Archive for November, 2013


Happy Thanksgiving!

turkey

Tis the season to be thankful.  Enjoy your Thanksgiving festivities, nosh on some delicious Turkey Day fare, and pay tribute to those leading the fight against Alzheimer’s disease. There are more than 5 million living with Alzheimer’s  in the United States and a whopping 15 million friends and family members providing care.  This year, let’s show our appreciation for the countless that have been impacted by this disease. Learn more about dementia and how you can help at alz.org. Interested in learning more about November, Family Caregiver’s Month? Click here.

Do your snacking habits affect brain health? Could your diet choices help to reduce (or elevate) your risk for diseases like Alzheimer’s? As the prevalence of Alzheimer’s disease continues to rise (more than 5 millions Americans have a diagnosis), many have been intrigued by these questions. Unfortunately, there is no proven method for preventing Alzheimer’s disease and the research into its prevention is lacking. However, an emerging body of scientific research indicates that certain food choices may be conducive to a healthy brain.

Ever heard the axiom “healthy mind, healthy body”? It’s often true! Hypertension, diabetes, high cholesterol, and other chronic diseases have been associated with an increased risk for developing Alzheimer’s disease and other types of dementia. These diseases are harmful to the blood vessels in the body, and they can ultimately cause a lack of blood flow to the brain.

Want to ensure that your diet will protect your body and your mind? Adhering to a heart healthy food selection, like the Mediterranean diet, may help.

mcdc6_pyramid_mediterranean

The benefits of diet on heart health are already well-documented, and many researchers believe that these same disease fighting foods can be beneficial in protecting the brain. The studies conducted on this subject have yielded promising results, however, more research must continue in order to learn more about effective prevention strategies for Alzheimer’s.

Don’t forget, aging doesn’t start when we reach 65. It’s happening to us all the time, everyday! Commit to a healthy lifestyle long-term, and you will be more likely to stave off chronic diseases, like Alzheimer’s. Life is a marathon, not a sprint!

grocery store

Want to give it a spin? Below is a sample grocery list that reflects adherence to the Mediterranean diet. The most effective eating plan is one that works with your preferences and lifestyle. Experiment with foods that are most appealing to you and enjoy!

  • Spinach
  • Kale
  • Eggplant
  • Tomatoes
  • Almonds
  • Sweet Potatoes
  • Celery
  • Carrots
  • Salmon
  • Brown rice
  • Whole wheat bread
  • Olive oil
  • Red wine
  • Blueberries
  • Strawberries
  • Bananas
  • Tilapia
  • Basil
  • Oregano
  • Black beans
  • Cannellini beans
  • Whole wheat pasta
  • Tomato sauce
  • Bell peppers
  • Zucchini

References

http://www.alz.org/we_can_help_adopt_a_brain_healthy_diet.asp

Arntzen, K. B. (2011). Impact of cardiovascular risk factors on cognitive function: The Tromsø study. European Journal Of Neurology18(5), 737-743.

Boost your memory by eating right. (2012). Harvard Women’s Health Watch19(12), 1-7.

Féart, C., Samieri, C., Rondeau, V., Amieva, H., Portet, F., Dartigues, J., & … Barberger-Gateau, P. (2009). Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA: Journal Of The American Medical Association302(6), 638-648. doi:10.1001/jama.2009.1146

Mediterranean diet associated with lower risk of cognitive impairment. (2009). Nurse Prescribing7(3), 134.

holiday

The holidays are a highly anticipated, but often stressful, season. For many, our financial, social, and physical demands increase significantly as the holidays rapidly approach. Buying gifts for others, entertaining guests, and making travel arrangements are common added responsibilities at this time of year. If you are a caregiver for a person with dementia, it may be difficult to juggle these additional tasks alongside your routine care provision.

Interactions with family members may add another layer of stress or possibly contention. Family members that visit for the holidays may be taken aback by the changes they observe in the person with dementia. They may be unsure of how to respond to the person with Alzheimer’s, and they may not use appropriate techniques. For others, suspicions that a family member has a memory loss disorder could be surfaced for the first time at a holiday gathering. Other issues, such as the person’s safety or whether he/she should be living alone, may not be addressed until the family comes together. Members of the family may disagree and conflict could ensue.

