Alzheimer's is incurable

You heard Glen Campbell has Alzheimer's, right?  Here is a video interview with him:

http://youtu.be/BCBCPVT93eg

Mom Sure Takes A Lot Of Meds

Q: I need to get a handle on all a these medications?
A:
Americans over the age of 65 take lots of medications: the average "healthy" adult takes 9 different drugs. If you are taking care of sick parent or spouse (or sibling), the average can be substantially higher.  Do you ever wonder if the side effects of one drug have caused the need for one of the other drugs? What about side-effects? Drug interactions?  How about this: Do you ever think that your loved one is unnecessarily taking multiple medications for the same condition? At the end of this article I am going to show you a free website that you can use to compare any two medications! My favorite part about this tool is that you don't even have to know how to spell them...it's like Google - when you start typing the name it will try to guess what you are attempting to spell (that saves me everytime).

But first allow me to state the obvious. You know that whenever you are taking your parent or spouse to the doctor you should take all of the medications that they own with you, so the doctor can check. (Don't count on your memory).  Also remember to include over-the-counter meds and even bring supplements and vitamins. Why? I am glad you asked.

The perfect example "why?" is baby aspirin.  Doctors are fond of prescribing 81mg baby aspirin to reduce the risk of stroke and heart attack because aspirin is a mild blood thinner.  If your loved one has ever had a stroke then the doctor has probably also prescribed a stronger blood thinner like Warfarin (Coumadin).  But lets look at something else. If you have ever researched anti-oxidants maybe you added supplements like Garlic, or Ginger. Maybe you added a little Ginko Biloba because you read (erroneously) that it is just as effective as Aricept?  Fish Oil for Omega 3 seems to be on everyone's supplement list for heart health too.  But you may not be aware that every one of the supplements I have just mentioned are also blood thinners! So it's best not to take chances and take everything to the doctor.
On average, Americans over the age of 65 have seen more than 28 different doctors in their life () In a Country with every kind of specialty under-the-sun, many seniors are regularly visiting their family doctor, a podiatrist, a neurologist and an internist.  Each one may be prescribing different medication, with significant overlap. This is yet another reason to take every pill bottle you can find with you to your next visit to the MD.
Considering how many doctors and medications you're juggling for your parent or spouse, you may have other reasons to compare drugs and their interactions: Saving money, eliminating unnecessary prescriptions and researching the source of side effects.  However, considering how little "face-time" time you get with the doctor, it is a good idea to do your homework first.  Generally, a doctor will respect a caregiver that has done a little research. At the very least it gives them a chance to show off their superior knowledge. 
Now for that website I promised you in the first paragraph: is my secret website that has wonderful and well written information, and the specific URL that has an amazing free tool that compares medication is: http://healthtools.aarp.org/drug-compare
Please look below for an example of what you will see when you go to the website.  I tested it out by comparing Namenda and Aricept.  Not only did it give me a great description...it also asked AND answered the most frequent questions that people have...
Please feel free to share this great tool with your friends.

Help for Alzhiemer's

Having posted information for the past 5 years, I want to offer you a more direct way to get information:

 I tend to post articles on topics that I think are important to family caregivers.  To be honest, my motives were in part to promote the assisted living communities that I worked at.  My reader's followed me, but as new families came to my community, I could direct them to these blogs, and give them confidence that they were putting their loved one in safe place.  So there was a duel purpose.

But it occurs to me, rather than guess what you might need to know and write an article about it, I could answer you questions directly. 

If you are taking care of a parent or spouse with Alzheimer's, you can write me at askdonahue .  that link is askdonahue@aol.com.  I really look forward to answering your questions...my agenda is only to help.  If you need another email address to reach me for any other reason, you can find me at
donahueg@alumni.usc.edu

yours, Donahue Vanderhider, MSG

caregiverrelief

Fight or Flight: The Result is The Same

If there is one thing in common for all caregivers it's STRESS! It doesn't seem to matter if you are caring for a parent or spouse or friend; if you are doing it long-distance or you are living in the same house - all caregivers suffer from stress. Call it "worry" , "anxiety", "fear" or any other word, the result is the same.
By result I mean the toll it is taking on your body and on your health. It is proven that long-term stress triggers the HPA response in your body. The HPA response refers to the Hypothalamic–pituitary–adrenal axis. The end result of which is a triggering of the same hormones and neurotransmitters that are released in the "fight or flight" response.
"Fight or Flight" is the bodies emergency response system designed to survive an immediate threat to life and limb. Which is great, except when it does not turn off. The same response system when left on too long starts to eat away at our immune system, thus increasing the chance of catching colds, flu, and other illness. But that is only the beginning. it also starts tearing away at the body so that what helps us in the short term, starts damaging us in the long run, increasing our chances for heart attack, stroke, diabetes, and much more.
Almost every caregiver I ever met, was a caregiver for the first time, on a steep learning curve, and was thrust into the roll unexpectedly. Naturally, it is very stressful: financially, emotionally, and physically. It strains family relationships and disrupts plans and goals.
However, caregivers must remember to take care of themselves. If you are a caregiver you are probably struggling on your own, with little or no help. But if something should happen to you what will happen to your loved one? Do you see why controlling stress is so important. Half of all caregivers pass away before the person they caring for. I don't mean to be an alarmist, but you need to start taking better care of yourself.
How? By taking advantage of all the programs and services that are available for caregivers. Many of them for little or no money. You may be an expert in your field. But I am an expert in this field. If you need to do taxes you go to an accountant, if you go to court you need a lawyer, if you are building a home you go to a contractor. Why would you try to delve into the world of caregiving without guidance?
Do you know how much money you are losing going it alone? First, there are services, products and ideas that you missed because you did not know about them, then there are the cheaper (and sometimes better) alternatives to the things you DO know about, and finally there is the value of all the lost time you spent researching the tasks and services that you did find.
Consider signing up www.EasyCaregiving.com . You may very well be glad you did, and if you learn nothing new or helpful, it cost you nothing to look. In addition, as a Gerontologist, I have website with free membership: SIGN UP Just put your name and email address and get a free stress management recording that can de-stress your day to day frustrations. Later you will get a free ebook on how to handle "sundowning" or wandering, a very dangerous symptom that happens to about 70% of Alzheimer's sufferers.

