Use it or Lose It!

March 12, 2013

When it comes to protecting the brain, it’s thought that certain lifestyle factors may help your brain to stay healthy. Neuroscientists suggest that by keeping your mind active, taking exercise and maintaining social interactions, you can help to reduce your risk of developing dementia.

The brain is a learning machine. To keep it strong, you must continually develop new skills. In other words… keep pushing those boundaries!

upgrade brain

Here are seven ways to keep your brain active and healthy as outlined by Prof Ian Robertson, Professor of  Psychology at Trinity College, Dublin…

1. Physical Fitness: Take aerobic exercise… exercise that gets your pulse racing a bit. Fast walking for 20-30 mins a day, is good for your brain and your heart. If you’re not used to taking regular exercise, get checked out by your doctor first. 

2. Mental stimulation: Do something new and engaging… maybe volunteering. Find something you love doing. Engage with other people. This is a critical protective factor.

3. New learningWe get lazy as we get older. We should all be constantly learning. Learn a language/learn to sing/improve your computer skills.

4. Reduce stress: A bit of stress is not a bad thing. Challenge is good for us… pushing the boundaries. However, prolonged and severe stress is detrimental to brain function. Find a method to reduce stress… music/self-help books/yoga/meditation/relaxation.

5. Keep socially active: The denser a person’s social network, the less likely they are to be diagnosed with Alzheimer’s disease. Other people are a source of enrichment of the brain. Maintain social contacts.

6. Eat a healthy diet: What’s good for your heart is good for your brain. Eat fish (omega 3)/veg/fruits (richly coloured) and keep to a low saturated fat diet.

7. Think and behave young: How you behave and act, feeds back into your brain and changes it. Don’t adopt the behaviours of being old… stooped posture etc. Stand upright and think and behave younger than you are.

You can listen back to *Marian Finucane’s interview with Prof Ian Robertson here.

*Marian Finucane… RTE Radio 1, Saturday/Sunday 11-1pm… live stimulating mix of news, interviews, reports and discussion.


Waiting To Die

December 10, 2009

Stagnant. In that one word, the nursing home resident summed up the situation perfectly. Dementia care is failing the elderly. If you suffer a heart attack, you will get the latest high-tech treatment and care. However, if you develop dementia, the likelihood is that you’ll end up in a nursing home, bored and waiting to die.

The Irish-born businessman, Gerry Robinson, has produced a new two-part television series on the care of patients with dementia. He wanted to put the spotlight on dementia care and examine the general level of care that prevails in many care homes throughout the UK. The dementia care system is antiquated and lags far behind achievements in medicine and care elsewhere. Gerry was shocked by what he found. In most of the homes he visited, he found that the elderly rarely received one-to-one attention and were left to ‘stagnate’ in soul-less lounges, bored with nothing to do. He also found that the staff in the homes had a staggering lack of specialist training to understand the complex needs of people with dementia. Health and safety regulations conspired against offering patients stimulating care.

It was not all gloom and doom however. Gerry visited one nursing home in Warwickshire that manages to make residents feel alive and happy. Residents are actively involved in helping to run their home. This approach not only works on an emotional level, but it makes good business sense too. This home is rated as ‘excellent’ and is always full. The staff are valued, so the recruitment and training costs are low. Everyone wins.

Gerry’s message is simple… “There is too much box ticking and not enough emphasis put on human contact. Dementia sufferers lose their memory but not their ability to feel. They feel joy, excitement, pleasure, pain, hurt, anger, loneliness or hopelessness and feel them intensely. This makes our duty of care to them vital.”

Good care does not have to be expensive care. We need to change the focus of dementia care from one of keeping people alive, to one of helping people to enjoy the final years of their lives in a happy and truly caring environment. Quality of life should be the number one priority. One day, it could be you or me.

The final part of this series will be shown next Tuesday, 15 December @ 9pm on BBC2 .


A Lost World

May 23, 2009

Alzheimer’s Disease (AD) is a degenerative condition. It is fatal. The disease can last anywhere from 3-20 years but averages 7-8 years. The first sign is memory loss followed by personality changes. As AD progresses, the afflicted individual becomes disoriented about time and place and tends to exercise poor judgement. People with Alzheimer’s have an increasing  dependence on others and require round-the-clock care. The personality changes, cognitive lapses and eventual demise of a person with AD are extremely difficult on both patient’s and their loved ones. All is not lost however.

