Posts By: The Bristal

How Alzheimer’s Disease Was Discovered

Posted by: The Bristal

How Al

The neurodegenerative disease we call Alzheimer’s is named for the German physician Alois Alzheimer, who first identified and described it more than a hundred years ago.

In 1901, Dr. Alzheimer, grief-stricken because of the recent death of his wife, plunged himself into clinical work with extraordinary fervor. To divert his mind from sorrow, he began personally examining all new patients admitted to his Frankfurt-based hospital at length, compiling extensive documentation on their conditions and prognoses.

Among the patient examined by Dr. Alzheimer was Auguste Deter, a 50-year-old woman experiencing memory loss, suspicion, agitation and other extreme psychological problems.  After Auguste died in 1906, Dr. Alzheimer — now working in Munich — had the opportunity to do a post-mortem examination of her brain.

Using a microscope, Alzheimer saw odd substances and structures (later called plaques and neurofibrillary tangles), in Auguste’s brain matter. He then was able to convince noted psychiatric practitioners in Germany that these plaques and tangles – together with the clinical symptoms and course of the illness – had never been seen before. In the following years, Dr. Alzheimer, along with Gaetano Perusini, a research colleague, published more case studies, with their findings being further validated in 1908 through inclusion in the noted textbook Psychiatrie.

Since Dr. Alzheimer’s premature death in 1915, science has credited him with his groundbreaking discovery, which set the standard for understanding neurodegenerative disease.

Other milestones in Alzheimer’s research

Research into Alzheimer’s disease has been ongoing during the 20th and 21st centuries. The 1931 invention of the electron microscope – which made it possible to magnify images of brain tissue up to 1 million times – has enabled further direct study; in the 1960s, researchers developed a measurement scale to assess the decline of cognition and function in older adults. Together, these tools allow for the correlation of behavioral impairments with educated guesses about brain lesions and tissue damage.

By 1976, medical science recognized Alzheimer’s disease as the most common form of dementia. Eight years later, two researchers, George Glenner and Caine Wong, identified “beta-amyloid” – the protein fragment making up most of the plaque material seen in the brains of people suffering from Alzheimer’s disease. Soon after, a second protein called “tau” was determined to be responsible for the tangles that are the other important marker of the disease.

What causes Alzheimer’s disease?

While these discoveries are important and fruitful, the causes of Alzheimer’s disease are still not fully understood by medical science.

Science continues to develop improved ways to study the plaques, tangles and other features of Alzheimer’s, through advanced brain imaging techniques and discoveries in genetics. For people with late-onset of the disease, the APOE gene, which takes several forms, seems to play a part. However, simply carrying the gene does not mean a person will certainly go on to have the disease.

Risk factors for the disease include age, genetics, environment and lifestyle factors, with the impact of each factor varying for any given individual. Vascular conditions, such as heart disease, stroke and hypertension may be involved in cognitive decline, as well as metabolic conditions, such as diabetes. Healthy eating, exercise, getting enough high-quality sleep and staying socially engaged and mentally stimulated are associated with remaining well with increasing age, and may reduce the risk of cognitive decline. Clinical trials are studying all of these areas.

The search for new treatments – along with research addressing the underlying disease process in hopes of preventing or postponing onset – is flourishing. Clinical trials of various behavioral and drug interventions are underway. Volunteering to participate in a clinical trial can help science progress toward better treatment – and perhaps, even a cure – for Alzheimer’s disease. To find out more, talk to your physician about local studies, or visit the ADEAR website (Alzheimer’s disease Education and Referral Center), a service of the National Institute on Aging, and search for clinical trials in your area.

Posted in: Alzheimer’s & Memory Care, Senior Care
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Kitchen Safety Tips for Seniors

Posted by: The Bristal

Kitchen Safety Tips for Seniors

The modern kitchen is central to American life, so much so that Julia Child’s actual kitchen from her Massachusetts home is a permanent exhibit at the Smithsonian Institution’s Museum of American History in Washington, D.C. As we get older, however, the kitchen can become an increasingly dangerous place, where a senior’s physical or cognitive impairments inflate the potential for fires, accidents and food-borne illnesses.

Fortunately, there are simple steps that seniors and their loved ones and caregivers can take to help reduce or eliminate the common dangers posed by the kitchen. Here are important kitchen safety tips.

Avoiding kitchen fire hazards:

  • Do not leave cooking food unattended. Doing so is a primary cause of kitchen fires, according to the National Fire Protection Association, whose recent statistics indicate that unattended equipment was a factor in one-third of home cooking fires and roughly half of the associated fatalities.
  • Keep ovens and stovetops free of food residues, which can ignite. If necessary, have someone periodically clean the oven for you, as it can be a difficult chore, especially for seniors.
  • If the oven has an exhaust hood and duct over it, see that they are kept clean as well.
  • Never allow dish towels and other cloth items to hang or sit near the burners.
  • Avoid loose-fitting clothing when cooking so that no part of your garments can come in contact with flames; long sleeves are especially vulnerable to catching fire.
  • Unplug countertop appliances, including the toaster, when they are not in use.
  • Never cook while feeling drowsy, or in a state of confusion, or after taking medication that might make you sleepy.
  • Do not let the handles of pots and pans extend out beyond the stovetop, where you might accidentally bump them and spill the contents; always turn them facing in, instead.
  • Use a timer to automatically remind you that the oven and/or stovetop are in use.
  • Make a habit of checking the kitchen every time you finish cooking to be sure everything is turned off.

Avoiding common accident traps:

  • Keep the kitchen uncluttered and brightly lit when occupied.
  • Heavy items, such as dishes, pots and pans, should be stored at waist level.
  • Do not use cabinets that are out of easy reach or require stepping stools.
  • Use unbreakable plastic for glasses, cups and dishes.
  • Beware of liquid spills that create a slippery floor; check the refrigerator for water leaks.
  • Be certain that electrical cords do not present tripping hazards, or dangle from the counter to the floor.
  • Protect your hands and wrists with mitts.

