Holiday planning: Alzheimer’s, other dementias create special needs for families

The holiday season is quickly approaching, and families are making plans to

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celebrate them. The hustle and bustle of the season often fills the household with an added measure of stress. Shopping has to be done. Dinner parties and other special functions begin to fill the family schedule. Those things are enough to cause headaches for any family.

But what about families caring for a loved one with Alzheimer’s disease or other forms of dementia? How will they cope with the holidays, when members of their families don’t see the world the same as they once did? What if the added activities elevate the level of anxiety for their loved ones? What should they do?

Two words for families: simplify and prioritize.

“Don’t attempt to do everything you did in the past,” “You will need to simplify and prioritize traditions. It may help to have a family planning session, including young children, well in advance to discuss everyone’s needs, expectations and roles.”

One way to simplify and prioritize, is to put everything on a large kitchen calendar.

“Before you write a party or event on the calendar, make sure you really want to attend and that it is worth the effort. The fewer events, the fewer things you have to make plans for, which frees up valuable time.

The family caregivers see the changes in their loved ones. Family members who come around infrequently may not be prepared to see their ailing loved ones in their current condition.  An open line of communication is important.

“Prepare your visitors for changes in the mood or the behavior of the person with Alzheimer’s disease or other forms of dementia.“Let them know what time and what type of visit are best for that person and for you. Share communication techniques with your visitors. And, be sure to turn off the television. It’s important to remember to be calm and quiet. It’s also wise to prepare distractions beforehand. Old family photos, old scrapbooks, folding clothes, wrapping pennies, matching buttons, matching socks are things that should be in your bag of tricks to have ready should a distraction be needed, if your loved one gets upset or agitated.”

“Learn to say ‘yes’ to offers of help, such as shopping, wrapping, writing cards or preparing your favorite recipe. Keep this practice of saying ‘yes’ even after the holidays are over.”

“Do something special for yourself,”  “Go out for lunch or shopping with a friend or family member. Schedule a manicure, a hair dressing appointment or a massage before or after the holidays. Put yourself high on your gift list. Get as much sleep as possible. Exercise as much as possible. Laugh. Eat breakfast. Try to relax every now and then. Close your eyes and imagine you are somewhere quiet and peaceful, like at the beach. Use all of your senses to focus on it. When you take care of yourself, you are taking care of your loved one.”

And, change the way you’ve handled holidays in the past.

“Avoid those traditions which bring more awareness of loss than pleasure.” “Focus on traditions which still bring joy and warmth. Try to remember that things can’t be exactly like they were. Life has changed for you. So, you do not have to live up to either the expectations you sense in others or those you have of yourself. Set your own limits early and be clear about them to others. There will be other holidays, when your hands won’t be so full.”

If planned out well, the holidays can be a time of creating new traditions and new moments of joy for all involved.

“Holidays have long been a time of conflicting emotions.” “Along with stressful and frantic rushing around, there are the beautiful shared occasions with family members and friends. But, when we add to that the care of an Alzheimer patient and the emotional and physical exhaustion of a caregiver, holidays can be overwhelming. Because the holidays, in particular, can be a time to rekindle beautiful memories and to enjoy the moment, it is important to approach them with the understanding that some of the traditions we shared in the past will need to be different.”

As a coping mechanism, Jones says it’s important to focus on the true meaning of the holiday season.

“The holidays are about sharing, caring, giving and loving.” “They are about giving thanks for the past, reliving and giving thanks for those memories. And, as we reflect on our memories and traditions, we are sharing the joy of the past with our parents and grandparents as well as with our future generations.

“When the hustle and bustle and exhaustion of the holidays are over, hopefully, those moments of joy, pleasure, remembering, smiling and loving during the holiday season will have been captured in our memories for many years to come – even as our own children will celebrate the holiday season one day with their families.”

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8 ways to prevent dementia in old age

Here are eight tips for cutting your chances of dementia later in life

With people living longer, the number of people suffering from dementia is expected to double in the next 30 years. There are two major types of dementia — Alzheimer’s disease, where parts of the brain waste away and vascular dementia, caused by inadequate blood flow to the brain. Sufferers experience symptoms such as memory loss and personality change.  “In some cases, it’s genetic,” says health expert Dr Bob Lister.

“Patients with either type of dementia often have parents who suffer from the same condition.”

Research has uncovered ways we can all decrease our risk. “Whatever your genetics, there are techniques to reduce your chances of developing dementia,” says Dr Lister. “Lifestyle is the most important factor in determining if and when these conditions develop.”

