Despite getting off to a bit of a shaky start, we rebounded rather nicely. We enjoyed relaxing by the pool while catching up on our summer reading. We noshed and napped at our leisure, and each day we ventured out to explore the high desert and the magic of Red Rock Country. Life was, in a word, sweet.

I confess that en route to our destination, I’d had some serious misgivings about our relationship surviving this trip. Away from the familiarity of his “home turf,” Mike’s struggle with short-term memory loss was clearly amplified. So, for my own sanity and to help him feel more comfortable in our new surroundings, I came up with a game plan before we even crossed the threshold of our home away from home. It was an ingenious stratagem, if I do say so myself!

It all started with unpacking our car. While Mike carried our boxes and bags into the condo, I did a little reconnaissance of our new surroundings. I had Mike put each item from the car in the appropriate room. Then, I began to unpack with one goal in mind: Make this condo as exact an image of home as possible.

I asked Mike to choose which side of the bed he wanted to sleep on, and I had him unpack and put away his own things in the dresser drawers. While he busied himself with that task, I moved on to the bathroom.

We didn’t have a lot of toiletries, so I placed everything on the vanity countertop where they could be easily found. Mike’s things went on one side of the sink and mine went on the other, with shared items like toothpaste in the middle.

Returning to the bedroom, I filled the remaining drawers with my things and then tackled the closet. Shoes, belts, hats, sweaters, and the like I placed on shelves where they could be clearly seen. Mike’s clothes went on one side, and mine went on the other.

The living room was easy. Books and magazines went on the coffee table, in plain sight. The little alcove normally used for a bar became our travel center—maps, tour books, binoculars, cameras, and local papers would live here. And then, of course, I added the infamous “dish”—a bowl placed strategically by the telephone, just like at home, that Mike could use for his hotel cardkey, wallet, car keys, cell phone and charger, and the packets of daily medications we’d made.

In the kitchen, I rearranged the pots, pans, and utensils (provided by the resort) just as we would find them at home. I placed the dining dishes and glassware in one cabinet and arranged the food and sundries in another with individual items lined up so they could be easily seen. A must in our home, coffee I placed on the counter next to the pot, along with all the condiments. The fridge was also easy—just like home minus all the drawings and pictures from the grandkids.

Let me tell you, after seven hours of driving, accomplishing this on our arrival was a push. It had been a long day, and we were tired. Nonetheless, when I gave my husband the grand tour, I could tell I’d made a place where he would be comfortable and I could relax.

And you know what they say: Happy wife,…happy life!

At that time I had been doing brain fitness in earnest for one year, but I still had a couple of basic questions:

Could these workouts help me recover some of my past knowledge?
And, even more important to me, could I learn new ideas and skills?

I wanted those answers., but even so, I knew I had to prepare myself for possible bad news.

I began this inquiry in earnest when I discovered a self-help course created specifically for people with ME/CFS. The 7-step online program was helping some people, to some degree, so I took the leap.

Win number one! I completed the enrollment requirements.
Win number two! I applied for and received a partial scholarship.
Win number three! I showed up for my online class each of the six weeks it was offered.

Because the course is designed for ill patients, the requirements were gentle and non-coercive. The material prompted consciousness-raising and offered coping skills—some of it new to me.

And the winning continued…

Win number four! I completed all six reading assignments.
Win number five! I interacted in assigned discussion topics with my other online classmates from all over the world.
Win number six! I felt comfortable as I self-revealed to these strangers.

In the course, I was also called upon to set a new target, of my own choosing, each week. I can report that some targets I was able to meet; on some I landed wide of the mark; and others I accomplished only in part. So, I would call this aspect, “win-ish.”

The class gave me a context in which to evaluate myself, cognitively, in present time. Organized, even lightly structured learning was generally fatiguing—not too surprising since that is a key symptom of my illness. By reducing (or, more often, eliminating) other computer-based activities, I was able to build the mental and physical stamina necessary to wear a student hat for a few hours a week.

My performance was better than I had privately predicted. In most discussions, my insight was more than adequate. In a few, it seemed excellent. I learned some new health management skills—a few of which I have maintained now for several months. I was able to teach others through sharing. It felt good to learn and to teach.

I consider that it took me much longer than it would have, pre-illness, to digest material, make critical evaluations, and write something “good enough” to share. I was so moved by the results, that after resting for several weeks, I enrolled and completed a subsequent course.

This is my primary discovery: Under carefully crafted circumstances—involving tempered expectations and carefully balanced study and rest—I CAN learn and apply new material.

Oh, and by the way, I still intend to continue my Dakim BrainFitness sessions. Why wouldn’t I? My brain fitness exercises are helping me recover (or create) enough cognitive “juice” to access some past knowledge and reach for new.

Will my desire to learn and willingness to enter virtual classrooms take me beyond the health management arena, toward other interests? It already has.

Travel is also the stuff of which memories are made, but we had no idea how much a trip away from home would also reveal about my husband’s continuing memory loss.

Two weeks ago, Mike and I packed our car and headed to Sedona, Arizona. Road map in hand, we put the hustle and bustle of Los Angeles behind us. We looked forward to seeing more natural scenery, and, as we moved across the Mojave Desert, we weren’t disappointed.

The austere beauty of the desert spread out before us and was slowly replaced by fragrant pines, red rock, and pristine blue skies. Near Flagstaff, we experienced the awesome power of an unexpected desert thunderstorm. The air cooled at higher elevation, and the sun returned. Winding our way down Oak Creek Canyon to Sedona, we were deeply enchanted and grateful to have the opportunity to experience a whole week in this very, very special place.

When I go on vacation, I’ve learned to expect the unexpected. Of course, we met new people and visited unfamiliar places. We explored with a sense of real wonder and adventure, visiting ancient Indian ruins, an old mining town, a fish hatchery—even a diner tricked out as a barbecue joint. What we hadn’t counted on, or even really considered, was what we would find out about ourselves.

A vacation provides a break from routine, and I think we all need that from time to time. However, as we discovered, routine and habit contribute significantly to my husband’s ability to successfully navigate his days. This was our first extended vacation since Mike’s challenges with memory loss began, and we soon found out just how much our reliance on routine has masked the decline of some of his cognitive skills.

Just packing for the trip itself was challenging. We were staying in a condo, so I had household goods as well as clothing and personal items to pack. Responsible for packing his own things, Mike struggled to remember what he had put in his luggage—and, yes, we continued to arm wrestle over his resistance to making a list or writing things down!

Outside our own community and familiar home environment, Mike and I enjoyed our journey, but we both also grew more frustrated with his inability to perform basic cognitive tasks. For example, his sense of direction became disoriented, and he had trouble reading a map. So the onus for “getting us there” fell on me. I had already done all the planning and most of the packing for the trip, so I began to feel a bit resentful—some vacation, right!

For at least a little while, fear and denial took over, and we bickered about everything and nothing. Neither of us wanted to face what we were seeing. It was kind of like the story of the Emperor and His New Clothes: Stripped of our routine, we were naked, but nobody wanted to talk about the reality of it.

Oh, yeah, we were off to a great start. And we hadn’t even arrived at our destination!

In my next blog, I’ll share how we brought the familiarity of home on vacation with us and what a difference it made. While we discovered you can’t escape memory loss—even in idyllic Red Rock Country—you can survive it just fine.

After all, it’s taking the journey that’s important.

When I was just starting out in the working world, one of my paychecks, probably in its entirety, went to buying myself a new leather coat—my first. And, as new clothing is known to do for girls in their 20s, it indeed put a fresh bounce in my step as I headed off for work.

I had built an entire “outfit” (or, as my brother used to call each of my ensembles: a “costume”) from head to toe that played off this hip-length, caramel-colored, creamy smooth, fabulous-fitting jacket di tutti jackets. Yes, I was feeling fine and inviting any and all admiration as I stood there waiting for my bus.

Now, I lived in the Northwest at the time, and as any self-respecting Seattleite knows, you do not even go out on the porch in a jacket such as mine without first Scotchgarding it to within an inch of its life. And that was the case on this particular morning, so when I felt a little rain, I thought nothing of it, and it did nothing to dampen my feeling of elation. I was in the right mood to notice people were noticing me,…and they were,…and I was loving it!

In my jubilation (do you remember how a new piece of clothing could make you feel that good!?), when I got to work I swung in through the doors like Mary freakin’ Tyler Moore! I immediately began, like a heat-seeking missile, to hunt down the guy that I currently had a crush on. As I hurried along, in all my glory, I paused only once, to glance at my image in a mirror that I passed. I fully expected confirmation of a perfect picture.

What I saw, however, stopped me cold.

It was only then that I realized that the “rain” I’d felt at the bus stop had, in fact, been a special delivery from a passing pigeon! Yes, bird poop now adorned not only the shiny shoulders of my dream jacket—but also my carefully coifed matching hairstyle!

I was frozen in disbelief and shock—mortified.

Then I was mortified in hindsight.

All those people who had been admiring me hadn’t really been admiring me. They had simply been smiling at the girl with bird poop on her head!

With the heat of humiliation not yet fully faded from my face, I quickly got to work with a tissue, dabbing my hair and polishing my jacket. As I did so, the embarrassment slowly passed, and I began to realize that even with the knowledge that I had traveled clear across the greater Seattle area on a public bus with my head and shoulders topped with guano, I was still feeling exceptionally terrific.

Truth is, I couldn’t know what those people were thinking. I can only know what I think. About myself. And one thing I know is, even though it’s hard some days—even with the inevitable bird poopy days—I still have every right to feel pretty any day, every day, and I will for as long as I live. There simply is no pull date on pretty.

Some people believe that having a bird poop on you is a sign of good luck. So—a new leather jacket AND bird poop? I felt pretty, and I was apparently lucky to boot. All in all, not a bad day.

I’m also a fan of self-improvement. Living healthier, more fully, smarter—making body and brain fitness a priority. Each offers a return on investment and is, as they say, “great at any age.”

That’s why, when I saw Carrie Fisher’s recent television ad for her participation in a popular diet plan, I was excited to see a woman I admire being that kind of role model for millions of other women. She’s lost 30+ pounds, which is fabulous—it can only lead to better health and higher self-esteem.

I watched the commercial eagerly, expecting some interesting insights from her—this child of Hollywood, accomplished writer, and iconic Star Wars actress (Princess Leia)—about feeling fitter, being more active, and the like.

But, not so much.

Instead, she makes a statement at the end of the commercial that dismayed me: As a result of her weight loss, she’s getting the chance “to feel pretty one more time.”

Egads.

I know conventional thought is that “feeling pretty” is the domain of the young, like Maria in West Side Story, but as I continue to ripen with age, I beg to differ. “Pretty” comes in all shapes and sizes—and at all stages of life. There should be no expiration date on feeling and being pretty. It’s truly unfortunate that such an accomplished woman could say—or think—that about herself. This, the woman whose most famous film role is a fantasy of young men everywhere—that iconic beauty ain’t the kind of “pretty” that dies easily with extra weight or age.

Don’t think I don’t understand what Carrie’s talking about. Growing older in a mentally healthy way requires adjusting some expectations—and, of course, undertaking some new activities such as the all-important physical and brain exercise. But the fact is, Carrie’s just 54! Her “last chance” to be pretty seems dishearteningly premature, if ever. And if not, what are the rest of us supposed to feel?

Well, when it comes to my valuable—and, yes, often fragile—self-esteem and I have these kinds of alarms going off in my head, I know it’s time to unplug from the media for a while and, instead, set my sights on my own feelings and beliefs about myself: That even if I struggle living it out every day, being me is enough at any age.

So, Ms. Fisher, hang in there. You are still a woman to be admired for so many reasons–including how pretty you are.

Ouch!

I found Mike’s observation a particularly bitter pill to swallow. After all, I’ve made a darn good living as a professional communicator. I’m a good writer and an excellent public speaker. And, albeit it was some time ago, I did graduate cum laude with a degree in speech and journalism from a major university. Mike and I also did our fair share of pre-marital counseling to give our relationship the best possible chance for success, and we do a pretty good job of getting along. So, to admit my communication skills might be slipping was an ugly prospect.

For the record: When it comes to healthy communication in a relationship, memory loss can change everything. Mike has lost much of his short-term memory function, so I am responsible for keeping track of most of the details of our day-to-day living. Sometimes, I see this as an excellent opportunity to exercise and maintain my own mental acuity. I’m a “take charge” kind of gal, so I enjoy the sense of control “running the show” provides. However, when personal issues of my own crop up and I feel overwhelmed or overburdened, I can be downright mean-spirited.

No matter how nicely I may frame a statement, it’s the tone of my delivery that gets me in trouble. And even though I may plaster a smile on my face, it’s my body language that projects how I really feel. And need I mention all those heavy, heavy sighs?

Mike uses his disability as an excuse not to share in taking care of household responsibilities—or so I start to think when I am stressed. Odd though it may seem, Mike doesn’t see things quite the same way! When, instead of asking him to do something, I stridently bark an order, should I really be surprised by his unwillingness to jump? And when my tone is condescending? I can’t begin to tell you just how much I hate it when Mike says, “If I wanted to be treated like a child, I would’ve married my mother.”

It truly pains me when I have to admit he’s right—that I haven’t been treating him as an equal. Mike may have lost most of his short-term memory, but he has not lost his dignity as a human being.

My husband is a sweet man. For the most part, he does the best he can. Sure, he could do better about writing things down or making little “crib notes” for himself, as both one of his doctors and I have recommended. It would eliminate some of the frustration of making two or three trips to the store for just a few grocery items, not to mention cut down on our fuel bills! And I’m certain there are other improvements he can make that will help eliminate some of my frustrations. I am learning, though, that it’s better when these “suggestions” come from almost anyone else but yours truly.

“You’re not the boss of me,” is a frequent catchphrase in our household—one that, thankfully, almost always brings some laughter to our situation. A real tension breaker, it is an inside family joke—a reference to a framed photo on our living room bookcase: one of little Tina in much, much younger days. I can still stamp my foot and shake my pointed finger just as well today as I did when I was “terribly two.” What I’m discovering is, at 55, it just isn’t nearly as cute or effective!

So, what about a little change in perspective?

R-E-S-P-E-C-T: Find out what it means “in the moment”!

Life with advancing dementia soon becomes largely about living in the moment. As the disease progresses, the past and the future become less and less relevant to the person who can neither remember nor plan ahead. And that doesn’t just go for the person with dementia—it applies to family and friends as well.

I originally learned about—and came to fully enjoy—the luxury of living in the moment from “nannying” my nephews (see my blog posting “A Change of Pace (Welcome or Otherwise”). I learned that it’s not just about living in the moment, which is often interpreted and exercised as simply existing in—or, worse, just surviving—a moment in time. To me, it’s about respecting the moment and all that is in it. And today I can’t think of any other situation than coping with dementia where doing so is more of an imperative than simply a luxury.

For example, next time you sit down with your loved one to play a brain fitness session or do any activity together, try this perspective on for size:

• Respect where your loved one’s cognitive skills are right now. What my volunteer player Harry could do yesterday may not be what he can do today, so I have to let go of my expectations, observe what’s happening right now, and then, as they say, “play it as it lays.” This is where understanding how your loved one feels about his or her cognitive impairment comes in handy. I always support stretching Harry a bit in his cognitive workouts, but there are days when his mind is fuzzy and his mood isn’t helping. I must temper my “cluing and coaxing” on days like this, always bearing in mind that the most important thing is for Harry to do as much as he can without getting overwhelmed and frustrated. That’s within my power, so I need to pay close attention and “ease up on the gas” a bit if he is not just struggling to keep up but suffering at the same time.
• Respect how your loved one is feeling right now. I make it a point to avoid trying to cajole Harry out of a bad mood if he arrives at my office feeling grumpy or any other manner of down. Nobody—large or small, young or old—appreciates having their feelings minimized in that way. It can feel a bit like being mocked. Before we start playing, Harry and I will talk a bit about how he’s feeling, and then we’ll wrap it up with, “Well, let’s give this session a try and see if that doesn’t help things a bit.” The one thing I do know is that if I do right by him, Harry will indeed come away from his session feeling happier. (For more about this, see Dan Michel’s blog entitled “The Shocking Truth: Dakim BrainFitness Causes Mood Swings!”)
• Respect how you are feeling right now. As I go into a session with Harry, I like to prepare a bit mentally by assessing my own feelings. I start with “HALT”—am I Hungry, Angry, Lonely, or Tired? If the answer is “yes” to any of these, I need to solve what I can of the problem (eat something, etc.) or simply be extra sure I keep it in check so my “issues” don’t spill over on to Harry. From there, I do a quick check of whether or not I’m feeling anxious—do I have a lot on my plate today? Did I forget altogether to make time for Harry’s session? Am I being haunted today by overzealous and perhaps completely unreasonable expectations of Harry’s cognitive abilities today? Am I mourning some of Harry’s apparent cognitive losses? Do Harry’s struggles make me fearful about my own cognitive future? Am I even in the mood to be helpful today, or do I feel resentful and sensitive to everything that is being asked of me? Am I worried because I don’t feel sharp enough to coach Harry during his session? (How I’m feeling doesn’t even have to make sense to an outside observer for it still to require my respect.) When I choose to be in the moment, letting go of future and past, it often allays these issues for me, and I generally end up having a pretty good time with Harry, even if my day in general has been a logistical or emotional wreck!
• Respect that the length of the session is the length of the session. With specific regard to Dakim BrainFitness, playing every game and activity faster is not going to make the session—or the moment—any shorter. If Session Length is set at 20 minutes, you will be playing for 20 minutes. Muscling your way (and your loved one) through game play is only going to add steam to that pressure cooker for both of you.

Respecting the moment will lead to appreciating the people, places, and things you do in that moment, I guarantee it. Whether the moment is fun or difficult, being present in the face of joy, adversity, hard work, or heart break will help you avoid packing a lot of pressure and stress around with you the rest of the time. And when you build up enough of those moments, you may find that it’s turning out to be a pretty good day, week, month, or year.

Dakim BrainFitness has built-in NuroLogic Technology, which adjusts the level of challenge directly based on a player’s performance. However, as we caregivers try to give our charges a good workout, stretch them a bit on good days, compensate for bad days, and keep their spirits up, sometimes we can help too much. Before we know it, we’ve inadvertently “played them up” to a point where they are being asked to perform brain exercises that are beyond their cognitive abilities. They can no longer play successfully on their own. They are in over their heads—and so are we!

Making adjustments for getting in over your (and your player’s) head

In working with my volunteer player Harry, I soon learned that when he and I reached this point, the stress was not just mine (because I had to help more and come up with more ways to “clue and coax” while protecting his score history (see my special note below)), but it stressed him out as well because, regardless of his overall dwindling memory, he still knew he wasn’t playing well without a LOT of help from me, which soured the whole experience for him. I needed to figure out how to get Harry back in play and succeeding under his own power.

With Dakim BrainFitness, here’s what I recommend from my experience: Play a session on your own (under your loved one’s name), failing questions on purpose in order to bump the level of challenge back down. In far less than one 20-minute session, you can do this quickly in any one or all cognitive domains, and it could be just the ticket to take the heat off–of your loved one AND you. (And if you bump the challenge down farther than you originally intended, no worries—players can play themselves back up to an appropriate level again in no time.)

A word to the wise about the effect of “playing down” on player scores: For my friend Harry, the carrot at the end of every session is his score. He lives for it; especially driving for 100%. He scoffs even at a 97% (with a lot of good humor) because, even though he knows he did great and that’ll make his day, it’s just not that almighty 100%! So when I play Harry down, I’m very careful not to upset his score history (the track record of scores he has earned in his most recent previous three sessions, which appears on the score details screen).

Specifically, if I were to play an entire session all the way through to the score screens and closing, my awful score for that session would get logged into Harry’s score history, which he would see the next time he played a session. And because at this point in his Alzheimer’s he can’t remember that he didn’t play that low-scoring session, he would be completely thrown off and even frightened that he did so badly on a session.

To avoid that problem altogether, I play only as far into the session as I need to in order to drop the level of challenge for the cognitive domain I’m targeting. I make sure to quit the session before I get through the last game in that session (it’s a specific game where the player has to determine which image is unique or is pictured the most or fewest times in a cluster of various similar images). That way, my lousy score will not register in Harry’s score history. He is none the wiser for my failings and all the happier when he can manage the challenge better the next time he plays a session himself.

Give this a try, and let me know how it works for you!

In my next blog, I’ll share with you my thoughts about “respecting the moment at hand”—an important change in perspective that can cool the pressure cooker for you and your love one, and make brain fitness a time you both look forward to!

As a caregiver helping a person with dementia play a brain fitness program like Dakim BrainFitness, “cluing and coaxing” is pretty straightforward. As I said in my comment to “BeWell,” I like to think of it as “me taking little steps toward the person with dementia until they have enough clues to help them take just one step toward the answer to whatever question is floating in the air at the time.” And that is true.

But brain exercises are pursued in a bell jar of sorts, where the goal is to build cognitive skills that can be transferred over to tasks of daily living. That is, although Dakim BrainFitness exercises are created to reflect daily living, during a brain training session, the real world is put on hold so that attention, focus, and concentration can be practiced to their fullest with a minimum of distractions.

So, what about the real world? Where the decks are not clear, the lighting isn’t perfect, time is not on our side, alarm clocks and doorbells are ringing, we have not had enough sleep, pots are boiling over, meals have been skipped, the engine on the car smells funny, and there’s way more than just one baby bird chirping for quality one-on-one time. These are the very natural and human factors that often contribute to the moment at hand, and they are not optimal for the same kind of “cluing and coaxing” that you do during a brain fitness session.

If your loved one has come to live with you and your family, or you’re just trying to include them in special family events, you  have got to learn what you’re up against (both from your and their perspectives) and plan for how you are going to achieve it.

As I’ve mentioned previously, playing along with the player can teach you a lot about your loved one’s “cognitive coping skills,” which is important in understanding how much they can absorb and process and how quickly they can respond in the real world. As you play together, however, you will also learn a lot about your own coping skills as you react to their abilities (or lack thereof) while trying to keep all balls in the air AND the world spinning on its axis at the same time. Perhaps the harshest news is that the latter is as critical as the former in how you are going to go forward together living with dementia in your lives because, yes, while the dementia marches on in your loved one, it is you, your family, and your friends who will need to adjust the most—particularly in understanding your own fallibilities and intolerances. Hence my title, “Caretaker, heal thyself!”

Now, you wouldn’t be reading my words here in the first place if you weren’t committed to trying to do just that—and although changing yourself may seem (and be) very difficult, and painful, and maybe even impossible at times, you also know it will be well worth the effort because celebrations and daily life are just not the same without our senior family members.

An invaluable place to begin is by using brain training sessions as not only your loved one’s cognitive workout for the day but also as a platform on which to train yourself for including and communicating with your loved one in the real world.

For now, we’re just going to start by observing your loved one during a brain fitness session:

• What’s the best time of day for them to do their brain fitness session?
• What are the activities they do successfully on their own?
• What are the exercises that take them a lot of time to accomplish?
• What activities require a LOT of “cluing and coaxing”?
• On which activities do they seem completely lost—perhaps not even able to get beyond the instructions for a given game?
• Which of their cognitive abilities seem to come and go from day to day?
• Which of their cognitive abilities appear to have completely disappeared?
• How do they respond to your method of “cluing and coaxing”?
• What seems to make them nervous?
• What embarrasses them or creates the most frustration for them when they can’t do it?
• When do you most often see frustration degenerate into impulsiveness, impatience, or anger?
• How do they react to missing a question?

Now look at your own feelings and behavior during the session:

• What’s the best time of day for you to help your loved one play their brain fitness session?
• Are you trying to squeeze this session in between other demands on your time?
• What frustrates you about their way of doing things?
• What saddens or even scares you about what they can’t do?
• What kinds of exercises do you seem to have tons of ideas on how to “clue and coax”?
• What kinds of activities do you seem to have no idea at all how to “clue and coax”?
• How do you react when your loved one misses a question, despite all the help you’ve given them?
• How do you react to their emotional state at a given moment?
• At what point(s) do you feel yourself “digging in” and perhaps becoming overly driven to compel them into delivering the correct answer (or any answer at all)?
• Does your method of “cluing and coaxing” somewhere along the way degrade into something more like “demanding and interrogation”?

Naturally, all of this can be better or worse from day to day and depending on outside influences, but in general, if all of these areas are in the negative, this is a pretty good recipe for turning a relatively simple “crockpot” brain fitness session into a real pressure cooker!

My next blog will talk about using WHAT you’ve learned from observing your loved one and yourself during brain fitness sessions to modify HOW you do things in the real world.

“Une femme d’un certain âge” was originally coined in France and reserved for reference to a late-middle-aged woman. For a great discussion of the phrase’s origin and meaning, see William Safire’s wonderful essay from the New York Times.

Today, the idea of “a certain age” is applied to both men and women. And while I like it—I also don’t like it. For all its elegance, it’s still a stereotype. The phrase seeks to create a definable stage of life without offending. So, if I’m “a certain age,” I guess it means I’m in “aging limbo” —a sanctuary (or sanitarium, perhaps?) where I can still be delightfully “colorful”—nay, even “wonderfully eccentric”—without the head-shaking that would ensue if I were truly “OLD”!

Indeed, being labeled as “of a certain age” would appear to be a reprieve from the harsh judgments directed at the “elderly.” At this, I’m expected to dance youthfully around, raising the roof, saying, “Woohoo! I’m not old, I’m just ‘a certain age’!”

Well, you know what? I’m not buying it.

I am 54 (according to my merciless siblings,…and, well,…yes,…the calendar, of course!) and grappling with many of the ideas that I myself have about what it means to age. For example, am I old because I am extremely aware of big new freckles (dare I call them “moles”?) and tiny new wrinkles? Or because I sometimes feel invisible and fear I catch the whiff (and that others do too!) of my creeping irrelevance—putting me past my “pull date,” as it were? And the idea of future illness and/or infirmity—will that signal to the world that my worth is waning? Oh, and God forbid I don’t remember the name of that movie with that actor that won that award! Egads! I might as well close the shutters, lock the doors, and lie down in the dark!

