How I Stopped My Mother from Being Mean to Me

Alzheimer's World is a wild, sometimes crazy, and backwards place. In Alzheimer's World words from an Alzheimer's patient are often a cry for help. Many times what an Alzheimer's patient says is exactly the opposite of what they mean.

By Bob DeMarco
Alzheimer's Reading Room

Does this person look mean to you?

The list of difficult behaviors that Alzheimer's patients express in the mid stage of the disease are long, and sometimes never ending.

I couldn't possibly list all of the mean and nutty behaviors my mother, Dotty, engaged in in those first few years of our life together with Alzheimer's. The list is just to long.

For this article I am going to focus in on one mean behavior: when my mother repeatedly told me to get out, she didn't need me, and she could take care of herself.

How to Get a Dementia Patient to Do What You Want Them to Do

Many of you can probably imagine what it feels like when a person living with dementia tells you - "I don't need you, get out". Or, says something even worse than that.

So there I was. I had dropped out of the world to care for my mother, 24 hours a day, 7 days a week. Could she have said anything meaner, "I don't need you, get out."

It hurt.

How to Understand the Difference Between Dementia and Alzheimer's Disease

These mean spirited episodes with my mother went on for years before they stopped.

However, I was never deterred by her mean spirited behavior because I made a decision from the very beginning - I am going to put a stop to this.

So I tried everything in the book. I tried being overly nice - didn't work.

I tried being overly positive - didn't work. I tried explaining why she needed my help - didn't work.

I told her if she didn't start accepting my help she would end up in a "home" - that did not work. In fact, it made things much worse.

I tried everything I could think of doing - it did not work.

Finally, I threw the book away and started thinking. And then it happened. I realized something had to change, and that something was me.

Pretty simple huh? Dotty wasn't going to change so it was up to me to change. To change the entire dynamic of our relationship.

Shortly after my realization that I had to change, I invented a new place I first called Dotty's World.

I started asking myself - why? Why does Dotty get so upset? What is happening that is making her upset? Is it me?

Yes, it was me. Okay, we had that out of the way. It was me.

Eventually I changed the name of our new world to Alzheimer's World.

Alzheimer's World was the place I would go to to better understand Dotty, and to better understand me.

At first, I found that it was difficult to change gears and get into AlZheimer's World. So, I actually started taking a giant step to the left when I needed to enter Alzheimer's World. To be honest, I couldn't get there without the step to the left. Just couldn't.

Next, I started taking notes in a spiral notebook. Every time Dotty would get mean I would write down what was happening before these episodes.

One thing stood out. Every time I left Dotty alone, shortly thereafter, she would get mean. "Get out, I don't need you, I can take care of myself".

It became obvious to me that I couldn't leave Dotty alone. I couldn't leave her alone for 30 minutes to go to the store. Or, for any other reason. This is pretty common in mid to later stage Alzheimer's. A person who is deeply forgetful cannot be left alone.

Yes, there were other cataylsts to this mean spirited and often bizarre and crazy behavior.

For example, if I would tell Dotty you can't do that. Or, if I would correct her and try to explain the errors in her thinking. Or, even if I would stop her from doing something.

Once I made it to Alzheimer's World I started looking at the world from Dotty's point of view. I looked at the world from her eyes.

Pretty soon I realized that the things that Dotty would do seemed very normal to her. I just looked at her while she did them and pretty much kept my mouth shut.

Pretty quickly, almost overnight in fact, I accepted that the things Dotty did were normal in Alzheimer's World. So, I stepped to the left to better understand.

Topic - Living in Alzheimer's World

In Alzheimer's World instead of getting all bent out of shape, I found myself marveling at the things Dotty would do. The things that Alzheimer's patients do are often fascinating. After all, their brain works differently that yours and mine. You have to start understanding the brain on Alzheimer's.

Now to my first major point. When Dotty said,

"Get out, I don't need you, I can take care of myself"

that is not what she meant. What she did mean is:

Don't leave me alone, I'm scared, please don't put me away in a home.

Yep, she was scared and, like it or not, I was the one causing the fear when I left her alone.

Simple solution, I stopped leaving her alone.

Once I realized that there was a very different meaning to Dotty's words in Alzheimer's World, I was able to develop better and better solutions to problems.

In this case, I didn't leave Dotty alone. But that is not all that I did. When she said "get out", instead of getting all bent out of shape and reacting back at her, I did the exact opposite. What did I do?

I smiled, walked over to her, put my arm around her, and calmly said, in a clear, low, confident voice,

I'm not going anywhere, we are here together now, and I am going to take care of you.

It took a while, but yes, it finally sunk into her brain.

Alzheimer's World is wild, sometimes crazy, a backwards place. I learned that in Alzheimer's World words from an Alzheimer's patient are often a cry for help. Many times what an Alzheimer's patient says is exactly the opposite of what they mean.

So I started meeting meanness with an equal and opposite reaction - kindness. Kindness, compassion, and understanding.

This is how you learn to cope with Alzheimer's. Understand, cope, communicate.

By the way, Dotty stopped telling me to get out.

In the last few years Doty only told me to "get out" a few times.

I actually laughed when she said it. Not at her, more or less, really laughed at myself.


___________________________________Related Articles

• What is the Difference Between Alzheimer’s and Dementia
• Test Your Memory for Alzheimer's (5 Best Memory Tests)
• What is Alzheimer's Disease?
• Is Alzheimer's World an Irrational Place?
• Communicating in Alzheimer's World
• 10 Symptoms of Early Stage Alzheimer's Disease
• The Seven Stages of Alzheimer's

___________________________________
Bob DeMarco is the Founder and Editor of the Alzheimer's Reading Room (ARR). The ARR Knowledge Base contains more than 5,000 articles. Bob lives in Delray Beach, FL.

You are reading original content the Alzheimer's Reading Room

Nutrition And Immunity In Children

Often in first signs of cold parents complain on weak immunity of child imagining badly what signs of illness exactly should cause anxiety. Does your child get diseased with influenza 3 – 4 times a year?

Most likely, in this case there is no need to worry and interfere with process of immunity formation in child. As general strengthening procedures may be recommended cold training of the body, walkings on fresh air and in children over 3 years old taking of natural botanical medicines based on Echinacea juice.