 

Do as the Japanese do
Evidence suggests that omega-3 fatty acids may help prevent both Alzheimer’s disease and vascular dementia. “Recent studies have found that nations such as Japan, with diets high in fish, have lower rates of the diseases in addition to longer life expectancies,” says Dr Bob Lister.  Eat cold-water oily fish such as tuna, salmon and sardines, which are packed full of omega-3, or take a supplement.

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Take it easy
If you’re struggling with stress, it might save your future health if you learn to manage it better. A 2010 study of around 1,500 Swedish women found that those who were more stressed in midlife were more likely to develop dementia later.  Other studies suggest depression can lead to dementia. If you’re struggling to cope with stress or are feeling down, you should speak to your GP.

Get better sleep
Getting plenty of shuteye is vital for the health of your brain. Disordered sleep patterns in mid to late life may affect the protein amyloid-beta, which has been associated with Alzheimer’s. “Studies have demonstrated an association between insomnia and the early onset of dementia,” according to Dr Lister.

Cut down on booze and fag
According to research, drinking and smoking can bring forward the onset of Alzheimer’s by up to seven years. “Common habits that can kill off your brain cells include smoking and drinking too much,” Dr Lister says.

– Quitting smoking improves circulation in the brain almost straight away. “And when it comes to boozing, make sure you remember your recommended daily limits — three to four units for men and two to three units for women.

Get out and socialize
Maintaining an active social life can help delay the onset of dementia. “Some scientists believe it may help strengthen the brain’s connections so that they’re more resilient to damage later in life,” says Dr Ridley. “Delaying the onset of Alzheimer’s has the potential to improve people’s quality of life and also helps them live independently for longer.

– If you enjoy socializing, get out and mix with other people more — it could help you live a healthier life.

Limit junk food
According to Dr Lister, a well-balanced diet and a healthy weight are essential in the fight against dementia. Foods like wholegrains and lean meats, which are low in saturated fat, keep cholesterol and blood pressure low. A recent report linked  diabetes, caused by diets that are high in sugar, and Alzheimer’s disease. “There’s evidence that dietary factors can reduce or delay the onset of dementia,” says Dr Lister.

– So eat five portions of fruit and vegetables a day, and swap chocolate bars for healthier snacks to lower the levels of sugar in your body.

Sharpen of your mind
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Keep yourself active
Looking after your heart is the first step to protecting your brain. “It’s all about blood flow,” says Alzheimer specialist Jessica Smith. “The brain uses 20% of the oxygen in the blood pumped around your body.”

– Exercise is one way to take care of the heart and brain. But don’t worry about hitting the gym every day. Twenty minutes of any sort of cardiovascular exercise daily will really help improve your health.

 

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These 9 behaviors could cut your dementia risk by 35 percent

Dementia has long been thought of as an inevitable part of aging, but researchers are increasingly learning that’s not quite true.

About a third of dementia cases might actually be avoided by living a lifestyle that better protects your brain.

Dementia is how we describe symptoms that impact memory and lead to a decline in cognitive performance, often in ways that disrupt daily living. There are different brain disorders that cause dementia, but Alzheimer’s is the most common, followed by cerebrovascular disease and Lewy bodies disease.

Around the world, some 47 million people are currently living with dementia — including more than 5 million Americans. The burden of Alzheimer’s alone on families and the health system is difficult to overstate: It’s the most expensive disease in America, costing up to $215 billion per year (more than double that of cancer or heart disease), and it can take a terrible toll on patient’s loved ones.

The number of people with dementia is also expected to triple worldwide by 2050 as populations age.

But there’s some good news: You might be able to modify some of your risk of developing dementia.

A recent Lancet report, by 24 leading dementia researchers from around the world, zeroed in on nine of the best-known lifestyle factors that contribute to the illness and account for more than a third of dementia cases. The takeaway: Addressing these factors might be able to cut our dementia risk by up to 35 percent.

Another bit of good news is that the prevalence rate of dementia has declined in some countries, including in the US. And researchers think it may in part be due to increases in levels of education, which seems to protect people from getting dementia. For a disease many of us fear, the message is hopeful: Dementia is not necessarily an inevitability.

9 ways to cut your dementia risk

Dementia symptoms typically show up in old age, but the brain changes that cause it are thought to develop years earlier. These are things that might help stave off those changes:

1) Check your hearing and get a hearing aid if you need one

It’s not yet clear why, but there’s a strong correlation between even mild hearing loss and an increased risk in cognitive decline and dementia (and the dementia risk goes up with more severe hearing loss). Hearing may be important to dementia because of what study lead author, University College London professor Gill Livingston, called “the use it or lose it model.”