Learning to Relax with Anxiety: Alzheimer's Caregivers Need To Do This

Learning to Relax with Anxiety

Many anxiety sufferers are learning the proper cognitive tools to overcome their anxiety.  It isn’t easy. It takes commitment. Learning to relax with anxiety takes daily practice and commitment. Here are some relaxation tips to get you started:  

1.    Acceptance - Whatever we resist will persist. Try not to see yourself as fighting your anxiety. Instead, see yourself as moving toward your goal of relaxation.

2.    Talk to someone - Many anxiety sufferers feel better almost immediately when they have a supportive person to talk with.

3.    Knowledge - The more you know about your condition, the better equipped you’ll be. Things work better when we understand why we are doing them. 

4.    Breathing Techniques - Practice belly breathing. Breathe in to the count of 3 and out to the count of 4. 

5.    Meditation - Listen to guided meditation tapes or CDs.

6.    Journal - Keep a notebook handy during the day, and when you recognize a “what if this happens?” thought forming, write it down. Review it later, when you are more relaxed. Ask the trigger question again, as if it were true. What would you do? Keeping a journal helps you discover possible hidden issues.

7.    Take a nightly news vacation - Before bed, listen to relaxing music or read a book. If your habit is to watch the nightly news, try watching it first thing in the morning instead.

Learning to relax with anxiety will command your daily dedication. Be sure and celebrate even minor improvements. They are likely to be permanent ones!

Please make sure you jump over to www.EasyCaregiving.com and sign up for the FREE stress management CD, and you will automatically put on the newsletter notification list. 

Part 1 of 3 solutions for caregiver stress

Subscribe to donahue101 to see videos on caregiver stress: here is the latest edition that begins the conversation about solutions.


http://www.youtube.com/watch?v=oAUzqTUgGyE

New Site

A new site from the Caregiver Relief family is hitting the blogosphere this week. They are just launching, but it looks promising. Even the title gives one hope: http://easyCaregiving.com. So i wouldn't hurt to click and take a look.
I will see you over there...

You Can Get The Alzheimer's Cure Today

Most people have only a vague understanding of how Alzheimer’s medications get approved by the FDA and come to market where we can get our hands on them. You read about promising medications that are being studied, but you never hear when and if something is going to come out. If Alzheimer’s is in your family, you sure wish they would hurry up, right?

How would you like to know what drugs are currently being tested for Alzheimer’s? How would you like to get your hands on those drugs right now, and not have to wait 5 or 10 years for them?

You should know then, that there is a way to do this without going to the Black Market. Actually, you will be surprised to know that it’s quite easy. In fact, the manufacturers of these new Alzheimer’s medications would love for you to have it. They are at this very moment actively looking for people that want to try these new medications.

The method for gaining access to these medications is ‘drug trials’ and they’re going on all the time, and you are about to learn how to find them and how to get into them. But first let me give you at least a basic understanding of the process.

When you talk about drug trials people respond in one of two ways. One groups shudders at the very thought of a drug trial; picturing themselves as proverbial guinea pigs, being fed toxic cocktails of chemicals that will cause them painful and crippling side effects and death. While the other group is practically leaping out of their chairs, hands raised to volunteer for what they believe is the best and finest medications that advanced scientific research has discovered; research based on the accumulated efforts of dozens of Universities and private laboratories. They reason that the minuscule risk is outweighed by the much more likely outcome that they or their loved one will get badly needed relief from a disease or condition that is carving away at their health and vitality.
Sounds pretty dramatic huh? Well, you get the point. People either think you are nuts to take an experimental drug or they are grasping at their last hope. You rarely find anyone on the fence about it.

But for these fence sitters, I am obliged to explain the drug trial process the best I can, because this article ends with a resource that you can use to find drug trials near you. Not just for Alzheimer’s disease, but for any condition or illness that concerns you.
First let’s look at a few of the advantages of participating in a drug trial:

* Free medication – when approved it will be very expensive. (For everyone else)

* Better yet… you get paid to participate. (both the caregiver and the patient)

* Lots of expensive examinations and medical tests for free. (seriously, you get a full workup worth thousands of dollars)

* Afterwards you get to continue with the medication indefinitely. (It’s called a follow up study and even if you were in the placebo group, you get the medication for as long as you like)

* A very good chance at symptomatic relief, if not a reversal of the condition altogether. (would they be doing this test if they did not already have a lot of promising results?)

* Hope. Never underestimate the power of hope and positive thinking.

But wait, what about all that stuff about guinea pigs, concoctions, and risky side effects? Well let’s look at the process of drug trials and FDA approval.

The heart of drug trial research is the “double-blind study” This is the only accepted method of research for the FDA.
A double-blind study is the FDA’s insurance that the results of any research is truly due to the effects of the drug, and not the opinion of the researchers that stand to make a lot of money. Nor the test subject’s psychosomatic wishful thinking that the drug did its job.

Here’s how it works; you have at least two groups of subjects, one group is getting the ‘test’ medication, and another group is getting a lookalike (a placebo), and then they check to see if there is a statistical improvement between the two groups. (Nowadays, placebos are much more than just a sugar pill. Typically they give both groups the exact same treatment, except one has the active ingredient and the other doesn’t). The researchers that are working directly with the patients do not know which treatment group is getting the active ingredient, they are ‘blind’. The patients are also ‘blind’, they don’t know if they are getting the active ingredient or not. Presto; you have a double-blind study. The reason this works so well is, scientists have learned over the years that even unbiased researchers will often think they see improvements, thus distorting the results. Then there is this strange phenomenon called the ‘treatment effect’; on average a certain percentage of test subjects improve even on the placebos. Interestingly the percentage of subjects improving is very consistent. If I recall correctly, it is around 12%. Double-blind studies eliminate the treatment effect because both groups will average the same treatment effect and cancel it out as a factor.

But you don’t want all this technical stuff, do you? Let’s get back on point. Drug studies have 4 phases they go through before they are approved by the FDA. Phases 3 and 4 are with groups of people. Phase 3 is usually the first time the drug is tried on the public, and they keep the size of the study very small. If all goes well in Phase 3, then they move to Phase 4, using a much large group of people. If you are interested in drug trials, you will almost invariably be involved in a Phase 4 study.

Getting into a drug study is a lot easier than you would imagine. All over the country there are Universities and private testing labs that are turning down drug studies because they can’t find enough participants. So don’t feel like you will be put onto a waiting list. Just be aware that these studies do have certain criteria that has to met.

