How To Care For Someone With Dementia

May 16, 2012 by  
Filed under ALZHEIMER'S

LivingSenior - Memory Care Resources

If a person is suffering from dementia they are losing their mental skills that will have an effect on their everyday life. Dementia is a gradually deteriorating condition that be brought about by strokes and if a person suffers from Parkinson’s disease. Also, Alzheimer’s disease is a type of dementia.

Dementia is different in each case, but it leads to memory problems, the ability to think clearly, and problems with daily planning. Depending on the stage of dementia people can function for some time while suffering from it, but since it gradually gets worse they need to be taken care of the more they suffer from it. Here are some tips on how to care for a person that suffers from dementia.

Medication

Since memory loss and forgetfulness is a symptom of dementia, it is important that if a person is on medication for dementia that they continue to take it as prescribed.

Physical activity

Staying physically active is important for anybody that has dementia and it can also give them a feeling if independence.

Eating healthy

You will need to help the person suffering from dementia to eat healthy and give them healthy meals and snacks even if they are not hungry.

Encourage mental activities.

This can help people stay mentally active and more alert by doing such things as crossword puzzles, reading, or playing games.

Daily Routines
 
The more a person with dementia has a clear-cut daily routine, the less confused or frustrated they will be. If there is any change to the routine, you should tell the person beforehand.

Give them their independence.

As long as the person who is suffering from dementia can make their own decisions pertaining to what they would like to eat, what they would like to do with their time and what to wear. These are just a few examples as it still allows them to feel independent.

Have patience.

You must have patience when taking care of someone who has dementia, as things will take longer to do than usual. Never get frustrated with the person, as that will only make them more frustrated as well.

Be there emotionally.

The person with dementia will know what is happening and offering them emotional support can make it easier on them. Listen to their problems and be there for them in a respectful manner. Be there as a helper more than a caregiver and, as much as they can, let them do things and make their own decisions. The more you do things for them that they still believe they have the ability to do the more frustrated they may become.

Safety issues

Make the residence of where the person suffering from dementia safe. This is more of an important issue as the condition becomes gradually worse. Handrails in the bathtub, removing sharp objects, and keeping walkways clear are just a few things you can do to make the residence safer. If the person cannot drive or cook in a safe manner, do not allow them to do these things. Do not move anything or make any drastic changes in the residence, as it may confuse and frustrate the person.

Decide If You Can’t Care For Them Yourself.

It’s understandable when a loved one begins to have trouble caring for someone with dementia. However, there are professional senior living centers where they can reside and be taken care of by professionals who understand their condition

 

Memory loss is not necessarily dementia

December 9, 2009 by  
Filed under ALZHEIMER'S

grandmothers_birthdayWhen we see an elderly person who is confused or incoherent, we tend assume it has something to do with senility or dementia. Loss of memory is not necessarily a sign of dementia and senility is not necessarily a sign of Alzheimer’s disease, even in the elderly. This is a comforting message from aging experts.

However, there can be other causes for memory loss. Stress is one. Side effects of medications are another. There are many more.

According to Mara Mather, reasercher on aging at USC:

“Memory loss is not always due to dementia and it’s not always due to aging… Stress has an impact on memory and long-term stress can diminish the size of the hippocampus and diminish memory abilities and it looks like to some extent that’s recoverable.”

In fact, there are many factors that can influence memory skills. Some of these are listed below (source: USNews.com)

  • Aging
  • Nutritional deficiency, e.g. deficiency in certain vitamins and minerals
  • Depression
  • Diseases and medical conditions such as diabetes or hypothyroidism
  • Oxygen deprivation of the brain, which can be cause by stroke, heart attack, or severe trauma
  • Structural abnormalities in or damage to the parts of the brain associated with memory formation
  • Free-radical damage.
  • Chemical poisoning, including consumption of alcohol, tobacco, and illicit drugs
  • Infections of the central nervous system (CNS) infections such as encephalitis, toxoplasmosis and neurosyphilis
  • Stress, emotional as well as physical
  • Sensory overload, e.g. when a person is trying to do too many tasks or worry about too many things at the same time, the brain is overloaded with information and cannot process short-term memories.
  • Low blood sugar
  • Genetic factors
  • Seizures, such as those related to epilepsy
  • Severe emotional trauma
  • Low estrogen levels in postmenopausal women

Thus, there is no reason to jump into conclusions about older people’s diminishing mental capacities. This could just well be temporary or “reversible” dementia due to one or more of the abovementioned factors. Instead, when signs of memory loss or confusion arise, we should first look at the possible factors involved. Is the person under mental or emotional stress? What sort of medications is the person taking? Family members and caregiver are also advised to talk to the patient’s doctor.

