such as nuts and olive oil. The MIND diet is a hybrid of the Mediterranean and DASH diets.
  3. Drink coffee if you can tolerate it. Research suggests that coffee consumption over a lifetime reduces the risk of developing Alzheimer’s disease, particularly in the elderly. http://Socała K, Szopa A, Serefko A, Poleszak E, Wlaź P. Neuroprotective Effects of Coffee Bioactive Compounds: A Review. Int J Mol Sci. 2020 Dec 24;22(1):107. doi: 10.3390/ijms22010107. PMID: 33374338; PMCID: PMC7795778.
  4. Sweat! Researchers at the University of Eastern Finland followed 2,315 men aged 42-60 years for 20 years as part of the Kuopio Ischaemic Heart Disease Study. Men who reported taking a sauna 4-7 times per week were 66% less likely to receive a diagnosis of dementia than those who only sauna once a week. They were also 65% less likely to receive a diagnosis of Alzheimer’s disease.http://Laukkanen T, Kunutsor S, Kauhanen J, Laukkanen JA. Sauna bathing is inversely associated with dementia and Alzheimer’s disease in middle-aged Finnish men. Age Ageing. 2017 Mar 1;46(2):245-249. doi: 10.1093/ageing/afw212. PMID: 27932366.
  5. Stay socially and mentally active. http://Zhu J, Ge F, Zeng Y, Qu Y, Chen W, Yang H, Yang L, Fang F, Song H. Physical and Mental Activity, Disease Susceptibility, and Risk of Dementia: A Prospective Cohort Study Based on UK Biobank. Neurology. 2022 Aug 23;99(8):e799-e813. doi: 10.1212/WNL.0000000000200701. Epub 2022 Jul 27. PMID: 35896434; PMCID: PMC9484730.

 “We’re learning new approaches to improve cognitive health all the time,” says Dr. Rusk. “We want to help people stay engaged with their lives, their emotional and brain health, and to feel empowered to make positive lifestyle changes. Stay hopeful.”

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.

15 Ways to Help You Deal with Caregiver Guilt

You spend countless hours taking care of your loved one and have given up so many things. So why do you still feel guilty about not doing enough? Why do you continue to second-guess yourself?

You may ask yourself Am I doing enough? Did I make the right decision? What if… what if…? Here are ways to recognize your feelings, tips for accepting them, and ways to forgive yourself.

Why do you feel guilty?

  • Do you feel that you aren’t doing enough for your care recipient? Make a list of everything you do for the person you care for. Preparing a meal, shopping for groceries, driving to appointments, making a bed, doing laundry, making a phone call, sitting next to the person, even just giving a hug: the list adds up! You are doing a lot more than you think you are!
  • Are you guilty about your negative feelings? Resentment, anger, and grief are all normal. They are just feelings and they aren’t wrong. Feelings are complicated and you are entitled to them. You probably love the person you are caring for but the time you spend is precious and you might rather be outside gardening or hiking or traveling.
  • Do you feel bad about taking time for yourself? Don’t! If you don’t stay well, including eating and sleeping well, there’s a good chance you will get sick. And that is not going to help anyone! Please take some time for yourself. If you are a full-time caregiver, at least take a 15-minute walk every day. Get some respite care. Your local county social services department can most likely provide you with some options for help.
  • Are you feeling inadequate as a caregiver? The Alzheimer’s Association offers free classes on caregiving. “The Savvy Caregiver” is an excellent five-session class for family caregivers. It helps caregivers better understand the changes their loved ones are experiencing, and how to best provide individualized care for their loved ones throughout the progression of Alzheimer’s or dementia.
  • Do you resent losing personal time for meeting with friends, exercising, painting, playing an instrument, or traveling? It’s normal and natural to feel like you’re missing out on the things that bring you enjoyment. Try to carve out at least an hour or two a week where you can do whatever you want to do.
  • Do you have unresolved issues that stem from your childhood that get in the way of your feelings for the person you’re caring for now?
  • Are you comparing yourself to other caregivers? For instance, if you’re in a caregiver group you may be in awe of the amount of time another caregiver spends taking care of a spouse or how many hours she sits next to her husband in a memory care home. You are YOU, you’re unique and have different needs, a different history, and a different relationship with the person you’re caring for. Don’t compare yourself with anyone.
  • Do you have past unresolved issues with the person you’re caring for?