Avoiding food-borne illness:

Anyone can catch food poisoning, but according to the U.S. Food & Drug Administration, seniors tend to be more susceptible because of “changes in our organs and body systems.” For example, the FDA notes, “our stomach and intestinal tract may hold on to foods for a longer period of time; our liver and kidneys may not readily rid our bodies of toxins, and our sense of taste or smell may be altered.” To lessen the chance of catching a food-borne illness and endangering others for whom you may be cooking, be aware of the following.

  • Keep the temperature inside your refrigerator at 40 degrees Fahrenheit or below.
  • Do not let leftover foods sit on the table after you have eaten; put them in the refrigerator immediately.
  • Use separate cutting boards for meats and vegetables.
  • Store meats and vegetables in separate sealed containers.
  • Understand that spoiled food does not necessarily look or smell bad, so discard it if you have any reason to suspect spoilage.

Keeping it a happy kitchen, however, means keeping it safe as we grow older.

Posted in: Lifestyle Blog
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Outdoor Walking Tips for Seniors

Posted by: The Bristal

Some 2,400 years ago, the Greek physician Hippocrates said: “That which is used, develops. That which is not used wastes away.” Today, that bit of ancient wisdom is often reflected in a more succinct phrase: “Use it or lose it.” Whichever way one says it, the concept has never lost its validity. In fact, it has become especially relevant to the subject of walking as a means of helping seniors preserve their mobility and overall state of health.

Virtually all medical authorities agree that walking is a vitally important form of exercise for older adults (including those who use a cane or walker for assistance), not only to maintain mobility, but also for potential benefits pertaining to blood circulation and heart health, joint diseases, bone density, breathing, balance and mental acuity. The Arthritis Foundation, for example, provides a comprehensive discussion of walking’s benefits here.

To realize all the advantages that walking can bring, however, it is necessary for a senior to consider the factors that will make his or her journeys on foot safe, comfortable and enjoyable. For starters, it is imperative to consult with your doctor before undertaking a substantial walking program. He or she will advise you if any aspect of your medical status warrants restrictions on the scope of your walking activity in terms of pace, distance, terrain and weather conditions. Having your doctor’s assessment in advance will – no pun intended – get you off on the right foot.

Here are tips to consider for general safety and comfort:

  • Warm up and cool down. Regardless of how fast you intend to walk, begin each walk at a casual pace to get the blood flowing to your muscles and joints. End the walk by gradually slowing your pace over a period of a few minutes.
  • Think carefully about intended routes. Plan ahead. Try to minimize encounters with broken pavements, construction hazards, congested sidewalks and heavily trafficked intersections. You may also wish to avoid steep inclines.
  • Dress for success. In this case, that means wear loose fitting clothes that are appropriate for an extended walk. Bear in mind that you may feel comfortable at the start, but get warmer as the walk progresses. Consider dressing in layers, which is a tactic that also can be useful when weather conditions are variable.
  • Choose appropriate footwear. Select walking shoes with good arch support and non-skid soles.
  • Air quality counts. Be alert to weather advisories about poor air quality, especially if you have asthma or other breathing disorders. Postponing or shortening walks on days with high air pollution may be the most sensible course to take.
  • Don’t forget water. Staying hydrated is always important, but all the more so in hot weather, regardless of the humidity level. Bring water along on extended walks. This may present a complication for seniors with such common conditions as an enlarged prostate or over-active bladder, so consider choosing walking routes that include accessible restrooms, such as the public library or a favorite diner or gas station.
  • Check out those canes and walkers. Don’t let the need for a walking aid prevent you from hitting the trail (providing that your doctor agrees, of course). Just choose an appropriate distance and go at a comfortable pace. However, do make sure the cane or walker is the right height for you to ensure maximum safety and comfort. In addition, you might want to consider a walker that includes a seat so you can rest along the way.
  • Stay focused. Some seniors prefer to chat with companions while walking or to listen to music. While that can make walking more enjoyable, don’t allow it to distract you from potential hazards, such as a pothole, patch of ice or uneven terrain. Be especially alert when stepping off a curb, where a misstep can result in a sprained or broken ankle. Always be focused on where you are walking.
  • Stay connected. Take a cell phone with you, for safety’s sake. If cost is an issue, consider a basic service plan that may be available for as little as $10 a month.
  • Forget the adage: no pain, no gain. The objective is healthy exercise, not a place on the Olympic team, so do not attempt to exceed sensible limits. If you encounter pain or serious discomfort, stop and rest. If it persists, notify your doctor.

Many seniors make their exercise a social occasion by joining walking clubs, which often are sponsored by community senior centers. If none is available or convenient for you, the American Heart Association encourages older adults to start their own, with advice on how to do it here.

Overall, walking is good for you at any age. Dr. Hippocrates, in fact, declared that, “Walking is man’s best medicine.” Just be sure to keep safety in mind and apply good sense along the way.

Posted in: Lifestyle Blog
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How Dementia Can Affect Communication

Posted by: The Bristal

People with Alzheimer’s disease and other types of dementia can find themselves gradually closed off from the world due to increasing cognitive dysfunction. According to the Alzheimer’s Association, this condition affects their ability to remember, speak and understand what they hear from others. Other challenges can include difficulties with writing and reading.

Your loved one may notice difficulty in finding the right words when speaking. He or she may describe a familiar object because they cannot recall its name—nouns are the first type of words to be affected. Trains of thought are frequently derailed, and logical word sequences become harder to summon up. People with dementia find it difficult to join a conversation, to understand a subtlety or a joke, or keep up with complex sentences that include two or more pieces of information.  Unable to find the right word, a person may say the wrong or a made-up word. As dementia worsens, these mistakes increase.

Some people try to conceal their communication problems by pretending to understand more than they do when, in fact, they may completely misunderstand the conversation or situation. They may revert to silence, relying more on gestures than speech. The inability to speak coherently as they used to can cause individuals with dementia to feel frustrated and alone.

There are ways that loved ones and caregivers can make communication easier. In a study with professional caregivers, methods that were successful included providing a single direction or idea at a time, asking close-ended questions and making repetitions with paraphrasing.