But that’s just not me. I will not, to use the fine words of Dylan Thomas, “go gentle into that good night”…OR live in a limbo of “a certain age”…OR let those who seek to pigeon-hole my age—and me—stop me from being who I am. Nobody should.

Striving to stay as vital as I can, engaged in and always curious about the world around me, enjoying each day in whatever way is open to me—all for my OWN sake—those are things I have always done and will continue to do.

In my future blog postings, I’ll be exploring some of the ways we “Victors” are defined and contained. (”Victors” being a nod to the name of actor “Victor Mature”—since physically “mature” is about all I’m ready to cop to in terms of generalities and emerging the “victor” in this debate is my intent!)

I want to add my voice—and yours—to the discussion. So join me; tell me what you think about what I’m saying, what you’re thinking and feeling, and maybe together we’ll come up with some new ways we can all say “Meh!” to the whole megillah!

This worked great for my older nephew because he, too, enjoyed conversation. When engaged in conversation with “Grandpa Mel,” he would ask questions and listen attentively (if not always enthusiastically!).

As for my younger neph…a non-verbal little fellow…the prospect of conversation?…not so much! He would stare at my dad, looking uncomfortable and cornered—like he’d been called on to defend a doctoral dissertation. If there is such a thing as an awkward silence with a toddler—well, that’s what generally resulted from their interaction.

I wish now that my dad had been around when he could have played a brain fitness program like Dakim BrainFitness with his grandkids. Sharing the responsibility of solving puzzles, remembering delayed-recall information, and figuring out solutions with kids simply adds a whole ‘nother dimension to a cognitive workout, not to mention what it does for their relationships. It is a wonder to see the interaction of children and seniors working their way through the brain games together.

In and of itself, the brain exercises in Dakim BrainFitness are designed specifically for the interests of older adults. Consequently, there are a lot of games centered more around the ‘30s, ‘40s, ‘50s, and ‘60s than the decades within the lifetime of the grandkids. But from what I’ve seen and heard about in other families, that doesn’t seem to be a problem.

For example, if my dad had played with my older nephew, the brain games would have acted as a springboard for conversation. Both of them being curious guys, my older nephew would have enjoyed hearing about the “ancient history” of the early 20^th century (World War II, old movies, and famous people he was learning about in school), and my dad would have been equally as happy to explain events to him, share his personal experiences and stories, and hear what his grandson thought about “the olden days.”

As for my younger nephew, who is more of a doer than a talker, he shared a competitive streak with my dad. And they each had their fortes: My dad was great at history (long-term memory) and language, and my nephew was terrific at puzzles (critical thinking) and math. Between the two of them, they could have worked together on a concrete objective—beating the program!—in a way that didn’t require a whole lot of talking, allowed each to contribute based on his strengths, and let them exercise a little competitiveness in a non-threatening gaming environment.

And speaking of technology… In his later career, my dad made his living largely as a writer, so as technology evolved from typewriters to word processors to computers, he didn’t have a huge fear of the change. However, many seniors do. Even a product as straightforward as the Dakim BrainFitness System can be daunting to a person who has virtually no experience with technology. For many technology-nervous seniors, having a technology-fearless young person as a co-pilot, easing them through those first experiences with computer use, is an enormous benefit—and relief! That confident helper (the same one who began his/her relationship with electronics by feeding Eggo waffles to the DVD player!) encourages Grandma and Grandpa to get beyond the technology quickly and easily, and on with the fun of the game play.

So what do the kids get out of this?

To begin with, bringing the kids into the brain fitness fun with their grandparents gives them something they often pine for—inclusion among the adults in their lives. We always hear how there is this natural affinity between grandparents and grandchildren, but that isn’t always the case. As with my younger nephew, playing a brain fitness program together can bridge a gap if there is one and get rich relationships started. For pre-teens like my older nephew, building on their relationship with their grandparents affords them the opportunity to be engaged with adults in a more mature way and be regarded for their thoughts and opinions–a reward that makes them walk a little taller out in the rest of the world.

On top of that, the simple fearlessness of most kids in using technology gives them relevance and value among the adults in their lives. And allowing them to exhibit their know-how that way and in the various cognitive areas of the games is confidence-building—the same way it is for their grandparents.

Kids also get access to the same rigorous cognitive workout their grandparents are getting. This can build their knowledge and skills in fundamental areas of education (such as vocabulary and math) as well as foster greater curiosity about the world around them.

And, finally, spending quality time with their grandparents and other older adults in the family helps kids appreciate all seniors. This can broaden their minds and hearts in terms of basic values like charity, generosity, and wisdom, as well as a greater appreciation of family history and connectedness.

Y’know, I think what creates quality of life isn’t all that different whether you’re a kid, a teenager, an adult, or a senior. We all seek connection with other people rooted in respect. We do that through contributing–our earnings to the household or company finances, our efforts to the achievement of team or family goals, or just our thoughts and ideas to the conversation at hand.

So, why not invite the kids to sit in on a brain fitness session? It’s a part of their grandparents’ life and world that they can contribute to, learn from, and enjoy!

Let me explain.

First, I felt it was really important to ask my husband, Mike, if he was okay with sharing our personal lives in such a public way. Mike is a pretty easygoing guy, but asking him to expose his struggle with a personal disability to potentially millions of people via the Internet was asking a lot!

Mike deserves tremendous kudos for so readily agreeing to participate in this project. His willingness to “help the other guy” is just one of the many things I love about him. The dialogue that has opened up between us about his mild cognitive impairment has been terrific. He’s interested in what I’m doing, and asking him questions about what he’s experiencing is now much less threatening.

Yes … I really think we’ve begun to move past his denial and my stoicism.

Now, I know not everyone blogs, but let me encourage you to try it, or at least share a comment on what you read here. I’d love to know more about how other couples are coping on a day-to-day basis with all the issues associated with memory loss. I’m no expert, so sharing experiences with others is one of the most important tools I have in managing both the emotional and practical challenges memory loss presents. If you’re struggling with memory loss yourself, or if you’re functioning in a caretaking role for someone with memory issues, I encourage you to respond to my blog, too.

Let’s build a solution-focused community where we can share our ideas and our feelings. Many of us are facing memory loss for the very first time. It can be scary and frustrating, especially when you’re going it alone. Having a little extra support never hurt, and there’s just so much to learn.

There’s so much misinformation and really absurd, impractical advice out there, too. I mean, if eating five cups of broccoli a day really staved off memory loss, there would be a run on the markets and it would sell like lemonade at a parade on the Fourth of July. You’d have to fly to another continent and a different time zone just to find a single spear.

And we all know that while regular exercise is central to any good health regimen, few among of us are willing or able to run a marathon no matter how many brain cells it might save!

What I’m really interested in is getting down to the real nitty gritty, like what are the clever little tools you’ve come up with to more effectively manage daily living? How do you handle working with healthcare professionals to see that the needs of the person affected by memory loss, as well as those close to him or her, are met? And most of all, how do you handle the emotions and the fears that facing memory loss can engender for everyone involved?

There. Now, I’ve said it: Despite the fact that we generally do pretty well; sometimes both my husband and I get scared. And I doubt we are the only ones. Talking with other people about their experiences helps me gain perspective and not feel so alone. Sharing both the setbacks and the victories of this journey is so much easier for Mike and me when we have fellow travelers to help guide us on our way.

Consider this an open invitation. We’d love to hear from you!

Since no one is cognitively perfect, it’s no surprise that we’ve all dabbled in this all of our lives. Such “cognitive coping skills” are the methods we use to stay in the game, protect our dignity, avoid embarrassment, retain control over our lives for as long as we can, and maintain as much of our sense of ourselves as we possibly can.

Charles Darwin, naturalist and author of "The Origin of the Species by Means of Natural Selection"

I think it’s easy to construe such coping skills as games people play, but they’re not. They are a result of the competition and natural selection that drive us at the very core of our being–yup, the stuff Darwin was talking about. Our nature is to keep moving so we can keep up with the pack. Coping skills of the kind I mean are part and parcel of our arsenal of how we do that.

For example, people who are illiterate, or even functionally so, have brains that work overtime assessing every possible clue in front of them—beyond the words they cannot read—to get through life successfully regardless of their inability to read. That’s work!

So it is the case with people struggling with progressive dementia. And when you are charged with helping someone with dementia, you come to learn a lot about his or her cognitive coping skills.

For example, sometimes Harry, the volunteer game-tester I work with three times a week, reads each of the possible answers out loud, waiting for me to confirm the correct one: “Is it Frank Sinatra? Is it Dean Martin? Is it Sammy Davis, Jr.? What do you think?” I don’t look at this as Harry trying to finagle the answer out of me so much as his effort to gracefully make his way through this very difficult moment with his dignity intact—he’s asking me to partner with him and share some of the responsibility for deciding on the answer.

Now, I could just go with that and give him the answers, but I also know that HE knows NOT earning the answers for himself doesn’t make him feel very good. So my job is to get him beyond those cognitive coping skills and help him actually work through the games in a way that gives his brain as rigorous a workout as he can handle on that day–while avoiding frustration and maintaining his dignity.

If I’m on my toes, whatever coping skill Harry lobs my way, I can turn it into an opportunity for him to figure out the answer himself. It helps that a nice feature of the Dakim BrainFitness System is that it always gives you one freebie guess that, if you guess wrong, doesn’t count against your score. So, whatever answer option Harry is pointing at on that first try, right or wrong, I encourage him by simply saying, “Give it a shot.”

(Many times, I use that first try to see what kind of a mood Harry is in that day. As I mentioned in my last blog post, if he begins stabbing all the buttons without thinking about it, I know he’s feeling impatient, frustrated, or both. If he pauses after making an incorrect guess, I know he is feeling confident enough to really try again.)

If he guesses wrong on that first try (AND is in the mood to figure things out!), that’s when the real work begins. I start by giving him hints—anything I can think of that can spur on his brain to dig for the answer:

• Giving him the first letter of the word he needs to figure out
• Drawing a picture either as a hint or just giving him something visual that he can put a name to
• Asking the question in a different way (our work in this area has helped my team a lot in reworking HOW we ask questions!)
• Providing various specific descriptions of the answer – if the answer is “horse,” I’ll provide something like: “It has four legs”; “It’s feet are hoofs”; “it eats grass”; “They’re also called ‘ponies’”; “Three kinds of them are pintos, mustangs, and palominos”; and “They run very fast”
• Describing some context around the answer, like “You saddle it up and ride it”; “Cowboys ride them”; and “People watch them race in the Kentucky Derby”
• Urging him to say things out loud because sometimes, even hearing part of a word he’s trying to spell can kick in the memory of the whole word.
• If the answer is really multiple right answers, encouraging him to scan all the options and see if any of them just “calls out to him, ‘Pick me!’” (My theory behind this is that sometimes it seems like the answer is floating around in his head and he just needs to trust his gut to act on even a glimmer of recognition of a picture or word.)

Any one of these kinds of devices just might be THE one that triggers his memory or gives his critical thinking skills a foothold in finding the answer. Most importantly, these are ways I can slide Harry closer to finding the answer himself—and ultimately, every question he answers correctly or puzzle he solves on his own, to whatever degree he can, adds to his confidence and lets us still see more of the Harry we know.

ALL of what I’ve just discussed is brain exercise, by the way. Even if Harry can’t figure out the correct answer outright, he still has to chew on all those hints and clues I’m giving him and work his brain toward the answer. And if he is more in the mood to try to finagle answers out of me? Well, all the thinking he has to do to accomplish that is still a lot of brain work!

Even though his short-term memory and language have been hard-hit by Alzheimer’s, I contend that Harry still has excellent critical thinking skills that, whether he realizes it or not, are often the way he makes up for those other declining abilities, both in brain exercises and in real life. If he doesn’t know the answer outright (and he isn’t conning me!), he will reason his way through the question and, if not determine the exact right answer, at least make a solid educated guess.

Then again, sometimes I experience that salesmanship of his first-hand on, what I call, “lazy days” (when he doesn’t feel like giving the Dakin BrainFitness System his all). On days like this, he’ll confidently wield his considerable persuasion skills and, if I’m not on the ball, sometimes manage to wheedle the correct answer out of me so he doesn’t have to work for it!

Of course, there are also the days when his response to every memory game is to begin defiantly stabbing all the buttons without thinking about it. On those kinds of days, I know it’s because he’s feeling impatient, frustrated, or both.

It’s not his declining-versus-intact cognitive abilities that are always my biggest concern, though, because whatever kind of day he’s having, I have always known he still had a good deal of fight in him!

As Harry’s Alzheimer’s has progressed, however, it has been eking away at the confidence he once had in such abundance and relied on in his successful career. More recently, I have seen a growing uncertainty in him; uncertainty as to whether he actually knows the correct answer, can figure it out, or even understands the task before him.

That’s the funny thing about shortcomings…it’s just so much easier to dwell on what we don’t do well than on what we do. It’s that voice in our heads—we all have it—that keeps close accounting of every forgotten name, misspelled word, checkbook error, and mistaken memory and constantly convinces us that we need to check, double-check, and triple-check before we act.

Harry’s sensitivity to what he can’t do overwhelms him at times. If impatience/frustration doesn’t kick in, then he is likely to proceed extremely cautiously through every activity. He’ll look to me for confirmation and reassurance that he is about to hit the right answer, even on the questions/activities that I know are very easy for him.

Another indication of Harry’s waning confidence is in his ongoing practice of second-guessing himself. I’ll watch his hand hover over the correct answer and can practically hear his inner dialogue telling himself that if he thinks it might be the right answer, then it couldn’t possibly be the right answer. Then suddenly he’ll move his hand to a decoy (that is, a wrong answer) and choose that.

Confidence is a quality we strive for and value in ourselves. Losing it—and, in particular, being aware of the loss—is one of the cruelest effects of dementia-causing illnesses like Alzheimer’s. It’s also hard for us to see that change in our loved ones with dementia. But it isn’t the end of the story.

In my next blog post, I’ll let you in on some of the ways in which the Dakim BrainFitness System, and how I work with Harry on it, builds his confidence in the face of Alzheimer’s.

As Alzheimer’s disease progresses, it blithely sweeps away more and more memories, independence, relationships, and quality of life. There are fewer and fewer victories (even if they can be recalled), which makes getting out of bed in the morning a feat of significant inner strength.

For many, once they are “up and at ‘em,” each day is about being parked in various places while life goes on around them. For others with the means, the day is scheduled up the wazoo—giving outsiders the impression of a fulfilled life being lived despite Alzheimers when, in fact, from the inside, there isn’t a lot of satisfaction in being shuttled from one activity to the next, essentially filling and killing time.

That’s why we’re happy to share the news that Dakim BrainFitness causes mood swings—for the better!

While there is a lot of science behind the feeling of happiness, generally none of us consults a biochemistry textbook, or even our doctors, when we’re trying to figure out what makes us happy. We just know what does—we know what we like to do, and we know what is meaningful to us.

Time and time again, we hear from our players that they can be in a foul mood when they sit down to play, and then, through a few challenges, a little hard work well-rewarded, and a bit of humor here and there, they come away from their session feeling accomplished, satisfied, and happier.

For those who try Dakim BrainFitness for even just one session, they experience a marked improvement in their mood and outlook.

For those who play on a regular basis—3-5 times a week—Dakim BrainFitness is an activity they look forward to. It quickly becomes a continuing source of buoyancy out of the darkness of the hard days and tough weeks living with Alzheimer’s.

And that’s what keeps them all swinging back by for more!

By nature, I am a pretty emotive person, so hiding my feelings didn’t come easily for me. Usually, stoicism would not be my first choice of coping strategies but, at the time, it was very expeditious. We were planning our wedding and had a lot on our plates. Staying focused on the positive seemed to be in everyone’s best interest. I had no doubts we’d be just fine: After all, we really loved each other… right?

Our marriage is a gift from God. My husband and I truly love each other. Perhaps because we met so late in life, it seems like we’re still on our honeymoon, even as our third anniversary nears. My honeymoon with stoicism, however, did not last. I embraced it for awhile, but was not altogether thrilled with the results. Eventually, I turned to my dictionary and looked the word up, just to be certain I was practicing stoicism correctly. What I found was not encouraging, because it seemed awfully extreme.

Zeno of Citium, 3rd c. B.C.

Around 300 B.C., the Greek philosopher Zeno founded Stoicism as a school of thought. He believed a wise man should be free from passion, unmoved by joy or grief. Further, Zeno advocated uncomplaining patience and impassive endurance in the face of adversity.

Let me give you my first thoughts: ‘What? Huh? You can’t be serious! Zeno, were you out of your mind?’

Obviously, Zeno’s partner (if he even managed to get one with this philosophy) never went to the grocery store for milk and came back with everything but. I wager this couple never held the same conversation six times in the space of an hour, day in, day out, again and again and again. And as for facing down a partner who won’t admit there is a problem? Well, as they say, denial isn’t a river in Egypt. It can be frustratingly divisive when one person refuses to acknowledge a problem and the other, overburdened with responsibilities, feels emotions they dare not express.

How surprised do you think I was to find that not one complete tablet or scroll of Zeno’s work remains? Ha! His partner probably broke them over … well, let’s just say they were turned into pot shards. Just what are you supposed to do with your feelings when your partner’s are too painful for him to acknowledge or embrace?

Marcus Aurelius, 121-180 A.D.

I discovered that the modern meaning of the word “stoic” is a far cry from the philosophy Zeno espoused. “How ridiculous and how strange to be surprised at anything which happens in life,” Marcus Aurelius wrote. He was a Stoic and, admittedly, he had a point – one it seems that, through a sheer lack of acceptance, I was failing to embrace.

My internal dialogue was fairly screaming, “This isn’t fair! This shouldn’t be! Why is this happening to Mike? Why is this happening to me?” It seems I have some work to do on my self-centeredness. I had to ask myself, “Why shouldn’t my husband be in denial?” “Look how I’m behaving and this memory loss isn’t even happening to me!”

When I ran across Epictetus, I knew I’d found a golden nugget and a philosophy I could embrace.
“Man is disturbed not by things, but by the views he takes of them,” he wrote.

Epictetus, 55-135 A.D.

So how am I choosing to cope, one day at a time, with how Mike’s memory loss impacts our relationship? Well, developing a sense of humor definitely helps. Sometimes our conversations really do remind me of an old George Burns and Gracie Allen routine. Coincidentally, when I am less fear-driven, Mike seems better able to step out of his denial and face his memory issues more squarely. He still has some work to do, but he seems much less defensive about it … and this is a very good thing.

When I can’t find the humor in our situation, I am stoically working on taking a different point of view. If I choose to see our path not as a burden, but as a challenging adventure, my attitude brightens. This change in mind-set empowers me to join forces with my husband and use our combined talents and skills to embrace the obstacles we face and try to overcome them.

In the face of frustration, I sometimes have to ask myself, “Just how important is this?” This new perspective has certainly helped, but some days are still tougher than others. On occasion, turning out the lights at the end of the day knowing we can try again tomorrow has to be enough.

With impaired short term memory, my husband pretty much lives in the present moment. And, for the most part, he seems to enjoy each day fully. I am the one who has some work to do and distance to travel before I can join him there, so this probably isn’t the last time you’ll hear from me on this topic!

We have one fellow, whom I’ll call Harry, who is much like me. In fact, he is so visually oriented that at first meeting, you might think he’s deaf. But it’s not his hearing that is a problem–that’s confirmed by regular check-ups and by his love of music, which is about the only audio input he doesn’t tune out, no matter how softly you play it.

If you look Harry square in the eye when you’re talking to him, he gets what you are saying. If you speak to him otherwise, he will either proceed as though he didn’t hear you or, perceiving that you are speaking to him, ask you to repeat it so he can specially focus on what you are saying.

Harry learns all instructions for games and activities from what is written on the screen in front of him. Even while the system is reading the onscreen text out loud, he has tuned out the voiceover and often reads aloud to himself, right over the voiceover.

Again, I’ve come to know that it’s not that Harry doesn’t hear you–it’s simply that he is not a “verbal hearing” guy.

The tricky thing with Harry is that he built a successful independent sales company, and being in such a business, he is very verbally expressive. And like me (coming from my very verbal family), while we can express ourselves verbally, spoken words are not our best means of absorbing information.

This is the kind of nuance that cross-training the brain with a brain fitness program can reveal. You can learn not only what skills are intact and what aren’t, but what specific parts of those cognitive abilities are involved–that is, what is the player’s specific version of that deficit or ability. And this is tremendously beneficial to the player, whether it’s you or someone you are caring for, because knowing this can help you find ways to bridge some of this issue in daily life.

(And, of course, if you want to discuss the selective hearing that is unique to teenagers, well, that’s a whole ‘nother bailiwick!!)

With brain health so prevalent in the news, it’s easy to think that Alzheimer’s disease is lurking around every corner ready to pounce on anybody. It can be particularly scary when you haven’t been putting your brain through its paces recently and don’t know for sure which of your cognitive shortcomings may be biological and which may be simply a matter of practice.

WAAAAAYYYY back when we were kids living in our parents’ houses, and then all the way through our schooling, when checking our homework for us and finding an error, our mothers, fathers, teachers, and mentors often responded with, “Did you read the instructions all the way through?” or “Did you even read the instructions??” We would then grumble back to our bedrooms, look over our own work, and, in the words of Homer Simpson, groan, “D’oh!”

As we grew up, we learned to pay better attention to detail and concentrate for longer, more productive periods of time. As we moved out into the world, developed interests, joined the workforce, and raised families, focus and attention were key to our success. (Yup, just because you’re no longer in school doesn’t mean you stop having to “check your work,” does it?) We all got kinda used to being sharp and at our brain power best. Ah, those were our cognitive salad days, weren’t they?

And so we come to today.

At no other time in history have we had so much information not just coming at us but being force-fed to us and demanded from us–all on the fly. The passwords, phone numbers (home, mobile, AND office!), identification numbers, and confirmation codes alone that our aging brains have to remember for all the transactions we undertake daily is mind-boggling…literally. So a little memory loss from cognitive overload is perfectly understandable. But it’s also perfectly manageable.

With brain exercise of any kind, your success and cognitive growth depend on building up and maintaining longer and deeper periods of focus–in fact, sustained concentration is the foundation for working on all the other cognitive areas of your brain. Like trying to balance my checkbook with a head cold or bad migraine, no matter how good my math skills are, or even how much I like math, if the illness clobbers my attention span, I’m going to have to postpone that task for another day.

A brain fitness program can help you tease all this out and pinpoint your cognitive strengths and weaknesses. From there, you can get some kind of an idea which of your weaknesses may not be organic brain disease but may only be a matter of paying a little more attention or developing your strategies and practicing your skills for accomplishing certain cognitive tasks.*

Either way, you win because your brain fitness efforts will sharpen your brain up to its full potential!

* Brain fitness products are not diagnostic tools. If, as you exercise your brain, you begin to suspect you may have organic cognitive impairment such as Alzheimer’s disease, see your doctor right away. Early diagnosis allows for more treatment and brain fitness options to slow the progress of dementia.

Although many years had passed (with only the occasional classic post-graduate nightmare!), when I played the Dakim BrainFitness System for the first time, I was very nervous. In the back of my head I had a list of my cognitive strengths and weaknesses. For example, I have always known I was Numbers Girl–I like numbers, and they like me. No problem there. But I had always stumbled on the verbal.

Now, I come from a very verbal family, and although by nature I was not the most talkative in my family, I valued language and always believed that I should have no trouble reading or listening to lectures. In practice, however, that had never really been the case. Ultimately, I pretty much gave up trying to figure out how that could be.

Even with all that baggage, however, after a few brain fitness sessions, I started to calm down. I think it was because the variety of exercises in the program was helping me, 30 years out of school, to confirm my cognitive strengths, work on my cognitive weakness, and, most surprisingly, discover some essential cognitive skills I didn’t even know I had.

It was the visuospatial and visual memory games in Dakim BrainFitness, such as Shifting Positions, My Favorite Things, Picture Pairs, and Make a Story, that showed me the rest of my cognitive skills. Through presenting images/photos to remember or calling on me to remember verbal information by imagining it as a picture, I soon started to feel I could be learn new information far more easily than I had in the past.

And like so many super heroes before her, Numbers Girl was awakened to a whole new super power–in this case, thanks to a brain fitness program!

The reporter spoke with Dr. David Bennett, who directs the Alzheimer’s Disease Center at Rush University Medical Center in Chicago. After 16 years of studying thousands of samples of postmortem brain tissue, Dr. Bennett has concluded that “a lot of people have a little bit of Alzheimer’s.” Even among those who showed no symptoms, he said, “It’s hard not to have at least a little bit of Alzheimer’s pathology.”

While he recognizes this knowledge “could frighten a lot of people,” Bennett sees in the finding both a positive and an opportunity:

The positive is many people clearly are able to tolerate “a little bit of Alzheimer’s” in their brains—or even more than a little bit.

The opportunity comes in the form of building a cognitive reserve—that is, extra brain capacity that compensates for whatever damage accumulates from whichever cause, be it illness or injury.

“I think of cognitive reserve like the side streets when there’s an accident on the expressway,” Bennett says. “Everything comes to a dead stop, and you get off and you meander through the side streets, and you can actually get to your destination.”

What this emphasizes is the importance for all of us of being proactive in protecting our brain health.

Both physical exercise and brain exercise are two ways to build up that cognitive reserve, so, let’s get to it! There is too much at stake to sit on the sidelines!

We improved our diets. We worked on getting more exercise. Mike went back to work and begrudgingly resumed his attempts to quit smoking. He adjusted to taking a plethora of heart medications, and I tried to curb my propensity to hover over him like a mother hen.

With time, our life together got back to our version of “normal”—until, very slowly, we began to realize it really hadn’t.

Our awareness of Mike’s memory loss crept into our lives without fanfare. At first, we didn’t give it much thought at all. After all, he’d just had a heart attack. We assumed his lapses in recall were a result of the trauma and that they would go away as he healed.

Frankly, our attention was also focused on what we felt were more pressing issues: How would he handle job-related stress? Would climbing stairs be too much for him? And how would his medical condition affect our sex life? My imagination flew into hyper drive, and what I imagined were always the worst possible scenarios. It was a difficult time for us overall, so we considered the occasional memory lapse on Mike’s part the least of our concerns.