Tips for easing guilt

  • Ask yourself what’s bothering you. Talk with a close friend who will not judge you, or with a professional therapist, clergyperson, spiritual teacher, or intuitive guide. Talk about your guilt until you feel your body release the tension that is stored in your muscles and cells.
  • Remember that you are human and not perfect. No one expects you to perform with absolute clarity and grace all the time.
  • You cannot control everything all the time. You are doing the best that you can with the information, strength, and inner resources that you have.
  • Join a support group. Caregivers share many of the same problems and issues. A support group meeting can be a safe place where you will not be judged.
  • Have an “empty chair” dialogue by speaking out loud and pretending that your care partner is in the chair next to you. Express your feelings openly and wholeheartedly. Ask for forgiveness if you feel that you wronged your loved one in any way.
  • Write down your thoughts and feelings. Journaling is a wonderful, inexpensive way to release your concerns and worries on paper. It’s available when your therapist and best friend are not, and you can do it anywhere at your leisure.
  • Strong feelings of guilt, remorse, and grief will diminish over time.  If they continue to haunt you, seek professional help.

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 ways for caregivers to reduce holiday stress

Happy holidays! Thanksgiving is almost here! It’s almost inevitable that most of us feel more stressed during the holiday season. There’s always so much to do if you’re planning to get together with friends and family. And for those who are grieving or alone, the stress can be debilitating. If you’re a caregiver, you’re undoubtedly even more stressed.

The most important thing is to take care of YOU. If you get stressed and exhibit anxiety, those around you are going to feel it. It becomes a vicious cycle. You get stressed, and then the person you care for may get irritable, nervous, or anxious.

Make this your mantra: eat healthily, drink water, take a daily walk, and sleep well. It sounds easy, but how do you do that when your time is limited and you feel stretched in every which way.

Or how do you take care of yourself when you’re so depressed it’s hard to get out of bed? (This is a huge topic that I won’t address here, but you might want to read: Have you tried any of these natural ways to combat depression? https://barbracohn.2018/10/03/have-you-tried-any-of-these-natural-ways-to-combat-depression/