Caregivers should use the person’s name to get their attention before talking. A gentle touch on the arm or shoulder can help; wait until the person looks at you, then begin to speak. Maintain eye contact, speak slowly, with pauses between sentences. Keep your sentences simple and short, choosing basic, easy words, and allow time for your loved one to respond. As verbal and cognitive abilities decline, both partners can rely more on the tone of the voice and body language. The caregiver can listen for and look for clues in communication from their loved one and react accordingly. It is helpful for the caregiver to minimize the number of words used and concentrate on his or her tone while simultaneously using gestures.

Watch the eyes of your loved one to see if he or she understands. Repeat what you heard back to the person and ask if it is accurate, or ask your loved one to repeat what he or she said. Try to be engaged by giving visual cues, and break instructions down into simple steps, conveying them slowly. At times, words can become jumbled and you may hear one or two clear words. Try repeating those words back to your loved one to let him or her know you are listening and understanding. Patience is key.

Communication is easiest for those with dementia when it is a quiet, peaceful place, where distractions, such as a television or other people’s conversations will not interfere. Also, they can communicate better when their physical needs are met first — thirst, hunger, pain, toileting, etc. — and should be attended to pro-actively.

The more advanced dementia becomes, the more important it is not to give up communication. Communication may come in many different forms; a bouquet of flowers, a card, a hug, a smile, working together or simply holding hands. Always convey a positive attitude, so as not to create anxiety. Interactions between loved ones and caregivers can help keep the affected person grounded and in the world, both receiving and giving love.

Posted in: Alzheimer’s & Memory Care
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How Caregivers Can Help Loved Ones with Oral Care

Posted by: The Bristal

Oral Care

As seniors age, they become more vulnerable to dental and gum problems. The danger is especially great for persons with dementia, who may lose the ability to properly practice oral care and be unable to alert caregivers to developing problems. However, caregivers can take several important steps to help their loved ones head off or lessen the effects of oral problems.

Several factors combine to make dental and gum problems more common among seniors. The Centers for Disease Control notes, for example, that gum recession, common in advanced age, exposes more and more of the dental roots to food, often resulting in cavities. Meanwhile, old fillings within the teeth may get partially chipped away, setting the stage for new cavities next to the original ones.

In addition, many seniors take prescription and over-the-counter medicines that cause dry mouth as a side effect, which contributes to oral problems. As the National Institutes of Health explains, saliva plays an important role in fighting tooth decay and oral infections. By inhibiting the production of saliva, the causes of dry mouth deprive seniors of the body’s natural defenses. Dry mouth also tends to increase the discomfort of denture wearers.

How can a caregiver address some of the difficulties listed above? Start by making an assessment of your loved one’s cognitive and physical capabilities as they apply to oral care. This will help you determine the extent to which self-care is possible and what level of assistance or intervention may be required on your part. If your loved one has sufficient physical dexterity and focus of mind for some degree of self-care, consider the following steps:

  • Make sure he or she is using a fluoride toothpaste, and add a daily fluoride rinse to the routine. Some people have the misunderstanding that fluoride use is only effective for children. That is incorrect. The Centers for Disease Control reminds us that fluoride should be used at “all ages.” It helps to strengthen teeth and prevent cavities at every age.
  • Impress upon your loved one that brushing at least twice a day is just as important as it is for young people. Preferably, use a brush with soft bristles, advises the American Dental Association. Flossing also is important, but if that is too difficult, other products are available in drug stores. As the Mayo Clinic suggests, “Resist the temptation to use toothpicks or other objects that could injure your gums and let in bacteria.”
  • Encourage your loved one to sip water frequently to keep the mouth moist and comfortable. Ask if he/she experiences dry mouth. If the answer is yes, ask the doctor if a medication may be to blame, and if so, whether a substitute drug is feasible. Also, consult with your loved one’s dentist regarding other possible causes and remedies regarding dry mouth.
  • Take your loved one to the dentist on a regular basis, at least twice a year.

If your loved one has very limited cognitive and physical abilities, caregivers will find it necessary to play a more active role in administering oral care. The Alzheimer’s Association, for example, advises that people in the middle and latter stages of the disease, “may forget what to do with toothpaste or how to rinse, or may be resistant to assistance from others.” In such cases, the association recommends trying short, simple instructions (“hold your toothbrush; put paste on the brush”) and using a “watch me” technique, in which the caregiver simulates brushing.

If you must do your loved one’s actual brushing, here are some tips to help you from the National Institutes of Health.

In general, if your loved one cannot communicate effectively, be aware of signs of pain or distress. Loss of appetite or resistance to oral care may be indications of something that needs to be addressed urgently.

Regardless of his or her state of health overall, proper oral hygiene can be a critical factor in heading off serious conditions and enabling a better quality of life for your loved one.

Posted in: Caregiving & Family
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Dancing May Improve Brain Health in Seniors

Posted by: The Bristal

The intense search for effective Alzheimer’s treatments has uncovered persuasive evidence that performing certain complex tasks may help the brain form new neural pathways that can slow cognitive decline and help ward off dementia. Most of those tasks are mental in nature, such as reading and doing challenging puzzles. However, there is also at least one physical activity that has been shown to help improve brain health: dancing.

Attention first began to focus on dancing with the results of a landmark study published in the New England Journal of Medicine in 2003. It showed that among 11 forms of physical leisure practiced by the study’s subjects over a 21-year span, frequent dancing was the only one that appeared to lower the risk of dementia.

Now a more recent study has produced new evidence that dancing can have beneficial effects on the tissue in the brain that biologists call “white matter,” which facilitates communication among different regions of grey matter in the brain. That communication is vital for preserving cognitive functions.

In the new study, conducted by scientists from five universities under the auspices of the University of Colorado, and partially funded by the National Institute on Aging, 174 healthy subjects aged 60 to 79 were divided randomly into four groups. Meeting in a gym three times a week for six months, one group took part in dancing, another was assigned to aerobic walking, a third combined aerobic walking with taking nutritional supplements, and the fourth served as a control group, confining its activity to stretching and toning exercises. Changes in areas of the brain were monitored periodically using a form of magnetic resonance imaging.

While the study’s complex findings covered a wide range of brain functions, the result that attracted the greatest level of attention is that the dance group participants experienced the most beneficial effects, strengthening the integrity of the white matter structure in their brains.

“We provided first evidence for a dance intervention resulting in (a white matter benefit),” said the study authors in their report. “We attribute this to the fact that dance is a combined cognitive, physical and social training, known to boost intervention outcomes.”

