Archives for November 2013

Alzheimer’s and Communicating with Your Doctor

(Family Caregiver Alliance) When was the last time you left a doctor visit feeling satisfied that your concerns were heard and responded to? Successful communication with your doctor demands effective two-way communication. Here are a few tips to consider:

  • Make a list of your concerns. Start a few days in advance, if possible, to track symptoms or other concerns. Be thorough and honest; the details are important. Keeping the list to one page will help the doctor stay engaged. Mention your most important concerns first. Consider giving the doctor a copy of your list so she can follow along. This will help make the best use of the limited time you have for your appointment.
  • Speak up. Doctors tend to prioritize diagnostic information and core concerns early in the office visit. Make sure you make your key concerns known at the onset of the visit to help prevent the doctor from jumping to conclusions about treatments or dismissing issues you believe are important.
  • Listen. It is so easy to get rattled at a doctor’s visit that it sometimes feels like the appointment is over in a blink of an eye and all you walk out with is the blurred memory of a meeting and a prescription. Take some deep breaths and focus on what the doctor is saying. Bring a tape recorder and ask the doctor if she wouldn’t mind your recording the visit to help you better remember the information you discuss.
  • Ask questions. Don’t hesitate to ask when words the doctor is using are unfamiliar or his instructions are not clear to you. Question the assumptions behind proposed treatments that do not seem viable in your situation. And above all, you deserve to know what the cost to you may be for a proposed treatment. Doctors’ recommendations are only as valuable as your interest and ability to put them into practice.
  • Don’t minimize the symptoms or situation. Remarks like “it’s just a little cough” or “my mother being up all night really isn’t a problem,” might lead your doctor to the same conclusion. If your real fear is that your sister’s lung cancer started with a similar cough, let the doctor know. If mom’s being up all night is preventing you from getting any sleep, say so. A few reassuring words, an appropriate test or as-needed sleeping medication can put your mind at ease.
  • Share your knowledge. The doctor knows medical care and you know family care. Share information with the doctor about valuable community resources that have helped you. The doctor and their staff appreciate patient recommendations. They, in turn, can use this information to help other caregivers and patients.
Citation

http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=999

© 2016 Family Caregiver Alliance

 

Video Tips for Caregivers from Johns Hopkins University

(Johns Hopkins University) Caregivers, often family members, are essential to the care of patients with Alzheimer’s disease and other forms of dementia. The goal of The Peter Rabins Alzheimer’s Family Support Center is to provide practical, up-to-date information about various challenges which arise in day-to-day care, discuss recent research advances, and to hear your questions.

The following conversations with family members offer ideas and advice for Alzheimer’s and dementia patient caregivers. Downloadable transcripts are available at the bottom of this page.

How Do You Know If You Have Alzheimer Disease

What are the early symptoms? When to get a professional evaluation.


Learning Not to Argue – Memory and Alzheimer’s Disease

Caregiver tips for learning to accept a different reality, for being patient and kind.

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Driving – Memory and Alzheimer’s Disease

Caregiver tips for how to help a family member stop driving.

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Dressing and Bathing – Memory and Alzheimer’s Disease

Caregiver tips for dressing and bathing a person with Alzheimer’s disease.

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Behaviors – Memory and Alzheimer’s Disease

Caregiver tips for how to deal with problem behaviors such as wandering and aggression.

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Caregiver Guilt – Memory and Alzheimer’s Disease

How to deal with caregiver guilt when caring for an Alzheimer’s patient.

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The Nursing Home Decision – Memory and Alzheimer’s Disease

When is it time for day care or a nursing home?

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Transcripts

How Do You Know If You Have Alzheimer Disease
Learning Not to Argue
Driving
Dressing and Bathing
Behaviors
Caregiver Guilt
The Nursing Home Decision

Citation

http://www.hopkinsmedicine.org/psychiatry/specialty_areas/memory_center/rabins_alzheimers/

© The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. All rights reserved.

 

10 Ways to Improve Your Day in Just 5 Minutes

(WebMD) Five minutes. It’s only a little bit of time. But it’s long enough for you to do one thing that could make your whole day better.

That’s a great return on your time investment!

So take five minutes and try one of these 10 simple ways to lower stress, boost your mood, and get more energy. It might give you that extra spark you need to meet the challenges of the day.