Day regimen
When sleep, rest, exercises, studies, work and food intake occur at one and the same time, then for the body it is easier to turn from one activity to another and there is consumed much less energy. Rhythmic cycle helps the body to effectively recuperate, optimally react on stress and changes, therefore child with an accurate and cozy regimen has more capabilities to meet an attack of bacteria and viruses.

Nutrition
First of all, for adequate development child should consume animal proteins and fats. For cold prevention it is good to eat onion and garlic – natural products containing phytoncides - and also vegetables, fruits and berries of red, orange and green color which do contain great amount of vitamin C.

It is better to avoid flavor enhancer, colorants and synthetic vitamins because they do give an additional load on body systems, provoke allergic reactions and do overload child's immunity because they are taken for a long time without taking into consideration individual needs.

Sugar also overloads immune system, helps to wash away from the body all vitamins and microelements and it would be better to exclude it from baby foods. It is good when meals take place at one and the same time as this helps body to better digest foods.

Children's Immunity

One of most important tasks of all parents is care about strengthening their children's immunity because immunity is the base of human health throughout the whole life from birth to decay.

In order to find out how to develop and strengthen child's body defences it is necessary to know nature and mechanisms of immunity. Immunity is the ability of body to effectively resist the action of foreign microorganisms, for example, viruses and bacteria that cause infectious diseases.

There are two types of immunity:

• specific immunity that develops after past diseases, for example, rubella or measles. This immunity type may be developed for the whole life or for some time depending on the disease.
• non-specific immunity that develops in a baby during pregnancy.

From mother's breast milk child gets antibodies to infectious disease which mother had. It means that child on breast feeding has passive immunity and this is very important in first months of life because in this period proper immune system only starts working. 

Therefore, when mother gets cold she needs to continue to feed child with her breast to give antibodies to baby. WHO recommends to feed baby up to two years or even more. Growth factors presented solely in female milk help baby's immune system develop normally.
 

Bifidus factor and lactoferrin presented in mother's milk do increase healthy bifido and lactic bacteria in bowels and reduce growth of pathogenic flora which strengthens child's immunity and lowers liability to colds. Breast feeding cannot 100% guarantee no diseases, but healthy gastrointestinal tract and calm emotional atmosphere in family lower likelihood of getting sick.

5 Effective Ways to Boost Your Immunity

1. Reduce stress in your life
Stress may have positive effects as it is a kind of training before real run, however excess of stress has negative effects and does great damage to your body. Health experts claim that stress decreases immunity and this makes body vulnerable to diseases. Learn to relax and occupy yourself with things you really like. This would have positive effects on your nervous system.

2. Enjoy regular sex
Remember that sex not only relaxes your body and gives pleasure, it also boosts your immunity. Studies showed that regular sexlife (ideally, with permanent partner) is a key to strong health. Latest study examined the connection between health of middle-aged people and sexual activity. Researchers came to the conclusion that people who lead regular sexlife have significantly better health condition than those who make sex rarely.

3. Smile more, laugh more
Researchers tried to find a connection between body protective functions and laugh. It turned out that those who truly laughed during watching cartoons showed immune functions increase.

4. Lead an active life
Regular exercises and generally physical activity do greatly train heart and persistence, they help to increase protective functions of the body and immunity. Spend 15 minutes each day for making exercises. Ideally, spend one hour three times a week.

5. Take up a family pet
Dog is called man's friend for a reason. Among with other pets dog brings a man joy and does not let him seat at one place but instead to move, thus helping to improve human health. It was proved that in these people blood pressure and cholesterol levels get normalized, heart health and vessels health get improved.

Treatment And Prevention Of Virus Infections

It is necessary to create conditions in which fighting between virus and child ends up with child's victory. These conditions include regimen, diet and special medications.

Treatment:
1. Fighting with concrete disease symptoms. For example, treatment of eruptions on skin or cough attenuation, or particular nose drops, or action on high body temperature.
2. Improvement of functioning and lowering of natural loads on cells damaged by virus. For example, anti-inflammatory remedies or medications improving work of liver cells, or medications that activate blood supply of brain cells.

Significant complications and significant limitations that appear when choosing treatment methods of virus infections do define the fact that it is necessary to pay spacial attention on preventive measures.

How to prevent virus infections?
1. Vaccination. Injecting in the body of weakened virus leads to production of antibodies protecting from a particular virus infection (measles, rubella, poliomyelitis, hepatitis B, influenza, tick-borne encephalitis).
2. Avoiding contacts with potential source of infection. At home patient with influenza should be isolated from other members of his family. Selective sexlife to prevent AIDS and other sexually transmitted diseases.
3. Healthy lifestyle helps to formation of a normal immune system.

What Happens When a Virus Enters Your Body

When virus enters human body it starts to fight against the virus, at the beginning at level of non-specific immunity then do appear antibodies. Antibodies do neutralize virus and the disease finishes.

However, it is not so easy as it looks at the first sight. In some cases during the time necessary for antibodies production the virus manages to cause many destructions in the body which leads to severe complications. Sometimes virus enters the human body, infects particular cells and stops his existence. It means that virus is in the body and it really is found in particular cells but this causes no disease – virus does not multiply, it stays in the cell waiting until the immunity weakens.

If virus is able to actively multiply it quickly leads to death and destruction of cell he captured. From destroyed cell they get into blood where antibodies are waiting for them. Thus it happens that active viruses cause acute contagious diseases (rubella, measles, mumps) which last all the time that body needs for antibodies production.

Terms for antibodies production are absolutely determined and as a rule it is 5 – 10 days, therefore it always may be said how long a man will be diseased with measles and when the rash would disappear. The doctor always knows after how many days a patient diseased with rubella would feel better. So if influenza lasts three weeks it means that it is not influenza.

The fact that viruses are found in cells of human body determines major complications in treatment of any viral infection. It is very difficult to destroy virus and leave the cell alive. Not surprisingly, there are few antiviral medications and all of them them are quite specific – it means they act against a particular virus (for example, Tamiflu acts against viruses of group A) or group of viruses (Acyclovir -  against all herpes viruses). It is clear that main principle of viral infections treatment is to help body to fight the virus.