How can seniors best take advantage of these findings? The primary answer is: prudently. While physical exercise is encouraged for people of all ages as a part of a healthy lifestyle, seniors may want to speak to their doctor before adding dance into the mix.

It should also be noted that the dancing in the study involved predetermined steps and the social interaction associated with more formal dances. By contrast, many of us associate dancing with simply standing on a dance floor and “doing our thing” to the music. Seniors who are not acquainted with ballroom or country dances, or even hip hop’s more gentle movements (there are classes for seniors), may not experience the same benefits as those that the study participants experienced. If you’d like to add dance in as a part of your health routine, opt for lessons or learn from your spouse or other dance partner.

Equally important, if your physical circumstances, or your loved one’s, simply will not allow for dancing, do not be discouraged. Virtually all forms of physical exercise can be highly beneficial, even leisurely walks. Do as much as you can, for yourself and your loved one.

Posted in: Lifestyle Blog
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Why Assisted Living is a Great Choice for Seniors

Posted by: The Bristal

Today’s seniors often live longer than members of previous generations did, but health challenges — both physical and cognitive — in the senior years can make it difficult or impossible to go on living independently at home. For seniors, the most basic daily chores; dressing, bathing, doing laundry, cleaning the kitchen and bathroom, vacuuming and so on; require more effort. While many elderly people want to remain in the old family house or apartment — with all its comforts and memories — the inability to keep it up can become an overwhelming burden.

Assisted living communities provide a great option for people who are ready to be relieved of some responsibilities of daily life, but are healthy enough not to require professional nursing care. For many choosing this option, the result can be renewed pleasure and participation in life.

Assisted living communities provide services and a social life that can make daily life easier, more comfortable and livelier. At an assisted living community, each resident is provided with his or her own room and bathroom. All the burdensome housekeeping tasks, such as cleaning and laundry, are done by the staff. Meals are served in a pleasant communal dining room, promoting socialization, and snacks and drinks are available around the clock. This means there’s no need to shop, cook, serve or clean up; just show up and enjoy each meal.

Aides are there to administer medications and help or supervise, as needed, with such everyday tasks as bathing, dressing, and grooming. Many assisted living communities provide the services of barbers, hairdressers and manicurists on site. Each day, different group activities are offered, including exercise sessions, holiday celebrations and outings for shopping and entertainment. Residents are also free to go out on their own and to receive visits from family and friends whenever they would like.

Assisted living apartments provide privacy and preserve independence; each resident can furnish and decorate their individual apartment to suit their own unique personality. Cable TV, phones and wireless internet are available in each apartment. When the resident leaves his or her apartment, the community is there to provide potential friendships, company at meals and engaging social activities. These activities are not mandatory; residents can choose which to participate in, based on their interests.

An assisted living arrangement typically is more financially manageable than the old house or apartment ever was, because all meals, utilities, transportation, housekeeping and personal assistance needed each day is included in the monthly fee. With so much taken care of, residents can once again live life to the fullest, enjoying dignity, companionship, and the exercise of personal freedom to make the most of each day, knowing any help they might need is already there.

Posted in: Transitioning to Assisted Living
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Understanding the Stages of Alzheimer’s Disease

Posted by: The Bristal

Alzheimer’s disease progresses slowly through a series of stages, gradually worsening over the period of a decade or more. By understanding those stages, a caregiver is better prepared to support his or her loved one, and to benefit from the activities and emotional connections that are still viable in the early and middle stages.

Because experts differ on how precisely they characterize each stage of the disease, opinions as to the actual number of stages vary. The Mayo Clinic, for example, delineates five stages, while other authoritative sources break down the characteristics of the disease into more or fewer categories. For the purpose of simplicity, here are general guidelines that will help the caregiver recognize how far Alzheimer’s has progressed and understand what to expect.

The early stages. As alterations in the brain leading to Alzheimer’s begin to occur, there usually are no recognizable changes in behavior at all. This is called the pre-clinical stage, and it can last for many years. When symptoms do start to appear, they are likely to take the form of mild memory lapses, especially regarding more recent events and discussions, and difficulty with certain cognitive functions. This is called mild cognitive impairment, or MCI. However, it is important to understand that not everyone with MCI is in the early stages of Alzheimer’s disease. These symptoms may simply reflect the aging process or the onset of dementia of a different type. The term dementia is used to describe the symptoms of various diseases or illnesses. It is important to understand that if these symptoms do occur, one should see a medical doctor for a full workup. There are illnesses that mimic Alzheimer’s disease and it is important that treatments are specific to the illness.

Over time, for a person who is actually in the early stages of Alzheimer’s, the problems will grow. Your loved one may begin to have difficulties finding his or her way to and from places away from home, even familiar places, such as favorite stores. He or she may misplace items frequently, have difficulty expressing thoughts clearly, and abandon tasks that require clear thinking and sound judgment. There also may be personality changes, including irritability and a tendency to avoid social situations.

Those are the common characteristics of mild dementia due to Alzheimer’s disease. A caregiver should be prepared to help with certain functions, such as household and finance management, and exercise greater vigilance over the loved one’s day-to-day well-being. There is also much that caregivers can do to help alleviate the anxiety their loved one may be feeling as he or she becomes increasingly aware of these cognitive impairments. It is important to concentrate on providing support rather than just control.

The middle stage. In the middle stage of Alzheimer’s disease, the effects of the disease grow to become moderate, at which point, it likely will be necessary not to leave your loved one on his or own. Memory loss usually starts to encompass details of one’s personal history, and there also may be difficulty in recognizing friends and even family members. In this stage, the person with Alzheimer’s easily can become confused about where they are, the time of day and what day of the week it is, and may show a tendency to wander. Early in the middle stage, a person with Alzheimer’s often retains some level of functionality in terms of hygiene and personal care.  A simplified daily routine is beneficial at this point.