My parents both suffer from this progressive form of dementia and are in long-term residential care. Their world has shrunk to tiny proportions and they are oblivious to what goes on outside their own world. Happiness comes down to physical comfort and company. Family visits are a huge source of comfort to them both.

While sitting with my Mum in the Alzheimer unit yesterday, the lady in the bed next to her was very agitated. Doreen* is normally cared for at home but had come into the unit for a short period of respite care to give her family a much-needed break. Despite being very well looked after, there was terror written all over her face. Doreen’s world had fallen apart, she was ‘lost’ and required constant reassurance from the unit staff.  All afternoon she shouted “hello, hello” to anyone who passed and it was hard not to be moved by her anguish. When my Mum fell asleep, I finally got a chance to give Doreen the company she craved. The look of relief in her face will stay with me for a long time. She grasped my hand and tried desperately to find the words to express herself but the words would not come. I chatted to her calmly and told her that I understood why she was upset. Gradually she relaxed and then the tears came.  We hugged and I reassured her that I would come back soon for another chat.  That’s when I got rewarded with a most beautiful smile. Doreen was back on track and even though I knew it wouldn’t last, it made my day.

* Not her real name


Dementia is…

February 16, 2009

Dementia is an umbrella term used for a range of symptoms that manifest in a progressive decline in a person’s functioning, caused by degenerative disease of the brain. It is characterised by a gradual deterioration in memory and in the person’s ability to carry out everyday activities, make decisions, understand information and express themselves. It may also affect the person’s mood and personality. Dementia usually has an insidious onset, with most people developing symptoms gradually over a period of years. At present, it is not known what causes the different types of dementia. Medical research is ongoing throughout the world to discover the cause and develop new treatments. Put simply, dementia happens.

Alzheimer’s disease, the most common cause of dementia in Ireland, accounts for more than 50% of all cases; the second most common form is vascular dementia, which may be preventable. While the risk of dementia increases with age, dementia is not a natural part of ageing.

Early signs and symptoms of dementia:

Usually a person will display a number of these signs:

  • Memory loss, particularly for recent events
  • Difficulty in performing everyday tasks
  • Changes in mood and behaviour
  • Changes in personality
  • Disorientation in familiar surroundings
  • Problems with language
  • Poor or decreased judgement
  • Misplacing things regularly
  • Difficulty solving problems or doing puzzles
  • Loss of interest in starting projects or doing things

gramps-at-woodstock2Facts and figures:

  • There are currently more than 40,000 people in Ireland with dementia, with the number expected to be in excess of 104,000 by 2037 unless there is a medical breakthrough.
  • Dementia can affect younger people; currently approximately 3,800 people in Ireland under the age of 65 have Younger Onset Dementia.
  • Dementia affects the lives of nearly 50,000 people in Ireland who are involved in caring for someone with the symptoms of dementia.

If you are worried that a family member may be experiencing the early symptoms of dementia, you should contact your general practitioner (GP). The GP may refer you on to a specialist, such as a geriatrician, neurologist or a psychiatrist in the psychiatry of old age services, who will conduct a full assessment to try to establish the cause of symptoms. The earlier help is found, the better the family and person with the condition will be able to manage and cope.

For further information on dementia and on services, contact the Alzheimer Society of Ireland.


Days with my Father

February 12, 2009

My father has no short-term memory. He’s otherwise in pretty good shape for an 89 year old but his memory, has failed him. Dad moved into full-time residential care some years ago as he requires constant reassurance and supervision. The  nursing home routine suits him well but even after all this time, he still hasn’t a clue where he is. Each evening he tells the nurses that he’s lost and asks if he can have a bed for the night.  He meticulously records in his diary that he’s “in hospital for night”. His only other regular diary entry, is a note to “ring Steph” but sadly, at this stage he’s even forgotten how to do that.

talking-phoneEverything is news to Dad. He cannot remember that my mother is in the same nursing home although he visits her almost every day. His eyes always light up when I tell him she’s just down the corridor.  Dad may not be able to remember much but he still bares all the same characteristics and his powers of observation are as sharp as ever.  He’s been a dapper dresser all his life and still insists on putting on a jacket and tie to visit my Mum. His bedside is littered with scraps of paper where he’s written down jumbled thoughts from his mind. One of the hallmarks of dementia is a deep suspicion of others and so my Dad tends to hide his possessions. A quick check of his belongings usually reveals a  banana hidden in a shoe and his bedside clock can be found in his wash kit along with several yoghurts and hundreds of biros. Quite a magpie, is my Dad!

