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 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.

Caring for yourself and others with good nutrition

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

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

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

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

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

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

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

 

 

Have you tried any of these natural ways to combat depression?

St. John's Wort capsulesOctober 11 is National Depression Screening Day. If you are feeling overwhelmed, depressed or have a hard time getting out of bed in the morning because you don’t want to face the world it’s time to evaluate your emotional health. You can take an anonymous screening online here: Select a state to find a screening.

If you are suicidal please call the national suicide prevention lifeline: 1-800-273-8255.  The Lifeline provides 24/7 free and confidential support for people in distress, prevention and crisis resources for you or your loved ones.


If you have mild to moderate depression, there are a number of proven natural supplements and modalities that can help.

While I cared for my husband who had younger-onset Alzheimer’s disease, I lived behind a persona of forced cheerfulness because I didn’t want anyone to know that my private world was being deconstructed bit by bit. I went through bouts of depression and grieving periods. I took the supplement St. John’s wort, danced and meditated. I met with girlfriends and did yoga. I also used essential oils and tried to eat well. It all helped.

I gave St John’s wort to my husband, too, until he was in late-stage Alzheimer’s disease. By then he needed a pharmaceutical anti-depressant. But the St. John’s wort worked well for mild to moderate depression.

  1. Here’s what we know about St. John’s wort
  • It is a safe and effective way to treat mild to moderate depression over long periods of time
  • Is similarly effective as standard antidepressants
  • It has minimal side effects when compared to standard antidepressants

One study done on laboratory animals found that St, John’s wort (Hypericum perforatum) has antidepressant properties similar to standard antidepressants. The antidepressant profile of H. perforatum is closely related to the selective serotonin reuptake inhibitors class of antidepressants.

A Swiss study evaluated 440 patients suffering from mild to moderate depression and treated them with 500 mg. of St. John’s wort for up to one year. Although mild side effects such as upset stomach were reported—which may or may NOT have been related to the treatment—the researchers reported that is a safe and effective way to treat mild to moderate depression over long periods of time. They also found that it is especially suitable for preventing a relapse.

A meta-analysis at the Centre for Complementary Medicine Research, Technische Universitaet Muenchen, Munich, Germany analyzed 29 trials (which included 5,489 patients), comparing St. John’s wort with placebo or standard antidepressants. The evidence suggests that the hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants.

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

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

3. Drink water. Your brain needs to stay hydrated. Make sure you drink at least six tall glasses of water every day. When my mom went into the hospital for severe dehydration, among other things, she began hallucinating. A psychiatrist called to tell me “your mom has full-blown dementia.” I said, “No she doesn’t,”  and refused to allow the doctor to prescribe an anti-psychotic prescription. Sure enough, several days later my mom sounded completely normal. Her body had been dehydrated, as well as her brain. The simple habit of drinking water is sometimes all we need to maintain mood and mental health.

4. The Canadian Network for Mood and Anxiety Treatments published a report in the “Canadian Journal of Psychiatry” in 2016 with this conclusion: For the management of mild to moderate depression it says exercise, light therapy, St. John’s wort, omega-3 fatty acids, SAM-e, and yoga are recommended as first- or second-line treatments.

5. A recently published study in the “Journal of Clinical Medicine” concluded that individuals who engaged in a meditative movement practice of Tai Chi, Qigong, or Yoga showed significantly improved treatment remission rates. The researchers conclude that emphasizing the therapeutic effects of meditative movements for treating MDD (Major Depressive Disorder) is critical because it may provide a useful alternative to existing mainstream treatments (drug therapy and psychotherapy) for MDD. Given the fact that meditative movements are safe and easily accessible, clinicians may consider recommending meditative movements for symptomatic management in this population.

6. Music is the universal language as well as one of the most common ways to affect mood.  My husband was never without head phones as he listened to music and wandered through the halls of the memory care home where he lived the last two years of his life. Music made him happy. It makes toddlers spin until they’re dizzy, teens hand bang until their necks get sore, and adults drum their car’s steering wheel. Music also helps decrease anxiety and improves functioning of depressed individuals as found in a meta-analysis that concluded music therapy provides short-term beneficial effects for people with depression. 