Which brings us to, “how DO you get involved in a study?” That’s the problem, there are several websites dedicated to providing information about the drug studies, but none of them seem to do a very good job. You can get a list of these sites at the following website: http://alzheimersecrets.com/drugtrial/. However, you may decide to not use them because this site synthesizes all of the information for you. Not only that, but you can actually make a direct inquiry for your location and for the condition or disease you want to address with them. And remember, you can approach any of these sites for any illness or condition, not just Alzheimer’s. Now let’s get into the drugs themselves.
Current Alzheimer Research

Dimebon
This one is getting all the “Press” right now, it seems everybody knows about it and so far it has promising results. Used as an antihistamine in Russia for many years, it also protects against brain cell death. Dimebon targets mitochondria (the cell’s power generator). Phase 3 results show significant improvement in all the key aspects of Alzheimer’s, including thinking, memory, behavior and overall function. Results have been published in “Lancet” July 2008 (Lancet in England is the equivalent of the New England Journal of Medicine in the U.S.). Rumor is Dimebon may be on the market as soon as next year.

Rember (Methylthioninium chloride)
Early research is promising, as researchers announced that the compound appears to slow and even halt the progress of Alzheimer’s. It does this by dissolving tangles of tau protein inside brain cells and preventing their accumulation, stabilizing the disease progression in patients with mild and moderate Alzheimer’s over a period of one year. Over a longer period of 19 months, researchers saw an 81% slowing of the disease. Rember may be on the market as early as 2012.

AL-108
This drug, like Rember, also addresses the problem of neurofibrillary tangles, also interfering with the formation of tangles by affecting the tau protein. However, this drug is administered as a nasal spray. Which brings up a rarely discussed aspect of drug trials: not all drug trials involve taking a pill! Some are nasal sprays, eye drops, some are even administered intravenously. The good news is results with AL-108 took far less time than Rember. Researchers reported a 62.4% improvement in memory with no side effects in only 4 months time.

Lupron (Leuprolide, Memryte)
Don’t you just love the way they name these drugs? Memryte (memory right?) or Rember (Remember?). Lupron is currently an approved drug for the treatment of advanced prostate cancer. But now they are looking at it for Alzheimer’s because it alters production of beta-amyloid in the brain. Beta-amyloid, in a nutshell, is the main material that plaques are made of. The theory is, no beta-amyloid = no plaques = no Alzheimer’s Disease.
Funny story: the connection between Lupron and Alzheimer’s was discovered accidentally, when the wife of a metastatic cancer patient who was receiving Lupron told the doctor that the drug worked well on his cancer – and his Alzheimer’s appeared to improve, too. (Wow, a doctor that listens! What a concept)

Immunoglobulins
Basically these are antibodies already in our blood. These antibodies are used by our immune system to hunt down and eliminate bacteria. This is one of those treatments that is being administered intravenously. It is still in the early stages of research, and larger studies are forming as you read this.

Rosiglitazone (Avandia)
One of the little know facts about drug approval by the FDA is that Pharmaceutical companies spend 10’s of millions of dollars bringing a drug to market. Therefore it’s safe to assume they have to be pretty confident of success before they decide to start a new drug trial. Furthermore, you can imagine that the process is complicated and technical. Let me give you an example, when they apply for a new drug approval, they have to be very specific about which disease, or condition they are going to test for. That makes sense. But occasionally after a drug comes to market it may start showing effectiveness on conditions that it was not originally intended for. But if they want doctors to legitimately prescribe their established medication for this new condition they have to start the drug trial process all over again from scratch.
Thus is the case with Lupon mentioned above (currently approved for prostrate cancer), as well as this one Avandia. Avandia is currently on the market for type 2 diabetes, in diabetics it enables their cells to use the hormone insulin more efficiently. But they now think it might affect the brain inflammation seen in Alzheimer’s patients, so they are starting new drug trials for it.

Alzheimer’s Vaccines
“Another method for targeting Alzheimer’s comes in the form of a vaccine that uses antibodies from the body’s own immune system to attack and destroy beta-amyloid and clear out plaques in the brain, or to eliminate clumps of tau protein (neurofibrillary tangles) in the brain that kill neurons responsible for memory”. Phase 3 studies are also starting this year, and they look promising. * (Oops, hold that thought, just yesterday as I was finishing this article there was story making the rounds that a prominent research physician was quoted in the press as saying that he has serious doubts that beta-amyloid is the cause of Alzheimer’s and that researchers are missing the boat, and spending a lot of time and money for nothing. Time will tell…)

Gene Therapy
This is another of those methods that have been around, getting perfected for years. It is very complicated, and involves genetically altering your own cells to produce nerve growth factor (NGF) and injecting these altered cells into the brain to slow the destruction of brain cells. They may sound creepy, but naturally produced NGF has amazing promise for many different illness and diseases. Some researchers are predicting extending the life span by decades when NGF is perfected.

Histone deacetylase (HDAC) inhibitor
Researchers are making impressive claims with this one. “This compound has the potential not only to slow degenerative memory loss, but also to reverse the process and bring back lost memories”. The HDAC inhibitor compound was first formulated at the Massachusetts Institute of Technology (MIT). “The research suggests that people with dementia might not completely lose their memories, but that the memories might be stored away somewhere that is inaccessible. The clinical trials are expected to assess whether ADAC inhibitors can safely and effectively improve cognitions and possibly reverse memory loss in humans.
This concludes the long list of drug trials that are out there for Alzheimer’s Disease. Can you imagine…this is just Alzheimer’s? I have heard of studies for just about every other major disease, and even for conditions that I did not know were a problem. For example I read about a study that was supposed to make eye-lashes grow longer and thicker. I don’t see anyone dieing of thinning eye-lashes, but I certainly see where something like that would make a fortune.
Nevertheless, if you or someone you know is interested in drug trials please go to this site for a complete list of different websites that promote and talk about drug trials: http://alzheimersecrets.com/drugtrial/.

Source: Special Report on: Combating Memory Loss (common problems and treatments) by Massachusetts General Hospital & the editors of Mind, Mood & Memory.

Why Don't Life style Changes Work?

The most popular program right not is the Longevity Now Program by David Wolfe and I wrote this article about it:
“Longevity Now is a rip off” That’s what people will say that buy the program but never take action. Which is true of many self-help programs in the world. People buy these products and programs and then find them too hard to follow. Or they start out like gang-busters, but peter out after a few weeks. It’s human nature, but it doesn’t have to be you!

