Wednesday, January 12, 2011

"Alzheimer's starts in your childhood"

"Alzheimer's starts in your childhood" Dr. Fortanasce was speaking to a packed hall. In all honesty, I jumped out of my skin when I heard this. Dr. Fortanasce was hosting this free seminar that helps us understand about what we can do, to change our lifestyles, to avoid getting the dreaded Alzheimer's disease. " Clinical studies have shown that 42% of the world's Alzheimer's population is in US". So the question is is it diet? or is it in our genes?

Dr. Fortanasce went in to details of our diet and compared diet of people from other nations. "Chinese don't drink as much wine as we do. Is that why they don't get Alzheimer's?  Wait a minute, Italians drink ten times more than what we Americans do, yet they don't have as many cases of Alzheimer's as we do".  Okay this was getting interesting.  How about Genes? Is it that we Americans are having it in our genes?  "Japanese living in America is having more chances of Alzheimer's than born and raised Japanese living in Japan".  Okay, I am confused. Is it the air we breathe? or the water we drink? Or is it because we live in our cars more than in our home.

"It is our lifestyle. Today's lifestyle rides on stress, bad diet, excessive TV, lack of sleep etc etc. We disturb our natural equilibrium and all these have a telling effect on our system. Alzheimer's is a direct effect of us abusing our own system". Our body needs nourishing and balanced diet. Our body also needs exercise, rest and relaxation. Our brain is like iron. If you don't use it it will rust.

Serotonin, Melatonin, and Sleep

In "The Secrets of Serotonin," Carol Hart explains that serotonin has a close relationship to the body's sleep-wake cycle. Serotonin levels are highest in the brain stem when you are awake and active, and almost completely absent when we enter REM sleep, the deepest stage of sleep. During sleep, the body's level of melatonin rises sharply. The production of melatonin is dependent on its synthesis in the pineal gland, which is powered by serotonin. While light increases the production of serotonin, darkness spurs on the synthesis of melatonin. Paired together, these two neurotransmitters are key in maintaining the sleep cycle.

Hart notes that anything that disrupts the rhythm of serotonin and melatonin production will disturb the natural sleep cycle. When you suffer from jet lag, for instance, your serotonin production cycle follows that of your home time zone and has trouble getting on track. During the winter, when sunlight inadequately triggers the production of serotonin, sleep cycles can also be interrupted.(source,

Science Daily reported in 2002 that research completed at the Brain and Behavior Institute at the University of Maastricht in the Netherlands found that depletion of tryptophan and serotonin "appears to impair memory and learning." The depletion of serotonin with age may increase the likelihood of diseases that affect the memory, such as dementia and Alzheimer's. (Source :- )

While light increases the production of Serotonin, darkness increases the production of melatonin. There should be a healthy balance between the twoo, not a situation of one more than the other. Watching late night TV shows and then getting up in the morning and rushing off to work is typical lifestyle in US. This contributes to  increasing  chances of getting Alzheimer's.

"35% of people who eat bread at a restaurant are more likely to go for the dessert. When it is time for dessert, desert the place" There was few laughter around the room. "When you go for a hamburger, what do you eat first? Fries? Studies shows that by eating carbs first, your ghrelin level goes up creating a craving for carbs and we consume more carbs than our body needs. Red Wine is good for you" I was happy to hear that. What tickled me the most was the picture of the evolution of man. We are all familiar with the ones from apes to neanderthal. This time there was one after the neanderthal, which was a fat sloppy modern man with a jar of soda in his hand. This way more than funny, little do we realize how we harm ourselves.   Speaking of diet, Dr. Fortanasce, gave us sufficient information on what to avoid and what is good for you.

"Do you know which three profession has the highest probability of getting Alzheimer's?"  Dr. Fortanasce was on a roll. "Doctors. Lawyers and policemen" He was looking around the room for agreement. " Do you see the reason? What do these professions have in common?  STRESS". I raised my hand from the back of the room " Doctor, can you add a fourth group, for Small Business Owners?" . The whole room burst out laughing. The talk by Dr. Fortanasce was very useful. I must admit that I learned a lot. Dr. Fortanasce is the author of the book "The Anti-Alzheimer's Prescription". It is a great book and I highly recommend this reading.
Dr. Fortanasce encourages D.E.A.R program as a way to prevent Alzheimer's disease. D.E.A.R stands for Diet, Exercise, Accentuate your brain reserve, Rest & relaxation. I learned a lot about the diet and the exercises that we should be doing. The lecture series continues every Tuesday and it would be wonderful for anyone with interest to participate.

