There are at least 10 different types of dementia and no two dementia's are the same. Our primary focus over the next few months will be discussions about the different types of Dementia, the behaviors for each and specific activities and techniques along with diet and exercise for caregivers to consider when working with individuals with Alzheimer's and other Dementia. Their loved ones can employ these techniques to help alleviate some of the behaviors, agitations and stress.
Remember Dementia is not Alzheimer's Disease. The definition of Dementia is "a chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning."
Let us take a look at the list of the Ten types of Dementia that should be studied. Some will be more recognizable while others may be less so.
- Alzheimer's Disease - Click here to Read
- Lewey Body Dementia - LBD Click here to Read
- Frontal Lobe Dementia Click here to Read
- Vascular Dementia Click here to Read
- Parkinson's Disease Click here to Read
- Creutz Jakob Disease Click here to Read
- Wernicke Korsakoff Syndrome Click here to Read
- Normal Pressure Hydrocephalus Click here to Read
- Huntington's Disease Click here to Read
- Mixed Dementia Click here to Read
Dietary Considerations for Individuals with Dementia
As a New Year rolls in and you resolve to provide the best quality of care for your loved one with Dementia, and you plan to improve their lives in as many ways as possible, a balanced diet with nutritious brain healthy foods must be top of mind. A vital part of our being healthy is our brain health. Home cooked meals should be planed with fresh ingredients, herbs and spices to meet an individuals taste and nutrition needs. Food textures should be considered and meals should be served at the right temperatures in order for the individual to enjoy the experience. Bland and pasty foods should be avoided in favor of foods that are fresh, flavorful and colorful.
Whenever possible, meals should be fresh cooked and prepared in an open kitchen or with the kitchen door left open to allow the sweet aromas to permeate throughout the home, helping to boost your loved ones appetite. Individuals with Alzheimer's Disease and other Dementia's respond well to these stimulating aromas and tend to have a healthier appetite.
Individuals with Dementia's should be encouraged to participate in food preparation. No matter how small their contribution to the process, be it soaking lentils or snapping peas, participation builds confidence and enhances their sense of worth. Simply observing the process as you cook could enhance their memory while improving their sense of wellbeing.
One meal plan doesn’t suit everyone, and as we age, our preferences change. This is true for people afflicted with Alzheimer's and other Dementia. Their appetites may fluctuate between strong or weak depending on their disease stage. Care is needed in selecting foods for different individuals at different stages of Alzheimer's. Brain nutrition is an important part of their wellbeing as it is with any individual. Let us Consider some broad food groups that are beneficial to individuals afflicted with Alzheimer's Disease.
A variety of Nutritious foods should be served, while each meal should have the colors of nature. Remember the golden rule ! - Serve Foods according to the time of day. Dark foods at night, Bright Yellow " Sunny " Colored foods at mid day and the lighter paler colors in the morning, Individuals with Dementia forgetfulness or any type of mental agitation or cognitive decline will benefit from a healthy diet made up of some or all of the foods listed here
- Grains - Serve Steel Cut Oatmeal in the morning
- Breads -Golden Toasted Brown Bread with Butter for Breakfast
- Oranges are the color of the Afternoon Sun - Serve them in the Afternoon
- Proteins - Serve Heavier proteins for lunch for better digestion
- Steamed Vegetables broccoli - potatoes, Beetroot, Carrots and Steamed Peas make for an easy to digest dinner
The time of day is important when planning a meal for individuals with Dementia. Remembering to serve three meals a day plus snacks and lots of fluids needs careful planning. Consider the continence of a person. If they become Incontinent, avoid too much fluid at dinner time. Instead plan lots of hydrating juices and water during the daylight hours. Similarly, too many carbs may cause constipation, so your senior needs a balance of protein-rich grains. Dementia and forgetfulness as well as mental agitation can be significantly reduced by following a well-thought-out meal plan. Here are a few Ideas of foods that may help stave off cognitive decline. Serve these at the appropriate time of day.
Activities for Individuals with Dementia
Most families expect to see highly stimulating activities throughout the day, however try to vary the intensity of activities depending on the individual with Dementia, as all residents respond to different levels of stimulation at different times of the day, and on some days, they are better left to rest and relax.
Activities of Daily Living are important to establish a routine. Below is an example of a recommended Day, keep in mind that each routine varies depending on the individuals care needs.
Following a Daily Routine can be extremely effective for individuals displaying signs of Dementia forgetfulness or any type of mental agitation or cognitive decline. Here is an example of one such daily routine
- Wake them up at the same time each morning -say 7 am
- Breakfast should be served by 7.30am
- A Short walk in nature - feel the sun
- Morning Devotional Reading 8.30 am
- Light Exercise and Stretching
- Relaxing Music to set the mood for the next activity
- Brain Stimulating Board Games - Trivia and Mental Exercises
- Lunch Should be served at 12 noon
- Music While you eat
- Siesta Time - A Short Nap to get ready for the afternoon
- Gentle Music to wake up to
- Afternoon tea and Snack
- Arts and Craft for Dexterity Building
- Puzzle Time
- Dinner Time 5.30pm
- TV time - Winding down for the evening
- Encourage them to go to bed by 8 pm every night
If a resident was private and not very social before moving into a community, it is more likely that they will not engage in social activities, just as the disease process for dementia residents is separate from one another, the way we engage should also be different from one resident to another.
When we have events and families attending large celebrations, sometimes this can be overwhelming for someone without dementia, so we like to keep the day and moments before the celebration calm, and light.
The Goal is to learn, and understand each resident, when this is established we can focus on the care we need to provide
Common Behaviors observed in Individuals with Dementia
"Acting Out" or Dementia related behaviors are common, it is our responsibility as the Caregivers to understand how to communicate positively. Remember a person with a Dementia Diagnose cannot control their emotions or actions, it is up to us to help them maintain safe and calm.
When residents experience complications associated with Dementia due to Alzheimer's Disease, Caregivers should use Clear communication this technique requires positive daily reinforcement and caregiver education. It is a Process not an event.