“To find the underlying cause of memory loss, your physician will obtain a detailed medical history, which documents the pattern, symptoms, and types of memory loss. He or she will also inquire about contributing factors that may worsen or trigger memory loss. A routine physical and detailed neuropsychological examination with a focus on memory function will be conducted. In addition, he or she will order several diagnostic tests.”

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Diet and Alzheimer’s disease

October 22, 2009 by  
Filed under ALZHEIMER'S

BrainLow-fat, low-calorie diets are not only good for cardiovascular health. It may also delay the onset or progression of dementia. Many epidemiological studies have presented evidence that diet plays a role in the clinical course of Alzheimer’s disease. Diet low in fat and calories and rich in fruit, vegetables and fish seem to be best for the brain.

Currently, there is cure or preventive therapy for AD. Many research studied looked into how nutrition can affect brain damage by dementia, hoping a certain type of diet can lower the risk, delay the onset, and slow down the progression of the disease.

Evidence suggests that high intake of saturated and trans fats can increase the risk for AD whereas a Mediterranean diet is associated with slower cognitive decline and reduced risk for AD.

In a more recent study using laboratory animals, a team of researchers from Europe and North America reported that a diet rich in protein may lead to shrinkage of the brain. The researchers tested four different diets on mice, namely:

The purpose of the study was to look at plaque development but one of the results came as a surprise: mice fed with a diet of high protein and low carbohydrate had brains which are 5% lighter that mice with other diet regime. Mice on diet with high fat/low carb had higher levels of plaque proteins but no effect on brain mass.

The results of the study highlight the necessity of more studies on the effects of diet on the brain in prospective randomised double blind clinical diet trials.

According to lead researcher Sam Gandy, a professor at The Mount Sinai School of Medicine in New York City

“Given the previously reported association of high protein diet with aging-related neurotoxicity, one wonders whether particular diets, if ingested at particular ages, might increase susceptibility to incidence or progression of AD. This would be a challenging undertaking but potentially worthwhile. If there is a real chance that the ravages of AD might be slowed or avoided through healthy eating. Such trials will be required if scientists are ever to make specific recommendations about dietary risks for AD.”

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Palliative care for patients with advanced dementia

October 15, 2009 by  
Filed under ALZHEIMER'S

wheelchairWhen we hear the words “terminal disease,“ we always think of cancer. “Terminal cancer” is a term that everybody has heard before. But have you ever heart of the term “terminal dementia?”

According to researchers at the Institute for Aging Research of Hebrew SeniorLife,, the clinical course of advanced dementia is very similar to those experienced by patients with terminal conditions. Dementia is just about being senile and forgetful. It also comes with symptoms such as discomfort, distress, pain, and eventually death. However, patients with advance dementia seem to be underecognized as being terminal or at high risk of mortality and tend to receive suboptimal end-of-life care. This was the result of the “Choices, Attitudes and Strategies for Care of Advanced Dementia at the End-of-Life,” or CASCADE study.

According to scientist and study author Dr. Susan L. Mitchell:

“Dementia is a terminal illness. As the end of life approaches, the pattern in which patients with advanced dementia experience distressing symptoms is similar to patients dying of more commonly recognized terminal conditions, such as cancer.”

Unlike those with terminal cancer, however, patients with dementia are seldom rendered the appropriate palliative care for the terminally ill. Instead, many receive interventions and treatments that are not only futile, but may also add to pain and distress.

The clinical progression of dementia is not as well understood as that of cancer. Most of the patients are elderly who are confined to nursing homes. Many of these have difficulty in communication or recognizing family members. It is not clear, however, whether these nursing homes are equipped to recognize the signs of advanced dementia and whether they are well-equipped to provide end-of-life care.

