I attended Dr. Lennox'talk this morning at the Atrium in Quincy entitled 'What is so funny about challenging behaviors?' After a few minutes I realized I'd heard this talk before, but as it is a salient topic, behavior, I stayed. It's always good too to get fresh material to add to my arsenal for giving presentations about the behaviors of Alzheimer's.
Well, something struck me as quite important in the care of the person with Alzheimer's; sequencing habits. We all have routines we do each morning. The question was asked What five things do you do upon arising? The only 2 activities that were common to all were toileting and brushing teeth. Then he asked, 'Which arm do you put into the coat or sweater first?' He noted when the sequence is reversed it causes some anxiety. I recently felt this when I decided to shop from the opposite end of the market than I usually do. I routinely go to the vegetables and automatically pick up onions, broccoli, mushrooms, lettuce, etc. Starting at the other end where the orange juice, ice cream, eggs, etc are made me feel quite awkward. Why? My sequence habit was disturbed. I am cognitively intact and it upset me; what does it do to the person who has a cognitive deficit, I wondered. Think about the ramifications of this knowledge in how we work with this population. I have to give this more thought. Today when I shop (again) I will save myself the trouble and start at the usual end of the store.
Tuesday, June 22, 2010
Sunday, June 20, 2010
Adult day programs
I was talking with Tammy, the owner of Pleasantries, an adult day program in Marlboro for early stage Alzheimer folks. She said that caregivers often wait too long to explore adult programs and the family member with Alzheimer's is denied productive enjoyable days in a program because they can't participate fully enough. It made me think that caregivers don't understand the value and purpose of a structured day or the differences in programs. Tammy's is structured for people who wish to engage with others and are able to be. There are social day programs that are for folks without medical conditions that would require attention from a medical staff. Then there are the adult day health programs that offer a variety of services for the person attending, both physical and social. This can vary from ability to remind to take medications to giving IV solutions, doing physical therapy and changing wound dressings in addition to being in activities with others.
We StilMee coaches most always recommend a day program for two reasons; one, it is good for the person with dementia who most often cannot initiate pleasureable activity throughout the day, and two, it is good for the caregiver to have time to pursue his or her own pleasant activities. I knew one caregiver who started out each morning with a walk around a pond near her home. She took care of her need for this first. She would then have energy to get her mother up, bathed, dressed and ready for an adult day program. She would get all her work done while mom was being cared for by a staff of people who are compassionate toward people like her mother, and she felt more carefree to do what she needed and wanted to do. There is a common adage for caregivers; take care of yourself first, then you can take care of someone else. Sound advice.
We StilMee coaches most always recommend a day program for two reasons; one, it is good for the person with dementia who most often cannot initiate pleasureable activity throughout the day, and two, it is good for the caregiver to have time to pursue his or her own pleasant activities. I knew one caregiver who started out each morning with a walk around a pond near her home. She took care of her need for this first. She would then have energy to get her mother up, bathed, dressed and ready for an adult day program. She would get all her work done while mom was being cared for by a staff of people who are compassionate toward people like her mother, and she felt more carefree to do what she needed and wanted to do. There is a common adage for caregivers; take care of yourself first, then you can take care of someone else. Sound advice.