1. Make your bed . This isn’t about being a clean freak. It’s a small ritual that can help create a calm environment for you in your bedroom — and a soothing bedroom is part of “sleep hygiene” — little habits that can help you sleep better. Author Gretchen Rubin recommends making your bed as a daily habit in her book, The Happiness Project. Do it first thing in the morning, and you’ve got one less thing to worry about for the rest of the day.

2. Pack a snack. Before you head out the door in the morning, prep a healthy snack to take with you. Ideas include fruit, unsalted nuts, and low-fat cheese or yogurt.  When you get hungry later in the afternoon, you’ll be ready!

3. Clear your desk. From stray papers to scattered coffee mugs, clutter can make you lose focus and curb productivity. Declutter your outer environment and you may feel more organized and better able to concentrate on the task at hand.

4. Pump up the music. Several studies have found that listening to music can help lower blood pressure, reduce stress, and boost mood. The right music has the power to change your attitude. So load up your MP3 player and create a playlist that will make you smile — whether you’re working or working out. As long as you don’t blast it (bad for your hearing), this is a safe, healthy way to make your day more enjoyable.

5. Sniff a lemon. For a quick de-stressing trick, turn to an underrated sense — your sense of smell. Japanese researchers found that linalool; a substance found in lemons, may turn down the classic “flight-or-fight” stress response. Not into lemons? Try basil, juniper, or lavender — those scents have also been found to lower stress.

6. Stretch. No need to put on your yoga pants or get all bendy. Just a few easy moves will do. Stretch your arms overhead. Raise and lower your shoulders a couple of times. Stretch your legs as you lean your torso against a wall. Be gentle, so you don’t overdo it.  Stretching can help improve your circulation and flexibility, and may help ease the tight muscles that come with stress.

7. Meditate . It’s easier than you may think. Here’s how: Settle into a comfortable position in a chair or on the floor. Then follow your breath — in, out — for a few minutes. Thoughts are bound to bubble up in your mind — no problem. Just let them float by and turn your attention back to your breath. Meditating daily, even just for a few minutes, may help tame stress.

8. Keep a gratitude diary. Take a minute every day to write down what you’re thankful for — big or small. It’s easy to vent about weather, traffic, or job woes, but complaining brings negative energy along with it. Being thankful for what you have can make you appreciate all the positives in your life.

9. Turn off your electronics. Take a little break, already, from all your gadgets. Staring at computer screens and electronics all day long can zap your energy and encourage inactivity. So log off — of everything — every now and then. This is especially important to allow you to unwind and relax before bed. Just because the world is on, 24-7, you don’t have to be!

10. Prioritize. Give yourself permission to admit that you can’t do everything, all at once. Instead, you can nibble away at your to-do list, and feel more satisfied, by setting some priorities. So make a list, figure out what really matters, what can wait, and what you can skip. Work your way down the list, handling your top priorities first. Bit by bit, you’ll get there!

Citation

http://www.webmd.com/balance/balanced-life-13/improve-day?page=1

By Jennifer Soong

Reviewed by Michael W. Smith, MD on September 30, 2013

© 2010 WebMD, LLC. All rights reserved.

 

Towards an Even Healthier Mediterranean Diet

Nutr Metab Cardiovasc Dis. 2013 Oct 11. pii: S0939-4753(13)00204-4. doi: 10.1016/j.numecd.2013.09.003. [Epub ahead of print]

Towards an even healthier mediterranean diet

Estruch RSalas-Salvadó J.

Department of Internal Medicine, Hospital Clinic, Institut d’Investigació, August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; CIBER Obn, Physiopathology of Obesity and Nutrition, Institute of Health “Carlos III”, Government of Spain, Santiago de Compostela, Spain. Electronic address: restruch@clinic.ub.es.

Abstract

Dietary guidelines to promote good health are usually based on foods, nutrients, and dietary patterns predictive of chronic disease risk in epidemiologic studies.

However, sound nutritional recommendations for cardiovascular prevention should be based on the results of large randomized clinical trials with “hard” end-points as the main outcome. Such evidence has been obtained for the Mediterranean diet from the PREDIMED (Prevención con Dieta Mediterránea) trial and the Lyon Heart Study.

The traditional Mediterranean diet was that found in olive growing areas of Crete, Greece, and Southern Italy in the late 1950s. Their major characteristics include: a) a high consumption of cereals, legumes, nuts, vegetables, and fruits; b) a relatively high-fat consumption, mostly provided by olive oil; c) moderate to high fish consumption; d) poultry and dairy products consumed in moderate to small amounts; e) low consumption of red meats, and meat products; and f) moderate alcohol intake, usually in the form of red wine.