Basic human psychology: if your life depends on it, you are more likely to take action then if it is just a good idea to look or feel better. Speaking for myself, I know that I need a sense of urgency to make the slightest change in my life style. And if you are like me, I am going to give you the same sense of urgency to in a few minutes…

First, I promised in the last post to talk about human electrical grounding. Which is something that is covered in the materials that you will receive when you sign up for David Wolfe’s program. The quick and dirty explanation: The Earth is a ‘grounding’ body, it dissipates electrical charges. Think of lightening, think of your house’s electricity. A million volts of electricity can move through any conductive object (a pole, a tree, a person), but when it comes in contact with the Earth it is rendered harmless.

What do you know about ‘free radicals’? We take anti-oxidant vitamins to neutralize free radicals in our body. Free radicals are the extra electron that is thrown off when our bodies convert food for use by our cells. Those free radicals are like little electrically charged bullets that bounce around at the molecular level in our bodies until they find another cellular molecule to attach to, and therefore change from ‘charged’ to ‘neutral’.

Free radical theory is one of only two scientifically ‘proven’ and accepted theories of aging. Over time (the years of our lives), these free-radicals cause minute damage to our cells, and eventually affect their ability to effectively duplicate and either die off, or create a mutated version the cell. (I said this was going to be quick and dirty, lol). Ok, quick and dirty: The reason you are taking anti-oxidants is they neutralize more free radicals and slow the decline and decay of bodies and potentially prevent bad mutation like cancer cells.

Now, do you think it would help the process if we were to occasionally ground our bodies to the earth? But when, we live in little boxes, we put on rubber soled shoes, we ride in cars with rubber wheels to other little boxes to visit friends or go to work. How often do we touch the Earth with any part of our anatomy? That’s grounding technology. We need more contact with the Earth. The one research article that I read on this subject was very conclusive that people that were regularly grounded reported better health, better sleep, less pain, and more energy. I will post some of it next time.

Now about the rip-off stuff. Understanding that people have trouble with lifestyle changes, David Wolfe addresses it in the program. He is very supportive, encouraging you to start new habits by reminding you that you already have many habits that you learned and are already following, like brushing your teeth. And like brushing you teeth, a habit becomes second nature after a while. But I promised to help you by giving you a sense of urgency. This is the same one that motivated me to start doing healthy things: AGING. How old are you? Have you been telling yourself on and off for decades that when you get a little older you will start making those big changes. But right now, you are a little too busy? I did. I did it when I turned 40, and again when I turned 45, and again at 50. Granted on some of those “resolutions” I did some of the stuff. I did the easy stuff. For me the easy stuff was to go to the gym. The super hard stuff was to change my diet. It may be the opposite for you. But look, its time. Stop screwing around! Nobody can see you reading this, I don’t know who you are. But you do, you know what you need to do, you know what you’ve been telling yourself for years. It is time.

If not this program another. But you can’t put it off any more. Do you ever read about people that beat Cancer? They got cancer, and then they did a massive life-style change, and with tons of will power they beat the odds. Do you think you have the same will-power? Honestly? What if those people made the life style change before they got sick? It would have been a lot easier, right? In fact, if they did it soon enough, chances are they would never have gotten the cancer at all. I can tell you this, slowing down the aging process is very doable. You can start it right now. But reversing the aging process, now that is another story, and much harder to do, if not impossible.

Here’s a video about the program. Watch it…it doesn’t bite. lol. Judge for yourself. There is a 30 day money back guarantee.

Its Time for Me to Put Up or Shut Up

Wow, I am really proud of myself, I actually built a blog/website all by myself! DiscoverLongevityNow.com Please take a look! lol.Basically, I have jumped on the health bandwagon with both feet. I have reached a point in my life, regarding changing my health habits, it's now or never.

Coincidently, one of the true Sage’s of our time, who has spent his life studying ancient arts of medicine and nutrition as well as modern discoveries and western medicine: David Wolfe, has finally put all of his knowledge together into a single program.

So if you follow the link and watch the video you will get a crash course in what herbs to start taking and which to stop.

Sincerely, Donahue Vanderhider, MSG

p.s. You can bet that from the day this launches, health food and treatment will move into a new era, compared to what we currently believe.


immunity now.

How long have you been planning to change your diet?

A little bird told me that David Wolfe, the famous nutritional authority for "Boomers", is launching something new. Its called the Longevity Now Program, and its not even public yet. But I can get you a little peak. Go to http://tinyurl.com/pmo7bj

Second bit of news: I am launching a new website too. And I GIVING AWAY my stress management CD just to get charter members. It's still under construction but you can sign up, and I recommend you do, because I am giving the CD to only the next 50 people that join: http://alzheimersecrets.com

I did my homework, now you should do yours

Look down below this post and you will see my last blog about 4 easy steps to prevent Alzheimer's. In a nutshell they are Diet, Exercise (body and brain), Supplements and Stress Management. Thinking about how well I follow my own advice, I thought I should share with you my absolutely most favorite thing. For brain exercise, I use something called Luminosity. It is tons of fun, and good for you too...here is a link: Free Trial.
Try it out! Its free, but even at the end of trial it is pretty darn inexpensive. And afterall what is your brain health worth to you?

Spouse with Alzheimers

Joan is a new friend. She has an amazing blog that is suited for spouses of Alzheimer’s sufferers. Recently I read the following post and thought to share it with you. Please feel free to go find and read her post, and don’t forget www.caregiverrelief.com for your caregiving needs, and please sign-up for the free newsletter while you are there (you get a very valuable gift when you do!)

JOAN’S BLOG – WED/THUR, APRIL 22/23, 2009 – THE WORST CASE EVER

For those of you who are not aware, my husband has been refusing to take his second daily dose of the anti-rage medication, Risperdal. He was taking the morning pill, but absolutely refused to take the afternoon pill, because he “didn’t need it”. Before you start scolding me that I should have resorted to a variety of deceptive practices to have made sure it entered his body without him knowing it, you must understand his level of functioning. His problems are behavior, impulse control, anger, memory, language comprehension, and processing. He is fully aware of what is going on around him, knows every pill he takes, and would taste the difference if it were crushed up in his food. The repercussions of such deception would irreparably damage whatever peace had been achieved from the medication. Every doctor and social worker agreed – there is no way to get a pill into him if he refuses to take it.