Each Viral Infection Has Its Specific Symptoms

Some time ago one of most terrible diseases was considered natural smallpox, virus of which may live only in human body. During two decades in the world there were registered no cases of infecting human with natural smallpox, it means that the virus causing the disease ceased to exist in wild life. This occurred due to compulsory vaccination against smallpox in past.

Before 1958 each year in the world the diagnosis “smallpox” was made at average 250,000 times. In 1958 the WHO started the campaign of total smallpox liquidation. In 1980 was declared that the Earth is free of natural smallpox.

Each cell in the body performs a number of specific individual functions. After infecting with virus sooner or later do appear problems. Virus damages liver cells – this causes yellow disease and other signs of liver failure. Virus damages mucosa of bronchi – this causes cough, rhonchi in lungs and hurried breathing.

Virus enters cells of the brain – do appear disorder of consciousness, cramps, paralysis. Selectivity of viruses leads to the fact that each viral infection has its specific symptoms and the symptoms will be determined by inability of group of cells damaged by viruses to perform their functions.

Severity of viral infection depends on what cells and how many of them are damaged. It is clear that damage of brain leads to more serious illness than damage of cells of nasal mucosa.

Every cell in human body changes in a certain way during its growth and development. It means that liver cell of a child is not the same as liver cell of an adult. In a child hepatic cell is not maturated yet and hepatitis A virus can hardly multiply in these immature cells, therefore one-year-child never gets diseased with hepatitis A, in older children the disease courses mildly, in teenagers severely than in children, in adults it courses severe.

Childhood infection (rubeola, chickenpox) do course severe in adults. The severity of disease is determined by the condition of a particular cell. For example, hepatic cell of a drunker is weaker than in a non-drunker.

The Variety Of Viruses

 Virus may be seen only with the help of electronic microscope. The vast majority of doctors meet viruses and electronic microscopes only on images in clever medical books. Diseases caused by viruses  have so specific symptoms that it makes no use of  electronic microscope and images because everything is clear.

The essential and most significant biological peculiarity of any virus is that it is unable to multiply without cells of other organisms. Virus enters a particular cell and this infected cell transforms into a factory of virus production.

It is clear that cell cannot work for both virus and body and thus it cannot perform its major function and here appear absolutely specific symptoms of the disease. Major feature of the virus is its selectivity. Virus cannot live in any cell, it needs a proper one which will work for it.

For example, infectious hepatitis virus may live and multiply only in liver cells. Epidemic parotitis virus (mumps) prefers cells of salivary gland, influenza virus – cells of mucous membrane of bronchi and tracheae, encephalitis virus – cells of cerebrum. Each virus may be associated with particular cells and tissues of human body which virus damages.

Virus selectivity is observed not only in damages of particular cells but also in the ability to cause particular diseases in particular biologic species. Measles virus may find necessary cells in human body and is not dangerous for a cat. Virus of hardpad is not dangerous for a human.

These are not common rules. Particular cells of different mammals are analogous with each other and some viruses cause one and the same disease in different animals, for example, rabies virus. The ability of some viruses to affect only particular biological species has a great significance.

Remedy Against Melanoma Found In Immunity

American scientists have developed a new method to treat melanoma which was successfully tested on mice.

What melanoma is
Melanoma is a cancerous growth on the skin that is developed from pigment cells containing melanin. Externally melanoma resembles a usual mole, however, there exist particular signs that help to define  cancerous growth. Unlike mole, cancerous growth is a non-symmetric formation with irregular edges and its diameter is more than 5mm. In some cases inoffensive mole which did not show itself for years  may turn into melanoma.

Signs that mole turns into melanoma:

• size increase
• color change
• reshaping
• itching
• ulceration
• bleeding

Major factor leading to melanoma development is action of ultraviolet irradiation.

What are the dangers of melanoma?
Major danger of melanoma is that even small tumors give metastasis into all organs and tissues of the body. The process of metastasis formation presents spreading of cancerous cells via lymphatic and blood vessels. When cancerous cells get into healthy organs and tissues they start multiplying which significantly aggravates treatment and the prognosis for treatment.

History of the research
Watching the mice which had no genes responding for production of special type of immune cells – T helper 17 cells., scientists found that in those mice melanoma was not developed. Thus appeared a hypothesis that blocking of signal path of T helper 17 cells would help to stop tumor growth. Besides this, scientists found that in mice bodies was presented a specific substance called interleukine that is formed under the action of other immune cells – T helper 9 cells.

Essence of the research
The research was performed on mice in which scientists modeled melanoma. As a treatment, scientists injected T helper 9 cells in mice. It turned out that immune therapy helps to slow down tumor growth. Besides this, scientists discovered that in a healthy man T helper 9 cells are found in blood and skin while in melanoma this type of immune system cells is absent or is found in small amounts.

Results of the research
Today is actively developed a new method of cancer treatment called immune therapy. Results of the latest study tell about success of usage drugs stimulating immune system in patients with melanoma. Scientists hope that data obtained will help to perform new studies to evaluate the role of T helper 9 cells in cancer treatment.

Bird Flu Just Three Mutations Away

Bird flu virus continues to mutate. If it would be able to transmit from human to human than humanity would face a new pandemic.

In spite of the fact that bird flu is the disease of birds, some viruses of bird flu may infect humans and cause severe infections that often end up with death.

Today bird flu virus is not transmitted from human to human. However, if the virus mutates, it may begin to transmit from human to human which may result in a pandemic.

Scientists claim that only several mutations do separate humans from a real pandemic.

Lack of Sleep and the Immune System

A group of researchers from Great Britain and Netherlands studied how human body reacts on lack of sleep. Like stress, lack of sleep (including chronic one) has negative effects on the immune system. 

During stress human body starts to produce granulocytic cells, a kind of leukocytes. Lack of sleep has the same effects. It was proved by a study in which participated 15 young people who slept 8 hours  daily during a week, after which they did not sleep for 29 hours.

Tests have shown that 29 hours of insomnia provoked not only increase in production of granulocytic cells but also break in rhythm of renewal of white blood cells. It was proved that lack of sleep may cause different diseases such as obesity, diabetes and increased blood pressure.

Researchers also say that chronic lack of sleep leads to absorption of body immune system. In the very near future they intend to make one more study during which they plan to study body reaction on stress at molecular level in order to understand how exactly lack of sleep provokes different diseases.

