Can Antidepressants Prevent Alzheimer's ? May 15, 2014

For the past two months articles have been appearing showing that, in healthy human volunteers, the antidepressant Celexa, was able to reduce the amount of amyloid in the bloodstream.

Previously, a 50 mg dose equivalent of celexa administered to mice was able to reduce the amount of amyloid significantly.

Don't run out and get yourselves prescriptions however. The researchers don't know yet if indeed reducing amyloid will prevent Alzheimer's disease.They do know that celexa doesn't remove the plaques in the brain. Once they are there, it's too late and that can be 20 years before any symptoms appear!

But wouldn't it be nice to imagine that all the depressives who have been taking meds for years would be spared this awful disease? Just like the professor from Ohio State whose research showed the benefit of cannabis in preventing Alzheimer's disease. We'll get some clue as the youngest of the baby boomers age and the incidence of Alzheimer's disease does not increase as it is predicted.

When my husband was first showing signs of dementia, the doctor thought he was depressed and prescribed antidepressants but he felt less clear-headed and more agitated while taking them and stopped. One man I know from the nursing home-he visits a resident there frequently while I am also visiting-- has had symptoms and a diagnosis of Alzheimer's disease for the past two years. He takes coconut oil, herbs and supplements without any prescription medications and has maintained both a positive attitude and basic self care skills for this time. His wife manages his life, drives the car, prepares his food, pays the bills, etc. and feels the burden of his illness more than he.

The one good thing about this finding about antidepressants is that it may encourage folks who are at risk for developing Alzheimer's disease to get themselves tested and perhaps to volunteer for a clinical trial. If otherwise healthy adults can reduce the amount of amyloid in their bloodstream before plaques appear in their brains, they may reduce their incidence of the disease. If many people volunteer, we will get the results sooner.

Mother's Day Review May 12, 2014

Not to brag, but as an idea to ponder, this was the 55th year since I became a mother and the most enjoyable, fun, special-feeling Mother's Day since my children were young.

I loved Mother's Day when I was a child; we made breakfast in bed for our mother and as eldest, I got to be in charge of something I really wanted to do. I always loved being in charge, still do, and most folks don't mind after they all realize that everyone has to do whatever it is -my way. 

After I turned eight and our grandparents arrived from Germany after successfully having survived the Holocaust, we celebrated Mother's Day in the afternoon by inviting first two, then three grandparents after my grandmother arrived the following year from Switzerland where she survived the atrocities.

These were joyful affairs where the children were always more vocally and affectionately celebrated than the elders, but there was always good food and plenty of home-baked goodies.

When my own children were small, I basked in their hand-made cards and projects lovingly created in school or at home, hand prints, silhouettes, flowers of paper or seeds which they sprouted.

I guess Mother's Day changed for me when my grandmothers passed, my sisters married and I became a single parent. No one took charge, including me, of making my day special any longer as we continued to celebrate with dinner for everyone, appreciating the next generation of children and watching the talent shows they devised for our enjoyment.

Now I am the grandmother generation. I moved to Arizona to live near my children so they could help me care for my second husband who has Alzheimer's disease and my grandsons are old enough to take charge of the day to make it memorable for their mother and for me. Were it not for my husband's illness, we would still be in New York and yesterday could not have happened. Good things can happen even when all looks barren and bleak; we carved out a time for a visit to the nursing home in the afternoon where he was in a good mood, wandering the halls as usual, but ready to play catch, look at pictorial magazines and enjoy eating an apple.

"You're Not Helping" May 5, 2014

Happy Cinquo de Mayo everyone. It is surely a huge holiday here in Arizona. Even in the nursing home they had a celebratory luncheon  featuring Mexican rice and beans and an enchilada!

Of course the traditonal fiestas include cervesa, which is beer to all you non-Hispanics.

I am continuing to learn new lessons and to re-learn old lessons I thought I had mastered when it comes to caring for a loved one who has dementia. 

Whenever as adults we are in a caregiver mode, we cannot expect anytning from the care receiver to meet our emotional needs. We need to rely on equal partners for our needs to be met--lovers, spouses,friends--or  when we are lucky enough or young enough--our healthy parents, siblings or other relatives.

 

This is a lesson that needs repeating all the time because we trick ourselves into believing a dependent person can be there for us. They may love us, be grateful to us, make us rise to a level of caring we never knew we were capable of achieving. We may be proud of them "chip off the old block" and all of that- but the caregiver is always in that dominant unequal position vis-a-vis the person or persons receiving care.It is very hard to switch into that role and equally difficult to switch out of it when the children are grown for example or when a person who is ill, recovers.