  1. Make a pot of soup that will last several days. Lentil, split pea, vegetable, chicken, butternut squash, and tomato soups are chockful of goodness. See below for a yummy recipe.
  2. Do you really need to drink 8 glasses of water each day? According to an article that recently appeared in the New York Times, the answer is no. It depends on a lot of things: how big you are, how active you are, and how much liquid you’re getting through foods and other drinks such as tea and coffee. I had always thought that caffeinated tea and coffee dehydrate you. But according to this article they don’t. Juicy fruits such as oranges, melons, and pears (not to mention summer fruits), contribute water to your total intake. Just make sure that you’re drinking enough so that you don’t get to the point where you feel thirsty or where your lips feel dry.
  3. Exercise is vital to overall health and stress reduction. Whether you live in a cold or hot climate, dress appropriately and find at least 15 minutes a day to get outside and walk.
  4. Show your care partner (the person you care for) a bit of extra attention if you’re able to. Take them for a drive to see holiday lights. Have an afternoon tea in a charming café. Visit your care partner’s best friend, or have them come for a visit. Buy a new CD of their favorite music and play it for them. Light candles at dinnertime. Have them help you with decorations, if possible.
  5. Plan a visit from a music therapist or animal-assisted (AAT)therapist, or find out where you might find them visiting facilities.
  6. Aromatherapy can be a resource of comfort to you and your care partner by providing an easy, natural way to reduce stress and anxiety and uplift mood. To make sure you are buying a pure essential oil and not synthetic fragrance oil, look for the botanical name of the plant and the phrase “pure essential oil” on the label. Essential oils can be used in a wide variety of ways, but the most common methods are by inhalation or topical use, such as lotion, body oil, or in a bath. My favorite method which I used for my husband is an electric micro-mist diffuser, and available by mail order or at health food stores. These disperse essential oils into the air in a cool mist or can be gently warmed in a candle-heated aroma lamp that releases the aroma into the air. Another easy way is to add 30-40 drops of essential oils to a 4-ounce water spritz bottle. Favorite oils for reducing stress and anxiety include: lavender, Holy basil, clary sage, geranium, rose, and ylang ylang. Citrus oils uplift the mind and emotions, relieve stress and anxiety, and are useful for appetite support: bergamot, grapefruit, lemon, and orange.
  7. Making art can help you regain a sense of balance. If you’re feeling out of control, and are inclined to create art, set aside a table just for art and make it sacred. Gather your materials and have them easily accessible so that the space is prepared for you to focus on the “now” without a lot of distraction. It’s amazing how making art can melt stress once you get into the creative zone. The same goes for playing an instrument. It doesn’t matter what is going on in the world or how I feel, when I sit down at the piano, everything becomes part of the past and I’m able to enjoy the moment. It actually becomes a meditation.
  8. Speaking of meditation, the buzzword these days is “mindfulness.” There are numerous apps and classes that can teach you how to stay present and act with kindness and compassion. You can also take a meditation class such as Transcendental Meditation, where you learn how to meditate twice a day for 20 minutes. TM has been proven to reduce blood pressure, and help the body recharge by reducing stress. It’s easy and anyone who can think a thought can do it.
  9. Keep it simple. You don’t have to make an elaborate feast (unless you’re a cook and love to do that) to make the holidays special. If you want to make it really easy on yourself, order a meal for the number of people at your table. Grocery stores like Whole Foods provide dinners that are yummy and healthy (and yes, a little expensive). Or make the essentials and buy a pie.
  10. This holiday season stop and smell the flavors and enjoy the little things: a walk in the woods, a new baby’s smile, a toddler’s romp, a new sweater, or a pair of socks. Get out the photo albums and reminisce. Watch funny YouTube videos of animals and children. Watch a comedy together. Borrow your neighbor’s dog to take on a walk. Walk in the snow (please wear treaded boots so you don’t fall). Enjoy the moment because time passes quickly and what’s here this year may not be here next year.

While most families are hoping to get together for the first time in a couple of years due to COVID, it’s important to keep abreast of the latest health and safety directives in your area. The number of COVID cases is on the rise again. Please wear a mask when flying, traveling by train or bus, and when you’re in crowded places such as a grocery store. Get a COVID booster and seasonal flu shot. If you feel sick, please stay home! There’s nothing like exposing your loved ones to an illness and having them get sick to make you feel guilty and everyone stressed.

One of my favorite soup recipes to enjoy throughout the winter

Pasta y Fagioli—a one-pot meal, 4 servings

  • 2 tbsp olive oil
  • 1 large onion, chopped
  • 3 carrots cut into 1/4 inch pieces
  • 2 stalks of celery, cut into 1/4-inch pieces
  • 1 leek, peeled and cut into 1/4-inch pieces (discard the top, tough stalk or keep to use when making vegetable broth)
  • 1 zucchini, cut into 1/4-inch pieces
  • 1 yellow squash, cut into 1/4-inch pieces
  • 2 large garlic cloves, finely chopped
  • Herbs of your choice: basil or thyme
  • 1 28-ounce can of chopped tomatoes
  • 1 quart of stock –vegetable or chicken. Add water if needed to cover the veggies
  • 2 cans of white beans (navy, butter, or cannellini)
  • 8 oz of pasta of your choice
  • salt and pepper to taste
  • Grated parmesan cheese

Heat the oil in a soup pot on medium. Add the onion and cook for about 5 mins., occasionally stirring. Add the other vegetables, until they begin to soften, about 8 minutes. Stir in the garlic, and cook for 2 minutes. Add the broth and tomatoes and their juice.

Separately, cook the amount of pasta you want to put in the soup. Keep the pasta separate or it will turn to mush. Add a serving of pasta to the soup and top with grated cheese. Serve with bread and salad. Delicious!

Happy Thanksgiving!

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.