Then, Mike started missing appointments. He would sometimes go to his workplace on the wrong days. He couldn’t go to the grocery store to pick up even just three items without a list. I grew frustrated with having to repeat myself again and again, and Mike couldn’t understand why I was becoming so testy.

What’s worse, my beloved seemed to be choosing denial as his coping mechanism: “Problem? What problem?” Mike huffed. He simply didn’t want to think about it. Oh, and that list to remember a few items at the store? He refused to make one.

As for my own coping skills, I tried the stoic approach. But privately I could feel myself gradually coming a little unglued.

Tina and her husband, Mike, on their wedding day

Ours is a May-September relationship, and we knew we were starting off married life later than most, but we continued to look forward to our wedding. There was a lingering concern, however: Would my husband lose his memory altogether before we had the opportunity to make more shared memories of our own?

In my upcoming posts, I will be sharing Mike’s and my journey through the surprising cognitive impact a single heart attack has had on our life together. Each day is an adventure, with new issues to confront and questions to explore. I will share with you what we experience and what we learn in the hope that it can help you and your family with memory loss, regardless of its cause.

My early life was spent in Salt Lake City, and after 40 years away in Chicago and Los Angeles, I ultimately returned home to assist my parents. My father (my “roomie” for five years) passed away in 2005. My mother, as I noted in my last post, has a joyful, productive life in southern Utah.

Fourteen years ago, I was diagnosed with an illness that I have learned I share with millions worldwide. In the U.S., it has the simplistic “non-name” of chronic fatigue syndrome (CFS). In Europe, it’s known by a more clinically credible name: myalgic encephalomyelitis (ME).

By either name, ME/CFS is a debilitating kind of fatigue, unrelieved by rest and accompanied by pain and flu-like symptoms. Studies suggest it may be caused by nervous system inflammation, immune dysfunction, and even a newly found retrovirus called XMRV. Research is only now identifying unique spinal fluid proteins and other biomarkers related to ME/CFS.

So what’s the long-term outlook for people with ME/CFS? At present, most will never return to their pre-illness state.

I had this going on already when a few years ago, along came fibromyalgia (FM) to complicate my health further with its soft tissue and joint pain.

Now, these disorders all sound like almost completely just physical problems. However, vexing to many of us is that along with these health challenges come memory and concentration problems. And these cognitive issues are not wholly unlike early stages of dementia.

For myself, I found that the physical disabilities coupled with my gradually eroding cognition severely truncated my professional life. They also altered my personal expectations of myself and got me wondering: Could this be a foreshadowing of what is to come?

Having always loved learning new things, I longed to audit a few university courses offered free to senior citizens by Utah’s state system. But even the walk from the parking lot to the classrooms was so daunting, it nixed that idea. Poor concentration and memory even squelched my alternative plan—online courses. So, mystery novels became my reading joy and refuge…until…

Enter Dakim BrainFitness Software for my home computer. I set an enthusiastic pace for myself of five sessions each week, and 11 months later I’m in the ballpark of that goal, with a current average of four.

I do pretty well. Of course, my scores would be stellar (at least on occasion!) if I could just subtract my Letter Trails and those darn percentage math problems from my overall score! I love the visuospatial exercises and surprise myself by even doing well on delayed recall. I’m challenged by but always improving in short-term memory and concentration.

Regular Dakim sessions have stretched me and even seem to have stopped my cognitive skid. My hope?: To reverse my losses. But for today, I’m cautiously optimistic that maybe,…just maybe,…I still have some serious “larnin’” years left in me.

Stay tuned!

They also compared us favorably to our competition and felt that our product was simple to use, even for anyone who “doesn’t spend all day at the computer”–as many seniors don’t.

We’re delighted with the recognition our clinically tested Dakim BrainFitness program is getting, and at the fact that it’s being appreciated for what it is: An enjoyable, personalized mental workout, specifically tailored to the needs and tastes of seniors and older boomers.

And if some find it little hokey, well, it just proves: One person’s corn is another person’s comfort food.

I encourage you to read the WSJ review. (Don’t forget to hit the “Like” button to let them know you’re out there!)

AND…if you’re already a Dakim BrainFitness player and feel moved to do so, please weigh in with a comment on the WSJ site. By doing so, you’ll be helping other readers understand, firsthand, what Dakim BrainFitness is all about!

Even though we all want the best care, we have to do something to control health care costs, or our health care system will indeed go bankrupt, as so many fear.

So, what can we do?

My brother, who was a very well respected oncological surgeon, once told me there is a lot of truth to the adage: “An ounce of prevention is worth a pound of cure.” I can think of two ounces of prevention, and happily, Dakim BrainFitness can help with both of them.

The first thing we can do is not wait for illness to strike but, rather, take charge of our own wellness.

Proactively doing what is necessary to preserve our health—to prevent or delay the onset of disease in the first place—saves millions of dollars in health care costs each year.

With that in mind, try these on for size when it comes to maintaining your brain health:

• Adopt a heart-healthy lifestyle. It turns out that what is good for our hearts is good for our brains. For me, that means keeping my weight, blood pressure, cholesterol, and diabetes under control and, with my doctor’s permission, getting 30 minutes of moderate cardiovascular exercise every day.
• Y’know that 63%-reduced risk of dementia I keep touting? That’s prevention, and clinically tested Dakim BrainFitness is the ideal way to get the kind of broad-based, therapeutic cognitive stimulation that can make a difference in your cognitive health.

The second thing we can do is to use technology—wherever we can—to get the therapies we need more consistently and cost-effectively than our beleaguered health care system can deliver.

Dakim BrainFitness is a perfect example of technology that can be available to you every day, in your home, on your own schedule, and without making an appointment. Every time you log into a session of Dakim BrainFitness, you have access to thousands of brain fitness exercises. It cross-trains your brain in six essential cognitive domains in a systematic process that precisely tailors the level of challenge of each exercise, in real time, to your abilities at that moment. Dakim’s patent-pending NuroLogic™ Technology delivers this preventative measure without any involvement from costly health care providers. And best of all, it costs just pennies a session!

What’s the bottom line? Our country’s future—both financially and health-wise—is in our own hands. Let’s all take responsibility and claim our wellness by exercising this couple of ounces of prevention that really can make a difference in our lives.

Look on them as long as thou wilt, stranger. Count and, if need be, handle. One look is enough for me. When thou hast counted and handled and art sure that thou canst remember them all, I cover them with this paper, and thou must tell over the tally to Lurgan Sahib. I will write mine.

The purpose of “the Jewel Game,” as it is called in Kipling’s novel, is to train the memory to remember, at first, just the gems on the tray, and then, with practice, not only the gems, but where they are. Eventually, the jewels are replaced by other objects, of various sorts, including photographs of people.

After Kipling’s book was published, Robert Baden-Powell, the founder of the Scouts and the Girl Guides, British organizations similar to the Boy Scouts and Girl Scouts, names the exercise Kim’s Game and describes it as follows in a book he wrote about games for scouts:

The Scoutmaster should collect on a tray a number of articles – knives, spoons, pencil, pen, stones, book and so on—not more than about fifteen for the first few games, and cover the whole over with a cloth. He then makes the others sit round, where they can see the tray, and uncovers it for one minute. Then each of them must make a list on a piece of paper of all the articles he can remember . . . The one who remembers most wins the game.

The first time I saw Dakim’s “Shifting Places” game, I was reminded of “Kim’s Game.” The difference of course is that with Dakim’s version, the player is automatically evaluated, and the exercise increases or decreases in difficulty according to the user’s abilities. It’s an exercise that’s designed to stimulate and possibly even improve short-term memory. With Dakim’s version, the player is encouraged to keep trying, and rewarded for success, but never made to feel bad for a less-than-perfect response. Short-term memory is partially organic, and partially, a learned skill; exercises like “Shifting Places” help teach us how to recall objects and events we’ve recently experienced.

Both my parents very strongly want to live at home as long as they’re able, and without having caregivers in their home seven days a week. I’m doing what I can to make that possible.

My mother takes a wide variety of prescription and over-the-counter medicines, and was managing them herself until about the last two years.

Since then, I’ve been portioning her pills out weekly into a pill box very similar to this one — seven columns for the days of the week, and four boxes in each column for breakfast, lunch, dinner, and bedtime.

That worked well until recently, when my mother started taking pills at the wrong time. She hasn’t known the day by herself for quite a while — she’d look at the date at the top of today’s newspaper to see which day’s pills she should take. That worked well as long as she wasn’t accidentally looking at yesterday’s newspaper. When my mom began taking extra doses — or not taking doses as scheduled — it was clear the old method was no longer working.

I found this monthly pill system online, and so far it has solved my mother’s medication taking problems. It includes a clock on the front of it giving the time, day, and date, and 31 labeled pill boxes. Both my parents were intimidated by the look of this dispenser — they said it looked like a typewriter — but my mother picked it up quickly. She simply takes today’s numbered pill container out of the rack and places it in the “today’s pills” horizontal slot next to the clock. From that point on, it’s a normal “Breakfast, Lunch, Dinner, Bedtime” pill dispenser for one day only.

The clock also has the option of announcing that it’s time to take a pill. I originally thought my parents would hate this feature and ask me to turn it off, but it’s been very helpful in reminding my mother to take her medicine, and it doesn’t seem to bother either of them. Thus far, my mother has a perfect record of taking her medication with this dispenser.

The other medical duty my mother has is to take her blood pressure several times a day and record it so her doctor can review it. (We use an automated blood pressure cuff that my mother has no trouble using.)

Like the pill dispensing, this worked perfectly for several years, until recently I found that the blood pressure records weren’t getting written on the right day. She’d find a sheet with the last day on it being January 11, 2010; assume that today was January 12; and record the blood pressure on the wrong day.

I bought this clock for her, which shows the year, month, day, day of the week, and time of day. I think it’s a very attractive clock, and I like the mechanical flipping that changes the day and date. However, the first word in its title is “Large,” and they mean that. I didn’t imagine how big this thing actually is — it’s ENORMOUS, measuring 13″ across and 4-1/2″ deep. (The page on Amazon does not list the dimensions.) My mother certainly has no trouble reading it, and now her blood pressure records are helping her doctor adjust her medications properly.

Eventually my parents will reach a point where they need someone in their home helping 24×7, and after that they’ll probably reach a point where they can’t be at home anymore. Gadgets like these can only help for a relatively brief time. But my parents are so firm and consistent in their desire to maintain their independence, in the house they’ve lived in for 40 years, that I’m doing everything I can to push that point out to the future.

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ABOUT THE AUTHOR: John Schofield is the Director of Information Technology at Dakim, Inc., and, as such, is a key leader in Dakim’s development of the system and software versions of Dakim BrainFitness. In this blog, he shares his only-child experiences as the sole caregiver of aging parents living life with neurological disease.

1. ^[1] It’s important for me to note, however, that Dakim does not endorse or recommend any of these products, and neither I nor Dakim have any relationship at all with these companies. I’m not writing as a Dakim employee; I’m writing about my own experiences as a caregiver and a consumer. In addition, I link to Amazon for examples of these products, but neither Dakim nor myself make any money from these links. ↩

The Elasticity of Memory Part 1

The challenges of being a caregiver for someone with Alzheimer’s Disease change as the disease progresses. Right now, what to say and when to say it are one of my biggest struggles.

Despite working at Dakim and being surrounded by people who are both compassionate and incredibly knowledgeable about Alzheimer’s Disease and senior care in general, it seems like I’m flying blind. Dan Michel and others here at Dakim have been down this road themselves, but every family is different – and there’s a huge gap between good advice and actually having a loved one with Alzheimer’s.

My mother’s grasp on reality has gotten unpredictable — some things she knows are hallucinations, some things she’s not sure about, some things she knows are real (but they’re not), and some thing she knows are real (and they are). It’s confusing for her to navigate, I’m sure, and it’s equally confusing for me, in a different way.

My mother has always had a strong belief in the value of honesty — not just as something she gave lip service to, but as part of her everyday life. There were times growing up when she would answer the phone when it was for me, and (as a painfully shy, socially awkward child) I would ask her to say I wasn’t home. Her answer to me was always the same: “No.”

She kept the same resolve for honesty in every way — she would never promise me something unless she was certain she could deliver — her answer in most cases was “I’ll try” or “we’ll see” — which was frustrating to me but kept her from breaking her word when circumstances changed.

Now that she’s battling dementia the question of how honest I should be keeps coming up. My mother last visited her family in Denmark in 2005, but has the repeated delusion that she’s very recently come back from there. She’ll ask who cooked my Dad’s food while she was gone, or (when she’s especially frustrated with my Dad, who has Parkinson’s and can be demanding) she’ll say that she sometimes wishes she’d never come back.

This pops up often enough that I have had to figure out what to say. Every time I correct her it causes her confusion and anguish — she has trouble understanding that this vivid memory she has isn’t true. She’ll even try to reason her way out of it — “You say I didn’t take a trip. But did I have luggage with me when I came back?”

“You didn’t COME back, Mom. You weren’t gone. You haven’t been to Denmark in six years.”

I could humor her — their neurologist suggested it during a consultation — but the idea distresses her, and I’ve decided not to, despite the pain it causes her to find out her reality is on shaky ground. She was horrified at the idea of humoring her in this way — deeply bothered by it, and wanted us to agree that we’d tell her the truth.

My Dad sometimes humors her — agrees when she talks about her trip, says that mysterious dinner guests left after my Mom set the table for four (my parents live alone) — and sometimes tells her the truth. The result is that she sometimes isn’t sure whether or not to believe him, and she’ll call me to referee. “Dad says you weren’t over here this morning. Were you here?”

While I don’t blame my dad for humoring her, (he’s there 24 hours a day; I’m there for hours at a time several days a week) my painful honesty with her means that she always believes me when I tell her something is or isn’t true. Even if she doesn’t understand how her memory could possibly be wrong, she believes me when I correct her version of reality.

Despite my promise to keep telling her the truth, I’m not sure I’ll be able to keep doing it forever. Alzheimer’s Disease is progressive, and she’s only going to get worse. At some point it may become more compassionate to humor her delusions. But we’re not at that point yet, and I’m thankful, as is my Mom, that our relationship, founded on honesty from the start, can continue that way.

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ABOUT THE AUTHOR: John Schofield is the Director of Information Technology at Dakim, Inc., and, as such, is a key leader in Dakim’s development of the system and software versions of Dakim BrainFitness. In this blog, he shares his only-child experiences as the sole caregiver of aging parents living life with neurological disease.

While my answer here may oversimplify the question a bit for some, I’m hoping it will provide useful information for people trying to decide what will best suit their individual needs and goals.

Brain Games

Brain games are perfect for people who aren’t concerned about protecting their brain health but, instead, simply want an occasional diversion that teases their brains. One of the attractions for many is that brain games are intended for casual use—just for fun or to pass the time. There’s no need for consistent commitment to a long-term routine.

Another characteristic of brain games is that they are generally individual, unconnected activities targeting single, separate cognitive areas. And while games can be helpful and may even improve isolated areas of brain performance, they also provide a strong temptation in all of us to play only the individual games we are good at; that is, exercise the parts of our brains that are already in great shape. In order to improve your all-around cognitive fitness using brain games, you would need to map out a breadth of games that include all major areas of the brain—especially those you need to work on.

Brain Fitness Programs

In contrast, brain fitness programs are for people who don’t just want to tease their brains; they’re serious about maintaining their overall brain health. A brain fitness program is a structured system of exercises designed to help you cross-train a wide range of cognitive areas.

As with physical fitness, a brain fitness program is also intended to be a regular part of your life. When used consistently over the long term, that is where the big returns—and the longest-lasting ones—come from. And that is also why comprehensive programs of this kind serve the needs of health care professionals as well—as a regimen, a brain fitness program is more likely to produce tangible, clinically verifiable results than individual brain games do.

Now, words like “clinical,” “regimen,” and “long-term” don’t mean that using a comprehensive brain fitness program like Dakim BrainFitness can’t be fun. We take pride in the fact that Dakim BrainFitness is the most fun you can have with your thinking cap on! Don’t believe it? Watch this blog for an announcement about our new website for user reviews—where players will tell you in their own words what they think of Dakim BrainFitness!

My first question each time I call her is “What’s your latest count of FreeCell victories?” This is her way to relax—FreeCell and Perry Mason reruns—and we are both convinced it is keeping her brain sharp. At last count, she had more than 19,500 victories under her belt.

FreeCell doesn’t do it for me. Truth be told, my record of wins is dismal. But Dakim BrainFitness? Now there’s my tool of choice. My love affair with this marvelous software continues. (And if my mother’s ancient computer met the tech specs needed to support Dakim BrainFitness, I would have installed it long ago for her!) I have never sat down to do my brain fitness sessions when it has not been an enjoyable pursuit.

I try to follow Dan’s rally cry for three to five 20-minute sessions a week. My sessions-per-week average swings between 3.75 & 5. I must be goal-driven because there are nights when, on a busy week, I will play a game at 11:30 p.m. and then get back on a few minutes after midnight to get my sessions in!

Linda Milne and her mom

Dakim BrainFitness has changed my life, and that is no exaggeration. Cognitive challenges came as one of the debilitating complications of the Chronic Fatigue Syndrome (CFS) and Fibromyalgia package I developed in middle age. I’m 68, so it could be argued I may even be tripping over dementia.

For those of us whose lives are complicated by the cognitive impairment of these particular illnesses, there is no study out there evaluating the efficacy of Dakim software, or any other brain fitness product for that matter. So, I have become my own one-woman study.

I started playing Dakim BrainFitness at a senior center where I participated in an exercise class. Admittedly, I played hit-and-miss; some weeks once or twice, and often, not at all. However, when the software became packaged for individual consumers, I wanted it in my home. And here it is, months later, and I am a believer in its ability to intervene in cognitive decline.

What’s my proof? OK, here is the biggest deal. I have not had to throw away even one scorched pan since I got serious about Dakim BrainFitness. If that doesn’t impress you, how about this?: I ceased losing my car in Costco’s parking lot. Now there is an unsung blessing.

Here’s another success that actually causes me to get moist eyes. I’m a movie buff of the highest order. However, it had become my disturbing norm to leave a movie, having enjoyed it thoroughly, and lose its content by the time I got to my car. True story. Now when I leave a movie and head to dinner with friends, I can talk about the movie—its title, story line, and actors. This is wonderful.

I am a Dakim champion. I can’t imagine being without the benefits it brings to me. I salute Dan and his colleagues for the contribution they have made to my quality of life. If you know people who deal with the obstacles of “Fibro Fog” or CFS cognitive deficits, put them on to Dakim BrainFitness. Never mind if they are not seniors. They will benefit.

Scientific validity and results are essential in brain fitness, so our first inclination was to develop games and activities that very closely paralleled standardized neurological tests and exercises. We thought that in doing so, we would make it easy for health care professionals to research their effectiveness. Today, in hindsight, it’s easy to see that if we had followed this path, Dakim BrainFitness would be repetitive and boring, and highly unlikely to sustain long-term use by the player.

That last point—sustaining long-term use—indeed turned out to be central to our customers achieving and maintaining long-term benefits. It would also become one of the key differentiators between Dakim BrainFitness and other brain-training products on the market.

So, using standardized neurological testing only as a springboard, and bearing in mind the goal of long-term benefits through long-term use, we forged ahead with our creative efforts. Then, one day, we came to a fork in our content development road, and everything changed!

Rob Miller, Director of Content Development, Dakim, Inc.

Rob Miller (our head of content development) and I were discussing the workings of a memory exercise known as Memory Pairs. In this exercise, a series of unrelated word pairs are presented, and the respondent is called upon to remember the pairs and then recite them after a given period of time. The word pair we were discussing at the time contained the words “Happy” and “Halibut.”

Somehow, that word pair just struck my funny bone. “It sounds like the name of a seafood restaurant,” I said to Rob. I then suggested we use it in another memory exercise we were developing, where a story would be presented, about which the player would later be quizzed regarding the various details included in the story. In this case, the story could be about a couple dining for the first time in a charming seafood restaurant, The Happy Halibut.

As Rob and I chatted about the story elements and the details to be remembered (menu items the couple would order, prices, restaurant slogans, etc.), I was struck by a funny notion: “Wouldn’t it be hilarious if the seafood was really awful at the Happy Halibut?”

We started riffing on the idea, and our little story seemed to get quirkier and funnier as we made up new, off-kilter details. We imagined that our diners were the only people in the whole place who didn’t know that the seafood stinks at the Happy Halibut. As they finished their meal, we thought an old friend might stop by their table and inquire as to how they liked their meal. In our story, the wife would confess that for a seafood restaurant, she was kind of disappointed…in fact, she thought the fish was lousy! To this, her friend would chuckle knowingly and inform her: “Everyone knows that it’s the Texas-style chili, not the fish, that brings in the crowds at the Happy Halibut!”

After five minutes of brainstorming, we had laughed so hard, our cheeks were cramping and our sides ached. But through the laughter we knew we had hit on something important. We had transformed our original concept from a series of detail-packed sentences into a real story that was engaging and amusing to hear. It actually made you laugh.

We realized that no one would want to do cognitive exercises that were boring and repetitive. People seeking cognitive exercise simply aren’t zombies! In reality, if we wanted people to use Dakim BrainFitness, the “secret sauce” was FUN!

This was a major “eureka moment” that changed the history of Dakim forever.

Today, Dakim BrainFitness comprises nearly a hundred different game formats, with thousands of variations on those formats, along with new games being added almost daily. I can honestly say with pride that there isn’t a single activity that isn’t really fun to do. On behalf of the thousands of enthusiastic users of Dakim BrainFitness, kudos to Rob and his content team!

Jack’s message was simple: Living a healthy lifestyle and exercising is not only good for you, it’s fun. He made spreading this message his joyous mission for more than eight decades.

While best-known as the godfather of the physical fitness movement, Jack was an equally enthusiastic proponent of brain fitness. He saw physical and brain fitness as essential tools for getting through daily life, and both as a matter of “use it or lose it.” He always did everything he could to help others get the most out of life by following that philosophy.

Jack LaLanne, a true original (2009)

We at Dakim, both young and not-so-young, were so honored to be associated with Jack these last few years as he brought his special brand of inspiration to the brain fitness movement. Our hearts go out to Elaine, his wife of 51 years, who has lost her loving partner in life. As for the rest of us, we have lost a great mentor and very dear friend.

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There are many videos available on the Internet from Jack’s fitness show, but we favored sharing this one with our blog-followers: Jack on simply being happy. Enjoy!

I had no source of income as I continued developing the concept and initial content (cognitive exercises) for this computer-based cognitive activities device. I’d spent months testing and refining the cognitive exercises in storyboard form with seniors who generously gave of their time. I’d partnered with Jerry Robinson to write the software to build a prototype (on an eMac computer converted to a touch-screen interface)… and finally our prototype was ready to test.

I had arranged with an amazing senior center in Van Nuys, Calif., called OneGeneration, to do my first test with the computer prototype. For better or worse, the first person who was going to “play” the Dakim Activity Center was an individual with mild Alzheimer’s disease. To start the program then, as today, the user had to touch an on-screen button.

The conventional wisdom was that this presumably simple act might present problems for someone with dementia. The conventional wisdom further said that to communicate with someone with dementia, you had to get their attention, stay directly in their view, and speak directly to them. A computer could do none of these things.

Would this man, who had never used a computer before, even realize he was sitting in front of one? Would he be able to use a touch-screen interface? Would he respond to directions and feedback coming from the computer’s speakers or headphones? Would he be able…not to mention interested and encouraged enough…to complete the session?

In short, everything was on the line.

As the man looked at the screen, my heart was in my throat. Slowly he extended his hand. Was he reaching to touch the screen, or just reaching out? To me, his actions seemed to be in ultra-slow motion. The pounding of my heart was the only sound I could hear. Then, he touched the start button and began his session.

I was instantly flooded with relief, joy, and the excitement of potential all at once. I had a smile that extended from ear to ear. And to my surprise, the smiles on the faces of the OneGeneration staff, as they watched their client getting a cognitive stimulation session—on a computer—that he actually enjoyed, were wider than mine!

At that moment, I knew the potential to help a lot of people benefit from rigorous cognitive stimulation was right before me.

In my next blog, I’ll tell you about the breakthrough in developing our content that has made Dakim BrainFitness a product that not only works but also is one that people love to use.

The Elasticity of Memory II: Honesty in Dealing With An Alzheimer’s Patient

My father says my mother hallucinates, but I don’t think “hallucinate” is the right word. It’s not as if you’re with her and she sees people who aren’t there. Instead, she remembers things—sometimes very vividly—that never happened.

At first, these were visits from people she knew—her father, her sister Greta, old friends. It was easy for us to tell these things weren’t real—her father passed away 20 years ago, her sister hasn’t left Denmark in 30 years, and her friends weren’t visiting either.

She’s come to accept that these things aren’t happening—though initially she had to call Denmark before she believed us that Greta wasn’t here in the States. More recently, she remembers things that are harder for her to verify on her own, so she asks my dad and me about them.

Once she called and asked me if I’d had a bunch of friends over last night. I don’t live with my parents and hadn’t been there the night before, but I had been there for lunch that day. Their next-door neighbors, Daniel and Tatiana, had also come over with their daughter Priscilla to visit for a while. Once I was sure Mom wasn’t talking about Priscilla and her parents, I knew this was another “dream memory,” and told Mom so.

“Well,” she replied, “your dad says the same thing, so I guess they weren’t really here.”

Later I asked her about these memories. “Today we talked about Daniel and Tatiana and Priscilla coming over yesterday, which did happen, and about a bunch of my friends coming over last night, which didn’t happen. Is there any difference between those two memories for you?”

“Oh, yes!” my mom replied. “They’re very different. When your friends come over, it’s like a Swedish movie. It’s just dozens of young girls flitting around in white dresses. They’re very nice and don’t cause any problems. They’re just always moving around the house. I just assumed they were your friends.”

In some ways my mother is in the most difficult part of dementia. She’s losing her reality—her ability to tell fantasy and imagination from reality—but she’s still alert and thoughtful enough to know it’s happening. At first this hit her very, very hard.

