Posts

The Process of Alzheimer’s Memory Loss

Alzheimer's memory lossHow memory loss in Alzheimer’s patients works may at first seem mysterious to those whose loved one’s are suffering from the disease. The senior can tell stories about their childhood, but doesn’t remember that they had lunch just a half hour ago. It just doesn’t seem to make sense. First, it may be helpful to learn a little bit about the nature of memory. When a person who does not have Alzheimer’s undergoes an experience or learns a piece of information, a part of the brain called the hippocampus plays a role in taking in that new tidbit. However, in Alzheimer’s patients the hippocampus is one part that suffers first, thus preventing new memories from registering properly. Also, memories that have an emotional component to them are stored separately from other memories. This may explain why dad can’t remember what he did with his glasses, but can talk about his service during the Korean War. As the disease advances, even older memories stored elsewhere in the brain begin to disintegrate. Also, plaque builds up in the nerve cells in the brain, which may lead to disorganized thinking or confusion. Unfortunately, there is nothing we can do yet to stop this process. However, you can help a loved one with Alzheimer’s by sticking to a routine. The regular schedule will help them be more comfortable and feel less confused. Also try to reduce the amount of extra stimulation, such as noise, that the patient is subjected to. All the additional activity can contribute to disorientation. It can be very stressful for caregivers to watch their loved one lose their memories, especially their most-cherished ones. During this time, be sure to take care of yourself. Seek out friends and family who can give you support. Caregivers can too easily feel alone and shut themselves in their own worlds. Don’t let this happen to you. You might find it helpful to learn as much about Alzheimer’s as you can, so that you know what to expect. Never take your loved one’s forgetfulness personally: it is the disease that is causing your dear Aunt Judy to forget your name, not any lack of love on her part. And finally, choose to make light of the situation as much as you possibly can. Yes, the pain will still be there, but if you can laugh about the effects of the disease, you can manage to ease the negativity you may be feeling.
/by

Alzheimer’s 101

Alzheimer's introductionIf you or a loved one has recently been diagnosed with Alzheimer’s disease, you probably have a lot of questions. This article is intended to address some of the most basic facts and get you started in the learning process. Alzheimer’s disease, which is the most common form of dementia, is a problem with the brain and affects a patient’s behavior, thought processes, and memory. The symptoms are fairly minor to start, and then gradually get worse to the point where they drastically affect the individual’s everyday life and they need other people to help them complete even basic functions. There are several million people in the US who have Alzheimer’s disease. It usually starts sometime after 65 years of age, and becomes more likely the older a person gets. Among those people older than 85, some estimate that half have Alzheimer’s. One of the first signs of Alzheimer’s disease is problems with thinking skills, especially memory, and behavior alterations. The person may be moody, restless, or confused. They may display uncharacteristically poor judgment or have trouble processing visual information. They may also experience difficulties communicating and using language. Alzheimer’s can be difficult to diagnose because its symptoms can easily seem like the normal effects of aging. The disease is frequently ignored in the early stages. How can you know the difference? When you see the doctor for a diagnosis, he or she will run a variety of tests designed to measure cognitive functioning and behavior. The only way anyone can know for sure that a person has Alzheimer’s, though, is to see if there is plaque in their brain tissue. This usually isn’t possible until after the patient has passed away and an autopsy is performed. The disease may take anywhere from around 5 to 20 years to run its course. Because it damages the brain, it can cause a person to have trouble with basic physical functions such as swallowing, which can in turn lead to death. Alzheimer’s patients are also more likely to get an infection. As of yet, no cure has been found for Alzheimer’s disease, but there are treatments available that can lessen some of the negative effects of the disease on patients and caregivers, as well as slow its progression. To learn more about this disease, see the articles below: How to Choose a Memory Care Facility When Your Parent Forgets Who You Are Three Big Questions to Consider After an Alzheimer’s Diagnosis
/by

