Music Therapy

Music as a Tool to Improve Communications Skills in Alzheimer’s Patients:

For people with Alzheimer’s disease and dementia, the body’s functions degenerate as the brain’s functions deteriorate. Among the most affected are the five senses, but the sense of hearing is usually the first to go. Before hearing finally shuts down, music therapy can be a valuable therapeutic tool to promote interactive communication.

According to researchers M. Brotons and S.M. Kroger of the Willamette University Psychology Department in Oregon, in their study on “The Impact of Music Therapy on Language Functioning in Dementia,” patients showed statistically significant improvements in speech content and fluency after eight sessions of music therapy combined with conversations.

Other researchers have reported on proven benefits to Alzheimer’s patients derived from music therapy on aspects such as cognitive functions, social skills, and behavior (including reduced agitation and behavioral problems). Music and music therapy are not curative of Alzheimer’s and dementia, but the use of music therapy results in the beneficial effects on dementia and Alzheimer’s symptoms. These benefits lead to an enhanced quality of life for both the patient and his or her caregiver.

Why music therapy works:

For centuries, music has been known to calm people down and provide relief from stress and tension. One possible explanation for its effects is found in a study by researchers at the University of Miami’s School of Medicine in Florida, led by Dr. Ardash Kumar.

The study assessed how music therapy affected secretion levels of five brain chemicals (melatonin, serotonin, norepinephrine, epinephrine, and prolactin) in Alzheimer’s patients.

“For centuries, music has been known to calm people down and provide relief from stress and tension. Music therapy can be a useful therapeutic tool to promote interactive communication.”

After a month-long program (30 minutes a day, five days a week), the team found that music therapy led to increased secretion levels of melatonin, a hormone associated with mood regulation, lower aggression, reduced depression and enhanced sleep. The higher melatonin levels persisted even six weeks after music therapy sessions had stopped. Secretions of epinephrine and norepinephrine rose immediately after music therapy sessions but did not remain for long after the sessions had ceased. Music therapy did not influence secretions of serotonin and prolactin.

How to make music therapy work:

The Alzheimer’s Association recognizes the enriching benefits of music therapy. Music can stir long-term memories; and, best results may be obtained from music popular during the patient’s youth. Some patients might respond well to rhythm-and-blues, or to instrumental hymns and spiritual songs. For the current crop of the over 80s, music from Glenn Miller and Lawrence Welk might be invaluable.

Singing along, or swaying or clapping hands with the music should be encouraged. Music therapy may awaken a desire to dance, which can be therapeutic. A patient’s enjoyment is typically increased as they move or sing with the music. Music therapy can also be linked to other memory-stirring activities such as looking at photographs.

Article from www.parentgiving.com

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Providing Care and Support for a Spouse

I love thee with the breath, smiles, tears, of all my life…” Elizabeth Barrett Browning, How do I love thee?
The care of a spouse surely has its rewards. One advantage is that the partner who is need of care or assistance is already comfortable with the caregiver. You know each other’s idiosyncrasies, habits and preferences. You also know each other intimately so it eases any embarrassment when dealing with private needs. You also know the home environment and what areas might be in question when it comes to safety issues.
On the down side, however, the caregiving spouse may feel odd about asking others for much needed help, fearing their loved one will be embarrassed or uncomfortable if anyone else provides care or knows that they need this care.
Spousal caregivers often feel so much stress since they also live with the person they are caring for, which doesn’t provide for any breaks physically or emotionally. “It is important that the spouse continue to do some of the activities she or he likes, whether it is singing in the church choir or going to the monthly book club meeting, so that he or she continues to socialize outside of the home and give themselves a breather,” advises Richard Schulz, Ph.D., caregiver stress expert at the University of Pittsburgh.
“It is important that, as a caregiver of a spouse, you don’t assume you can handle everything,” said Dr. Schulz. “In a study in the Journal of the American Medical Association, we found that spousal caregivers who experienced mental or emotional strain were more likely to die sooner than non-caregivers. Sometimes even the most resourceful person needs to ask for help from other family members or outside professionals – the hard part is knowing when to ask.”
In order to help you understand when the stress might be getting to be too much for you, we’ve created a list of signs that spousal caregiving may be becoming too risky for you.
In the end, it is important that as a caregiver, you maintain your own health, because if you aren’t well, you will be less able to help your spouse.