Little research has been done about caregiving during the holiday season, although it has been acknowledged by many as a uniquely stressful phenomenon. Below are some helpful hints on how to best prepare for and survive this special time of year. Happy Holidays everyone!

Prepare Family Members in Advance

The holidays are full of emotions, so it can help to let guests know what to expect before they arrive. Initiating the conversation early will also allow family members an opportunity to surface any questions or concerns they may have.

If the person is in the early stages of Alzheimer’s, relatives and friends might not notice any changes. But the person with dementia may have trouble following conversation or tend to repeat him/herself.  Family can help with communication by being patient, not interrupting or correcting, and giving the person time to finish his or her thoughts.

If the person is in the middle or late stages of Alzheimer’s, there may be significant changes in cognitive abilities since the last time an out-of-town friend or relative has visited.  These changes can be hard to accept. Make sure visitors understand that changes in behavior and memory are caused by the disease and not the person.

You may find this easier to share changes in a letter or email that can be sent to multiple recipients. Consider also including a recent photograph of the person with dementia, so family/friends are aware of any physical changes that may have taken place. Here are some examples of what you may write:

>> “I’m writing to let you know how things are going at our house. While we’re looking forward to your visit, we thought it might be helpful if you understood our current situation before you arrive.

>> “You may notice that ___ has changed since you last saw him/her. Among the changes you may notice are ___.

>> “Because ___ sometimes has problems remembering and thinking clearly, his/her behavior is a little unpredictable.

>> “Please understand that ___ may not remember who you are and may confuse you with someone else. Please don’t feel offended by this. He/she appreciates your being with us and so do I.”

For more ideas on how to let others know about changes in your loved one, join ALZConnected, our online support community where caregivers like you share tips on what has worked for them.

Re-evaluate Holiday Traditions

It’s likely that both  the person with dementia and the family would still like him/her to participate meaningfully in the holiday celebrations. Involve the person by building on past traditions and memories. Focus on activities that are meaningful to the person with dementia. Your family member may find comfort in singing old holiday songs or looking through old photo albums. As the person’s abilities allow, invite him or her to help you prepare food, wrap packages, help decorate or set the table. This could be as simple as having the person measure an ingredient or hand decorations to you as you put them up. (Be careful with decoration choices. Blinking lights may confuse or scare a person with dementia, and decorations that look like food could be mistaken as edible.)

Sticking to the person’s normal routine will help keep the holidays from becoming disruptive or confusing. For instance, if the person is accustomed to eating lunch at a scheduled time, stick to that time. Encourage family members and friends to assist you in this. Plan time for breaks and rest.

Be flexible and adjust traditions appropriately. For example, a smaller, shorter gathering during the day may be more successful than a large celebration that carries on into the late evening.

Adapt Gift-Giving

gift

Encourage safe and useful gifts for the person with dementia. Some gifts may be unusable or even dangerous to a person with dementia. If someone asks for gift ideas, suggest items the person with dementia needs or can easily enjoy. Ideas include: an identification bracelet (available through MedicAlert® + Alzheimer’s Association Safe Return®), comfortable clothing, audiotapes of favorite music, videos and photo albums. Also, put respite care on your wish list. If friends or family ask what you want for a gift, suggest a gift certificate or something that will help you take care of yourself as you care for your loved one. This could be a cleaning or household chore service, an offer to provide respite care, or something that provides you with a bit of rest and relaxation.

