Tag Archives: dementia

March 24, 2025 · 8:00 am

Spring is an ideal time to increase physical activity

As the weather begins to warm and flowers bloom, it’s a good time of year to consider increasing physical activity. A new study suggests that even a small amount of moderate to vigorous physical activity each week can lower dementia risk by a significant amount. The benefits were also seen for older frail adults.

According to researchers from Johns Hopkins who conducted the study, as little as 35 minutes of activity per week helped to lower dementia risk. Each additional 30 minutes of activity was associated with a 4 percent reduction in dementia risk, according to study findings. The Physical Activity Guidelines for Americans recommends at least 150 minutes of moderate intensity exercise per week, which is an average of 20 minutes per day. While that may seem like reasonable guidelines for those in good to average health, for older frail adults, it may be more of a challenge.

My father’s love of walking didn’t prevent his dementia, but it probably did contribute to him maintaining a healthy weight throughout his life, which has a myriad of benefits.

Walking of course isn’t the only exercise that counts towards physical activity recommendations. In some areas of the US, it’s time to get out in the garden. I’ve found yardwork to be a surprisingly good workout. If springtime pollen allergies are too much for you, doing an indoor spring cleaning can be a rewarding physical activity. For older frail adults, there are chair exercises that can be done to support flexibility and reduce fall risk. Yoga and water aerobics are other gentle forms of exercise that can be modified to safely accommodate a variety of physical limitations.

Hope you can find enjoyable ways to be active while welcoming springtime in your area.

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March 17, 2025 · 8:00 am

How using improv skills could help dementia caregivers

If you’ve ever attended an improv comedy show, you know that part of the fun is the unexpected ways the skits unfold. Each show is a bit different, based upon the contributions from the players on stage as well as the audience.

Now think about having a conversation with a person with dementia. It may go in unexpected directions. You have to think on your feet about how to respond. Politeness may go out the window; humor, whether intended or not, may present itself. Sometimes conversations may run off the tracks altogether, or into a darker, angrier place, and you’ll need to deploy distraction and redirection techniques.

As a dementia caregiver, you may not have considered the improvisation skills you’ve been implementing in daily communication, but geriatric professionals have taken notice. Where I live in Atlanta, there’s an organization called Improving Through Improv that has a program dedicated to facilitating communication between those with dementia and their caregivers.

A common improv technique is using “Yes, and …” as a bridge between recognizing what the previous person said and then adding to the conversation. One can either build upon what the previous person said or take the conversation in a different direction. The idea is to keep the communication moving forward in a positive manner. For those with dementia, the simple “yes” affirmation may be meaningful and effective, as they may have to deal with other people who constantly correct their mistakes.

Many family members who care for loved ones with dementia find it difficult to let go of a strict sense of reality; my mother struggled with this when caring for my father. She would always correct my father when he said something that wasn’t true, which only left him more confused. For some caregivers, giving in can feel like they are losing their minds too. By using “Yes, and …” caregivers can acknowledge their loved one’s viewpoint without having to agree and remain empowered to steer the conversation forward.

One of the most difficult aspects of dementia caregiving is accepting the fact that while your loved one may look the same, they may be moving in a different reality. “Meet them where they are,” is one recommendation for dementia caregivers, and deploying improv techniques can help in bridging the gap and building a new way of communicating.

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March 10, 2025 · 8:00 am

Deaths of Gene Hackman and wife sad reminder of the risk of a spouse-caregiver dying first

Image of Santa Fe via Pixabay.

The unusual circumstances surrounding the deaths of actor Gene Hackman and his wife serve as a stark reminder of what can happen when a spouse who also is the primary caregiver of a spouse with Alzheimer’s dies before their loved one.

Hackman and his wife, Betsy Arakawa, who at 65 was 30 years his junior, were found deceased in their secluded Santa Fe, New Mexico home on Feb. 26. A pest control worker alerted security for the gated community in which the couple lived after showing up to provide service but not receiving a response, KRQE reported. Upon investigating, the security officer found the bodies and contacted authorities.

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An autopsy revealed that Arakawa died of hantavirus pulmonary syndrome around Feb. 11, KRQE reported. Since my parents retired to New Mexico, I was aware of hantavirus, which is rare, with most cases appearing in the southwestern part of the U.S.

Hackman, 95, died of heart disease with complications of what the medical examiner noted as an “advanced state of Alzheimer’s disease.” He’s believed to have died on Feb. 18, when the last activity on his pacemaker was recorded. That means authorities believe Hackman could have spent up to a week alive after his wife died. We will likely never know the details of those days, and whether Hackman realized his wife was deceased or whether Hackman’s cognitive decline may have prevented him from understanding the dire situation.