Eventually, however, he or she will begin to need assistance with tasks, such as grooming, bathing and selection of proper clothing. In some cases, bouts of aggressive behavior reflecting suspicions of theft or conspiracy may flare up. Restlessness and agitation can become frequent behavioral characteristics, especially as evening approaches. This is a phenomenon known as “sundowning.” In some cases, visual or aural hallucinations may occur. Read our blog on suggested ways to cope with the symptoms of sundowning. Your loved one’s day should include purposeful activities. Continue to encourage independence by concentrating on what a person can do rather than what they can no longer do.

The severe stage. This phase of the disease is marked by an accelerating decline in physical abilities, together with continuing loss of mental function. The person will no longer be capable of coherent speech, and will need daily assistance with eating, dressing and bathroom activities. Incontinence is likely. He or she also may be unable to walk unassisted or to maintain a normal seated posture. In time, an inability to swallow properly, together with lack of physical activity, may lead to pneumonia or other lung infection, which is a frequent cause of death in Alzheimer’s disease.

For the caregiver, it is essential to pay close attention to one’s own physical and mental health throughout the arc of a loved one’s experience with Alzheimer’s. Consider joining support groups and enlist the help of family and close friends to provide periods of relief and diversion whenever feasible. Eat properly, and get as much physical exercise as you can. Do not try to do the impossible. The love and compassion you devote to your loved one will require that you take proper care of yourself.

Posted in: Alzheimer’s & Memory Care
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Helpful Relaxation Techniques for People with Dementia

Posted by: The Bristal

Anxiety and panic attacks often afflict people with symptoms of dementia, especially in the early stages of the disease, as they first come to grips with the loss of memory and declining cognitive capabilities. Caregivers can help calm their loved ones with a number of time-tested relaxation techniques. Not all of them will work in every circumstance, or with every individual, so a caregiver may have to take a trial and error approach to determine what steps are most helpful in getting a loved one to relax.

Begin by making your own assessment as to what factors seem to trigger anxiety in your loved one. Your own careful powers of observation, together with gentle discussions with your loved one, can yield important clues as to how to adjust his or her environment to reduce levels of anxiety and to choose the most appropriate relaxation techniques. Are loud noises especially upsetting? Is lack of sleep exacerbating anxiety? Is there a particular part of the day’s routine, or an activity that is prone to setting off a panic attack? The answers to basic questions such as these can help you take effective action to make your loved one more relaxed and comfortable.

Here are some ideas to consider:

Breathing exercises. Controlled deep breathing is one of the most widely recommended exercises for promoting calmness among people with dementia. By fully expanding the diaphragm, deep breathing allows oxygenated air to fill the lungs completely, prompting a relaxation response in the brain. By contrast, shallow “chest breathing” is associated with the release of stress hormones. There are many controlled breathing techniques, suggested by various authorities, but for your loved one it will be important to take an uncomplicated approach. In a quiet environment, simply encourage him or her to inhale slowly and deeply through the nose, causing not only the chest but the belly to expand; hold that position for a second or two, and then slowly exhale through the nose or mouth. Repeat the process for several minutes until he or she appears to be in a more relaxed state. Try to make this exercise a regular feature of each day, or whenever it seems necessary. By the way, as a caregiver, you may well benefit from practicing controlled breathing on yourself.

Yoga or tai chi. Do not assume that yoga and tai chi are beyond the physical capabilities of your loved one. Both of these holistic disciplines, which coordinate mind and body, are practiced at various levels of difficulty, including introductory courses that offer relaxing meditation exercises that you and your loved one may enjoy together. In addition to the calming effects of the exercises, the potential benefits include improvements in balance and participation in a social activity, which may help your loved one feel less isolated by his or her condition. Many private and non-profit organizations offer classes for people with limited mobility. However, check with your loved one’s doctor before engaging in yoga or tai chi.

Spending time outdoors. When weather permits, take slow walks together. Exposing your loved one to a pleasant outdoor environment can be a relaxing form of diversion. It breaks up the routine of the day and may take your loved one’s mind off sources of anxiety. Tending a garden is another fine out-of-the-house activity worth considering, offering fresh air along with a sense of accomplishment.

Listening to music. Listening to different types of music can help set the tone for the day. It can help invigorate or act as a calming element for your loved one, when needed.

Making things accessible. Not being able to locate commonly used objects can be an extra source of anxiety, and even panic for your loved one. Keep his or her possessions, such as grooming, hygienic and clothing items needed each day, well organized and within easy reach. If it seems advisable, go over their locations frequently.

Adjusting the environment. Light, noise, even cooking smells can have an impact on your loved one’s ability to relax. Be sure that indoor light levels are adequate for good vision in the daytime and appropriate for sleeping at night, using low-wattage night lights to allow for safe trips to the bathroom. If ambient noise from street traffic is a problem at night, consider a sleep machine that provides white noise or pleasant sounds, such as light rainfall or waves on a beach. As for scents, are there dishes whose aromas stir pleasant memories for your loved one? If so, put them to use as a source of calm, when feasible.

Exercise the brain. Cognitive exercises, such as playing cards, engaging in active discussions, and doing crossword puzzles and computer generated brain games can help keep the brain active. It is helpful to match abilities with the type of brain exercise. A challenge can be beneficial from time to time, but not in a situation where it can cause frustration.

Above all, be well attuned to the factors that tend to trigger or worsen anxiety in your loved one, and do your best to avoid or mitigate them. Dementia does not take away the need for an individual to feel purposeful and successful. By removing barriers and prepping for each part of your loved one’s daily ritual, you can help set the stage for success.

Posted in: Alzheimer’s & Memory Care, Caregiving & Family
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Top Ways to Help Seniors Reduce Stress

Posted by: The Bristal

Reducing stress is a major concern for seniors, often even more so for those with a chronic illness or a sedentary lifestyle. When we’re under stress, the brain releases hormones that support our “fight or flight” instincts. It’s a survival mechanism that makes us temporarily stronger and faster. However, “In late life, when the immune system tends to show functional decline, the effects of stress are especially potent. Stress can not only mimic, but also exacerbate the effects of aging,” as revealed in a National Institutes of Health study.

Moreover, seniors who lead an inactive existence, whether by choice or because of a disability, generally are even more susceptible to the effects of stress hormones because lack of exercise further weakens their natural defenses.