When Your Parent Forgets Who You Are

Photos can help Alzheimer's patients remember loved ones.On your last visit, Mom seemed kind of down so you’re determined to cheer her up today. You open the door to her room. She looks up with a smile that reminds you of the days you’d run home from school with a 100 on your spelling test. She rises and gives you a big hug. “Ella, I am so glad to see you. I was beginning to think you’d forgotten all about me.” She’s showing more enthusiasm than she has in weeks. So why is your stomach in free fall, and your heart pounding to beat the band? It’s because your name is Barbara. Ella is Mom’s older sister who died four years ago. What do you do? You want to keep her spirits up, but you don’t feel it’s right to play along. Mistaking children for siblings or other loved ones is not uncommon in Alzheimer’s patients. Alzheimer’s patients lose short term memory but not their recall of the past. You look after her interests. You make sure everything’s going well. You’re her protector, just like big sister Ella used to be. Seeing you may have caused a cross wire. When Mom recalls her long ago, it’s like she’s living in a dream. Now you’re here but the dream remains. She’s made you a part of it. You want to wake her up, but gently. There are several things you can do. But first and foremost, do not take offense. Think of her misrecognition as a compliment. She’s connecting you with someone she loves. Secondly, do not argue with her. Don’t make her see. Help her see. Listen to her, let her say what she has to say, then try to re-direct her focus. Switch the topic. A change of scenery may help. Suggest going for a walk. Address her by name – Mom. Hearing that one word may be all it takes, but it may not always work. It’s in both of your interests to try to prevent this from happening again. Here’s a suggestion you may want to try. This may even be fun – for both of you. First, gather up all the old photos you have at home. Scour the basement or the attic. What you want is a time line of Mom’s life: as a young mom, with you and all your siblings, and on through all the stages of the family’s life If you’re lucky you can extend it even further back, with photos of Mom when she was a child – with Aunt Ella. This may keep her in the present and if nothing else, will be an emotional bonding experience for you both. Next, gather some present time photos. You, Mom, your siblings, the grandkids, if they visit. That’s all you need. You don’t want to confuse her or you’ll be back where you began. Bring some cute labels. Make it a project. Label each photo, and create a timeline from past to present. This may help to trigger mom’s memory about who you are, by connecting an image of you from the past with what you look like now. Hang the timeline in a prominent place in her room. Finally, you don’t want to go down this path again, so next time you visit, identify yourself – face to face. “Hi Mom! It’s your daughter Barbara.” If mom has a favorite nickname for you, refer to yourself that way. If you can keep her in the present, there’s no need to bring her back.  
/by

Coping with the Loss of Your Loved One to Alzheimer’s

Losing a loved one to Alzheimer's isn't easy.If you feel that you’ve already lost your loved one, even though he or she is still alive, you may be experiencing some of the classic and normal signs of grief that usually aren’t felt until your loved one has died. Reading articles, websites, and books about coping can be helpful, and you can also consider some of these ideas. Know That They’re Still There Remember that at one time, your parent knew a different “you.” You as a baby, a toddler, and a child were a different version of you, but it was you nonetheless. If you can see your parent as being at a different phase of his or her life, it can be less painful than allowing yourself to think that he or she is gone. Cherish the Memories Make the assumption that your loved ones can see and hear some of what you’re saying and doing. Talk to them, read to them, and continue the same as you would if they were sitting up smiling at you. It will absolutely give you much comfort in knowing that you have truly done your best. Be Kind to Yourself Were you patient enough? Did you love them enough? Did you respond quickly enough to feed them, change them, and answer the phone when they called? Were you…good enough? Yes. You were. The loving care that your parent is receiving now is a result of you being “good enough.” Your parent cared for you, and you were able to come full circle and care for him or her and ensure that he or she is receiving the best possible care. Explore Others’ Experiences When he was diagnosed at the age of 57, Tomas DeBaggio wrote Losing My Mind: An Intimate Look at Life with Alzheimer’s. His book, the first of its kind, chronicled the extraordinary account of his journey through the disease. He said that it “silently hollows the brain” and slowly “gobbles memory and destroys life.” He wrote the book for himself in an effort to remember his life before he lost it forever, but it serves as a landmark piece of literature that helps the aging and their families understand the mind of the Alzheimer’s victim. The first step in this challenging time is for families to understand that their loved ones are not gone. They may appear to be gone, and their doctors may say that their minds are gone, but they are still there. All research indicates that though they may not respond to much and they cannot express themselves, they do feel. Above all, be good to yourself. This time is probably at least as difficult for you as it is for them.
/by