Saturday, June 19, 2010
Second Edition
I've been thinking about how much I've learned since I finished writing Matters of the Mind two years ago, and how many more wonderful stories of caregiving I've heard and been privy to. And some people have asked when the 2nd edition is coming. Since I'm a new author I have not a clue how a 2nd edition gets created and published. But, I will write it, as soon as I find out how. I imagine one expands on what is there already and adds new learnings, stories, research findings, etc. I'm already jotting notes about some funny and some less funny stories that have to be included. Add yours here and I'll put them in the book. I invite you to send them to me at StilMee@comcast.net
3 myths about Alzheimer's
I was on Greg Porell's South Shore Senior News radio this morning on my monthly Alzheimer's spotlight. I always look forward to these; giving out 6 minutes of tidbits about Alzheimer's. John Zeisel PhD of Hearthstone brought up these myths. It is disturbing to think some still believe them to be true. # 1. People with AD cannot learn. Well, ask Lynn Serper of the SerperMethod if that is true. Try to sit in the usual place at the table of the person with AD and see if she doesn't remember it is HER seat and you don't belong there. # 2. People with AD are no longer a person. I met a salesman at a recent event who, when he learned what I did, said, "They aren't really a person anymore, are they?" I nearly lost my cool, but instead did some serious teaching. Engage the person with AD and talk about something that evokes positive memories for him and see his 'person' emerge. # 3. People with AD have no future. Well, I may have a day to live, or a year, or another 3 decades. The person with AD has between 2 and 20 years to live. Is that enough of a future to pay attention to its being a meaningful one. Each day is a treasure to us all. People with and without a progressive disease like Alzheimer's need a purpose to get up in the morning and a sense of well being and value during the day. Caregivers are being taught by StilMee coaches how to bring value and purpose and control back to the person with Alzheimer's. It is a wondrous sight to see.
Thursday, June 10, 2010
Food for thought
This good bit of information from Stafford Hill of Plymouth e-newsletter for June...
Low blood levels of vitamin D effect more than bone health. Studies find a greater risk of heart problems and depression in older adults. In one study, people taking a vitamin D supplement were 7% less likely to die than those who didn't take a daily supplement.
The darker a person's skin, the more difficult it is to get vitamin D from sunlight. Fair-skinned people might be willing to risk the 10 to 15 minutes they need to get enough. But there's still a problem. Unless you live south of a line from Los Angeles to Columbia, S.C., there isn't enough sunlight year round to produce all the vitamin D you need. Most people need other sources. Your diet may increase your risk if it's low in milk or the foods that naturally contain vitamin D, such as salmon and eggs. In the U.S. nearly all milk if fortified with vitamin D, and many brands of OJ are too. Even some cereals contain a healthy dose. So make every day a "D" day.
Low blood levels of vitamin D effect more than bone health. Studies find a greater risk of heart problems and depression in older adults. In one study, people taking a vitamin D supplement were 7% less likely to die than those who didn't take a daily supplement.
The darker a person's skin, the more difficult it is to get vitamin D from sunlight. Fair-skinned people might be willing to risk the 10 to 15 minutes they need to get enough. But there's still a problem. Unless you live south of a line from Los Angeles to Columbia, S.C., there isn't enough sunlight year round to produce all the vitamin D you need. Most people need other sources. Your diet may increase your risk if it's low in milk or the foods that naturally contain vitamin D, such as salmon and eggs. In the U.S. nearly all milk if fortified with vitamin D, and many brands of OJ are too. Even some cereals contain a healthy dose. So make every day a "D" day.
Wednesday, June 9, 2010
Choose activities wisely
So often I visit a caregiver whose family member is sitting in front of the television kind of zoned out. TV is probably the poorest activity for someone with Alzheimer's. Why? TV is not interactive, is ever changing from programming to advertisements of several different products in the span of a few minutes, and the program is often a subject matter unsuitable for a person already having difficulty staying in touch with what is going on around him.
People with Alzheimer's have slowed processing of information meaning it takes longer for them to absorb information and decide what to do with it. Switching subjects is very hard and holding on to information is difficult at first, then very hard to not able to at all.
I remember a caregiver who was very tired as his wife with Alzheimer's was up much of every night insisting that bad people were trying to get into the house. She would be very frightened, asking her husband to 'check the doors and windows'. Upon questioning, I learned it was their lifelong habit of watching the 10 o'clock news before going to bed. I suggested that perhaps she couldn't let go of the news and translated it into happening right there in her house. He substituted a calming video of lovely dressed ice skaters at 10 o'clock instead and they watched the news at 6 instead. Her delusions disappeared and he got much needed sleep.
Sometimes a person with Alzheimer's cannot differentiate reality from what is on TV and will become frightened. As a caregiver it is important to take note of what upsets and causes fear and then get rid of the fear provoking activity.