The hardest hit was also one of the most mundane. We were in the doctor’s office, and she needed to give a urine sample. She had gone to the restroom before we left the house, so the medical assistant gave her a paper cup full of water, intending for her to drink it. My mom brought the cup back—empty—and somehow that got transmuted in her mind to her giving a urine sample. And no matter how much my father and I tried to convince her that she hadn’t given a sample yet, she stood firm. It wasn’t until all the nurses in the office and the doctor confirmed that she hadn’t given a sample that she realized she was mistaken.

This simple error shook her much more than thinking her dead father was visiting. She could no longer trust the evidence of her eyes and ears and mind.

All of this raises thorny questions about the nature of reality that I don’t feel qualified to talk about. Our eyes and ears and other senses are the instruments we use to model the world in our own heads. But the brain is an instrument as well, and when it’s not working correctly, it doesn’t matter how sharp your vision or how sensitive your hearing. When the instruments we use are imperfect, so is our perception of our world.

I’ve discovered that this concept completely unnerves me. Not only because of the obvious impact on my mother, but also because I’ve become aware of my attachment to my own rationality and ability to perceive the world accurately. I’m a student of Buddhism, and I’ve found the knowledge that all things end to be a comfort during such difficult times. I’ve come to accept the inevitability of death—but this is rubbing my face in the likelihood of my own loss of awareness before death. It will take much more meditation before I come to accept that.

My mother grew up in a small farming village in Jutland, Denmark. It’s the kind of place that people in Copenhagen make fun of, filled with people that city-dwellers think of as ignoramuses with funny accents. She went from there to an elite boarding school near the capital, and eventually from there to America, where she met my father, earned a master’s degree, taught in high schools and colleges, and had a son.

A voracious reader of newspapers, news magazines, and books, she’s always been proud of her academic ability. Lately, she’s come to terms, at least a lot more, with the fact that she can’t trust her own brain or her own perceptions. It no longer seems to shake her so deeply when she finds her memory at odds with reality. She even jokes about it now—when I offered to take her to the public library, she said there’s no need: “The best part of Alzheimer’s is that you can read the same book over and over again and not mind.”

She sometimes gets frustrated—more so on good days than bad—for example, when she asks me five times in ten minutes if I’d like steak for dinner (I’m a vegetarian) and then realizes how many times she’s asked the question.

On bad days, though, she doesn’t realize it—she just asks again and again—and this actually seems easier for her. Alzheimer’s is a disease that may actually get easier for her as it progresses.

I’m very thankful for one thing: The Alzheimer’s doesn’t seem to be changing the basic nature of my mother. She’s losing her reality, but she’s not losing herself. She actually seems to be getting sweeter, more gentle, more loving, and more able to express that love as the disease progresses. Even her fantastical memories are of people she loves coming to visit, or of friendly young people filling the house.

At least for now, she’s still the mother I love and the mother who loves me. And I’m going to treasure that for as long as it lasts.

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ABOUT THE AUTHOR: John Schofield is the director of information technology at Dakim, Inc., and, as such, is a key leader in Dakim’s development of the system and software versions of Dakim BrainFitness. In this blog, he shares his only-child experiences as the sole caregiver of aging parents living life with neurological disease. A version of this blog entry was originally published July 19, 2010, as an essay on John’s personal website.

The fundamental problem was that there were just nine doors with nine pictures and sounds. After doing all nine exercises once, my dad and his fellow residents were bound to find it less stimulating and a lot less fun each subsequent time they played. I guess I shoulda thunk of that before I invented it!

To add variety, or even to meet the needs of individuals with differing levels of mental acuity, a staff member would have to be on hand to rotate the transparencies and switch out the sound chip. In the world of senior living communities where the staff is already over-burdened and stretched thin, this would never work.

So I put my thinking cap back on. The answer came in loud and clear: I needed to abandon my months of hard work on the Activity Center and take an entirely different tack.

All of my thinking up to that point had been about analog devices. To put it simply, I had been pursuing a solution in a very mechanical—and old school—way. When I stopped thinking about how to make changing transparencies and sound cards easier, and instead conceptualized the problem more abstractly, it became clear that the solution I sought was digital—a computer.

A computer could present an infinite variety of stimulus activities at an infinite variety of difficulty levels, and best of all it could do it conveniently and cost-effectively.

With a lot of paper, a lot of pencils, and a LOT of coffee, I began designing exercises and creating general specifications for a digital cognitive activity system. One day, after working on this for several months, my wife, Kim, said to me, “We need to build a prototype of this idea to find out if it has any merit.”

They say if you have a choice between being good and lucky—take lucky! But what if you can have both…?

Jerry Robinson, Co-Founder & CTO/CFO, Dakim, Inc.

My quest for a prototype took me to the one and only person I knew who was a hands-down expert in computers: Jerry Robinson, owner, operator, and chief honcho of JPR Engineering. I had been a client of JPR Engineering for six or seven years through my ad agency, Michel/Russo. Jerry’s team had configured the software and hardware for all our digital workstations.

I brought my wooden, analog Activity Center to Jerry’s office and laid out my vision for a digital activity system. I explained that it needed to have a touch screen, be smart enough to adjust the level of challenge on its own, and have a vast library of exercises. At the end of the meeting, I asked Jerry if he could build a prototype to meet those specifications. He said he could and that he’d call me the next day with a bid.

When Jerry called, he detailed, as I expected, the costs and process of building a prototype. What I didn’t expect was that he had a proposal in mind as well. In thinking about this project, he could already see the potential of such a project becoming a viable product. And the more he thought about such a product, the more he believed it could have a significant and positive impact on the lives of thousands, if not millions, of seniors desiring to maintain their cognitive health. In short, he wanted to be involved in the project in a more meaningful way than just building a prototype.

I took all of 24 hours to think over this proposal. Let’s see…a smart, motivated computer expert who I was comfortable working with already and was not just willing but excited to join me in tilting at the windmills of brain fitness. Yup, I called Jerry the next day and offered a partnership. Happily, Jerry agreed, and the direction of Dakim changed forever…and in more ways than I possibly could have imagined!

You see, one of the things I knew for sure at that time was that Jerry was one of the smartest (a bona fide genius), most creative, and hard-working people I had ever met. But what I didn’t know then that I sure know now (and here’s where being lucky comes in) was that Jerry was and is one of a small handful of experts in the world in the fields of automated workflow production software and digital asset management and utilization.

It would be this expertise that would enable Dakim to produce a broader variety and higher volume (by a mile!) of original, richly produced brain games that were—and are—unlike any other product released by the competitors we would soon meet down the road. And so we built our first prototype on an eMac: Some 25 original exercises presented at three different levels of difficulty.

Well, at that point I was pretty convinced that, as Sister Maria sings in The Sound of Music, “Somewhere in my youth or childhood, I must have done something good!”

In my next blog, I’ll describe our early adventures in usability testing with seniors. Let’s just say that before the very first test, my heart was pounding out of my chest as the computer asked the test subject, who had never used a computer, to touch the screen to get started!

Early on, I noticed that one aspect of my dad’s particular progression of Alzheimer’s was that, in addition to losing short-term memory, he was also forgetting how to do simple things; the kinds of things that involved both cognition and hand-eye coordination. For example, opening a lock with a key, or undoing a latch on a door—things he had never had to think about before—now proved difficult.

My earliest cognitive stimulation invention (dubbed “The Board”!)

So the first (very crude) device I invented was essentially a wooden board on which there were a series of doors that required the user to open and close common household locks and latches. Behind each of these doors, I put pictures of objects and/or pictures of our family or famous people (past and present). When my dad opened one of the doors, I would ask him to describe what he saw, and then we would talk about it.

This device stimulated my dad, and I could see the benefit he was gaining from it. Another happy surprise was that the device was so popular with the other residents, I ended up building several more so that others could use them as well. In turn, this got me thinking about what would add to and enrich the experience even more. What else? Light and sound!

Dad working with the 9-window version of my invention (dubbed “The Box”!)

So I built a larger version—a tabletop cabinet with a series of nine doors. As before, each door locked using a different common household latch. Behind each door was a dark screen, along with four buttons—two for sound, and two for picture. When my dad pushed the two sound buttons at the same time, he’d hear a sound—say, the roar of a lion. I would then ask him what made that sound. Whether he got the answer right or not, he could push the two picture buttons at the same time to get a reward (or to learn the answer). A transparency of a picture—such as a lion—would be illuminated in the window. The picture, and the exercise as a whole, acted as a springboard into conversation. In this case, we talked about lions, Africa, zoos—whatever seemed related.

Now, although my dad was an inventor, I myself had never done much in the way of tinkering with electronics. To make this box work, I had to figure out how to wire the sound and hook up some lights to illuminate the image transparencies.

For the sounds, my grandson Jack “donated” one of his toys called Animal Train…which I promptly took apart! This toy used a sound chip to play the voices of eight animals and a train—the exact kinds of sound I was looking for. (Thanks, Jack!) To illuminate the picture transparencies, I used a low-voltage Malibu Garden Light set.

Up to this point, I had seen the activity directors at my dad’s residence often use children’s toys or educational supplies with dementia patients. They had the right idea, and these were pretty much the only kinds of devices that were available at the time to meet their needs, but I felt that while their intentions were good, the use of stimulus intended for children was still demeaning to adults. To remedy this, I made a point of ensuring that everything about the look and feel of this device (and the many versions to come) was adult in its orientation, including the choice of images, which were largely photos instead of cartoons.

Dad and great-grandson Jack, working on a modern art sculpture together

But wait! There’s more!

A second stimulation device I made was inspired by how my dad had always liked to build things and do things with his hands. My idea was to create a grown-up version of the Erector Set (a wonderful construction toy from the 1940s and ’50s that still sells today). This took me to Home Depot, where I purchased a bunch of metal brackets, nuts, bolts, and washers.

The “Modern Art Sculpture Kit” was a hit! The complete experience included not only the construction phase but also taking the sculptures apart and sorting and putting away the components in designated storage containers. I eventually purchased four times the components I had originally so that four residents could sit around a table and construct their sculptures. All I had to do to get the residents started was to hand them some parts—they did the rest. They even connected their sculptures to each other’s by creating bridges between them. All in all, the residents were kept engaged, stimulated, and entertained—on their own—for about an hour at a time (which, in community residence time, is pretty significant!).

One of the women in residence at my dad’s senior living community, working with the Modern Art Sculpture Kit

On a side note, the sculpture kit also revealed an interesting reality. In working to understand my dad’s cognitive condition, I had previously learned that individuals experiencing dementia gradually lose self-awareness. As part of this process, they also lose the gender biases that have been drilled into all of us all of our lives. This was actually evidenced by the fact that the women residents in the assisted living part of the community took to building these nuts ‘n’ bolts sculptures with as much enthusiasm as the men!

Well, that’s enough for now! In my next blog, I’ll tell you how I founded Dakim, and how we made the transition to the digital age.

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ABOUT THE AUTHOR: As co-founder and CEO of Dakim, Inc., Dan Michel is the visionary behind Dakim BrainFitness. This blog chronicles his journey through being a caregiver of a parent with Alzheimer’s disease to establishing Dakim BrainFitness as a leading tool for seniors in the fight for brain fitness. He writes from the “Corner Office,” which he shares with Dakim’s comptroller!

I don’t know about you, but I’m at a point where time goes by, perhaps, too fast. I do remember a time in my life, though, when I had the opportunity to slow things down—it was when my brother hired me to nanny his sons, my nephews. I was now on “kid time.” I learned quickly that as hard as I tried to fill my nephews’ time with exciting, fun (and often expensive!) things to do, the best times we ever had together were what we called “dumbing around.”

Sitting in the house watching workers reroofing the neighbor’s house; taking hikes where we never got very far because we sat down to watch a train of ants going about their business; my poor nephews patiently trying to teach me how to play video games(!); working on projects for school, not at the last minute but with time to actually enjoy the process; carefully shopping for just the right toys and gifts for charity at Christmastime; making beds with clean sheets and immediately flopping down on their fragrant warmth just to stare at the ceiling and talk. And for me, it was the first time in a great while that I actually noticed the early signs of each changing season.

The time I spent with my young nephews gave me a break from the rat race and reacquainted me with a perspective on living that I had not had since childhood. Unfortunately, all good things usually come to an end, and after a few years enjoying this welcome change of pace, the nephs were old enough to care for themselves. So, I re-entered the working world and soon had my target heart rate and blood pressure back up to society’s contraindicated norms! And then, I came to work at Dakim.

One happy aspect of my job is “riding along” with seniors who come into our offices to play Dakim BrainFitness. Observing and interacting with them, I learn how we can improve the “playability,” effectiveness, and overall enjoyment of our games. But this part of my job was not initially so happy.

Working with seniors brings with it yet another change of pace. Unfortunately, this one is the kind of pace that most of us are raised to associate less with living and more with the end of life. And it didn’t help me, either, that when I started at Dakim, I was on the steepest slippery slope of 45, careening toward 50!

For me, being around seniors had always been just mildly uncomfortable. I was comfortable with that discomfort because it seems natural to avoid reminders of our fragility and vulnerability—after all, they represent and sometimes even foreshadow our own unavoidable futures. What surprised me, though, was that in my recent years, as I had gotten so much closer to my future, I had become somewhat unnerved in the presence of aging.

Today, I consider myself a “recovering old-ageist.” When I managed to set aside my fears (in short spurts, at first!), I realized that this new pace I experience working with our players is actually very familiar—in fact, it’s just an adult version of “kid time.” And in the same way as before, I have come to relish my sessions with our visiting players as a welcome break from the rat race—a chance simply to be in the world, enjoying how good my cup of coffee tastes today and noticing what looks like the first signs of a new season.

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ABOUT THE AUTHOR: Brenda Matteson is the editorial manager at Dakim. Her position entails envisioning, editing, and writing new games for Dakim BrainFitness. She has been with Dakim since October 2006, where she came as an already well-established editor and content creator for various forms of media for “end users” (a fancy technology industry term for “all us regular folks”!).

For a man in his 80s, my dad was generally a healthy guy—with the one key exception being his Alzheimer’s—therefore my concerns for his quality of life from then on centered almost solely on his cognitive condition. I was not only acutely aware of his condition but also on what his caregivers could do for him.

My dad’s senior living community was very nice, and the staff who worked there seemed to really care about the residents. But like most residences of this kind, the staff were stretched thin and already stressed out by their physically and emotionally demanding responsibilities. Above all, it seemed to me then, as it does even now after ten years of experience, that most senior living communities view their role as one of taking care of people—helping them live safely and comfortably—not helping them live the fullest, richest lives they can.

Dad and me at the bowling alley, celebrating his latest roll—a strike!

Providing one-on-one, personalized cognitive stimulation activities is also very expensive. The community offered a variety of group activities that they hoped would provide some level of socialization and cognitive stimulation—bingo, movies, trivia discussions, and reading from the daily newspapers. I noticed, though, that an almost exclusive schedule of group activities often left my Dad—like many other residents—only marginally involved, and sometimes not engaged at all. It soon became apparent that if he was going to get individualized cognitive stimulation, I was going
to have to think of something.

Now, the community in which my dad was living was in the Chicago area. At that time, I lived, as I do now, in southern California. I knew that being my dad’s primary caregiver meant that I would need to be physically present on a regular basis in order to participate meaningfully in his care. So, one week a month, I would fly to Chicago early on Monday morning and return to California the following Sunday evening. I did this for about a year and a half.

Every day I was in Chicago, I was at the community with my dad from the moment I woke him up in the morning to when I put him to bed at night. We spent every waking hour together. Now, I loved my father, but even when you love someone very, very much, if you spend every waking hour together, you eventually run out of things to talk about. And we did.

Dad re-engaged in painting, something he’d enjoyed his whole life

In trying to fill our time together, I sought out activities we could do together. My dad was an artist, so one of the first things I got him was a painting set. We began painting. Almost immediately I noticed something that was at the same time miraculous and completely understandable. As my dad’s mind was engaged and stimulated by painting, his mood, his focus, attention, and cognitive connection improved.

Heartened by what I observed, I tried to find other stimulating activities we could do together. I started reading to him from books and magazines that I thought would interest him. After finishing an article or passage from a book, we would discuss what we had read together. And from this I learned two things: First, that like the painting, the stimulation of listening and discussion worked; and second, that my dad’s tastes and interests were specific…to him! If he didn’t like a particular activity, he told me so: “Kiddo, I just don’t want to do this.” And that was that.

Although I didn’t know it at the time, in these few events, and in watching my dad engaging in life again, Dakim had been born.

In my next blog, I’ll describe how I invented my first cognitive stimulation devices.

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ABOUT THE AUTHOR: As co-founder and CEO of Dakim, Inc., Dan Michel is the visionary behind Dakim BrainFitness. This blog chronicles his journey through being a caregiver of a parent with Alzheimer’s disease to establishing Dakim BrainFitness as a leading tool for seniors in the fight for brain fitness. He writes from the “Corner Office,” which he shares with Dakim’s comptroller!

Up to that point, I was used to the “9th” years always being the hardest. Being 29 meant saying farewell to my giddy 20s where you’re old enough to enjoy the benefits of being an adult but young enough to feel immortal and infallible—no need for hitting the gym (except to meet people) or watching what you eat; a time to say whatever you think and, in general, be fearless.

At 39, I noticed a considerable increase in gray hairs, which led to an obligatory investment in covering them up! The gym was no longer optional or a place where I felt in my element. The salt and fat I’d been eating for decades was starting to show up in force on my medical chart; although I did manage to console myself with the fact that however frequently this was mentioned by my doctor, it was generally in terms of a “borderline” case! And instead of sweating over the unavoidable but good-natured “over-the-hill” party pranks that were bound to come my way (particularly since I had dished out my own share of them to others who had gone over that hill before me!), I embraced them—throwing myself a 40th birthday party and encouraging the guests to hit me with their best shot.

But the latest one, 49, being the ending of half a century, was not so easy to soft-peddle to myself. First off, I think it was simply a day I never really thought would come. I did ride out that year as I had the other “9ths” of my past: With the confidence that each time I had turned the big “0” year, I’d always looked back and said, “What was I so worried about?” However, for me, the truth about turning 50 is that it was the first time that the idea of aging hit me like a ton of bricks (most likely because it was no longer just an idea!).

And of course I responded accordingly! Like a drowning woman grasping for a life preserver, I adopted the well-promoted mantra: “50 is the new 40!” I repeated it, however, with ever-decreasing enthusiasm after I did the math and realized that, with my family’s genes, I’d more likely live to 90 than 100, and therefore I was definitely beyond middle age!

Memories of my parents at 50 flooded my thoughts. What kinds of things were these 50-year-olds still physically able to do at this age? Did I ever see my mother run—even short distances—after she turned 50? How old was my dad when he drove off one morning with my parents’ entire card file on top of the car, scattering a lifetime’s worth of business and Christmas card contacts to the four winds?

I didn’t realize it at the time, but I had moved into a front-row seat on aging!

One thing I cannot deny at 50-something is my low-simmering fear of losing my edge and my relevance, not only in the world but possibly even in my own family. Images come to mind of the native grandma of the Arctic being put out on an ice floe because she couldn’t keep up with the tribe anymore—which in this day and age could mean something as simple as not knowing who George Clooney is!

Don’t get me wrong, I know my family and friends love me very much—I am confident that even when we don’t see each other, they think of me as often as I think of them. The fact remains, however, that “keeping up with the tribe”—that is, getting every nuance of every joke; being able to express my thoughts and feelings (without an interpreter!); remaining valuable in my work so I can be employable and employed for as long as I need to be; and remembering all the extraordinary people, places, and moments I’ve experienced throughout my life—is what I value most about myself, and I want to continue to be that person. So, where do I go from here?

Well, life’s a journey, right? In my future blog postings, I’m going to share with you my journey in brain fitness—not only my personal experiences and epiphanies about my own aging brain, but also what I’m learning from working in this field and spending time with some remarkable people I now consider my mentors. Stay tuned!

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ABOUT THE AUTHOR: Brenda Matteson is the editorial manager at Dakim. Her position entails envisioning, editing, and writing new games for Dakim BrainFitness. She has been with Dakim since October 2006, where she came as an already well-established editor and content creator for various forms of media for “end users” (a fancy technology industry term for “all us regular folks”!).

Let’s start with a little background. I’m a Boomer. I was born in Chicago in 1946. My dad was an inventor (he invented the valve on whip cream cans), and my mother was a homemaker and a volunteer. I had an older brother, Arthur, who was an outstanding oncological surgeon until he died of cancer at age 59.

At Yosemite and still crazy about each other after all these years!

I fell in love with my wife, Kim, when we were both in high school, and we’ve been married for 42 years. We have two daughters and three grandchildren. I’m the luckiest guy on Earth.

My undergraduate degree is in archeology and anthropology, and my graduate degree is in journalism. For most of my career I worked in advertising, marketing, and the entertainment industry (I am a member of the Academy of Motion Picture Arts and Sciences). I have loved every minute. I worked with some really talented people and solved some very challenging business problems. I was busy focusing on my career and my family when life threw me a curve ball.

Dad as a young man, c. 1934

About 20 years ago, my dad was diagnosed with Alzheimer’s disease. Because my dad’s second wife was unable to care for him, he moved into an assisted living community (in the Chicago area), and I became responsible for his health care.

On the first day after he moved in, I took him out for lunch at a local restaurant. Midway through our lunch, my dad said he didn’t feel good. He said he needed to go to the bathroom. By the time we made our way to the men’s room, he had explosive diarrhea in his pants. As the smell filled my nostrils, my first reaction was “Uh oh, this isn’t good!” And then I asked myself, “Who’s going to clean this up?” After what seemed like a lifetime, I figured out who was going to clean this up: me.

I finally got my father to the men’s room and got him out of his clothes. I’ll spare you the worst of the details, but I threw away his underwear, and wiped him as clean as I could with wet paper towels. I was gagging and fussing the entire time. Somehow, some way, in the midst of what I thought at the time was the most unpleasant experience of my life, I had an epiphany—this is what love is all about—being of service to someone else, expecting nothing in return.

Dad and granddaughter Katie on vacation

This realization changed my life and set me on a new path that I’m still traveling today. And looking back, I can now see that I’ve been presented with an important opportunity—to help my generation as well as my parents’ generation fight the threat of dementia. All this comes as a direct result of my dad’s struggle with Alzheimer’s. So in a very real way, my dad’s disease was his final gift to me.

In my next blog, I’ll share what I learned about brain health working with my dad and other residents at his community that led me directly to the invention of Dakim BrainFitness.

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ABOUT THE AUTHOR: As co-founder and CEO of Dakim, Inc., Dan Michel is the visionary behind Dakim BrainFitness. This blog chronicles his journey through being a caregiver of a parent with Alzheimer’s disease to establishing Dakim BrainFitness as a leading tool for seniors in the fight for brain fitness. He writes from the “Corner Office,” which he shares with Dakim’s comptroller!

Dementia is the big umbrella name for diseases that are neurological and affect our memories and other cognitive abilities. Alzheimer’s is the largest sub-category of dementia followed by vascular dementia.

What is vascular dementia?

Vascular dementia is caused when the blood supply to the brain is blocked. It affects a person’s memory and cognitive functioning, which includes the ability to reason, recognize things, and make sound judgment. It tends to affect people between the ages of 60 and 75. It affects more men than women and appears to be related to heart disease and—particularly—high blood pressure. It can come on gradually or suddenly.

*Vascular Dementia Symptoms Include:

• Memory problems; forgetfulness
• Dizziness
• Leg or arm weakness
• Lack of concentration
• Moving with rapid, shuffling steps
• Loss of bladder or bowel control

Vascular Dementia Can Affect:

• Slurred speech
• Language problems
• Abnormal behavior
• Wandering or getting lost in familiar surroundings
• Laughing or crying inappropriately
• Difficulty following instructions
• Problems handling money

There is a bit of good news: by doing all you can to prevent heart disease and high blood pressure, you help to prevent vascular dementia. Daily exercise, eating healthy, taking medications prescribed for your conditions, and keeping your brain sharp and engaged are the best ways to prevent vascular dementia and heart disease.

Know the signs of a stroke:

• Brief episodes of numbness
• Temporary loss of vision, speech, or strength may indicate a mini-stroke (TIA) or a stroke.

If you experience these symptoms, call 911 immediately. There are medications that, when taken early, can help to prevent or deter the effects of a stroke.

The better we educate ourselves, the more we empower ourselves. Share this information with family and friends. Vascular dementia is one disease we can help to prevent.

*from Helpguide.org

1. Grab a handful of almonds and dried berries – look for unsweetened dried blueberries, cranberries, and strawberries in your grocery store. Easy to carry in a ziplock bag, the berries add antioxidents and satisfy your sweet tooth, while almonds are rich in Omega-3′s, give you a crunch and a feeling of fullness from their healthy fats. For even more variety, add walnuts, raisins, pumpkin and sunflower seeds – just try and choose unsalted, unsweetened varieties!

2. Try smoked wild salmon, or foil pouches of salmon and albacore tuna. Again, it’s easy to carry with you, provides you with a mid-afternoon protein boost, and plenty of omega oils for an extra brain boost.

3. If you’re more adventurous with fish, try canned sardines, herring and kippers. Opt for lower salt versions packed in water.

4. If your sweet tooth needs a fix, try the darkest chocolate you can find. Yes, chocolate can actually be *good* for your brain if you eat it in moderation, keep the sugar content down and the cocoa content up.

5. Experiment with teas. Herbal teas come in a wide variety of types and flavors – green teas are a great choice, and have been the focus of many brain-related studies. Other herbal teas are being investigated for stress and mood related impact… and simply the ritual can be calming and beneficial.

With a bit of creative thinking, snacks can do far more good than harm when it comes to cognitive health. And as a bonus? Every time you stretch your synapses to think up new snacks, you’re exercising your brain.

What’s your favorite brain healthy snack? Have an idea or recipe to share?

Every family caregiver with a “wanderer” knows what a challenge this can be. It’s like having a toddler (or a teenager) you can’t turn your back on. You panic and think of every awful, terrible scenario the second you can’t find them.