Currently, more than 5 million Americans suffer from dementia, a number that is expected to increase by almost three-fold in the next 40 years. A recent study by Alzheimer’s Disease International estimates that the number of people with dementia worldwide will exceed 35 million by 2050. Dementia is a group of symptoms severe enough to interfere with daily functioning, including memory loss, difficulty communicating, personality change, and an inability to reason. Alzheimer’s disease is the most common form of dementia.

Prof. Greg Sachs writes in his editorial in the New England Journal of Medicine,

“Since individuals with advanced dementia cannot report their symptoms, these symptoms often are untreated, leaving them vulnerable to pain, difficulty breathing and various other conditions. We shouldn’t allow these people to suffer. We should be providing palliative care to make them more comfortable in the time they have left.”

He recommends that caregivers and medical personnel should learn to look for nonverbal cues of pain and distress. Palliative care should focus relieving symptoms such as pain, shortness of breath, fatigue, nausea, eating problems, and sleeping difficulties.

Married at midlife: lowering your risk for dementia

July 7, 2009 by  
Filed under ALZHEIMER'S

married-handsSocial life is important for patients with Alzheimer’s disease and other forms of dementia, as many research studies have reported. A more recent study pinpointed something even more specific – that patients who are married or living with a partner at midlife have a much lower risk of developing dementia later in life. The research was conducted by Swedish researchers on more than 2000 Finnish adults.

Furthermore, the increase in risk seems to be dependent on the type of singlehood. The researchers reported that:

  • People who were single during their entire adult life were two more likely to develop some form of dementia compared to married or partnered people of similar age.
  • People who were married but were divorced at middle age have a three-fold increase in risk.
  • Those who were windowed or suffered through the death of a partner have an even higher risk for Alzheimer’s – almost 6 times higher than their married counterparts.

According to author Krister Håkansson of the well-known Karolinska Institute in Sweden “This suggests two influencing factors — social and intellectual stimulation and trauma. In practice, it shows how important it is to put resources into helping people who have undergone a crisis. If our interpretation holds, such an intervention strategy could also be profitable for society considering the costs for dementia care.”

So what does marriage and partnership have to do with cognitive decline?

Researchers believe that partnership and marriage provide social as well as intellectual stimulation that keep the brain functioning even in old age. The next step is to look into the effect of other types of relationships (children, grandchildren peer support groups) and the quality of the relationships (happy or not happy):

Previous studies have shown that an active social life help keep the mind and the memory sharp late in life. A study by Harvard researchers revealed that those who have the most social interaction within their social circle, be it with friends or family showed the slowest rate of memory decline.

These results give some important insights on currents standard of care for people with dementia and Alzheimer’s. In addition, it gives people who are approaching the middle age a strategy to counteract the cognitive decline that comes with age.

Pain relievers: do they or do they not prevent Alzheimers?

June 25, 2009 by  
Filed under ALZHEIMER'S

old_man_and_dovesPrevious studies have reported that pain relievers such as the anti-inflammatory drugs (NSAIDs) may prevent the onset of Alzheimer’s disease. This study by American researchers, however, shows a different story.

The researchers looked at 2,736 members of Group Health, an integrated healthcare delivery system, who did not have any form of dementia when they were enrolled in the study. The average age of the study group was 75 years. The researchers then tracked these patient for 12 years, monitored their use of NSAIDs, both as prescription and over-the-counter (OTC) drugs, and their likelihood of developing dementia especially Alzheimer’s disease.

In the study group, 351 participants had a history of heavy NSAID use at the start of the study. Over the follow up period, another 107 participants became heavy NSAID users. “Heavy use was defined as having prescriptions for NSAIDs at least 68 percent of the time in two years.

The results of the monitoring for dementia gave the following results:

  • 476 participants developed Alzheimer’s disease or dementia during the study period.
  • Heavy NSAID users were 66% more likely to develop dementia compared to those who use little or no NSAID.

According to study author Dr. Eric B. Larson, executive director of Group Health Center for Health Studies.

“Although we hoped to find a protective effect, there was none. Thus, for this age group, there’s no basis for taking NSAIDs to prevent Alzheimer’s disease. Our study in this quite elderly population showed more risk of dementia with NSAIDs, especially when used heavily.”

The study results indicate a need to re-evaluate earlier research findings that suggested that NSAID use can delay or even prevent onset of Alzheimer’s disease.