However, these protective effects of the traditional Mediterranean diet may be even greater if we upgrade the health effects of this dietary pattern changing the common olive oil used for extra-virgin olive oil, increasing the consumption of nuts, fatty fish and whole grain cereals, reducing sodium intake, and maintaining a moderate consumption of wine with meals.

Citation
Copyright © 2013 Elsevier B.V. All rights reserved.
http://www.ncbi.nlm.nih.gov/pubmed/24263037

National Center for Biotechnology Information, U.S. National Library of Medicine

 

Caregivers: Tips to Feel Better All Day

(WebMD) What are the most important steps to follow if you want to feel good from morning to night?

David Rakel, MD, spends his days helping people figure that out. He’s the director of the integrative medicine program at the University of Wisconsin and to him, feeling good means that your body and mind are working at their peak level, and you have a general sense of well-being.

To feel good day after day, he suggests these tips:

Get sunlight during the day.

Sunlight stimulates the brain chemical serotonin, which plays a role in helping you feel happy.

While you’re outdoors in the sun, use the time to exercise for an extra boost, Rakel says. Research has found that physical activity can work about as well as medications for treating mild to moderate depression, and it may work better than medicine for preventing depression from returning. It can also help your anxiety.

Set yourself up for good sleep.

In the evening as the sky grows darker, your brain makes a hormone called melatonin. This helps you get sleepy. Some of your choices during the day and evening affect your melatonin levels, which in turn can play a role in how well you sleep. Rakel suggests that you:

  • Be sure to get that daily exercise in the sun, since it also helps you sleep at night. In part, that’s because “melatonin is related to how much serotonin you have,” Rakel says.
  • Turn down your thermostat. You make melatonin when your body is cooler, so you’re likely to sleep better if you aren’t too warm.
  • Turn off the lights. If your bedroom isn’t completely dark, you won’t make as much melatonin.

Eat “feel-good” foods

The way you fuel your body and mind makes a big difference in whether you feel strong or weak, focused or groggy. Keep these tips in mind:

  • Focus on “multicolored whole foods that were recently alive,” he says. That means fresh vegetables, fruits, and beans, and whole grains instead of refined or processed foods.
  • Make room for cruciferous vegetables, which include broccoli, cauliflower, cabbage, and kale. “Those vegetables contain chemicals that support immunity and help detoxify the body. They’re super-foods for feeling good,” he says.
  • Avoid foods that make your blood sugar soar, like sweetened sodas and sugary baked goods. Your body will respond with a rush of insulin, which makes your blood sugar crash. These highs and lows aren’t good for your health, your focus, or your energy level.

Stay focused on the present moment.

“If we can learn to recognize the clutter that our mind is in and learn to be more mindful of the present moment, that can be a tremendous asset to our overall sense of well-being,” Rakel says. The “clutter” that can make you feel bad includes regret about the past and worry that bad things might happen to you.

A practice called mindfulness can help you reduce the clutter by keeping your focus on the present moment. To be more mindful, try to:

  • Take in the colors, sounds, and smells that surround you at any given time.
  • Pay attention to your breath moving in and out of your body for a few moments.
  • Let worrisome thoughts flow out of your mind when they pop up, rather than giving them attention and dwelling on them.

Try to stay positive.

The same event can happen to two people, and one views it as a positive and one views it as a negative. So try to see the good side of the things and people around you; it can help you stay free of anxiety and depression, Rakel says.

Make a spiritual connection.

Rakel defines this as spending time on “that which gives your life meaning and purpose.”This could be your religious beliefs, enjoying nature, or sharing moments with loved ones. “If we get up in the morning excited about something that gives us meaning and self-purpose, our bodies do all they can to heal,” he says.

Be around people.

Having a good support network of family, friends, coworkers, and other people who care about you can help you stay healthier, feel less stressed, and even live a longer life. Spend time with these people regularly, and work to keep your relationships with them strong.

Citation

By Eric Metcalf, MPH

Reviewed by Brunilda Nazario, MD on October 01, 2013

http://www.webmd.com/balance/balanced-life-13/more-energy

© 2013 WebMD, LLC. All rights reserved.

 

Caregivers: Make Time for Play

(WebMD) Play is very easy for children. It’s hard for them to notdo it. By adulthood, though, most of us have gotten the message that we should be working or spending our time on more useful matters.

