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Special publication of L’OBSERVATEUR

WA V E S Head to the Mediterranean

...In the Kitchen

Move,Think, Thrive 1 in 8 Americans will develop Alzheimer’s disease. New studies show that exercise, both physical and mental, could be one of the most powerful tools to stave off its onset. Get started today!

Care and Care Alike

Providing care for a loved one with Alzheimer’s? Put yourself first today to ensure a healthier, vital future for patient and caregiver

Senior Friends Keep Active in River Parishes

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| Brain Waves |

Sharp as a A

By Bev Bennett CTW Features

2 Pencil

Just because your school days are long behind you doesn’t mean you should stop learning. In fact, taking classes and exploring new ideas will keep your mind agile for years to come

fter a stirring visit to Israel just after the sixday war in 1967, Donna Yanowitz decided to learn Hebrew. “I had to learn the language. I find it fascinating,” says Yanowitz, who immersed herself in Hebrew studies and has been at it ever since. “It’s difficult, idiomatic. But I keep at it,” says the Cleveland, Ohio-area resident who turns 89 in August. Yanowitz is one of more than 7 million adults age 66 and older taking adult education courses, according to the Statistical Abstract of the United States: 2010 from the U.S. Census Bureau. By taking classes, you can learn new skills, socialize and enjoy yourself as you reduce your risk of cognitive decline. “It’s not too late to stimulate your brain,” says Virginia Wadley, Ph.D., associate professor of medicine, gerontology, at The University of Alabama at Birmingham. Research suggests that people who have advanced degrees or held jobs that required speaking, instructing or negotiating have a lower risk of memory loss than those whose jobs were less intellectually demanding. But even if you didn’t spend your life as a courtroom lawyer or a college lecturer, you can protect your memory by learning new things regardless of your age, according to Wadley, writing in an email interview. “The brain remains flexible into old age and is able to generate and strengthen connections between neu-

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rons. These connections are what help to support an agile memory,” she says. If you’re wondering what kinds of studies to pursue, experts on aging offer some guidance. “What’s recommended is reading, writing, learning something new,” says Cynthia J. Brown, M.D., associate professor in the division of gerontology, geriatrics and palliative care at UAB. Embrace different experiences, the experts say. “You want to learn something that’s far away from what’s familiar to you,” says T.J. McCallum, Ph.D., associate professor of psychology, Case Western Reserve University, Cleveland, Ohio. If you’ve ever wanted to learn to play a musical instrument, now’s the time to take lessons. Likewise, learn a new language. You’ll tap parts of the brain you haven’t been using, according to McCallum. Although you might be initially intimidated, pursue something challenging. It’s good for you. Mental challenges may reduce the risk or lower the development of dementia or cognitive loss, according to Brown. However, your class doesn’t have to be academic to be beneficial. Try dancing, for example. “Physical activity increases blood flow to the brain and solid research has shown that dancing is one of the best activities for brain protection,” Wadley says. Dancing may support brain health in a variety of ways. “Dancing involves the body, music engages the brain and there is usually social engagement as well,” Wadley says. “Your brain is like other organs of your body. The more you exercise it, so to speak, the stronger it will stay,” says Kaycee Sink, associate professor and medical director at Kulynych Memory Assessment Clinic, WinstonSalem, N.C.

Overcoming Doubt

When Donna Yanowitz tells other seniors she’s taking college level classes, they’re sometimes

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hesitant to follow her example. “People will say ‘I can’t do that. I’m a dummy.’ I tell them to sit there [in a class] and listen and absorb. They may eventually participate. If not, they can sit there and learn,” she says. Yanowitz did have her own moment of doubt. Over her years of study, she racked up an admirable number of credits at the Laura and Alvin Siegel Lifelong Learning Program at Case Western Reserve University, Cleveland, Ohio. “I always wrote the papers and took the exams and was told I should get a master’s. I said, no way could I write a thesis at my age,” Yanowitz says. But she did. Now her thesis on Jews in Ethiopia is used in schools when discussing the history of Jews in that region, she says.