Other natural ways to combat depression

7. Create a calm environment. Light candles at dinner, play classical music, have a vase of fresh flowers on the table.

8. Get some physical exercise every day; even just a 20 minute walk helps tremendously.

9. Use aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn

10. 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.

11. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.

12. Sleep well by getting to bed before 11:00 pm, eating your last meal before 8pm, turning off your electronic devices, and eliminating light in your bedroom. If you have trouble sleeping consider using a lavender essential oil spray on your pillow or a sachet of lavender inserted into the pillowcase. There are lots of natural sleep aids available at your local health food store, such as melatonin, calcium/magnesium, valerian, hops, etc. Consult with a nutritional consultant about what might work best for you.

“Surround yourself with people who are only going to lift you higher.” anonymous


 

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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.

Do you have any of these risk factors for Alzheimers?

Woman with hypertension treating by a nurse

  1. Dizziness when standing up
  2. Reduced levels of plasmalogens
  3. High blood pressure
  4. Obesity
  5. Alcohol
  6. Head trauma
  7. Family history
  8. Smoking
  9. Age
  10. Social Isolation (see Loneliness vs. Aloneness: Why one is dangerous to your health

Most people know that old age is a risk factor for Alzheimer’s disease. In fact, after age 65 the risk of Alzheimer’s doubles every five years. And after age 85 one out of three seniors dies with Alzheimer’s or other form of dementia. You’ve probably also heard that obesity, alcohol consumption, head trauma, family history, smoking, and social isolation put you at increase risk.

But here are a few risk factors that you may not have heard about.

Dizziness when standing up

A new risk factor, and a concern for me personally, is orthostatic hypotension (OH), a fancy name for feeling  dizzy when you stand up. According to a new study, middle-aged people who experience orthostatic hypotension may have a higher risk of developing dementia later in life. The study analyzed data from 11,709 participants without a history of coronary heart disease or stroke. It concluded that individuals who experience a drop in systolic blood pressure (the bottom number) of at least 20 mm Hg or a drop in diastolic blood pressure (the top number) of at least 10 mm Hg on standing are said to have orthostatic hypotension.

Over a 25-year period, 1,068 participants developed dementia and 842 had an ischemic stroke. Compared to persons without OH at baseline, those with OH had a higher risk of dementia and ischemic stroke. Persons with OH had greater, although insignificant, cognitive decline over 20 years. But since the study doesn’t take any other risk factors into consideration, I’m not going to lose sleep over this.

2. We’ve heard how omega 3 fatty acids are necessary for a healthy cardiovascular system. But if your liver doesn’t process these key lipids properly it can spell trouble in your brain.

Reduced levels of plasmalogens — a class of lipids created in the liver that are integral to cell membranes in the brain — are associated with an increased risk of Alzheimer’s Disease, according to new research presented at the Alzheimer’s Association International Conference (AAIC) 2018 by Mitchel A. Kling, MD, an associate professor of Psychiatry in the Perelman School of Medicine at the University of Pennsylvania and the Veterans Affairs Medical Center. A reduced level is also implicated in Down’s Syndrome and Parkinson’s disease.

In 2012, scientists found a 40% reduction in plasmalogen content of white matter in the brain in individuals with early stage Alzheimer’s.

Plasmalogens are created in the liver and are dispersed through the blood stream in the form of lipoproteins, which also transport cholesterol and other lipids to and from cells and tissues throughout the body, including the brain. The researchers measured several plasmalogens including those containing omega-3 fatty acids docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), as well as an omega-6 fatty acid and closely-related non-plasmalogen lipids, in blood-based fluids collected from two groups. The first group included 1,547 subjects that have Alzheimer’s disease, MCI or significant memory concerns (SMC), and subjects who were cognitively normal (CN) and who are enrolled in the Alzheimer’s Disease Neuroimaging Initiative. The second group included 112 subjects from the Penn Memory Center, including those with Alzheimer’s, MCI, and CN.

“Our findings provide renewed hope for the creation of new treatment and prevention approaches for Alzheimer’s disease,” Kling said. “Moving forward, we’re examining the connections between plasmalogens, other lipids, and cognition, in addition to gene expression in the liver and the brain. While we’re in the early stages of discovering how the liver, lipids, and diet are related to Alzheimer’s disease and neurodegeneration, it’s been promising.”