Okay guys, I plan to go home now, it is almost 8:00 PM. I need my food, exercise and rest to star tomorrow with  fresh energy. Good night everyone.

Wednesday, January 5, 2011

Alzheimer's Care Giving

"What makes a good care giver for Alzheimer's"?  Dan was curious to hear about what made our services special. Dan's wife Lisa is suffering from Alzheimer's and they have been trying several agencies without much success. " My wife prefers to sleep in all the time and it is not good for her health. She needs to go out a bit more and also eat better. Right now the appetite is not there and she is losing weight".

Dan's concern is legitimate. The caregivers right now sit and watch the TV, because his wife is sleeping. " This is ridiculous. Isn't there a better way?". "Of course there is a better way" I told Dan. The most important thing to realize with Alzheimer's patients is that there are no standardized approaches that would work for all Alzheimer's cases. Each case is a unique case and the care plan has to be developed customized to work for that client. It may or may not work for the next client. Also the approach has to be one of constant improvement.

Caring for Alzheimer's and Dementia clients can be quite unlike caring for any other type of situations. A patient rehabilitating from surgery or muscular dystrophy etc are all capable of thinking and understanding. They can have good communication with you and understand your conversations. They can also tell what they need and what they don't. However, in the case of Alzheimer's clients, the caregiver has to do the thinking. Alzheimer's clients are like children and the caregiver becomes the parent.

Alright, Care giving for Alzheimer's is not just a regular care giving job. There are some unique approaches that helps in caring for Alzheimer's clients.


In many situations verbal communications does not get very far with Alzheimer's clients. Clara, one of my client's wife recently asked me to take her husband Paul to the doctor's office. Paul has been very challenging to handle, he does not understand any verbal communication. The nurse at the doctor's office asked Paul to sit on the hospital bed. Paul was not getting it. They tried several ways to get Paul on the bed. No luck. I then jumped up on the bed like a kid and started bouncing up and down like a kid, "hey Paul, want to try this?". Paul could see this was a lot of fun and he to jumped up on the bed. Next the nurse wanted to get his BP and Paul would not the girl touch her. I rolled up my arm showing off my biceps and Paul instantly did the same. Nurse could now take his BP, making it look like she was checking out his muscles. Here standard verbal communication did not work. But they can mimic your actions.

Change of scene, Nancy's dad has been driving away all the caregivers she hired for him. I covered this under my previous blog " I don't need a nanny". here the difference was the dad does not know the caregiver as a nanny or a caregiver. He thinks she is someone he knows and she is there to hang out with him. So the approach has to be constantly creative. Look for things that will connect with your Alzheimer's clients and develop from there. Don't be stuck to a standard approach.

Take Charge
When the caregiver for Nancy's dad meets him, she would immediately take over. "Fred, are you ready to go on our lunch date", would be her opening conversation. She would take charge of the situation right away and orchestrate the activities. Remember, you are able to think and act and your Alzheimer's clients depends on your thinking ability. Take charge and please do not wait to be told what needs to be done.


Smile a lot and that brightens up your clients face and her demeanor. Show enthusiasm and drive to be there. In my experience, I have seen the Alzheimer's clients are very perceptive. They may not be able to express it, but it certainly reflects in how they connect with you or responds to you. Enthusiasm sends out a positive vibe and I have seen in most cases than not, they respond positively to it.

You will need a lot of patience. Many communication may be repetitive and in circulatory mode. Owing to their reduced information retention capacities, they are bound to repeat their questions or conversations. Don't be offended, it has nothing to do with you. It is a function of the disease they are going through. Also there are no rules of conduct that your Alzheimer's client is going to remember. We have have the patience to start the conversation all over again and again.

Let us be honest. Caregiving for Alzheimer's clients can be very taxing. You need to have good endurance skills. So make sure you rest well and you have fun doing what you are doing. If you ignore your health, there is only so much you can do to help someone with Alzheimer's.

Love & Compassion
Caring for Alzheimer's clients is like parenting. Your words and action has to come from a high point of love and compassion. Trust me, you are doing god's work taking care of Alzheimer's clients. If you are the chose one to provide care, you are already better than most people.

Have a good night folks and thanks for reading my blog. If you have any feedback, I will be delighted to receive them.

Warm Regards