5 Tips to Keep Our Elders Safe from Wandering:

• “Elder Proof” your house just as you would for a toddler. Move dangerous chemicals and medication out of reach, make sure your bath water isn’t too hot, and take extra caution when you’re cooking. Be sure to keep stairs clear (or consider a gate). Even consider keeping your keys put away and take precaution if you have a pool or live near a body of water.
• Get an alarm system on your house and doors. It’ll beep any time there’s activity—because wandering happens all hours of the day and night, even when you are home. Also, get a dead bolt lock (great for doors you don’t use frequently) and keep the key on your keychain—hooked to your person or put up safe.
• Get your loved one an ID bracelet or other forms of identification. Be sure to have a photo of how they look now.
• Check to see if your state has the Silver Alert system. It broadcasts a missing elder alert to the news and on the highways.
• Be friendly with your neighbors, and ask them to help “keep an eye” out. Nothing is more helpful than being surrounded with people who care. If you need to go off, ask a neighbor, church volunteer, or community volunteer to come and sit with your loved one. If they’ve wandered once, they’ll do it again.

These simple tips can help keep your loved one safe. And in the end, gadgets alone don’t keep our elders safe—having people who care and who check on them often is crucial to their safety.

Why is it so unique? Building your personal family history starts with your own memories. Recording what you know about your family strengthens those memories, and every time you go back over that information, the neural network that supports it becomes stronger.

At the same time that you’re reinforcing old memories, you’re laying down new memories – new information that you’ll discover about family members, history, geography.

Once you’ve gone beyond the known history and start filling the blanks, the family tree becomes a puzzle.  You’ll need to guess at names, spellings, misspellings, and name changes.  You may need to try and decipher which Ruth Justin is your great great grandmother, and which one is your great aunt.   You’ll learn little bits of history and geography as you go, and find yourself imagining what your ancestors looked like, how they lived.

Keeping track of all the begats, birth dates, and knowing which scraps of information go where? It’s a pretty good intellectual workout.!  Even with modern genealogical software and the extensive online databases, tracing your family is a complicated, mentally challenging process.

Although much of the work can be done online, before long, you’ll likely find yourself wanting to visit the areas your family lived in.  You may want information directly from court houses and libraries, you may need to visit cemeteries, or you might need to drop in on distant relatives to ask questions and get copies of documents and photos.

The whole process is quite the brain workout. You’ll reinforce old memories, build new ones. You’ll learn to use new research tools, software, develop new organizational skills.  Once you start contacting distant family members, it becomes a social outlet (also good for the brain) and travel to new areas?  Exposure to different environments is connected to keeping a sharp and active mind.

And it’s never ending – there’s always more to find, new challenges to conquer, more puzzles to work out, different things to learn.  As you move deeper into your history, the difficulty increases, and you’ll find yourself looking into distant lands and times – meeting the requirements of “new and novel” brain exercises.

Have older relatives you’d like to involve, but you don’t think they’ll remember?

The parts of the brain that store our oldest and most important memories are some of the last to be effected by diseases like Alzheimer’s – so even family members who suffer from cognitive difficulties can often contribute to a genealogy project.  Going through old photos can trigger memories, and participating helps to restore a sense of self and purpose, and a challenging project like putting together family information might help even the most senior of brains be a bit more healthy and fit.

I love the idea that remembering who we are, in terms of our family history, can help us strengthen our minds and memories.

What do you think about the idea? Going to give it a whirl? I warn you… it’s addictive!

But actually *being* active?

Sometimes that’s easier said than done, especially as we age. Injury, illness, and just general out-of-shapeness make the idea of going to the gym or jogging around the park out of the question.

So what can we do, when our bodies just can’t drop to the floor and give us 100 push-ups anymore?

We adapt, and find new, gentler ways to keep our bodies moving – ways that don’t involve “pushing past the pain” (as many people were taught to do in their youth) but still keep the blood pumping and oxygen flowing.  You don’t have to be a full-fledged senior athlete in order to get the benefits of exercise!

A few suggestions? Sure thing! But first that standard disclaimer – be sure and check with your doctor before starting any kind of new exercise program.  Really.  We mean it!

Ok, on with the exercise ideas!

1. Walking.

Whether it’s around your neighborhood, in the park, or on a treadmill, walking is just good exercise.  Start slow, with short distances and comfortable speeds, and work your way up.  Walking outdoors, on community tracks or even in malls is popular, and has its benefits… but  home treadmills are good options for many of us, too.

Treadmills don’t provide the varied terrain or environment of “natural” walking, but if you get tired, you can stop just where you are, and there are some pretty cool videos available that allow you to feel like you’re walking through a rainforest or national park!  Check out these, available through Amazon: Scenic walk videos – or if you’re in the mood for a bike trip, there’s a series made for cycling, too! Bike-0-Vision DVDs

2. Balance Balls

Balance balls are sort of like overgrown beach balls, that you sit on.   I know, I know, it seems silly, but it’s actually good exercise.  Just sitting on one for a while works on your balance and helps develop your core muscles.  It’s easy to start even if you’re very out of shape, and as you improve, there are a wide variety of exercise routines built around them, from simple to advanced.

3. Chair Dancing

Dance is great exercise, but not everyone can get up and boogie.  Joints stiffen, hips give out, and sometimes our bodies just don’t let us standup and do the jitterbug anymore.  But that doesn’t mean dancing is out of the question!

Enter chair dancing… dancing in a chair.  You can still move your feet, twist, and shout… you just don’t do it standing up!  For examples, check out these videos (again, from Amazon): Chair Dancing Dvds

In fact, there are a whole series chair aerobics and other exercises.

4. Water Aerobics

Doing your workout in the pool not only cushions the body, keeps weight off your joints and prevents falls, the water actually increases the resistance and gives you a more effective workout! Many senior and community centers, pools and colleges offer these courses, and it’s definitely worth checking into — or if you’re lucky enough to have your own pool, there are water aerobics dvd’s available, too!

These are just a few of the possibilities.

Exercise doesn’t have to mean a workout in the gym.  It can be a walk in the park, a game of golf, or just moving to the music.   All kinds of physical activities can benefit your brain (as well as your overall health).

How ’bout you? Have any creative ways to get active?

The idea behind the film?  Creative workshops, museum trips, and classes that allow hands on artistic expression are being effectively used as therapies for patients with Alzheimer’s and other forms of dementia.    The artistic process taps into parts of the brain largely untouched by  Alzheimer’s,  not only allowing the patients a means of expression, but also forming a bridge of communication with loved ones and caregivers.

As a writer, the idea of losing my words is a frightening one.  But as a visual artist, I also know how powerful images can be when it comes to expressing a thought, a feeling, a moment.  It’s a different process of communication, but it’s still clearly communication — and having that outlet for patients is, I imagine, a welcome relief from the frustration of Alzheimer’s, a frustration that so often finds expression in anger.

As an artist I also know how being able to produce a work of art gives purpose to what I’m feeling. Even the darkest of moments can be captured and given value – and it’s not just value to myself, but to others.  And as recent research has shown, having a sense of purpose is another key in promoting brain health.

So pick up a paint brush, a stick of charcoal, a lump of clay.   Play with found objects, shapes and colors, notes and rhythms.  It can help you now, by exercising your brain and providing you with the language of art.  It can help you later, by slowing and reducing the risks of cognitive decline.  And in the worst case scenario, it will provide you with purpose and a means of communication.

You can pick up a copy of the complete film through Amazon, the ArtistsForAlzheimer’s website, or directly from the filmmakers at French Connection.   Along with the 54 minute film, you’ll find bonus features about organizing outings and creative workshops for patients, how the methods can be used to recreate social bonds, and a variety of other helpful related topics.

If you’ve seen it, let me know what you think in the comments.
And  I owe a big hat tip to Donald for pointing me to this clip
at the Alzheimer’s Reading Room.- Thank you!

It has the power to move us emotionally, and get us moving physically.  Its rhythms can affect our brainwaves.  It stimulates multiple,  diverse areas of the brain, improving connectivity. And when we associate a particular piece of music with our experiences and emotions, it becomes a trigger that can help us to recall those experiences — who hasn’t had heard a familiar song, only to have a long-lost memory come flooding back in full detail?

And now, a group of researchers  at  the University of California believe that they can use the power of music to help Alzheimer’s patients hold onto their memories of their life just a little bit longer.

How does it work?

It turns out that an area of the  brain associated with music is also linked to powerful, vivid memories and emotions.  It also appears to be one of the most immune to the damage of Alzheimer’s.

That means for Alzheimer’s patients, some of their most important and cherished life memories may be among the last to go.

And since each time we recall a memory, it’s strengthened  – patients may be able to not only retrieve those precious memories, but reinforce and preserve them by using “soundtracks” of their lives, a play list of songs that have special significance to them.

While this doesn’t hold the promise of a cure or prevention for Alzheimer’s, it has the potential to comfort and improve the quality of patients lives significantly.   The biggest fear many patients have is of losing the memories of their most precious life moments;  if developing a way to use custom play lists and mp3 players can help them recall and preserve those memories? Music will have given them a marvelous gift indeed.

So, what songs make up *your* life’s soundtrack?
What memories are forever linked to certain music for you?

But I sometimes shy away from writing on the subject here.

Why shy away? I try to base the posts here on science, whenever possible, and there’s just not a lot of research being done on the cognitive impact of finding meaning in life. There’s been research on how a sense of purpose can lead to longer lives, happier lives, better mental and physical health – but little that could directly tie it to brain fitness.

But a new study just came out, specifically addressing the relationship between Alzheimer’s disease, and feeling that our life has meaning and purpose – and they did, indeed, find a positive relationship.

To discover that relationship, Researchers at Rush University Medical Center worked with 900 retirement community residents, none of them showing signs of dementia. Each participant was given a list of questions about much purpose and intention they brought to their life, questions like “I feel good when I think of what I have done in the past and what I hope to do in the future” and “I enjoy making plans for the future and working them to a reality.”

Then the participants were followed for up to 7 years, to assess their cognitive function; 155 of them developed Alzheimer’s disease.

So, what were the results in relation to the sense of purpose?

Those who had a greater sense of purpose in life were more likely to remain clear and sharp minded, with lower risks of both mild cognitive problems, and Alzheimer’s disease. A sense of purpose also seemed to slow the rate of cognitive decline – meaning that even when the participants with a sense of purpose did have problems, the problems developed more slowly.

The researchers aren’t exactly sure why a sense of purpose seems to help the mind stay sharper, but other studies have suggested that a positive, meaningful approach to life seems to affect immune responses, inflammation, cholesterol levels, and even how the body stores fat.

What are the challenges?

Changing our outlook on life is a comparatively simple and risk-free change to make in our lives. That’s not to say it’s always easy – it means fighting sometimes long-held beliefs, treating depression, and being active participants in life. And as our life changes with age and circumstance, our purpose must change, too. That’s not always easy for some of us to accept, but it may be something we need to learn, if we want to lead healthy, long and clear minded lives throughout our years.

You can learn more about the Rush Alzheimer’s Disease Center here: http://www.rush.edu/rumc/page-R12388.html
And if the science interests you, check out more details from the study here:
http://www.medpagetoday.com/Psychiatry/GeneralPsychiatry/18758

But evidence is piling up that naps are not only good for general brain health, but can improve our memory and actually make us smarter. The longer we stay awake, the slower our minds seem to function – and this is true whether we’re pulling all-nighters or just staying awake during a normal working day.

In a new study led by Matthew Walker of UC Berkeley, researchers separated 39 healthy adults into two groups. Both groups were put through a mentally taxing study session at noon, requiring them to connect faces and names. Both groups did about as well on their tasks this first time around.

But at 2pm, one of the groups was sent to take an hour and a half nap, while the other group stayed awake.

At 6pm, all of the participants were put through a new learning session – one on which the ‘nappers’ did better than the non-nappers, and actually improved on their own earlier results.

The results support the idea that sleep helps to move newly formed memories from short to longer term storage, where there’s more room. The lead researcher compared it to having a full email-box that just can’t receive any more mail. But if you move some of that mail to a storage folder, the information flows freely again.

This wasn’t the first study on memory and napping, but it’s significant because it focused on a particular type of sleep – non-REM, a stage where we don’t dream. The researchers plan to do more investigation, to see if the lower amount of sleep that many seniors experience may be related to the failing ability to learn as we age, and hopefully will provide new clues to Alzheimer’s treatment and prevention, as well as general brain fitness in seniors.

Me? I don’t plan to wait for their results. I’m already working to change those views of naps I grew up with. Far from being indulgent or lazy, it seems that mid-afternoon siestas may be more like…. well…. medicine for the memory!

What say you? Have you always seen value in naps, or do you tend to see them as indulgent?

Seniors are in a unique position to educate their families and community on the subject. But since most brain fitness material is aimed at older generations, how do you get the younger ones to sit up and pay attention?

I’ve put together a few ideas that might help; please read on, and see what you think:

1. Be A Role Model: Grandparents and other elders have many roles in the family and community, but one of the most important is in forming a child’s expectations of their future. In the time they spend with you, they’re forming their ideas of what they will be like many years down the road. So make sure that young ones around you have an image of you as an active, interesting person with an ongoing interest in the world, social connections, and a healthy diet, some one who is still smart, and intends tto stay smart! .
2. Talk About It: Get conversations going about how smart the little ones are, and how well they’re doing in school. Talk about how what they eat helps them to be brighter. With older children, explain how new neural pathways are formed. Talk about how being physically active helps the brain grow, how each new thought helps the brain grow. And while it’s ok to mention the future, keep the focus of most discussion on the here & now – let your actions model the future, but talk about how their brain is affected *now*.
3. Brain Foods! Make meal and snack time a brain-challenge, explaining how some foods (like salmon, berries, and nuts) are especially good for the brain. Even young children can be fascinated by how walnuts look like little brains, as does cauliflower and broccoli. Make up clever names for foods and snacks: brain-berry parfaits, synapse salads, and nuts-for-noggins. They don’t need to focus on brain foods, of course – the idea is to just get them to understand that what they eat affects their brain.
4. Not Beauty Sleep, but Brain Sleep: Good sleep habits are crucial for healthy brain function, but many kids and teens try to skimp on sleep. Something as simple as changing the cliche of “getting beauty sleep” to “getting brain sleep” can get the idea across that sleep is important for a bright and healthy brain.
5. Demonstrate An Interest In Learning and make them a part of the process. Take them on field trips, go to museums, participate in community classes on things they’re interested in. And ask them to teach you what they’re learning in school – and let them see you learning, studying too.
6. Family Brain Game Sessions: Yes, the kids will likely beat you horribly at any sort of video game… it’s still fun, challenging and good for all of you! Games don’t need to be marketed as “Brain Games” and in fact, they don’t need to be video or computer games. Just make sure they’re mentally challenging, new to you, and varied – and teach that those elements are important to making a game a “brain game”.
7. Getting Physical: Put a stress on physical activity and exercise, and how it impacts the brain. Go for walks after meals, take breaks from games and study periods for walking around the house, stretching, dancing. And speaking of dancing, it’s a great activity for the generations! Agree to alternate the music you dance to – try songs from the years everyone was born, and let each person pick a favorite song of their own.

If you don’t have grandkids, nieces or nephews to share brain fitness with, consider putting together a program for the local schools, daycare centers or community centers. Look for adopt-a-grandchild programs, or simply offer to watch the neighbor’s children a few days a month.

You won’t just be helping the youngsters with these practices… you’re helping yourself. Sharing the concepts behind brain fitness (finding creative ways to demonstrate them) will cement the ideas in your own mind, as well as challenging you intellectually and giving you yet another reason to cultivate your own healthy habits. And the social factor shouldn’t be minimized — interacting with others is simply good for your brain, and reduces your risk for cognitive problems.

Don’t forget to mention that by doing brain fitness activities with you, your young charges are actually helping you to keep mentally sharp. And if you’re really feeling ambitious, put together a family project of teaching brain fitness to local groups of seniors and kids, creating community of cognitive health!

What do you think? Any more ideas?

Punch in the gut.

I was scared. How do you care for a person with physical and neurological issues? How wild was it going to get? Could I handle it?

I was heartbroken. I thought we had more time. I thought it was hard enough already. I hurt for her, how lost she felt, and how nothing seemed to comfort her.

It made sense. The confusion, agitation, paranoia—the million little things started to add up. We had been dancing around this for months and months.

I knew I had to get educated. I knew I needed a plan. But like most huge things, from the moment I didn’t know to the moment I did, nothing cataclysmic had changed. She was still my mom. I would give her the next dose of meds, make her dinner, and then we’d watch a bit of television.

The changes would come in the next few weeks. I’d go online, make some phone calls, and schedule a doctor’s appointment.

I didn’t know what was up ahead. Not the specifics. I’m glad I didn’t.

Yes, there were rough times and sweet times.

The day I faced Alzheimer’s was in some ways a relief—and a re-committment.

Whatever was to come, we’d face together.

In fact, care home studies have proved that bored elders act out—or worse—zone out. There’s nothing as sad to see as a once-vibrant loved one completely pull in and not respond. Your mom or dad (or spouse) might be fussy and hard to get along with because they’re bored—not ornery. It takes a little work and creativity, but we can help our elders stay vibrant.

Keeping busy is important, but it’s not the magic cure-all. Our elders don’t necessarily want or need as much stimulation as we do, but they do long to feel engaged. Do things together. Enjoy the connection and find things that give you—and your loved one—purpose.

5 Tips to Spark Home Care:

• Make sure that there’s something to look forward to every day: Record a favorite TV show and watch it together while sipping on hot cocoa. Consider getting Netflix so you get lots of good movies right in your mailbox. They have a decent selection of oldies as well.
• Connections: Keep ‘em coming. Plan for an old friend to visit or get involved at your church or a civic organization—and reconnect. Dial the number of a cousin and hand your elder the phone. They might not make the initiative, so you might have to.
• Create a routine you look forward to: Make a monthly trip to the library and another for a pedicure. It’s worth the money and trouble to get out and connect, and it’s better to plan a pleasant outing than to spend all your time at yet another doctor’s visit. Lunch out is cheaper than dinner, so find a place your mom or dad likes to go. Take a ride after you eat. There are parts of your own hometown you haven’t explored.
• Make something together: an indoor garden, a quilt (even if all they can do is pick out the colors), learn your favorite recipes from the master, or refinish a piece of their furniture. They may only be able to keep you company—or boss you around—but the more you invite them to participate, the more they realize you’re not going to let them curl up in a ball and give up.
• Enjoy nature right around you. No matter how much they balk, sunshine and fresh air is good for them—and you. Insist they go outside for at least 20 minutes a day in order to get the recommended dose of Vitamin D. Make a small barrel garden with a tomato plant and flowers (marigolds go well and bugs don’t like them). Do some bird-watching or plant a butterfly bush or red flowers such as canna—hummingbirds love them.

Keeping our brains and bodies in good fitness takes a bit of a nudge as we age, but learning to enjoy life again is worth the effort.

Head injury is the most obvious risk; concussions can have both short and long term affects on cognitive functions like memory and decision making. A knock on the noggin increases the likely hood of developing Alzheimer’s. And even minor brain injuries often affect balance, putting patients at risk of even more falls.

Broken bones put the brain at risk, too; blood clots and strokes are common in people who are temporarily immobilized by many injuries. And immobilization itself isn’t good for the brain, which needs physical activity to stimulate the protection of existing neurons and the production of new brain cells. And serious falls are a common cause for loss of independence in seniors, which in turn causes stress, depression and a sense of isolation, all of which contribute to poor cognitive functions.

Another link between falls and brain health? The more fit your brain is, the less likely you are to fall!

So how can you minimize your risks?

The CDC’s National Center For Injury Prevention And Control offered 4 areas to look at for fall reduction:

1. Engage In Regular Exercise Physical exercise improves your strength, balance and coordination, reducing your falling risk considerably. The weaker you are physically, the less able you are to catch yourself if you trip or lose your balance. And exercise is a big plus when it comes to overall brain fitness, too. Consider exercise programs that work develop balance and coordination: Tai Chi, Yoga, training with light weights are all good choices for reducing the risk of falls.. but as always, check with your doctor before making any changes to your routine, or starting a new program.
2. Fall-Proof Your Home Many falls occur at home, and the risk can be reduced by taking a few precautions. Remove small throw rugs, and use double sided tape on the edges of those you don’t remove. Keep walkways, steps and stairs clear of loose items like shoes, books or papers. Wear quality shoes that support your feet; avoid flip-flops, slippers and shoes with thick soles. Install grab bars and extra lighting in high risk areas like toilets, showers, and staircases. Avoid step-stools, and rearrange cabinets so you won’t need to stand tiptoe to reach things you need.And don’t be ashamed to use a cane or walker for extra balance at home, or when out in public – that extra little support may keep you from taking a frightening fall!
3. Have Your Medications Checked Regularly Many medications (especially in combination) can cause issues with balance, light-headedness, or weakness, increasing your risk of a fall. So ask your doctor or pharmacist to look over the list of everything you take, even occasionally: don’t leave out over-the-counter medicines and any herbal or other supplements.Additionally, keep an eye on your blood pressure, especially if you’re on medication for it. Dosages sometimes need adjusting, and if the amounts aren’t just right, your blood pressure can drop dangerously low, making you dizzy and at risk for a fall.
4. Mind Your Vision!Have your eyes checked regularly; not being able to see the floor clearly can cause you to catch a foot on a rug, step, or small item in your path. Eyeglass prescriptions need changing frequently, or can be damaged by scratches and peeling anti-glare film that obscures vision. And conditions like glaucoma or cataracts can develop so slowly that you don’t notice your decreased vision until you find yourself tripping over items in your way.And consider improving the lighting in your house – nearly everyone needs more light to see clearly as we age. Make sure hallways, bathrooms and pathways through your house are well lit. Consider keeping a small flashlight at your bedside to light your way at night, or use a walker or cane that also has a light on it.

Any other suggestions for reducing the risk of falling?

Please share! Granted, it’s not a “fun” topic, but it is an important one!
Take steps to avoid falls, and your brain will thank you.

Easier said than done.

Alzheimer’s can cause the areas of the brain that house our emotions to go haywire—those feelings of mania, anger, and anxiety are all lit up even where there hasn’t been a trigger event to cause such feelings. Understanding why our spouses or parents are “acting mean” can help us realize that they can’t remember what we said five minutes ago, they can’t necessarily control their unpredictable and unstable emotions, and they can’t always feel love or connection with us. Also know that drug interactions can aggravate behavior and increase feelings of paranoia—so mention any changes to your loved one’s doctor.

I grieved when I lost my mother to Alzheimer’s. I grieved when I finally hit that wall and knew she didn’t know me and didn’t feel anything for me. It felt so cold. So lonely. And yet I had to keep on keeping on, as the saying goes. I had to do intimate things for her—change her clothes, bathe her, brush her hair—and yet to her, I was a “nobody.”

Finally, I turned the corner. I chose to remember for the two of us. Her “mean” behavior didn’t throw me nearly as much. I would be our anchor. I would love when she couldn’t. I would show kindness and patience when she couldn’t.

Yes, there are neurological explanations for Alzheimer’s behavior, but the bottom line is that we—the daughters, sons, spouses, friends, and caregivers—have to dig deep and choose to go on, to love, and to act with maturity and grace—regardless.

And it just might be really good for the brain, at least according to Andrew Newberg, the director of the Center for Spirituality and the Mind at the University of Pennsylvania.

In an essay published last November, Newberg explains that yawning isn’t just a response to being tired or disinterested, but an attempt by the brain to be more alert and focused. Yawning also reduces stress, improves self-awareness, and, curiously, ties strongly into social connections.

Intrigued? Me too!

Turns out that yawning stimulates parts of the brain that deal with social awareness and empathy, which is why yawns are contagious. (In fact, yawns are so contagious and responsive to suggestion that I bet you’ll be yawning by the time you finish reading this post! ) One of the affected areas of the brain is the precuneus, which is believed to be central to our self awareness, ability to reflect, and retrieving our memories.

According to Newberg’s article, it’s also a part of the brain strongly affected by cognitive declines, which suggests that yawning might just exercise it enough to help keep our memories fit and healthy.

How else might yawning benefit brain fitness?

It actually touches on several elements of our 7 keys:

• It’s relaxing, and reduces the effects of stress and anxiety, which take a huge toll on the health of our brain, our memories and general cognitive function.
• Yawning helps to regulate sleep and wake cycles; sleep deprivation is very harmful for the brain.
• It regulates the temperature and metabolism of the brain, increases blood flow, and stimulates a cocktail of bio-chemicals that improve mood, social connection, and empathy.
• And although Newberg doesn’t say so directly, I have to wonder if the social connection in yawning might be related to the importance of social interaction on brain health. Social activities are known to be a factor in preventing/minimizing the effects of age-related cognitive decline and disease.

So Go Ahead.
Yawn.

Now do it again.

And one more time!.

If you don’t feel like yawning, fake it a few times and let the auto-response take over. Pretty soon you’ll be yawning away naturally, and almost certainly feeling the positive effects.

Newberg suggests we yawn often, whether waking up or falling asleep, trying to focus or relax. For more of his suggestions and futher information, check out Dr. Newberg’s essay in the Penn Gazette:

Yawn: It’s one of the best things you can do for your brain

That’s why starting your day is so important. A few minutes of calm thought and preparation can affect every aspect of your day.

Creating Order to Your Caregiving Day:

• Don’t rush out of your bedroom in the morning. Spend a few minutes in prayer, thought, and reflection.
• Don’t allow your feet to hit the floor without noting three things to be grateful for.
• Keep a journal, the Bible, a book of poetry, or other inspirational material next to your bed. Words of encouragement can soothe you in times of worry and grief.
• Use that paper and pen to plan out your day. Your caregiver brain is frazzled, so keep a pen and paper with you at all times. It’s your brain outside your brain—let it keep track of things for you.
• Do some deep breathing and stretches before you turn the bedroom doorknob. Feel your body. Be grateful for every muscle and bone you have.
• Get dressed—shoes and all. It tells the world you mean business. And brush your hair. (I can’t tell you how many days I forgot to do that when I was caring for my mom!)
• Remind yourself that you are choosing to care-give. You believe in it. Choice is power.
• Remember that list in your pocket? You were probably a tad too optimistic. Pick the three most important items (first things first) and make sure those get done early in the day. Even one item checked off is a victory.
• Take care of yourself first. Train your spouse, elder parent, and kids to get up after you—and to know that if they interrupt your first half hour or so, they’re on their own. You’re not on duty yet. (No one gets so much as a nod good morning until I’ve had my coffee, prayer, and journal time.)
• Remember Covey’s other wise words: Think efficiency with things, effectiveness with people. Greet your loved ones in the morning like they matter—because they do. Ask them what their plans are for the day—they might not have thought of a plan yet, so you’re helping them get a jumpstart to their day.
• Get those chores and to-do’s done fast. Zip through that monotonous list and let your day know you mean business. No whining or dragging—just do it. (Nike chose a good slogan!)
• Make sure you’ve got a little fun tucked in every day. If you’re running errands, stop by DQ and get a small-dip cone. If you’re walking the dog, take the ball and let him play (and you, too). If you’re going to the doctor’s office, slip that steamy romance novel into your purse and read a couple of paragraphs before getting your teeth cleaned. Life’s little pleasures make the tough stuff tolerable.

