There are many useful resources at our disposal such as exercise, leisure activities, and cognitive tasks that therapeutically reduce the risk factors of dementia, Parkinson’s disease, and Alzheimer’s. In all of these conditions the neurons and tissues in the brain can deteriorate, which can impair our ability to use our mind to its fullest ability. The effects of neural impairment can affect our memory, our ability to perform basic motor functions, and our basic understanding of responsibilities and relationships. Having a loved one with dementia or a condition precipitating dementia-related symptoms such as Parkinson’s, Huntington’s, or Alzheimer’s can place profound accountability on ourselves, family members and caregivers. We should all take some time to acknowledge the tremendous potential of various strategies for preventing cognitive remissions and deterioration and make sure we are taking proactive steps to stay sharp as we age.

Idle Hands are the Devil’s Playground
It is vital that we elderly, family members, and caregivers truly utilize our creative tool boxes and find regular activities that keeps the mind engaged to some capacity. Walking, dancing, exercising, and even housework can all profoundly replenish endorphins, hormones, and chemicals in the brain which serve to help prevent neural deterioration. However, if mobility is an issue of concern and you find that physical exertion is either risky or too difficult to accommodate, then there are other ways to attain the desired effects through mental exercise.

Studies have shown that much is to be gained from steady participation in simple activities such as these leisure activities which require less physical exertion:

•   Reading
•  Writing for Pleasure
• Doing Crossword Puzzles
• Playing Cards
• Playing a Musical Instrument
• Playing Board Games

Whichever strategy you find to be more comfortable—exercise-based, cognitive-focused tasks, or a combination of the two, remember to choose tasks that come natural to you. The type of activity performed is far less fundamental toward a healthy brain than the frequency and consistency of involvement, so make sure to choose a task you are confident you can incorporate in your daily routine with regularity.

Mild Cognitive Impairment
Many studies have been conducted over the last several decades with regards to the specific activities that can serve to keep the mind from deteriorating via physical exercise, mental activities, continued hobbies, and music therapy. All of the studies arrive at the same conclusion: than no single task has been identified as overwhelmingly more effective than the other activities, so rest assured there is likely a fun, meaningful activity that is suited for everyone. It is important, however, that we determine that task organically and make sure to incorporate it in our daily lives with vigilance.

These studies sought to establish whether or not, for example, playing chess three times per week would prove more effective than 15 minute walks three times per week. Although most studies did seem to indicate a very slight favoritism toward exercise as a task that mitigates mental deterioration more effectively, the improvements were very minimal. Concurrently, studies such as The Bronx Aging Study which followed the activities and health of individuals from 75-85 years of age for 20 years found that individuals who strayed from their routines suffered the greatest risk for developing dementia. In addition, several of these studies seemed to find that many individuals who developed dementia-related characteristics in later years were less involved in leisure activities and exercise, but that this may have very well been as a result of having Mild Cognitive Impairment to begin with.

What we can take away from these claims is that it is never too early to build a strong routine to defend against neural deterioration. Once our mind becomes less engaged with our relationships and daily activities, we begin to lose the motivation to follow the instructions of our caregivers, doctors, and even family members. We must then develop regular routines that we don’t view as burdens, so that we can more willingly adhere to these vital proponents of our continued health and prosperity.
Patients with Mild Cognitive Impairment are generally able to live their lives without the assistance of others, but they will experience issues with memory, language, and some basic cognition problems. It is possible for MCI to remain unchanged throughout the years, to progress into Alzheimer’s, or to fade and allow an individual to regain full cognitive ability. Again, proper involvement in exercise and/or leisure activities along with a proper brain-healthy diet are the best tools to mitigate the progression of cognitive loss. So, detecting MCI early becomes equally fundamental toward reducing risk as we age further.

These early warning signs will help identify the onset of Mild Cognitive Impairment:

• Frequently Misplacing or Losing Things
• Frequently Forgetting Conversations, Appointments, or Events
• Difficulty Remembering the Names of New Acquaintances
• Difficulty Following the Flow of a Conversation

Final Thoughts
Developing any form of cognitive deficiency, dementia, or otherwise neural incapacity is both a struggle for the individual and the family members and caregivers supporting that individual. Depression is a likely side-effect of dementia once it has set in, and it then becomes increasingly difficult to perform these exercises and leisure activities that serve to sharpen or mental acuity. No small task is too insignificant to aid in the process of exercising the mind, and we as caregivers, family members, and potential dementia sufferers should make an earnest effort toward incorporating a lifestyle rich with steady activity. Whether we choose to walk around the yard, take up knitting, playing chess, stroking the piano, doing dishes, or reading the paper, stick to a routine that you find fun and meaningful to ensure that you maintain those habits and promote a healthy mind for as long as possible.