Finding a class that’s the right fit You’ll find a wide range of adult education classes at local colleges and universities as well as in community centers. But you may have questions. Do you look for a small class or large? Lecture or participation? And do you, at your stage of life, really want to do homework? Although it may be tempting, don’t opt for an easy course, the experts on aging say. “You want challenges [and] engagement, but not so challenging you give up,” says Dr. Kaycee Sink, Wake Forest Baptist Medical Center. Classes in which you engage with other students and talk to the professor may be more beneficial than listening passively in a lecture hall, according to T.J. McCallum, Ph.D., at Case Western Reserve University. “The social aspect is very big. You really want to be involved and have an interactive experience,” he says. You may have a choice to attend classes with younger students or those limited to seniors. Both have advantages, according to McCallum, but he suggests being with your own age group because the pacing and speed of

learning may be similar. Setting up a class in which you and your classmates teach each other may be useful, because “you’re not just sitting and learning,” McCallum says. Homework, as dreadful as it seems to your grandchildren, has advantages for you. When you do the assignments you feel competent and you’re once again exercising your brain. Even using your computer for homework may be beneficial, according to Dr. Cynthia Brown at UAB. She points to studies looking at what happens to the brain when you do online searches. “Going through the act of searching on the computer is stimulating,” Dr. Brown says.


Brain Waves Contents Always keep learning ~~~~~~~~~~~~~~~~ 2 Senior Friends keep it active~~~~~~~~~~ 4 Ask the experts if forgoing the nursing home is right for you~~~~~~~~~~~~~~~~~~ 6 Mediterranean diet may help~~~~~~~~~ 9 Caregivers face obstacles~~~~~~~~~~~~~ 11 Help a loved one with Alzheimer’s~~~ 14

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Members of River Parishes Hospital’s Fit at 50 exercise class work through the paces as led by certified instructor Lisa Burbank. (Photos by Stephen Hemelt)

Senior Friends Program stays


Fit at 50, volunteer efforts keep many engaged

By Stephen Hemelt L’Observateur

LAPLACE — There may be no better medicine than staying active. Whether speaking of brain health, cardiovascular health or general stress release, physicians suggest their patients stay active within relation to their physical ability. Dr. Andrew St. Martin of LaPlace Medical Center said he does not think there is a particular vitamin or anything else someone can take to absolutely prevent Alzheimer’s, but a well-balanced diet and keeping yourself physically and mentally active are probably the best chances of delaying or preventing Alzheimer’s. Many medical centers and hospitals

in the River Region have programs designed to keep area seniors active. River Parishes Hospital has been working for close to 10 years to maintain its Senior Friends Program, boasting approximately 200 members today in an effort to stimulate and engage the region’s more veteran community members. The membership program, which costs $15 a year, is open to anyone 50 or over, with enrollees receiving national discounts through various book, travel and retail outlets. Members receive discounts at the hospital, according to Community Relations Coordinator Tammy Waltz, including a 25-percent discount on food purchased in the cafeteria or anything purchased in the gift shop.

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Instructor Lisa Burbank works with members of the Fit at 50 class three days a week at River Parishes Hospital.

| Brain waves | One complimentary meal per day for a guest that visits a member if the member is hospitalized, Waltz said, is designed to help someone stay with members should they become patients. “We do different social activities here at the hospital,” Waltz said. “We usually have meet-and-greets, where members can come and meet other members and bring a guest if they want to. “We have different speakers that come in on healthrelated topics or senior-related topics. We have the sheriff’s office do safety tips for them. The credit union has come in and done some financial planning.” The speakers usually come once every other month, and members also gather for quarterly birthday celebrations, in which members can also bring a guest. Bingo games, movie days and discounted day trips are also part of the Senior Friends Program. An offshoot of the program is the Fit at 50 exercise class. “It’s low impact aerobics and light stretching,” Waltz said. “Before they can actually participate in the class, they do have to have a physician waiver signed just saying the physician feels they are physically fit enough to participate in the classes.” Certified instructor Lisa Burbank is contracted to teach the class from 8:30 to 9:30 a.m. Mondays, Wednesdays and Fridays on the hospital’s third floor. Participants pay $15 a month for the program, and

