Alzheimer’s and Alcohol Use

The Alzheimer’s Association often gets calls from caregivers overwhelmed with the challenges of caring for a person with Alzheimer’s disease.  When that person with Alzheimer’s is also abusing alcohol, problems tend to multiply.

In a recent call, a wife caring for her husband reported that her once gentle spouse had now become loud and aggressive, often angrily blaming her for things he could not understand or remember.   She expressed her understanding that her husband’s daily glasses of wine were contributing to his angry outbursts, as things became worse after drinking.  She also wisely expressed understanding that he was depressed about his growing feelings of helplessness as his Alzheimer’s grew worse; she knew that the wine an was an attempt to numb those feelings.

When driving is involved, the combination of Alzheimer’s and alcohol can be deadly.  The person with Alzheimer’s is already impaired; alcohol intensifies that impairment and greatly increases the chances that accidents will occur.

Attempting to “reason” with the person who has Alzheimer’s about his or her alcohol use often does not have a positive result, leaving family members feeling overwhelmed and defeated.  They realize that the situation must change, but feel helpless as to what they can do.

Of course, not all persons with Alzheimer’s are affected so negatively by alcohol use.  Some families report that the person continues to enjoy a beer or glass of wine in the evening, with no ill effects.

If you are a caregiver who recognizes problems related to alcohol use, please know that help and support are available.  Here are some possible action steps:

• Call the Alzheimer’s Association 24/7 Helpline at 1-800-3900.  Trained counselors who understand these issues are available.
• Consider quietly substituting a non-alcoholic “beer” or “wine” for the real thing; you can often purchase look-alike items like sparkling cider.  Or, pour a non-alcoholic beverage into an empty bottle for the real thing.
• Talk with the doctor about your concerns; try to have this conversation privately, not in front of the person with Alzheimer’s.
• Hide car keys or disable the car if necessary.
• In an emergency, call 911 for help.

Lewy Body Dementia: What We Need to Know

Alzheimer’s disease is the most common form of dementia, accounting for between 50 and 70 per cent of cases.   But there are other types of dementia.  One of the most important types for us to be aware of is  Lewy  Body Dementia (LBD), which accounts for a significant percentage of non-Alzheimer’s dementias.   Until recent years, many people with LBD were diagnosed with Alzheimer’s disease.   While it is more likely now for persons with LBD to be correctly diagnosed, there are still challenges with the diagnostic process for these individuals.

Many people note that different types of dementia tend to have similar symptoms and ask, “What difference does it make what type it is?”  With Lewy Body Dementia, the answer is that we know people with LBD can be very sensitive to certain drugs.  Furthermore, limited doses of a drug a person is sensitive to can be detrimental, sometimes even causing irreversible damage.

So, what is Lewy Body Dementia (LBD)?  LBD is related to Parkinson’s disease.  It is degenerative and has no cure, but it can be slowed.  LBD is caused by microscopic Lewy bodies in the cognitive and motor areas of the brain.  It is more common in men than women.

Symptoms of LBD include fluctuations in cognitive functioning, vivid visual hallucinations, and motor dysfunctions (parkinsonism). REM sleep behavior disorders are common, as are repeated falls and fainting.

The most dangerous drugs for a person with LBD are traditional antipsychotics (such as Haldol)  and benzodiazepines (such as Valium, Xanax, and Ativan) .  A traditional antipsychotic may be prescribed for persons with dementia, usually for symptoms of agitation and/or aggression, or for hallucinations.   Benzodiazepines may be prescribed for such problems as anxiety and sleep problems.

Other drugs that can cause adverse side effects for someone with LBD include atypical antipsychotics, decongestants and antihistamines, some antidepressants, antispasmodics used to relax muscles and treat incontinence, strong pain medications, and inhaled surgical anesthetics.

Each person with LBD is an individual.  What causes problems for one person may not cause problems for another.   The important thing is to be alert and aware of possible issues.