Here are some steps that can help you reduce levels of stress in your daily life:

Talk about it. Freely discussing the stresses you feel with someone who is trusted and caring can serve as a safety valve, relieving at least some of the stress for short periods. It also can be revelatory; you may learn something about what is causing stress that was not previously apparent, opening the way for a new course of action. Seeing a professional therapist may be most helpful, but if that is not feasible, talking to a family member or close friend is useful.

Find a “relaxation response.” According to the Harvard Medical School, “a big part of stress management focuses on triggering the opposite of the stress response: the relaxation response,” which helps lower blood pressure, heart rate and the stress hormones themselves. Yoga, tai chi, meditation and deep breathing exercises are examples of relaxation response triggers. Listening to classical music can have a similar effect.

Establish a good sleeping environment. Sleep is very important for stress reduction for a number of reasons, including the fact that levels of stress hormones are reduced during a sound sleep. Try to ensure that your nighttime environment is as conducive as possible to good slumber. Keep the room dark, except perhaps, for a small safety night light for going to the bathroom. Avoid eating heavy meals near bedtime, consuming caffeine or watching late night TV.

Pursue a more active and stimulating lifestyle. A dull, inactive daily routine offers no defense against stress. Make every effort to be as active as your physical condition allows. Take long walks when the weather is good, attend shows and lectures, participate in a book club or perhaps volunteer for a worthy cause. Go dancing or engage in aerobics or a mild form of sports, if feasible (and with a doctor’s prior approval, of course). All of these activities provide something to look forward to and may instill a sense of satisfaction and accomplishment, which can counter feelings of stress.

Focus on a balanced diet. Eat healthy foods and reduce consumption of processed and sugary products. Emphasize vegetables, fruits, nuts, whole grains and lean protein. Restrict use of alcohol and caffeine to modest levels. A healthy diet helps the body combat excessive stress.

Eat dark chocolate? Yes, according to the Center for East-West Medicine at UCLA, dark chocolate can “help relieve stress at the molecular level,” and also can be beneficial for people “suffering from high levels of anxiety.” While any dietary restrictions should be followed, a list of “comfort” foods that may help alleviate stress is available.

In general, give careful thought to identifying the sources of stress that affect you and take positive action to reduce or eliminate them to the fullest possible extent.

Posted in: Lifestyle Blog
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Understanding the Common Symptoms of Alzheimer’s Disease

Posted by: The Bristal

Alzheimer’s disease causes changes in the anatomy of the brain, which leads to declining mental functioning and memory loss. The range of symptoms, and the rate at which they progress, vary from person to person. Alzheimer’s disease is not a normal part of aging. In the early stage of Alzheimer’s, the patient or people around him or her may notice changes in cognition. Most people can do things to compensate for cognitive deficits in the early stages.

It’s always important to consult with a medical professional and receive a proper diagnosis when deficits in cognition are noted. Some types of dementia, such as those caused by drug interactions, depression or other reasons, can be treated, relieved or even reversed. While this, unfortunately, is not the case with Alzheimer’s, getting a diagnosis is crucial so that one can make a plan to get the right kind of care.

Symptoms of Alzheimer’s

Difficulty in remembering newly learned information is the most frequent early sign of Alzheimer’s. This is due to the changes in the brain that make it physically unable to form and retain new memories. As the disease progresses, more memories are lost. At this point, the person may only remember memories from the more distant past, but eventually, even childhood memories may be gone.

Apart from memory challenges, other symptoms may be present in the early stages of Alzheimer’s, including:

  • Communication difficulties, such as being unable to find words
  • Getting lost in familiar places
  • An increase in feelings of confusion, fear, anxiety or loneliness
  • Mood or personality changes
  • Lessened ability to concentrate
  • Poor judgment
  • Difficulty with planning and carrying through tasks in the proper sequence
  • Making mistakes in tasks you’ve always done effortlessly

As Alzheimer’s progresses, the symptoms increase in severity, and may include:

  • Disorientation, mood and behavior changes
  • Deepening confusion about events, time and place
  • Unfounded suspicions about family, friends and professional caregivers
  • More serious memory loss and behavior changes
  • Difficulty speaking, swallowing and walking

Behavioral Changes

The behaviors of people with Alzheimer’s can be emotionally challenging to experience, to witness, and to address. As the disease progresses, it’s crucial that loved ones offer understanding — as well as productive help — so that the deficits and emotional challenges of living with Alzheimer’s disease can best be handled. The main behavioral changes include:

  • Aggression, both verbal and physical, can be due to pain or fatigue, environment, medication side effects or communication problems. It’s important to always keep in mind the fact that the person with Alzheimer’s cannot help his or her behavior. It may arise from a particular frustration or have no apparent cause.
  • Agitation arises when people with Alzheimer’s are biologically experiencing a decreased ability to absorb new information and cope with their surroundings. It can also arise from certain medical conditions, fatigue, changes to the environment or personnel, or other factors giving rise to fear, anxiety or frustration.
  • Depression is common in the early and middle stages of Alzheimer’s disease as the individual is aware of diminishing mental functioning. Depression may be hard to diagnose because the symptoms may overlap with those of Alzheimer’s. These symptoms should not be ignored; a physician can diagnose and prescribe treatment that may help relieve them.
  • Confusion is a common symptom in Alzheimer’s, when a person with the disease may cease to recognize familiar people, surroundings or the passage of time, as well as the purpose of common household items, such as pens or spoons. Confusion can occur in varying degrees of severity and is especially common after a change in living situation or daily routine.
  • Hallucinations, in which a person perceives things that are not physically present, is a common symptom of Alzheimer’s disease, involving any or all of the senses of seeing, hearing, tasting, smelling and feeling. Hallucinations can be frightening to the person having them, though not always — sometimes they are a return to the past.
  • Sundowning occurs when a person with Alzheimer’s experiences problems with sleep and/or cognition. These problems may worsen at dusk and can persist all night. Some 20% of people with Alzheimer’s are estimated to suffer increased symptoms of confusion and agitation that begin late in the day, according to the Alzheimer’s Association. Others may have restless nights of broken sleep.
  • Wandering affects 60% of people with dementia, according to the Alzheimer’s Association. Anyone with Alzheimer’s who can walk is susceptible to wandering and getting lost, due to the potential inability to remember his or her name, home address or the route to return home. Those who speak about wanting to go home even when at home, or who cannot locate the kitchen, bedroom or the bathroom within their own residence, are more likely to wander.