In addition to the couple, one of their dogs died, while two were found alive. The deceased dog was found in a crate near Arakawa’s body. Veterinary records show that the dog had undergone a recent medical procedure, which likely was the reason it was confined to the crate, authorities said.

Such a tragic ending is a sobering reminder for those who serve as the sole caregiver for a spouse or other relative with a condition like Alzheimer’s in which the care recipient may not be able to call for help or care for themselves in the case of a medical emergency involving the caregiver. By all accounts from friends of the couple, Arakawa closely managed Hackman’s health. As his Alzheimer’s progressed, he likely became even more dependent upon her guidance.

Some have questioned why Hackman didn’t have a professional caregiver, or even a live-in care provider, as he likely could have afforded such a service. It seems Hackman and his wife enjoyed their privacy, and with Arakawa considerably younger than Hackman, and very capable of managing his care, outside help may have felt intrusive and unnecessary. As those of us who have cared for loved ones know, bringing in external help can be upsetting and disruptive to those with Alzheimer’s, as they thrive on routine and familiarity.

What can caregivers do if they find themselves in a similar situation? Having a plan in place to account for a caregiver’s acute health crisis is vital. Share a document with family that includes key health information, current prescriptions, etc. Technology can help; there are numerous medical alert systems available which can call for help with a click of a button or can sense when someone has fallen and automatically send help. My mother found such medical alert services useful as she lived alone. Having a trusted friend or relative who can serve as a check-in buddy can be helpful. Over the last year or so of my mother’s life, we spoke almost daily, which allowed me to assess her wellbeing in addition to offering social connection.

If you have a loved one that you haven’t heard from in awhile, don’t hesitate to check on them.

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March 3, 2025 · 8:00 am

Why women are at an increased risk of dementia

March is Women’s History Month, so it’s a good time to dive into research regarding women and dementia. We know that women are more likely to develop Alzheimer’s than men, but why?

One commonly cited factor is a simple one: age. Women on average live longer than men, therefore, they have an increased risk of developing conditions like Alzheimer’s, in which advanced age is a top factor. According to the Alzheimer’s Association, about two-thirds of those living with Alzheimer’s in America are women. However, the UK-based Alzheimer’s Society points out that not all studies support this theory.

One interesting data point is that the gender differences are specific to Alzheimer’s risk, and not risk of other forms of dementia, according to Harvard Health Publishing.

There are other factors, both physical and cultural, that may play a role in increased Alzheimer’s risk for women. The hormonal impacts of menstruation, pregnancy, and menopause and dementia risk is being studied, but more research is needed to reach any definitive conclusions. The Alzheimer’s Society discusses the current state of hormone replacement therapy (HRT) and dementia risk. Early research suggested that HRT may increase the risk of dementia, but newer research disputes that, and suggests that HRT may even have a protective effect. STAT also explored the latest studies on hormone therapy and dementia risk for women, with researchers focusing on the timing of hormone treatment. Harvard Health Publishing points to women’s immune systems, which are considered to be stronger than men’s immune systems, and that the robust immune response may deposit more amyloid plaque in the brain.

Genetics likely plays a role too. The Alzheimer’s Society points out that while men and women are both about as likely to have the ApoE4 gene variant, the related dementia risk seems to be greater in women that men. I have the the ApoE4 gene variant. Cases of Alzheimer’s appear on both sides of my family tree, but more of my female relatives were diagnosed. Unfortunately, I don’t know their ApoE4 gene status.

For the current elder population, gender norms of yesteryear may have limited women’s ability to receive higher education and work in more complex jobs, or have careers at all for that matter. Education levels are believed to play a role in reducing the risk of Alzheimer’s.

Moving forward, women need to advocate for more research to better understand the potential for increased Alzheimer’s risk, as well as steps women can take to reduce their risk of this terrible disease.

Looking for caregiving books? It’s Read an Ebook Week and I’m participating in the Smashwords sale. Get my award-winning personal essay collection, The Reluctant Caregiver, for half-off through March 8. Use the code EBW50 at checkout.

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February 24, 2025 · 8:00 am

When home can no longer be found

One common behavior in those with Alzheimer’s disease is to ask to “go home.” It seems like the simplest of requests, but caregivers are often stumped because their loved one may make this request when they are already home. That’s because the meaning of “home” can change as the disease progresses.