Children Remember, Alzheimer’s Patients Don’t

Remember that Alzheimer's patients aren't children You finally made the decision to entrust Mom to assisted living. You know she’s being cared for with respect and dignity. She’s made friends with the lady in the next room. She seems to be eating well. So why does your stomach do a free-fall each time you drive over to visit her? Is it because you’re not sure what Mom will be like or how she will receive you? Watching a parent disappear into the muddle of age-related dementia or Alzheimer’s disease is not a charted course, nor is it a smooth one. Don’t Be the Teacher Do you find that one of the hardest parts of dealing with your parent’s aging is the reversal of roles? All of a sudden you’ve become Mom’s mom. You’re in charge. You have to come up with the answers. Or do you? You try to give her the tips and tools that worked so well with your kids, but in the end, your efforts end up frustrating and angering her. For example, she’s told you how frustrated she feels about not knowing what month it is, let alone what day. When your son was in kindergarten, he always wanted to know this information so he could report it at opening ceremony in school each morning. You bought him one of those A-Day-At-A-Time calendars, a Charlie Brown one. He’d faithfully tear off a cartoon each morning and be ready for the day. So you buy one for Mom: A Joke-a-Day. That will get her day off to a good start. But each time you visit, the pages remain un-torn. You tear them off and remind her how this will help her. Sometimes she seems to ignore you. And other times she rages out. “I”m sorry! I forgot! What’s the difference, anyway?!” Be Subtle The difference you need to remember is that what works with children will not work with an Alzheimer’s patient. Children’s brains are developing, displaying a sponge-like ability to absorb and imitate. They want to remember so they’ll do it right next time. So does Mom. But the plaque that is part of the Alzheimer’s puzzle has literally clogged her brain. She may be able to retain your tip for a day, an hour, maybe only a minute. Lessons won’t work. Don’t be a nag. Why not begin each visit with “Wow, what a stormy Tuesday this turned out to be!” or “Can you believe how April is just flying by?” This is a subtle way to clue her in to where we are on the calendar. Easy Does It Are you concerned that she seems to be spending more time in the past than the present? Remember when you chastised your kids for fantasizing or daydreaming? That’s not what Mom is doing if she thinks she’s back in her childhood days. Her short term memory is gone, but long-ago remembrances remain. For her, the past is more tangible than yesterday. When it’s your turn to speak, try to gently bring her into the present with tidbits of what’s going on in your life. Stay on the easy does it road and bring her into the present. Yanking is never a good idea Look for Options Remember how frustrated your daughter used to become, bursting into tears when she couldn’t zip her jacket? Well, that’s exactly how Dad feels now. Your daughter eventually learned, through necessity. But does Dad need a zippered jacket? Buttons do the same job. As you discovered with your children, some approaches work. Some don’t. If you’ve found one that does – great! If you haven’t, sometimes it’s best to follow the advice of The Beatles and… Let It Be.
/by

Activities to Do with a Loved One Who Has Dementia

With some creative thinking, you can come up with activities to do with a person who has dementia

Photo used under Creative Commons from Marg S.