Experience shows us that one approach or technique will not always work for all residents or is the fix all to address each issue. Caregivers must understand that the person they are caring for cannot help their behaviors, and that they have reasons for every reaction. It is our responsibility as experts to understand how our direct care can affect your loved ones willingness to complete tasks.
Care communities are licensed by their state and are required to perform monthly caregiver training. These In Service training sessions can last up to two hours and strive to inform caregivers of the latest research and best practices when approaching residents with Alzheimer's Disease. Walking the care staff through the differences of each resident's unique disease process helps them better understand and appropriately care for each resident in a dignified manner.
Consider the following techniques when dealing with common behavior's in individuals with Dementia.
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The most common form of Dementia is Alzheimer's Disease. Each type of dementia is different and must be treated according to its unique differences.
Alzheimer's Disease is a progressive neurological disorder that causes the brain to shrink and the brain cells to die (Mayo Clinic, 2022). It affects mostly people aged 65 years and older, both men and women. Alzheimer's is not a normal part of aging. A few signs and symptoms include increased memory loss, confusion, difficulty with language such as finding the correct words, unable to make logical decisions, inability to handle new situations or learn new things, wandering, and anxiety just to name a few.
Mental and Physical Stimulation is a hallmark of our care program at Evergreen Cottages that out Residents benefit from. Our Executive Directors will share some of the Brain Healthy Foods, Activities, and Caregiving Tips organized for our residents with Alzheimer's.
The importance of Good Nutrition for Individuals with Alzheimer's Disease
Nutrition is a top priority in the care of residents with Alzheimer’s Disease. A variety of fresh healthy food options helps promote a feeling of well-being and reduces adverse behaviors in people afflicted by Alzheimer's. Caregivers caring for people with Alzheimer's should focus their attention on whole foods with healthy fats and serve foods that are rich in vitamins and known to provide neurological benefits.
Daily servings of the following foods high in Vitamins E and C, nutrients that are essential for people with Alzheimer's to maintain a healthy diet.
- Leafy greens
- Whole Grains
- Legumes such as Lima beans, black beans, black-eyed peas and pinto beans
- Apples, Oranges, Bananas
A weekly serving of fish containing good omega three fatty acids that not only help improve hair, skin, and nails, but also help promote cognitive abilities and some memory challenges.
Reducing Red Meat servings and favoring grilled chicken along with a variety of legumes such as Lima beans, black beans, black-eyed peas and pinto beans may help improve brain nutrition.
Choose fresh fruit Snacks such as apples, oranges and bananas loaded with potassium and Vitamin D & E. both essential nutrients for the body.
Avoid Junk foods, sodas, candy and any artificially sweetened or highly salty foods. These empty calories disrupt the body's stability and increase cravings and ultimately cause agitation, which too often leads to lost sleep and a cycle of disruptive behavior.
Stimulating Activities for Individuals with Alzheimer's Disease
As we discuss Alzheimer's disease, it is important to consider the last few senses our residents may have and the activities they can enjoy. One of the most common activities you will see are Sensory and Tactile items. These items are usually vibrant, and should have things like zippers, buttons, a variety of textures to stimulate the touch sense and can be an apron, hand muff or even a table mat or blanket. Fidget blankets, as some may know these items can help promote hand dexterity.
Brain Stimulating Activities for individuals with Alzheimer's Disease
- Sensory and Tactile Items
- Fidget Blankets
- Music Therapy
Music therapy has been proven to help residents with Alzheimer's before starting most activities of daily living such as bathing or getting ready for bed. Soft quiet music that is easy to sing along can stimulate residents and alter their mood or disposition.
Our activity program is always evolving, and very fluid as our residents change. Be sure to visit and Follow our Facebook page to keep up to date with the many varied activities we enjoy at our cottages.
Care giving Tips to help your loved one with Alzheimer's Disease
Today we focus on Alzheimer’s Disease and one of the training topics our care staff receive is in Redirection to care more effectively with residents who have Alzheimer's Disease.When considering the disease progression, it is important to remember that individual may experience different stages of the disease at different times. No two residents are alike.
In the Initial stages, the individual experiences memory impairments with behaviors such as repeated questions or phrases, sometimes even repeated activities such as packing their belongings into a suitcase late in the day or waiting at the front door for a ride home. With that repetition, utilizing things in our cottages to help redirect, and instill a feeling of security.
Tips & Techniques to Consider when caring for individuals with Alzheimer's Dementia.
- Never to Argue with residents when they are exhibiting behaviors
- Redirect them when possible is sure to win their hearts and cooperation
- Try to remain calm and minimize the situation
- Agree with a loved one to maintain safety
- Direct eye contact and a tone of voice that is appropriate for the resident at that moment are also essential
Education and ongoing training are a prerequisite for residents to maintain their independence and dignity while affording caregivers the opportunity to better the lives of our residents. Feel free to visit our Facebook Page Evergreen Cottages to keep up with our Activities.
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Continuing on our education series on Alzheimer's Disease and other dementia's, we examine Lewy Body Dementia (LBD) which affects over One million individuals over 50 years of age in the United States. This makes Lewy Body the second most common manifestation of Dementia.
Abnormal deposits of proteins called alpha-nucleic deposit on the nerve endings in the brain, causing cognitive dysfunction, changes in mood, behaviors, movement and thoughts. Lewy Body Dementia (LBD) is named after Dr. Frederich H. Lewey who discovered them while working in Dr. Alois Alzheimer's laboratory in the early 1900's.
One of the first signs and symptoms of LBD would be visual and audible hallucinations. These could be as simple as what seems to the significant other as talking to themselves. Loss of motor coordination is another early sign, manifesting as rigid muscles, or loss of balance.
Many individuals diagnosed with LBD also display signs and symptoms of Parkinson's Disease, sometimes even being miss-diagnosed as Parkinson's. These two diseases usually occur together.
While there is no known cure for LBD, the treatment plan should be focused on a lot of support to help the individual attain comfort and a higher quality of life.
Nutrition and Lewy Body Dementia Individual
Lewy Body is the second leading form of Dementia, and nutrition is of extreme importance. Recognizing the disease progression is helpful when considering the foods for individuals with Lewy Body Dementia. Lack of hunger and an increased craving for sugar in the form of candy, deserts ice cream, cookies and pastries are the most common visible signs. Along with this change in taste, physical changes compound difficulty with swallowing, chewing, and being unable to feed themselves.