Gardening as therapy for caregivers and their care partners

Senior couple gardening in the garden

Clipping vegetables and watering flowers can do wonders for the soul and have a profound effect on a stressed physiology. Horticultural therapy is a health-care specialty that uses gardening to promote physical and emotional health by creating a peaceful oasis amid the challenges of Alzheimer’s disease, or any other caregiving situation.

Therapy gardens encourage memory-impaired people and their caregivers to take a moment to smell the roses and perform tasks that magically momentarily take away their cares and worries. You might already being working in the garden, which is a natural balm for these anxiety-filled days.

If you are caregiving for a loved one at home, gardening is a great opportunity for you and your care partner to spend time outdoors, connect through memories that might arise, and de-stress. You’ll also gain the satisfaction of accomplishing something that will, hopefully, provide you with beauty, sweet scents, and/or food!

Here are some ways to include your care partner so that you both benefit—from the “Horticulture Therapy by horticulurual therapist Pam Catlin, chapter 17 in my book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.


Throughout the ages people have connected over food and the garden setting provides an abundance of taste experiences through edible flowers, herbs, and vegetables.  Not all non-poisonous flowers are tasty or have a pleasing texture, however.  Some tried and true edible flowers are nasturtiums, lavender, day lilies, roses, tulips, pansies and violas.  The flowers can be used in salads, baking, decorating cakes and so much more. In caring for these flowers, chemical pesticides must be avoided.

Herbs and vegetables are a great addition to a garden and they provide another taste experience for the gardener.  Examples of easy to grow herbs are basil, chives, mint, oregano, parsley and rosemary.  Some are even perennials that will come back each year. These herbs might be enjoyed by being mixed into plain yogurt or softened cream cheese to create an easy dip to spread on a cracker.  When selecting vegetables, keep in mind that all of the solanaceous family (tomatoes and eggplant) have toxic foliage.  With close supervision, they can still be planted as most gardeners love a beautiful ripe tomato.

For those who have retained their olfactory senses, just running hands over herb plants provides a fragrance to inhale and enjoy.  Scented geraniums, grown for their foliage and not their bloom, date back to Victorian times and are now available in most nurseries in a variety of fragrances including but not limited to citrus, chocolate and rose. Particularly fragrant flowers to include in your garden are sweet alyssum, heliotrope, pansies and cosmos.

When selecting plants to stimulate the visual senses, it is important to remember that bright colors such as reds, pinks and yellows are more easily seen by older eyes than subtle, pastel colors or white.   Don’t forget interesting leaf patterns when looking for visual stimuli.  Unusual leaf patterns and colors can be found in coleus, Rex begonias and some grasses, such as zebra grass.

Consider adding some auditory elements to the garden.  Wind chimes near the patio door can assist in orienting an individual to the door’s location.  Grasses, trees, plants with seed pods, water features and bird feeders can all add a variety of pleasant sounds to the garden.

As the other senses fade, tactile stimulation becomes an important part of the gardening experience.  Selections that are surprisingly soft to the touch are dusty miller, African fountain grass and lamb’s ears.  Smooth skinned succulents provide tactile interest and can be grown indoors and (weather permitting) outdoors.  Placing plants with texture near the edges of containers or beds is an invitation to garden visitors to touch and feel as they move through the outdoor space.  If the gardener with cognitive issues is not responsive to the stimuli when touching with their fingers try running a fuzzy leaf across the cheek.  The apple of the cheek is filled with tiny nerve endings that will often be more receptive than the nerve endings in older fingers.

What you need to set up a therapy garden in your yard or porch

As the person with memory loss advances in his or her disease process, physical balance tends to become a challenge. an effective way to create a safe gardening experience is to elevate the growing areas either through raised beds or large ports. For those able to stand for short periods of time, a variety of planter heights would be ideal to support gardening while standing or sitting. rEcommended dimensions for planter height is 2′ – 2 1/2′ for sitting or 3′ – 3 1/2′ for standing. Acceptable dimensions for widths are 2′ if accessible from only one side or 4/ if accessible from all sides.

If the gardener has limited reach, avoid building materials such as bricks or block as it would be difficult to reach the soil to plant. It’s a good idea to measure what would be comfortable for the user before constructing the garden. Growing in pots or raised beds requires good planting mixes (combination of peat moss, topsoil and sand or perlite or a good quality soilless mix), regular fertilizing and plants that are no taller than 3′.