You would think that taking omega 3s would help, right? Well, according to the study, they don’t. However, plasmalogens from mussels are being sold in Japan and Singapore as a health supplement for Alzheimer’s disease. See Scallop-derived PLASMALOGEN. There is also a Singapore product for sale in the U.S. that supposedly helps your body increase the level of plasmalogens. It’s called NeuroREGAIN. You can read about it here: NeuroREGAIN

According to the first study cited, these products don’t help because of the pH in the
digestive system and the ability to utilize the ingredients.
But it’s up to you. I tried lots of things with my husband, and if he were still alive I’d probably try this product, too.


3. Recently, researchers from the Rush Alzheimer’s Disease Center at Rush University Medical Center in Chicago, IL, set up a study funded by the National Institutes of Health to look for links between blood pressure and physical markers of brain health in older adults. The findings are published in the July 11, 2018, online issue of Neurology. Study co-author Dr. Zoe Arvanitakis explains the types of pathology they were searching for.

“We researched whether blood pressure in later life was associated with signs of brain aging that include plaques and tangles linked to Alzheimer’s disease, and brain lesions called infarcts, areas of dead tissue caused by a blockage of the blood supply, which can increase with age, often go undetected and can lead to stroke, said Arvanitakis.”

Healthy blood pressure is less than 120/80 millimeters of mercury (mmHg). The higher number is called systolic blood pressure, the pressure in the blood vessels when the heart beats. The lower number is called diastolic blood pressure, the pressure when the heart is at rest.

For the study, 1,288 older people were followed until they died, which was an average of eight years later. The average age at death was 89 years. Blood pressure was documented yearly for each participant and autopsies were conducted on their brains after death. The average systolic blood pressure for those enrolled in the study was 134 mmHg and the average diastolic blood pressure was 71 mmHg. Two-thirds of the participants had a history of high blood pressure, and 87 percent were taking high blood pressure medication. A total of 48 percent of the participants had one or more brain infarct lesions.

Researchers found that the risk of brain lesions was higher in people with higher average systolic blood pressure across the years. For a person with one standard deviation above the average systolic blood pressure, for example 147 mmHg versus 134 mmHg, there was a 46 percent increased risk of having one or more brain lesions, specifically infarcts. For comparison, the effect of an increase by one standard deviation on the risk of having one or more brain infarcts was the equivalent of nine years of brain aging.

Those with one standard deviation above the average systolic blood pressure also had a 46 percent greater chance of having large lesions and a 36 percent greater risk of very small lesions. Arvanitakis noted that an important additional result of the study was that people with a declining systolic blood pressure also had an increased risk of one or more brain lesions, so it was not just the level but also the declining blood pressure which was associated with brain lesions.

Separately, higher average diastolic blood pressure was also related to brain infarct lesions. People who had an increase of one standard deviation from an average diastolic blood pressure, for example from 71 mmHg to 79 mmHg, had a 28 percent greater risk of one or more brain lesions.

The results did not change when researchers controlled for other factors that could affect the risk of brain lesions, such as whether they used high blood pressure drugs.

When looking for signs of Alzheimer’s disease in the brain at autopsy, researchers found a link between higher average late-life systolic blood pressure across the years before death and a higher number of tangles, but not plaques. Arvanitakis said this link is difficult to interpret and will need more research.

 The bottom line is be aware of your blood pressure and how to maintain healthy levels.

Natural remedies to support healthy blood pressure and circulation:

  • Magnesium
  • Potassium
  • Vitamin B complex
  • Vitamin C
  • CoQ10
  • Resveratrol
  • Astaxanthin
  • Nattokinase
  • Pomegranate
  • Acetyl-L-carnitine

A healthy heart supports a healthy brain. Here are 12 ways to support both.

12 ways to support a healthy heart

  1. Eat a nutritious, high-fiber, low-fat heart healthy diet.
  2. Include foods high in phytonutrients (the nutrients found in plants)
  3. Get plenty of foods containing omega-3 fatty acids (found in cold water fish). Vegetarians should take flax-seed oil or ground flax seed.
  4. Take nutritional supplements proven to support a healthy heart
  5. Practice a stress reduction technique such as yoga or meditation
  6. Exercise
  7. Stop smoking!
  8. Reduce and/or avoid alcohol
  9. Get an annual physical exam to rule out other health factor risks
  10. Protect yourself from environmental toxins
  11. Drink 6 to 8 glasses of purified, filtered water every day
  12. Get plenty of restful sleep!