Scientists consider that results of the study are an occasion to overview schedule of work in professions which are connected with long periods of awakenings, for example, where people work in rotating teams.

How To Fight Summer Cold

It is considered that colds are winter problems. In fact, 20% cold-related diseases occur in summer months. To catch a cold in heat is not just an annoying confusion. Specialists say summer colds are more dangerous than winter ones because summer symptoms are not so manifestative. Many people do not pay attention to sore throat and running nose and therefore even do not try to treat them. So they feel sick for a longer time.

There exists another cause. Upper respiratory tract infections together with sore throat, cough, running nose, temperature increase are caused by parainfluenza viruses, coronaviruses and rhinoviruses. They circulate all the year round but in summer time enterovirus joins them and it shows with rash on skin and diarrhea. Enterovirus is transmitted not only via dirty hands but also via airborne. It means that risks to catch a virus in summer time even increases.

Why do we catch cold in summer?
1. Air-conditioner
Habitually we do escape from heat and prefer to stay in places with air-conditioners and ventilators, but namely they are major causes of colds. Permanently circulating air dries nasal mucosa that is a protective barrier against infections which makes viruses easily enter the body. Besides this, conditioned air is not only dry but also cold one and these are perfect conditions for virus replication.

Solution: do not do at home air colder than 21C. Ideally, the difference between air temperature in the house or office and outside must be not more than 5 – 7C.

2. Icy drinks
Sensation that icy drinks allay thirst is deceptive one. They do freshen up for a quite short time but for throat it is a real icy shock. Overchilled mucous loses its ability to fight viruses and bacteria. After ice cream and other diary products those effects are stronger than after icy juice or water.

Solution: do not drink beverages with ice. It would be better to eat slightly melted ice cream. It is necessary to drink beverages or eat cold food with small portions in order to let them warm in the month.

3. Journeys
In summer we do actively travel and microorganisms do travel with us. In hotels holidayer may face infections unknown before. There is a major risk to catch a virus in air plane. Restricted space of air plane together with very dry air is an ideal medium for disease transmission. It was proved that chance to catch a cold depends directly on duration of flight – the longer you fly, the higher the risks are.

Solution: do not admit mucous drying, use rewetting drops and sprays for nose, drink more water. In vacations use antibacterial wet wipes. Remember that easiest way to catch cold is after flight during period of acclimatization. Those who like to spend time under the sun should know that the excess of solar radiation lowers the immunity.

Low Dose of Stress Strengthens Immunity

It is well known fact that chronic stress is destructive for the body, however, low doses of stress may be helpful. According to a research, acute stress has positive effects on human nature, makes him more accurate and punctual, and sets up his immune system.

During experiments scientists subjected participants to small stress by making them solve simple and difficult tasks, and then invited them to play a game connected with the ability to share. It turned out that those who experienced more stress, were more friendly, generous and trustworthy.

Acute stress helps to better memorizing, say scientists from Buffalo University, USA. Experiments were performed on rats and they showed that stressed animals digest information more quickly and do reproduce it more exactly. The point is that stress hormone cortisone has protective effects on prefrontal parts of brain cortex which controls emotions and learning.

Low dose of stress strengthens the immune system. Review of 300 scientific works showed that chronic stress weakens defense mechanisms of the body making it more vulnerable to infections. Short-term stress trains the immunity, making it more willing to fight pathogens.

Acai For Your Health

A group of medical workers carried out a research in Amazon rainforest and found that the natives show resistance to unbearable heat typical for this region. The natives who spent many time under the sun without cloths had no skin diseases (including cancer).

Besides this, they looked younger and kept energy and health till extreme old age. After analyzing their diet, scientists found that besides products common for this region, the natives consume little known berry called acai.

Scientists claim that berry Acai is most nutrimental and energy product in the world.

The secret of Acai was discovered only in 2004. The initiative of research belongs to Dr.Alex Schauss, who is director of natural and medicinal products research for the American Institute for Biosocial and Medical Research. The researches showed that today Acai occupies leading place among natural antioxidants. Thus, medical and biological research showed that Acai contains most antioxidants than any other edible fruit on the planet.

In fact, this amazon berry contains 33 times more antioxidants than red grapes, 18 times more than mangosteen, 4 times more than cranberries or wild bluberries which previously was considered a champion among antioxidants. Moreover, Acai contains 30 times more antioxidants and 10 – 20 times more anthocyanins than red wine.

Acai healthy properties
1. Acai contains same amount of proteins as cow milk, and with its energy values and fat content Acai even goes before it.
2. Acai contains vitamin A, B1 (thiamine), B2 (riboflavin), B3 (nicotinic acid), C (ascorbic acid), E (tocopherol), D, iron, potassium, phosphorus and calcium.
3. Acai contains fatty acids essential for human body such as Omega-6 and Omega-9 necessary for lowering of “bad” cholesterol in blood, and many other essential asids.
4. Acai contains cyanidine that prevents from development of obesity and diabetes. Latest studies show that Acai would play an important role in cancer treatment.

Preventive Measures Against Influenza

 Prepare healthy drink “80 berries”
Fill three liters of water into a pot, put 40 berries of brier and boil it on a very small fire for three hours. After this add necessary amount of water as it was in the beginning, put 20 berries and boil it again on a small fire for three hours. Add the rest of 20 berries, bring the amount of water to three liters and boil it for three hours again.

What is the effect?
In 9 hours  you will get a concentrate of multivitamin complex and other important micro and macro elements which may compete with tablet vitamins and strengthen protective powers of the body. Besides this, this beverage has a good diuretic effect which helps to quicker toxin release. A man may drink it in unlimited amounts.

Contraindications
People suffering from thrombophlebitis, endocarditis and heart failure should not drink this drink, because berries of brier increase blood coagulability.

Prepare Vitaminic Coffee
Mill berries of brier in coffee-grinder. Put them in a cup and fill it with boiling water. Let it infuse for 10 – 15 minutes.

What is the effect?
Due to small thermal processing in 100g of berries is kept 50 times more vitamin C than in 100g of lemon.

Contraindications
This drink is contraindicated to people who suffer from ulcer disease and gastritis because large amounts of vitamin C irritate stomach walls which leads to aggravation of inflammations.

Dementia Care is not a 9-5 job!