But play time isn’t wasted time for adults. It’s not something you should leave behind in your childhood. And it’s not something you should have to hide, says Stuart Brown, MD, in his book Play.

That’s because spending time at play — whether it’s getting outside, working on your favorite hobby, telling jokes, or just goofing off — provides mental and physical health benefits, says life coach Susan Biali, MD. Those benefits include:

  • Stress relief. When we’re focused on play, “it takes us out of our daily routine and the ‘grown-up’ worries that occupy our mind so much of the time,” Biali says. If you laugh while you do it, all the better; it may provide even more health benefits. Research has found that laughter may relax your muscles, help you breathe better, promote better blood flow, and improve your immune system.
  • Better physical health. Stress can cause many symptoms, such as headaches, back pain, fatigue, trouble sleeping, and upset digestion. As a stress-reliever, play may help lessen these problems. If you’re physically active during playtime, it can improve your fitness and energy level, too.
  • Better self-esteem. Play can make you feel good about yourself and your life.
  • Social support. Spending time with people who care about you — like when you’re playing — can be good for your health.

Also, spending time while at play may boost your creativity and help you become a better problem-solver, says Kevin Carroll, author of What’s Your Red Rubber Ball and related books. This, in turn, can help you perform better during your time at work.

To get the most fun out of your playtime, try these ideas:

Do whatever brings you joy.

Look for activities that “tickle your brain,” Carroll says. That could be dancing, running, playing chess, or figuring out the missing numbers in Sudoku puzzles. “If you can find ways to surround yourself with those things from time to time, it’s only going to be a benefit to you,” he says. However, he warns against activities that are harmful to your body or mind, like overusing alcohol.

If it’s been awhile since you truly played, think back to what made you laugh as a child, Carroll says. You may still find joy in these things. (If you have any toys or books from your childhood, take a look at them. They may set you back on the path toward playfulness.)

Bring in a play expert.

Have you forgotten how to play? Is your imagination not as vivid as it used to be? “Children are happy to take the lead on this!” Biali says. Let your child, grandchild, or other kid in your life teach you how to play a new game or go on an adventure. If you don’t have any children around, grab a pet toy and play with a dog or cat.

Join your coworkers.

Carroll often speaks to companies and their workers about the need for play in the workplace. If your company offers chances to play — such as a basketball court, a softball team, a walking group, or social outings — take part.

Spend some time playing with people from other departments, he says. This is a great way to learn more about your company. Also keep an eye on how your boss and familiar coworkers play. This might give you clues about how to work with them better.

Keep play from turning into work.

“One does have to be careful with play, as if we get too serious about it or start earning income from it, it can stop being so deliciously playful,” says Biali.

If your fun hobby turns into work, be sure to explore parts of it that still feel like play. Biali still finds her sense of play in dance while dancing at home or taking classes with her favorite teachers.

Citation

By Eric Metcalf, MPH

Reviewed By Brunilda Nazario, MD

http://www.webmd.com/balance/balanced-life-13/fun-play

©2005-2013 WebMD, LLC.

 

Personal Care for a Loved One with Alzheimer’s Disease

(WebMD) People with Alzheimer’s disease have special needs and require special help, which can pose unique challenges for their caregivers. Depending on his or her level of independence, your loved one with Alzheimer’s disease may need help with personal care activities, including eating, bathing, shaving, and using the toilet. To assist with these activities, caregivers need knowledge, skill, and patience.

General Tips for Alzheimer’s Disease Caregiving

  • Establish a routine for your loved one with Alzheimer’s disease. Schedule grooming activities for the same time and same place each day; for example, brush his or her teeth after meals, or schedule baths for the mornings or evenings. Choose the most relaxed time of the day for bathing and grooming.
  • Respect your loved one’s privacy. Close doors and blinds. Cover him or her with a towel or bathrobe.
  • Encourage your loved one to do as much as possible. This will help to promote a sense of independence and accomplishment.
  • Keep in mind your loved one’s abilities. Give him or her enough time to complete each task; for example, brushing his or her hair or teeth.
  • Give your loved one encouragement and support as he or she completes tasks. Acknowledge his or her efforts when completed. For example, say, “You did a nice job brushing your hair today.”
  • Tell your loved one what you are doing before doing it. For example, “I’m going to wash your hair now.”
  • If your loved one can dress himself or herself, lay out the clothes in the order they are to be put on. Clothing that is easy to put on, with few buttons, is best.