Not every caregiving day is great. You’re not always at your perky best. I do know that when you put first things first—with purpose and passion—that eventually it will become your new norm. You’ll find yourself halfway through your morning and much to your surprise, you’re zipping right along. Habit becomes the backbone of your day and gives you a sense of calm and trust.

The very “first” thing to remember about caregiving is why you’re caregiving in the first place—because someone you love needs you.

When I was caring for my mom, who had Parkinson’s and Alzheimer’s, I felt like I couldn’t do enough, give enough, or fix the pain and loss we all faced. It was too easy to feel like a failure—and the more I gave in to frustration and apathy, the more those feelings grew. I found that the best thing I could do was to prioritize, focus on the little things I could do, and find little solutions along the way.

What’s your biggest caregiving challenge?

Is it getting the doctors to listen to you and give your loved one the meds or treatment they need?

Is it getting along with your elder parent?

Is it dealing with the challenging behaviors of Alzheimer’s?

Is it being there—for your mom, your kids, your husband—and even having a sliver of time left for yourself?

3 Steps to Help You Focus on Solutions:

• List exactly what the problem is and every little part.
• List several possible solutions.
• Break the solution down to small steps.
• Do one step. Pick one that’s doable, that interests you—something you think you have a chance of accomplishing.
• Now, leapfrog over the problem and focus on this one small part of the solution.
• Celebrate your small victory. If you were able to make your situation even the tiniest bit better, you have something to feel good about.

It may not be the ideal solution, and it probably won’t solve the bigger issue, but impact is power. You start to feel hope again. This fuels you to try another small step and another.

For example, my mom was extremely difficult at night. They call it sundowning. It wreaked havoc on me and my family and left me exhausted. Sundowning has so many different components (pacing, agitation, wrecking her room, not sleeping, paranoia, trying to escape, stubbornness, not staying in the bed) that focusing on the problem(s) were too much.

But I did find that my mother was calm in the morning. I started fixing her a hearty breakfast, bathing her, and then napping in the chair beside her as she watched Andy Griffith reruns. She and I would usually nap, and I made sure she was up by noon or 1 p.m. so she would still have a chance of sleeping at night. It wasn’t perfect, but I could catch an hour or so of sleep, which was a godsend. That was only a small part, but it was the only thing that worked at the time. The more sleep I got, the better I felt—and finding one small solution encouraged me to look for more.

It may feel good to gripe about your problems to a girlfriend or your spouse. Venting is cathartic at times, but it’s not as good as making your life—and your loved one’s life—better. By focusing on the solution and breaking it into small, doable steps, you might find you can make a real difference.

On the first day of Brain Fitness
My true love gave to me,
Brain training For neuro-plasticity!

On the second day of Brain Fitness
My true love gave to me,
Two power naps,
And brain training for neuro-plasticity!

On the third day of Brain Fitness
My true love gave to me
Three kinds of berries
Two power naps,
And brain training For neuro-plasticity!

Ok, ok, so you know how the song goes. I won’t torture you any longer than necessary. For more information on any of the “gifts” listed, and how they relate to brain health and fitness for seniors, just click on the associated links. The only one not linked is Day 12 – because I couldn’t find an appropriate article to link to! You can bet I’ll be writing about that one, in the next week or two! Meanwhile, Here’s the final verse:

On the twelfth day of Brain Fitness
My true love gave to me:

12 New Neural Pathways
11 Social Card Games
10 Dark Chocolate Bars
9 Oz of Salmon
8 Hours of Sleeping
7 Cups of Green Tea
6 Bottles of Red Wine
5 Hours of Exercise
4 Walnuts and Almonds
3 Kinds of Berries
2 Power Naps
And Brain Training For Neuro-plasticity!

Have a Happy & Brain Fit Holiday!

During the holidays, depression rates rise significantly, and depression is a major drain on cognitive function. The more blue you feel, the less effective your brain is… and if a seasonal funk becomes longer term, it has serious implications for the health of your brain. Even short term depression can be responsible for problems with memory, concentration, focus and decision making. Long term depression is associated with an actual reduction in brain size, with implications of increased risks for dementia and Alzheimer’s. symptoms.

So what can you do about it?

Be Physically Active: Go for a walk, use a balance ball, attend a water therapy class. Physical activity is one of the simplest and most effective means of warding off depression, and it’s good for your brain, too! .

Watch Your Diet: All of those sugary sweets that make the rounds this time of year are tempting, but they can also cause spikes in your blood sugar… spikes that further affect your mood and energy levels and can cause cognitive issues on their own.

Be Around Others: This can be a lonely time, especially for seniors whose families may be far away. So make an active effort to be around others – attend community and church events, volunteer, offer to keep a neighbor’s pet while they’re away, invite friends to help trim the tree or the mantle or just share a cup of eggnog.

Get Enough Sleep: Extra demands on your time, or changes to your social schedule may cost you some sleep…. work in an extra nap if you can, and if you have a busy day, don’t feel bad about resting the next day.

Limit Your Nostalgia Time: It’s easy to dwell on memories during the Holidays – that’s part of the point of the little rituals, after all. But make sure you don’t get lost in the past, dwelling on old hurts, grief or loss. Instead, focus on the here and now, and the good things that are present.

Put Things In Perspective: Things really, really don’t need to be perfect, or even impressive. Your family and friends really will understand if you don’t bake those cookies, don’t put up lights, or can’t send Christmas cards. It’s more important to keep your heart and mind in the right place, than to try and do everything else “right”.

Get Extra Sunlight: In the Northern Hemisphere (which includes the US, Europe, and most readers of this blog) we get less sunlight during this season – and lower exposure to sunlight means lower levels of Vitamin D and a higher risk of Seasonal Affective Disorder.. a type of depression linked to lower levels of sunlight. So try and spend extra time outdoors (with arms uncovered if its not too cold!) or consider one of the high intensity light boxes used to treat SAD. A bit of extra Vitamin D might be a good idea, too – check with your doctor about the amounts.

Keep An Eye On Your Symptoms: If you feel you might be drifting into depression, it might be worth a trip to the doctor, who can assess whether you may need medication, if you might have an underlying condition, or if something as simple as St John’s Wort might help lift your spirits. If caught early, a simple lifestyle change may help lift your spirits before depression becomes a serious problem. Look for symptoms like insomnia, headaches, lack of energy, loss of appetite, interest in things you ordinarily enjoy – they’re as common as the more typical feelings of sadness we think of as depression.

In summary, try to keep the 7 keys of brain fitness balanced in your life, even during this hectic time of the year.

And if you do feel a bit down during the holidays, try not to be too hard on yourself about it. The season will pass, spring and sunshine will bounce back, and so, most likely, will your mood and mental function!

This divide can continue to grow and cause our care receivers to be unable to share when they have a headache, toothache, back pain, sinus infection, urinary tract infection, pneumonia, arthritis pain, or—even worse—symptoms of cancer, broken bones, or elder abuse.

Here are some “signs” that your loved one may be in pain:

• Anxiety and agitation: UTI’s can cause a sense of heightened awareness—a nervous feeling that’s part pain and part irritation.
• Wincing or tensing when moved: Watch their facial expressions as you lift them on and off the toilet or in and out of bed. Watch their muscles—see if they’re favoring one side or another, or acting protective of one area. Watch their hands or feet—do they curl or spaz when being moved?
• Moaning, yelling, whimpering, swaying, or cradling: Think how you act when you stub your toe or have a toothache. How would you communicate that if you didn’t have words?
• Changes in appetite, sleep, or avoiding certain habitual routines: Just like when we’re in pain, we can’t concentrate. We spend all our energies on our pain, and other normal routines get sidelined.

These are some of the basic pain indicators. They’re what humans tend to do when in pain. As a family member or friend, it’s your job to be their care advocate, to keep the continuity in their care. Even if your loved one is in a care home or has a health aide, don’t expect them to be on top of this. You know their personality and can notice subtle changes. You’re the one who has been in their life the longest. You’re the one they need, the one they’re most likely trying to ask for help.

Do some basic health checks each week. Look for cloudy or odd-smelling urine. Look for dark stool that has changed and might have blood in it. Put on a glove and run your finger through their mouth to check for abscesses or loose teeth. Do a light massage from head to toe, gently pull on their limbs and rotate them, and feel for broken bones, cracked ribs, and a swollen abdomen.

Check for bruises, swollen places, and lumps on the head. Make sure their pupils are the same size. Listen for a bad cough or for rattling in the chest (might be bronchitis, pneumonia, or congestive heart failure). You might want to buy a blood pressure cuff (they’re easy to learn to use), stethoscope, and have a good flashlight available. This can save you exhausting doctor visits and give you an indication as to what’s going on.

Even though your spouse, mom, or dad has Alzheimer’s, they don’t stop being themselves. You’ll still see aspects of their personality, and you know them—you’ll be able to pick up on small cues. Listen to your gut. If you really have a deep gut feeling that something is wrong, it probably is. Don’t rule out elder-abuse. It’s sad, but it happens. Sometimes care assistants are just rough and don’t realize how fragile an elder can be. Others are cruel. If you have doubts, install a granny cam and stop by often.

We have to be sharp and aware of what’s going on. Even though we’re exhausted and have too much to do, this isn’t an area we can slack on. Our loved ones needs us. And if you find something now that you’ve overlooked, don’t beat yourself up. You’ve been thrown into the deep end of the caregiving pool and sometimes it’s all you can do to keep from going under.

Guilt paralyzes and you don’t have time for inaction.

Now you know. Now you’re taking action.

The meaning of “Neuro” is pretty easy, it means it has to do with the nervous system – and in this case, specifically the brain. And in this case, “plasticity” doesn’t refer to a brain wrapped in Saranwrap, but rather to the properties of plastic – something that is moldable, changeable, flexible.

So neuroplasticity means the brain is not concrete and fixed, but flexible and changing. And although the idea was suggested over a hundred years ago, it’s only recently that it’s been taken seriously by the scientific community. Numerous tests and studies have demonstrated that adult brains continue to produce new brain cells and connections throughout life, turning a lot of assumptions about how the brain works upside down.

But what’s really interesting about neuroplasticity is that the brain seems to change itself, specifically in response to what we think, do and experience. Each new thought we have produces a new neural pathway, and every time we repeat that thought, we strengthen that pathway. The result? We can physically grow and shape our brains by choosing to actively develop and train it… just like we develop and change our bodies.

Another powerful part of neuroplasticity is that the brain can reorganize itself when damaged, at least to a certain extent. When parts of the brain are damaged, the brain can sometimes rewire itself so that the functions usually handled by the damaged areas can be moved to other, still healthy and intact areas.

That means that because of your brains special plastic powers, you have a much better chance of recovering from a stroke, brain injury or disease. Even in cases of severely debilitating diseases like Alzheimer’s, neuroplasticity may help minimize symptoms for many years.

So, how do you keep your brain plastic as you age?

• By keeping the brain active and stimulated – mental exercise encourages the brain to build new neural pathways, and exercising its plasticity.
• By staying physically active – physical exercise seems to be a key in encouraging the brain to produce new brain cells.
• By tending to overall brain health – eating a healthy diet, getting enough sleep, staying hydrated, reducing stress and staying socially active all seem to contribute to the brain’s ability to build, protect and restore itself.

There you have it.

Neuroplasticity is the brain’s ability to change and reshape itself in response to new experiences, injury and disease. It can help you stay sharp in old age, recover from brain injury and stroke, even delay symptoms of dementia due to disease. You can encourage your brain to stay plastic through mental and physical activity, and tending to your over all health and well being.

Who knew that having a plastic brain would be a good thing?

It’s not that you mean to be a Scrooge, but caregiving during the holidays can trigger a lot of “Ghosts of the Past and Future,” (otherwise known as regret and worry) not to mention even more work to your already sleep-deprived self. It’s hard to muster up a cup o’cheer when you’re overwhelmed and you’ve got six dozen cookies to make for the neighborhood party in two days.

First, take a minute to figure out what’s really bugging you.

Is it all the extra work—or is it that you’re worried that this might be your last Christmas together? Sometimes our frustration and fussiness is really covering up fear. But facing that fear and taking a minute to breathe deeply can make it less scary.

Next, figure out what you like best about the holidays.

You might like snow globes. And gingerbread men. If that’s Christmas to you, then only set out your snow globe collection. Who says you need a tree? Spend one afternoon making gingerbread dough and then freeze it. Plan another day when you and your spouse or elder-parent can decorate your gingerbread men. Set up a card table by the fireplace and put all the sprinkles and candies in little bowls. Put on a Perry Como rendition of White Christmas and enjoy that one day.

Caregivers have so much on their plates already that we have to find ways to make Christmas or Chanukah easy—so we don’t wind up resenting it. Let go of that long to-do list and only do what brings you joy. When you share your new ways to celebrate the holidays—simple and easy—you’ll find that other people admire you for bucking the overpriced and overworked system. You could start a trend.

None of us know how many holidays we have left. Spending them with those we love, really being present, and making good memories—that’s what it’s all about.

There’s no one magic solution. Every family is different, but I do know that arguing about it probably won’t get you anywhere.

5 Tips to Encourage Your Siblings to Help with Caregiving:

• Give them something specific to do. Ask for one consistent thing—that they take your parent to one appointment a month, the same one so that it’s easy to remember. Ask clearly for their help. If they don’t help out, ask why. Remind them that their parent’s care is meant to be shared.
• Let them throw money at it. So they’re not into hands-on caregiving. Then let them contribute in other ways. Ask them to pay for a housekeeper twice a month, or lawn work. Ask them to pay for respite care once every three months. Give them something ongoing that gives you the most relief—or something they value or would like to get noticed for.
• Focus on relationships first. Don’t be petty and try to isolate your loved one and in turn “punish” them by not allowing them to see their other children. You might not like that your siblings aren’t participating, but your mom or dad needs all of their children. They don’t need to be aware of sibling spats, not when they’re dealing with cancer, dementia, heart disease, or some other catastrophic illness. Encourage your siblings to spend time with their parent regardless of what they do—or don’t do.
• Choose not to fall into the vortex of resentment and anger. Give to your loved one wholeheartedly. Let go of what someone else does or doesn’t do. If they still refuse or avoid, then start to make other plans. Utilize community resources, churches, and neighbors who are willing to pitch in. Be grateful for those who choose to help. Your thoughts and energy are better spent on good thoughts than chewing on the bone of what somebody else should do. In the end, we’re only responsible for our own actions.
• Realize that many people are scared of caring for someone who sick or is dying, so help them get over it. We’re afraid of what we don’t know. It may look like your sibs are selfish and lazy, but it may also be that they don’t know what to do to help. They may feel pushed aside. They may have created all these barriers—I’m busy, I have too much on my plate already, you’re doing it well so why should I bother—in order to avoid what’s painful or uncomfortable. Don’t make caregiving look so miserable! Invite them over to hang out. Have a pizza and movie night. Give them time to warm up to the idea. Give them something small to do and then don’t micro-manage them. Caregivers (and I mean me here) tend to be controlling—it comes with the territory—and we tend to be perfectionists. No wonder they don’t want to get involved. Learn to make it easy and inviting, even when parts of caregiving are clearly not—you dont want to scare them away.

I can’t promise that your brothers and sisters will ever come around. Some don’t. Then it’s your job to pace yourself and find others to help support you and your loved ones. It may not be ideal, but you may find a different kind of community/family to surround yourself with. We can’t control what others choose to do. Decide that you’re caregiving largely because you want to and you believe it’s the right thing to do. Once you start to let go of the “shoulds,” your load somehow gets lighter.

High blood pressure, in this study, was defined as a reading of 140/90 or higher (normal for this study was considered 120/80), or taking medication for the condition. It was found that for every 10 point increase in diastolic blood pressure, there was a 7% increased risk of having difficulties with memory and thinking.

This study involved nearly 20,000 Americans ages 45 and older. In this study, the researchers used data gathered for another study about strokes. None of the participants in the stroke study, Reasons for Geographic and Racial Differences in Stroke, had ever had a stroke.

The researchers found that 7.6% of the participants had cognitive problems, and 49.6% were taking medication for high blood pressure. In analyzing the data, researchers took into account other factors that might raise the risk for Alzheimer’s—advancing age, smoking and exercise habits, education, and other medical factors. High blood pressure was independently linked with cognitive issues.

“It’s possible that by preventing or treating high blood pressure, we could potentially prevent cognitive impairment, which can be a precursor to dementia,” said study author Dr. Georgios Tsivgouli, of the University of Alabama at Birmingham.

Dr. Tsivgouli says that more research is needed to confirm the link between high blood pressure and cognitive impairment.

The National Institutes of Health is now organizing a large clinical trial to evaluate whether aggressive blood pressure lowering can decrease a number of important health outcomes including cognitive decline.

-Summary of an article posted November 16, 2009, on the Web site of Fisher Center for Alzheimer’s Research Foundation.

I didn’t talk about it for awhile. I didn’t share it with my husband or other family members. It hurt too much to say out loud. I asked my family not to celebrate my 40th birthday. My mother was living with us, and I just couldn’t deal with the pain of her looking across the table at me—her face in the glow of birthday candles—and for me to be a stranger.

I still had to care for my mom. It didn’t matter—the hurt, disappointment, and grief didn’t matter. I had to keep going. I had pills to cut, food to prepare, doctor appointments to take her to, and sheets to wash. I had to go on. And that’s what I did.

And then something shifted. In the midst of my caregiving duties, I remembered I was her daughter. And I chose to accept that role. Even if she couldn’t remember, I would. I was already making notes about our days that would later become my book, Mothering Mother. I wanted to capture “us.” I wanted to remember, even the hard parts.

It took some time to work through the grief and accept where we were. Yes, Alzheimer’s takes many precious things from you. It affects your relationship, no doubt about that. But what it can’t take from you is your resolve. That’s who you really are.

Choose one thing to be thankful for. You don’t have to go for something big, and if you’re feeling rather curmudgeonly, it’s OK. For me, being grateful can come early in the morning. When everything else goes wonky, I always know that I get to start my day with morning coffee. I don’t want to be made to feel grateful for everything and everybody, because sometimes I’m not. For coffee, I’m always grateful. Gratitude should be simple. I have a favorite coffee, and I try my best not to ever run out. I’d rather run out of gas or toilet paper before I run out of my coffee! Sipping that first cup and taking in that deep, nutty aroma calibrates my day.

Thanksgiving is about giving. Yes, you give a lot, but who gives to you? Do you have a neighbor who always waves? A cousin who calls every holiday—just to chat? A faithful old dog who’s been your companion for years? Look around at who gives to you. Don’t worry about being patted on the back. That will come in time. It’s more important that you recognize that many people support you—in large and small ways.

Scale back. If you’re in the midst of some major caregiving this year—if your loved one has been ill, recovering from surgery, or has entered hospice—then this might not be the year to kill yourself on a big dinner or a fancy table. Buy a pre-made meal from a catering company or even parts of it from your local grocery store. Who cares if it’s a store-bought apple pie? It still tastes good, and it probably tastes better if you didn’t have to stand up for hours making it.

Decide to be together this holiday. Grab a cup of cider, eggnog, or coffee, and actually sit with your loved ones. Watch a video, play cards, talk, or even take a nap. Being together and really being present is the best gift you can give.

Naps. Now that’s something to be grateful for.

“These findings support the link between physical health and cognition in aging and the importance of maintaining good physical function and strength,” says Dr. Patricia Boyle.

The researchers measured the strength of nine muscle groups in the arms and legs of 970 dementia-free men and women ages 54 to 100. They also tested the breathing muscles of the participants.

During the four-year follow-up period, 138 people developed Alzheimer’s. These individuals were older and had worse mental function than the rest of the participants. After the researchers adjusted for age and education level, they still found that muscle strength had a strong influence on the risk of the disease. People who ranked in the top 10 percent for muscle strength were 61% less likely to develop Alzheimer’s than the weakest 10%. Stronger people also showed a slower decline in their mental abilities.

The researchers also found a relationship between muscle strength and mild mental difficulties. The strongest 10% were at a 48% lower risk rate for mild mental difficulties than the weakest 10%.

The study cannot say definitively that staying strong will keep Alzheimer’s at bay, however, it does support that staying fit is a good idea for body and brain.

“We certainly think that it is important to be physically active and to work to keep our muscles strong,” Boyle said. “Good physical health is important for good brain function.”

-Summary of the article “Muscle strength may reduce risk of Alzheimer’s,” from the November 9, 2009, posting on nationalpost.com. (NOTE: This article is no longer available on the National Post Web site, but go there and search on “Alzheimer’s” for current news on this topic.)

Maybe you’re the designated caregiver and all the family members are gathering at your house for Thanksgiving since your parents are already with you. It’s time to make some plans!

3 Tips to Easy Caregiving at Thanksgiving:

• Divvy up the workload. Send out an email or make a few calls. List the menu and other “chores” that have to be done—setting the table, washing the dishes, making appetizers, coffee and dessert, putting the leftovers in containers, and cleaning the guest bathroom. Don’t leave out a thing. Ask for help. Give them choices and accept their help. Even if you prefer your pecan pie recipe over theirs, let them make theirs—this isn’t the time to quibble.
• Lower your standards. What can be done more easily? How about plastic cups and paper plates? If no one wants to wash the china by hand, then nix the china. If you don’t feel like washing and cooking a turkey, then order one from a local restaurant or catering company. Yes, it’ll cost more, but not that much more when you factor in the work that goes into cooking such a mammoth bird.
• Keep what matters most. Ask yourself what Thanksgiving means for you and your loved ones. Do you have a fondness for sweet potato souffle? Do you love the all-day football? Do you like going around the table and saying what they’re most thankful for? Keep the traditions that are dear to you, but begin to let go of the “to-do’s” that exhaust you.

The hardest part of the holidays for caregivers? Not overdoing. It’s easy to fall into host mode. We try to please our families by creating the perfect atmosphere, but there’s a price to pay. Notching Thanksgiving down a bit can still allow you to incorporate the things you love—and make it manageable.

Over a span of 20 years, these researchers studies a group of 241 healthy elderly volunteers, giving them tests designed to measure their thinking or cognitive powers. When reviewing the results, the doctors found subtle clues that in retrospect, hinted at ensuing impairment.

The patients who did eventually develop mild cognitive impairment or pre-dementia had found difficult the tasks involving language expression, learning or recall. And the volunteers who were older and who scored lower on the language or memory tests tended to deteriorate more quickly.

Rebecca Wood of the Alzheimer’s Research Trust said: “This significant long-term study shows how subtle, but measurable, problems with language or memory can predict when a healthy elderly person is likely to develop mild cognitive impairment, which frequently develops into dementia.

“Early intervention will be crucial for future dementia treatments. Being able to spot and measure the initial stages of dementia is a crucial challenge if we are to improve drug testing and lay the groundwork for prevention trials.”

-Summary of the article, “Memory test spots pre-dementia,” posted November 3, 2009, on BBC Health News.

What if we fight all the time?

What if she tries to mother my children?

What if they like my mom better than me?

What if she monopolizes all of my time?

What if my dad starts barking out orders?

What if dad doesn’t adjust and gets depressed?

What if it affects my marriage negatively?

What if I can’t do it all?

Those are just some of the questions that might be swimming around in your head.

How do you decide?

Perhaps your mom or dad becoming a part of your household is just the next natural step. Maybe your dad spends the weekends and the holidays already. Maybe your mom has been making excuses to stay over more and more. It may be time because of financial reasons, the beginnings of dementia, or maybe this last bout of cancer has left your dad weak—and you want more time together.

In some ways, living together is easier than trying to maintain two households. But there is always an adjustment period.

Five Ways to Create a Smooth Transition to Becoming a Multi-Generational Household:

• Sit together and have an honest talk about living together—expectations, assumptions, and concerns. Keep it light amd laugh about it, but be brave and broach those uncomfortable topics so you can work through them early.
• Commit to each other that no matter what situation comes up, you’ll work through it together. There’s a reason why we make those vows when we get married—because we might need to be reminded of that promise to stick together no matter what when the ca-ca hits the fan!
• Give each other permission to get mad, have a fight, make up, enjoy privacy, take time off, and on some days, be a royal B (you know what I mean). All of us have off days and when we do, we just need to announce it and everyone else needs to back far away and give us some room.
• Decide important subjects up front—finances, who’s going to pack, how much you stuff you can bring with you, and other new territories. Most people have issues because they’ve made assumptions and haven’t cleared the air.
• Admit that you may need outside assistance. Time goes on, your parents continue to age, and diseases progress—you can’t do it all and keep your health and your sanity. It’s easy to assume that because you’re living under one roof that you should take care of all of a person’s needs. That’s not humanly possible. Find community resources, hire part-time help, and be sure to get some respite care. You need a break—from each other!

Most people go through a romantic phase at the beginning of the transition—a time when everyone’s excited and happy—and then you have your first big fight or a problem arises you hadn’t planned for. Don’t let this throw you or make you think you made the wrong decision. It’s just the first of many changes—but it’s worth it. There’s something comforting about having everyone close to you under one roof when the time is right.

There is a lack of understanding about the physical toll of dementia, therefore many patients are subjected to aggressive treatments such as dialysis. Some patients may even get preventive care. Also, treatment of dementia patients that is focused on prolonging life can mean that pain relief is inadequate, often worsening the confusion and anxiety that is already an issue with dementia.