There were, of course, key differences between previous studies and this study. For one thing, the study participants in this study are on average older. This could have a big influence on the results considering that dementia and Alzheimer’s disease are basically an elderly disease, even though there are cases of early onset.

NSAIDs such as Ibuprofen are available over-the-counter are popularly used as anti-fever drugs and pain relievers. In the older population, NSAIDs, marketed in the US as Advil, Motrin and Aleve, are used as pain relievers especially among those who suffer from arthritis. Recently, the US FDA has issued new labelling requirements for OTC drugs including NSAIDs, which should provide warnings about safety, including interaction between NSAIDs and alcohol.

 

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Your brain needs good cholesterol, too!

June 11, 2009 by  
Filed under ALZHEIMER'S

brainIt is well-known that high blood cholesterol levels are not good for the heart. Is is also quite known that high levels of low-density lipoproteins (LDL) – the bad type of cholesterol – can build up and block arteries and adversely affect cardiovascular health.

What is not so well-known is the fact that low levels of high-density lipoproteins (HDL) – the good type of cholesterol – is linked to memory loss and increased risk for dementia. This is according to a study by European researchers.

It seems that cholesterol levels are important not only for heart health but for brain health as well.

The study followed up 3,673 people as part of the long-term Whitehall II study involving British civil servants. The results showed that low levels of HDL cholesterol are associated with diminished memory by age 60. No link was found between memory loss and levels of total cholesterol and triglycerides. The use of statins to manage cholesterol levels did not seem to have an effect.

According to lead author Dr. Archana Singh-Manoux of the French National Institute for Health and Medical Research (INSERM, France) and the University College London (UK)

“Memory problems are key in the diagnosis of dementia. We found that a low level of HDL may be a risk factor for memory loss in late midlife. This suggests that low HDL cholesterol might also be a risk factor for dementia.”

The mechanism behind this link between HDL cholesterol and dementia risk is not so clear but the following hypotheses are proposed:

  • HDL cholesterol blocks the formation of beta-amyloid.
  • HDL cholesterol may affect memory in relation to its role in maintaining vascular health.
  • HDL cholesterol could influence memory through its -inflammatory and antioxidant.

HDL cholesterol… serves several vital biological functions. It helps clear excess cholesterol from the blood; assists nerve-cell synapses to mature; and helps control the formation of beta-amyloid, the major component of the protein plaques found in the brains of Alzheimer’s patients.

Dementia usually occurs in people 65 years or older. Alzheimer’s disease is the most common form of dementia. In the developed world where a large proportion of the population are elderly, dementia is becoming a major – and costly – health concern. The monitoring of HDL cholesterol (and not only LDL cholesterol!) should therefore be encouraged – for the heart as well as for the brain.

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Hope and Help for the Holidays

October 13, 2008 by  
Filed under ALZHEIMER'S

It’s October and according to some retailers, the holidays begin now.

I don’t listen to the marketing hype, but when I am hosting Thanksgiving dinner (which I am not this year), I start thinking about the menu and planning in September. However, it’s hard logistically and emotionally to plan for the holidays when you are caring for someone who has Alzheimer’s disease.

By their very nature, the holidays cause us to look back. In most cases, celebrations and traditions of years gone by determine the tenor of today’s customs and rituals. For many of us, the holiday season begins with talking to our loved ones, planning where celebrations will be and what they will entail. We speak the plans for the upcoming holidays, but what we don’t say, what goes unspoken is the foundation upon which those plans are made. Here is where the friction comes in. Looking back is fine, but looking forward is scary. Your mom doesn’t remember the traditions that she couldn’t live without. Your dad is agitated by the very lights that he used to meticulously string on the Christmas tree; today, he couldn’t pour a cup of hot chocolate, much less man the omelet station for the traditional holiday brunch.

So, where does that leave you? I’m not sure, but I know where it left me. It left my heart aching for the past and sometimes dreading the future. It left me hanging on to old traditions and knowing that it was time to start new ones. It left me wondering how I could celebrate in a way that mom could enjoy without being scared, anxious or agitated.

In this series I’ll share my holiday experiences (some were nightmares) with the hopes that you can learn from MY mistakes. I’ll give you some do’s and some dont’s. I’ll hopefully inspire you to hold on to some old traditions, but encourage you to try some new ones as well.

