Book Review: Love, Loss, and Laughter

Why do I appreciate this book? Let me count the ways.

1. I read about this book on The Alzheimer's Reading Room here and knew I had to get it and I have not been disappointed. If Maria Shriver's book, What's Happening to Grandpa? reviewed here is great for kids, Dr. Cathy Greeblat's Love, Loss, and Laughter: Seeing Alzheimer's Differently is perfect for the carer and the family of the person with dementia.
2. The pictures do justice to those suffering with dementia illnesses and Alzheimer's and the captions that go with them show so much love and respect. Contrast this with the very AARP pictures that I wrote about here. Rather the book contends that "people with dementia don't disappear unless we disappear from them"(p. xiv). The pictures are from all over the world and do show wonderful carers and people being cared for. Richard Taylor (man with dementia) writes eloquently in this book.
3. The book contains not just Greenblatt's writing, but wonderful insightful quotes from everyone including Princess Yasmin Aga Khan to Bob DeMarco of The Alzheimer's Reading Room.
4. Specific ways in which carers can bring to life the people they care for are mentioned. Basically they highlight what the person used to like to do or what their career was. I have been worried about all the TV my husband watches, but then I realized that movies have always been his thing. He has a great collection of them and uses his mind to operate the controls needed to view. He has his favorites and while this used to bother me (Don't you get tired of the same movies? I would think), nonetheless it is who he is. It is his hobby that he enjoys.
5. The theme of the book seems to be:

   Enhancement of personhood and efforts to maintain quality of life should be our highest priorities. (p. ix)

   This is illustrated with all the pictures and captions/notes for the pictures that Cathy Greenblat included.
6. Should we ever need a nursing home placement, the book contains wisdom in selecting one including web sites to choose one in our area.
7. More than any other book I have read on the subject, this one highlights the need of our loved ones to feel useful. No, I am not being condescending when I ask my husband's opinion on something, or have him move boxes for me, but rather we both feel better about the situation. Currently I have carpal tunnel again and do need his help.
8. In the moment. Oh yes. Sally's husband and my husband do not always remember what happened earlier in the day. Sally and Jake took a week vacation and when they were home Jake had forgotten all about it. I mentioned this to DH and he said sympathetically (despite his own short-term memory) "Is Jake that bad?" Life then can be celebrated in the moment. This may be why I take so many pictures of my husband's moments. And it actually might not be a bad idea to live in the moment for all of us. We can't change the past and the future is in the LORD's hands.
9. The best practices include letting patients socialize. I see this in our life and also in the nursing homes described in the book.
10. I hadn't read this before, but have felt that my husband is indeed learning new things. "If we get past the stigma, we realize that it's always possible to build cognitive abilities, and that people have the ability to progress right until the end"(p. 71). The book specifies using Montessori principles as outlined by psychologist Cameron Camp. I had only been using one technique with my husband and now have more ideas for helping him learn.
11. Many times I read about bloggers who are angry with their loved ones who, yes, can be very difficult. Yet Michael Verde, President of the Memory Bridge in Chicago, is quoted:

    Either we learn how to love each other, or we keep disappearing to each other. (p.88)

    Indeed being a caregiver lets us appreciate life and each day; we don't have to grieve yet. They are still here.
12. Perhaps worth the price of this book ($24.95--but I got a used copy), is the chart on pp. 104-105. It tells the caregiver what to do and not to do for oppositon, aberrant behanvior, agitation, aggression, delirium, hallucinations, and so forth.

After finishing this book today, I reflected that I can only do this excellent lovegiving with the LORD's help. Others have all over the world as this book chronicles.  Today I heard on The Daily Audio Bible:

Thanks be to God who gives us the victory through our Lord Jesus Christ. Therefore . . . be steadfast, immovable, always abounding in the work of the Lord, knowing that in the Lord your labor is not in vain.

 (I Corinthians 15:57, 57)

What I'm Learning About Senior Health, Part One

Some of this information may not be new, but I decided to blog about it anyway, both for the lovegiver's health and the loved one's health.

