With Alzheimer’s, it becomes emotionally very difficult for family members who are involved in the daily care of the patient. Here are a few tips to help family members manage their dear ones with Alzheimer’s disease:

Avoid generalising the memory loss

Alzheimer’s patients tend to not remember most things, due to which family members or care givers may tend to assume that they remember nothing. Such assumptions can be detrimental in the care of the patient as it further alienates them from the people around them and may set back their treatment and worsen prognosis.

Support them in retrospection and recollection

The ability of Alzheimer’s patients to remember diminishes with age, therefore patients tend to forget recent events more readily. Though they tend to remember cherished memories which are deeply engraved in their minds, talking about the old times helps them in recollecting those memories. Going through family photos, videos or reminiscing about events may help them to jog their memory in a relaxed manner without them feeling pressurised to recall something that they may have forgotten. Allow them to take the lead in a conversation.

Address them by their name

Based on the patient-caregiver relationship, it is important to call the patients by their name. This helps in keeping the relation in perspective and they become more acceptable of the people around them.

Create eye contact and sit at the same level

It is important to make the patient feel that they are being cared for. Eye contact plays a very important role in comforting them and creating a sense of belonging. Maintain eye contact with them. Instead of standing over them, sit at their level, as this helps in reducing the feeling of skepticism they may feel about your actions.

Help them understand

While speaking, keep the pace slow and talk to them in short sentences so they can comprehend better. Alzheimer’s impacts their capability to understand many different things at a time. If introducing a new person, activity or a change in their routine, be extra patient with them as they may have many questions or may take time to comprehend you.

Be patient with them

Many a times Alzheimer’s patients ask questions that can irritate and frustrate family members or caregivers. Therefore, the situation needs to be handled with patience. Talking to them like they are children may not work either. Also, one should not force them to recall anything during conversations as they may feel embarrassed and insulted. From time to time you can have a discussion with them, and get them to agree that they can just ask for answers when they are unable to recall something.

Build involving and consistent experience

It is not easy to involve Alzheimer’s patients in social activities at home. But the patient can be involved with other family members by engaging them through pictures and music. It is advisable not to shift their rooms or living place frequently as they take more time to adjust to the surroundings.

Take safety measures

Use anti-slip mats at home which can be replaced for the safety of the patient. Leave the lights switched on at night as they might lose direction at home or trip while walking. Make sure that the doors are locked to avoid the patient from wandering out. Inform neighbours about the patient’s condition, so that help can be sought quickly in case of an emergency or when the patient is alone at home. Keep the home—or at least the patient’s room—clutter free and devoid of any sharp objects or plastic bags, in order to avoid risk of injury or suffocation.

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Advances in medical sciences means that fewer people die young. As the population grows older, there are newer health problems facing us: age-related neurodegenerative disorders. More and more older people are now finding themselves in the danger zone of Alzheimer’s and Parkinson’s diseases. It is projected that by 2050, the number of people suffering from Alzheimer’s will triple—from five million today to 15 million.

In this TEDx talk given at the John Hopkins University, neuroscientist Dr Mark Mattson establishes a clear link between our energy intake and cognitive abilities of the brain.

In his laboratories, Dr Mattson found that reducing the energy intake in mice could increase their lifespan by 30-40%. So he and his team started studying the effects of energy restrictions on the brain in the context of age-related neurodegenerative diseases. What they found is that when they reduced the energy intake, they could slow down the factors that lead to the degeneration of neurons in the brain.

Dr Mattson shares a few anecdotal insights on the benefits of fasting, a practice that goes back thousands of years before explaining the benefits of intermittent fasting. “Fasting is a challenge to your brain and your brain responds to fasting by activating adaptive stress response pathways that help [it] cope with stress and resist disease,” says Dr Mattson.

Whether you want lose weight, lengthen your lifespan, reduce the risk of neurodegenerative conditions such as Alzheimer’s disease and Parkinson’s disease or simply have greater energy, fasting is a proven way to do it, provided you do it correctly. Watch this talk to find out more.