Activity of well known tasks like helping dust, set a table, help do laundry, create a photo collage and other enjoyable activites, perhaps accompanied by soft music will induce good feelings instead of fearful ones.
Another time I coached a caregiver whose husband wasn't responding to her request to come to dinner. She would tell him dinner was ready and he would look at her perplexed, not knowing what to do. I discovered their passion in recent years was dancing. To get him to the table where the visual cue of food on a plate told him it was time to eat, she turned on dance music, asked him for this dance, and danced him to the table! Ingenious!
People with Alzheimer's have slowed processing of information meaning it takes longer for them to absorb information and decide what to do with it. Switching subjects is very hard and holding on to information is difficult at first, then very hard to not able to at all.
I remember a caregiver who was very tired as his wife with Alzheimer's was up much of every night insisting that bad people were trying to get into the house. She would be very frightened, asking her husband to 'check the doors and windows'. Upon questioning, I learned it was their lifelong habit of watching the 10 o'clock news before going to bed. I suggested that perhaps she couldn't let go of the news and translated it into happening right there in her house. He substituted a calming video of lovely dressed ice skaters at 10 o'clock instead and they watched the news at 6 instead. Her delusions disappeared and he got much needed sleep.
Sometimes a person with Alzheimer's cannot differentiate reality from what is on TV and will become frightened. As a caregiver it is important to take note of what upsets and causes fear and then get rid of the fear provoking activity.
Activity of well known tasks like helping dust, set a table, help do laundry, create a photo collage and other enjoyable activites, perhaps accompanied by soft music will induce good feelings instead of fearful ones.
Another time I coached a caregiver whose husband wasn't responding to her request to come to dinner. She would tell him dinner was ready and he would look at her perplexed, not knowing what to do. I discovered their passion in recent years was dancing. To get him to the table where the visual cue of food on a plate told him it was time to eat, she turned on dance music, asked him for this dance, and danced him to the table! Ingenious!
Sunday, June 6, 2010
Tips from Nancy Lombardo Ph.D of BUADRC
"Eat Your Veggies"
is at the Heart of Memory Preservation Nutrition®
Continuing our series on Consumer Guidelines for a Brain Healthy Nutrition, this month's feature is VEGETABLES. Study after study, using different populations around the world, has concluded that people who eat more vegetables than others in the study, have lower risk of cognitive decline and brain diseases such as Alzheimer's disease (lead scientists include Amy Graves, Martha Morris, and James Joseph).
A variety of green leafy and brightly colored vegetables, as well as dried beans and peas and low sodium vegetable juice, are essential to brain and body health. Vegetables, beans and peas are major elements of the Mediterranean Diet and the DASH diet. People scoring high on each of these diets have been shown to have lower risk of cognitive decline (see publications by Nikolaos Scarmeas, MD at Columbia School of Medicine, and Heidi J. Wengreen with the Cache County (Utah) Study on Memory, Health and Aging).
Among vegetables, the stars appear to be leafy green vegetables which contain high levels of antioxidants including vitamins A and E, as well as traces of omega 3's, and other brain healthy nutrients. Leafy green vegetables include spinach, broccoli, delicious Swiss chard, kale, collard greens, all the bok choys and their relatives, pea stems/leaves (all the rage in Chinese restaurants) and all the lettuces except iceberg, and many many more. Explore to give your taste buds a treat!
Romaine lettuce, among other leafy vegetables, also contains high levels of S-adenosylmethionine, more well known as SAM or SAMe, which Professor Thomas Shea of the University of Massachusetts in Lowell, discovered to be important to brain health and related metabolic processes in the brain. Our bodies like all living cells make some SAM but usually not enough to meet our needs, and so it is essential to ingest more of it in the food we eat. There are also supplements available, such as Dr. Shea's/U Mass Lowell's patented product licensed and marketed as "Great Mind®" by Nature Made. Which contains SAM, folic acid, B-12, N-Acetyl Cysteine (NAC), and Acetyl L Carnatine.