Needless to say, the situation has been deteriorating steadily here since the elimination of that second pill. I could see the anger building; it was just a matter of time, and Tuesday was the day. I suppose I should have been grateful that he woke up refusing to speak to me rather than screaming at me. (No need to wonder why he was angry – it is ALWAYS the same – I destroyed his life, stole his freedom, made him a prisoner in his own home, by taking away his driving. He will never accept it and never forgive me. Period.) By the time we got to our support group meeting, the rage was so apparent on his face that those who know him well, and those who barely know him, remarked to me about it.

If I were in the mood to find humor in this situation, and I am not, I suppose it would almost be funny to say that he has now earned the undistinguished honor of being the worst, most stubborn, impossible to deal with “driving issue case” ever seen by every social worker, psychiatrist, psychologist, and doctor who has tried to deal with him. I have actually had two psychologists throw up their hands and say that there is nothing they can do for him. He is undealable ( I know that’s not a word – I made it up because it seems appropriate to the situation). The only option is to get him on the medication and keep him on it. Catch-22. He won’t take it and no one can make him take it.

What do you do when no professional can handle your situation? You handle it yourself. I spent 25 years dealing with brain damaged, psychotic, violent children, adolescents, and adults. I dusted off my therapist hat, locked my emotions in the closet, and spent 2 ½ hours dealing with the situation. In the end, he agreed to take the second pill, and I agreed to put his “travel” needs ahead of my work, and take him where he wants to go when he wants to go. My end of the bargain is irrelevant, because he will not be satisfied being “carted around by his wife”, as he calls it, but my hope is that the medication will once again smooth him out enough that we can both function at some level of peace.

Feedback to joan@thealzheimerspouse.com

caregiver stress revisited

If you're like many people with Alzheimer caregiver stress, it means you're either the adult child or the spouse of a loved one with this devastating disease. Like many other people in your position you probably worry, "What happens if I become critically ill or succumb to heart attacks, strokes or maybe cancer?"

For many people with these medical conditions (including influenza, diabetes, cancer, etc.) stress played a large role in their circumstance.

An in-depth analysis can be found at www.caregiverrelief.com

Alzheimer Caregiver Stress Is Chronic Stress

First, let's look at chronic stress. Alzheimer caregiving stress, for example, is considered chronic stress because it's the result of constant exposure to circumstances and conditions often beyond your control that cause a hyper-alert state. You're frequently dealing with unpredictable and/or volatile situations and irrational behavior. To compound the problem it's often without reliable recourse that is dependable and consistent.

Living under such trying, emotional pressure has long-term effects on your mental health, with ailments like clinical depression. But it also has bearing on your physical heath.

In fact, the past 20 years of research shows that people who suffer from chronic stress, like caregiver stress, are at much greater risk FOR heart attacks, strokes, and even cancer than others in their age bracket. In fact, according to the Alzheimer's Association, 50% of caregivers die before the person they are caring for. It's theorized that chronic stress, which weakens the physical body, (and dampens the immune system) is one the main culprits for this high mortality rate.

What Happens Physically During Caregiver Stress?

First realize that stress is not an emotional state, but rather a physiological reaction that occurs in your body. Doctors refer to it as the hypothalamic pituitary axis; the connection between the hypothalamus, pituitary and the adrenal gland.

These three 'elements' work together in a stressful situation to put the body into a heightened state of preparation to overcome a potentially life threatening event. This stress reaction is actually a left over from a survival mechanism called, "Fight or Flight."

When faced with tremendous stress, where survival might hang in the balance, humans have one of two instant reactions – run from the situation (flight) or meet the challenge head-on (fight).

How a person reacts will differ from one to the next. But the thing that is consistent is the hypothalamic pituitary axis (HPA) itself. Everyone has the HPA and it regulates:

• Blood Pressure
• Heart Rate
• Body Temperature
• Sleep Patterns
• Hunger and Thirst
• Among many other activities

When stress becomes great, the HPA system takes over in a matter of seconds. Blood circulation is diverted from the extremities to internal organs. Adrenaline is secreted in massive amounts for instant energy. The adrenal gland starts producing and releasing steroid hormones, including the primary stress hormone cortisol. This hormone travels to all areas including the heart, lungs, circulation, metabolism, immune systems and skin.

Now, if a bear in the wild (or a thug on a street city corner) attacks you, then this HPA system can literally be a lifesaver. But here's the problem as it relates to Alzheimer caregiver stress…

When stress is routine, so is this constant biochemical release that, over time, actually harms the body in various ways such as:

• Decreased immune system
• Greater chance for infection and disease
• Digestive tract problems like ulcers
• Lung problems like asthma
• Heart disease, which causes strokes and heart attacks

The HPA system is an intelligent design within the human race. The problem is it doesn't automatically distinguish caregiver stress that is continuous, day after day, from a bear attack, which is temporary. That means the stress that caregivers endure is chronic, and therefore, more debilitating to the human body. The good news is there are ways to combat its effects.

It's called stress management.

How Does Stress Management Help with Alzheimer caregiver stress?

Good question! And that's the main purpose of my website www.caregiverrelief.com, because caregiver stress is practically unavoidable.

Take The Oxygen First, pt. two

If this is first time you are looking at my blog, please go back and start with the first half of this article.

These stubborn caregivers have made up their mind, sometimes decades earlier, and they are not about to listen to anything that challenges their preconceived notions...

But there are some very good reasons for being open-minded about assisted living. For example there comes a time, especially with Alzheimer’s disease, that the care needs of the sufferer are greater than the caregiver’s ability to provide for them. Given this circumstance, it would be a terrible disservice to the loved one, to keep them at home with inadequate care.

Unfortunately, when their care needs are this advanced, the only placement option is going to be a nursing home. The care required at that stage are medical not custodial, and therefore surpass the services offered by assisted living or board and care.

I want to propose a better course of action. If the caregiver relents, and a placement is made into an assisted living, they now have a home-like environment that will be safe, comfortable, and friendly towards the disabled family member. The caregiver is still able to oversee their loved one’s care. And as I will explain in a moment, the impaired family member can age in place and the assisted living will continue to provide care as demands increase, even end-of-life care.