 

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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-Helpin 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 does marijuana do for Alzheimer’s and dementia patients?

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

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

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

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

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

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

Conclusion

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

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

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


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

 

 

 

 

 

 

Are you putting yourself at risk for dementia with OTC medications and prescription drugs?

Reading Instructions from PharmacyA new study links the increased risk of dementia with certain medications. (Anticholinergic drugs and risk of dementia: case-control study) The focus of the study was on drugs that have anticholinergic effects. Acetylcholine is vital to memory and learning. There are lower levels of this neurotransmitter in the brains of people with Alzheimer’s disease. Additionally, animal studies have shown that anticholinergic drugs may contribute to brain inflammation, another risk factor for dementia.

It’s estimated that approximately 50% of adults in the U.S. take one or more medications with an anticholinergic effect. Some of the most common are:

  • amitriptyline (Endep, Elavil), paroxetine (Paxil, Pexeva), and bupropion (Aplenzin, Wellbutin). These drugs are commonly taken for depression)
  • oxybutynin and tolterodine, taken for an overactive bladder, found in Ditropan, Oxytrol.
  • diphenhydramine, a common antihistamine found in: Advil PM, Aleve PM, Bayer PM, Benadryl, Excedrin PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom, etc.
  • Chlorpheniramine, found in Actifed, Allergy & Congestion RElief, Chlor-Trimeton, Codeprex, Efidac-24 Chlorpheniramine, etc.

According to Shelly Gray, professor pharmacy at the University of Washington, and author of  Cumulative Use of Strong Anticholinergics and Incident Dementia” (March 2015, JAMA Internal Med.), the longer people took the drugs and the higher the dose, the higher the risk of dementia, although it’s important to note that short-term use was not linked to higher risks.

Gray suggested that people, especially seniors, who have trouble sleeping find a non-drug therapy for insomnia Celexa and Prozac for depression and Claritin for allergies.  She emphasized that it is important to speak with one’s doctor before stopping a medication that you have been taking.

Natural alternatives

Help for depression

  1. Get some physical exercise every day; even just a 20 minute walk helps tremendously.
  2. Use aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn
  3.  I gave my husband Ginkgo biloba for depression (and also took it myself). It helped right up until he was in late stage Alzheimer’s. One word of advice, not all brands are efficacious, so pick one carefully. Also note that it takes about 6 weeks to notice an effect. This is a typical difference of taking a pharmaceutical versus a natural remedy.
  4. 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. 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.
  6. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group, or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.

Natural sleep aids

  1. Try valerian, passion-flower or skullcap herbal tea at least a couple of hours before bedtime.
  2. A cup of warm milk with a small pinch of cardamom, coriander, cinnamon, turmeric and cumin, and an 1/8 of a tsp of ghee is a tasty and relaxing bedtime drink. The calcium in the milk is a muscle relaxant and the Indian spices help induce relaxation. Experiment to see which spices you like.
  3. Eat a banana. Bananas contain potassium and magnesium that help reduce risk of muscle cramps. These two minerals also support heart health and cognitive function.
  4. A drop in blood sugar during the night can cause us to wake up. Although it’s better to not go to sleep on a full stomach, a small protein snack such as a slice of cheese or smear of peanut butter on a cracker can help maintain balanced blood sugar.
  5. Melatonin supplements help some people, but you might have to experiment with the dosage. I like Natural Vitality’s Natural Calm, a powdered calcium supplement that you put in water or juice. I also like the homeopathic remedy Hyland’s Calms Forte.
  6. Spritz lavender oil on your pillow or put a sachet of lavender flowers under your pillow.

Natural antihistamines

  1. Quercetin is a bioflavonoid that is naturally found in plant foods such as apples, cruciferous vegetables (like broccoli or cauliflower), onions/shallots, green tea and citrus fruits. It stabilizes the release of histamines and helps to naturally control allergy symptoms.
  2. Apple cider vinegar is my new “go to” remedy for almost everything. I take 1 Tablespoon everyday by pinching my nose and drinking water to flush it down. It helps alkalize the body and supports immune function.
  3. Butterbur is a natural herb that is sold as an extract. A study published in August 2005 in Phytotherapy Research found that when compared to an antihistamine, the butterbur extract worked just as well, without the side effect of drowsiness.
  4. Remember that Claritin does not contain diphenhydramine, so use it by all means if these other remedies do not do the trick.