It’s important to learn as much as you can about Alzheimer’s disease, participate in making a comprehensive plan for your immediate future and take advantage of the assistance and coping support that may be available in your community. Early diagnosis and intervention methods are improving all the time.

Posted in: Alzheimer’s & Memory Care
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Tips on How Seniors Can Stay Fit This Summer

Posted by: The Bristal

While staying fit should be a prime objective for seniors all year round, there is no denying that warm weather allows for a range of outdoor activities that can make daily fitness more fun in the summer. Here are some of them:

Do aerobics in a pool. You don’t have to be an Olympic swimmer to get enormous benefits from exercising in a pool. In fact, you don’t have to swim at all. For example, the simple act of walking in waste-high water is a great muscle-toning exercise. Many gyms and community organizations offer water exercise classes for seniors.

Take early morning walks. A long walk before the temperature gets too high can be an invigorating way to start the day. Do it on your own if you prefer a contemplative experience, or arrange to do it with your spouse or friend. Walking improves circulation, strengthens bones and muscles, supports your joints and may even help avoid dementia, according to the Arthritis Foundation.

Tend a garden. It doesn’t sound strenuous, but gardening requires a lot of movement, and uses many different muscles. For seniors who have sufficient range of movement, it is an excellent way to retain strength and flexibility. Gardening also can be a highly social experience. Consult the 126-year-old National Garden Clubs for information about a club in your area.

Ride a bike. It’s said, one never forgets how to ride a bicycle, and that must be true, because according to the AARP, seniors comprise the fastest growing group of cyclists. Health benefits are one of the major reasons for this trend. If bike riding appeals to you, it’s best to stick to parks and streets that have designated bike lanes.

Consider Tai Chi. The ancient Chinese practice of Tai Chi Chuan is an exercise that involves a series of relaxed and graceful movements that “have potential for a wide range of benefits” for seniors, according to Mount Sinai Hospital.  Those benefits include improved balance, coordination and flexibility, as well as reduced stress. Many non-profit organizations, including some “Ys”, offer Tai Chi classes for seniors. Classes often are conducted in parks in the early morning.

For some other ideas on how to stay socially active outdoors, visit https://thebristal.com/blog/staying-socially-active-part-2/.

Regardless of which summer fitness activities you choose, several basic precautions must be taken to ensure your safety:

  • Do not begin any activity without consulting with your doctor to be certain it is appropriate for your current state of health.
  • Avoid strenuous activities during mid-day; try to schedule them primarily in the morning before too much heat has built up.
  • Stay properly hydrated; take water with you and drink it even if you do not feel thirsty. Also important, avoid alcohol and caffeine, which act as diuretics and eliminate water from the body.
  • Put on loose fitting, comfortable clothing, and wear a hat if you will be directly exposed to the sun. Be sure to use a strong sunscreen on all exposed skin.

With these points in mind, take advantage of all the summer activities that make fitness fun!

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When is the Right Time for a Memory Care Community & What to Consider?

Posted by: The Bristal

Alzheimer’s disease is the common form of dementia, whose effect is a progressive loss of cognitive abilities. Some families may choose to place their loved one with Alzheimer’s into a memory care community, a type of long-term care that is designed to meet the needs of a person with Alzheimer’s disease or dementia. It provides around the clock care and assistance with the tasks of daily life, such as bathing, dressing, grooming, medications, etc. They also provide daily recreational programming and outings, all tailored to your loved one’s ability, so there is always something fun and social to do.

Memory care areas are typically situated within assisted living communities, but can also be standalone communities. Availability varies based on the area you live in and if there is space at the community. Because laws vary from state to state, it’s important to ask specific questions about what type of care is provided in a memory care community to ensure that the level of care is appropriate for your loved one.

When deciding whether it’s time for memory care, it can be helpful to consider these questions offered by the Alzheimer’s Association:

  • Is the person with dementia becoming unsafe in his/her current home?
  • Is the health of the person with dementia (or the health of the caregiver) at risk?
  • Do the person’s care needs extend beyond the caregiver’s emotional and/or physical abilities?
  • Would the structure and social interaction provided at a memory care facility benefit the person with dementia?

The difference between assisted living and memory care is that memory care communities have staff which are specially trained on caring for people with Alzheimer’s disease and other forms of dementia. Activities are planned with the population in mind, designed to support socialization and stimulate cognitive abilities. Additionally, memory care communities are secured to ensure consistent and familiar surroundings, and to prevent wandering – a major behavioral issue with people suffering from Alzheimer’s disease.

Costs depend on the level of care the individual needs, as well as the size of the room, whether it’s private or shared, plus the community’s geographical location.

In considering whether any particular assisted living or memory care area can meet the needs of an individual suffering from Alzheimer’s disease, there are three major considerations: how good is the quality of the care, how robust is the activity program and finally, how well-laid-out and maintained is the facility?

Here are some things to look out for when touring a prospective community:

  1. Is the facility responsive to family requests, and do they allow family members to visit at any time?
  2. Does the community resemble a home or nice hotel, light and airy? Are common areas actually used by residents?
  3. How does the staff interact with you and with the residents? Are they friendly? Do they seem to know the residents well?
  4. Is the calendar of activities varied and aimed at meeting the social, physical, emotional and spiritual needs of the residents? Is there arts programming? Are activities led by skilled activity coordinators?
  5. How is the care staff trained? An ongoing training program is important to ensure that staff is aware of current best practices for care.
  6. What are the rooms or apartments like? Is the dining area pleasant? Check out the bathrooms, as well as the room in which the person will live, in order to evaluate whether the privacy needs of the individual will be met.
  7. Is the building well-maintained, with rooms and furniture clean, odor-free, and in good repair?

When being given a tour, make notes regarding the above situations. This way, you can always refer back to them and refresh your memory when it comes time to make a decision. Ask questions and expect good answers in return.

Transitioning a loved one into any kind of assisted living or memory care situation can be stressful and emotional, but bear in mind that gathering good information in advance can relieve some of the worry and help maximize the chance of making the right decisions. Regardless of where the care takes place, it should be a priority that the person you care about receives the care that he or she really needs, in a safe and caring environment.