When a spouse or a parent develops dementia and more specifically Alzheimer's disease or fronto-temporal lobe dementia the balance shifts and it is no longer about the caregiver--it is only about the care receiver. It becomes the caregiver's responsiblity to make life as pleasant as possible for their loved one while also finding other sources of emotional sustenance for themselves. That's the main reason why support groups are so important.

Being angry when a care receiver refuses a request is about you, not the person you are caring for. Feeling abandoned when the care receiver no longer can say your name is also not about the care receiver. Their forgetfulness has an effect on us, but it is the disease not the person that causes those feelings and the loved one cannot be made to feel responsible for his or her forgetfulness.

Also when we visit or spend time with a care receiver they want our full attention. A toddler who acts up when we are on the phone is a perfect example from child-parent relationships. And with my husband this week, a care worker asked innocently what he was like before he became ill. I spent a few minutes standing next to my husband tellling her all good things about my husband when he stopped me and said, "You're not helping."

At first I thought he didn't like the topic of conversation, that he was chastising me for reminding him of his past life, but no, he wanted to walk and I was standing still. His immediate needs were not being met and he let us know it.

Goodbye to Lindy April 25, 2014

We all met Lindy when he accompanied his wife last year to our support group meetings. We knew him as quiet, intelligent, knowledgeable, sweet and unassuming. He lived at home with his devoted wife until he was unable to care for himself and she was no longer physically capable of caring for him. He finally was able to live in a brand-new assisted living facility where his wife joined him every evening for dinner in the well-appointed chef-run dining room.

Finally because the family was not able to support his placement without financial assistnce from the state. His children were not able to assist financially  but also not helpful in getting this accomplished.

We members of the Alzheimer's support groups I lead or belong to in Arizona have many members who live in second marriages which have been happily in existence for two or three decades after one or both spouses retired. Arizona is of course one of  the most popular retirement destinations and many people marry again after their first beloved partners die and most marry partners who have been bereaved themselves or divorced.

The families I have been privileged to meet really appreciate their good fortune in finding second spouses with whom they are compatible and in living comfortably in warm winters without the strains of professional life or child-rearing. They make new friends, pursue hobbies, volunteer their time in many organizations until --booom- one of them begins to change due to incipient dementia, cognitive impairment and Parkinson's disease or Alzheimer's disease is diagnosed. 

Most of the couples I have met merely shift the responsibilites slowly from the affected person to the more cognitively healthy one, although many of them have physical lmitations themselves. They don't often share their burdens with their own children who live in another state and rarely confide in the affected spouse's children. It is only  when the children arrive for a holiday visit that they begin to sense something is amiss. Some children return home and do nothing until the next visit; some offer helpful suggestions, increase the number of visits and participate in the decision-making. Others less so.

The burden and the stress of caregiving for a beloved spouse weighs heavily on the caregiver. Nancy Reagan called it The Long Goodbye.  It is so helpfu to have adult children and grandchildren support the caregiver to make the affected person's life as meaningful and as safe as possible.

The Visiting Wife is Here April 17, 2014

Just as new parents and grandparents tell all who will listen of the ingenious feats of their newest family members, we caregivers of Alzheimer's diseased spouses and parents reduce the tension in our lives and in our support meetings by recounting the antics of our loved ones. For example when my Mom had Alzheimer's disease and was in the middle stage of the disease she no longer could hostess or prepare food for herself or others, but when she greeted vistors she always continued to ask "Can I get you anything?" I tell this story as well as the fact that Mom could play the piano "get music out of that" which is what she would say anytime she saw a piano.Then she would sit at the piano and play parts of classical pieces she recalled until three months before she died.

My husband has been in out of home placement due to his agitation, aggression and violent behavior for three years now. I visit daily and my son visits at least once each week when I am in town and more frequently if I am away. We did not know for a while whether my husband recognizes us still, as his speech is less intelligible all the time and he no longer calls us by name. He hold his arms out for a hug whenever anyone comes to visit him or the other residents who have been at the home with him for a

significant period of time.His speech is usually clear only when he needs something such as food or assistance in the bathroom. This in itself is amazing. He sounds just like his pre-Alzheimer's disease self when he is demanding. Sometimes he asks for a banana or an apple, milk or coffee specifically. Mostly he says "I'm hungry."