My father asked to go home almost every time my mother visited him at the memory care center during the last year of his life. But my mother didn’t get the sense that my dad meant home as the condo they had purchased. Home seemed to be a more vague destination. In fact, my dad and his roommate reportedly hatched a plan to escape the memory care center and catch a bus to … somewhere undefined. The memory care center had secured access and the escape plan was quickly forgotten.

The last time I saw my father alive, he also expressed a desire to go home. This time, it was clear that home meant to Belfast, his birthplace, because he mentioned wanting to see his sisters. There is some evidence to suggest that those with dementia hold on to their earliest memories longer than more recent ones.

For caregivers, the “going home” request can be difficult to navigate. This recent article in Self has some good tips and strategies. Once physical discomforts are ruled out, caregivers can implement a variety of strategies to engage with their loved one and help them move on from the “going home” obsession loop. These strategies may need to be adjusted over time; be prepared for a period of trial and error.

Loved ones with dementia who express great distress about their current surroundings may attempt to wander. In these cases, making sure home are adapted to prevent escape attempts is essential. Specialized door locks and high-tech tracker tags can help in these situations.

Losing a sense of home must be frightening, as our homes are often our sanctuaries. Helping loved ones with Alzheimer’s navigate this disturbing yet common behavior takes compassion, patience, and creativity.

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February 17, 2025 · 8:00 am

How common is it to receive a misdiagnosis of dementia?

A diagnosis of dementia can be devastating, but the damage of an incorrect diagnosis has its own fallout. But how common is it to receive either a false diagnosis of dementia or a misdiagnosis for a specific type of dementia? As those who have dealt with dementia, there are several different types, each with its own set of treatment protocols and expected disease progression.

A recent study conducted by Australian researchers looked specifically at the frequency of misdiagnosis of frontotemporal dementia (FTD), comparing the initial referral data to the final clinical diagnosis, according to SciTechDaily.

The study reviewed the records of 100 patients referred to a memory disorders clinic by specialists. Researchers found that 70 percent of patients initially suspected of having frontotemporal dementia (FTD) were ultimately misdiagnosed.

Insights from the study:

  • 34 patients were accurately diagnosed while 66 were false positive.
  • Researchers determined that misinterpretation of neuroimaging, specifically nuclear imaging, was the primary cause of misdiagnosis of FTD.
  • Cognitive testing also played a factor in misdiagnosis.
  • Patients who presented with prior psychiatric histories were more likely to be misdiagnosed with FTD.

The study was small and based upon cases at a single clinic, so it’s difficult to know how widespread the issue of misdiagnosing FTD is in other countries.

FTD has been in the news this past week due to the ongoing saga of media personality Wendy Williams, who is claiming she doesn’t have FTD after reportedly being diagnosed and assigned a court-appointed guardian. There has been an ongoing controversy about the continued need for the legal conservatorship, and Williams is speaking out, frustrated by the lack of control she now has over her finances and living arrangements. As the above study found in some of the cases it reviewed, it may be possible that Williams was misdiagnosed with FTD and instead experienced alcohol-induced dementia, related to her well-documented struggles with alcohol, or another form of mental illness which had gone untreated. I am not a medical professional, but it seems reasonable that a second opinion and additional testing should be conducted, if it hasn’t already been done. If a celebrity like Wendy Williams can find herself in such a challenging situation, think about regular people like the rest of us who don’t have such a public platform to ask for help.

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February 10, 2025 · 8:00 am

How heart and brain health are connected

February is American Hearth Month, so it’s a good time to learn more about the connection between heart disease and dementia, especially in women.

According to the American Heart Association, “older female heart attack survivors were twice as likely to see declines in memory and cognitive ability.” Multiple factors may contribute to the gender disparity, including blood pressure fluctuations during pregnancy and early menopause, per the American Heart Association. Other risk factors include obesity and diabetes.

A scientific statement published in Oct. 2024 by the American Heart Association noted that “heart failure, atrial fibrillation and coronary heart disease are linked to cognitive impairment and increased risk of dementia.” Heart disease can lead to decreased blood flow, inflammation, and structural brain changes, which can impact cognitive function, according to the American Heart Association report.

We often think of Alzheimer’s and other dementias as a brain disease but there’s a growing body of scientific evidence supporting the connection between the cardiovascular system and cognitive function. A holistic approach is recommended, with regular monitoring of blood pressure, managing stress, routine exercise, a heart-healthy diet, and quitting smoking all ways people can support not only the health of their hearts, but their brains.