When the Person is in a Care Facility

  • Consider joining your loved one in any facility-planned holiday activities
  • Bring a favorite holiday food to share
  • Sing holiday songs and ask if other residents can join in
  • Read a favorite holiday story or poem out loud

References

Liken, Michelle A, PhD,R.N., C.S. (2001). (Not) a hallmark holiday: Experiences of family caregivers of a relative with alzheimer’s disease. Journal of Psychosocial Nursing & Mental Health Services, 39(12), 32-7. Retrieved from http://search.proquest.com/docview/225538122?accountid=27927

http://www.alz.org/care/alzheimers-dementia-holidays.asp

http://www.alz.org/national/documents/topicsheet_holidays.pdf

The prevalence of Alzheimer’s disease today is unprecedented in human history. Presently, more than 5 million Americans have a diagnosis. In Michigan alone, roughly 180,000 individuals are living with memory loss. Approximately every 68 seconds, someone develops the disease. By 2050, the numbers are projected to increase to between 11 and 15 million nationwide. Alzheimer’s disease is the 6th leading cause of death in the U.S., and it is the only cause among the top 10 that cannot be prevented, slowed, or cured.

The cost of Alzheimer’s disease is high. This year in the United States, we will spend more than $200 billion caring for people  with Alzheimer’s or another dementia. Unfortunately, family caregivers are absorbing a majority of this burden. In fact, in 2012 15.4 million caregivers provided an estimated 17.5 billion hours of unpaid care, valued at more than $216 billion, in the United States.

pie chart cg

Family members are often the front line of Alzheimer’s care, but they may lack the appropriate support, resources, or education needed to execute their job effectively. Caregiving can be extremely taxing work, and dementia caregivers are particularly at risk for burnout, distress, and other negative outcomes. Research indicates that dementia caregivers have poorer physical, mental, and financial well-being, than their non-caregiving counterparts.  Caregivers are also more likely to experience depression, anxiety, reduced immune function, increased incidence of disease and mortality,  as well as disruptions in employment and depleted incomes.

November is “National Alzheimer’s Disease Awareness Month” and “National Caregiver Month”. If you know someone who is a caregiver, show them your support and offer respite. Learn more about this special month and pay tribute to a caregiver here.

If you are a caregiver for someone with Alzheimer’s disease or another dementia, consider following these 10 tips to being  a healthier caregiver:

1. Understand what’s going on as early as possible.

Symptoms of Alzheimer’s may appear gradually. It can be easy to explain away changing or unusual behavior when a loved one seems physically healthy. Instead, consult a doctor when you see changes in memory, mood or behavior. Don’t delay; some symptoms are treatable.

2. Know what community resources are available.

Contact your local Alzheimer’s Association office. The staff can help you find Alzheimer’s care resources in your community. Adult day programs, in-home assistance, visiting nurses and meal delivery are just some of the services that can help you manage daily tasks.

3. Become an educated caregiver.

As the disease progresses, new caregiving skills may be necessary. The Alzheimer’s Association offers programs to help you better understand and cope with the behaviors and personality changes that often accompany Alzheimer’s.

4. Get help.

Trying to do everything by yourself will leave you exhausted. Seek the support of family, friends, and community resources. Tell others exactly what they can do to help. The Alzheimer’s Association 24/7 Helpline, online message boards and local support groups are good sources of comfort and reassurance. If stress becomes overwhelming, seek professional help.

5. Take care of yourself.

Watch your diet, exercise and get plenty of rest. Making sure that you stay healthy will help you be a better caregiver.

6. Manage your level of stress.

Stress can cause physical problems (blurred vision, stomach irritation, high blood pressure) and changes in behavior (irritability, lack of concentration, change in appetite). Note your symptoms. Use relaxation techniques that work for you, and talk to your doctor.

7. Accept changes as they occur.

People with Alzheimer’s change and so do their needs. They may require care beyond what you can provide on your own. Becoming aware of community resources — from home care services to residential care — should make the transition easier. So will the support and assistance of those around you.

8. Make legal and financial plans.

Plan ahead. Consult a professional to discuss legal and financial issues including advance directives, wills, estate planning, housing issues and long-term care planning. Involve the person with Alzheimer’s and family members whenever possible.

9. Give yourself credit, not guilt.

Know that the care you provide does make a difference and you are doing the best you can. You may feel guilty because you can’t do more, but individual care needs changes as Alzheimer’s progresses. You can’t promise how care will be delivered, but you can make sure that the person with Alzheimer’s is well cared for and safe.