Caregivers interested in reading more about LBD may find the following book a very helpful resource:

A Caregiver’s Guide to Lewy Body Dementia by Helen Buell Whitworth and James Whitworth

Helpline Support

The Alzheimer’s Association Helpline can provide a needed listening ear during a difficult time.  In addition to providing resources and information, Helpline Staff are trained to provide emotional support when needed.  Counselors are available to help you work through a problem or provide a listening ear.  One helpline caller reached out to the association during the holidays because she was “alone for the holiday”.  She was able to talk through her loneliness and was so thankful to have someone to share her holiday with.  Sometimes, a simple phone call with a caring person can make a big difference.  Helpline Staff are there to help at any time.  The Helpline is available 24 hours per day 7 days per week and can be reached by calling 1-800-272-3900.

Brain Health – Physical Activity & Diet

Many people know that physical activity is a great way to care for the body.  Not many people think to exercise the brain.  Keeping your brain strong is a great way to support healthy aging.  Here are 10 ways to maintain the health of your brain:

1. Head first - Good health starts with your brain. It’s one of the most vital body organs, and it needs care and maintenance.

2. Take brain health to heart - What’s good for the heart is good for the brain. Do something every day to prevent heart disease, high blood pressure, diabetes and stroke — all of which can increase your risk of Alzheimer’s.

3. Your numbers count - Keep your body weight, blood pressure, cholesterol, and blood sugar levels within recommended ranges.

4. Feed your brain - Research suggests that a diet rich in dark vegetables and fruits may help protect brain cells. Eat less fat and more antioxidant-rich foods.

5. Work your body - Physical exercise keeps the blood flowing to the brain and may encourage new brain cells. Walking just 30 minutes a day can help keep both body and mind active.

6. Jog your mind - Keeping your brain active and engaged strengthens brain cells and the connections between them, and may even trigger growth of new cells. Read, write, play games, learn new things, and do crossword puzzles.

7. Connect with others - Leisure activities that combine physical, mental and social elements may be most likely to prevent dementia. Be social, converse, volunteer, join a club or take a class.

8. Heads up! Protect your brain - Take precautions against head injuries. Always wear a seat belt; unclutter your house to avoid falls; and wear a helmet when cycling.

9. Use your head - Avoid unhealthy habits. Don’t smoke, drink excessive alcohol or use street drugs.

10. Think ahead – start today! - You can do something today to protect your tomorrow.

Compassionate Decision Making

Caregivers of persons with dementia often struggle with feeling they are making the right decisions for their loved ones.   Should I take the car keys?  Is it time for a long-term care facility?  What would she have wanted?  Should I be substituting my judgment for his?

Viki Kind is an bioethicist with her own personal experiences of being a decision-maker for her parents.  She has written a very helpful book that gives caregivers tools they can really use in making difficult decisions.  Ms. Kind has the gift of combining practical information with the needs of the heart – both the heart of the person who needs help and the heart of the decision-maker.  The book is The Caregiver’s Path to Compassionate Decision Making: Making Choices for Those Who Can’t, by Viki Kind, MA.

Susan Formby, LCSW

Care Consultant

Alzheimer’s Association, Georgia Chapter

Brain Health: Sleep

On these rainy, dreary days, many times all we want to do in the mornings is stay in bed and sleep! We probably all know that exercise, stimulation and socialization are important factors in helping our brains stay healthy – but so is sleep! Sleep is a vital part of daily physical and mental healthy renewal. According to the American Academy of Sleep Medicine, most adults need about seven to eight hours of sleep each night to feel alert and well rested during the day. Sleep is as vital to our health as nutrition and can improve mood, cognitive function and overall physical well-being.

Are you or a loved one having trouble getting enough sleep? Try the following tips:

-          Keep a consistent bedtime routine

-          Exercise regularly, but not right before bedtime

-          Avoid caffeine or other stimulants before bedtime

-          Prepare a comfortable and quiet sleep environment

If you regularly experience difficulty sleeping, consult with your physician.  For additional tips on assisting a person with dementia with sleep, visit www.alz.org .

Kara Johnson, MSW Care Consultant Alzheimer’s Association of Georgia

American Academy of Sleep Medicine http://www.aasmnet.org

Alzheimer’s Association: www.alz.org

Adult Day Programs for Persons with Dementia

We humans are all social creatures.  We like to see some friendly faces, share a meal, and share a laugh with others.  That doesn’t change when a person has dementia.

