Use it or Lose It!

When it comes to protecting the brain, it’s thought that certain lifestyle factors may help your brain to stay healthy. Neuroscientists suggest that by keeping your mind active, taking exercise and maintaining social interactions, you can help to reduce your risk of developing dementia.

The brain is a learning machine. To keep it strong, you must continually develop new skills. In other words… keep pushing those boundaries!

Here are seven ways to keep your brain active and healthy as outlined by Prof Ian Robertson, Professor of  Psychology at Trinity College, Dublin…

1. Physical Fitness: Take aerobic exercise… exercise that gets your pulse racing a bit. Fast walking for 20-30 mins a day, is good for your brain and your heart. If you’re not used to taking regular exercise, get checked out by your doctor first. 

2. Mental stimulation: Do something new and engaging… maybe volunteering. Find something you love doing. Engage with other people. This is a critical protective factor.

3. New learning: We get lazy as we get older. We should all be constantly learning. Learn a language/learn to sing/improve your computer skills.

4. Reduce stress: A bit of stress is not a bad thing. Challenge is good for us… pushing the boundaries. However, prolonged and severe stress is detrimental to brain function. Find a method to reduce stress… music/self-help books/yoga/meditation/relaxation.

5. Keep socially active: The denser a person’s social network, the less likely they are to be diagnosed with Alzheimer’s disease. Other people are a source of enrichment of the brain. Maintain social contacts.

6. Eat a healthy diet: What’s good for your heart is good for your brain. Eat fish (omega 3)/veg/fruits (richly coloured) and keep to a low saturated fat diet.

7. Think and behave young: How you behave and act, feeds back into your brain and changes it. Don’t adopt the behaviours of being old… stooped posture etc. Stand upright and think and behave younger than you are.

You can listen back to *Marian Finucane’s interview with Prof Ian Robertson here.

*Marian Finucane… RTE Radio 1, Saturday/Sunday 11-1pm… live stimulating mix of news, interviews, reports and discussion.

The Long Goodbye

My dear Mum died in the nursing home today.

She has gone to a better place.

Rest in Peace, Mum

In respect to my mother, no comments will be facilitated on this post.

A Lost World

Alzheimer’s Disease (AD) is a degenerative condition. It is fatal. The disease can last anywhere from 3-20 years but averages 7-8 years. The first sign is memory loss followed by personality changes. As AD progresses, the afflicted individual becomes disoriented about time and place and tends to exercise poor judgement. People with Alzheimer’s have an increasing  dependence on others and require round-the-clock care. The personality changes, cognitive lapses and eventual demise of a person with AD are extremely difficult on both patient’s and their loved ones. All is not lost however.

My parents both suffer from this progressive form of dementia and are in long-term residential care. Their world has shrunk to tiny proportions and they are oblivious to what goes on outside their own world. Happiness comes down to physical comfort and company. Family visits are a huge source of comfort to them both.

While sitting with my Mum in the Alzheimer unit yesterday, the lady in the bed next to her was very agitated. Doreen* is normally cared for at home but had come into the unit for a short period of respite care to give her family a much-needed break. Despite being very well looked after, there was terror written all over her face. Doreen’s world had fallen apart, she was ‘lost’ and required constant reassurance from the unit staff.  All afternoon she shouted “hello, hello” to anyone who passed and it was hard not to be moved by her anguish. When my Mum fell asleep, I finally got a chance to give Doreen the company she craved. The look of relief in her face will stay with me for a long time. She grasped my hand and tried desperately to find the words to express herself but the words would not come. I chatted to her calmly and told her that I understood why she was upset. Gradually she relaxed and then the tears came.  We hugged and I reassured her that I would come back soon for another chat.  That’s when I got rewarded with a most beautiful smile. Doreen was back on track and even though I knew it wouldn’t last, it made my day.