Article from Caregiver Stress

Increase Your Ingestion of Vitamin “N”!!!

Vitamin “N” you say? Don’t bother to search on the shelves of a health food store or a pharmacy. This vitamin cannot be found in such places. In order to find this vitamin and “ingest” it, one must visit the great outdoors – nature! Fall is the perfect time of year to be outside – not too hot or too cold yet – and yet full of beautiful colors and fresh air. Many of us do not get outside enough – we don’t partake of the free “nature” vitamin. We are Vitamin “N” deficient. The lure of electronics, the belief that our houses need to be spotless, the syndrome of needing to get just one more thing done – all add to this deficiency.

So – what can we do to get more of this fabulous vitamin? Why get out into nature? What are the benefits of doing so? What can it do for our brains and memory? There’s not enough room in any blog to list every advantage but here are some important ones:

• Nature brings our senses alive. We are able to use our sense of smell to the max – flowers, crisp air, trees, mowed lawns, barbeques, etc. Our sense of smell holds more memories than any other of the senses. Being outside helps us to bring up these memories and to make new ones.
• Being inside a great deal often leads to a sense of isolation. Being outside can do the opposite!
• Nature heals – research has found that hospital patients in rooms with a view of trees heal faster than those with no view.
• Nature can build community bonds and family and friends ones as well. Researchers have found that being exposure to nature leads people to nurture close relationships. And – socialization is very necessary for memory enhancement .
• Nature provides a great opportunity for new learning experiences – and we all know that learning new things is GREAT for our memory.
• Nature decreases stress. Just think about relaxation tapes that you might have heard in the past. They all have sounds of nature – water babbling in a brook, birds singing, waves crashing in on the beach, or wind blowing.
• Nature improves mood and combats depression.
• Nature increases our ability to cope with a variety of situations.
• Being outside opens up our eyes to the beauty surrounding us and increases our optimistic attitude.
• Being in nature increases our overall sense of well being.

Lastly and as important as any of the above benefits – our future is at stake. As Richard Louv, author of the Nature Principle states, “ The natural world’s benefits to our cognition and health will be irrelevant if we continue to destroy the nature around us, but that destruction is assured without a human reconnection to nature.”

Hopefully, after reading this blog, you are inspired to get outside more. Ingest more of that ever so necessary vitamin – Vitamin “N”. Reconnect to nature. It will increase your overall well being and you will do your part in assuring its future well being!

Bring On the Curry Vegetables!!

As is the case with so many foods and food supplements, research is currently looking into the possible benefits on memory of Turmeric. Turmeric is a spice whose active and most popular ingredient is Curcumin. This is what gives curry its yellow flavor. It is traditionally used in India and other Asian countries. It is interesting to note that India has the least amount of cases of Alzheimer’s disease worldwide. Could their consumption of this possible wonder spice be the reason for this? A number of human trials are underway and show some possible promise. Though definitely not a cure-all, it definitely could have some positive effects on memory.

India believes that curcumin acts as a purifier and helps to free the body from toxic agents. Certainly it is a powerful anti-oxidant which can help the body get rid of some of those free radicals roaming around in our bodies. This is a huge benefit of eating curry and other foods high in anti-oxidants such as dark and bright fruits and vegetables.

In addition to benefits on memory, turmeric also has these benefits, among others:
• It’s a natural anti-inflammatory.
• It’s great for the skin and for skin conditions.
• It helps prevent certain cancers.
• It aids in fat metabolism and weight management
• It lowers cholesterol.
• It improves digestion.