A University of Massachusetts-Lowell clinical trial showed that drinking apple juice significantly improved mood and behavior among a group of patients diagnosed with moderate-to-severe Alzheimer's disease. Cornell University research also suggests that quercetin may be the compound in apples that protects brain cells against oxidative stress associated with Alzheimer's.

This was reported on The Alzheimer's Reading Room. Of course actual apples have more fiber than apple juice has. My husband regularly gets applesauce.

Get the proper rest you need according to a study here.  Research suggests:

1. Avoid going to bed and getting up at different times.
2. Don't do games and social networking before bed. These keep your mind racing.
3. Don't read or watch TV in bed.
4. Keep the light in the bedroom low. I do think that the Alzheimer's patient does need some light, however, so they can identify things at night.
5. Sleep helps fight off infections by releasing hormones in the body.
6. Energy is restored.
7. The brain is working to create new pathways. You know the expression, "Let's sleep on it."
8. While we sleep the heart rate and blood pressure are reduced.

I also wrote earlier on this blog about rest here.

How we process our food is important according to Kimberly Snyder. I have also pinned some of her health ideas on my Pinterest Board which you can follow by clicking below. Our loved ones need fiber from vegetables, fruits and whole grains. According to Kimberly, artificial sweetners aren't absorbed by our bodies, so they pull water into the intestines leading to loose stools. Stevia is the most acceptable artificial sweetner and I use a combination of real sugar and stevia for my husband. Murky pee could be a uninary track infection that caregivers are so concerned about for their loved ones; patients can go downhill with these infections but not complain I read on The Alzheimer's Reading Room (see link on side). So we need to check their pee.

The older we get, the less thirsty we feel and then the more tired. I have a friend, Shirley, who sends me wonderful e-mail and I discovered from that e-mail a strategy for drinking our water.
Drinking water at a certain times maximizes its effectiveness on the body:

• 2 glasses of water after waking up - helps activate internal organs  
• 1 glass of water 30 minutes before a meal - helps digestion
• 1 glass of water before taking a bath - helps lower blood pressure  
• 1 glass of water before going to bed - avoids stroke or heart attack

We also know that we wake up in the middle of the night and get a cramp in our leg because we needed more water or maybe the potassium in a banana. Older people need potassium, but I have heard that potassium pills need careful monitoring and the banana is as easier way to obtain that potassium. On Weight Watchers I can count a banana as zero points (as long as I limit them).

I also found out that a person needs to take CoQ10 with a stanine such as Lipitor or Crestor. Our chiropractor also recommended it as I wrote here.

Oh, and walk carefully so you or your loved one don't fall. My husband and I usually hold hands. Slows me down, but oh well! I get my exercise separately from my husband.

In vain you rise early and stay up late, toiling for ... ... It is of no use for you to get up early, and to go late to your rest, with the bread of sorrow for your food; for the Lord gives to his loved ones in sleep.  Psalm 127:2  

Anger of the Alzheimer's Loved One

“Whatever I neglect now I shall have to pay for later.”
― Nelly Ptaschkina

 Bob DeMarco on the Alzheimer's Reading Room (see above link) wrote this today:

The proactive Alzheimer's caregivers decide to do. This changes the way their brain is wired. This change leads them away from the "lamenting of their own sad fate", away from "venting" and puts them on the path to the positive. The path of doing.

De Marco says that he has been interviewed and he is asked to talk about how horrible being a caregiver is, but he doesn't respond to how horrible being a caregiver is. When you read his interaction with his mother, Dotty, you see how he cares for her proactively.

We can do much proactively ourselves with the LORD's help to not have an angry loved one. Yet anger is inevitable for our Alzheimer's loved one. The brain's hippocampus, which controls social behavior, is losing neurons.  One man in my support group whose father had Alzheimer's reported that the family had to hide all the knives in the house. The 36-Hour Day, 4th Edition, says: "Try not to interpret anger in the same way as you would if it came from a well person." (p. 153) Jennifer Ghent-Fuller says that person with AD have both "an altered view of reality" and "behavior that can change depending on how we interact with them." See Ghent-Fuller's Internet Article. Excellent help in this article.