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February 3, 2025 · 8:00 am

New sleep study focuses on REM phase onset and Alzheimer’s link

You don’t have to be a medical professional to know that getting a good night’s sleep is important for overall health and wellbeing. A new study, following up on findings from previous studies, finds evidence of a potential link between a particular phase of sleep and Alzheimer’s.

The study, published in the Alzheimer’s Association Alzheimer’s & Dementia Journal found a potential link between Alzheimer’s and a delay in the onset of the rapid eye movement (REM) phase of sleep. The study was small (128 people) and was conducted in a sleep clinic, which could have impacted sleep quality. Still, the findings were notable due to its focus on REM sleep. According to HealthDay, researchers focused on this key phase of the sleep cycle because its during this period that the brain processed memories.

Half the patients in the study had been diagnosed with Alzheimer’s, and another third had mild cognitive impairment (MCI), while the average age of the study participants was 70.

Two groups were created for the study: those who entered the REM sleep phase earlier (less than 98 minutes after falling asleep), or later than average (more than 193 minutes after falling asleep.) The study found that those with Alzheimer’s were more likely to experience delayed REM sleep. This group also had higher levels of amyloid and tau, toxic brain proteins long associated with Alzheimer’s disease., and lower levels of healthy brain proteins than those with an earlier onset REM sleep phase.

I’m fortunate to never have suffered from insomnia, but I’ve seen the negative impact that being unable to get a good night’s sleep has on the lives of others. My mother had chronic insomnia, though she never developed dementia. My father didn’t suffer from insomnia but he had a sleep cycle that was outside the norm. He worked the swing shift most of his work career, so he wouldn’t get home until very late at night, and then stay up until the early morning hours to wind down. My father also suffered from periodic nightmares. Decades later, my father began having disturbing dreams whose effects lingered long after waking, which coincided with his earliest symptoms of dementia.

As insomnia has seemingly become more common in our society, there’s a lot of resources out there for those who are sleep deprived and looking for better quality sleep. Sleep hygiene has become a popular concept in recent years, which can include everything from diet to bedroom setup. Natural supplements like melatonin may help some, while OTC and prescription medication may be necessary for stubborn cases but come with a host of side effects. Non-medication options include meditation and things like the Calm app’s “sleep stories.” (Check with your health care insurer as some offer complimentary Calm subscriptions.)

While researchers haven’t been able to determine whether insomnia is a risk factor and/or an early sign of Alzheimer’s, good sleep comes with a host of health benefits beyond cognitive function. That’s something worth sleeping on.

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January 26, 2025 · 3:15 pm

A sobering reminder for those on the dementia caregiver journey

Dementia Does What It Does

I hope those dementia caregivers who wonder if they are doing enough or doubt their capabilities of caring for their loved one take the time to read the above post, “Dementia Does What It Does” on the When Dementia Knocks blog. Elaine captures quite eloquently the progressive march that dementia eventually takes, no matter what cures or solutions you throw at it. Elaine’s message may sound pessimistic, but its intention is to give yourself a bit of grace and self-compassion. When you accept the current reality of a dementia diagnosis, you may blame yourself less when your loved one continues to decline, in spite of your best efforts.

There is some tentative hope of more effective treatments on the horizon, but for now, just know that you are doing your best as a caregiver.

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January 20, 2025 · 8:00 am

How color plays a role in dementia care

After learning about colors as a child, we may take their appearance for granted, unless you are an artist. But colors can take on different meanings for those with dementia, and understanding those changes can be helpful as a dementia caregiver.

I remember seeing the visual impact of dementia in person when visiting my parents. We were in a building with an elevator, and my father took a very large step across the threshold of the elevator, where a black mat was placed. As Linda Slaton Anderson points out in this article published in Today’s Caregiver, “some therapists recommend placing black mats in front of doors or stairs since Alzheimer’s patients perceive them to be holes and thus tend to avoid walking on them.” Clearly, my father experienced that “black hole” visual disruption.

While some changes in processing colors can be frightening for both those with dementia and their caregivers, colors can also be used in positive ways. For example, those with dementia with diminished appetite may benefit from using red dishes on a white tablecloth, due to the higher contrast attracting attention to the food on the plate.

“Colors are processed by our brains more quickly than words,” Anderson notes. As those with dementia lose their language abilities, colors may remain a way to convey feelings and encourage engagement.

Color choice can impact mood, which those with an interest in interior design understand well. This applies to those with dementia as well. Blues and greens can provide a calming, soothing effect, while orange and yellow are cheerful colors that can lift one’s mood.

For caregivers trying to decode or address negative behavior in their loved one with dementia, consider the role color may be playing.

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