Educating yourself is a pivotal part of developing a strategy that combats worsening symptoms. The Understanding Dementia article linked below provides a great reference for the various kinds of symptoms and types of dementia that can afflict our beloved elders, along with steps you should be taking with your caregivers and physicians.

References
-The New England Journal of Medicine; Leisure Activities and the Risk of Dementia in the Elderly; http://www.nejm.org/doi/full/10.1056/NEJMoa022252#t=articleTop
-The Nurse Practitioner; Exercise Alleviates Dementia in Elderly
-Understanding Dementia; http://www.helpguide.org/elder/alzheimers_dementias_types.htm

During the close family gatherings you had during this past holiday season you may have noticed a depreciation of cognitive abilities in a loved one. The early signs of dementia are often difficult to detect or could be misinterpreted, for many of them are common expectations of aging.

Mild cognitive impairment is an intermediate state between developing dementia and forgetfulness due to aging. The first thing to look for is forgetfulness, which often does not stand out because this is a common vulnerability for the elderly. According to the UCSF Memory and Aging Center, the most typical memory complaints include difficulty with the following: names of people, the location of recently placed items, and conversational skills. Other signs of mild cognitive impairment include difficulty recalling recent events or conversations, multi-tasking, and problem solving. Yet, it is important to note that despite its association with Alzheimer’s disease or other forms of dementia, this intermediate stage will not necessarily develop into dementia.

The later stages of dementia can be distressing for families, and assistance may be required. According to the Alzheimer’s Society, people in the later stages of dementia will likely experience severe memory loss and may have difficulty recognizing friends and family. However, they are likely to still appreciate stimuli such as music, scent and touch. Alzheimer’s disease is the most common form of dementia, and there are more specific warning signs for its onset.

The Quad-City Times summarizes the signs to look for in terms of assessing Alzheimer’s disease:

• Forgetfulness- similarly to the condition of mild cognitive impairment, the most common sign of Alzheimer’s disease is forgetfulness, especially about recent events and dates.
• Difficulty with decision-making, problem solving, or familiar tasks at home, such as cooking from a recipe or playing a game.
• Confusion about the passage of time and places. For example, one may become suddenly bewildered about his or her whereabouts.
• Vision and perception problems, with difficulty reading or classifying space or color.
• Tendency to remove oneself from social activities and lose interest in his or her hobbies or work.
• Changes in personality- people with Alzheimer’s disease are susceptible to anxiety and depression and can become easily confused, upset, and fearful.

It is important to detect Alzheimer’s so that one with this disease can receive proper care. While family members and friends may want to be there to assist as much as possible, it may be difficult to offer the extent of the help one needs and deserves. Utilizing Aarris Homecare’s services for companionship and assistance is an excellent alternative to uprooting a loved one and sending them to a facility.

Sources:

• UCSF Memory and Aging Center: http://memory.ucsf.edu/education/diseases/mci
• Alzheimer’s Society: http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=101
• Quad-City Times: http://qctimes.com/lifestyles/health-med-fit/health/know-the-warning-signs-of-aldzheimer-s/article_f6cfff5e-5105-11e2-aa90-0019bb2963f4.html

Dementia is a term that is often misunderstood. Stemming from our last blog post about the difficulties of detecting dementia, let’s clarify its precise meaning. According to the Alzheimer’s Association, dementia is an “umbrella term” for a variety of conditions arising once the nerve cells in the brain no longer function properly. Dementia itself is not a disease- it is a category that describes the conditions of certain diseases. Dementia includes difficulty in the following areas: language, memory, perception, emotional behavior, personality, and cognitive skills. Dementia encompasses more than the memory loss that is common with aging, and it can result from a variety of conditions.

Alzheimer’s disease is the most common form of dementia. Regrettably, Alzheimer’s disease affects an alarmingly high percentage of the elderly: one in eight people aged 65 or older and half of people aged 85 and older have Alzheimer’s disease. Alzheimer’s disease is due to a build-up of protein plaque and tangled nerve cells in the brain, but its direct causes are unknown. Symptoms for Alzheimer’s disease usually begin to appear a decade or so after the onset of damage. With time, the neurons lose functionality and communication between other neurons, and they eventually die. The Hippocampus, a part of the brain essential for memory, is particularly susceptible to this degeneration of neurons.

Although Alzheimer’s disease is the most common form of dementia, other medical conditions that could lead to dementia include the following:

• Parkinson’s disease
• Multiple sclerosis
• Huntington’s disease
• Pick’s disease
• HIV/AIDS
• Lyme’s disease

The following conditions put people at risk for dementia, but they can be reversed if found early enough:

• Brain tumors
• Changes in blood sugar, sodium, and calcium levels
• Low vitamin B12 levels
• Pressure hydrocephalus
• Alcohol abuse

In terms of diagnosing yourself or a loved one, remember that a loss of cognitive abilities is often a product of aging. However, it is important to be aware of one’s susceptibility in order to detect dementia. The sooner dementia is diagnosed, the sooner the proper care and treatment can be given.