So, let’s plan together as we approach the holidays. I’ll specifically reference Thanksgiving, Christmas and New Years, but it really doesn’t matter. The principles are the same for Yom Kippur or Purim.

I’ve learned, it doesn’t matter what our ethnic background or religious tradition. Alzheimer’s disease hurts all of us. It makes us all cry and it takes away a little of our past and our future as it creeps through the brains of our loved ones.

Look for upcoming posts on Hope (and Help) for the holidays. Do you have any tips for making it through the holidays? Please share.

Dementia and your cholesterol

July 21, 2008 by  
Filed under HEART AND STROKE

When we speak of cholesterol, negative thoughts of blocked arteries and heart attacks come to mind. However, not all types of cholesterol are detrimental to our health. There are 2 main types of cholesterol in our body – the low-density lipoproteins (LDL) and the high-density lipoproteins (HDL). LDL cholesterol is considered to be “bad” cholesterol and is linked to atherosclerosis. LDL levels in our blood should therefore be kept low. HDL is deemed to be the “good” cholesterol and high levels of HDL in the blood may actually be beneficial and decrease the risk of heart attacks. HDL cholesterol plays important roles in several vital biological functions including clearance of excess cholesterol from the blood, assistance in the maturation process of nerve-cell synapses, and controlling the formation of beta-amyloid. Beta-amyloid is the major component of plaque deposits found in the brains of patients with Alzheimer’s disease.

A recent study demonstrated the role of HDL in the development of dementia. Low levels of HDL are linked to having memory loss in middle age and dementia later in life. The report is based on data collected by the Whitehall II study, a long-term health research study involving more than 10,000 British civil servants working in London. The study has been ongoing since 1985.

“Observing 3,673 participants (26.8 percent women) from the Whitehall II study, researchers found that falling levels of HDL cholesterol were predictors of declining memory by age 60.”

The research defined low HDL levels as less than 40 mg/dL and high HDL levels as 60 mg/dL or more. The researchers analysed blood-fat and memory data collected during 2 phases of Whitehall II. Phase 5 was conducted from 1995 to 1997 and involved study participants with an average age of 55. Phase 7 was conducted from 2002 to 2004 and involved participants with an average age of 61 years.

The main findings of study are as follows:

In the industrialized world, where the population is aging, dementia is becoming a major concern. People 65 years or older are the ones who are usually affected. For a quick review of dementia, check this previous post.

 

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Dementia, Alzheimer’s, the Elderly and Sex (part 3)

July 2, 2008 by  
Filed under ALZHEIMER'S

Okay, this is my last post on the whole dementia, Alzheimer’s and sex subject. But this subject really has me thinking about the rights of people with dementia.

Is a 14 or 15 year old any more able to give consent than a person with dementia?

Is it actually possible for caregivers to discuss this issue and come to a conclusion when the loved one is in the earlier stages of Alzheimer’s disease?

Should long term care facilities/nursing homes make provision for spouses or “friends” to have sexual relations?

How does the dynamic change is one person has dementia and the other does not? Does it matter if the affected person is a male or female?

Should families or facilities make arrangements for safe/clean sexual encounters between residents?

At what point, if any, should facility staff/management get involved in relationship between patients?

Was there a relationship prior to the dementia (as in the case of a spouse or a person who entered the facility for something other than dementia, but now has dementia)

What part do the persons past morals and values play in the decision?

Should the caregiver’s morals be considered?

I suppose all of these questions mean that it’s an area that must be carefully studied, that there are as many answers as there are individual situations. In many religious traditions, sex outside of marriage is forbidden. The “rule” is usually enforced for the young or for divorcees. Does it actually apply to the elderly as well?

Please, I’ll give you a virtual penny for your thoughts. What’s your opinion?

Alzheimer’s, Dementia and Sex (part 2)

June 30, 2008 by  
Filed under ALZHEIMER'S

Okay, so let’s finish this conversation.

Like I said the other day, if you want to see anyone on the caregiving spectrum from a teenager to an adult child blush-talk about their loved one’s sex life.