A new study suggests that caregivers would be less apt to subject loved ones to such aggressive treatment if they had a better understanding of the physical toll of dementia.

Harvard researchers followed 323 residents of 22 nursing homes. The residents in the study all had end-stage dementia. During the 18-month study, more than half of the patients died.

During the last three months of life, 41 percent of the patients received at least one “burdensome” treatment. When the investigators looked into the reasons behind the treatment decisions, they discovered that only 27% of caregivers who understood the physical nature of dementia allowed for aggressive care. This figure jumped to 73% in family members who did not understand the disease

“When family members understood the clinical course of dementia and the poor prognosis, the patients were far less likely to undergo these distressing interventions,” said the study’s lead author, Dr. Susan L. Mitchell, senior scientist at the Institute for Aging Research of Hebrew SeniorLife in Boston. “Dementia is a terminal illness and needs to be recognized as such so these patients receive better palliative care.”

The researchers also reported that pain control was often inadequate. One in four subjects was clearly suffering from pain, but that number might even be higher because many of the patients were unable to talk about their pain.

Doctors who treat the elderly say that a large part of the problem is that patients with dementia are often unable to make their wishes known. Family members struggle with guilt, wondering if they are doing everything they can to care for their loved one.

Dr. Greg A. Sachs, chief of general internal medicine and geriatrics at Indiana University School of Medicine, says that the doctors of dementia patients need to spend more time explaining to caregivers and loved ones the prognosis for advanced dementia, making it clear that palliative care does not mean less care.

“We’re not talking about aggressive care versus no care,” Sachs said. “Palliative care is aggressive and attentive and focused on symptom management and support of the patient and family. It’s not any less excellent care.”

-Summary of the article, “Treating dementia, but overlooking its physical toll,” by Tara Parker-Pope. Posted October 19, 2009, on NewYorkTimes.com.

All my life I’ve been the guy that’s encouraged, cajoled and pushed you to stay active and keep moving. So, what I’m about to say may seem a little strange coming from me, but here goes – GO TO SLEEP!

It’s good for your body and your brain. The experts say you need at least seven hours of sleep each night to literally turn off your brain so you can have optimal cognitive performance the next day. And the last five hours of sleep—the REM stage—are important. Because that’s when your brain locks in information to improve memory function.

So, how do you get a good night’s sleep? Some people turn to medication, but that can sometimes lead to memory impairment, not to mention other side-effects. Experts and common sense tell me these are a few things you can do today to get a good night’s sleep tonight:

• Exercise. At least 20-30 minutes a day. You knew I was going to say that. But try not to do too much for about two hours before bedtime.
• Don’t fall asleep with the TV on. The light from the screen will disrupt your sleep. Honestly, there are far better things to do in the bedroom. But if you have to watch TV before you go to sleep, put it on a timer.
• Steer clear of caffeine and alcohol after noon. You might think alcohol will help you fall asleep faster, but what it also does is wake you up at night after its effectswear off.
• Keep a schedule. Go to bed and get up the same time each day. Even on weekends.
• Keep your room cool and dark and your bed nice and comfortable.
• If you have to eat close to bedtime, make sure it’s a light snack only. Too much food and your body will be up digesting all night.
• If you have real trouble sleeping, try to avoid napping during the day. If you’re a little tired, go for a brisk, invigorating walk instead.

-Article from BrainStorm by Dakim, Fall 2009

There’s a great new book out titled The Boomer Burden. It delves into the subject of what it’s like to inherit all our parents’ stuff. How do we know what to keep and what to pitch? Should we really hold onto that ball of aluminum foil—and why do they balk when we suggest that they don’t need to keep every birthday or Christmas card they’ve ever received? Knowing what to keep and what to toss is a big caregiver bone of contention.

Sometimes, you have to make an executive decision. You have to step in and deal with the mess. Be sure to pick this battle with care. Hurt feelings can cause them to stick out a defiant chin and refuse to get rid of anything. Before you get bossy, consider the following:

When is Clutter a Hazard?

• When there are items on or near the stove or other cooking/heating appliances that could catch fire. They can say all day they don’t cook, but stoves get turned on. Nothing should be that close. This isn’t an option. Deal with it quickly.
• When there’s no clear path to the exits. No exit should be blocked. You never know which door you might need. No boxes or furniture should block a door. I know many elders are so afraid of break-ins they block or cover doors, but the fact is, the house is much more likely to catch fire and exits are crucial for firefighters. Create 3-foot paths.
• When important and needed items can’t be found—phones, medications, important numbers and papers, canes, and other assistance items. If their eyesight isn’t keen and they tend to live in a dark home, it would be easy to mistake the wrong medication, or simply give up trying to find them. Make these items clearly seen. Use baskets or hooks—anything that makes them obvious.
• When you start hearing excuse after excuse. They forgot their appointment. They don’t like their new medication. They didn’t hear the doorbell for the physical therapist. The neighbor hit their mailbox. Excuses are ways to avoid that something’s not right. Dementia, clutter, and other factors may play into why important dates or items are falling through the cracks. Don’t fall for it. Start keeping track. Pay attention—it could give you the clues you need to figure out what’s really going on.

This is going to take your time and energy. It isn’t going to be easy, and it’s likely your mom or dad is going to fight you on much of this. Do it anyway. Get plastic bins and save anything you believe is really important, but get your parent’s house safe as soon as you can. Try to get them on board. Make it fun. Put on some music. Bribe them with lunch out, a new paint color, or something they can look forward to. Don’t discuss every item. Move quickly and don’t let a pouty look stop you.

Also realize that it’s only a matter of time until you’re going to have to look at other living arrangements. This may buy you a bit of time. Use it wisely. Begin to research and ask yourself what will work—for everyone.

That being said, Dr. Susanne Sorensen, head of research at the Alzheimer’s Society, said “Indian communities that regularly eat curcurmin have a surprisingly low incidence of Alzheimer’s disease, but we don’t yet know why.” The Alzheimer’s Society is conducting their own research into this area.

While no one is advocating over-doing any food, studies have shown that curcurmin is an antioxidant, so adding a little spice to your life certainly couldn’t hurt. In fact, Dakim’s own Chief Scientific Advisor, Dr. Gary Small, said that as he gets older, he might try eating more foods with curry in them.

-Article from BrainStorm by Dakim, Fall 2009

A recent French study shows that people with diabetes and Alzheimer’s disease have less memory loss that those without diabetes. American expert have cautioned that more exploration of the relationship between diabetes and Alzheimer’s is necessary to establish the connection.

It has been proven that having diabetes increases the risk of developing Alzheimer’s. This is acknowledged in the report on the French study from the October 27th issue of Neurology. But this particular study looks at the effect of diabetes on the progression of Alzheimer’s.

The French researchers followed and tested 608 people with mild to moderate Alzheimer’s for four years. The 63 people with diabetes had a slower rate of decline in thinking ability scores.

American experts, including William Thies, chief medical and scientific officer of the Alzheimer’s Association, and Dr. Robert Friedland, chair of neurology at the University of Louisville, have noted some issues with the study. Including:

1. The stage the disease was studied in—early or late. This affects how fast the disease progresses.
2. The diabetic participants in the French study had Alzheimer’s disease for a shorter period of time than the non-diabetics.
3. And the difference in the rate of decline seen in the study were minimal.

Friedland noted several reasons why a difference was found. The medications taken for diabetes to help control blood sugar level could have a beneficial effect on the brain, Friedland said. “Also, patients with diabetes have more vascular disease in the heart as well as the retina, and some of their impairment might be due to that, so it was progressing more slowly,” he said.

For Thies, the lesson of the study is that “to understand relationships like this, you need more long-term cohort studies like this one.”

Summary of the article, “Does diabetes slow Alzheimer’s?” by Ed Edelson, posted on October 26, 2009, on HealthDay.com.

Dr. Small took a few minutes from his busy schedule to talk with us about brain fitness:
Gray Power!

In my new book, I talk about the benefits that young people enjoy in this highly technological age. These Digital Natives have a brain “leg-up” when it comes to processing all things technological because they’ve never been without a computer, a video game or a cell phone. Whereas Digital Immigrants – whose brains were hard-wired back in the days of five TV channels and a typewriter, have to play technology catch-up which presents a challenge, especially when it comes to life in the workplace. But the good news is that brain wiring can be re-fired with training.

Mature brains still flex. So, although Digital Immigrants tend to have fewer of the technology skills that seem second nature to Digital Natives, recent studies demonstrate that older brains do remain malleable and plastic throughout life. In fact, while it may take older people longer to process information, mature neural circuits are often more effective in seeing the big picture, which can be optimized to improve memory and learning. It just takes some training, patience and a “no fear” policy when it comes to dealing with new technology like a computer or an iPhone.

And in a case where age comes before beauty, baby boomers actually appear to have higher developed social skills than their younger counterparts, no doubt due to the fact that they grew up interacting with humans—not video monitors. So, when all is said and done, the mature person may actually have an advantage in both the real and in the corporate world.

-Article from BrainStorm by Dakim, Fall 2009

Am I kind enough? Patient enough? What if I don’t make the right decision regarding medicine, surgery, or treatment for my loved one? Is this what Dad would have wanted? Is my mom or dad better off in a care home or with me? Alzheimer’s, cancer, Lewy Body, Parkinson’s, heart disease—how can a spouse, son, or daughter know what to do? Learning to trust your heart is about the hardest thing to do.

You can’t know it all. You don’t have to know it all. It’s not even about knowing it all! Yes, as a caregiver you need to educate yourself, know what resources are available, and ask for help. But as important as it is to be a savvy caregiver who knows what’s going on, it’s equally important to trust your instincts.

When I say “you’ll figure it out,” it’s because you will. You’ll use all your senses, all your past experience, all your knowledge, and it will come together just when you need it.

You know your spouse. You know your mom or dad. You know what they need. And most likely, that tiny alarm going off in your head is something you should listen to. We’re connected to those we love on a spiritual and biological level. How many amazing stories have you heard about a family member who knew a loved one was in danger—or had a health issue that the doctors were missing?

That’s why it’s essential that you stay healthy and get the rest you need. Your senses are dulled when you’re exhausted. Your loved one needs you to be their advocate and to do for them what no one else in the world can do. You listen, pick up clues, love wholeheartedly, and pay attention when others can sadly consider it “just a job.” Not to you. It’s family. A part of you.

Trust your heart. Speak up when you feel a check. Your good heart will guide you.

The somewhat silver lining in this report is that while some of the causes appear to be genetically based, the majority appear to be preventable. According to the National Institutes of Health’s Cognitive and Emotional Health Project, physical exercise not only helps keep the heart healthy, it also keeps the brain healthy. Mental stimulation has an impact as well. Andrew Carle, assistant professor in the Department of Health Administration and Policy at George Mason University, states “Our brains can be made stronger through exercise. In the same way physical exercise can delay many of the effects of aging on the body, there’s some evidence cognitive exercise can at least delay the onset of Alzheimer’s.” So, you don’t have to just sit back and wait to become another international statistic. More and more scientists are in agreement – there is something you can do right now. Take your mind into your own hands, and get a thorough mental workout each and every day.

-Article from BrainStorm by Dakim, Fall 2009

My mom has passed away. She was 92 years old, and during her last few years she struggled with Parkinson’s, Alzheimer’s, and heart disease. Doesn’t sound like much fun, and it wasn’t—not that part, anyway. The part about hanging out with my mom was often quite enjoyable. I learned that I had to separate the daughter in me from the caregiver in me. Caregiving is a role, but a daughter is a state of being. It’s a relationship.

My mom was still my mom and much to my surprise, I found that I enjoyed being with her. If you had told my twenty-something self that I would ever enjoy walking extremely slow (can we say sloths move faster?) next to my mom, or that taking in a small antique store would be somehow deeply satisfying, I would have shaken my head in serious doubt.

So from one daughter to another, one daughter to a son, don’t forget to enjoy your parents. Alzheimer’s or not. You can still enjoy their company. You don’t always have to go somewhere or do something, but don’t count it out.

• Take your dad to a car show, gun show, or a baseball game. If he liked it when he was young, it’s likely he still enjoys the same pastimes he used to.
• Take your mom to a doll store, a doll show, or a craft show. The holidays are coming up and that’s when crafts explode. Women like Christmas items, like nutcrackers and handmade ornaments. You don’t have to stay long, but getting out and enjoying the season gives the two of you something to do that doesn’t involve the medical community.

Take clues from your parents’ past. What hobbies have they enjoyed through the years? Rekindle those pleasures. Whether you see it on their faces or not, they’re probably enjoying themselves because those old memories are what’s left intact. Don’t let a deadpan expression fool you. Many diseases, such as Parkinson’s, creates a “mask” and hides their feelings. Notice how long they stay engaged, what they read for, how they watch other people, and how they interact. That means their brains are active. They’re exercising those neurons in a natural way.

Continue to make memories with your parents. Each one is a gem in your pocket. The more you do together and enjoy each other’s company, the more you will enjoy caring for them. It becomes much more of a two-way relationship. You’ll get more out of it when you start enjoying your parents. Alzheimer’s or not.

“We found that for older people with minimal experience, performing Internet searches for even a relatively short period of time can change brain activity patterns and enhance function,” says researcher Gary Small, MD, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, in a news release.

The researchers say the results of the study suggest that training to search on the Internet may be a simple brain training activity that can enhance cognitive function in older adults.

In this study, presented on October 19, 2009, at the annual meeting of the Society for Neuroscience in Chicago, the researchers used functional magnetic resonance imaging (fMRI) to look at brain activity in 24 healthy adults between the ages of 55 and 78.

Half of the group was experienced with the Internet. The remaining participants had very little experience searching the Internet. An fMRI scan was done while the volunteers performed Internet search tasks, recording levels of brain activity. After this initial scan, the participants were sent home with instructions to search the Internet for an hour a day for seven days over a two-week period.

After the two-week period ended, the participants received a second brain scan while performing the same Internet task as during the first scan, but with different topics.

The results showed the same regions of the brain activated in the second scan as in the first, but two additional activity centers were activated in the second scan among those who were new to the Internet.

The results suggest that it may only take a few days of brain training, like searching the Internet, for brain activity activation to reach the same levels found in people with more Internet experience.

Summary of an article, “Older people get brain boost from Internet,” by Jennifer Warner. Posted on WebMD.com on October 19, 2009.

As adult children and caregivers, we want to swoop our parents in our arms and make this terrible disease go away. Sadly, we tend to rush in, take over, and overwhelm those we love with our worries and fears. Alzheimer’s isn’t a “life is over” right here and now type of disease, and if your parent is in the early stages, you have time to find out what’s best for them and what’s best for you.

First, I hope you take a little time to process the news and to educate yourself. Talk to a good friend. Take a deep breath. Cry. Scream. Grieve. Ask questions. Search the web (the Alzheimer’s Association at www.alz.org is a great place to start), get some books, and start to make a plan—short term and long term.

Here are some questions to ask yourself:

• What stage of Alzheimer’s is your parent at? No matter what the medical community tells you, how do you think your dad (or mom) is doing?
• How isolated is your parent? Could they get out and wander? Are they still driving? Do you or other family members live nearby? Are their neighbors caring? Are there church or family friends close and willing to pitch in?
• What community resources are available? Do your parents live in a rural area or near a city with lots of services available to them?
• Would it be best to hire live-in care? Move them into your home—or you move in with them? What about an assisted living facility—or is your parent’s Alzheimer’s more advanced? If so, check out memory disorder facilities where they’ll be safe and not wander.

Don’t freak out. There’s a lot you can do to keep your parent’s brain as healthy and active as it can be. You can find your way. You can get the care your parent needs. It won’t necessarily be easy—I can’t promise you that—but trust yourself. You’ll figure it out.

The answer was a “Dakim Day” event at the community. Lee promoted it weeks in advance and promised it would be a fun social mixer complete with a cake and refreshments. He even decorated the lobby to make it extra festive. After a short presentation about the brain, he showed the guests a formatted 20-minute session. He then offered demonstrations on Dakim BrainFitness and took sign-ups right on the spot. The event was a huge success, and Lee now has a waiting list for his Dakim units. After the “Dakim Day,” residents created their own buzz about the program, and now it is self-promoting with virtually no extra effort required by the staff. It’s amazing what a little party, a little cake, and a lot of caring can do.

- Dan Michel, Founder and CEO of Dakim, Inc. Message from BrainStorm by Dakim, Fall 2009

“We may need to rethink what we look for as the earliest signs of mental change associated with Alzheimer’s disease,” says senior author James Galvin, M.D., a Washington University neurologist who is also on staff at Barnes-Jewish Hospital. “If we can better recognize the first signs of disease, we can start treating patients earlier and hopefully with new treatments we can slow or perhaps even stop their progress into dementia.”

The results of this study are published in the October issue of Archives of Neurology.

Galvin and his coauthors analyzed long-term data already collected from volunteers participating in studies at the Memory and Aging Project at Washington University’s Alzheimer’s Disease Research Center. The scientists categorized the cognitive testing results into a measure of three specific types of mental skills: episodic memory, visuospatial skills and working memory.

Declines in episodic memory and working memory became discernible a year before participants were diagnosed with Alzheimer’s disease. Visuospatial skills began to decay three years before diagnoses.

This new information and perspective may allow doctors to detect signs of Alzheimer’s earlier. Researchers are now trying to take what they learned in this study and correlate the findings to biomarkers, which are physical changes associated with preclinical Alzheimer’s disease.

-Summary of the article, “Skills Tests Like ‘Connect The Dots’ May Be Early Alzheimer’s Indicator,” posted October 14, 2009, by the American Health Assistance Foundation (AHAF). (NOTE: This article is no longer available, but see the AHAF Web site for additional news on the latest research on Alzheimer’s disease.)

“If I eat another piece of chicken I’m going to start clucking.”

My mom pushed her food around the table with a sour look on her face. I would have laughed, but I was too tired and too aggravated to let her think she was entertaining. Was it as simple as a power struggle? Did my mother have an appetite? Should I enforce “family rules” or respect her choice to eat whatever she wanted? Was my mom’s nutrition something I needed to be concerned about? So many worries.

Like many caregivers and family members, I tried really hard to make my mom happy and take care of her at the same time. I bought whatever she asked for. I cooked what I thought she would like—even if it meant fixing a whole separate meal for my family. I also had kids who were observing my mom’s antics, but they understood it wasn’t the same.

Soon after my mom turned 90, I gave up the food fight. I decided that my mom could eat anything she wanted—or not eat. I found that not fighting with her made it easier to live with her. We went from grumbling and moving cold eggs around the plate to just eating rice and butter, or just eating pudding, or just drinking Ensure. Finally, my mom settled on Klondike bars. By that time, my mom had late-stage Alzheimer’s. and I was grateful when she’d eat anything.

I guess my point is, do the best you can.

Our elders aren’t our children, and we don’t have to prepare them for a lifetime of good eating habits.

We don’t have to follow the rules or make the rules—we have to adjust to what life has handed us. Sometimes it seems pretty crazy and chaotic, but I learned that caregiving isn’t about rules and shoulds, it’s a lot about intuition.

I knew we didn’t have a long time left together. All we had to do was the best we could do.

What’s right for your situation? I don’t know because you just have to take it a day at a time. Figure it out as you go. Trust that you’ll know what to do when it’s time.

The study looked at two groups of mice. For four weeks, the first group of mice ran in their regular wheel—an activity most mice enjoy. The second group of mice spent time on a mini treadmill at a speed and duration controlled by scientists. After four weeks, the treadmill mice showed more improvement in tasks that required complicated cognitive responses. The treadmill mice also showed evidence of molecular changes in several portions of their brain, and the first group only showed changes in one portion.

This line of study wasn’t new. Researchers had already discovered that exercise changes the structure of the brain and affects thinking, but fundamental questions regarding the type and difficulty of exercise needed for benefits still lingered.

Other recent studies also provided some answers.
1. An experiment published in the journal of the American College of Sports Medicine, looked at 21 students at University of Illinois, testing their ability to memorize and interact with letters after 30 minutes of sitting quietly, running on a treadmill, or lifting weights. The students were noticeably quicker and more accurate in recall tests after running on the treadmill versus sitting quietly or lifting weights.
2. Scientists at University of Illinois studied elderly people assigned to a six-month program of either stretching or brisk walking. The walkers were the only group to improve on tests of cognition.

These studies seem to indicate that aerobic exercise has the most affect on brain function. “It appears that various growth factors must be carried from the periphery of the body into the brain to start a molecular cascade there,” says Henriette van Praag, an investigator in the Laboratory of Neurosciences at the National Institute on Aging. For that to happen, “you need a fairly dramatic change in blood flow,” like the one that occurs when you run or cycle or swim. Weight lifting, on the other hand, stimulates the production of “growth factors in the muscles that stay in the muscles and aren’t transported to the brain,” van Praag says.

The above mentioned treadmill mice probably showed cognitive improvement beyond that of the running wheel mice because the treadmill mice strained in their exercise. They were forced to pant, leading to improvements in “muscle aerobic capacity,” thus improving brain function.

The mouse researcher, Chauying J. Jen, a professor of physiology and an author of the study, concludes that while human bodies work differently than that of a mouse, “It would be fair to say that any form of regular exercise,” he says, if it is aerobic, “should be able to maintain or even increase our brain functions.”

Summary of the NYTimes.com article, “What sort of exercise can make you smarter?” by Gretchen Reynolds, September 16, 2009

Researchers from the universities of Minnesota, North Carolina and John Hopkins and the University of Mississippi Medical Center studied more than 11,000 people aged 46-70 who were participants in a 1990 study, Atherosclerosis Risk in Communities. The participants underwent a physical exam and cognitive testing. In 2004 the researchers followed up with the individuals to see how many had been hospitalized for dementia. The researchers identified 203 cases of hospitalization.

The results showed that smoking, high blood pressure and diabetes are all strongly associated with dementia. The rates of hospitalization with dementia increased exponentially with age in men and women, and in different ethnic backgrounds. African American women had the highest rate of all.

• Current smokers were 70% more likely to be hospitalized for dementia later in life.
• Individuals with high blood pressure were 60% more likely.
• And people with diabetes were twice as likely.

The authors of the study say the results suggest that smoking cessation and prevention, or control of blood pressure and diabetes starting in midlife may have the added benefit of decreasing the risk factor of dementia hospitalization later in life.

In related research, published in the journal Dementia & Geriatric Cognitive Disorders, researchers found that elevated cholesterol levels in midlife significantly increased the risk of Alzheimer’s disease.

The research spanned four decades, studying 9,844 men and women starting when the individuals were 40 to 45 years of age. It is the largest long-term study with the most diverse population to examine midlife cholesterol levels and late in life dementia.

The findings were as follows:
-High cholesterol (240 or higher milligrams per deciliter of blood) increases by 66% the risk for Alzheimer’s disease later in life.
-Borderline cholesterol (200-239 mg/dL) raised the risk by nearly the same amount.

“Our study shows that even moderately high cholesterol levels in your 40s puts people at greater risk for Alzheimer’s disease and vascular dementia decades later,” said the study’s senior author. Rachel Whitmer, Ph.D., a research scientist and epidemiologist at the Kaiser Permanente Division of Research in Oakland, Calif.

“This study, funded by the National Institutes of Health, adds to other research emphasizing the importance of addressing dementia risk factors in midlife, before an underlying disease or symptoms appear,” the researchers said.

Summary of an article published on AlzheimersWeekly.com.

A phone survey of 1,063 former players found that 6.1 percent of players aged 50 and older reported they had received a dementia-related diagnosis. That is five times higher than the national average. And players aged 30-49 reported dementia-related diagnoses at a rate of 1.9 percent—19 times the national average.

The telephone study was conducted by University of Michigan’s Institute for Social Research in 2008. The lead author, David Weir, said that while they did not prove a link between playing football and later mental troubles, the results do show the topic should be pursued.

“The study was not designed to diagnose or assess dementia,” Weir said. The study did not rely on medical records, rather relied on a telephone survey of the former players during which the researchers asked the player, or a caregiver, if they had ever been diagnosed with “dementia, Alzheimer’s disease, or other memory-related disease.”

The New York Times reports that NFL spokesman Greg Aiello said in an e-mail message that the study gave the league something to look at. “Memory disorders affect many people who never played football or other sports,” Mr. Aiello said. “We are trying to understand it as it relates to our retired players.

The NFL is currently conducting a study of 120 retired players, and Dr. Ira Casson, a co-chairman of the league’s concussions committee is conducting the neurological examinations. The results of that study are expected within a few years.

Summary of the article, “Dementia risk seen in players in N.F.L. study,” from NYTimes.com, September 29, 2009.

In the current online edition of the journal Human Brain Mapping, Paul Thompson, senior author and a UCLA professor of neurology, and lead author Cyrus A. Raji, a medical student at the University of Pittsburgh School of Medicine, and colleagues compared the brains of people who were obese, overweight, and of normal weight, to see if their brain structure looked different.

The researchers used brain images from an earlier study called the Cardiovascular Health Study Cognition Study. They used scans of 94 elderly people in their 70s who were healthy (not cognitively impaired) five years after the scan. Using the Body Mass Index (BMI), they defined the weight categories as follows: normal weight—BMI between 18.5-25; overweight—between 25-30, and obese—greater than 30. The researchers converted the scans into three-dimensional images with high-resolution mapping of anatomical differences in the brain.

They found that:

• Obese people had 8 percent less brain tissue than people with normal weight, making their brain look 16 years older than a lean participants brain.
• Overweight people had 4 percent less tissue, making their brain look 8 years older than a lean participants brain.

Of the results Thompson said, “That’s a big loss of tissue and it depletes your cognitive reserves, putting you at much greater risk of Alzheimer’s and other diseases that attack the brain, but you can greatly reduce your risk for Alzheimer’s, if you can eat healthily and keep your weight under control.”

Adapted from the University of California, Los Angeles (UCLA)

Summary of an article from August 25, 2009, posted online by the American Health Assistance Foundation (AHAF). (NOTE: This article is no longer available, but see the AHAF Web site for additional news on the latest research on Alzheimer’s disease.)