It’s difficult to think of things to do with a parent or other loved one who has dementia. Your options may seem quite limited. However, it’s important to make the effort to find ways to spend quality time together: this will improve your loved one’s happiness and their health. Below are some tips to get you started: once you begin to think about it, you may realize that there’s more that you can do than you think. 1. Come up with activities that incorporate their interests. All of us thrive and are much happier when we’re doing things we enjoy. But what if your loved one is no longer capable of taking part in the activity in the same way they once did? The answer is to think of ways to modify their hobby. For example, if they once loved to read but their eyesight has deteriorated to the point where they can longer read even large-print books, you can get them audio books and a good set of headphones. If they once loved to play baseball, make sure they have a radio or TV that they can use to catch the game, or even take them to a day at the ballpark. 2. Don’t just try to pass the time. Ideally, the activity you do together will have a lot of meaning to both of you. Don’t plan to do something that neither of you would have enjoyed twenty years ago. Sometimes people rationalize not putting much thought into the time they spend with loved ones with dementia by telling themselves that the person won’t remember the activity anyway. It’s true, they may not remember, but they can enjoy the present when they’re in the moment. 3. Do something that involves social interaction. We all need to feel connected to others, even those of us with dementia. We make an effort to visit with a loved one in assisted living for this very reason. But try to add variety as much as you can. Consider taking your loved one with you on outings – even just a simple trip to the mall or to a park can be interesting and different for them. (Do try to avoid very hectic places, though, as that could make your loved one anxious.) Even if they’re not able to leave home, try to make sure they see new faces. Ask visiting relatives to come to their care home with you when they’re in town, or bring one of your loved one’s former neighbors by to say hello. 4. Do something that involves exercise. Does your loved one tend to wander, as many dementia patients do? The underlying cause of this behavior may be a lack of exercise. Try going for a walk with them around the neighborhood, or get them an exercise bike if they’re still limber enough to use it. This can be a solution for boredom and anxiety.
/by

Understanding Parkinson’s Disease

Parkinson's disease becomes more severe over time.Parkinson’s disease is something that develops slowly over time. In the beginning, symptoms may be mild, but will eventually become more severe. This is due to the gradual decrease of the neurotransmitter dopamine. Nerve cells that use dopamine to send messages to control muscles can no longer do so if the brain cannot supply them with sufficient amounts of the chemical messenger. Recognizing Parkinson’s The common conception of a person with Parkinson’s is that they suffer from uncontrollable tremors and muscle movements, but this doesn’t occur in the early onset of the disease, nor is it universal in all sufferers. Researchers have isolated four pre-motor symptoms:
  1. Body movements occurring during REM sleep when only the eyes should be moving
  2. History of constipation
  3. History of depression and anxiety
  4. Diminished sense of smell
Since early treatment can keep the disease under control, it is vital that you be aware of the above warning signs in loved ones as well as:
  • Changes in speech patterns such as slurring, hesitation, low volume, a monotonous voice, and difficulty in choosing words
  • Increased sweating or urination
  • Changes in personality
  • Low blood pressure when standing
  • Foot cramps
  • Drooling
As the disease continues to progress, the following areas may be affected:
  • The face: this manifests itself as “Parkinson’s Mask,” or the loss of ability to smile, blink, or alter facial expressions
  • Fine motor skills: handwriting may be unusually small
  • Muscle coordination: there may be difficulty with walking, rising from a seated position, and swallowing
  • Cognition: watch for memory problems, the degeneration of problem-solving skills, attention deficit, confusion, and the inability to make decisions,
  • Mental health: the person may experience depression, hallucinations, or signs of dementia
Diagnosis The importance of early diagnosis and treatment cannot be overstated since Parkinson’s often makes an insidious entry into a victim’s life, establishing itself before he or she realizes something is wrong. So if you notice even one of the above symptoms in a loved one, pursue immediate medical evaluation. There is no definitive diagnostic tool for Parkinson’s. Blood testing rarely uncovers abnormalities, nor do MRIs, EEGs, and CAT Scans spot any brain change. Therefore a doctor must make a clinical diagnosis (one based on his or her own judgment). It is crucial you seek a neurologist with a thorough knowledge of Parkinson’s disease to evaluate your loved one. Evaluation After taking a family history and performing a physical examination, the doctor will ask you and the patient about observed symptoms, then watch him or her stand up, turn around, walk around the room, etc… all in an effort to judge movement, balance, and coordination. Treatment The Doctor will prescribe drugs to alleviate symptoms, the most common of which is Sinemet (Levodopa/Carbodopa).
  • Levodopa, also known as L-Dopa, travels to the nerve cells of the brain that should be producing dopamine, where it is converted to dopamine for use as a neurotransmitter.
  • Carbidopa increases Levodopa’s effectiveness and decreases possible side effects like nausea, vomiting, and occasional heartbeat disturbances.
If medications have minimal effects, or cease to be effective, depending on age and overall physical condition you may want to pursue alternate treatments as Deep Brain Stimulation or Stem Cell Treatment. Care A Parkinson’s patient needs individual care and constant observation. In a perfect world he or she could remain in their own home, but this is often not possible. An excellent alternative is a board and care home, like Raya’s Paradise, where staff keep a watchful eye and make sure medication is taken. There is no cure for Parkinson’s, but we can buy time and make that time as pleasant as possible.
/by