“We get a lot of intellectual stimulation through hearing,” she said, so when a person can’t hear as well their brain may begin to shrink. Researchers think hearing aids could help reduce that risk, but they need better evidence to know that for sure.

2) Keep learning

Less education is also associated with an increased risk of dementia because of something researchers call “cognitive reserve,” or a person’s resistance to assaults on the brain. “Low educational level is thought to result in vulnerability to cognitive decline because it results in less cognitive reserve,” they wrote, “which enables people to maintain function despite brain pathology.”

3) Stop smoking

Smoking is bad for the brain because it degrades cardiovascular health (and interferes the body’s ability to deliver oxygen to the brain). Tobacco also contains neurotoxins, which damage the brain.

4) Seek out treatment for depression

It’s still not entirely clear whether depression contributes to dementia, or whether dementia puts people at an increased risk of depression. But the researchers concluded that it’s “biologically plausible” depression boosts a person’s dementia risk because it “affects stress hormones, neuronal growth factors, and hippocampal [brain] volume.” Making sure people are treated for depression could mitigate a person’s dementia risk, and the researchers said antidepressants might also help, but called for better evidence to understand the effects of the medications.

5) Exercise

Exercise is believed to protect the brain by reducing cortisol levels in the body, cutting vascular risk, and increasing the growth of nerve cells that are related to memory. So people who are inactive are at a greater risk of dementia because they don’t get the extra protection exercise confers.

6) Manage high blood pressure

Stress on the circulatory system increases the risk of neurodegeneration, which also contributes to dementia.

7) Be social

Like depression, it’s unclear whether social isolation is a symptom or cause of dementia. “However, evidence is growing that social isolation is a risk factor for dementia and it increases the risk of hypertension, coronary heart disease, and depression,” the researchers wrote.

The theory is that social isolation is similar to not being able to hear, Livingston explained. “You need a cognitively enriched environment to keep the brain in good health, and if don’t see people or can’t hear them, you get less of that stimulation.”

8) Maintain a healthy body weight

Researchers believe obesity causes brain damage because it’s linked with reduced blood flow to the brain and it increases oxidative stress, which is also bad for the brain.

9) Keep your blood sugar in check

People with diabetes are more likely to have dementia. One reason why: Having diabetes means you can no longer control your blood sugars. And having more sugar in your blood stream means more sugar in your organs, including the brain. So just as diabetes can damage other organs in the body, it also damages the brain.

By 2050, an estimated 140 million are expected to be living with dementia

CAT scan of a person’s brain with Alzheimer’s disease. 
 

This list of nine contributors is only the beginning. The scientific community is already learning about other potential contributors to dementia, such as exposure to pollution and lack of sleep.

“So we don’t think this [list of nine things] is everything but this is what we have evidence on now,” said Livingston.

There are other caveats to note about this research. Some of the factors — such as hearing loss, or social isolation — are again associated with dementia, but whether they causedementia isn’t yet clear, and researchers are working to better understand dementia’s causes.

What’s more, not all cases of dementia are preventable; about 7 percent are linked with genetics and can’t be modified with lifestyle changes. And, the researchers wrote, “age, the greatest risk factor for dementia overall, is unmodifiable.”

Even so, Livingston added, people should think about finding ways to cut their dementia risk, and policymakers should think about creating environments that promote health. For example, some communities aren’t walkable, or lack strong tobacco control policies. Making exercise more accessible, and helping people quit their smoking habit, could reduce the dementia burden. Considering what a costly and devastating problem dementia is, we can’t wait for better evidence. And, it seems, even small steps toward living a healthier and more active lifestyle not only boost your overall health, but the health of your brain, too.

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Dementia/Alzheimer’s Recipes

Carrot, turmeric, and ginger soup with cumin roasted chickpeas

Ingredients

For the soup:

  • 1 tablespoon coconut oil
  • 1 small yellow or white onion, diced
  • 2 cloves garlic, minced
  • 2 tablespoons turmeric root, grated (or 1½ teaspoons, ground turmeric)
  • 1 tablespoon ginger, grated (or 1 teaspoon, ground)
  • ¼ teaspoon cinnamon, ground
  • ½ teaspoon salt (and more to taste)
  • Dash red pepper flakes
  • 1¾ pounds peeled and roughly chopped carrots (about 6 cups)
  • 4 cups vegetable broth
  • ½ cup coconut milk, canned and full fat

For the cumin toasted chickpeas:

  • 1½-2 cups cooked chickpeas
  • 1 tablespoon coconut oil
  • 1 teaspoon cumin, ground
  • 1 teaspoon chili powder
  • ¼ teaspoon smoked paprika
  • Salt and pepper to taste