I mean, I am grown, have children of my own and have literally written the book on teen sexuality (Straight Talk, How Teens Make Wise decisions About Love and Sex, Review and Herald, 2000). Yet, I just can’t imagine my mom and dad uh…..er…..um….. well, you know…having (whisper) sex. And furthermore, I really wouldn’t want to have to make decisions about their sex lives, especially when they were in their golden years and one of them had already died – because that would mean that one of my parents was having sex with someone other than my other parent.

However, putting your head in the sand, and ignoring the issue isn’t going to make it go away. I’ll never have to consider such things, as both of my parents are now deceased. But YOU may and again, like other care concerns, it’s better to give the issue consideration now, before it becomes a major problem.

Honestly, when I first read the story of Dorothy and Bob in Slate, I was amused. However, as I read and considered the depth of Dorothy and Bob’s relationship and the obvious furor of Bob’s son, I realized that this is no laughing matter. Most importantly, when I read of Dorothy’s depression and despondency after the relationship was abruptly forced to an end by Bob’s son, It made me realize that this issue of seniors, dementia and sexuality is an area that must be given serious consideration.

Here are some questions to consider:

  1. Can someone with dementia give consent?
  2. What if the current behavior violates grandma’s long standing moral principles?
  3. What if the relationship violates the primary caregiver’s morals or principals?
  4. Do facility employees have a right to get involved?

In this situation, there may be more questions than answers. Personally, I’d want my family to make decisions for me based upon my life’s principles, morals and values up to that point. The problem is that if I had dementia, I wouldn’t be logical enough to understand my family’s possible “restrictions” on my desires.

It’s something to think about and seriously consider. My advice. Think about it now. Consider it before it becomes an emergency. Talk about it with potential long term care providers and be prepared. As baby boomers age and the number of people with Alzheimer’s disease and dementia increases as well. This won’t be interesting or amusing. It will just be another issue that caregivers consider as they battle, the monster, Alzheimer’s disease.

What do you think? Have you been forced to think about and consider your loved one’s sex life?

The link between dementia and “ministrokes”

June 25, 2008 by  
Filed under HEART AND STROKE

Is there a link between dementia and ministrokes? This seems very likely, according to researchers who conducted studies on several people with dementia or cognitive impairment.

What is dementia?

Dementias are a group of neurological disorders characterized by progressive decline of cognitive and brain functions. Dementias take different forms. The most well-known and most common form of dementia is Alzheimer’s disease. Other types include Lewy Body dementia, Creutzfeldt-Jakob and Parkinson’s disease. Some of these types can co-occur together resulting in a condition called mixed dementia.

Our mental capabilities decline as we grow older. However, in case of dementia, this mental decline can occur even in younger people and goes abnormally fast. In its later stages, the disease renders its victims incapacitated and incapable of carrying out normal daily activities.

What are “ministrokes?”

Ministrokes are also called transient ischemic attacks or silent strokes. The symptoms of transient strokes are temporary and often go away. Silent or asymptomatic strokes happen without the patients being aware of their occurrence and are associated with brain abnormalities are aneurysms. Hypertension and diabetes may also cause ministrokes

Because of their transitory or asymptomatic nature, ministrokes are more common than initially thought. Though they do not manifest in serious symptoms, multiple ministrokes present a real danger because “the cumulative effect reaches critical mass” and brain damage occurs.

Where is the link?

In one study, Dutch and American researchers discovered aneurysms, benign brain tumors and asymptomatic strokes using magnetic resonance imaging (MRI) in 2000 older adults. Their results indicate links between silent strokes, symptomatic strokes and dementia.

In another study, researchers of the University of Washington autopsied brains of patients with dementia and found evidence of damage to the small vessels in the brain which is indicative of injuries probably brought about by multiple small strokes.

Unlike previous studies on dementia, this recent study included patients from different ethnic groups and from a large range of educational and professional levels. It ran for over ten years, from 1994 to 2006. The study followed up 3400 participants with or without dementia or cognitive impairment. About a third of the patients died during this period and 221 autopsies were performed.

The study concludes that

small blood vessel damage caused by hypertension and diabetes may be among the leading causes of dementia.”

These recent developments indicate a need for people to be more aware of the dangers of ministrokes. Most often, “silent” strokes may not be necessary silent. We need to recognize the symptoms, no matter how mild.