* Not her real name

Dementia is…

Dementia is an umbrella term used for a range of symptoms that manifest in a progressive decline in a person’s functioning, caused by degenerative disease of the brain. It is characterised by a gradual deterioration in memory and in the person’s ability to carry out everyday activities, make decisions, understand information and express themselves. It may also affect the person’s mood and personality. Dementia usually has an insidious onset, with most people developing symptoms gradually over a period of years. At present, it is not known what causes the different types of dementia. Medical research is ongoing throughout the world to discover the cause and develop new treatments. Put simply, dementia happens.

Alzheimer’s disease, the most common cause of dementia in Ireland, accounts for more than 50% of all cases; the second most common form is vascular dementia, which may be preventable. While the risk of dementia increases with age, dementia is not a natural part of ageing.

Early signs and symptoms of dementia:

Usually a person will display a number of these signs:

• Memory loss, particularly for recent events
• Difficulty in performing everyday tasks
• Changes in mood and behaviour
• Changes in personality
• Disorientation in familiar surroundings
• Problems with language
• Poor or decreased judgement
• Misplacing things regularly
• Difficulty solving problems or doing puzzles
• Loss of interest in starting projects or doing things

Facts and figures:

• There are currently more than 40,000 people in Ireland with dementia, with the number expected to be in excess of 104,000 by 2037 unless there is a medical breakthrough.
• Dementia can affect younger people; currently approximately 3,800 people in Ireland under the age of 65 have Younger Onset Dementia.
• Dementia affects the lives of nearly 50,000 people in Ireland who are involved in caring for someone with the symptoms of dementia.

If you are worried that a family member may be experiencing the early symptoms of dementia, you should contact your general practitioner (GP). The GP may refer you on to a specialist, such as a geriatrician, neurologist or a psychiatrist in the psychiatry of old age services, who will conduct a full assessment to try to establish the cause of symptoms. The earlier help is found, the better the family and person with the condition will be able to manage and cope.

For further information on dementia and on services, contact the Alzheimer Society of Ireland.

Senior Moments

An elderly male resident at the nursing home said to a female resident in a wheelchair, “Betcha can’t guess how old I am.”

She replied, “I can if you take off all of your clothes.”

So he did as she asked and she instructed him to turn around slowly.

Then she said, “You’re 95.”

“That’s amazing!!” he exclaimed.  “How could you tell?”

“You told me at breakfast.”

Where There’s Hope

Daffodils are one of the icons of Spring. Sitting at my mother’s bedside in the nursing home where she lay motionless, I gently whispered in her ear yesterday that Spring is on it’s way. I told her about the first daffodils of the year beginning to peep their heads above the freezing ground. On hearing this news, my mother opened her eyes and rewarded me with a huge smile.

This conversation brought me back to a time when I was in a little hospital room in the UK, recovering from major surgery. My husband had returned to Ireland to sort out a business problem leaving me to fend for myself for a couple of days. Being in hospital was bad enough but being far away from home meant that I had no visitors. My beacon of hope during that time, was a huge bunch of daffodils in the corner of my room. They had been given to me by a doctor from a nearby hospital whom I’d never met but who I knew to be an old school friend of my husband. When he heard news of my operation, he picked the daffodils for me from his garden to brighten up my stay in hospital. I’ll never forget this kind gesture. Those flowers represented a world with which I was familiar, unlike the lonely surroundings in which I found myself at that time.

My mother has always loved garden flowers and although now severely disabled, she welcomes any opportunity to be taken outside in her wheelchair. We made a pact yesterday to mount an expedition outdoors as soon as the first flowers of Spring appear.

Where there’s life, there’s hope and where’s there’s hope, there’s life.

A Better Place

I knew the moment I walked into the dementia unit at the nursing home that something had changed. My mother was up and dressed and sitting in her wheelchair beside the window. I settled down beside her to chat and it was only then that I realised what was different… one of the long term residents was missing and her possessions were all neatly piled on top of her bed. Poor Hannah* had died during the night.