Instructions

  1. Roast the chickpeas. Preheat your oven to 400 F. Toss the chickpeas in the oil, cumin, chili, and paprika. Spread them onto a parchment-lined baking sheet, and season generously with salt and pepper. Roast the chickpeas for 35 minutes, or until they’re quite golden brown and a little crispy. Give them a stir a few times during roasting to prevent sticking. Chickpeas can be stored in an airtight container for up to one week.
  2. To make the soup, heat the coconut oil a large Dutch oven or heavy bottomed pot over medium high heat. Add the onions. Cook, stirring frequently, for 5-7 minutes, or until the onions are clear and soft. Add a few tablespoons of water as you go along to prevent the onions from sticking. Add the garlic, turmeric , and ginger, and cook for another two minutes, or until everything is very fragrant.
  3. Add the cinnamon, salt, pepper flakes, carrots, and vegetable broth. Bring the broth to a boil. Reduce heat to a simmer and cover the pot.
  4. Simmer the soup for 30 minutes, or until the carrots are totally tender. When the soup is ready, transfer it to a blender (in batches, if necessary), and blend carefully until it’s totally smooth (stand back from the blender, as hot soups tend to spatter). Alternately, you can use an immersion blender to blend the soup till smooth. If the soup is too thick for your liking, add another ½-3/4 cup broth.

PROCEDURE

MAKE THE SAUCE

Heat oil over medium-high heat in a wide, heavy bottomed saucepan. Add onion and cook without browning until softened, about 5 minutes. Add garlic, tomato paste, cinnamon and saffron, and stir well to incorporate. Season generously with salt and pepper, and allow to sizzle for 1 minute more. Add broth and simmer gently for 5 minutes. May be made several hours in advance, up to a day.

FOR THE SAFFRON TOMATO SAUCE

  • 2 tablespoons olive oil
  • 1 and 1/2 cups finely diced onion
  • 3 garlic cloves, minced
  • 2 tablespoons tomato paste
  • 1 inch piece cinnamon stick
  • Large pinch saffron, crumbled
  • Salt and pepper
  • 3 cups chicken broth, vegetable broth or water

    FOR THE MEATBALLS

    • 1 and 1/2 cups cubed day-old firm white bread
    • 1 cup milk
    • 1 pound ground beef or lamb
    • 1 large egg, beaten
    • 1 teaspoon salt
    • ¼ teaspoon black pepper
    • 4 garlic cloves, minced
    •  teaspoon grated nutmeg
    • 1 teaspoon ground ginger
    • 1 teaspoon turmeric
    • 2 teaspoons paprika
    • ¼ teaspoon cayenne
    • ¼ teaspoon ground cloves
    • ¼ teaspoon ground coriander
    • ½ teaspoon ground cumin
    • 3 tablespoons chopped parsley
    • 3 tablespoons chopped cilantro
    • 3 tablespoons finely chopped scallion
    • All-purpose flour, for dusting
    • Coconut oil or olive oilMAKE THE MEATBALLS
      1. Put bread cubes and milk in a small bowl. Leave bread to soak until softened, about 5 minutes, then squeeze dry.
      2. In a mixing bowl, put squeezed-out bread, ground meat and egg. Add salt, pepper, garlic, nutmeg, ginger, turmeric, paprika, cayenne, cloves, coriander and cumin. Mix well with hands to distribute seasoning. Add 2 tablespoons each of parsley, cilantro and scallion, and knead for a minute. May be prepared several hours in advance, up to a day.
      3. With hands, roll mixture into small round balls about the size of a quarter. Dust balls lightly with flour. Heat a few tablespoons of oil, or a quarter-inch depth, over medium-high heat and fry meatballs until barely browned, about 2 minutes per side. Drain and blot on paper towel. Simmer meatballs in saffron-tomato sauce, covered, over medium heat for about 20 minutes, until tender.
      4. Garnish meatballs with remaining parsley, cilantro and scallion.

      Serving suggestions:

      • Couscous
      • Brown rice
      • Roasted tomatoes
      • Pilaf

        Guidelines for creating recipes for Alzheimer’s – Use organic and fresh ingredients whenever possible. If nothing else, organic food is less likely to contain the chemical pesticides and preservatives that are common on “traditionally grown” foods. Stay away from prepared foods that contain artificial sweeteners (aspartame in particular), artificial colors, MSG (and hydrolyzed vegetable protein), and any other artificial ingredient. Many, if not all of the substances named in this paragraph are suspected of causing damage to brain cells and contributing to dementia.

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