According to the American Stroke Association, signs of a potential stroke include:

Alzheimer’s, Dementia and Sex

June 23, 2008 by  
Filed under ALZHEIMER'S

If you want to make a teenager or young adult blush, mention their parents having sex.

Let’s face it, there aren’t very many “children” be they teens, young adults, baby boomers or elderly who want to talk about their parents (aunts, uncles, grandparents) um….er……uh sex life.

Now, toss in dementia affecting one or both of the parties, and now you’ve really got something to talk about or not talk about.

I mean, first of all, what caregiver wants to think about, much less talk about their loved ones sex life? And then, who gets to make the decision as to whether the relationship continues? Let’s say John and Mary live independently, and one or both has dementia and they decide that they want to engage in a sexual relationship. Should their children or other family members get involved?  When the spouse is primary caregiver, it’s complicated too.  Can a person with dementia “consent?”

Another scenario. What if Joe and Martha (one or both have dementia) are in an assisted living facility or even a nursing home and they decide they want to be sexually active. Should the facility or family members have a say or just allow the relationship to go on?

Over the next two days, we are going to delve into this subject and discuss the pros and cons of dementia, dating and sex.

According to the CDC, Alzheimer’s disease has surpassed diabetes and is now the sixth leading cause of death. They say that 10million people will suffer from Alzheimer’s disease. So, in essence, what makes a cute kind of tongue in cheek story today could tomorrow necessitate careful thought, planning and possibly even policies regarding the sex lives of people living with Alzheimer’s disease.

There are many questions to consider, but the hardest part my be getting caregivers to add their loved one’s sex lives to the ever growing list of things to think about and handle as they battle Alzheimer’s disease.

Brain Games and Other Activities

April 15, 2008 by  
Filed under ALZHEIMER'S

This post discusses brain games and other activities that may delay the onset and reduce the impact of Alzheimer’s disease and dementias

I want to say off the bat that I am quite familiar with Alzheimer’s disease and I am fully aware that there is not a game around that will prevent it from running its course.  So, my intent is not to provide snake oil or false hope.  Brain activities such as video games, crossword puzzles, sudoku checkers and chess to name few do have thier place though.  They provide activity and exercise for the brain, they require hand eye coordination and they require more complex thought than does say listening to the radio or watching TV.  In addition, in all honesty, they might keep your loved one busy enough to provide you as a caregiver a few moments while you attend to dinner or take care of other responsibilities.

As a person who suffers with Alzheimer’s disease or other form of dementia, these games can provide a great escape.  doing theme related crossword puzzles or word-finds is a great way to relax and remember a time that was much more carefree and much less confusing than these days are.  Sudoku and chess are great games for those who are still able handle the complexities associated with those activities.

Although alzheimer’s disease and other types of dementia, such as vascular dementia initially present similarily with symptoms such as confusion, short term memory loss and difficulty handling day to day activities such as balancing a checkbook.  They differ widely in their progression and end result.  I will save the details for another post.  My point for today is that activity is good for all types of dementia.

Why activity is important:

Physical activity-Physical activity is as good for the brain as it is for the body. Exercise increases blood flow to the brain and creates an overall feeling of well being.  From a physical perspective, it strengthens the heart, muscles and combats extra pounds piling on.

Here are some things you can do to keep moving:

Walk

Take the stairs

Join an exercise class

Mental Activity-The brain needs exercise too. The Alzheimer’s Association of Canada endorses brain games.  You can click here for the entire article, but some of the activities they recommend are:

Crossword Puzzles

Reading and keeping up with current affairs

Computer games

So, no matter what you do, as you battle the monster, Alzheimer’s disease know that activity, whether physical or mental is a good thing!

Alzheimer’s and Dementia-The Differences

March 25, 2008 by  
Filed under ALZHEIMER'S

The terms dementia and Alzheimer’s are often used interchangeably.  In fact, dementia is not Alzheimer’s and Alzheimer’s is not dementia, although, they are certainly related.

For example, let’s say you your stomach is bothering you. You can’t eat much and it’s difficult to drink.  At first you shrug it off and hope you’ll lose a few pounds, but then you try to ignore it and finally attempt to soothe it with over the counter medicines, nothing works.  You call your Dr. and make an appointment. A couple of days later, you find yourself in the Dr’s office.  She asks you some questions, examines you and declares, “You have an acute pain in your stomach.”  You think to yourself, “Uh….duh……tell me something I don’t already know.”