We need to do whatever it takes to make them feel emotionally secure so they don't become angry. We need to change--they can't. Show them respect. Let them in on their medical situations perhaps by saying I need to provide clues for you because you have short-term memory. Then do not harp on this fact. My husband came up with several solutions himself. He asked for a daily checklist for when I am gone. DONE. (Some days he doesn't remember to use it, however.) He asked for a small calendar like the one he used for 2009-2010. DONE. I went to Staples today and got the earlier one for all of 2011-2012 essentially for free because it was discounted to $5.99 and  I had $6.00 in reward points. (More on couponing later.) Then I wrote events in that calendar.

Scripture says, "A gentle answer deflects anger, but harsh words make tempers flare." Later in that same Proverbs 15 chapter we are admonished to think carefully before speaking. We have to give important information simply.  Keeping a journal of problem behavior and that journal can lead us to solutions. What led up to the anger? How did I respond--gently? If not, how did I make the anger escalate. The Alzheimer's Reading Room always has great clues for speaking gently and we can put our ideas out there for solutions and Bob and his readers generally reply.

We can affirm the emotions the Alzheimer's loved one  feels. You greatly miss driving. . . .  I see what you are saying. . . .  It may be okay if we give it time.  However, we have to say only one idea at a time. See if we can figure out their point of view.  Sometimes we can distract them with something they like such as ice cream. There may come a time when the neurologist or primary care physicial needs to prescribe anti-psychotics or anti-depressants for either the AD loved on or the caregiver herself!

Back to the quote at the top of this post. We can be proactive. Judy Berry on The ALZHEIMERS READING ROOM writes

 The ONLY Way to Deal with Challenging Behavior

 in Persons with Dementia IS

"To PREVENT IT in the First Place"

Alzheimer's Reading Room Quotes Post One

Bob DeMarco writes the Alzheimer's Reading Room. See link at right.  Bob is taking care of his 94 year old mother.  Here are some of his quotes and that of others from his Reading Room.

• I am saddened when I hear these words --this is not the person I knew -- because those words objectify the person suffering from Alzheimer's. When you objectify a person you also dehumanize them. Once dehumanized the person becomes a villain.
• My mother is still the same person I have known all my life.  She suffers from Alzheimer's disease.  Her brain sends her the wrong signal quite often. Its up to me to let her use my brain.When necessary.....
• Dotty and I would start living our lives as we always had. It took me at least two years of Alzheimer's caregiving to figure out that we needed to start living our life the way we always had. I knew we had to do something or the end was going to come sooner rather then later. Either Dotty was going to drop off the edge of a cliff, or I was going to jump off the edge of a cliff.
• Carol Blackwell quotes someone else in a Reading Room article. “If you face a difficult situation, you have two choices. You can change the situation or, if you can’t do that, you must change yourself to meet the situation.”
• Tom and Karen Brenner are quoted: Pay attention; look at the faces of the people you love, listen to the music of your life, feel the wind on your face, taste the ice cream. These moments are like jewels, strung on the necklace of time. If we lose these small jewels of life, we lose ourselves.
• Barbara Pursley writes about taking care of her mom who has Alzheimer's:  The essence of my being is constantly changing from happy to sad, from mental order to disorder, from freedom to chaos, from physical energy to fatigue, from hope to hopelessness, from my life to her life to our life. I know people mean well when they say, “Don’t forget you have to have a life of your own, aside from your mom, but maybe what I’d prefer to hear is “I know how difficult it must be caring for your mom and meeting your own needs too, so if there is anything I can do to lessen your burden, please let me know.”

Dear Lord, We are letting You know. Please be with and bless these people who write on the Alzheimer's Reading Room and help them with their challenges.  Thank you that I am learning to bless my husband and enjoy the simple life we have together. Help me to not whine, but to trust You for the challenges ahead this month. Thank you that the expert plumbers are here. Amen.