Individuals living with Lewy Body Dementia are more inclined to experience severe constipation. It is vital to monitor these symptoms and promote hydration along with foods rich in fiber. Natural stool softeners should be favored over medicinal alternatives where possible. A well-balanced diet comprising foods rich in antioxidants, anti-inflammatory foods and spices helps combat the cravings for sweets.
Foods Rich in Fiber to Consider for individuals with Lewy Body Dementia.
Communication is key to ensure the entire care team, including clinicians, caregivers, family members and assisted living home staff, can work together to improve the quality of life and deliver care and comfort to a resident with Lewey Body Dementia.
Activities for Individuals with Lewy Body Dementia
We would like to focus our attention on Lewy Body Dementia and activities. When residents with Lewy Body dementia start to decline or exhibit symptoms, rigidity in their muscles and limbs is very apparent.
It is important to have a good exercise schedule where the routine of stretching and warming up has mirrored movements and a visual representation. It is also important to try adjusting the stretching or warm-ups to modified seated versions. This will help build balance and flexibility.
When approaching any activity, it is important to stay positive and calm as people with Lewy body may experience changes in cognitive skills and mood changes which can make following instructions difficult. You can set a calm environment with soft light and soft music that will help promote relaxed feelings.
Activities that are good for people with Dementia with Lewy Bodies.
- Music Therapy
- Pet Therapy
When rigidity or muscle tension is deterring exercise its important to utilize massages or range of motion to keep blood and muscles moving. Assisting with these activities can be beneficial physically and emotionally for residents with Lewy Body.
How to Care for a loved one with Lewy Body Dementia (LBD)
Training is essential for the proper care of individuals with Lewy Body Disease and to address the physical changes that contribute to the individuals' unique needs. For example, with changes to cognition, individuals with Lewy body will and can exhibit vivid and more realistic hallucinations, delusions, and can also be more likely to misidentify familiar people. Redirection training is a key skill for caregivers, helping to not aggravate the individual, allowing them to process emotions safely.
Caregiver's training should include education on the importance of sleep for residents with Lewy Body Dementia and their inability to regulate sleep, specifically the REM cycle. This cycle is so important as it restores our natural ability to memorize things throughout the day, it also helps regulate emotions and helps restore energy. It is important to give our residents with Lewy Body Dementia, time to sleep when they are resting. It is prevalent to notice someone with Lewy Body Dementia take short naps throughout the day. Monitor and reporting any changes in sleep patterns should be emphasized.
To provide feedback or have your questions answered, please feel free to reach out to me if you wish to learn more on how to help your loved one with Lewy Body Dementia.
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Let's focus on Frontal Lobe dementia, FLD is a form of dementia that affects the nerve cells located in the frontal areas of the brain. The Loss of these nerve cells can cause a change in personality, language comprehension, and will cause difficulty with logic and reasoning.
Most individuals with FTD are diagnosed in their early 40's to early 60’s. Personality changes are the first noticeable signs of FLD, such as spatial orientation. For example, .
Recognizing the Signs: Frontal Lobe Dementia
- Individuals perhaps have trouble thinking of the right word or remembering names
- Understanding others
- Common symptoms also include hallucinations, and delusions that are relatively common in dementia
- Muscle weakness and coordination are also common symptoms which cause more problems for falls
- Individuals may become confused in familiar places such as their home
- There are currently no known risk factors associated with this form of dementia, but genetic counseling and testing are currently available for individuals with family history
There are medications available to help reduce symptoms associated with FLD, Treatment for depression and irritability can help improve the quality of life for individuals. FLD is one of the dementia as that is known to decrease abilities quickly, and decline is different from person to person .
Frontal Lobe Dementia Can good Diet and Nutrition help?
When considering the diet for an individual with Frontal Lobe Dementia, it is important to focus on the physical changes to the brain that are occurring during the disease process.
The frontal lobe portion of the brain manages decision-making, speech and impulse control. A nutritious diet for an individual with Front Lobe Dementia, it's vital to offer healthy options, it's very common for individuals to have changes in eating habits.
With that being said, most individuals with FLD will fixate on eating everything they can access, sometimes even items that are not edible. It is very important to ensure your loved one is offered high caloric items as well, as most individuals with FLD will wander or walk for most of the day.
It is highly recommended that meals be served in small portions and simultaneously daily to ensure a routine is a constant for rapid changes in behavior. Aspiration Pneumonia is common for individuals with FLD, as the impulse to inhale or swallow items is consistent with behaviors. Having appropriate textures, and ensuring caregivers maintain a watchful eye on individuals when eating to help minimize the issue.
Foods to Consider for individuals with Frontal Lobe Dementia.
- Finger foods, to help minimize the use of silverware
- Blueberries and Strawberries full of antioxidants and helpful in reducing inflammation
- Spinach and Kale
- Dark Chocolate high in Antioxidants
Frontal Lobe Dementia and stimulating activities
We will focus on activities for Frontal Lobe Dementia. Common symptoms and behaviors include changes in personality, loss of speech or difficulties speaking. Most common behaviors that consider patience and prior knowledge include lack of social awareness or empathy, and sometimes increase in repetitive behaviors such as tapping, clapping, or lip smacking.
With some of these behaviors, it is important to consider activities that will stimulate both physical coordination as well as mental coordination. Most individuals with FLD will With FLD, the best activities may last longer than most and on different occasions. For example
Daily Activities for individuals with Frontal Lobe Dementia.
- Walk throughout the day and for long periods of time if they can
- Using visual cards with pictures to recall words is a very effective way to stimulate mental abilities
- Memory Games are important for individuals they can participate with a caregiver
- Sensory blankets or Sensory aprons are highly beneficial for Individuals with FLD they can benefit from the physical and sensory activities to keep their hands stimulated
It is always exciting to see how our residents get involved and participate in the activities we offer. You can always visit our Facebook where we share current photos and videos of our Community Activities.