The problem is, having dementia can be a very isolating experience.  The person is often not able to participate in activities in ways he or she once did.  And, many people with dementia begin to withdraw from activities they once enjoyed.  “I don’t feel like going to church today . . . maybe next week.”  The truth is that the person may fear embarrassing herself in a social situation.  No one wants to see the puzzled or disapproving looks on the faces of people who don’t understand why one couldn’t quite respond “normally.”  And, busy caregivers simply don’t have time to “entertain” the person.  All too often, the result is a bored and depressed person with nowhere to go and nothing to do.

For many, it doesn’t have to be that way.  Adult Day Care programs provide caring places where people with dementia can interact and enjoy activities.  These programs are different from many programs at Senior Centers; most Senior Centers are for older adults who are cognitively normal and can function independently.  Adult Day Care programs adapt their programs to meet the special needs of persons with dementia.  They have staff who understand how to make the person feel welcome and accepted, exactly as they are.  They greet each person warmly and “make a fuss” so that everyone feels special.  Who wouldn’t want that?

If you are a caregiver reading this, you may be thinking, “That’s fine for others, but my Harry will never agree to go to a program like that!”  Well, Harry is in good company.  For people with dementia, anything new is generally greeted with “no!”  Understandably, most people with dementia seek the familiar, as they already feel vulnerable and fearful.

So, that’s our “starting point” – realizing that we’ll need to introduce something new in a thoughtful way.  Here are some pointers that may help with a successful experience with an Adult Day Care program:

• Start by making a appointment to visit a potential program(s) without the person who has dementia.  This will give the caregiver an opportunity to see the program and ask questions and begin a plan.
• Avoid “overselling” the program to the person (“You’re just going to love this place!”)  This approach may backfire.
• A low-key approach is generally best.  A first visit might simply involve stopping by for a few minutes.  Staff might suggest coming for lunch or for an activity.
• Realize that the person may need to attend for a time, in order to begin to feel comfortable.  Don’t space visits too far apart.  With short-term memory loss, it could feel like starting over each time.
• If, after a visit, the person says, “I’m never going back there again,” don’t argue, but don’t necessarily give up.  As they say, “Rome wasn’t built in a day.”
• Some people respond well to the idea that they are attending as a “volunteer.”
• Let staff help.  They will meet you more than half way.

For more information, call our Helpline at 1-800-272-3900, during business hours.  Atlanta staff will be glad to help you find programs in your area and talk about having a successful experience.

Just One Day a Year—That’s All It Takes…

Often, we feel powerless to control those things in our lives that are most difficult and disruptive.  Alzheimer’s is one of those things.

Imagine if by committing just one day  per year, you and your friends and your family and your co-workers could change the trajectory of Alzheimer’s—and realize our vision of a world without Alzheimer’s.  My mom and grandmother had Alzheimer’s—and they’re worth a lot more than just one day per year—but, that one day can change the course of Alzheimer’s disease in Georgia.

You can do that—you can commit to one day a year.  Join us for Alzheimer’s Awareness Day at the Georgia State Capitol—it’s only one day.  Commit to use your VOICE to tell your state senator and your state representative that we need a Georgia Alzheimer’s and Related Dementias State Plan.  When you join us, we will ROCK THE STATE!

Advocacy is not complicated or technical.  You don’t need to be “political.”  The most important ingredient is YOU.

Will you commit right now to take just one day this year to change the course of Alzheimer’s in Georgia?  Will you:

1. Help us to create a Georgia Alzheimer’s and Related dementias State Plan by sharing with us your concerns about Alzheimer’s?  http://act.alz.org/site/Survey?ACTION_REQUIRED=URI_ACTION_USER_REQUESTS&SURVEY_ID=12741
2. Commit to join us at the Georgia State Capitol on Wednesday, February 27, 2013, 9:00 a.m. – 3:30 p.m., to use your VOICE to tell your state senator and your state representative your story of your family’s journey with Alzheimer’s?  http://act.alz.org/site/Survey?ACTION_REQUIRED=URI_ACTION_USER_REQUESTS&SURVEY_ID=15600
3. Attend an Advocacy Training either in a city near you, or an on-line webinar, to learn the details about the State Plan?  http://act.alz.org/site/PageNavigator/georgiaadvocacy.html1
4. Commit to send an e-mail, make a phone call, or write a letter—even if you can’t attend Alzheimer’s Awareness Day at the Georgia State Capitol—to ask your Georgia Senator and your Georgia Representative to support Senate Bill 14, the creation of a Georgia Alzheimer’s and Related Dementias Plan?