PAGE 5 members of Senior Friends receive a $5 monthly discount. River Parishes Hospital also utilizes a volunteer program made up of many of its Senior Friends members. “We ask our volunteers to work a minimum of one 4-hour shift a week,” Waltz said. “Our volunteers receive one complimentary meal for each day that they work as our way of saying thank you for working for us.” All volunteers have their membership fee waived for Senior Friends. “We have about 20 (volunteers), but not all of them are active,” Waltz said. “Most of our volunteers are seniors who are retired. We’re really trying to recruit right now for volunteers. They are very often the first face visitors see when they come into the hospital.” Experience is not required. Hospital officials are just looking for friendly and outgoing residents with some extra time. Volunteers help in the gift shop and are present on many of the hospital’s units, assisting patients with pillows, blankets and ice water after consultation with the medical staff. They also work in the surgery waiting room and help as a liaison between family members of patients and the nursing staff. Those interested in signing up can call 985-653-1644 or stop by the hospital, suite 101 on the medical pavilion, to fill out the pertinent applications.

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Ask the Expert: Robert Bornstein Author of “How to Age in Place: Planning for a Happy, Independent, and Financially Secure Retirement” talks about how to know if forgoing a nursing home or assisted living is right for you By Rachel Graf CTW Features Independence is the name of the game – at least for the later years in the game of life. Many seniors want to forgo nursing homes, full-time care or other versions of assisted living. Those who are proactive with their health and wellness during their 50s can lay the foundation to live independently through their 70s and 80s, Robert Bornstein explains in the book he co-authored with his wife Mary Languirand. “How to Age in Place:

Planning for a Happy, Independent, and Financially Secure Retirement”

(Ten Speed Press, 2013) is set for release this September as a comprehensive guide to aging independently. Dr. Bornstein, recipient of the American Psychological Association’s 2005 Theodore Millon Award for excellence in personality research, has published more than 150 articles and book chapters on personality

dynamics, diagnosis and treatment. Q: As a clinical psychologist, have you studied the effects that living independently might have on mental health at an advanced age? If so, what have you found? Living independently is associated with less depression, a generally better mood and more optimism. One of the things that people sometimes find surprising is people who live independently are healthier as well: They have fewer episodes of illness and the flu. So, it has a very broad base of positive effects. Q: What types of planning would you encourage senior citizens to undertake while making the move to “age in place?” When we talk about aging in place, it’s not something you want to start thinking about when you’re 70 but rather when you’re 50. Odds are that you’ll be able to live independently longer if you’re in a single-story home than in a multi-story home. If the issue isn’t mobility, but perhaps memory failings that a lot of people experience, keeping the environment stable (not rearranging your space) is huge. If all of that isn’t working, the next step is to get in-home care, and for many people that’s a terrific strategy for maintaining independent living. Q: When deciding whether to move to a nursing home or to continue living at home, what should

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senior citizens and their family members consider? The bottom line in terms of deciding whether or not you or a family member needs higher-level care is safety. One thing we like to reinforce when we do talks in this area is no one has ever had to enter a nursing home because they have Alzheimer’s. The only reason ever is because their behavior renders living alone unsafe – the source of that safety concern does not matter. Q: Many children of senior citizens may have different ideas of whether living at home or in a nursing home is best for their mom or dad. What is your advice for people in this situation? Often, sibling conflicts around caregiving for parents, even though it’s not explicit, center on money. Very little of skilled nursing home care is covered by Medicare, and so it is often the case that one or more members of the family see nursing home care for their parent as their inheritance disappearing. Families break up over this. The best route to take is to have a family meeting and try to come to an under-

standing of what the best options are. Q: Let’s face it: Some seniors are just more capable of living independently than others. How do you approach a conversation with someone who wants to live alone but might pose a danger to him or herself by doing so? Nothing is going to make it a pleasant conversation, but I think there are two things that you can do that will help. One is to empower the person: Giving them as much autonomy as possible in the decision-making process is very helpful, as you can imagine. And sometimes, if the parent is very resistant, it is helpful for the family to present a unified front. It’s very hard for any person to resist that kind of social pressure.