Frontal Lobe Dementia and how to maintain communication
With loved ones with Frontal Lobe Dementia, one should focus on the most common symptoms. Becoming aware of common behaviors and how to navigate small changes, this will help the individual live safely and with dignity. It is important to stay in a routine and prioritize activities of daily living with the individual's mood and ability to participate.
Understanding people with Frontal Lobe Dementia.
- Consider having minimal items that will pose choking threats
- Most individuals fixate on picking up items around the house and moving them around, as well as putting non-edible items in their mouth
- It is important to let individuals sleep during their time of rest
- Individuals are more likely to suffer from brain shrinkage, which will be displayed in behaviors that are not socially acceptable
- Frontal Lobe Dementia can cause individuals to wander and walk for hours on end
- It is widespread for individuals to have issues communicating with others and maintaining conversations
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As the Month of May greets us with longer warmer days we continue our dementia series. This month we focus on Vascular Dementia, a condition that changes memory, thinking and behavior resulting from conditions that affect blood vessels in the brain.
Vascular dementia is caused by inadequate blood and oxygen flow to the brain. This inadequacy causes damage to the brain cells and eventually causes cells to shrink and shrivel. The Symptoms of Vascular Dementia can be similar to Alzheimer's Disease.
Diseased small blood vessels cause changes in "connecting wires" or "White Matter" that is critical in relaying massages between the brain regions, leading to a Vascular Dementia diagnosis.
This death of cells changes the way individuals may think, act, or communicate. Persons with vascular dementia may experience sudden changes in thinking skills following a stroke.
Multiple minor strokes and other conditions that affect smaller blood vessels and lead to widespread damage may also cause diminished cognitive performance. As with other stroke symptoms, cognitive changes may improve during recovery and rehabilitation. The brain can generate new blood vessels, and brain cells, can take on new roles and create new pathways.
Treatment for vascular dementia is often managed with medications to prevent strokes and reduce the risk of additional brain damage. Some studies suggest that medications that are used to treat Alzheimer's maybe beneficial in early onset cases.
Treating modifiable risk factors such as high blood pressure, diabetes, high cholesterol, and problems with the rhythm of the heart can help prevent additional strokes. Living a healthy lifestyle is important to help reduce the risk factors of vascular dementia.
If you notice your loved one experiencing changes in sleep patterns, misplacing items, loss of interest in things or people, hallucinations, mood swings and changes in behavior, it's likely they are showing signs of Vascular Dementia, and it's time to seek professional help.
Healthy Activities for Individuals with Vascular Dementia
When caring for a loved one with Vascular Dementia it is important to focus on activities that are stimulating and engaging to their ability. Too much outside stimulation can cause disruptive behaviors.
During the warmer Summer days a calming indoor activity you can try is Happy Hands.
How to do Happy Hands at HomeItems needed: Washcloths, Water, Essential Oils
Method: In the microwave warm up damp washcloths for a few seconds, then add a few drops of your preferred Essential Oils. Use these washcloth to clean hands after dinner or as a separate activity to calm the individual during times when they are restless This simple exercise can help induce feelings of well-being and promote calmness and may help individual get a good night sleep.
Below are a few scents that stimulate good feelings
Caring for Individuals with Vascular Dementia and Minimizing Slips and Falls
We'll be focusing on Vascular Dementia as it is important to consider all the ways the body functions. Any trauma to the brain can cause changes in behaviors; Individuals with Vascular Dementia will exhibit changes to their cognitive functions such as:
- Changes in mood
- Mood swings
- Agitation and even..
With basic knowledge of dementia, trained caregivers who care for individuals with vascular dementia should consider similar considerations. When approaching an individual, who is displaying behaviors one should use a gentle and soft tone, in a very non-threatening approach. This is a safe practice for both the individual with Vascular Dementia and the caregiver.
Maintaining a routine would be beneficial to ensure your loved one is always aware of what tasks need to be accomplished. For example, utilizing the same time daily to serve or prepare lunch would help when redirecting. "Let's freshen up before Lunch" is a great way to remind individuals during moments of stress tasks that need to be accomplished.
Understanding fall prevention and keeping a safe home environment would also help with everyday tasks. To learn more about Vascular Dementia or if you have questions or concerns, feel free to reach out to the writer who is a nurse working in one of our communities.
Your Loved ones attending Physician one can help determine the potential of a Vascular Dementia diagnosis:- Here's how you can help
- keep a log of vital signs and share it during the next Doctor visit.
- Let the Physician know if you observed confusion or disorientation
- Did you notice Aggression or extreme personality changes? Mention these
Caring for your loved one with Vascular Dementia goes well beyond simply keeping them Showered, Clothed and Well-Fed. Their mental wellbeing is to be considered and all your efforts should be directed towards helping them feel loved, cared for and mentally stimulated in a dignified manner.
Tips to reduce fall risks for individuals with Vascular Dementia.
- Limit the use of area rugs, these .
- Install adequate lighting in the home
- Remove excessive Clutter
- Install Hand Rails in Corridors
- Grab Bars in the Bathrooms
- Monitor the use of Open Flame Gas Appliances
Continuing on our Dementia Education series we will be shining a light on Parkinson's Disease. A disorder of the brain that causes uncontrolled muscle movements, such as shaking or Tremors. Parkinson's can also cause stiffness and make mobility difficult and progressively impair speech. Soft or Slurred speech, slow movements and difficulty with mobility are some of the symptoms that begin gradually and progress over time >
Parkinson's Disease develops when the area of the brain called the Basal ganglia is damaged. The Basal ganglia is the area of the brain that controls movements and produces a chemical called dopamine. Dopamine is used as a transmitter or messenger for your neurons. When the brain's dopamine production decreases or neurons die, this begins to cause involuntary body movements. There is no explanation as to why these neurons begin to deplete or die.
Individuals afflicted by Parkinson's Disease also lose the nerve endings that produce the chemical norepinephrine. This chemical is produced by the brain and used to communicate with the sympathetic nervous system. The decrease in this chemical helps to explain the impaired movement and symptoms such as fatigue, irregular blood pressure, and constipation.
Parkinson's disease although hereditary, does not seem to run in families. It is believed to be caused by specific gene mutations and or a combination of genetic and environmental factors.
