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.

The Power of Optimism

Have you ever been feeling down – then spent time with a good friend who is very optimistic, coming away feeling much better? Conversely, have you ever been feeling really happy – then had lunch with a pessimistic person, coming away feeling dejected? These situations are great examples of the power of optimism!! The American Heritage College Dictionary defines optimism as a tendency to expect the best possible outcome or dwell on the most hopeful aspects of a situation. An optmist is one who usually (but not always) expects a favorable outcome. optimism is indeed very powerful in so many ways. One recent study showed that optimistic people can outlive pessimists by seven years, even taking into account all other factors!! This alone is reason enough for me to maintain my optimistic attitude!

Other benefits of optimism include a reduction in stress, decreased likelihood of depression, better overall health, an increase in self-esteem, a greater sense of life satisfaction, a reduction in the time one needs to recover from set-backs and a greater likelihood of having healthy relationships. Even if you have been a pessimist in the past, there is hope! Following are some ways in which we can nurture optimism:

1. Limit the time you spend with pessimists, as much as possible!

2. Incorporate more humor and laughter into your everyday life. More about this in a future blog!

3. Look for the positive in every situation.

4. Develop friendships with those who are optimistic. Optimism can be contagious!

5. Look at the mistakes you make as opportunities to grow.

6. Look for the best in every situation.

7. Try to solve problems rather than just complain about them.

8. Adopt positive language. Saying that you can’t do something is often a self-fulfilling prophecy. On the other hand, saying that you will be able to do something can result in success!

0. Do things for others. Volunteer.

10. Celebrate each day and all that it has to offer.

All these things are within your reach. Try them out and see just how powerful optimism can be and what a profound impact it can have on your life. If you’re already one of those lucky people are very optimistic, celebrate!!