The difference is this – an assisted living will accept a client that meets their resident profile, and when they do they generally make an unwritten commitment to their families. They will always provide the necessary care, and they will monitor the resident’s decline and keep the family and the doctors properly informed.

Generally the first level of care in assisted living is bathing assistance, medication management, and personal laundry. Nevertheless, as more care is need they will provide care and supervision, incontinence care, wheelchair transfers and escorts. The care in Assisted Living can increase to keep pace with the resident's decline. And when the end of life is approaching they can introduce the family to hospice, which in turn can provide the maximum amount of comfort measures to insure a peaceful passing.

So, if you approach board and care or assisted living while your loved one fairly high functioning, chances are they will keep your parent or spouse no matter how much they decline, thus permanently avoided a nursing home placement. Saddly, if you wait too long, no assisted living will touch them. Not so much because they don’t want to, but because the State regulations that govern them have strict admission criteria. The State wants to insure that board and cares and assisted living communities do not take high accuity that belong in a nursing home. However, once a client is admitted to assisted living, the same State regulations protect the resident’s ability to remain in the facility, thus aging in place.

To summerize, we now have a strong argument in favor of placement for your loved one, and preferably sooner than later.

Granted no employee of an assisted living knows or loves your parent or spouse the way you do, and no one understands them or their needs the way you do. There is not a person or facility that can replace you. So it behooves you and your loved one that you take proper care of yourself, so that you are around for the rest of their life. But as I described in part one of this article, I have seen many a late-stage Alzheimer's patient with no family, per se, to oversee thier care, because the primary caregiver has passed away themselves.

So let this be one more reason for considering assisted living: There is only one of you. You prepare and provide meals, you ensure a safe and secure home, you provide transportation, you are the eyes and the ears for the doctor, and you provide medication management. You also provide socialization and human contact and interaction. You make sure they have emotional stability, and feel loved. You provide entertainment. You do the laundry and make sure they bathe. You see to their grooming and you make sure they are dressed appropriately. You are burning yourself out.

However, if you were to place your loved one in a nice assisted living community, all these activities of daily living will be handled by their staff. This in turn frees you up to not only spend time on yourself, but to also spend quality time with your parent or spouse. Again, I suggest you take the oxygen first. If you do that your health will improve, you will extend your life, and you will always be there to care and advocate for your loved one.

take the oxygen first: advice to stubborn caregivers

Caregivers seem to be naturally stubborn. Maybe it takes a hardhead to be able to focus on the day to day grind of meeting the needs of our loved ones. But while stubbornness can be a positive personality trait when it keeps us going month after month, year after year; it can also be a negative trait when it suppresses an open mind. Being hardheaded can prevent us from accepting new ideas, or opening up to new concepts. It narrows our field of vision, like blinders on a horse. It creates a closed-mind.
I have seen it over and over again, maybe you have too. Too often I meet a caregiver that is wound up and ready to explode. It is obvious to everyone around them, but they cannot see it. They will tell you that everything is under control. “I’m fine”, they say. And, tragically, to the extent that they are “fine”, they are heading for a very big crash. Besides the toxic effects of stress on one’s health. They are closed off to the concept of surrender and the acknowledgement that they need help. But that is exactly what every caregiver needs…help. Remember, more than 50% of caregivers die before the person they are caring for.
Dr. Jamie Huysman, the co-founder of Leeza’s Place, gives a great talk. In his speeches you can often here him suggest that caregivers “take the oxygen first”. What a marvelous concept! This is a perfect analogy to the average caregiver’s dilemma. And, it is the very concept that I have been advocating all along. Flight attendants, when giving preflight instructions, direct people traveling with children, that if cabin pressure is lost and the oxygen masks are deployed, that they should put their own oxygen mask on before helping their children with their mask. The reason is that there are only a few second before you lose consciousness, and in order to be effective and save others, the parent (caregiver) needs to see to their own needs first.
So I plead with my stubborn caregivers. Acknowledge that you need help, and be willing to hand the job over to others whenever you can, and see to your own needs. Remember that alarming statistic from earlier posts that over 50% of caregivers die before the person they are caring for. Well add to that another 10 – 20% that become incapacitated and no longer able to continue caregiving for their parent or spouse. The causes are many, it might be a major stroke, or a serious cancer, or a fractured pelvis. Unfortunately, I have seen too many a cases of older adults with profound Alzheimer’s whose caregiver is out of the picture.
Over the years I have spoken, one on one, with hundreds of caregivers. My overwhelming impression is their unwavering commitment to their loved one. They believe, that no one can care for their parent or spouse as good as they can. That no one can possibly know their loved one as well as them. I happen to agree with them. This is why I continue to recommend that they take action to preserve their health. Because if something happens to them, who will care for their loved one? So I encourage them to use adult day care, to find respite care options, to attend support groups. In support groups they can share their experience with other, newer caregivers, and they can also learn from other, more experienced caregivers.
I also recommend board and care and assisted living. Usually, this is the option that caregivers are very specific about NOT doing. And there you have it, before you can finish your sentence; they are railing how they will never allow it. These stubborn caregivers have made up their mind, sometimes decades earlier, and they are not about to listen to anything that challenges their preconceived notions.
part 2 next week