Symptoms of Parkinson's Disease
There is No Cure for Parkinson's Disease
Parkinson's Disease Nutrition Considerations
In the absence of a specific prescribed diet for Parkinson's disease, it is essential for Individuals to maintain a balanced diet including a variety of whole grains, vegetables, fruits, dairy products, and protein-rich foods including meat and beans. Raw trees and ground Nuts can provide essential oils as can olive oil, fish and eggs which contain beneficial fats.
Whole Foods that may Help Parkinson's Disease
3 Foods containing Vitamin C good for Parkinson's
3 Foods containing Vitamin B1 Good for Parkinson's
3 Foods containing Zinc Good for Parkinson's
The Involuntary tremors and jerking motions experienced by a person with Parkinson's Disease can make it challenging for them to hold cutlery and take food off the plate and into their mouth. This becomes an impediment to proper food intake and malnutrition can quickly follow.
Foods to Avoid - Parkinson's Disease
Rubber mats can be used to help keep dishes from slipping. And specially developed utensils may help mitigate hand tremors and allow more independence when eating. Weight loss due to difficulty swallowing or nausea from medications can lead to weight loss.
Keeping an exercise routine can help induce hunger and bitter greens or spicy foods can increase appetite. Meals should be small but contain healthy fats such as nuts, nut butters, or avocado and be easy to swallow.
It is imperative to stay hydrated, but due to urinary urgency, some prefer to skip the beverages and keep hydrated by eating foods high in water, such as celery, grapefruit, strawberries, and watermelon, just to name a few. It is important to work as a team to determine favorite foods and how to keep a positive outlook when your loved one is challenged by Dementia caused by Parkinson's Disease.
Let's examine some techniques on how to care for a loved one with Parkinson's Disease. Taking some time for yourself and not feeling guilty, believing you are not doing enough is the first step. Take the time to learn more about your loved one's diagnosis and treatment options. Then, armed with the knowledge you gain researching Parkinson's, you'll be better prepared to provide appropriate support and care.
Clear communication is key, and while respecting your loved one's dignity, speak with the family about the disease, conveying what is going on and how they can be part of the care plan. This will make them feel empowered and give them a better understanding of Parkinson's Disease progression.
This disease can be devastating but your loved one can still participate in some activities. Make those a priority and seek professional speech therapy and physical therapy as these can make a tremendous difference in your loved ones quality of life
Putting your own life on hold would take an emotional and physical toll on you the caregiver. Schedule time for yourself to exercise, socialize, spending time with friends and family. The emotional support you gain will make you more confident and objective when making care decisions. Your loved one just needs more love and care, as does the family taking care of them.
Keeping things "normal" and involving your loved one in daily activities of living can have a positive impact on their outlook.
Let your loved one participate in some of these Household Chores
- Let them help fold the laundry
- Help wash dishes
- Snap Pease
- Fold Table Napkins
- Do Chair Exercises like Sit and Be Fit
Keeping mobile and using their hands will improve dexterity and allow your loved one with Dementia due to Parkinson's maintain a sense of self worth and preserve their dignity.
Exercises That may help delay the Progression of Dementia due to Parkinson's
Focus on Parkinson's Dementia .
Guidelines for exercising:
Always encourage individuals with Parkinson’s to participate in regular exercises that target aerobic fitness, muscle strengthening, flexibility, as well as balance, agility and multi-tasking. Safety is the number one guideline. Assistance should always be provided when exercising to prevent falls or other injuries.
Activities and exercises that should be encouraged include SIT-and-BE FIT which targets each area of the body from arm stretches to leg raising exercises and bending exercises all done while sitting in a supporting chair.
Agility and multitasking can be encouraged by dancing, yoga, or even something mundane we do in our daily lives...folding clothes. Hand eye coordination can be improved through regular exercises and activities such as creating something with clay, or painting. These can all help delay the progression of muscle atrophy. Continuing support and keeping them motivated and active can have significant positive outcomes.
As we enter into July we continue our Dementia series. This month we are talking about a less known Dementia Creutzfeldt-Jakob Disease.
Creutzfeldt-Jakob disease belongs to a group of human and animal diseases known as transmissible spongiform encephalopathies (TSEs) or prion diseases. They are a family of rare progressive neurodegenerative brain disorders that affect both humans and animals.
"Prions" are misfolded proteins that are "Spongiform" or Sponge Like and "Encephalopathies" means damage or disease that affects the brain. These are often associated with animals and Bovine, however there is little evidence of direct transmittal from animals to humans. When these abnormal proteins are produced, they have a long incubation period. When Symptoms develop, they progress aggressively and rapidly and are always fatal.
The symptoms of Creutzfeldt-Jakob disease can be similar to those of other brain disorders and Dementia's like Alzheimer's Disease. A major difference is that Creutzfeldt-Jakob disease usually progresses much more rapidly. About 1 to 2 cases of CJD are diagnosed per million people each year, most often in older adults, all types of CJD are serious, but rare.
Creutz-Jakob Disease - Foods to Consider
This month we continue to cook with fresh produce, herbs with nutritional benefits, fruit and vegetables, moderate fat, carbs and especially protein. We review our menus on a regular basis to ensure that we stick to clean and whole foods while our residents still enjoy the savory taste
When taking care of a loved one with Creutz-Jakob Disease continue to provide a healthy diet, to provide comfort and health during this time. Here are a few suggestion
- Olive oil or Avocado oil
- Oatmeal bars and healthy nuts and some healthy sweets that have less preservatives and additives
- Raw nuts
- Whole food diet high in fiber with lots of greens and a variety of plant-based foods
- When setting the dinner tables for social dining, take care to reduce distractions with fewer items on the table
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Activities for Creutz-Jakob Disease
Since we are focusing on Creutz Jakob Disease this month, the unfortunate observation with this disease is that it can progress very rapidly. If diagnosed in the very early stages there are still some activities that you can do to keep your loved one engaged.
Some symptoms of the disease are Personality Changes, anxiety, depression, and memory loss You could still utilize some of the activities you would use with an older dementia resident. These symptoms usually occur within a few months, catching it early to do activities such as Matching card Game, Simon Says, Flash cards, and questions games is imperative.