So – now is the time! Introduce more turmeric and curry dishes into your diet. Try these links for some great recipes: http://allrecipes.com/recipes/herbs-and-spices/spices/more-spices/turmeric/top.aspx and http://allrecipes.com/recipes/world-cuisine/curry/. Isn’t it great that we help our brains just by enjoying delicious foods?

Increasing Quality of Life for Those with Dementia Through Their Environment

We all want to do whatever we can to positively influence the quality of life for those suffering from Alzheimer’s and related dementias. There are many ways to do this – medication management, mental stimulation, personal care, etc. – but also important is the management of environmental factors. Recent research has shown that the environment indeed has a significant effect on those with dementia, whether in a residential setting or in ones’ own home. Though the impact may be more significant for those with advanced dementia, it can affect anyone with dementia.

So – what are some of these environmental factors? They include light, sound, temperature and movement. It’s important to keep rooms well-lit except when getting ready for sleep. Many people believe that in the late afternoon, when many are prone to agitation, that it’s best to keep the lights low. This is, in fact, not the case at all. It’s best to keep the lights bright. Low light can be associated with negative mood. High intensity light during the day can enhance both mood and sleep patterns.

As for temperature, it’s important to keep it well controlled and not too warm. High temperatures are often associated with a lower overall quality of life and increased need for assistance in care. What about noise of which there is often an abundance, especially in residential settings? Again, it’s best to keep it at a minimum for many reasons, not the least of which is that it results in fewer social interactions. This includes television, radio, noise from children and pets, intercoms if in a facility, traffic if outdoors, and conversations other than those with the person with dementia. It’s best to minimize as many of these as possible.

One more factor is the amount of movement there is in the space. It’s best to limit people coming into and out of the room or outside if they are within view as well as pets running around continually – especially if one is trying to communicate. Constant movement serves as a distraction which in turn can have a negative impact on the person with dementia in terms of comprehension.

These environmental factors are among the easiest on which to have a positive effect. They cost nothing or very little, they take no time and basically take no energy – what a perfect combination! So – turn up those lights, turn down the temperature and limit as much extraneous noise and movement as possible. Hopefully your results will be positive for you as a caregiver and for your loved one with dementia.

Together We Can Make a Difference

September is World Alzheimer’s Month. Over thirty five million people and their families are affected by Alzheimer’s worldwide and more than five million of those are here in the United States. Though there is research taking place throughout the world, a cure is not yet in site. President Obama recently increased the funding for research but it’s not enough. I firmly believe that we must all get involved on some level. We can certainly do more collectively than any of us can alone. We can give money to the Alzheimer’s Association or other groups focusing on the disease if we are able to afford to do so in these tough financial times. But there’s much more to do than to give money. Below are a few suggestions.

• Wear purple on September 21st – Alzheimer’s Action Day
• Talk to friends and family about the disease. Education is power!
• Write to your legislators about the need to increase funding for Alzheimer’s research, expand programming for those with Alzheimer’s and expand services for those caring for this population.
• Do what you can personally do to keep Alzheimer’s from affecting you – eat nutritiously, exercise, reduce stress in your life, keep socializing and stay mentally active in a variety of ways.
• If you have friends or family with Alzheimer’s, maintain those friendships. You are needed now more than ever!
• Volunteer for programs in your community that raise awareness about the disease – research programs, caregiver programs or programs that assist those with Alzheimer’s.
• Help to reduce the stigma of Alzheimer’s. Talk openly about it. Learn more about it. If you have the disease, seek out friends and foster a positive way of communicating. Be open and direct. Stay connected to those friendships. Connect with others who are affected by Alzheimer’s.
• Advocate far and wide, wherever you can.
• Join a Walk to End Alzheimer’s. Check with your local Alzheimer’s Association or http://www.alz.org to find out more.

Do whatever you can do. Together we can make a difference

More Fuel for the Fire!!