Eating with Alzheimer’s Disease

  • Some symptoms of Alzheimer’s disease, including confusion and lack of energy, can be worsened by poor nutrition. Be sure to provide your loved one with a nutritious diet and plenty of healthy fluids, such as water or juice.
  • Encourage independent eating if your loved one is able. Consider serving finger foods that are easier for the person to handle and eat.
  • Adaptive equipment such as plate guards or silverware with specially designed handles is available for individuals who have difficulty holding or using utensils.
  • Don’t force feed. Try to encourage your loved one to eat, and try to find out why they don’t want to eat. Always remember to treat your loved one as an adult, not a child.

Bathing and Alzheimer’s Disease

For someone with Alzheimer’s disease, a complete bath may not be needed every day. A sponge bath may be enough.

  • Always check the temperature of the water in the bath or shower.
  • If giving a bath in the tub, try using a bath chair with handrails. Also, place rubber mats in the tub to prevent slipping.
  • Make sure the bathroom is warm and well-lit.
  • Remove or secure throw rugs to prevent falls in the bathroom.
  • If your loved one is heavy or can offer little help, special equipment may be needed. Your doctor can give you advice on how to safely bathe your loved one.

Helping with Hair Care and Shaving

  • Try washing your love one’s hair in the sink, especially if he or she prefers baths to showers.
  • If your loved one is able, a trip to the salon or barbershop may be a fun and positive experience.
  • Try using a dry shampoo if your loved one is bed-bound or fearful of having his or her hair washed.
  • To reduce the risk of cuts, use an electric razor for shaving, especially if your loved one is taking blood-thinning medicines (such as Coumadin).

Dental Care for People With Alzheimer’s Disease

  • Brush your loved one’s teeth daily. If your loved one wears dentures, clean them every day. Check that the dentures fit properly, and examine the gums for sores or areas of redness.
  • If your loved one refuses to open his or her mouth, try brushing only the outside of the teeth. Ask your dentist for advice on providing good dental care.
  • If your loved one brushes his or her own teeth, help by putting the toothpaste on the brush.

Using the Toilet

  • Install safety features in the bathroom, such as grab bars and raised toilet seats.
  • A bedside commode or urinal may be helpful if getting to the bathroom, especially at night, is a problem.
  • Schedule routine bathroom visits to prevent accidents.
  • Tell the doctor about any loss of bowel or bladder control. These problems may be symptoms of conditions that can be treated with medication.
Citation

http://www.webmd.com/alzheimers/guide/caring-loved-ones

SOURCE: Alzheimer’s Association.

© 2012 WebMD, LLC. All rights reserved.

 

Cognitive, Emotional, and Social Benefits of Regular Musical Activities in Early Dementia

Gerontologist. 2013 Sep 5. [Epub ahead of print]

Cognitive, Emotional, and Social Benefits of Regular Musical Activities in Early Dementia: Randomized Controlled Study.

Särkämö TTervaniemi MLaitinen SNumminen AKurki MJohnson JKRantanen P.

Abstract

Purpose of the Study: During aging, musical activities can help maintain physical and mental health and cognitive abilities, but their rehabilitative use has not been systematically explored in persons with dementia (PWDs). Our aim was to determine the efficacy of a novel music intervention based on coaching the caregivers of PWDs to use either singing or music listening regularly as a part of everyday care.

Design and Methods

Eighty-nine PWD-caregiver dyads were randomized to a 10-week singing coaching group (n = 30), a 10-week music listening coaching group (n = 29), or a usual care control group (n = 30). The coaching sessions consisted primarily ofsinging/listening familiar songs coupled occasionally with vocal exercises and rhythmic movements (singing group) and reminiscence and discussions (music listening group). In addition, the intervention included regular musical exercises at home. All PWDs underwent an extensive neuropsychological assessment, which included cognitive tests, as well as mood and quality of life (QOL) scales, before and after the intervention period and 6 months later. In addition, the psychological well-being of family members was repeatedly assessed with questionnaires.

Results

Compared with usual care, both singing and music listening improved mood, orientation, and remote episodic memory and to a lesser extent, also attention and executive function and general cognition. Singing also enhanced short-term and working memory and caregiver well-being, whereas music listening had a positive effect on QOL.

Implications

Regular musical leisure activities can have long-term cognitive, emotional, and social benefits in mild/moderate dementia and could therefore be utilized in dementia care and rehabilitation.

Citation

http://www.ncbi.nlm.nih.gov/pubmed/24009169

National Center for Biotechnology Information, U.S. National Library of Medicine