Photo credit: lssi.org

Sources:
Alzheimer’s Association, “2012 Alzheimer’s Disease Facts and Figures”

http://www.alz.org/downloads/facts_figures_2012.pdf

Alzheimer’s Disease Education and Referral Center

http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet

Penn State Hershey, “Dementia”

http://pennstatehershey.adam.com/content.aspx?productId=113&pid=1&gid=000739

Could this Tragic Death Have Been Avoided?

A tragic death in an independent living home stirred recent controversy when an 87-year-old woman recently died after being denied CPR because it was against the policy of Glenwood Gardens, an independent living home in Bakersfield, California.

Listening to the seven minute 911 call is truly astounding.  A nurse from the Glenwood Gardens called 911 for assistance once a resident, Lorraine Bayless, collapsed in the dining facilities. The dispatcher pleaded with the nurse to do CPR, telling her that the resident would die if denied CPR.  In desperation, the dispatcher gave the order:  “Anybody there can do CPR.  Give them the phone please.”  The nurse refused to perform CPR because it was against Glenwood Gardens’ policies and claimed that there was no one in the facility who could perform it at that time.  Once the paramedics arrived at the scene, it was too late. Lorraine Bayless died in the hospital soon afterwards.

Jeffrey J. Toomer, Executive Director at Glenwood Gardens, explained the policy of the facility as the following:

In the event of a health emergency at this independent living community our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives.

He also explained that it is an independent nursing facility, rather than a nursing facility, and that the residents are informed of these policies.
The daughter of Lorraine Bayless reportedly appears to not have a problem with the manner in which the situation was handled.  She claims that she was previously aware of the policy and that her mother wished to die from natural causes. In fact, the family said it would not be filing a wrongful death suit and called it, “a lesson we can all learn from.”

It is uncertain whether or not performing CPR would have saved Lorraine’s life.  But the fact that CPR, if performed in a timely manner, may have saved Lorraine’s life is unsettling.  It is difficult to imagine how it would feel in her daughter’s position.

From a legal perspective, the facility has most likely not violated any regulations.  Police are looking into whether there is criminal culpability, such as whether or not the facility has history of neglect or abuse. We live in a society in which employers often discourage employers from taking certain actions in fear of their consequences, without taking into account the moral obligations of a particular situation.  According to Dr. Patricia Harris of the University of California’s geriatrics division, survival odds are not the best for elderly people who receive CPR.  However, Dr. Harris states that she would have overridden the facility’s policy “rather than watch somebody die in front of [her].”

At Aarris Homecare, we firmly believe that when choosing a caregiver for yourself or your loved ones it is important to know that proper care and medical assistance will be provided if necessary.  Every Aarris Homecare caregiver is CPR certified and trained in first aid.  With Aarris Homecare, you can rest assured that you or your loved ones are in safe hands.

Sources:
RYOT
Fox News

“Music is magic; it is a backdoor into the mind, into parts of the brain that dementia and Alzheimer’s can shut off.” These are the words of Michael Rossato-Bennett, director of the upcoming documentary “Alive Inside.” You may have seen the YouTube clip (with more than 6.5 million views) that was the starting point for this project. This video clip inspired thousands of people to share similar stories.

The clip highlights Henry, a 94-year-old dementia patient who, for the most part, is responsive to “yes” or “no” questions but cannot give embellished answers. But once the iPod begins playing music from his past, Henry is “awakened.” He immediately lights up and begins rocking his hands and feet and singing along to the music. Once the headphones are taken off, Henry becomes quite receptive and opens up about his love for music in his youth. He then sings the lyrics to his favorite song, “I’ll be Home for Christmas.” Michael Rossato-Bennett hopes that his documentary will spread awareness and encourage the implementation of more music programs for Alzheimer’s and dementia patients.

Studies have found that music can help elicit memories and improve cognitive abilities for patients with Alzheimer’s and dementia. Music therapy can stimulate parts of the brain that became dormant due to degenerative diseases. In one study by Dr. Peter Janata, published in the journal Cerebral Cortex, 13 UC Davis students listened to excerpts of 30 songs chosen from the “top 100” charts over the past decade, and their brain activity was measured using fMRI (functional magnetic resonance imaging). Researchers found strong activity in the medial prefrontal cortex, which elicits an emotional response and “a mental movie” in the mind. The medial prefrontal cortex largely becomes degenerated with the progression of Alzheimer’s disease.