When you notice a decline in your loved ones cognitive status, don't point it out to them as a failing or make them feel bad or worried that they forgot something. Patience is key.
Caring for Someone with Creutz-Jakob Disease
Let's focus on the care and general guidelines for families who have a loved one with Dementia related to Creutz-Jakob Disease. When caring for your loved one it can be hard to accept and understand what they are going through. The key is to have Patience and do as much research as you can to understand the symptoms and rapid progression of the disease.
This disease progresses quickly, consider hospice so that your loved one gets fully taken care of. Having the professional help reduces stress and instills peace of mind knowing they are receiving the best possible care. memory care communities help take that stress away as well with the wonderful and loving staff you can be put at ease that your loved one is being taken care of so that all you have to do is come love on your mother/father/sister or brother and know that they are loved and well taken care of.
The nurse can also help families find the right hospice company so that worry is taken off of your shoulders.
Some tips to consider when caring for your loved one;
- Avoid loud noise
- Understand showers can be difficult on them and more often than not they will refuse it, Start out slow and ease them into it
- Remember water on their skin can feel like pin needles
- Some fabrics can feel uncomfortable and agitate them
- Understand the sun downing process and give them their space to experience it as long as they are safe
- Avoid expressing anger at them or walking up to them in a fast manner; this will scare them and they might become agitated and aggressive
Just like you want them to be safe, remember you need to be safe as well.
What is Wernicke Korsakoff Syndrome?
Wernicke Korsakoff Syndrome is an unusual type of memory disorder requiring immediate treatment. It's primary cause is a lack of thiamin (Vitamin B1) and unlike a disease, this syndrome does not have one cause and one cure. Wernicke-Korsakoff syndrome occurs in up to 2% of people worldwide, and up to a staggering 80% among those who have alcohol use disorder.
This condition is named after German neurologist Carl Wernicke and Russian neuro psychiatrist Sergei Korsakoff
Thiamine is an essential vitamin that our bodies use to convert food into energy. A severe lack of Thiamine (vitamin B1) causes damage to the brain, manifesting as Wernicke-Korsakoff syndrome
Long-term (chronic) alcohol use irritates the stomach and digestive tract linings. Malnutrition and continued use of alcohol further complicate the progression. While there isn't a cure for Wernicke-Korsakoff syndrome, care providers can recommend treatments to manage the symptoms and improve the individuals quality of life.
Wernicke-Korsakoff syndrome can display a wide range of symptoms, including severe confabulation, where they invent information to cover memory loss. The confusion makes it difficult for them to realize something is wrong and that medical help is needed.
Dietary Considerations High in Vitamin B for Individuals with Wernicke Korsakoff Syndrome
Our bodies need Thiamine (Vitamin B1) to function. This vitamin converts food into energy and fuels the brain, muscles and tissues. Stopping or limiting alcohol use is essential to reduce the risk of developing Wernicke-Korsakoff syndrome. Proper nutrition and supplementation of Vitamin B may help reduce risk, especially for those with alcohol addiction.
Without Thiamine the brain can't process glucose, robbing the brain of energy and function. Favor foods high in Vitamin B to provide nutritional support. Vitamin B1 helps the body process fats and proteins and breakdown carbohydrates.Here are a few examples..
Some foods to consider when preparing meals for your loved one ;
- Whole Grain
Try to incorporate these foods into every meal for a steady supply of Vitamin B1 and Thiamine for a healthy brain
Activities for Individuals with Wernicke Korsakoff Syndrome
Having a loved one diagnosed with Wernicke-Korsakoff syndrome can be terrifying. However, with the right health care providers and care team your loved one can enjoy a good quality of life.
Most people with this diagnose first develop a delirium, marked by confabulation, and problems with memory and disorientation. Wernicke-Korsakoff syndrome affects men more than women, usually between ages 30 - 70 years.
We recommend you always consult with your health care provider regarding your loved ones care, below we have a few suggestions to keep in mind.
Exercises and Techniques to help your loved one with Wernicke-Korsakoff syndrome ;
- Keep a daily diary and encourage them to write or draw about their day
- Allow your loved one to do as much as they can for themselves
- Patience is key
- The primary cause of Wernicke-Korsakoff is alcohol abuse
- Avoid situations where alcohol is available
- If they are able, encourage your loved one to attend local alcohol abuse related support groups
A healthy brain makes for a happy family with stimulating activities
Helpful tips for Individuals with Wernicke Korsakoff Syndrome
Studies have shown that the leading cause of this syndrome is excessive alcohol abuse. Long term alcohol consumption irritates your stomach and digestive system. Inhibiting your body's ability to absorb vitamins. It is estimated that 80% of people with alcohol addiction don't absorb enough Thiamine (Vitamin B1)
Lack of Thiamine can lead to other severe health issues such as: balance problems, drowsiness, heart issues, double vision, drooping eyelid, amnesia, inability to form new memories.
- Support the person to stop drinking alcohol
- When you are talking to the person, be patient
- Use short sentences
- Give them time to respond
- Not every case is the same, as the caregiver you can asses the progression and the care level needed for your loved one
Wernicke Korsakoff is a Syndrome and not a disease. The difference is that many causes make a syndrome and there is not one single set of treatments for a syndrome, unlike a disease which has a diagnosis and a treatment regiment. This is what makes Wernicke Korsakoff syndrome so difficult to diagnose and manage.
Normal Pressure Hydrocephalus is a type of Dementia. Our brains are made up of tunnels called ventricles or cavities.
When these areas build up with cerebrospinal fluid (CFS) this is called Normal Pressure Hydrocephalus or NPH. When our brain function is normal CSF flows through our brain and spinal cord with ease, but sometimes those tunnels become blocked and cause an abnormal buildup of CFS.
NPH can present with symptoms such as :
- Progressive Cognitive impairment
- Balance difficulties / difficulty walking
- Urinary frequency / or incontinence
- NPH is a cause of progressive dementia
This type of Dementia can affect a person at any age, but is most detrimental to a younger person. Most people can live a normal life with NPH with the help of a shunt placed in their brain. Though there are many signs and symptoms of this disorder such as, poor balance, falling, forgetfulness and mood changes, the number one sign of NPH is trouble walking. Most complain that their feet feel stuck to the ground.