Dr. Robert Bornstein

Raise the red flags Because health tends to decline gradually with time, here are some warning signs that might signal it’s time to make the move toward more permanent care. • Significant decline in the cleanliness of the home: This is especially worrisome if a person’s home is typically very well-kept. • Financial issues such as bills going unpaid: This may indicate that a person has lost the ability to understand how to write a check, balance a checkbook and so forth. • Food that is not properly stored: This indicates that the person is confused. More importantly, improperly stored food can be a safety issue.


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Try a diet of Mediterranean By Bev Bennett CTW Features Vibrant vegetables and fruit, hearty grains, flavorful fish and rich and satisfying nuts. Just thinking about these robust, delicious foods, the foundation of the Mediterranean diet, is enough to make you crave a healthy meal. And, it turns out, this plant-centered eating pattern can actually support your thought processes, reducing your risk of cognitive decline. Healthy older adults who more closely follow the Mediterranean diet are 19 percent less likely to develop problems with their thinking and memory skills than those who didn’t, in new research from The University of Alabama at Birmingham. This accords with an earlier study in which the Mediterranean diet is associated with slower rates of cognitive decline in the elderly. Seniors who adhered to the Mediterranean diet were cognitively younger than those who didn’t, according to nutrition experts at the Rush University Medical Center, Chicago. Both studies looked at long-term dietary habits of large numbers of mature adults. The Mediterranean diet has benefits for brain health that are just being discovered. The foods have already been linked to reduced incidence of stroke, according to Georgios Tsivgoulis, M.D., a neurologist

with UAB and the University of Athens, Greece. With lower risk of stroke, people may also lower their odds of vascular dementia, according to Dr. Tsivgoulis, whose work was published in “Neurology,” the medical journal of the American Academy of Neurology. In addition, “the food ingredients in the Mediterranean diet contain anti-oxidative properties that may be protective against neuro-degeneration,” writes Tsivgoulis in an email interview. This research comes after decades looking at the Mediterranean diet and heart disease. After World War II, health experts examined the food habits of people in Mediterranean


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countries. They were intrigued because these populations had excellent cardiovascular health and consumed mostly vegetables, fruits, whole grains, fish and olive oil with lesser amounts of red meat. Many studies now recommend a Mediterranean diet for heart health. The link between the diet and cognitive health is so new, that “right now we are only seeing the tip of the iceberg,” Tsivgoulis says. Researchers can’t pinpoint how the Mediterranean diet provides brain protection. In the Rush study, the people whose meals most closely resembled the diet didn’t consume fewer calories, according to Christine C. Tangney, Ph.D., professor of clinical nutrition, College of Health Sciences, Rush University Medical Center. Nor did they favor a few specific foods. “When I tried to look at the diet, nothing was glaring. No one thing stood out,” Tangney says. “That’s the whole point of the Mediterranean diet,” Tangney says, whose work was published in “The American Journal of Clinical Nutrition.” You can’t focus on one food that’s promoting brain health. But not being able to tease out one food is a good thing. It’s beneficial to eat a variety of foods together; there’s a “synergistic” effect in the nutrients consumed, according to Tangney. Even though the research is centered on the “Mediterranean diet,” you don’t have to take it literally, eating Greek, Spanish or Italian foods to reap the healthful effects. The positive studies were done with people in the U.S., who are eating familiar and local ingredients. “Eat whatever vegetables you have in your locale, not necessarily the vegetables used in Greece,” Tangney says. Take inspiration from the diet, adapting it to your lifestyle. These salads provide smart and delicious dining the Mediterranean diet way.