Studies have found that music can help elicit memories and improve cognitive abilities for patients with Alzheimer’s and dementia. Music therapy can stimulate parts of the brain that became dormant due to degenerative diseases. In one study by Dr. Peter Janata, published in the journal Cerebral Cortex, 13 UC Davis students listened to excerpts of 30 songs chosen from the “top 100” charts over the past decade, and their brain activity was measured using fMRI (functional magnetic resonance imaging). Researchers found strong activity in the medial prefrontal cortex, which elicits an emotional response and “a mental movie” in the mind. The medial prefrontal cortex largely becomes degenerated with the progression of Alzheimer’s disease.

Music therapy can also help improve cognitive abilities in patients with dementia. Another study conducted by Dr. Concetta Tomaino examined 45 patients diagnosed with mid to late-stage dementia who attended an hour music therapy session three times a week over a 10-month period. The study found that the participants’ scores on a cognitive-function test increased by 50% on average. This is a noteworthy improvement. Although Dr. Tomaino states that music therapy cannot cure neurological diseases such as dementia, “playing familiar music frequently can significantly improve a patient’s mood, alertness and quality of life.”

Beginning a music regime at home can be as simple as programming an iPod with music tailored to a specific genre and era. Music has the power to improve cognitive abilities and bring dementia and Alzheimer’s patients a sense of their own memories and life stories.

Sources:

Alive Inside: A Story of Music and Memory
http://www.kickstarter.com/projects/1406732546/alive-inside-a-story-of-music-and-memory

Alive Inside:
http://www.ximotionmedia.com/

Music Therapy for Individuals With Alzheimer’s and Other Dementias
http://www.huffingtonpost.com/ronna-kaplan-ma/music-therapy_b_1749980.html

The benefits of pet interactions for one’s emotional and physical health are truly remarkable. Pet therapy does more than simply provide entertainment- it is an applied science that is utilized for a variety of medical conditions.

Pet therapy began in the 1860s to provide social support for the mentally ill. The National Institute of Health funded grants for research to encourage further advancements. It has been found that dogs can calm down children with epileptic seizures and improve communication skills in autistic patients. Dogs have even been found to smell cancer in owners before they get a formal diagnosis. The most common therapeutic animals for older people are dogs, cats, and rabbits. Pet therapy can benefit elderly people, particularly dementia patients, in the following ways:

Mood Boost: Depression is common among older people, often a result of losing of a spouse, getting a terminal diagnosis, or leaving the comforts of home-life. Pet therapy can help to boost morale and reduce agitation and stress levels. Animal interactions increase oxytocin levels, which help with feelings of happiness and trust; they can also lower the stress hormone, cortisol, and increase levels of serotonin, a “feel good hormone.” Therapy animals also offer entertainment, and many patients simply enjoy observing therapy dogs’ mannerisms and tricks that the majority can perform.
Socialization: Older people, whether living on their own, with a caregiver, or in an assisted living home, may feel isolated. Pets can offer comfort and unconditional love. According to Mara M. Baun, coordinator of the PhD nursing program at University of Texas, people with Alzheimer’s disease can recognize a dog as someone new in their environment with whom “they can interact with without any worry.”
Physical Activity: Pet therapy can encourage physical activity, whether from simply grooming the animal, tossing a ball, or going on a walk (depending on a patient’s mobility).
Eating Habits for Dementia Patients: Weight loss is common among patients with Alzheimer’s disease and is associated with an increased progression of the disease. One study examined residents in a dementia-specific unit in Indiana. Based on measurements taken prior to the start of the study, there was an average decline in weight loss amongst the residents. With the four-month installation of a fish tank in the dining room, there was a significant average increase in weights and a 27.1% increase in nutritional intake.

For caregivers seeking pet therapy for their loved ones, there are several options. Many organizations offer pet therapy services; the most qualified dogs will be registered with the Delta Society, Pet Therapy International, or Therapy Dogs International. Another option is pet ownership. Pets can help to reduce stress levels in caregivers, who are more likely to suffer from prolonged stress due to the responsibilities of caring for a loved one. When making a selection, the best therapy dogs are easy-tempered, tolerant, groomed, and well-trained (knowing tricks is an added plus). Considering its multitude of benefits, pet therapy may be a good option when tailoring a treatment plan for a loved one.

Sources:

Photo credit: Telluride Pet Sitting

“Animal-Assisted Therapy and Nutrition in Alzheimer’s Disease” – http://wjn.sagepub.com/content/24/6/697.full.pdf+html

“How Caregivers Can Use Pet Therapy to Care for Their Loved One” – http://blog.alz.org/how-caregivers-can-use-pet-therapy-to-care-for-their-loved-one/

“How Animal Therapy Helps Dementia Patients” – http://www.everydayhealth.com/alzheimers/how-animal-therapy-helps-dementia-patients.aspx