The other residents of the unit were all sitting staring into space as per normal and while they appeared oblivious to the fact that one of their own was no more, a sombre mood was palpable. Looking at them sitting in silence, I found it hard not to ponder over who’s turn it will be next… for that is the reality of this unit.

Alzheimer patients slowly fade away, it’s like a living death as bit by bit they withdraw from the world. The staff of this unit are very supportive of the families. We are like one big family who are on a difficult journey together and everyone supports one another. When a bereavement occurs, it affects everyone in the unit.

When Hannah’s family arrived to collect her belongings this afternoon, the sense of togetherness was powerful. We all hugged and shed a few tears and remembered the good times together. We’ve come to know each other well over the years and today’s farewell was a reminder that one day my turn will also come, to say goodbye.

My mother is one of the few residents in this unit that can still hold a conversation although she has great difficulty processing her thoughts. She loves to listen to the staff chatting as they work and will occasionally chip in with her penny’s worth.

Today, when I was discussing Hannah’s demise with the staff, my mother suddenly joined in and asked “well, is she better yet“?

I looked at her and smiled. “Hannah’s in a better place now, Mum, don’t you worry” and she smiled back at me happily.

Rest in Peace, Hannah.

* denotes a name change.

How Great Thou Art

Last night, I listened to RTE radio’s ‘Documentary on One‘ and was completely blown away by ‘The Long Goodbye’, a hugely moving documentary on Alzheimer’s disease. It was first broadcast in January 2007 and has since won a silver medal at this year’s New York Media Festival. The documentary follows the daily routine of a couple who have been married for 44 years but who’s lives have been changed dramatically in recent years, due to Alzheimer’s disease.

“Seven years ago May started mislaying her handbag and amounts of money and her husband Matt noticed that she would start to cry during the day. She was diagnosed with depression but after a year and a half, it finally emerged that May had Alzheimer’s disease.

On the verge of his retirement, Matt was now facing a new journey with his wife May, as her carer. The couple moved from their home in London back to her hometown in the midlands.

As May’s illness has progressed, the couple have swapped roles. Matt has taken over all domestic tasks, a world he never inhabited during the first few decades of their marriage. As her carer and husband, Matt acts as May’s voice and is her rock.

This documentary looks at the relationship between Matt and May, as May’s ability to communicate decreases with progression of the illness while Matt’s responsibilities for her care continue.”

Compiled and presented by Sarah Neville
Production Supervision Liam O’Brien

Click here to listen to the documentary.

RealPlayer is required to open. Fast forward to 2.23 minutes and prepare to be blown away by the power of love. And as Matt would say “play every day as it comes.” Who knows what the future holds?

With thanks to RTE Radio One.

Dementia Happens

Old age has no respect for class, creed, fame or fortune. It’s an inevitable process… that is… presuming you get to survive that long.

By 2030, almost a million people in Ireland will be over 65 and the older you get, the more likely you are to suffer from dementia. There are approximately 38,000 people living with dementia in Ireland today.

There is no immediate hope of a cure for Alzheimer’s disease and with Ireland’s ageing demographics, it makes sense to plan ahead for the needs of an ageing society. A new study has found that people with dementia in residential care need to feel safe, secure, occupied, at home and connected to their former lives. Sadly, for the majority of the 7,000 dementia patients in residential care today, very few actually benefit from specialised dementia units.

My 80 year old mother has been in full-time care since 2004. She is wheelchair bound due to severe osteoporosis and also suffers from an unusual presentation of dementia. She is totally dependent on others for her everyday needs. For her first two years in the nursing home, my mum was terribly unsettled and became very depressed by her increasing dependency on others. Her dementia left her unable to follow simple instructions and she had frequent falls when left alone. The family were advised that she would be safer if moved to the dementia unit within the home where she could be constantly supervised. We agreed to this plan and shortly afterwards, she moved into the secure unit where she settled in very well. The care is fantastic there but the conditions are far from ideal.