Unfortunately for my Dad he did have hallucinations that night which resulted in 100 mgs of Seroquel being administered. Thus, began my Dad’s downward spiral into a personal hell we are still struggling to correct.

By Ellen Belk
Alzheimer's Reading Room

This is a Call-to-Action to the myriad of ‘service providers’ that litter the landscape of Senior Care.

The operations, organizations and companies that cater to the care providers of the memory impaired.

Please keep in mind, that although your offices may shut down at 5pm each day and are closed on weekends, those of us who seek your help after hours are left to fend for ourselves in serious moments of crisis.

If you aren’t available, where are families to turn in their greatest moment of need?

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As an accomplished dementia care employee myself, I’ve personally guided families after regular business hours. I’ve greeted them at the door on a Sunday. I’ve held the hand of an anxious son, past 8pm on a Friday, when his father was moving in. I’ve answered my phone on holidays and weekends many times throughout my career. Professionally, I’ve made the conscious decision to be available to folks during their times of struggle.

Recently, my professional and personal worlds collided when I got the call from my 83 year old mother on a Sunday, that my dad had fallen and she was in the local Emergency room with him awaiting X-ray results. I, like so many other adult children of aging parents, am a long-distance care provider. I live in the South and my parents, in the Midwest.

On that Sunday, my dad awoke, like any other day. He dressed and had breakfast with my mom in the condo they share. Unfortunately he fell in the bathroom that day, sometime around Noon. Ten days prior to his fall, he’d visited his primary Doctor, where it was discovered that Dad had a UTI. Not uncommon for a man of 82 years. Although the Doctor had commented on my Dad’s noticeable weight loss, he prescribed a strong anti-biotic for the infection. In the days leading up to the fall, Dad had experienced nighttime hallucinations, which we now know may have been due to the medication.

Dad walked into the ER that Sunday with Mom and was able to fully explain to the hospital personnel what had happened. My parents were simply there as a precaution to make sure there were no hidden injuries, to be concerned about. As the hours dragged on, and they were still sitting in the waiting room, it became apparent that Dad would be held overnight in the hospital.

I immediately called my brother and sister, who live in the same state as my parents and alerted them of the situation. Because I’m familiar with how Hospitals treat those, who have hallucinations, I became anxious from long-distance with dread of what may happen if my Dad had one of those episodes overnight.

My brother and I spoke via phone as he drove to the hospital and I instructed him to find out if they ‘medically restrain’.

In an instant, I began a crash course with my siblings, who up until this incident were ignorant of the procedures and methods of an industry that isn’t equipped or trained to handle dementia-like behavior.

As a precaution, I called a well known company that provides companion services with the intention of hiring someone to stay with my dad overnight to ensure his safety. It was approximately 3 PM on that Sunday. The first company I contacted told me point blank that it was too short of notice for anyone from their office to assist. When I asked her if someone from another of their offices could help, she told me she wasn’t familiar with the area and I abruptly ended the call, as I quickly realized this was not going to be an easy task.

Through internet research, I found another office that served the area my parents were in, however was told again, it was too short of notice for them to be of any assistance. Realizing that industry professionals were not going to be our answer; my sister willingly agreed to hold vigil with Dad that night in the hospital. Because the X-rays had been negative, we all thought it would be a one night stay and he’d be home by late Monday.

Unfortunately for my Dad, he did indeed, have hallucinations that night which resulted in 100 mgs of Seroquel being administered. Thus, began my Dad’s downward spiral into a personal hell we are still struggling to correct. Dad had a significant adverse reaction to that medication and by Tuesday, he was unable to speak coherently, walk or feed himself. I arrived at the hospital on Wednesday and he didn’t even recognize me.

I reached out to various Geriatric Care Management companies in search of a professional advocate who would assist my family, when I had to return to my home. Unfortunately, I had to make those calls, after 5 PM, as time becomes your enemy when you are sitting bedside with your loved one all day.

And again, I was hearing automatic answering responses instructing me to call back during ‘normal business hours’. Normal? There is no normal when you are in crisis and seeking help for a loved one.

Our journey still continues and throughout our two month journey, we’ve endured Doctor’s who couldn’t be reached because they were on vacation, another Geriatric Care Management company who couldn’t provide weekend coverage and a primary Doctor who was too busy with patients to return our calls.

Newsflash to those of you touting your ‘Senior Care services’, find a way to be available after hours and on weekends. Because the reality is; crisis doesn’t always occur Monday thru Friday between 9 AM and 5 PM.

Surely, there has to be an organization who will realize this phenomenon and become an industry leader in offering services when the others have gone home for the day.

Ellen Belk is President of Keep In Mind™ and creator of Memory Magz™. Since 2001, Belk has specialized in developing programming for the memory impaired. A mature musician concert band, an intergenerational Senior Prom and a Fine Art appreciation program are amongst her professional highlights. Memory Magz™ are ‘magazine style’ picture publications with full page vibrant images purposefully designed for people with cognitive decline and/or developmental disabilities. As a public speaker, Belk engages the audience with her inter-active style and witty story telling. www.keepinmindinc.com.

More Insight and Advice from the Alzheimer's Reading Room

• What’s the Difference Between Alzheimer’s Disease and Dementia
• Something Had to Change
• Alzheimer's Caregivers are the Chosen
• What is Alzheimer's Disease?
• What is Dementia?
• Communicating in Alzheimer's World
• Alzheimer's and Learning How to Trust
• Learning How to Communicate with Someone Suffering From Alzheimer's Disease
• Alzheimer's World -- Trying to Reconnect with Someone Suffering from Alzheimer's Disease
• Rewiring My Brain and Stepping into Alzheimer's World
• Why I Invented Alzheimer's World and the Power of Positive Reinforcement

Original content Ellen Belk, the Alzheimer's Reading Room

LADA (LATENT AUTOIMMUNE DIABETES IN ADULTS)

Latent autoimmune diabetes in adults (LADA) is a disorder in which, despite the presence of islet antibodies at diagnosis of diabetes, the progression of autoimmune β-cell failure is slow. LADA patients are therefore not insulin requiring, at least during the first 6 months after diagnosis of diabetes. Among patients with phenotypic type 2 diabetes, LADA occurs in 10% of individuals older than 35 years and in 25% below that age. Prospective studies of β-cell function show that LADA patients with multiple islet antibodies develop β-cell failure within 5 years, whereas those with only GAD antibodies (GADAs) or only islet cell antibodies (ICAs) mostly develop β-cell failure after 5 years. Even though it may take up to 12 years until β-cell failure occurs in some patients, impairments in the β-cell response to intravenous glucose and glucagon can be detected at diagnosis of diabetes. Consequently, LADA is not a latent disease; therefore, autoimmune diabetes in adults with slowly progressive β-cell failure might be a more adequate concept. In agreement with proved impaired β-cell function at diagnosis of diabetes, insulin is the treatment of choice.