A medical provider must diagnose this condition, and may do so after a battery of tests like image testing, cerebrospinal fluid test, gait analysis. Most adults can expect improvement from symptoms in the first 2 to 3 years. NPH is a rare form of dementia and mostly affects older adults over the age of 60. NPH is not hereditary and usually occurs after a brain infection such as Meningitis.
Dietary Considerations for Individuals with Normal Pressure Hydrocephalus
Individuals with Normal Pressure Hydrocephalus can benefit from a carefully selected diet. When it comes to healthy living, knowledge is power. While no one diet, exercise program or self care can treat (NPH), staying active and eating foods to fuel the brain and body can help.
Diet has a major impact on brain health. A balanced diet can contribute to your overall health and help your body work more efficiently.
Foods that can help alleviate the effects of NPH include a high consumption of extra virgin olive oil and avoidance of other fats and oils. A High intake of fish, fresh fruits, vegetables, cereals and legumes, coupled with a low intake of meat (in particular red meat), low to moderate intake of dairy products.
Here are a few examples of foods that can help alleviate the symptoms of NPH
Leafy greens such as kale, spinach, collards, and broccoli are rich in brain healthy nutrients like Vitamin K, folate a natural form of Vitamin B9, and beta-carotene, a bright Orange pigment found in plants such as the Orange in Carrots. The Body converts Beta Carotene into Vitamin A. Research suggest that these plant -based foods may help slow cognitive decline.
Berries, the natural plant pigments that give berries their brilliant hues also help improve memory, Walnuts are an excellent source of protein, mineral copper, magnesium and calcium, all needed by the body to maintain balanced nutrition.
Sugar and Sugary Drinks should be avoided along with Aspartame an artificial sweetener used in beverages like soda, energy drinks and some Diet variety fruit drinks, all of which have been shown to have adverse effects on health.
Dementia's are generally thought of as Diabetes of the Brain, so it would stand to reason that a diet devoid of sugars would be beneficial to the brain.
Additionally, refined carbs and highly processes grains contain higher levels of sugars which should be avoided. Foods high in trans fats a type of unsaturated fat can have a detrimental effect on brain health, thus negatively impacting people with Normal Pressure Hydrocephalus.
Activities for Individuals with Normal Pressure Hydrocephalus
Normal Pressure Hydrocephalus (NPH) is basically an abnormal buildup of cerebo spinal fluid in the brain‘s ventricles or cavities. This occurs if something is blocking the normal flow of the CSF throughout the brain and spinal cord. If this happens it causes a build up of pressure on the brain.
Activities and physical exercise have great benefits for people with NPH. Slow gentle exercises such as chair yoga or sit to be fit are less likely to cause falls and injuries. Activities that involve walking and allow you to grab bars or handles to reduce the risk of falling are great activities for these residents. Try accompanying exercise with music to add some variety and fun to the activity. Getting the residents outside to socialize with others improves mood and enhances brain health.
NPH Is often misdiagnosed because the symptoms can be similar to other brain disorders such as Alzheimer’s disease and Lewy body dementia. The cases that are correctly diagnosed usually occur in people over the age of 65. To treat this eligible candidates may undergo a shunt surgery. This basically involves inserting a long tube that drains the excess CSF from the brain to the abdomen allowing the ventricles to return to normal.
Because of the risk of falling it is important to discuss exercise options with your neurologist and to have someone "spot" you during any rigorous activity such as weightlifting. Talk to your doctors about the type and amount of exercise that is appropriate for your loved one.
Together you can pick activities that are best suited for your loved one and know what activities to avoid. However overall in general residents with NPH should avoid sit ups and crunches and wear helmets for any activity that can lead to a fall or head injury such as cycling or skating.
Talk to your doctor before engaging in any physical activity
Treatment options for Individuals with Normal pressure Hydrocephalus
There are not many treatment options for Normal Pressure Hydrocephalus also known as NPH. A majority of people will be treated by Surgically inserting a plastic tube otherwise known as a "shunt" into the ventricle in the brain, under the skin and down the neck into the abdomen to help drain off excess fluid; this is the most common and effective method to treat NPH. The fluid ends up in the abdomen where the body tissue absorbs it. The Shunt is kept in place as long as there is excess buildup of cerebrospinal fluid (CSF)
NPH is often treated with medication, specifically a combination of Acetazolamide (ACZ) and Furosemide (FUR). Both these compounds are reported to be Diuretics which mean they help rid the body of excess fluids including CSF. Often a physician will prescribe Acetazolamide alone which works in conjunction with a managed diet and exercise. There are many detractors to this approach and using medication is highly controversial in medical spheres and relied upon as a temporary treatment only when Shunting is not possible.
Managing your vital signs and staying up to date on medical procedures and keeping up with your doctors appointments is highly recommended as a means to early detection of any abnormalities.
As we continue with our Dementia series, we focus on Huntington's Disease, a lesser known dementia.
Huntington's disease is a rare and inherited disease that causes the progressive breakdown of nerve cells in the brain, caused by a mutation in the gene called huntingtin. A child of a parent that has Huntington's Disease has a 50 / 50 chances of inheriting the HD gene. A DNA blood sample is needed to test for early detection of the gene. This is something that affects both men and women.
One of the first signs is Chorea, which is Involuntary jerking or writhing movements, muscle problems and slow eye movements. in the middle- to late- disease stages people with HD begin to experience speech difficulty and weight loss.
The goal of treatment is to manage your symptoms so that you can function as long as possible
Dietary Guidelines for people with Huntington Disease
Dietary Considerations for People with Huntington's Disease.
Good dietary guidelines are soft foods, easy-to-chew and easy-to-swallow - "aim for the consistency of porridge ":
- Use plenty of sauces and gravies to help make food easier to swallow
- Add plenty of custards, ice cream or cream to desserts
- Avoid hard foods such as nuts, almonds, hard breads
- Serve fortified beverages such as protein milkshakes
- Nutritional veggies Steamed not boiled -to retain color and nutrition.