Caregiving at a distance: when parents are in denial

The other day I was asked to speak to a large group about stress and stress management. It was not my typical audience. These were professionals of a large company that produces pace makers and other sophisticated medical equipment. Not the usual caregivers or healthcare professionals that comprise my audiences.
In giving my credentials during my introduction, I included my gerontological experience and offered to stay afterwards and talk to any caregivers that had questions or needed guidance. They were a great group and we had a lot of fun. Not surprisingly however, a half of a dozen people approached me afterwards.
A couple of these caregivers brought up a dilemma that I find to be all too common. Of all the possible situations this scenario the one that stumps me the most: What to do when your parent, who obviously needs help, refuses it? There are many variations on this theme. But they all fall under the heading of “stubborn refusal”. As a professional, I can help families in just about any circumstances they find themselves in, but when it comes to that “dig your heels in” kind of situation, it’s the worst.
For example, Margaret who lives 60 miles away from her mother has been trying to get her mom to move in with her for some time now. Mom is 80, getting frail, unable to really take care of herself, as she should. She has fallen a couple of times, once requiring a 911 response, but has had not broken any bones yet. She does not suffer from dementia, but is showing some forgetfulness. I would guess “Mild Cognitive Impairment” (MCI). Mom calls Margaret several times per week; each is a demand for some kind of assistance. Mom can no longer drive safely, and fortunately, out of fear, she doesn’t. However, this is an added burden to Margaret, as she has to make the round trip several times per week to do mom’s shopping, to help her with appointments, help with laundry. You know the drill. As you can imagine, Margaret is exhausted. She has her full time job, her own marriage and her kids with whom she wishes to spend time.
She has asked her mom to move in with her and the family, but mom refuses. She stubbornly clings to that age old mantra so many older adults use, “I’m not going to give up my independence”. Margaret has also discussed a senior community for mom. But that idea meets the same resistance as the first. All the while, mom’s independence is a delusion cultivated by conveniently ignoring the evidence and selfishly continuing to completely wear her daughter out.
There are only a few options open to Margaret, here’s the milder sneaker solution for getting her into a senior community.
Margaret needs to plant a seed in mom’s mind, here’s how. First, Margaret should contact a ‘referral agency’. A referral agency is a free service that helps you find board and care and assisted living communities. Generally, the way they work is you give them a physical description of your parent, a budget range, and preferred location, and they, in turn, give you a list of “communities” that fit your criteria. The next step is to go visit a few senior communities, Alone! Don’t let your parent know what you are doing yet. Once you have toured a few of these places, pick your top two. Next, invite mom out to lunch. Make arrangements with the facility to come for lunch and tour with your mom. As you are driving with mom, tell her that something came up and you need her help. You have a friend who is looking for a place for her mom, and your friend needs your help to check out this place. Explain to mom that you made a lunch appointment and ask her to help you. (“After all mom, it’s a free lunch, what have we got to lose”?)
Make sure you tell the marketing director of the facility what you are up to, so she can play along. (Fear not; they do this kind of stuff all the time). Afterwards, you can pick mom’s brain about what she liked and didn’t like. Beyond that, don’t bring it up again, the seed is planted. It may be months but she will more than likely bring it up again on her own. Don’t be surprised when out of the blue, your mom says “I’ve been thinking about that place we had lunch at…”
Nevertheless, even if she does figure out the ruse, and finds out that you tried to trick her into looking at one “of those” places, the deed is done. Hopefully, she knows you meant well. But if she gets mad, that’s ok too, she will get over it. The important thing is to get her in to see what these communities look like. So many older adults have a warped idea of what they are. You can never hope to see your parent in a safe environment like this until their preconceived prejudices are dispelled.
Some other options are: Get your parent to agree to a temporary stay (a 2-week vacation stay). Or if they are warming to the idea and on the fence, ask them to try it for 3 months and that you will keep their home or apartment available. Ultimately, their health is at stake. That’s why you are pushing for this. The truth is, if they do not take the board and care assisted living option, something catastrophic will happen and they could end up in a nursing home instead…and many consider that a fate worse than death.

Caregiving at a distance: when parents are in denial

The other day I was asked to speak to a large group about stress and stress management. It was not my typical audience. These were professionals of a large company that produces pace makers and other sophisticated medical equipment. Not the usual caregivers or healthcare professionals that comprise my audiences.
In giving my credentials during my introduction, I included my gerontological experience and offered to stay afterwards and talk to any caregivers that had questions or needed guidance. They were a great group and we had a lot of fun. Not surprisingly however, a half of a dozen people approached me afterwards.
A couple of these caregivers brought up a dilemma that I find to be all too common. Of all the possible situations this scenario the one that stumps me the most: What to do when your parent, who obviously needs help, refuses it? There are many variations on this theme. But they all fall under the heading of “stubborn refusal”. As a professional, I can help families in just about any circumstances they find themselves in, but when it comes to that “dig your heels in” kind of situation, it’s the worst.
For example, Margaret who lives 60 miles away from her mother has been trying to get her mom to move in with her for some time now. Mom is 80, getting frail, unable to really take care of herself, as she should. She has fallen a couple of times, once requiring a 911 response, but has had not broken any bones yet. She does not suffer from dementia, but is showing some forgetfulness. I would guess “Mild Cognitive Impairment” (MCI). Mom calls Margaret several times per week; each is a demand for some kind of assistance. Mom can no longer drive safely, and fortunately, out of fear, she doesn’t. However, this is an added burden to Margaret, as she has to make the round trip several times per week to do mom’s shopping, to help her with appointments, help with laundry. You know the drill. As you can imagine, Margaret is exhausted. She has her full time job, her own marriage and her kids with whom she wishes to spend time.
She has asked her mom to move in with her and the family, but mom refuses. She stubbornly clings to that age old mantra so many older adults use, “I’m not going to give up my independence”. Margaret has also discussed a senior community for mom. But that idea meets the same resistance as the first. All the while, mom’s independence is a delusion cultivated by conveniently ignoring the evidence and selfishly continuing to completely wear her daughter out.
There are only a few options open to Margaret, here’s the milder sneaker solution for getting her into a senior community.
Margaret needs to plant a seed in mom’s mind, here’s how. First, Margaret should contact a ‘referral agency’. A referral agency is a free service that helps you find board and care and assisted living communities. Generally, the way they work is you give them a physical description of your parent, a budget range, and preferred location, and they, in turn, give you a list of “communities” that fit your criteria. The next step is to go visit a few senior communities, Alone! Don’t let your parent know what you are doing yet. Once you have toured a few of these places, pick your top two. Next, invite mom out to lunch. Make arrangements with the facility to come for lunch and tour with your mom. As you are driving with mom, tell her that something came up and you need her help. You have a friend who is looking for a place for her mom, and your friend needs your help to check out this place. Explain to mom that you made a lunch appointment and ask her to help you. (“After all mom, it’s a free lunch, what have we got to lose”?)
Make sure you tell the marketing director of the facility what you are up to, so she can play along. (Fear not; they do this kind of stuff all the time). Afterwards, you can pick mom’s brain about what she liked and didn’t like. Beyond that, don’t bring it up again, the seed is planted. It may be months but she will more than likely bring it up again on her own. Don’t be surprised when out of the blue, your mom says “I’ve been thinking about that place we had lunch at…”
Nevertheless, even if she does figure out the ruse, and finds out that you tried to trick her into looking at one “of those” places, the deed is done. Hopefully, she knows you meant well. But if she gets mad, that’s ok too, she will get over it. The important thing is to get her in to see what these communities look like. So many older adults have a warped idea of what they are. You can never hope to see your parent in a safe environment like this until their preconceived prejudices are dispelled.
Some other options are: Get your parent to agree to a temporary stay (a 2-week vacation stay). Or if they are warming to the idea and on the fence, ask them to try it for 3 months and that you will keep their home or apartment available. Ultimately, their health is at stake. That’s why you are pushing for this. The truth is, if they do not take the board and care assisted living option, something catastrophic will happen and they could end up in a nursing home instead…and many consider that a fate worse than death.