With me he directs me to walk, to "get up" if I sit. "Let's get out of here" is still a favorite refrain but when we do leave the premises his wish is to return quickly to the comfort of his familiar surroundings."Let's go back" he will state clearly. Sometimes he is annoyed with the leaves that have fallen on the path or the sidewalk or with the temperature. "It's too hot," he will say or "I'm cold."

He is quite anxious lately and seems to need to walk all the time except whe he naps.

So we were really amazed this week, when Steve entered the unit, saw my husband walking, greeted him and said "Look who I brought with me." My husband turned, saw me, turned back to Steve and said, "The visiting wife is here." So now I have the validation I have been seeking for several months. Inside his head and his heart, sometimes, my husband still knows who I am and that knowledge makes it all worthwhile and lifts my spirits.

Clearing the Fog April 9, 2014

When I get sidetracked it is often difficult to return to routines I find fulfilling and helpful. Thus, when my husband became ill last month, I stopped writing--including this blog-- even though he has since fully recovered and is requiring less of my time visitng and worrying.

When there is a difficult problem I need to solve, I seem to get lost in a fog with only the problem and its subsequent decisions and behaviors taking up all of my energy; the rest of my days seem to go by on automatic pilot even after the crisis has past, usually until someone calls me on my neglect.

It is so helpful to me when a friend phones and says "I've missed you at the gym. Are you all right?"

This time it was a friend from NY who phoned and asked why I had not written a blog entry since March 18th. It is time to awaken to the beauty of the Arizona Spring - April when the cactus bloom and the desert is alive with color!

I attended an Alzheimer's Association Support Group Facilitator's Training session yeaterday about the need for healthy as well as symptomatic folks to volunteer for clinical trials at the Alzheimer's Institutes. The speaker stated it was due to the thousands of volunteers that an antivirus was found to treat HIV-AIDS. We need to find a cure for Alzheimer's disease! It is so difficult to watch the fog around my husband deepen which locks him far from us who love him.

Clearing the fog is sometimes as simple as cleaning our eyeglasses and seeing the world more directly. Sometimes it is confronting an issue that seems too difficult to tackle; facing it head-on, asking for help will often clear my head so I can deal with whatever I have been avoiding.

And now preparing for the holiday will give me the lift I need. Passover and Easter are times of rebirth, revitalization, of reconnectiion with friends and family. It is time in April to remember the six million who perished under the tyranny of Nazism and it is also the time to celebrate life, to appreciate the blessings we have and to purposely enjoy the relationships old and new we have made, to invite others to share in the bounty of the spring fruits and vegetables and to share ideas and companionship.

Happy Passover and Happy Easter.

Illness March 18, 2014

When my children were young, I was always so upset when they were sick-- and so fortunate that none of them was sick often or severely-- but as parents, we worry. What can we do to make them comfortable? When do we need to see the physician? When do we need antibiotics or just let the flu or cold run  its course?

This week, my husband is ill; he has a chest cold and similar to his behavior during the many years when he was healthy, he wants nothing more than to be left alone when he is sick. But just as when my children were young, my husband who has Alzheimer's disease cnnot tell me his symptoms, cannot make good decisions regarding his health or anything else and it is so hard to just sit there, hold his hand, place a cold cloth on his forehead, give him tea with honey and let him rest.

It seems as if he has aged ten years in the past week; he no longer greets me as someone special in his life. I am merely one of the kind people who care for him on a daily basis. It is so sad to see his stooped form walkng slowly from the dining table to the recliner, relating to no one, eating very little.

What can I do? I can increase my diligence to advocating for this disease, to advocate for increased funding to provide research to find a cure for this devastating slow deteriorating brain disease -and to refute claims by some that this disease is merely the result of an aging brain!!!

My grandson and I had a late brakfast at our favorite restaurant ysterday and overheard a conversation at another two tables. At one table a man sat alone, a widower for 30 years who said his children swore to disown him and never let him see his grandchildren again if he dated or married another woman, an edict he has followed all these years!  A man across from him, a minister, said his wife is in a home; she has Alzheimer's disease and was diagnosed in 2001. His seatmate lost his wife to Alzheimer's disease 4 years ago. 

Maybe it is because I live in a state with a large population of older adults, maybe I listen for these stories more now, but when I spoke at a church last Sunday, almost everyone's hand went up when I asked how many folks knew someone who has Alzheimer's disease. I think the incidence has been increasing. Is it because we live longer now?