Caregiving is in large part, being a manager and being a manager means you’re in charge. As a caregiver, you have many balls to juggle–you’re part-nurse, part-cook, part-psychologist, part-driver…the list goes on. You have many people you have to manage in order to create a cohesive team of care for your loved one: home health aides, perhaps willing family members, doctors, nurses, physical therapists, and when you start into hospice you get a whole slew of people to weave into your life–a nurse, a chaplain, and more aides.

So is it bad thing to be controlling? Most people cringe at the word, but someone’s got to be in charge–and to me, I like calling it being “in-charge” instead of controlling because face it, there’s so little we can control even when we think we are.

Have you ever been in a stressful/dangerous situation and someone stood up with quiet confidence and said, “Don’t worry, I’m in charge, and I’ll make sure everything turns out okay.” Whew. You let out a sigh of relief. You listen, ask what he/she plans to do, and you expect that you might be given something to do to help. You’re now a part of a team, a part of the solution.

That’s what you can exude as a caregiver when you accept your role with quiet confidence. You’re in charge. You’re in search of solutions, and it’s your role to assign jobs that all work together for the greater good. Do you have your act together? Sometimes, sometimes not, but you know that people need to feel safe, and you’re willing to accept the responsibility of making sure that happens. Yes, lots can and will go wrong, and some of it you might even get blamed for, but you’re brave enough and strong enough, and you know it’s necessary, so you step up.

Caregiving is about stepping up.

Three Keys to Becoming an In-Charge Caregiver:

• Accept who you are–the “in-charge” person. Make a plan. Divvy out the work.
• Keep the big picture in mind at all times. You can’t afford to get bogged down with the myriad of details. You have a goal–to help your loved one walk again, to help their pain be manageable, to get some extra care so you can take a well-needed break. Break down each of your smaller goals and make sure they fit into the overall picture.
• Be willing to be the bad guy. If a health aid isn’t a good fit, then you have to be the one to let her/him go–and then find another one. If your dad doesn’t want to do his therapy, but he really needs to, then let him be mad at you all afternoon–pout, sulk, give you the silent treatment, but he still has to go to therapy because it helps him walk and heal faster. Being in-charge isn’t going to win you the Miss Congeniality crown and sash, but you will feel good about doing the right thing–even if you’re the only one who seems to notice.

Being in-charge isn’t about throwing your weight around and being a bully. It’s about doing the right thing. It’s allowing others to relax and trust–even when you’ve got your own concerns. The good thing about being in-charge is that you learn a lot about yourself, how you react under pressure, about your resiliency and what kind of person you really are. Some days, you miss the mark–we all do. But other days, you look in the mirror and you’re amazed at who’s staring back at you.

A recent study of sedentary adults showed that jogging for half an hour, 2 or 3 times a week, for 12 weeks, improved memory and ability to multi-task by 30%. And just as important, inactivity stopped this process. John Medina, PhD, director of the Brain Centre for Applied Learning at Seattle Pacific University says, “Exercise is as close to a magic bullet as brain fitness gets.”

Below is a 7-day plan that combines brain exercise with physical activity.

Day 1: Take a nature walk. Try tuning out the chaos of the urban environment and immerse yourself in a natural setting.

Day 2: Connect with your senses. Not only will Tai Chi help with your balance, but it may also protect the area of your brain responsible for your sense of touch. A better sense of touch means fall prevention, quicker reaction time to say, a hot stove, and improved ability in tasks such as threading a needle.

Day 3: Add speed. Cardio exercise increases blood flow, and research shows that this can trigger growth in the area of the hippocampus responsible for memory and verbal learning. So, pick up the pace in short spurts as you exercise your body, and sprint your way to a bigger brain.

Day 4: Challenge your balance. Emerging research reveals a link between toning your muscles and toning your brain. Add a balance and coordination challenge to strength moves to firm faster and gain brainpower.

Day 5: Toss a ball while walking. Workout the part of your brain that controls focus while taking your daily walk.

Day 6: Repeat day 3 with a friend. Research shows that beefing up your social calendar keeps memory loss at bay. An added benefit—a friend to cheer you on.

Day 7: Repeat day 4 with your eyes closed. Closing your eyes forces you to use new sensory information to coordinate your body movements. This adaptation can improve your mind’s ability to deal with new experiences.

This is a summary of the article, “The brain-power workout,” by Jennifer Matlack, posted at IndiaToday.in. Check out the article to learn more about the current research driving the daily activities.

It’s amazing how good we are to our cars–and not ourselves. We may run our car down to the “E” for empty, but we know that if we run out of gas on the side of the road, there are consequences, so we avoid them and put gas int he car. How can we not think that same principle applies to us? How can we go without sleep, stuff our faces with low-nutrient food, take no time to walk or meet friends or plan financially for our own futures–and somehow we expect to live like this? Without consequences?

Five Signs of Caregiver Stress:

• Sleep issues–insomnia, falling asleep within minutes of sitting down, sleeping as a form of escape
• Inability to think straight–forgetting things in mid-sentence, can’t follow a conversation, difficulty comprehending what you could before. This is your brain throwing out warning signs–listen to them.
• Little accidents–giving the wrong dose of medication, forgetting where you’re driving, zoning out, fender benders
• Inability to control your emotions–tears, outbursts, uncontrollable laughter at inappropriate moments–or an inability to feel anything at all, no matter how serious. Don’t rule out depression–when we feel we have no choice, we implode.
• Starting to show physical signs–high blood pressure, a new diagnosis–an ulcer, a respiratory problem (asthma, bronchitis), arthritis and other inflammatory based illnesses. Your body is trying to tell you something

These warning signs are the equivalent of your car knocking, sputtering, and breaking down on the side of the road. You can ignore a few signs for a period of time, but after while, the car simply won’t run.

Why not take care of yourself better than you take care of your car? Cars are replaceable.

 Your health (and your life) isn’t.

Dakim Inc. announced today that AmericanWay, a senior living provider with seven homes on four campuses has become the first provider in Wisconsin to adopt the Dakim BrainFitness System company-wide.

AmericanWay started using the Dakim system at its community in Madison in May. They recently installed additional units in the housing for dementia and frail elderly care in Portage and Randolf, Wisconsin. The company also plans to offer use of the system to local seniors as a community service, and recruitment tool for area residents.

“We are always looking for strategies to enhance our residents’ quality of life. Dakim’s brain fitness technology is proving to be a major contribution to that effort,” said Janis Nowak, president of AmericanWay and incoming president of the Wisconsin Assisted Living Association (WALA). “We have people at our Madison community who are on the Dakim system several times a day, and their faces light up when they sit down to play.”

“Brain fitness is becoming a cornerstone of wellness programming for senior care providers,” said Dakim CEO Dan Michel. “AmericanWay’s commitment to providing residents in all of their communities with daily cognitive stimulation is another sign of the momentum that is building in the industry, and we believe we will see more chain-wide adoptions in the coming year.”

Summary of September 16, 2009, press release on Reuters.com

Those were some of the questions I asked when I was caring for my mom. She had Parkinson’s, heart disease, and then developed Alzheimer’s and there were days where I dreaded saying “Good Morning,” because to my mom, nothing was good about it.

What I do know is that being grumpy doesn’t naturally come with old(er) age. There are some really up-beat life is sunny-side-up personalities out there celebrating their 90′s and beyond. It’s not that life hasn’t handed them their fair share of difficulties, it has, but they just seem to keep on smiling and look for something to be cheerful about.

But it is true, that if you don’t start working on having a good attitude now, it probably isn’t going to come easy later in life. Happiness is in part, habit.

Ways to Cope with “Grumpy” (and I’m not talking about an adorable dwarf who helped Snow White find her Prince!)

• Separate your emotions from theirs. It’s healthier to decide that you’re going to have a good day no matter what life throws at you–and to love your care buddy but not fall down the dark hole of gloom after them.
• Really listen. Sometimes it just takes five minutes to sit down and look them in the eye so they feel heard. Tell them you’re sorry they’re in pain and you’re doing all you can to eleviate that pain. Hug them, pat their hand, really listen–but then know that you have to chart the course for the day.
• Consider that some medications make it harder to handle your emotions, and it really is difficult to be in a good mood if you’re in constant pain. Do all you can to make sure their physical condition is properly diagnosed. Something as simple as a low-grade UTI (Urinary Tract Infection) can greatly alter a person’s mood–and it’s a simple to fix as a round of antibiotics.
• Decide that you’re in charge. You have to be. It’s best that you are. You don’t have to act like “Miss Bossy,” but that quiet air of confidence and firm structure you give their day actually settles their anxiety.
• Use humor everywhere you can. Life can really throw us some miserable curve balls and the only defense we have is to laugh. Make a joke about the difficult nurse who wouldn’t hear you out. Figure out a great come-back line for the insurance agent who tried to get snippy with you. Being snarky is a form is self-defense and it helps to get a big miffed and make a sarcastic joke–it’s better than crying or giving up–so learn to laugh at the absurdities that come with caregiving.
• Ignore the grumpiness but not the person. Sometimes you have to let your loved one know that you can’t reward their fussiness. After a while, they just may give up this attention seeking behavior.
• Maybe you’re the fussy one. Take a hard look at your own thoughts and words. Have you fallen into some bad habits as well?
• Realize that some of it is just being said for drama’s sake. My mom used to tell everyone “Look at what all I gave up to move in with my daughter.” Now if that isn’t drama, I don’t know what is! I just smiled and let her have her drama moment.
• If things get ugly, walk out of the room. They may wonder what you’re doing, but tell them you’ll come back in when you can be spoken to in a decent and pleasant manner. Do this a few times and they’ll get your point. But do realize that if they have some form of dementia, nothing’s going to stick.
• Take a break. Take a ten minute walk a day, maybe a couple of times a day. If you can run errands alone, don’t rush back–stop by the library and pick up some books of DVD. Go by a fast food place and grab lunch–and then take it to the park. Little breaks can relieve big stress. It’s tough being with someone, anyone 24/7. You’re bound to get on each other’s nerves. Let them miss you a bit. Be sure to find a neighbor or sitter if your elder really shouldn’t be left alone. Budget in a few extra dollars a week and get out a bit.
• Decide how your day’s going to go before you open your bedroom door. Give yourself a few extra minutes alone in the morning. I actually bought a small coffee pot I kept in my master bath and I’d make myself a cup of coffee before I left the sanctuary of my room. I’d spend the first half hour of my day with my journal, my coffee, and a few stretches. My mom didn’t miss me or demand me (yet) and that private time gave me a chance to give the first part of the day to myself–and to formulate a game-plan for dealing with anything I’d have to face.
• While I’m not a big proponent of mood altering medications, never say never. If you–or your loved one–is suffering from depression, a hole they can’t get out of without help, then investigate your options. There are supplements, prescription meds, therapists, and other ways to deal with depression and anxiety. Caregiving is tough, and so is dealing with the fact that your body is failing you and life isn’t going the way  you planned. If you need help, ask for it and get help.

You might not be able to turn Mr. Grumpy into Mr. Happy, but you can set the mood and decide to do all you can to care for yourself. After all, the only person you can really help, is you.

Dr. Charles B. Hall, Ph.D., is Professor of Epidemiology & Population Health at the Albert Einstein College of Medicine. His new, compelling research connects mental activity and memory decline.

The key findings of this study are that memory decline was slower in persons who developed Alzheimer’s disease but engaged in a brain fitness activity such as reading, writing, or crossword puzzles, compared to those participants who developed Alzheimer’s disease and did not engage in cognitively stimulating activities.

The people in this study all started out healthy, without any evidence of dementia. This is unique in dementia research. The entire aging process was followed, and those who developed dementia and engaged in mental activity had their memory decline delayed.

The team has determined the next step will be to discover what types of mental activities are most beneficial.

Delaying the average time at which people lose independence by just a year would have serious implications for public health and the cost of healthcare resources all over the world.

Summary of Dr. Hall’s transcript posted on Alzheimer’sWeekly.com. http://bit.ly/1LMzcs

Most days, it was just her and I. I’d sip on my coffee and watch my daughters head off to school and after-school jobs, and I’d watch my husband dress for work. He’d kiss me goodbye and I wanted to cry–or scream, “Take me with you!” Caregiving can be lonely.

I’d look over at my mom sitting beside me at the kitchen table, both of us still in our house robes, and at times, I wished I could be a thousand other places. It’s a quiet, necessary job. It’s not even fair to call it a job when you’re caring for a dear loved one, but aspects of it are job-like. Day-after=day, I’d count pills, wash sheets, answer the same questions (my mom had Alzheimer’s and Parkinson’s), and it felt as if we were getting nowhere fast.

How do you handle the isolation and monotony?

By first remember why you’re caregiving. You’re caregiving someone you love. Your’e caregiving because they need you–you’re their advocate. The why of caregiving is important. It’s your anchor, and no matter how crazy-stormy-angry-lost you may feel at times, remembering the why will guide you.

Seven Tips to Avoid Caregiver Isolation and Monotony:

• Find or start a caregiving co-op. Trust me, you’re not the only at-home caregiver in your area. I bet there are a handful within a ten-mile radius of your home. Go to a caregiver meeting (check your senior community center, or your local elder-care association or Meet-Ups.com to find other caregiving families in your area. Why not have a one-day a week care-share day? Invite another care family over for lunch. The two of you can chat while the two care-buddies hang out. Depending on how things go, you may find that the two of your could swap and give each other a few hours off here and there.
• Take an online class. Do you know there’s everything from cooking lessons to guitar or foreign language lessons online? Even YouTube.com offers mini-lessons for free. You can learn how to knit, how to write a memoir, how to draw, how to change the oil in your car–all online. Learning keeps your brain active and gives you something to look forward to. Those neurons will be popping like popcorn with the joy of learning.
• Join an online forum. It could be one on AARP (their forums are great), or on Alz.org (Alzheimer’s Association), but don’t limit it to caregiving. You’re so much more–join a group on Gather.com. Even an online game can be a fun break from caregiving chores. You don’t have to leave home to make a friend.
• Don’t do the same things the same way. Take a different route home from the grocery store of the doctor’s office. Take an extra ten minutes for a nice drive. Turn down a road you’ ve never been on. Get lost. Your brain loves the stimulation and likes to problem solve. Don’t worry–you’ll find your way back, and who knows what you might discover just a few streets over. Do one thing different a day–brush your teeth with your less dominant hand, color your head red instead of its usual brown. Try cooking couscous instead of rice with dinner. Your brain will thank you, and you might even find something new that you really like.
• Exploring doesn’t have to involve a passport. Explore your own home and yard. Most of us have at least a dozen unfinished projects. Now’s the time, so finish that baby scrapbook of your granddaughter’s, or refinish that old desk of your mom’s. Sure, it may take six months because you can only spare a few minutes a day, but it’s a pleasant diversion and you may find out that you like it.
• Consider starting a home-based business. Start a website or join one that’s already active. Etsy.com is a place you can all kinds of art–from knitted hats to pottery to paintings to jewelry. Many caregivers have found that their caregiving years allowed them to discover new interests and new business opportunities. Even ten minutes a day adds up.

Yes, it takes effort, and you feel like a zombie most days. I hope you’ll push yourself a bit because the pay-off is tremendous. Just because you’re home–a lot–doesn’t mean that there are amazing opportunities and friendships to be found. Get out of your old habits, peek your head out of your rabbit hole and see what interests you.

I was powerless to stop the corrosion of Alzheimer’s.

That’s what I realized was the seed of my frustration, but layered on top of that was the daily frustrations and aggravations that ranged from feeling like a mosquito driving you crazy in the middle of the night to having your eyes pecked out by vultures!

My mother may have had lost her cognitive abilities to Alzheimer’s and her agility and walking to Parkinson’s, but she didn’t lose her uncanny skill to aggravate the plum fool out of me! She could still come back with a put-down with laser accuracy–and to this day, I believe that some of her antics were on purpose and meant to get my goat.

On top of all this, add the frustrations of dealing with doctors, nurses, pharmacists, home health services, the check-out girl at the grocery store, your brother who won’t lift a finger to help…and yeah…your eye’s probably twitching by now.

What’s a caregiver to do?

Let it out! Stress is dangerous when it’s held inside. You have to get over your be a ”nice girl/good boy” upbringing and start telling it like it is!

Five Ways to De-Stress Fast:

• Ask yourself: Do you feel like laughing (insanely) Crying (okay, sobbing), or screaming (like a banchee, maybe in the privacy of your car). Do whichever feels best–for you–right now.
• Tell someone the truth. Caregiving freed me to confront someone who was not treating me or my mother properly. I was too tired and too impatient to put up with being disrespected. You don’t have to curse at them, or yell, but sometimes people need to know how they’re treating others. It’s so freeing to finally say what’s on your mind!
• Break something, slam a door, hit a pillow with a baseball bat. Life is unfair, it’s hard, and we offer ourselves no physical relief. No wonder we turn to prescription drugs and alcohol just to allow ourselves to unwind. Slamming a door is much healthier than swallowing a pill.
• Make sure you aim your emotions at the disease and not at the person you love. Yes, they can really get on your last nerve, but you two are a team–so don’t fire those flaming arrows at each other.
• Encourage your care buddy to get mad, too! Have a “We hate Alzheimer’s day!” Make a list of all the sucky things you don’t like about the disease and your life right now. Throw some old cups against an outside wall of your house. Take turns blasting your car horn. After a while, anger offers release and laughter follows.

Don’t be afraid of your emotinos. You’re doing a lot right now–caring for others is a big deal–on your heart and your head. Laughing, crying, and screaming is emotionally cleansing. Remember what it feels like after a good cry? Or a good scream? It feels like you’re 20 pounds lighter and you’re breathing pure mint. Go ahead, give yourself permission.

Confusion starts out as a tap on our shoulder. “Pay attention,” it whispers. Then, if we don’t pay attention, confusion gets louder.

We forget things as we age, right? Everyone gets confused at times.

I tried to “cut my mom some slack”  as I called it. She so wanted to live in her own home and I had tried so hard to arrange everything from her food to her transportation needs…but I worried. A lot.

Confusion can be due to medication side effects, and confusion can simply be mild dementia, or it can be a sign of stroke, diabetes, Alzheimer’s, Lewy Body, or other issues.

You might not be able to cure your loved one’s confusion, but if you see it as a clue to help lead you to diagnosis, then confusion can be a good thing.

I finally caught on and shared with my mother’s neurologist about her growing confusion. She had already been diagnosed with Parkinson’s, but her doctor took her new symptom quite serious and did further testing and readjusted her medication.

Practical Ways to Help Your Loved One with Confusion:

• Try not to confront them. It’s scary to be confused. Your mom or dad (or spouse) may be afraid to share what’s really going on because you have the “power” to take away their independence. So coming at them head on will only cause them to cover up what’s going on.
• Don’t argue the point. If they believe that they fed the cat, but you don’t think they did, then quietly feed the cat a “snack.”
• Keep their safety in the forefront of your mind–and decisions. Ask yourself: is my mom safe to drive? Safe to live alone? Safe to shower or bathe when I’m not here? Safe to manage his/her medications? Safe to feed themselves reguarlfy? If you’re not sure about any of these questions, then start paying close attention.
• Drop in at odd times, or even follow them in your car. If your loved one is still living alone, do a little spying and follow them to the grocery store and see how they park, whether they pay attention to the cars as they cross the street, or if they leave their purse unguarded in the cart for minutes at a time.
• Make decisions about change (driving, living arrangements) after much thought. It’s so easy to panic and rip the car keys out of their hands or start calling assisted living homes. Do some research and think it through. Where should your mom/dad live? With you? Near you? What’s best for them–and for you? Take a bit of time to prepare and then prepare them with kindness and patience.
• Be patient. Confusion doesn’t always go away. If you let it get to you, you’re in for a long road. You don’t have to be right, and they don’t have to be wrong.
• Grieve what’s gone. It’s quite an adjustment to realize that your loved one has  lost some of their cognitive abilities. It effects your life and at first, you’re reeling with questions, concerns, and trying to figure out how to manage not only your chaotic life, but now your parents/loved one’s issues as well. It’s okay to be sad and scared. Consider calling a dear friend and pouring your heart out–or joining a caregiving support group. There’s something comforting in knowing youre not alone.

After time, you’ll see that initial stage of confusion as a blessing. It will lead you to ways to help your loved one get better care. Sometimes (oftentimes) their confusions are fodder for great stories and laughs. You’ll have a few tiffs and few tears, and hopefully some hugs and smiles all along the way.

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GearDiary.com says Dakim has stepped up with the development and design of the BrainFitness System.

Brain training sweeps across America: Alzheimer’s Weekly talks about the System and its success.

Memory Loss:

1) Supply what’s missing; don’t “test” the person’s memory.
2) Be prepared to explain to others that the person is affected by a disease that may lead to loss of social manners at times.
3) Remember that the person won’t remember; it will reduce your frustration and the communication of that to the person.
4) Be prepared to demonstrate and remind the person how to do familiar tasks; this may be required on a daily basis or even many times each day.
5) Use repetition and routine to increase security and comfort for the person. Use familiar objects and pictures to help them connect with you and with the world around them.
6) If a situation is not going well, when possible leave the interaction and come back to it later; the person likely will not remember and that gives you a chance to start over afresh.
7) Be prepared for the emotional reaction you will have when the person doesn’t remember who you are.

Language:

1) Fill in missing words when you can; don’t try to force the person to remember.
2) Simplify your language by using shorter sentences and emphasizing key words. Match your language to the person’s abilities and skills.
3) Bring the person back on track when they get lost in speech; do so in a casual manner without drawing attention to the problem.
4) Be prepared to use visual and tactile (sight and touch) cues and prompts as communication abilities change.
5) Continue to have social conversations with the person while understanding that the content of their communication may not be accurate. Look for the feelings under the words and respond to these.

Reasoning:

1) Become more directive over time; offer fewer choices and less explanation. Later in the disease, make choices for the person, but present these as things that will happen next (put on this shirt, here’s your lunch, it’s showertime).
2) Determine what motivates the person to do things; it may be just because you tell him/her or perhaps an appeal for help may be effective such as, “It would help me out so much if you could slip your shoes on before we leave the house.”
3) Avoid arguing with the person.
4) Listen for phrases from yourself that assume the ability to reason, such as “Don’t you understand?” or “Can’t you see that…?” Remove these from your interactions with the person.

Abstraction:

1) Adjust your expectations that the person will understand or relate to anything outside of the present moment.
2) Statements using abstract concepts such as time, value or relationships may confuse the person rather than motivate them.
3) You will need to take responsibility for thinking about the future and making plans for both of you.
4) Expect the person to appear increasingly self-centered as their ability to understand how their behavior affects others decreases.
5) Become more directive and provide less explanation.

Judgment:

1) The value of safety becomes primary over that of autonomy or the “right to choose” when the person is no longer able to make reasoned judgments for their own protection. Be prepared to take control and make necessary decisions for safety. Expect to be watchful at all times for the person’s safety.
2) Pick your battles wisely; if the issue does not involve safety, it probably is not important enough to confront the person. Avoid being overprotective when safety is not involved. Let the person make errors in judgment sometimes. Lower your own standards of perfection!

Perception:

1) Monitor the environment for overstimulation and evidence of misperception and be prepared to make changes.
2) Understand that you and the person are not sharing the same perception of the world.
3) Reassure the person rather than trying to reason.
4) Choose outings carefully and be prepared to try quieter locations than may have been their (or your) preference in the past.

Attention:

1) Recall the types of activities that used to hold the person’ attention and try them out.
2) Be prepared to get the materials, define and set up the task and get the person going.
3) Simplify activities and tasks by breaking them into smaller parts and using prompts to help the person be successful.
4) Control the distractions in the environment.
5) Know that it will likely take a lot of caregiver time and attention to keep the person involved.
6) Focus on the process (what you are doing together) rather than the outcome or quality.

Organization:

1) Fit the task to the person’s abilities, using the appropriate number of steps, sequencing these for the person and prompting as needed.
2) Remind the person of the purpose of the activity.
3) Let the person do whatever he/she can still do.
4) Form patterns and routines; encourage use of over-learned behaviors, which are those that have become “automatic” to the person due to daily repetition in their past.

-Submitted by Liz Doyle, Community Relations Ambassador for the Midwest

Holding a grudge takes work. It’s an active process, during which we consciously recall the initial insult or replay the event over and over again in our mind and allow the anger, hurt, and resentment to control our thoughts and feelings.

There’s an old saying that goes, “Holding a grudge is like drinking poison and waiting for the other person to die.” This insightful little gem of wisdom likens a grudge to poison, and it’s a pretty good comparison. Research has shown that carrying a grudge is bad for our physical health and our mental well-being.

In one study conducted at Hope College in Holland, Michigan, researches asked subjects to recall a situation in which they had been hurt and then imagine either forgiving their offender or holding a grudge. The researchers found there was a physiological response in subjects who imagined holding a grudge. Their facial muscles tensed, they perspired, and their heart rate and blood pressure increased in comparison to subjects who imagined forgiving. In fact, the physical response of holding a grudge was sustained even when the subjects were instructed to stop thinking of the situation. Long-term effects of carrying a grudge can range from depression to cardiovascular ailments, even diminishing a person’s outlook on life and overall well-being.

Conversely, there is also some very powerful research being conducted on the power of forgiveness. Through his research, Dr. Fredrick Luskin out of Stanford University, has shown that forgiveness can reduce anger, hurt, depression, and stress, and actually increase feelings of hopefulness, optimism, compassion and self-confidence. Dr. Luskin developed Nine Steps to Forgiveness and here are few:

• Make a commitment to yourself to do what you have to do to feel better. Forgiveness is for you and not for anyone else.

• At the moment you feel upset practice a simple stress management technique to soothe your body’s flight or fight response.

• Put your energy into looking for another way to get your positive goals met than through the experience that hurt you. Instead of mentally replaying your hurt seek out new ways to get what you want.

Deciding to forgive rather than hold a grudge is a very powerful choice that can have long lasting effects on our physical and mental health. When we are feeling badly about ourselves or angry at our memory–remember that forgiveness is most important when aimed at ourselves and our own lives. Be kind and forgiving to yourself, and the world will appear brighter and more forgiving towards you.

-Submitted by Maureen McGarry, Director of Community Relations