How to Address the Effects of Vision Loss

Vision loss is more than simply loss of sight.The loss of your loved one’s vision is a loss of their independence and a battle with their quality of life. The decline in their depth, central, and peripheral perception has a negative effect on mobility, communication skills, safety, and emotional health. It’s very important to come up with a plan to help them cope. Impact of Vision Loss The easiest way to think of how your loved one feels is to think of someone who is hearing impaired. They communicate by sight, with their hands, and read lips. They are able to pick up facial expressions, head nods, and gestures. You may already have to speak louder to a loved one because of hearing loss. The loss of two senses is heartbreaking and leads to a lack of social interest and activity, a poor quality of life, anxiety, and even depression. There are also safety issues associated with vision loss. Your loved one is in danger of falling doing normal activities, slipping on spilled oils, lotions, or food. They could trip over cords that were previously tucked away, or miss stepping over something because of poor judgment of the height of an object. Loss of vision impairs driving ability and increases the chances of vehicle accidents. The worst safety concern is that your loved one might not be able to effectively communicate what is wrong because they’re in a state of panic and not able to see their surroundings properly. Living in assisted living can mitigate some of these risks because the environment is designed for senior safety, but it’s impossible to completely prevent accidents from happening, especially if a senior miscalculates what they can handle. Helping Your Loved Ones Cope With Vision Loss There are many things you can do to help your loved one cope with vision loss.
  • Color code medicine bottles or purchase pill containers to help with medication management
  • Make standardized arrangements of household items
  • Add safety features to household items such as table edge guards and gates around stairs, and place non–slip mats around slippery areas such as the kitchen
  • Decrease glare from the sun or other light sources in the home; add motion sensors and plenty of lighting
  • Minimize clutter and bulky furniture
  • Attend eye doctor appointments with your loved one; discuss all medication because drug reactions can have side effects on vision as well
Your loved one may feel they are a burden and keep important issues away from you. It’s important to let them know you are there for them. Set up a caregiver treatment plan. Help them connect with community resources for assistance such as transportation services and support groups. Provide self-help aids such as magnification devices, various eyewear, tinted lenses, closed-circuit television, large print books and telephones with dials. If they enjoy sewing, have a needle threader and plenty of thimbles. If they love novels, get them a subscription to an audio book of the month club. By being mindful of what loss of vision means and showing compassion and support, you can ease the negative effects of this health condition.  
/by

