What you Should Know if Dementia is in your DNA

For those of us caring (or have cared) for parents with dementia, you should know there are a variety of factors that we can control that will reduce our risk.

The first is good news for those of us that worry that genetic factors have sealed our fate.

Association of Lifestyle and Genetic Risk With Incidence of Dementia (JAMA, July 2019) The study sought to determine if a healthy lifestyle was associated with lower risk of dementia, regardless of genetic risk. They found that a favorable lifestyle was associated with a lower risk of dementia among participants with high genetic risk. There is considerable evidence that individuals who avoid smoking tobacco, are physically active, drink alcohol in moderation, and have a healthy diet have a lower dementia risk.

The next study reports that higher levels of daily physical activity may protect against the cognitive decline and neurodegeneration (brain tissue loss) from Alzheimer’s disease (AD) that alters the lives of many older people. This was from researchers at Massachusetts General Hospital (MGH). Exercise offers protection against Alzheimer’s (JAMA Neurology, July 2019)

I noticed what a difference exercise made for my Dad who was diagnosed with Alzheimer’s. I worked to encourage him to get exercise, but it got to the point that the only way it worked was when I would challenge him to play Racquetball with me. He had a group of friends that he regularly met in the mornings, but after he fell on the Racquetball court and broke his hip, he was just unable to return more because he couldn’t manage to plan ahead and would not allow me to help. When I did get him moving he was just more communicative. I do need to add that he recovered from his hip surgery and was still able to beat me. While I could run, I just couldn’t outsmart his crafty shots.

I have also seen this with the older adults I work with. The more they are engaged with others and active, the better they seem to manage when it comes to working on daily finances and household chores. I have many that really want to stay in their homes but also don’t realize how isolating that can be.

The middle stage is hard to navigate as our loved ones think they are managing but are unable to recognize what they are not able to do or follow up on. If there is anyway to incorporate friends who can help them return to an activity they shared it will give them both a social and a physical boost?

The research has proven that we aren’t predestined to the fate of our parents if we have a favorable lifestyle. The good news for our loved ones is that exercise will help them even after a diagnosis. Let me know if you have had some success getting your loved ones that have been diagnosed moving again. Encouraged.

What I Wish I Knew When Dementia Was Diagnosed: The role of Palliative & Hospice Care (#2)

Palliative-vs-HospiceMy parents and in particular my Mom often shared that QUALITY of life was her goal, not QUANTITY. After a diagnosis of dementia which can result in death, I had an ongoing struggle with what was important to do to honor my mother’s wishes.

The lines between “palliative care” and “hospice care” are confusing but they both focus on providing comfort. Palliative care can begin at diagnosis, and at the same time as treatmentHospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness. These lines are kinda blurry with dementia since there really is no “treatment” or “cure” (YET). 

I wanted to manage and strive for quality of life, keep Mom comfortable, but be mindful that we were not providing things that could extend her life.

When Mom started to refuse to take the anti-anxiety medication the care community was delivering, I realized that it was being delivered with a host of vitamins. Was it important to give my 80-year-old mother a multi-vitamin?

My Mom didn’t really like taking pills, so delivering 4, of which one was really important to minimize her stress became the only one I asked them to deliver. I followed up with the doctor who agreed that the other pills were not really necessary and her medication regimen was updated.

When Ensure was recommended as an addition to her meals, I asked more questions to make sure it wasn’t been forced or delivered as a meal replacement over providing her with food options she would still eat.

Apparently dementia and age can impact your taste and there seemed to be a strong preference for salty and sweet foods. She was never much of a salad or veggie person and it seemed odd to start worrying about nutrition when she often couldn’t remember names or faces. I didn’t want her to be hungry, but I also wanted to let her have some control even through her diagnosis over day-to-day choices.

My toughest challenge was when her hip broke and the doctor insisted we lift the DNR (Do Not Resuscitate) order for her so they could repair her broken joint. At 83 and very frail, there was no way she would have survived the surgery and they agreed to move her into Hospice Care. Over the previous year, she had been in and out of Hospice Care as she continued to weaken. However, with the addition of the broken hip, we now had the option to keep her comfortable with morphine that would eventually end her life.

These were difficult and guilt-inducing decisions, but I always worked to meet what I believed to be my mother’s wishes. Knowing these options may not just better serve the comfort, but also allow you to focus more on enjoying time with your loved one than managing medical matters.

Would the vitamins and Ensure prevented the eventual hip break? I will never really know but after caring for two parents now realize how important it is to let the will of the individual influence their daily choices, even after a diagnosis of dementia.

You will have a lot of options and choices to make over the course of your journey. Just know you will make the best decision you can with the information you have at the time you need to make choices for your loved one. Hospice can be a valuable option during your care journey. Reminded. 

 

Break a Habit of Drinking Alcohol #6

drinkinganddementiaOne of my big fears after caring for my parents is that should I lose my short-term memory, I will also lose the ability to know that I have had more than one, or even two drinks.

I have yet to see alcohol on any healthy diet without an asterisk next to it. I’m always intrigued to read interviews with octogenarians (and older) to learn what they chalk up to their healthy aging habits. I swear that a snifter of whiskey or brandy has been in the largest majority of those I have read.

What I do know is that the habit of “quiet hour” honed over 5 decades of marriage became a problem for my parents when they lost their short-term memory. Instead of stopping at one or two drinks, they started to drink more. It was one of the most obvious signs to their adult children that something was different with our parents.

During this period we learned that there is a form of dementia that is a result of alcohol abuse. Drinking and drug use is proven to kill brain cells faster than aging alone. You can learn more about these impacts on this page at the American Addiction Center.

At first we thought my Dad’s quietness and forgetfulness were because of the increased drinking. We later learned that he had Alzheimer’s. Had there been no habit of drinking, we may have gotten to an answer sooner.

During this time, I was able to encourage my parents to purchase Umbrella insurance. I was terrified that their actions could hurt someone and they could lose all of their savings.

If you have a study that shows that alcohol does lead to healthy aging … please share! My belief is that like many things, moderation is the key. My goal is to age without a habit of drinking alcohol. Aspired. 

Little Proof that Supplements Improve Brain Health

brainfitness

When you have two parents with dementia, you start to worry about your own cognitive outlook. I poured over the research and have been exposed to a host of “supplement plans” proposed to families throughout my work and personal life. I have yet to have anyone emerge from these plans, that typically cost over ten thousand dollars, with a noticeable change. I’m not a doctor, and I don’t really know if there is peer-reviewed research supporting this … I know the claims are made that they are proven. I just haven’t seen them positively impact anyone yet. And I’m very well connected to hundreds of individuals with dementia … so you think a great result would be freely shared.

The Washington Post carried a snippet of the story, but you can read the full summary that Supplements for Brain Health Show No Benefit – a Neurologist Explains a New Study. Everything I have read and seen play out jives with the explanation. However, it feels better to think that a simple pill can be a cure-all.

I believe that the food we eat makes a difference and even more so, the habits we develop now can make a huge difference to how long we can manage if we start to have cognitive issues.

If you use a calendar system and a to-do list, you could find life much easier to manage should you start to have short-term memory issues. In working with a variety of clients I have found those that have a habit of using the calendar and making to-do lists have an easier time of continuing to manage and control their own affairs. They don’t make your brain lazy and are actually recommended in the classes taught by Total Brain Health.  After going through the program, I highly recommend it. If you can’t find a class, maybe consider getting Dr. Cynthia Green’s book Total Memory Workout. You will find a host of ways to rev up your recall and be more educated about what you can do to improve your own brain health. Recommended.