Diabetes Types Key characteristics of type 1, LADA (latent autoimmune diabetes in adults), and type 2.
	Type 1	LADA	Type 2
Typical age of onset	Youth or adult	Adult	Adult
Progression to insulin dependence	Rapid (days/weeks)	Latent (months/years)	Slow (years)
Presence of autoantibodies*	Yes	Yes	No
Insulin dependence	At diagnosis	Within 6 years	Over time, if at all
Insulin resistance	No	Some	Yes

 SURPRISE FINDING

 Doctors stumbled upon the LADA phenomenon quite by accident back in the 1970s. They were testing a way of identifying proteins called auto ­antibodies in the blood of people with type 1. The presence of these proteins is evidence of an attack by one’s own immune system. The new test was successful and confirmed for the first time that type 1 is an autoimmune disease in which the body’s immune system kills off the beta cells in the pancreas, the makers of insulin.
As part of their study, the researchers also looked for the same auto antibodies in the general population and in people with type 2 diabetes (which is not an autoimmune disease). The proteins were virtually absent in the general population, but they showed up, to the scientists’ surprise, in about 10 percent of people diagnosed with type 2. This suggested that there was a subcategory of people who could now be diagnosed as having LADA instead, even though there was no obvious difference in their symptoms from those of people with type 2.
While not everyone has settled on calling the condition LADA (some prefer “type 1.5”), or even whether it’s distinct from type 1, researchers are working on a set of criteria for its diagnosis: 1) the presence of auto­antibodies in the blood, 2) adult age at onset, and 3) no need for insulin treatment in the first six months after diagnosis. This definition would distinguish LADA from type 1—because people diagnosed with type 1 typically need to start insulin immediately—and from type 2, because of the presence of auto antibodies in the blood.

The Warning Signs YOU May Have LADA

1. You are diagnosed with Type 2 diabetes while at a normal weight.

2. Whatever your weight, either you or a member of your family has some other autoimmune disease such as thyroid disease, rheumatoid arthritis, lupus, or multiple sclerosis.

3. You lower your carbohydrate intake shortly after diagnosis to no more than 15 grams a meal and still have a fasting blood sugar over 110 mg/dl and blood sugars that rise 40 mg/dl or more after each meal.

4. No matter what your weight, you do not see a dramatic drop in your blood sugar when you take metformin, Avandia, Actos, Januvia or Byetta in combination with a lowered carbohydrate intake.

5. Your blood sugar deteriorates significantly over the period of a year despite treatment with oral drugs and carbohydrate restriction.

What To Do To Get A LADA Diagnosis

If you think you have LADA ask your doctor for:

1. A fasting C-peptide test. If the value is low, it is suggestive of LADA.

2. GAD and Islets antibody tests. High levels of these antibodies are diagnostic of LADA especially in combination with lowered C-peptide.

Could Deep Brain Stimulation be a Treatment for Alzheimer's Disease

For the study, surgeons implanted a tiny electrode able to deliver a low-grade electrical pulse close to the fornix, a key nerve tract in brain memory circuits.

Alzheimer's Reading Room

Gwenn Smith

This is an interesting Phase 1 study that is designed to establish safety.

The current study came about almost by accident. Deep Brain Stimulation (DBS) was being used to treat an obese man. Unexpectedly, the man had a significant increase in memory.

DBS is accomplished by what could best be described as a pacemaker for the brain.

It is our understanding that the Phase 2 clinical trials will take place at the University of Toronto, Hopkins and additional sites in the United States. We will be on the lookout for the clinical trial filing, when recruiting of patients will start, and the eligibility requirements.

We will let you know.

Deep brain stimulation may hold promise for mild Alzheimer's disease

Small phase I study suggests 'brain pacemaker' could slow progression of AD

A study on a handful of people with suspected mild Alzheimer's disease (AD) suggests that a device that sends continuous electrical impulses to specific "memory" regions of the brain appears to increase neuronal activity. Results of the study using deep brain stimulation, a therapy already used in some patients with Parkinson's disease and depression, may offer hope for at least some with AD, an intractable disease with no cure.

"While our study was designed mainly to establish safety, involved only six people and needs to be replicated on a larger scale, we don't have another treatment for AD at present that shows such promising effects on brain function," said the study's first author, Gwenn Smith, Ph.D., a professor in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine.

The research, published in the Archives of Neurology, was conducted while Smith was on the faculty at the University of Toronto, and will be continuing at Toronto, Hopkins and other U.S. sites in the future. The study was led by Andres M. Lozano, chairman of the Department of Neurosurgery at the University of Toronto.

One month and one year after implanting a device that allows for continuous electrical impulses to the brain, Smith and her colleagues performed PET scans that detect changes in brain cells' metabolism of glucose, and found that patients with mild forms of AD showed sustained increases in glucose metabolism, an indicator of neuronal activity. The increases, the researchers say, were larger than those found in patients who have taken the drugs currently marketed to fight AD progression. Other imaging studies have shown that a decrease in glucose metabolism over the course of a year is typical in AD. Alzheimer's disease cannot be precisely diagnosed by brain biopsies until after death.

The team observed roughly 15 percent to 20 percent increases in glucose metabolism after one year of continuous stimulation. The increases were observed, to a greater extent, in patients with better outcomes in cognition, memory and quality of life. In addition, the stimulation increased connectivity in brain circuits associated with memory.

Deep brain stimulation (DBS) requires surgical implantation of a brain pacemaker, which sends electrical impulses to specific parts of the brain. For the study, surgeons implanted a tiny electrode able to deliver a low-grade electrical pulse close to the fornix, a key nerve tract in brain memory circuits. The researchers — most with the University of Toronto — reported few side effects in the six subjects they tested. Just as importantly, says Smith, was seeing that DBS appeared to reverse the downturn in brain metabolism that typically comes with AD.