The Stress of Caregiving

The Stress of Caregiving
If you give care for a parent, spouse or elderly family member, you are certainly under a lot of pressure and stress. Perhaps you feel guilty because you think you aren't doing enough, and you're frustrated that you can't do more.
You are not alone. Most everyone who provides major care for parents and spouses experience stress and depression. Studies show that long-term stress is not just unpleasant – it can negatively affect your health, well-being, and ability to provide care. The strain of caregiving is so detrimental that statically, 50% of caregivers for loved ones with Alzheimer's die before their infirmed spouse or parent. Clearly, when you are caring for others, taking care of yourself and your needs is imperative.
Managing your stress and resolving your caregiving problems will improve your physical and mental health to benefit yourself, your elderly loved ones, and others who depend on you.
How can I do that you may ask? Well one way is to enlist the help of a life coach. My website is in the works and not up yet. But here is an excerpt from it. Besides offering geriatric care managment, I've started a more affordable alternative. For that matter, a more effect alternative in the long run. Its called Caregiver Coaching. Here's the excerpt:
CAREGIVER COACHING
A revolutionary concept for helping caregivers, caregiver coaching unlike geriatric care management, is an affordable support option for struggling or new caregivers.
If you are familiar with ‘life coaching’ then you can easily imagine how Caregiver Coaching works.
Wikipedia.org defines it this way: Life coaching is a practice of assisting clients to determine and achieve personal goals. A coach will use a variety of methods, tailored to the client, to move through the process of setting and reaching goals.

Many caregivers often feel alone in their struggle to care for their spouse or parent, having little contact with people that understand them or what they are going through. With caregiver coaching, they now have a knowledgeable and understanding person that they can turn to whenever they want or need encouragement and informed feedback. A caregiver coach gives you a calm, objective view on your life and circumstances, and even a structured plan for improving it. You may think of a life coach as a knowledgeable friend or companion with no agenda except to help you live your life at the best possible level you can imagine. You can view your coach as a best friend with no problems of their own and a management consultant without a high price tag.
Caregiver Coaching starts with initial interview. The client and the coach get to know one another. We cover everything from you current circumstance to your personal philosophy of life; from your goals or vision, to your limitations. We will help you design your support structure and frame our relationship. It may be that we speak on weekly basis with the option of calling me when you have a need for guidance or just to vent your frustration, or it may daily contact, it’s all up to you. Caregiver coaching has brought many caregivers back from the throws of depression and desperation to a renewed sense of joy and purpose.

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So what do you think? Do you think it can help you? Please contact me. Either here, or a www.caregiverrelief.com or at donahueg@alumni.usc.edu

TEN THINGS EVERY NEW CAREGIVER SHOULD KNOW

Going on two decades, I have met hundreds of family caregivers. What is interesting is that they are all mostly self-taught. For most of them it’s a long and difficult learning curve. Not because the necessary information is difficult to learn or understand, but because there are few centralized sources that give you the full range of services and programs that you will need and that are available.

Part of the reason is that each business which has a focus on older adults is biased to the services that they provide. It’s natural. Every business is an expert in their own field, and their knowledge, and their interest for that matter, in other services is limited. For example, if I need a car and go into a Ford dealer, do you think they are likely to refer me to Dodge dealer? Even if they know that Dodge has the exact type of vehicle that I am looking for, they will probably try to fit me into the best Ford that matches my needs. I don’t fault them for that. If anything, I have myself to blame. I should have done my homework. Unfortunately the information I need to buy a car is lot easier to find that the information I need to best take care of my mom. And this is why I say most caregivers are self-taught. It is often a case of trial and error.

I am not implying that these service providers are dishonest; it’s just that each has a field that they favor. For example, a home health agency provides paid caregivers for the home. That’s their business, that’s what they know best. Their knowledge is limited about other options like assisted living or nursing homes. And by virtue of who they are, they think that home health care is always the superior option. Conversely, assisted living communities have the same mind-set about what they do. They in turn believe that theirs is the better option. And so it goes with most service providers, regardless of their service or product. The upshot is that we have a fragmented delivery system for senior services. And as a result, caregivers and seniors end up having to do a lot of homework to navigate the maze of senior services and programs.

Sometimes their introduction to the world of gerontology is the result of a sudden illness or accident, precipitated by trip the emergency room and a short stay in the hospital. Other times it’s the result of a progressive chronic illness or disease. If I could be there for the first group, I would suggest that they find a Geriatric Care Manager right away. It will be worth the initial assessment and consultation fee, and it will save a lot of time, grief and money (More about that later). I say this because hospital discharge planners are notorious for giving a family 24 hours notice or less before sending a patient home. And if you feel that you are unable to take your parent or spouse home, they may suggest a transfer to a nursing home. Therefore, if you want to avoid having to pick a nursing home sight unseen, you may want to do some homework ahead of time.

If you are in the second group, you are fortunate to have the luxury of doing some research in the early stages of your loved ones illness. Unfortunately, many put this off way too long and find themselves in a downward spiral of providing care beyond their ability and capacity. They wear themselves out, and unintentionally putting themselves and their loved ones at risk. All too often they do this until they end up in the first group, with their parent or spouse in the hospital and a discharge planner giving them 24 hours notice to make important decisions for placement and/or care options.

In either case, fear not, there is still time to do some research and start making plans that are well-informed and appropriate. If fact a short stay in a nursing home may buy you precious time to do some homework that suites both you and your family. In the following pages and posts I will explain the “Ten Things that Every New Caregiver Should Know”

1. Know your loved one’s true condition
a. Physically
b. Cognitively
c. Financially
2. Learn the territory
3. Find out where you stand
4. Know the future (yes its possible)
5. Know your options
6. Recognize your needs
7. Find your allies
8. Know your limitations
9. Develop your contingency plan
10. Know your enemy

Please stay tuned…