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PAGE 11 By Marla R. Miller CTW Features

In a Hard Place Caregivers are strong, loving and selfless, but usually not for themselves. Taking care of a loved one with Alzheimer’s takes an overwhelming physical and mental toll. Here’s why some good old-fashioned self-care will make you better able to give back

A former caregiver herself, Joanne Koenig Coste has heard the word “I’m fine” so often from Alzheimer’s caregivers, she made it the title of her developing book and created an acronym: FINE Frustrated. Isolated. Numb. Exhausted. While there is more awareness for the illness itself, Coste says not much has changed for caregivers since she found herself in the role in the 1970s. Caring for her husband, who suffered a stroke with progressive memory loss, has guided her life’s work. Now a nationally recognized expert and Alzheimer’s consultant, she authored “Learning to Speak Alzheimer’s” (Mariner Books, 2004) and has another book specifically for caregivers due out in fall 2014. “All of our caregivers are feeling one or all of those emotions,” she says. “We’re so busy being brave and strong, saying we’re fine, we don’t accept help from people.” Currently the sixth leading cause of death, Alzheimer’s affects an estimated 5 million people ages 65 and older. As a disease that attacks the brain and cognitive function, caregiving has become a full-time job for many elderly spouses. More and more adult children, concerned for mom and dad or responsible for one or both of them, also have taken on the caregiving role while juggling their own jobs, families and health issues. For caregivers to survive the dementia journey, they must take care of themselves first, ask for help, accept unsolicited help and seek support through online communities or local support groups, according to experts who work with caregivers. Caregivers need to schedule time for respite and activities to renew the body, mind and spirit. That might include taking an exercise class, relaxing with a bath, reading a book, remembering to laugh, getting a massage

Page 12 or going on a guilt-free vacation. In 2012, 15.4 million caregivers provided more than 17.5 billion hours of unpaid care for loved ones with Alzheimer’s, according to the Alzheimer’s Association. Beyond that, more than 60 percent of Alzheimer’s and dementia caregivers rate the emotional stress of caregiving as high or very high; more than one third report symptoms of depression. The larger implications for the entire health care system are staggering. Alzheimer’s and dementia caregivers paid $9.1 billion in additional health care costs of their own in 2012. Coste encourages caregivers to be proactive before a crisis hits. They cannot do it alone. It helps to assemble a team of support. Find a personal therapist or a caregiver support group or line up regular relief through friends, other family members or hired in-home help. She also leads support groups and suggests people who attend groups together use the buddy system by taking turns watching the other’s loved one so they both get free time. “When caregivers learn to be selfish, they’re much better caregivers,” she says. Laura Wayman, author of “A Loving Approach to Dementia Care” (Johns Hopkins University Press, 2011), travels the country providing work-

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shops, training and in-services to professional and family caregivers as owner of The Dementia Whisperers, Inc., a support organization. Caregivers need compassion, education, encouragement, and support, Wayman says. “It takes a village to care for someone with dementia,” Wayman says. “There’s not any way to turn it off. It’s ongoing care. They need to understand how overwhelming the disease can become.”

wednesday, June 25, 2014 Many caregivers do not outlast Alzheimer’s. The disease can take two to 20 years to run its course and many caregivers are elderly and frail themselves, Wayman says. They frequently fall victim to autoimmune disorders and illnesses associated with chronic stress, such as diabetes, heart attacks, strokes and cancer. Caregivers become so consumed with caregiving, they forget to practice good self-care habits. They don’t make time to exercise or eat right. They often put off going to their own doctor appointments because they are too busy or tired. Conditions like heart disease or diabetes, which could be caught at an early stage, aren’t found until the illness has advanced. The Dementia Whisperers tries to help find resources when a health crisis happens to the caregiver because they usually haven’t developed a backup plan, Wayman says. “It eats away at the relationship, at the caregiver’s strength,” she says. “It can be financially devastating and unbelievably overwhelming. A caregiver doesn’t realize that stress is robbing them of so many pieces of who they are.” The experts agree: It’s best for all involved to seek out help as soon as possible. For those feeling overwhelmed, ashamed or afraid, online resources can be a good place to