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

Can depression be a sign of dementia?

Depressed Senior Woman Sitting OutsideDepression can affect our memory, and it can result from not being able to do the things that were once easy for us, as in the case of Alzheimer’s or dementia. Depression can result from a number of factors and it often appears differently in different people

Some people are able to hide the fact that they are terribly depressed. I did. I tried to put on a happy face during my husband’s illness, but inside I often felt as though I was dying. Following the recent suicides of Kate Spade and Anthony Bourdain, we have to remind ourselves that we usually don’t know what is happening inside someone else’s head.

Before my husband was diagnosed with younger-onset Alzheimer’s disease he was withdrawn and depressed. I didn’t know what exactly what was going on, and he was unable to articulate how he felt. I eventually realized that he was depressed because the things that were once effortless for him to do, such as driving around town or figuring out how much tip to leave in a restaurant, had become difficult.

Alzheimer’s and depression often occur simultaneously, which often makes it difficult for physicians to make a diagnosis without further testing. According to James M. Ellison, MD of the Swank Memory Care Center, Christiana Care Health System, approximately half of individuals affected by Alzheimer’s disease will experience clinically significant depressive symptoms at some point.  Depression can occur during any phase of the illness.

Symptoms common to Alzheimer’s and depression

  • Loss of interest in things that were once enjoyable
  • Memory issues
  • Sleeping too much or too little
  • Social withdrawal or isolation
  • Impaired concentration
  • Eating too much or too little
  • Crying, feelings of hopelessness, despair
  • Unmotivated
  • Lack of energy, lethargy, apathy
  • Irritability
  • Thoughts of death or suicide

A case of the chicken or the egg: which came first, Alzheimer’s or depression?

Some health professionals think that depression can put one at greater risk for Alzheimer’s. There is also a belief that depression is a symptom of Alzheimer’s. In any case, physicians feel that a person with dementia who is depressed can experience a quicker cognitive decline and need to rely more on caregivers.

What to do?

8 natural ways to combat depression.

Antidepressants may not work as well with people who have Alzheimer’s and are depressed. Before resorting to antidepressants and other drugs,  try these options:

  1. Provide a safe and calm environment. Light candles at dinner, play classical music, have a vase of fresh flowers on the table.
  2. Get some physical exercise every day; even just a 20 minute walk helps tremendously.
  3. Use aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn
  4.  I gave my husband Ginkgo biloba for depression (and also took it myself). It helped right up until he was in late stage Alzheimer’s. One word of advice, not all brands are efficacious, so pick one carefully. Also note that it takes about 6 weeks to notice an effect. This is a typical difference of taking a pharmaceutical versus a natural remedy.
  5. Vitamin B complex optimizes cognitive activity and brain function, has a positive effect on memory, learning capacity and attention span, and supports a healthy nervous system and a stable mood. Vitamins B6 and B12, in particular, play a role in the synthesis of serotonin, the neurotransmitter linked to improving memory, lifting mood and regulating sleep.
  6. Omega-3 fatty acids are rich in DHA, the major unsaturated fat in the brain. This long-chain fatty acid provides the necessary fluid quality to the membranes of the nerve cells so that electrical nerve impulses can flow easily along the circuits of the brain. One study found that Alzheimer’s patients given an omega-3-rich supplement experienced a significant improvement in their quality of life.
  7. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group, or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.
  8. Sleep well by getting to bed before 11:00 pm, eating your last meal before 8pm, turning off your electronic devices, and eliminating light in your bedroom. Studies have indicated that sleep deprivation can increase risk of dementia and Alzheimer’s disease. If you have trouble sleeping consider using a lavender essential oil spray on your pillow or a sachet of lavender inserted into the pillowcase. There are lots of natural sleep aids available at your local health food store, such as melatonin, calcium/magnesium, valerian, hops, etc. Consult with a nutritional consultant about what might work best for you.

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