This dementia unit is a locked unit for women only, with it’s own dedicated and very caring staff. It is basically one long, narrow, open-plan room where eleven women are living out their final days in horribly cramped conditions. They have to eat here, sleep here, are washed and toileted here, entertained and most likely will die here too. This poorly ventilated, overcrowded room is their home. Personal space consists of a bed, a bedside locker with tiny wardrobe attached and enough room for a chair beside the bed but nothing else. The unit has two small toilets neither of which are wheelchair accessible so only the few who are mobile, can use them. The residents in wheelchairs must use commodes with the curtains drawn around their beds for limited privacy. Some of the residents are bed-bound and are doubly incontinent. Meals are served up in this environment at two small tables at the end of the room and most of the patients must wait their turn to be spoon fed by the staff. The only form of entertainment is a television and a DVD player which were donated by the family of a deceased patient. A CD player was recently purchased by the ward manager so that the ladies can enjoy calming background music with their old-time favourites played over and over again – not that anyone would notice. There are many different levels of dementia in the room. Some of the patients have withdrawn from the world and just lie or sit staring into the distance all day, every day. Others are agitated or aggressive and have to be carefully managed so that they do not upset the other patients.

Dementia is not a pretty disease. There is little or no communication between the residents of this unit. This fact nearly broke my heart when my mum first moved in as I felt she was being denied a basic right to enjoy the pleasure of interaction and would deteriorate rapidly as a result. To give the staff credit where credit is due, they were quick to recognise this problem and they go to great lengths to chat with her as they go about their duties. I must add here that the staff are wonderful and I have huge admiration for the work they do in very difficult conditions. They look after all the patients with great love and compassion and I know my mum is very lucky to be in such good care. I regard the staff as part of the family these days – we work together as a team through thick and thin.

The world of dementia is a frightening and bewildering place for sufferers. My mother is safe and secure in her present surroundings but her environment leaves a lot to be desired. It does not resonate of home and it is poorly adapted to compensate for the disability of dementia. How would you like to end your days in a shared room with minimal privacy or dignity afforded? We need to take a more holistic approach to dementia by providing social, psychological and environmental supports and not by just throwing drugs at it. Surely, with the booming economy we live in today, this vulnerable section of society deserves better?

The real meaning of Christmas

Today I spent the day with my parents. Nothing unusual there I hear you say, except that my Mum and Dad are both resident in a nursing home and Christmas to them, is just like any other time of the year.

My Dad will be 88 shortly and is still a sprightly, well-dressed man who loves any excuse for a gin and tonic. Every day after his lunch, he gets spruced up to go and see Mum where she resides in the Alzheimer unit of the home. He polishes his shoes, puts on a clean shirt with a suit and tie, and then he’s ready for his outing of the day. Sadly, his short-term memory has completely deserted him and by the time he’s ready to go, he’s often forgotten the purpose of his mission. His memory loss causes him great confusion and anxiety. He has to be escorted to visit Mum to make sure he reaches his destination, and that he comes back safely again.

My Mum turned 80 recently. She’s been in the nursing home for over three years with a slow deterioration into dementia and physical impairment. She’s completely immobile at this stage and is barely able to sit propped up in a wheelchair. She has a tough time getting through each day but she still manages to smile and say thank-you to everyone who helps her. Thankfully she still recognises me as her daughter and yet whenever she introduces me to someone else, I suddenly become her twin sister. It makes for some interesting reactions and lots of laughs too.

I had great plans to do some Christmas shopping today after my visit to the nursing home, but it was not to be. My Mum was having one of those days where extra time, and reassurance, was needed. Dad too was in a muddle about almost everything. I sat with them both while Mum dozed in and out of sleep and each time she woke, she smiled with delight to see us there. My Dad enjoyed a gin and tonic which we rescued from the muddle of his bedside locker and we chatted away together all afternoon, with the same topics coming round and round.

This Christmas no amount of shopping will make life any easier for my parents. Their needs are few, but precious. My gift to them this year cannot be bought or packaged. Like that advert for a well-known brand of cider, they need nothing added but time.