Notice the Seniors Around You

Noticing the seniors around you can bring rewards.When you visit your loved one, do you ever take a look at any other residents? I mean really take a look. Or have these elders become part of the background of the facility? How about that tiny woman with the thick glasses who’s always in the main lounge, shading her eyes from the light; or the frail man with the gray hair who nods at you from his wheelchair whenever you pass by? And that Asian man who likes to sit by the window watching the traffic outside, have you ever wondered about him? Your mom or dad’s new neighbors all have a piece of history attached to them. Some struggled in school, while others triumphed. Some worked with numbers while some pursued their creative abilities. Some individuals worked at exciting or prestigious jobs, others at boring repetitious ones. They lived, loved, and laughed, just like your mother or father. Why not take the time to learn a bit about them, too? When you’re spending time in the lounge with your mom or dad, choose a seat within speaking distance of another resident. Start with a smile. You never know where a casual comment may lead. We all crave conversation. In most cases, it doesn’t diminish with age. In sharing their stories, a senior has a chance to relive their experiences here and now, rather than in the recesses of their memory. They matter to someone who wants to know who they are. As for your mom or dad, perhaps they will gain a new friend out of your simple outreach. Maybe your dad was a pharmaceutical salesman, too. Maybe your mom was an I Love Lucy fan, too. Common experiences can serve as a firm foundation for a friendship. You’ll feel better knowing she’ll have someone to “hang out with.” You might benefit in other ways too. Widening your circle of older acquaintances might result in practical advice you can put in place in your own life. And when you least expect it! Take that lady mentioned above, the one with the glasses. A woman visiting her father, who was a writer experiencing a string of rejections, struck up what she thought was a casual conversation with the unassuming senior. As she wheeled her father toward the elevator, she offered her arm to the old lady hobbling beside her. She learned that the woman had been an accomplished illustrator of children’s books in the 1960s and ‘70s. “Oh, I tried writing children’s books,” our visitor replied. “And what happened?” asked the woman. “I gave up.” “Well, you must start again,” was the advice offered. And so she did. So, look around. At the very least you’ll break up the monotony of another human’s life. You never know, you might hear about a life of accomplishment. That Asian gentleman by the window, he was the youngest in a family that emigrated from China. Inspired by parents who believed in education and excellence, he went on to medical school and opened his own neighborhood practice, holding off retirement until the age of 82. And the friendly gentleman in the wheelchair — after a career as a cameraman in Hollywood studios, he opened a successful store specializing in nuts and fine candies. It flourished for years. Notice someone, because you never know where it will lead.  
/by

Caregiving and Anxiety

These three tips can help ease caregivers' anxiety.We probably don’t have to tell you that those with elderly parents are more prone to anxiety. The root of anxiety is unexpected changes, and the health of seniors can change suddenly. Caregivers are also working hard to balance multiple priorities, and often feel stretched to the max. Addressing severe anxiety will require help from a doctor or therapist, but the tips below will give you some tools that you can use on your own to get to a more relaxed, peaceful state. 1. Do something you enjoy. Yes, we know you don’t have a lot of spare time. But there’s much you can do to make life more pleasant in the bits of time you do have. A ten minute walk on a nice day can work wonders, especially if you make a point of being in the moment and enjoying it. Another thing to do that adds virtually no extra time is to listen to your favorite music while you’re in the car, at your desk, or doing chores. Also, try to squeeze in time for your hobbies. Even spending just an hour a week, or one day a month, can help lift your mood and give you an outlet. 2. Try meditation or breathing exercises. Simply taking a few minutes to focus on your breathing has more of an effect than you might think. If you find your anxiety rising, stop and take some slow, deliberate, deep breaths. This basic technique should help, but you can search online for more breathing exercises to get further benefits. Meditation or prayer can have similar advantages. Don’t worry if you think you don’t know how: meditation can be as simple as taking the time to pay attention to your breath and the present moment. You don’t have to be an expert. 3. Focus on nutrition and exercise. When we’re busy, taking care of ourselves can be one of the first things to go. But sticking to healthy routines goes a long way to staying on track in life. If you find that in your stress it’s hard to say no to fatty or sugary comfort foods, start not by cutting back on the things you crave but by adding healthier options into the mix. Have a piece of fruit as a snack or a salad along with your dinner. You’ll likely find yourself wanting less as these additions help curb your hunger, and as you develop a taste for healthy choices you’ll pick them more often. As for exercise, even a walk and a quick stretching routine can make a difference. Addressing your anxiety is not just about helping you feel more calm and peaceful, but about helping your loved one as well. Your parent is probably picking up on your stress, even if you think you’re hiding it, and they themselves feel more stressed in turn. Taking a little time for yourself to follow these steps will benefit not just you, but everyone around you. For additional tips, check out our post on caregiver stress.
/by