Last week I wrote about the importance of getting a diagnosis if you or a loved one is having significant issues with memory. This week I want to add “fuel to that fire”, again stressing the importance of a diagnosis for a variety of diagnoses. It is important not to always assume that memory issues are caused by “old age” or stress. Significant memory issues are, a majority of the time, caused by neurological issues, most often dementia. However, there are plenty of other health issues that mimic the symptoms of Alzheimer’s disease and related dementias. Hence – getting a diagnosis is absolutely imperative even if only to rule out reversible causes (though there are certainly many other reasons to get a diagnosis, too).

First of all, there are medication side effects which can cause confusion, memory loss and personality changes. These medications include but are not limited to Benadryl, sleeping pills, Aleve, Darvon, Valium, Xanax, Risperdal, Seroquel, Zyprexa, Lipitor, Detrol, Ditropan, Zantac, some blood pressure and heart drugs, Parkinson’s drugs and some stomach drugs.

Other possible causes for confusion and memory issues include:
• Exposure to high levels of iron, lead and copper
• Heavy alcohol consumption for long periods
• Urinary tract infections
• Depression
• Blockages in tiny blood vessels in the brain known as “silent emboli”. High blood pressure, high cholesterol and diabetes all raise the risk for such silent emboli as do many common surgical procedures. The damage they cause can’t be reversed but experts say reducing risk factors may prevent further harm.
• Vitamin and hormone deficiencies
• Normal pressure hydrocephalus

Again, this is not an exhaustive list, but hopefully it’s enough to spur those with significant memory issues on to be tested. Even if the diagnosis is dementia, it’s important to remember that though there is no cure, there are many treatments that can lead to greater quality of life.

How Quickly Does Alzheimer’s Progress?

I am continually asked what stage a person with Alzheimer’s is in or how long it will be before they are confined to bed. There is no simple answer and certainly one size does not fit all. One of the first things I learned in this business is that if you’ve met one person with Alzheimer’s disease, you’ve met one person with Alzheimer’s disease. In other words, everyone with Alzheimer’s is different – just as you and I are. Some people live only a few years after diagnosis and some for many years. Richard Taylor, a noted PhD. and worldwide lecturer, received a diagnosis ten years ago and still advocates throughout the world very successfully for those with Alzheimer’s.

Research has shown that if one looks at the millions of people with Alzheimer’s disease (AD) that about a third of them, such as Richard Taylor, don’t experience a noticeable decline in the first five years. Another third decline at a moderate rate during the first five years and another third decline fairly quickly. Much of the research shows that on average, people with AD live for 8 to 10 years after diagnosis. Of course though, this all depends at which point they are diagnosed. Many wait until the symptoms of the disease are into the middle to end stages to even be diagnosed and it’s obvious then, that their life expectancy at this point is relatively short. Others are diagnosed very early on in the process of the disease. These people often have the best chance for a longer survival rate and slower progression if they stay both mentally and physically active.

Those diagnosed before the age of 65 – early onset Alzheimer’s – often show faster rates of brain tissue loss and cognitive decline than those who are older. Those who are over 80 when diagnosed often experience a less aggressive form of the disease.

As for which stage a particular person is in, there are many theories on this. Dr. Barry Reisberg created a scale of 1 to 7, with 1 being no impairment and 7 being very severe cognitive decline. Others simply use early, middle and late stages as a tool for how the person is progressing. I prefer this when speaking with caregivers as I feel it’s easier. A scale of 1 to 7 is often difficult as most don’t fit exactly into any one set of characteristics.

The most important point that I think one can gain from any of this is the importance of early diagnosis. Though there is no known cure yet, there are certainly things that can be done to possibly delay the onset, slow the progression or at the very least, increase quality of life. I hope that if I begin experiencing symptoms characteristic of AD in the future that my loved ones assure that I get the very earliest diagnosis possible. With knowledge comes power and I want to be as powerful as possible!!!