Wednesday, JUNE 25, 2014 start. It’s less intimidating and people can remain anonymous or search the web at their leisure. Many sites offer message boards and forums to post questions and communicate with others who can relate to their position. National nonprofit organizations such as the Alzheimer’s Association and Caregiver Action Network provide many free services to people and will connect caregivers to local resources. The Alzheimer’s Association offers a variety of free services

| Brain Waves | through its 24/7 toll-free helpline (800.272.3900) and website,, including a care team calendar to let others schedule times they can help, caregiver stress check, free e-learning workshops and a community resource finder. People can call the helpline and talk to master’s level care consultants who understand caregiving and can offer new solutions – or simply listen. People feel empowered when they have options, says Ruth Drew, director of family and information services at the Alzheimer’s Association and manager of the helpline. “It puts them in the driver’s seat,” Drew says. “No one has ever told us they wish they had waited. It’s never too soon to call. No one needs to go through this alone.” Drew encourages caregivers to seek out peer support. Caregivers should never feel guilty about taking a well-needed timeout. They actually will be better caregivers if they carve out some worry-free time each week to pursue their own interests and hobbies. “Everyone needs a break and an opportunity to recharge,” Drew says. The longevity of the illness and the progressive decline of the patient eventually take their physical and emotional toll. As more cognitive abilities go, caregivers must always be “on,” in constant crisis mode and alert, even throughout the night. This can lead to sleep deprivation, depression, frustration and feelings of helplessness. Caregivers also suffer from loneliness and the loss of the person they once knew, especially


“Wherever people are at, they feel overwhelmed. Connect to a community that understands and gets it.” — Stefanie Elkins, Leeza’s Care Connection

if the patient is their longtime spouse. Many caregivers feel like married widows and struggle with their own emotions, regardless of whether they were happily married or on the verge of divorce before the diagnosis, Coste says. They provide care out of love, duty, obligation and guilt. They might feel resentful and angry, yet sad and sentimental. It is very difficult to watch a person lose cognitive and physical functions, as well as deal with unpredictable behavior, Coste says. It may help to talk through these feelings with a professional. “We lose the patient to the disease, we lose the caregiver to a broken heart,” she says. “Most of them are older. They’re the heroes in this.” Those who live in larger cities can take advantage of special centers such as Leeza’s Care Connection, which has locations near Los Angeles, Chicago and Miami. It operates as a community gathering place where family caregivers can come together and learn new skills to help them become stronger, more resilient, and grounded – and all programs are free. Beyond mentoring, referrals and workshops, some centers offer wellness programs, alternative healing sessions, classes on mindfulness, meditation, yoga and social gatherings and events. The organization helps people who call or stop in regardless of where they live. Nearly 15 percent of caregivers are long-distance caregivers, living an hour or more away from their loved ones, according to the Alzheimer’s Association.

Relatives in a cross-country situation trying to coordinate care often need help finding resources where the patient lives, says Stefanie Elkins, program and outreach director of Leeza’s Care Connection at Providence Saint Joseph Medical Center in Burbank, Calif., and operations manager of Leeza Gibbons Memory Foundation. Elkins says caregivers need to make sure they include themselves as a piece in the puzzle. Her best advice includes getting educated about the disease and the role of being a caregiver, in addition to asking for help and finding the right community resources. Support groups often provide that judgment-free space. “Wherever people are at, they feel overwhelmed,” she says. “Connect to a community that understands and gets it.” Many families delay nursing home placement. Some cultures would never consider it. In some cases, it’s best for all involved to pass the responsibility to trained professionals, Coste says. The decision to put a loved one in a special Alzheimer’s facility can be very difficult, but staff is well-equipped with special training to deal with the intricacies of the illness, Coste says. Plus, they work eight-hour shifts and get to go home. It often comes down to financial resources. Adult day programs and in-home care can be good options for families who cannot afford full-time nursing home care but need additional help. Sometimes it involves baby steps and meeting the caregiver or family where they are, Elkins says.