AD is a progressive and lethal dementia that mostly strikes the elderly. It affects memory, thinking and behavior. Estimates vary, but experts suggest that as many as 5.1 million Americans may have AD and that, as baby boomers age, prevalence will skyrocket. Smith says decades of research have yet to lead to clear understanding of its causes or to successful treatments that stop progression.

The trial of DBS came about, Smith reports, when Lozano used DBS of the fornix to treat an obese man. The procedure, designed to target the regions of the brain involved in appetite suppression, unexpectedly had significant increases in his memory. Inspired, the scientists persisted through rigorous ethical and scientific approvals before their AD phase I safety study could begin.

Smith, who also is director of the Division of Geriatric Psychiatry and Neuropsychiatry at Johns Hopkins Bayview Medical Center, is an authority on mapping the brain's glucose metabolism in aging and psychiatric disease. It was Smith's earlier analysis of AD patients' PET scans that revealed their distinct pattern of lowered brain metabolism. She determined that specific parts of the temporal and parietal cerebral cortex — memory network areas of the brain where AD's earliest pathology surfaces— became increasingly sluggish with time.
___________________________

The new study was supported by grants from the Neurosurgical Research and Education Foundation, the Dana Foundation and the Krembil Neuroscience Discovery Fund.

Clifford I. Workman, B.S., of Johns Hopkins also contributed to this research.

For more information: http://www.hopkinsmedicine.org/psychiatry/expert_team/faculty/S/SmithG.html

More Insight and Advice from the Alzheimer's Reading Room

• What’s the Difference Between Alzheimer’s Disease and Dementia
• Something Had to Change
• Alzheimer's Caregivers are the Chosen
• What is Alzheimer's Disease?
• What is Dementia?
• Communicating in Alzheimer's World
• Alzheimer's and Learning How to Trust
• Learning How to Communicate with Someone Suffering From Alzheimer's Disease
• Alzheimer's World -- Trying to Reconnect with Someone Suffering from Alzheimer's Disease
• Rewiring My Brain and Stepping into Alzheimer's World
• Why I Invented Alzheimer's World and the Power of Positive Reinforcement

Original content Bob DeMarco, the Alzheimer's Reading Room

Online Alzheimer's Support, and Dotty Update

Don't get me wrong. We are not giving up. I have no idea what tomorrow will bring.

By Bob DeMarco
Alzheimer's Reading Room

You read a lot about how kids these days communicate via text and online. Some worry that the lack of personal, face to face communication, is a bad thing. Maybe, maybe not.

I can say this with complete confidence. The emails and comments I received today, when I wrote about Dotty here in the virtual world, mean as much to me as face to face communication. I feel empowered, energized, and I know I am not alone.

The Alzheimer's Reading Room is a virtual place, an online place. But where would I be right now without it?

I know one thing for sure, I would be feeling mighty lonely, and stressed out to the max. My level of stress went straight down today reading your best wishes and prayers to us.

I understand that I don't know most of you in person, but that does not stop me from feeling and believing that I know those of you who write to me, and those of you that share by commenting.

The comments section on this website are as important as any other part of the blog.

I probably won't get the chance to thank each and everyone of you by writing back. So, I'll do it right now.

Thank you.

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As I mentioned previously, I Would Rather Be Lucky Than Smart, Dotty Gets a New Doctor, we just moved to a new personal care doctor. My immediately impression was that we had finally found a replacement for the wonderful Dr Chiriboga. Today proved me correct.

We went into the examination room and before I could ask Dr Abreu, he asked me if I wanted Hospice. In fact, he looked me right in the eye and asked.

I had intended to ask for Hospice once we went through what was currently happening with Dotty.

So as I am writing, the paper work is flying. I expect to hear from Hospice by tomorrow and then I expect an in home evaluation by a Hospice nurse. We will take it one day at a time.

Right now my greatest concern is that Dotty is not eating, not much anyway. I am getting some liquids into her and some Boost. But so far, not enough.

To be honest, I had expected to be at this point at least two years ago. As I sit here typing, I am amazed, quite frankly, at how well the last two years together with Dotty have gone. There was a lot of happiness. My real life cartoon character Dotty, certainly filled me up with joy.

In New York I said, Dotty re-taught me how to think and feel. It is true.

When a caregiver opens their heart they can get a feeling that is totally unexpected. Joy. This is my belief.

Don't get me wrong right now. We are not giving up. I have no idea what tomorrow will bring.

Could be sadness, could be joy. Either way I'll take it.

This has been one incredible experience with Dotty, and with all of you.

Its not over by the way, not by a long shot.

Bob

More Insight and Advice from the Alzheimer's Reading Room

• What’s the Difference Between Alzheimer’s Disease and Dementia
• Something Had to Change
• Alzheimer's Caregivers are the Chosen
• What is Alzheimer's Disease?
• What is Dementia?
• Communicating in Alzheimer's World
• Alzheimer's and Learning How to Trust
• Learning How to Communicate with Someone Suffering From Alzheimer's Disease
• Alzheimer's World -- Trying to Reconnect with Someone Suffering from Alzheimer's Disease
• Rewiring My Brain and Stepping into Alzheimer's World
• Why I Invented Alzheimer's World and the Power of Positive Reinforcement

Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,511 articles with more than 297,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

Dotty is Sick, Off to See the Doctor

As many of you know, I am good at handling stress, and we have been in similar situations in the past. However, I am going to say this rates a 10 on the stress meter, and I don't think I have been here before with Dotty.

By Bob DeMarco
Alzheimer's Reading Room

Dotty is not feeling well and she has a temperature.

This is an ongoing problem that has been persisting for more than a week and is worsening.

I took Dotty to the doctor on Friday and he checked her out and couldn't find a problem. She also had a blood test the previous week which was negative for any identifiable problem. Negative in this case means good.

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On Friday, Dotty seemed okay but she could not walk without assistance. Saturday she seemed okay, but couldn't walk. On Sunday she wouldn't eat and was basically listless.

This morning she is more or less "out of it". Dotty has no energy at all. She is also very negative. She is saying she can't move, can't walk, and when I got her up to pee (she did), she immediately said she wanted to get back in bed.