The future of Alzheimer’s and related dementias in Georgia is in your hands—won’t you use your VOICE to help change the future—NOW!

JOIN US NEXT WEDNESDAY, FEB. 27TH!! For more detailed information, please click here.

 

Alzheimer’s can’t wait!

Alzheimer’s can’t wait!

There are as many as 5.4 million Americans living with Alzheimer’s, and that number is expected to grow to as many as 16 million by 2050.  Every 68 seconds another American gets Alzheimer’s, and as the baby boomers get older those numbers will double.

The human cost of Alzheimer’s is devastating. Alzheimer’s is the only disease where people lose their loved ones twice – first to the ravages of the disease and then ultimately in death, while their family and friends look on helplessly.  We need to make research a priority, not just for those with the disease, but for their loved ones as well.

Many of America’s baby boomers will spend their retirement years either with Alzheimer’s or caring for someone who has it.  Alzheimer’s caregivers -which are usually family members – can lose their savings, their jobs, their homes and their own health as they struggle to cope with the disease and its effects on their loved ones.

Americans are living longer, but with old age comes new risks. Half of people 85 or older will develop dementia, and it’s an incredibly expensive disease.  Caring for people with Alzheimer’s will cost 20 trillion dollars over the next 40 years, the overwhelming majority of which will be paid by Medicare and Medicaid. With 76 million baby boomers in the U.S. advancing in age we can’t keep postponing a cure.

Caring for people with Alzheimer’s disease will cost the United States 20 trillion dollars in today’s money over the next 40 years.  The overwhelming majority of that will be paid by Medicare and Medicaid.

Become an advocate today:  http://act.alz.org/site/Survey?ACTION_REQUIRED=URI_ACTION_USER_REQUESTS&SURVEY_ID=6118

Ask your Congressman and your Senator to:

• Ensure the implementation of a strong National Alzheimer’s Plan
• Make Alzheimer’s research a priority at the National Institutes of Health
• Sponsor legislation that will ensure diagnosis and care planning for people with Alzheimer’s disease.

Alzheimer’s can’t wait.

Ralph Stewart, Alzheimer’s Ambassador to Congressman John Barrow, delivers an information packet to the Congressman. Ralph makes quarterly visits to the Congressman to ensure that we keep him “in the know” about Alzheimer’s. Congressman Barrow has been extremely supportive of Alzheimer’s issues.

It’s coming – are we ready?

When we become aware that there is a problem looming, we typically assess the problem, think about the options, then put in place a plan to address that problem. Some of us are better at this than others.

Right now, thirty-four other states either have an Alzheimer’s State plan or have a study committee or task force currently working to develop a plan—much as our country has created a National Alzheimer’s Plan.  Georgia, however, is not one of those states.

Yet, even after two attempts where the Georgia Senate passed resolutions to create a study committee or a task force, neither was appointed—due to budget constraints.

How else will we be ready when funds are available…don’t we need to assess what is already in place, what gaps exist, and therefore what our roadmap should be?

Don’t we need to build a strong collaborative effort between the Georgia State Government, voluntary health organizations, non-profit organizations, the faith community, and professional organizations representing those medical and care professionals providing services to Georgians with Alzheimer’s disease and related dementias and their families?

Georgia has programs to address many issues—both health-related and non-health-related:

• Cancer (Breast and Cervical  Cancer),
• Comprehensive Cancer Control Program,
• Cardiovascular Health,
• Diabetes Prevention and Control,
• Stroke and Heart Attack Prevention Program,
• Statewide Strategic Transportation Plan,
• Comprehensive State-wide Water Management Plan,
• Statewide Comprehensive Outdoor Recreation Plan
• State Plan on Aging
• Agriculture Strategic Plan

Alzheimer’s is the 6^th leading cause of death in the United States.  There is no other chronic disease that affects so many without a way to cure, prevent, or even slow its progression.  Between 2000 and 2008m, while death attributed to the number one cause of death, heart disease, decreased 13%, deaths from Alzheimer’s disease has risen 66%

The Time Is NOW–Georgia needs an Alzheimer’s and Related Dementias State Plan now.  Tell your state senator to vote for Senate Bill 14!

Alzheimer’s can’t wait…Georgians with Alzheimer’s can’t wait!