Aim high, as vegetables are key to brain and body health. 7-10 portions a day of a variety of vegetables is ideal. You can obtain at least one portion's worth by drinking a glass of low sodium vegetable juice a day. Best are the 100% vegetable juices such as low-sodium V-8. Those mixed with fruit juices may taste better to you but you are then drinking less vegetable juice and more fruit juice laden with fructose (a form of sugar).
Most Americans do not eat many or hardly any vegetables. And French fries and ketchup do not really count, though they are better for you than a donut or pastry.
Another solution for people who can't or don't eat enough vegetables and fruits is a supplement with impressive research credentials comprised of dehydrated vegetable/fruit juice in a capsule or delicious chewable form (the tastiest "gummy" you ever experienced) ...salt, sugar is removed so safe for diabetics, and essential nutrients of 17 different fruits and vegetables are included so it is classified as a whole food by the FDA (no sales tax in MA!). Special orders for just the vegetable form is possible. Contact me for more information or check out my website: Nancy's Juice Plus Website
Also check out delicious veggie recipes on my other website: www.healthcareinsights.net
Public invited to five presentations
is at the Heart of Memory Preservation Nutrition®
Continuing our series on Consumer Guidelines for a Brain Healthy Nutrition, this month's feature is VEGETABLES. Study after study, using different populations around the world, has concluded that people who eat more vegetables than others in the study, have lower risk of cognitive decline and brain diseases such as Alzheimer's disease (lead scientists include Amy Graves, Martha Morris, and James Joseph).
A variety of green leafy and brightly colored vegetables, as well as dried beans and peas and low sodium vegetable juice, are essential to brain and body health. Vegetables, beans and peas are major elements of the Mediterranean Diet and the DASH diet. People scoring high on each of these diets have been shown to have lower risk of cognitive decline (see publications by Nikolaos Scarmeas, MD at Columbia School of Medicine, and Heidi J. Wengreen with the Cache County (Utah) Study on Memory, Health and Aging).
Among vegetables, the stars appear to be leafy green vegetables which contain high levels of antioxidants including vitamins A and E, as well as traces of omega 3's, and other brain healthy nutrients. Leafy green vegetables include spinach, broccoli, delicious Swiss chard, kale, collard greens, all the bok choys and their relatives, pea stems/leaves (all the rage in Chinese restaurants) and all the lettuces except iceberg, and many many more. Explore to give your taste buds a treat!
Romaine lettuce, among other leafy vegetables, also contains high levels of S-adenosylmethionine, more well known as SAM or SAMe, which Professor Thomas Shea of the University of Massachusetts in Lowell, discovered to be important to brain health and related metabolic processes in the brain. Our bodies like all living cells make some SAM but usually not enough to meet our needs, and so it is essential to ingest more of it in the food we eat. There are also supplements available, such as Dr. Shea's/U Mass Lowell's patented product licensed and marketed as "Great Mind®" by Nature Made. Which contains SAM, folic acid, B-12, N-Acetyl Cysteine (NAC), and Acetyl L Carnatine.
Aim high, as vegetables are key to brain and body health. 7-10 portions a day of a variety of vegetables is ideal. You can obtain at least one portion's worth by drinking a glass of low sodium vegetable juice a day. Best are the 100% vegetable juices such as low-sodium V-8. Those mixed with fruit juices may taste better to you but you are then drinking less vegetable juice and more fruit juice laden with fructose (a form of sugar).
Most Americans do not eat many or hardly any vegetables. And French fries and ketchup do not really count, though they are better for you than a donut or pastry.
Another solution for people who can't or don't eat enough vegetables and fruits is a supplement with impressive research credentials comprised of dehydrated vegetable/fruit juice in a capsule or delicious chewable form (the tastiest "gummy" you ever experienced) ...salt, sugar is removed so safe for diabetics, and essential nutrients of 17 different fruits and vegetables are included so it is classified as a whole food by the FDA (no sales tax in MA!). Special orders for just the vegetable form is possible. Contact me for more information or check out my website: Nancy's Juice Plus Website
Also check out delicious veggie recipes on my other website: www.healthcareinsights.net
Public invited to five presentations
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