About Mark Mattson

Chief of the Laboratory of Neurosciences at the National Institute on Aging. He is also a professor of Neuroscience at The Johns Hopkins University. Dr Mattson is one of the foremost researchers in the area of cellular and molecular mechanisms underlying neurodegenerative disorders such as Alzheimer’s Disease, Parkinson’s Disease, and amyotrophic lateral sclerosis.

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My mother is angry about her diagnosis. More than anything it’s that she’s caught something my father has not. “Don’t come into my MRI appointment with me,” she sneers in my dad’s direction. “They may figure out that you have it too.”

My father has never been a patient man. He ignores her and heads towards the garage.

“I may outlive all of you,” she says as he closes the back door. She flips through a pamphlet on dementia from her doctor. She says to me, “Sometimes it’s better for old people not to know all this stuff.” She recently turned 73. After a year of mom’s absent mindedness, my dad made an appointment for her with their family doctor.

Now I look over her shoulder at the description of ’cognitive decline’. She pronounces the words slowly: cog-NITE-ive. I read moderate dementia, a label I suspect may anger her the most. Like saying ‘half pregnant’—you know what’s coming.

After a week on Alzheimer’s medication, her disposition seems to improve. “Dad even cuddled me,” she tells me one day. “And I get two kisses: morning and night.”

One day I show up at my parents’ house when they’re in the middle of an argument. I take a spot at the dining room table. Lately my mom is angry at my dad much of the time. “You shut up,” she yells at him. “You don’t know.”

When we were kids none of us was allowed to say “shut up.” I’m still shocked every time I hear it come out of my mother’s mouth. Until recently, I’d never heard her yell.

My dad clears his throat the way he does before he cries.

She says to me, “People keep saying I have something, but I don’t. What is it called again?” Part of me wants to burst out laughing: the Alzheimer’s patient can’t remember the name of her disease. “Mom,” I say gently. “You have Alzheimer’s.” It’s the first time I’ve used that word with her.

“No, I don’t,” she says. “My doctor said I have memory loss. Not Alzheimer’s. Dad forgets things too, you know.” How happy she’d be if he was also afflicted, and she wasn’t alone.

“He does forget some things, but you’re the one on Alzheimer’s medication.” I’m not sure where this is going. My mother has never been reasonable.

“For memory loss,” she says. “And I’m going to start to take more pills.”

“And why do you want to take more?” “To stop the memory loss.”

“Because it’s getting worse?” I ask. I want her to admit what she’s said to my sisters and forgotten: that she thinks she can actually feel the blood vessels in her head bursting and she can’t remember anything anymore.

I know she uses 20 dollar bills for book marks and that my dad doesn’t leave her alone when they go to a grocery store or the casino. I know her arms are often covered in burns from the oven. I suspect that by tonight she’ll forget I was here today.

She says, “Because if I take one pill, then two would be much better.”

This was first published in the July 2014 issue of Complete Wellbeing.

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My father had always been 90 per cent great, but his temper was a doozy. He’d never turned it on me before, but then again I’d never gone against his wishes either. When my mother nearly died from an infection caused by his inability to continue to care for her, I flew from southern California to San Francisco to try to save her life—having no idea that in the process it would nearly cost me my own.

Playing Jekyll and Hyde

I spent three months nursing my mother back to health; while my father said he loved me one minute, he’d get furious over some trivial little thing, call me nasty names and throw me out of the house the next. I was shocked to see him get so upset, even running the washing machine could cause a tizzy, and there was no way to reason with him. It was so heart-wrenching to have my once-adoring father turn so much against me.

Choked!

I immediately took my father to his doctor and was flabbergasted that he could act so darling and sane when he needed to. I could not believe it when the doctor looked at me as if I was the crazy one. Then things got serious. My father had never laid a hand on me my whole life, but one day he nearly choked me to death for adding HBO to his television, even though he had eagerly consented to it just a few days before. Terrified, I called the police and asked them to take my father to the hospital for evaluation. I was so stunned when they released him right away, saying they couldn’t find anything wrong with him.