She has some strength in her neck, but is constantly looking down, and is having problems keeping her eyes open. Almost like she has a concussion.

Her temperature is elevate this morning and she has a fever. On Friday at the doctors office her temperature was 97.5, now its 99. Well above her core body temperature. This is like a temperature of 100 for you or me.

I called the doctor's office and her current doctor can't see her until 2 PM. We could have gone in earlier to see another doctor, but since her current doctor saw her on Friday, I want him to be the one that examines her. It is always hard to explain to the on-call doctor what is going on. And who knows if they will really listen.

As many of you know, I am good at handling stress, and we have been in similar situations in the past. However, I am going to say this rates a 10 on the stress meter, and I don't think I have been here before with Dotty.

I am concerned and worried. That said, we are going to do the best we can and take it from here.

Thanks to those of you that continue to ask how Dotty is doing. It really helps us to know you care.

I'll do my best to report the results of the doctor visit this evening.

Bob

More Insight and Advice from the Alzheimer's Reading Room

• What’s the Difference Between Alzheimer’s Disease and Dementia
• Something Had to Change
• Alzheimer's Caregivers are the Chosen
• What is Alzheimer's Disease?
• What is Dementia?
• Communicating in Alzheimer's World
• Alzheimer's and Learning How to Trust
• Learning How to Communicate with Someone Suffering From Alzheimer's Disease
• Alzheimer's World -- Trying to Reconnect with Someone Suffering from Alzheimer's Disease
• Rewiring My Brain and Stepping into Alzheimer's World
• Why I Invented Alzheimer's World and the Power of Positive Reinforcement

Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,511 articles with more than 297,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

When Frontotemporal Dementia Makes a Spouse a Stranger

You and I are in this together and I am not going anywhere.

Alzheimer's Reading Room

Families and caregivers of persons living with Frontotemporal Dementia often feel left out by the Alzheimer's community. That is not the case here in the Alzheimer's Reading Room. I picked the brand name long before I understood the different types of dementia. Everyone is included here.

Frontotemporal Dementia is a rare and very aggressive form of dementia. There is no cure.

The video below about Michael and Ruth French is intense and moving.

To read more about Frontotemporal Dementia, Michael, and Ruth in the New York Times go here -- When Illness Makes a Spouse a Stranger.

Also see --
What is Frontotemporal Dementia?
Frontotemporal Dementia: Information for Patients, Families, and Caregivers
Caregivers of Frontotemporal Dementia Patients

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More Insight and Advice from the Alzheimer's Reading Room

• What’s the Difference Between Alzheimer’s Disease and Dementia
• Something Had to Change
• Alzheimer's Caregivers are the Chosen
• What is Alzheimer's Disease?
• What is Dementia?

Original content Bob DeMarco, the Alzheimer's Reading Room

MindStart

By Monica Heltemes

Today 5.4 million Americans are living with Alzheimer’s disease or other forms of dementia. Over 15 million family members or friends serve as caregivers (Alzheimer’s Association Facts and Figures 2012). These caregivers watch their loved one struggle with everyday tasks and lose memories of their life. Caregivers often do not know the steps to take to help keep the person “doing things” or staying active.

The new MindStart website at http://www.mind-start.com is the only one of its kind, providing both original Alzheimer’s activity products and education for family and professional caregivers on how to keep the person active and engaged.

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The new MindStart website features expert-designed activity products that are made specifically for individuals with dementia and their caregivers. MindStart dementia products include large piece jigsaw puzzles, memory books, dementia games, word searches, and more. Products can be used with people at various stages of dementia and include user guides to help caregivers to choose the right level of challenge for the person. Multiple photo images and product videos are available through the website, to allow customers to see the products in use.

In addition to the products, the new MindStart website also includes educational content, including:

• A section on how dementia affects the ability of the person to “do things”.
• Easy tips and techniques to help caregivers incorporate activity into the day of the person with dementia. The latest Alzheimer’s and dementia care research on the use of activity engagement, or cognitive stimulation, in dementia care. A 2012 report by the Cochrane Review found that “activities that provide cognitive stimulation have a beneficial effect on the memory and thinking test scores of people with dementia… benefits that were over and above any medication effects".
• A section that describes how staying active through cognitive stimulation serves as a form of therapy for the person with dementia and how the MindStart products might be used in this therapy.
• A blog with informative posts about dementia care techniques and about noteworthy dementia-related news.
• Access to the MindStart Facebook page, LinkedIn account, newsletter sign-up, and MindStart YouTube channel, which features videos about the MindStart products and videos about keeping people with dementia active.

The MindStart website is a valuable resource to both families and professional staff. It has already reached nearly 50 countries around the world. Monica Heltemes, OTR/L, founder of MindStart and occupational therapist, explains that people living with Alzheimer’s and other forms of dementia and their caregivers are starved for more information and resources.

 “Unlike medical conditions that are well known, Alzheimer’s is a hidden disease, for which most people do not understand, know how to handle, or are afraid to talk about. We need more resources, products, and overall awareness to help people living with dementia to have active and joyful lives. The MindStart website opens doors for educating caregivers and offers tools to use, so that the person with dementia can continue to live an active and joyful life.”

Learn more about keeping people with dementia active at http://www.mind-start.com. Also, a special thanks to Bob and readers for allowing me to share about this website.

Monica Heltemes is a practicing occupational therapist and owner of MindStart™. MindStart designs hobby-style items, such as games and puzzles, specifically for persons with memory loss. They keep persons with dementia active, while giving support to caregivers, and are quick and easy to use. Visit MindStart (Activities for Persons with Memory Loss) to learn more.

More Insight and Advice from the Alzheimer's Reading Room

• What’s the Difference Between Alzheimer’s Disease and Dementia
• Something Had to Change
• Alzheimer's Caregivers are the Chosen
• What is Alzheimer's Disease?
• What is Dementia?
• Communicating in Alzheimer's World
• Alzheimer's and Learning How to Trust
• Learning How to Communicate with Someone Suffering From Alzheimer's Disease
• Alzheimer's World -- Trying to Reconnect with Someone Suffering from Alzheimer's Disease
• Rewiring My Brain and Stepping into Alzheimer's World
• Why I Invented Alzheimer's World and the Power of Positive Reinforcement

Original content Bob DeMarco, the Alzheimer's Reading Room