The Power of Play

Last week I had the wonderful fortune to be offered a whale watching trip for two to the Farallon Islands, some 30 miles past the Golden Gate Bridge in San Francisco. Though I have had the good luck to see whales on quite a few occasions, nothing came close to this trip. First of all, I shared it with my best friend which made it very special. Second of all, it was a gift and so the price was right! Most importantly though, it was an opportunity to see animals in their natural environment, seemingly enjoying themselves and having a great time playing. The humpback whales “waved” with their flukes, the dolphins danced along the boat and the mighty blue whale seemed to swim playfully – all 80 feet of it!

The entire experience reminded me about the power of play. Most of us spent much of our childhoods playing – with dolls, with marbles, playing hopscotch, tag or hide and seek, on the baseball field, wreaking havoc running around the neighborhood and generally having a great, unencumbered time. No worries – just fun! As a matter of fact, when we were 5 or 6 years old, most of us laughed at just about anything – as much as 450 times per day!!

Then comes adulthood and what happens? We stop laughing nearly as much. The average adult laughs 12-15 times per day. What’s up with that? Is life at 6 really 30-40 times happier than when we’re adults???? The answer is an absolute NO as far as I’m concerned. Sure – we have more responsibility. Sure – we can’t just spend our summer days playing and thinking about basically nothing but having fun. Sure – we have to pay the bills. But – we still have time to play – and laugh – and romp through the wet grass – and laugh at silly jokes – and play with toys, – and wear silly hats – and act like clowns, etc. etc etc. Do we really need to constantly take ourselves so seriously? I think not. We need to learn from our children – from our grandchildren – and maybe from some of our friends who still hold onto the importance of play!

So – go out and play. Take care of your responsibilities and then go outside – play with your pets or your grandchildren, make funny faces, laugh at anything appropriate (or maybe sometimes even those things which may not be so appropriate!), tell jokes, read the funny papers, see a comedy at the theatre, watch Lucy eating chocolates candy on the assembly line, – find humor in everyday life. Laugh at yourself – we’re often funnier than anyone around! But, whatever you do, laugh and smile and celebrate all that’s fun and funny in your life. You will be better off for it – and so will your brain!!!

A Silent Plea for Help

How can you help a caregiver or a family of caregivers who is caring for someone with Alzheimer’s disease or a related dementia? Many times, they themselves either don’t realize that they need help – or, even more often, don’t really know how to ask for help. That’s where we, as friends or family, need to step in. We need to find specific ways in which we can help – and then offer, sometimes to the point of insisting, that specific help. Following are some possible ways in which to do this:

1. Stay in touch – with a card, a phone call, an email, a visit. Caregivers often feel alone in their “job” and contact with those who care can make a big difference.
2. Offer to help out with specific jobs – running errands, helping to pay bills, fixing meals, cleaning house, mowing the lawn, etc.
3. Take the person with Alzheimer’s on an outing, giving the caregiver time to themselves – or offer to stay at home with the person so that the caregiver can get out and do something for herself/himself.
4. Listen – the value of simply being a good listener is often overlooked!
5. Include the person with the disease in things. Treat them with respect and always, always, always keep in mind that they are adults and need to be treated as such. Don’t leave them out of fun activities but plan these activities around their schedule and their strengths.
6. Be specific when offering to help. Remember that caregivers often are so tired and stressed that they can’t name specific ways in which they need help. It’s up to us to help them do this. Rather than asking if there is anything you can do for them, let them know that you are going to the grocery store and would be willing to pick up items for them. You may even need to help them write an actual grocery list, checking cupboards and the refrigerator.
7. Check out resources for caregivers. Is there a local adult day program that would be suitable? Are there respite services available? Are there home care agencies that could help with the day-to-day responsibilities? Are there agencies that could provide financial help?
8. Perhaps most importantly, be a friend, in every sense of the word. Friendship is certainly one of the most important necessities for caregivers – and is all too often missing as the disease progresses.

I hope you’ll try out some of these suggestions. There are certainly more but trying these now could make a big difference in the lives of those who are giving so much of themselves that they often don’t have time or energy for themselves.