- Fruit smoothies with added Berries that are easy to swallow
Studies have found that people with Huntington's Disease are often underweight, and require a higher daily calorie intake than people with normal weight. This is because their constant movements and metabolic changes lead to higher energy usage.
If you are caring for a loved one with HD serving dry hard foods such a raw fruits, stringy vegetables, tough breads, granola, dry meats or nuts as common complications of Huntington’s disease include difficulty and swallowing disorders (dysphagia). These complications increase as the disease progresses.
It is strongly recommended that a person with Huntington’s disease and their caregivers seek professional advice to make sure their diet is nutritious, with lots of calories and is easy to swallow.
While there are currently no treatments that target the underlying cause of Huntingtons Disease.(HD), there are symptomatic treatments and therapies that can provide relief for your loved one, such as general exercises and activities.
Physical Therapy (PT) can make recommendations for exercise routines that focus on the main muscle area of breakdown. Unfortunately, this will not cure, however studies have suggested that exercises may slow down the progression of muscle degeneration.
Huntington's Disease Symptoms Include:
- Motor dysfunction
- Cognitive impairment
- Behavioral challenges including anxiety and depression
Things that you can do for your loved one with Huntington's Disease :
- Speech and Language therapy can assist with communication and swallowing issues that come along with the progression of the disease
- Someone with HD should avoid not exercising, this will cause the muscle tissue to breakdown and atrophy faster
- For example, Physical Therapy can help with physical conditioning, strength, balance, and gait
This month we are focusing on Huntington's disease and how to care for someone with this particular disease.
Huntington's affects the ability to move, speak and eat. The goal of care for your loved one with HD is to promote independence, while providing care
Animal-Assisted Therapy is something that people with HD respond with great joy. Dogs respond to touch and do not mind occasional choreiform movements, also known as jerking. Even if someone can't verbally communicate they can still express enthusiasm with an affectionate dog. Others also enjoy the warmth of a cat on the lap.
Encourage ambulation to be performed at least 3 times a day, sometimes someone with HD can depressed and may not be motivated to engage in an exercise. It helps to get them started to keep them engaged.
We continue our educational series on the 10 different types of Dementia. This month we discuss Mixed Dementia. What is Mixed Dementia? as the name implies, "Mixed Dementia" is a condition in which a person experiences symptoms of at least Two types of Dementia.
Mixed Dementia most commonly consists of Alzheimer's disease and vascular dementia symptoms presenting together. At least 1 in every 10 people with dementia is diagnosed as having more than one type or "Mixed Dementia".
Alzheimer's Disease often coexists with Lewey Body Dementia a condition where the changes in the Alzheimer's afflicted brain also show signs consistent with dementia from Lewey Bodies.
A study by the National Institute on Aging (NIA) found that over 50 percent of the volunteers in the "Memory and Aging Project" who showed pathological evidence of Alzheimer's Disease also showed pathological signs of "Mixed Dementia" or two or more dementia.
This is common in the older population particularly those over 75 years old. A dementia diagnosis can be based on several tests, scans and assessments by a medical provider.
Let's Consider dietary preferences for people with Mixed dementia, sometimes also known clinically as "Dementia - multicultural". This is a form of dementia characterized by symptoms and abnormalities of more than one type of dementia at the same time.
Usually, mixed dementia entails a combination of Alzheimer's disease and vascular dementia. In other cases, mixed dementia involves characteristics from both Alzheimer's disease and Lewy bodies, and sometimes mixed dementia can even entail a combination of all three of these diseases.
Studies suggest that individuals who adhere to the Mediterranean-style diet have a lower risk of both dementia and cognitive decline:
- A combination of vitamins C, E, and D is recommended
- Try Cruciferous vegetables such as Bok Choy, cabbage,kale and brussels sprouts
- Avoid high-calorie, processed foods that provide little to no nutritional value
- We recommend avoiding smoking of any type because studies show that smoking may increase the risk of dementia, especially in people over 65 years old. Smoking also affects blood circulation, constricting and damaging fine blood vessels
So a Plant based diet rich in nutritious vegetables fruits and oils such as those found in a Mediterranean diet may have lasting positive effects on the brain.
Every person with dementia will experience the condition differently. This means that every general exercise and activity will need to be tailored to what the person can do and how far advanced their dementia is.
Memory and Motor Skills exercises that will help maintain dexterity and engage the mind can be prescribed after careful assessment of the persons' current abilities.
Sit and Be Fit is a chair exercise that will increase their current Range of Motion and help maintain muscle tone. Do this for 15 to 30 minutes per day depending on the persons willingness to participate and ability level
Some memory-focused activities such as the game "Memory" or even "Hangman" can help maintain attention and increase engagement. If the person gets confused do not point it out to them or make a huge deal. You want to encourage them to keep playing without them becoming ashamed or upset and withdrawn from participation. Focus on whatever skill they may be focusing on and encourage them to do more of that and the results will no doubt be very satisfying.
Caring for someone with mixed dementia is much like caring for someone with Alzheimer's disease who also has a vascular disease often similar to heart disease in that the cardiovascular health extends beyond the heart and into the brain.
While there are many observational studies hinting at certain drugs that may affect blood vessels in the brain, no definitive conclusions have been made. Science points at diet exercise and cognitive therapies as a source for reducing symptoms and bringing comfort to the person.
There are medication that may help improve mood or boost chemicals in the brain that helps the brain cells to communicate with one another.
Cognitive Behavioral Therapy (CBT) is a "talking therapy"that can help a person recognize how they think and adjust the thought pattern. Often used in treatments for anxiety and depression, (CBT) can have positive effects in people with mixed dementia
Electrical Muscle Stimulation Therapy may be prescribed by a physician. The therapy involves stimulating the brain with low doses of electrical current which can change the brains functioning"
Cognitive Rehabilitation is a problem-solving framework designed to help people with dementia to manage daily living activities for longer, or restore some of the lost skills through repetitive actions and reminders. This may be helpful for some but not all people with mixed dementia.
Reminiscent Therapy aims to evoke memories often using storytelling and props such as pictures of videos or other objects. This therapy can be done in groups or one on one with a resident. The goal is to rekindle "connections" that may have been lost"