10. Visit your doctor regularly.

Take time to get regular checkups, and be aware of what your body is telling you. Pay attention to any exhaustion, stress, sleeplessness or changes in appetite or behavior. Ignoring symptoms can cause your physical and mental health to decline.

References

2013 Alzheimer’s Disease Facts and Figures

Take Care of Yourself Alzheimer’s Association brochure

http://www.alz.org

http://www.alz.org/gmc

www/alz.org/care

Although Alzheimer’s disease may be credited as the most notorious memory loss disorder, it is certainly not the only dementing disease. There are many other types of dementia — upwards of 50 different types. Depending on the type of dementia, the disease may have different symptoms, trajectories, or treatment options. Frontotemporal dementia is one non-AD type of dementia.

What is it?

Frontotemporal dementia (FTD) accounts for approximately 15% of cases of dementia. It is characterized by degeneration in the frontal (executive functions) and temporal lobes (memory, language, emotions) of the brain.  In Alzheimer’s the person may have stark cognitive deficits early on in the disease (e.g. short term memory problems, word finding difficulties), but the person with FTD may have more obvious behavioral symptoms  in the early stages (such as spending copious amounts of money, eating without restraint, apathy, disinhibition, etc.). FTD also typically affects individuals at a younger age than those who are diagnosed with Alzheimer’s. Most people are diagnosed in their 50s or 60s.

brain_colour_cropped

FTD can be grouped into three different types

  • Behavioral variant frontotemporal dementia (bvFTD) takes its greatest toll on personality and behavior. It may begin with subtle changes that may be mistaken for depression. As bvFTD progresses people often develop disinhibition, a striking loss of restraint in personal relations and social life.
  • Primary progressive aphasia (PPA) affects language skills in early stages, but often also affects behavior as it advances. The two chief forms of PPA have somewhat different symptoms:
    • In semantic dementia, people speak easily, but their words convey less and less meaning. They tend to use broad general terms, such as “animal” when they mean “cat.” Language comprehension also declines.
    • In progressive nonfluent aphasia, people lose their ability to generate words easily, and their speech becomes halting, “tongue-tied” and ungrammatical. Ability to read and write also may be impaired.
  • FTD movement disorders affect certain involuntary, automatic muscle functions. These disorders also may impair language and behavior. The two primary FTD movement disorders are:
    • Corticobasal degeneration (CBD), which causes shakiness, lack of coordination, and muscle rigidity and spasms.
    • Progressive supranuclear palsy (PSP), which causes walking and balance problems, frequent falls and muscle stiffness, especially in the neck and upper body. It also affects eye movements.

How to cope?

As with other types of dementia, managing the behavioral changes that occur with the disease is a daunting task for any caregiver, potentially leading to burnout and distress.  Furthermore, research indicates that FTD caregivers may experience a greater financial, emotional, and psychological burden than their AD caregiver counterparts. Because of the extreme toll that caregiving can pose, the caregiver must take good care of themselves! Support groups and/or therapy may be very helpful outlets. Taking time out and enjoying free time as a caregiver is not frivolous but an essential component in preserving the caregiver’s mental and physical well-being.

Managing behaviors is a common issue when the diagnosis is FTD. Validating the person’s feelings and reality, taking time out for one’s self, implementing a regular routine, and consulting with a physician are all viable methods for tackling this issue.

Research continues to emerge which indicates that physical activity may help to stimulate learning and memory and effectively manage some of the symptoms associated with dementia (Ahlskog et al., 2011). Engaging the person in activities, particularly physical exercise, may be another helpful intervention for managing behaviors.

References

Ahlskog, J. E., Geda, Yonas E,M.D., M.S.C., Graff-Radford, N., & Petersen, Ronald C,P.H.D., M.D. (2011). Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clinic Proceedings, 86(9), 876-84. Retrieved from http://search.proquest.com/docview/886577831?accountid=27927

Rabinovici, G. L. (2010). Frontotemporal Lobar Degeneration. CNS Drugs24(5), 375-398.

Seltman, R. R. (2012). Frontotemporal Lobar Degeneration: Epidemiology, Pathology, Diagnosis and Management. CNS Drugs26(10), 841-870. http://www.theaftd.org