A year-long ordeal

I was trapped. I couldn’t fly home and leave my mother alone with my father—she’d surely die from his inability to care for her. I couldn’t get healthcare professionals to believe me—my father was always so normal in front of them. I couldn’t get medication to calm him; he refused to take it or flushed it down the toilet. I couldn’t get my father to accept a caregiver. I couldn’t place my mother in a nursing home; he’d just take her out. They both refused Assisted Living and legally I couldn’t force them. I became a prisoner in my parents’ home for nearly a year trying to solve crisis after crisis, crying rivers daily, and infuriated with an unsympathetic medical system that wasn’t helping me appropriately.

What the heck!

You don’t need a doctorate degree to know something is wrong, but you do need the right doctor who can diagnose and treat dementia properly. Finally, I stumbled upon a neurologist who specialised in dementia and performed a battery of blood, neurological, memory tests and scans on my parents. He also reviewed my parents’ medications and ruled out reversible dementias such as a B12 and thyroid deficiency. And then, you should have seen my face drop when he diagnosed Stage One Alzheimer’s in both of my parents—something all other doctors had missed entirely.

Polar opposites

So, what I’d been coping with all these days was the beginning of Alzheimer’s, which begins intermittently and appears to come and go. I didn’t understand that my father was addicted and trapped in his own bad behaviour of a lifetime and his habit of yelling to get his way was coming out over things that were illogical… at times. I also didn’t understand that demented does not mean dumb and that he was still socially adjusted never to show his ‘Hyde’ side to anyone outside the family. Even with the onset of dementia, it was just amazing how he could still be so manipulative and crafty. On the other hand, my mother was as sweet and lovely as she’d always been.

Balancing brain chemistry

I learned that Alzheimer’s makes up 65 per cent of all dementias and there’s no stopping the progression nor is there a cure. However, if identified early there are four FDA approved medications that in most people can slow the symptoms of the disease, keeping a person in the early independent stage longer, delaying full-time supervision and care. More medications are still in clinical trials.

After the neurologist treated the dementia and the depression [often present with dementia] in both parents, he prescribed a small dose of anti-aggression medication for my father, which helped smooth his temper without making him sleep all day. It wasn’t easy to get the dosages right, but at least we didn’t need police intervention any longer. Once my parents’ brain chemistries were better balanced, I was able to optimise nutrition, fluid intake and their medicines with much less resistance.

Finding creative solutions

Finally, I was also able to implement techniques to cope with my parents’ bizarre behaviours. Instead of logic and reason, I used distraction, redirection and reminiscence. Instead of arguing, I agreed, validated frustrated feelings and lived in their realities of the moment. I learned to go with the flow and let the nasty comments roll off. If nothing else, the bribe of ice-cream worked the best to get my father in the shower, even as he swore at me that he’d taken one yesterday.

Then finally, I was able to get my father to accept a caregiver. And with the tremendous benefit of Adult Day Care five days a week for them and a support group for me, everything started to fall into place. It was so wonderful to hear my father say once again, “We love you so much, sweetheart.”

Infuriation to passion

No one discussed with me the possibility of the beginning of dementia in my parents that first year. One out of eight elderly people by the age of 65, and nearly half by the age of 85 get Alzheimer’s. Healthcare professionals need to know the warning signs of Alzheimer’s [see box] and share them with patients to save everyone so much time, money and heartache.

What I had endured, compelled me to give up my career as a television executive to become an advocate for eldercare awareness and reform. Passion to save others from a similar experience [or from getting so frustrated that they commit elder abuse] somehow resulted in my first book, Elder Rage, or Take My Father. Please: How to Survive Caring for Aging Parents. I also launched the ‘Coping with Caregiving’ radio programme to help caregivers.

Now I am grateful for the experience that took me to my knees and nearly destroyed me, as it was also the catalyst that compelled me to a higher purpose, passion and reward than I could have ever imagined.

This was first published in the February 2010 issue of Complete Wellbeing.

Reprinted with permission of the Alzheimer’s Association

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