Well, if you take your grandfather to the Dr. because he is acting strange, and has a set of symptoms that concern you, and the Dr. says, “He has dementia,” and sends you home.  It is akin to telling you he has a pain, which brings me to my main point.

Dementia is a SYMPTOM.  It is caused by something.  What you know after hearing the word is simply this. The symptomology that caused you to take your grandfather to the doctor is called dementia.  The “pain in the brain,” so to speak, is dementia.  What you need to know now is, what is causing the dementia?  You can click on the link for a detailed definition, but for now, here’s a simple one from Dr. David Roeltgen.

“Dementia is an impairment of thinking and memory that interferes with a person’s ability to do things which he or she previously was able to do.”  Dementia is NOT a part of the normal course of aging.

There are many causes/types of dementia, some of the common ones are:

Parkinson’s disease, Picks disease, brain tumor, alcoholism, Acute B12 defeciency, Hunington’s disease, depression, multi-infarct, and of course, Alzheimer’s disease.

Alzheimer’s disease: A progressive neurologic disease of the brain that leads to the irreversible loss of neurons and dementia. The clinical hallmarks of Alzheimer’s disease are progressive impairment in memory, judgment, decision making, orientation to physical surroundings, and language. A working diagnosis of Alzheimer’s disease is usually made on the basis of the neurologic examination. A definitive diagnosis can be made only at autopsy. (Definition adapted from medicinenet.com)

So, it’s important for you to ask questions, do some research of your own and then ask the doctor to do more tests to discover the CAUSE of the dementia.

Tomorrow, I’ll discuss Alzheimer’s testing and diagnostic measures.

In the meantime, I’ll give you a “virtual” penny for your thoughts. Or if you’d rather comment privately, feel free to contact me at:    battlingforhealth.com/contact  

Either way, I’d love to hear from you!

Does Alzheimer’s change your character?

January 11, 2008 by  
Filed under ALZHEIMER'S

Basic guides for relatives of people with Alzheimer’s say, “Don’t get upset about what they say or do. If they lash out at you or don’t remember you, it’s the disease talking. It’s not them. Don’t take it personally.”

I can appreciate that advice and I’ve tried to follow it. Though it’s hard to watch someone acting violently or hatefully, and tell yourself it’s not them. Because it sure looks like them. They are living in the same well-beloved body you remember. I try to think prosthetically. If they were twenty years old, with a fever of 104, it might well be the disease talking then too. I want to have the same patience now that they are ninety years old.

But I have some questions about that theory. I think we take the easy way out when we assume that all uncomfortable behavior is caused by deterioration in the brain. When my grandmother got angry, it was for the same reasons that she got angry when she was twenty. Not remembering that you are in your own home – that’s a sign of disease. Feeling lost and confused when you don’t remember where you are – that isn’t a sign of disease. That’s a normal human reaction. We need to help our loved ones who feel lost, by not moving things around and maybe by not moving them around.

But I wonder how often the negative emotions that appear during an episode of dementia are simply emotions that have always been present but hidden. My great-aunt was a Pentecostal preacher, a warm and sunny lady, with purpose and victory in her life. When the symptoms of Alzheimer’s appeared, her faith didn’t disappear. Her essential character didn’t change. She continued to be polite, saying Thank you when she couldn’t say much else. She didn’t begin cursing or lashing out at her family. I’ve heard of religious people who did, but we all know that sometimes religion changes you deeply and sometimes it doesn’t. One daughter said about her father, “His faith has helped him to be happy through AD. I think my dad will always have that in him…bet it will be the last to go.”

Alzheimer’s disease does change you, but not all at once. It takes humility to admit that maybe it isn’t the disease that makes me act this way. Maybe I really am this way. It’s easier to fix character flaws before the symptoms get bad.

Now, before I get any more forgetful than I’ve been all my life, I’m making a resolution. I resolve to remember that I am not perfect. I can get very high scores on standardized tests, but my mind was never perfect. If someone contradicts me, I want to remember that they might be right. I want to learn how to find peace even when I don’t know where I am.

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