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5 Ways to Help a Loved One with Alzheimer’s Provide a safe and secure environment Make safety a top priority. As the disease progresses, Alzheimer’s patients risk falling, wandering and becoming easily confused and agitated. Provide calm and peaceful surroundings, says Joanne Koenig Coste, patient and family advocate and author who encourages “habilitation.” It’s the idea of making life as comfortable and pleasant as possible for patient and caregiver, rather than resisting what is happening or fretting over things you cannot control. Enter their world and join the patients there. Rearrange homes and furnishings to meet special needs and accommodate the person with Alzheimer’s. Give them what they want, within reason. Simplify the environment for the patient. Remove trip hazards, sharp objects and clutter. Protect the car keys if they should no longer drive.

Lock doors to the basement, cabinets than medicine and physical support, Wayman says. She suggests or other unsafe areas. reading books, attending support groups and connecting with others Learn to advocate, who can validate your experiences communicate and speak and feelings.


Caregivers must become an advocate for their loved one, assemble a solid medical team and educate themselves on the disease. This includes what to expect as it progresses, what is normal and how to communicate with the patient. It helps to gain perspective on what it’s like for the person with the disease. Keep a list of symptoms as they present or get worse. Find out the best ways to manage them. Change diet and create ways to avoid triggers if necessary. Beyond a good neurologist, your care approach should cover social, emotional, behavioral and psychological aspects of the illness, says Laura Wayman, author of “A Loving Approach to Dementia Care.” There is so much more to care


Create routines and plan pleasant activities Alzheimer’s patients respond well to structure, mixed with relaxation and enjoyable activities, says Ruth Drew, director of family and information services at the Alzheimer’s Association. Establish regular routines: Wake-up and bed times, meals and daily naps. Take them for a walk or to sit outside in nice weather. Let them do art or a relaxing hobby. Capitalize on their remaining skills. “Try to fill the day with a blend of pleasant activities that are predictable,” Drew says. “It’s easier to care for someone who is happy and content.” Coste’s book “Learning to Speak Alzheimer’s” offers caregivers techniques to help patients compensate for cognitive and sensory losses. Physical exercise, snacks and chores can help reduce difficult behaviors and promote a good night’s sleep. Directions for simple activities, recipes for nutritious “finger foods,” and tips for hiring home caregivers are included.

Meet them where they are Practice empathy and patience – over and over again. Remember the patient cannot control what is happening to his or her brain. Make an effort to understand what life must be like for the memoryimpaired. “Accept them without judgment,” Drew says. “Their brain has changed. Try not to belittle them.” Coste takes a humanistic approach to caregiving that focuses on enhancing the individual’s remaining functional, intellectual, emotional and spiritual abilities by creating a positive atmosphere

that promotes feelings of success. Laugh instead of getting mad. Support the patient in his or her new state of mind, avoid conflict and offer praise. Caregivers must maintain their cool in the midst of childish outbursts, tantrums and generally trying behavior. The nature of dementia also causes resistance from the person who has been diagnosed. They can become unruly, wander, make extreme demands and sleep irregularly. They may need help with eating, bathing and dressing. It’s hard to rationalize or argue with someone in the later stages, Wayman says. “You can never win an argument with a person with dementia,” Wayman says.

Take regular breaks Caring for someone with Alzheimer’s is like taking care of a big kid. Just like parents, caregivers need help, support and time away. Go with the flow when possible. Take a time-out if frustrated. Learn to detach and not take their behavior personally. Taking regular breaks isn’t being selfish; it’s about self-preservation, says Stefanie Elkins, program and outreach director of Leeza’s Care Connection at Providence Saint Joseph Medical Center in Burbank, Calif. “Make sure you take time to check in with yourself,” she says. “A lot of times people isolate [themselves]. Asking for help can be a very big help. Be very specific with the ask.” Ask other relatives to help pay for care, if necessary. Reach out to church friends and others going through a similar situation. Find an adult-day program or regular respite care. Find ways to renew the mind, body and spirit. Make time to laugh. Listen to music. Prioritize your own health, hobbies and happiness. Practice regular stress-management and selfcare routines.

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