These days, many large pots are lightweight and easy to move andn place prior to filling with soil mix. Pots can be placed on rolling saucers, provided the wheels have brakes, or on pavers to help raise

Successful Plants

There are a number of tried and true plants that are safe for the garden.  For cool weather gardening, calendulas, pansies/violas, and stock add bright color.  Cool season vegetables are broccoli, cabbage, cauliflower, kale, lettuce, peas, radishes and spinach. Suggested plants for the warm season shade garden are coleus, impatiens, begonias and mint.  Good plants for warm season sunny locations would be alyssum, dusty miller, geraniums, marigolds, purple cup flower, petunias, portulaca, snapdragons, zinnias, most herbs other than mint and most vegetables other than those mentioned for cool season planting.   Bush varieties of squashes and cucumbers are best suited for raised beds and pots, as are some varieties of tomatoes.

A piece of advice when creating a garden space is to start small.  The primary purpose of this growing area is to provide peace of mind and an avenue of connection for the person with memory loss and those providing care, not food production.  A garden that provides a balance of physical activity and just being in nature is a perfect addition.


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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.

10 New Year Resolutions for Caregivers

2020 New year concept. Goals list in stationery, blank clipboard, smartphone, pot plant on pink pastel color with copy spaceYou’re tired, you’re stressed–You and 45 million or so American caregivers. So what are you going to do about it? Don’t say that “I don’t have time to take care of myself.” I’ve been there and done that. But I always promised myself that I was not going to be a martyr and sacrifice my health for my husband’s illness. Because if both of us went done that wasn’t going to serve any purpose, least of all our children. They were barely adults when my husband was in the throes of Alzheimer’s disease. They needed at least one healthy parent. And whether you are taking care of a spouse, parent or child, there are other people in your life who love and need you, not necessarily to take care of them, but to love and support them emotionally.

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

Here are 10 easy ways to take the edge off your stress and fatigue so you feel some relief.

  1. Say a positive affirmation before you get out of bed. “This day is going to be a good one.” “I am grateful for my friends and family.” “I am healthy and full of energy.” “I am strong and competent.” Say something positive to set the tone of the day.
  2. Before you reach for a cup of coffee, drink a glass of hot water with lemon. It hydrates your body and brain, the lemon helps to alkalize the system (yes, it’s counter intuitive), which is usually too acidic, and it helps with regularity.
  3. Ask for help! You don’t have to do it all by yourself. No one is going to think badly of you if you take some time for yourself. If your loved one resents your going out, it’s okay. Don’t become a slave to their wishes and rants. If you can’t leave your loved one alone, please ask a neighbor, friend or home care professional to help at least a couple hours a week. Some social service programs provide free respite care.
  4. Many cities throughout the U.S. offer volunteer snowbusters (volunteers who will shovel your walk and driveway), fix-it volunteers who will help with easy home repairs, and yard maintenance volunteers.
  5. Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  6. Find a walking partner in your neighborhood and try to walk at least once a week (preferably 3 times a week).
  7. Put on a CD, vinyl record or the radio and listen to your favorite music. If your care partner is mobile, ask him/her to dance. There is nothing like music or dance to uplift the spirit.
  8. Use essential oils to immediately diffuse feelings of sadness, depression, anxiety, etc. Lavender oil is the most frequently used fragrance. You can also try bergamot, grapefruit, lemon, orange, clary sage, geranium, rose, and ylang ylang, frankincense, and myrrh. Put the oil in a diffuser or spray bottle to mist your collar or pillow. Find a fragrance that is pleasing to your care partner. It’ll help him/her also.
  9. Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  10. It’s important to get at least 6 hours (preferably 7 or 8) of sleep every night. Of course, this isn’t always possible if you are caring for someone and need to get up at night, or are worried about paying the bills, taking care of the car, getting a new stove, etc. If you can’t get in the hours at night, put your feet up for 10 minutes during the day when your care partner naps. Or take a power nap. It really helps.

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

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

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.