Posted in: Alzheimer’s & Memory Care
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How to Help an Aging Loved One During a Hospital Stay

Posted by: The Bristal

Hospital stays tend to be especially stressful for seniors, who must give up the familiar surroundings of home in exchange for the strange environment of a medical facility. However, there are many things that a senior’s spouse, children or other caregiver can do to reduce the stress and anxiety from an aging loved one’s experience in the hospital.

Here are some helpful tips: For starters, be aware that in recent years, geriatric specialists increasingly have called attention to the phenomenon known as hospital-acquired delirium, a temporary form of mental impairment that may affect seniors in a hospital setting, especially those in an intensive care unit. This condition, common even among patients who have not previously shown signs of dementia, can lead to complications, lengthen the hospital stay and result in problems even after the patient returns home. According to the Harvard Medical School, hospital-acquired delirium is “the most common complication of hospitalization among older people.”

To help prevent its onset or lessen its effects, experts recommend the following:

  • Take along to the hospital a few items that are familiar or even cherished by your loved one, such as family photos or a favorite article of clothing.
  • To the extent possible, familiarize your loved one with the immediate environment of his or her room and the hallway. This may help to remove some of the disorientation he or she may feel.
  • When visiting, talk about topics with which you and your loved one are mutually familiar, and which he or she enjoys. Stimulate the conversation with interesting news of family and friends. Take walks in the hallway together, if practical, after advising the nursing staff of your intentions.
  • Try to time your visits with the serving of meals. Having company during meals often stimulates the patient to be more enthusiastic about the food and to consume more. Bring a favorite food treat to supplement the meal, if doing so does not violate any dietary restrictions. Also, encourage your loved one to drink water and other fluids to guard against dehydration, which can contribute to delirium. If your loved one enjoys reading, make sure there is ample access to the types of reading material – books, e-books, magazines — he or she enjoys.

In general, to help minimize stress, do all you can to keep your loved one stimulated and mentally connected to his or her home life, family and friends while he or she is in the hospital.

Other ways to help your loved one during a hospital stay include:

  • Bring a complete and accurate list of your loved one’s medications and dosing schedule and provide it to the nursing station. Make sure the nurses and hospital staff physician are aware of any problems your loved one may have with taking medications.
  • Keep in mind that certain medications, including sedatives, sometimes can precipitate delirium. If you suspect that your loved one may be receiving too much sedation, do not hesitate to raise the issue with hospital staff.
  • Bring a small amount of cash, no more than a few dollars to cover incidentals. Discourage your loved one from bringing jewelry and other valuables.
  • Make sure to stay abreast of the hospital’s plans for your loved one’s discharge, especially if he or she will need a rehabilitation facility before returning home. Decisions about when to discharge a patient are heavily influenced by Medicare reimbursement rules. Research rehab centers as early as possible, preferably before your loved one enters the hospital.

Finally, be aware that most hospitals have social workers on staff who can provide counselling, help resolve issues and assist in finding sources of supplementary services in the community. Get to know the social worker assigned to your loved one as soon as you can. It can be a big step toward alleviating your anxieties, as well as those of your loved one.

Posted in: Caregiving & Family
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Ways to Boost Your Energy as a Caregiver

Posted by: The Bristal

The physical demands of taking care of a loved one can make the caregiver feel drained of energy at times. The caregiver may even be making the problem worse by practicing eating and lifestyle habits that contribute to the energy drain, or by overlooking opportunities to become more energetic. If you are a caregiver who feels in need of an energy boost, consider the following suggestions:

Eat the proper foods. It is hard to overstate the importance of proper food choices on boosting and maintaining energy levels. For example, while sugary snacks often are intuitive choices for a quick energy boost, and may also offer the prospect of a little “reward” for the difficult tasks a caregiver faces, in fact, they do more harm than good. That is because your energy level can plunge once your body uses up the sugar, making you feel even more tired. Moreover, such foods contribute to unhealthy weight gain. The alternative is to snack on fruits and nuts, which provide a steadier energy boost derived from highly beneficial nutrition. Similarly, at regular meal times, give preference to nutritionally well balanced meals and try to avoid processed foods that remove fiber and usually contain too much salt.

Do NOT skip breakfast. This is the meal that sets the day’s energy supply in motion. As for mealtimes in general, avoid heavy amounts of food, which require a lot of energy from your body to digest and can leave you sluggish. Eat light meals, spaced about four hours apart, up to four meals a day if that works for you.

Avoid excessive caffeine. It’s tempting to rely on a second or third cup of caffeinated coffee for an energy boost, but that boost is likely to be offset by caffeine’s damaging effect on sleep. In addition, the caffeine can have unwanted side effects, advises the Mayo Clinic. Those potential effects include nervousness and irritability, in addition to insomnia, all of which are factors that a caregiver emphatically wants to avoid. Consume caffeine in modest amounts, and never close to bedtime.

Make good use of water. Drink several glasses of water each day to stay properly hydrated because even mild dehydration can make you feel rundown. Moreover, splashing cool water on your face is an easy way to reinvigorate yourself when energy starts to lag. Going a step further, as the AARP points out, taking a cold shower during the day is an even more powerful remedy, provided your loved one can be unattended or there is a stand-in caregiver available for the time it takes to do so.

Get exercise and fresh air. Exercise is widely recognized by medical authorities to reduce feelings of fatigue and boost energy levels. One study, for example, from the University of Georgia, found that moderate exercise reduced levels of fatigue by 65 percent and increased energy levels by 20 percent. Of course, it can be difficult for a caregiver to work regular exercise into a daily routine, but try to take a walk each day. The fresh air also will help counter the sometimes draining effects of being indoors all day. If you cannot always get away for a brisk walk, take your loved one for a more casual one, if possible.

Get enough sleep. Sleep deprivation is one of the most prevalent and difficult problems that caregivers face, and it is a major contributing factor to feeling rundown and lacking energy. In a recent post, this blog offers a number of suggestions on ways to get the sleep you need to protect your own health while being the best possible caregiver to your loved one. Consider making those suggestions part of an overall program to boost your energy level.

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