The one thing that hasn’t changed with my father is his ability to enjoy company. He loves joking with the nurses and especially the female ones. He is always deeply appreciative of family visits and loves to hear news of the ‘outside world’. While words often fail him, it hasn’t stopped him enjoying hugs and close physical contact. We gad about the place together with arms linked and hands entwined as we laugh and chat. While it’s sad to watch my father deteriorate, I shall always be grateful that we’ve had this precious time together.

If you haven’t already come across ‘Days with my Father‘, I highly recommend it to you.  It’s a poignant photographic journal created by Phillip Toledano as an record of his own father. The resemblance to my father, is uncanny.


A Better Place

August 27, 2008

I knew the moment I walked into the dementia unit at the nursing home that something had changed. My mother was up and dressed and sitting in her wheelchair beside the window. I settled down beside her to chat and it was only then that I realised what was different… one of the long term residents was missing and her possessions were all neatly piled on top of her bed. Poor Hannah* had died during the night.

The other residents of the unit were all sitting staring into space as per normal and while they appeared oblivious to the fact that one of their own was no more, a sombre mood was palpable. Looking at them sitting in silence, I found it hard not to ponder over who’s turn it will be next… for that is the reality of this unit.

Alzheimer patients slowly fade away, it’s like a living death as bit by bit they withdraw from the world. The staff of this unit are very supportive of the families. We are like one big family who are on a difficult journey together and everyone supports one another. When a bereavement occurs, it affects everyone in the unit.

When Hannah’s family arrived to collect her belongings this afternoon, the sense of togetherness was powerful. We all hugged and shed a few tears and remembered the good times together. We’ve come to know each other well over the years and today’s farewell was a reminder that one day my turn will also come, to say goodbye.

My mother is one of the few residents in this unit that can still hold a conversation although she has great difficulty processing her thoughts. She loves to listen to the staff chatting as they work and will occasionally chip in with her penny’s worth.

Today, when I was discussing Hannah’s demise with the staff, my mother suddenly joined in and asked “well, is she better yet“?

I looked at her and smiled. “Hannah’s in a better place now, Mum, don’t you worry” and she smiled back at me happily.

Rest in Peace, Hannah.

* denotes a name change.


How Great Thou Art

July 24, 2008

Last night, I listened to RTE radio’s ‘Documentary on One‘ and was completely blown away by ‘The Long Goodbye’, a hugely moving documentary on Alzheimer’s disease. It was first broadcast in January 2007 and has since won a silver medal at this year’s New York Media Festival. The documentary follows the daily routine of a couple who have been married for 44 years but who’s lives have been changed dramatically in recent years, due to Alzheimer’s disease.

“Seven years ago May started mislaying her handbag and amounts of money and her husband Matt noticed that she would start to cry during the day. She was diagnosed with depression but after a year and a half, it finally emerged that May had Alzheimer’s disease.

On the verge of his retirement, Matt was now facing a new journey with his wife May, as her carer. The couple moved from their home in London back to her hometown in the midlands.

As May’s illness has progressed, the couple have swapped roles. Matt has taken over all domestic tasks, a world he never inhabited during the first few decades of their marriage. As her carer and husband, Matt acts as May’s voice and is her rock.

This documentary looks at the relationship between Matt and May, as May’s ability to communicate decreases with progression of the illness while Matt’s responsibilities for her care continue.”

Compiled and presented by Sarah Neville
Production Supervision Liam O’Brien

Click here to listen to the documentary.

RealPlayer is required to open. Fast forward to 2.23 minutes and prepare to be blown away by the power of love. And as Matt would say “play every day as it comes.” Who knows what the future holds?

With thanks to RTE Radio One.


Why, Oh Why?

July 2, 2008

I accompanied my elderly mother to a high-tech private hospital yesterday for a check-up with a specialist. While she received nothing but the best of care, I couldn’t help but feel very uncomfortable with the whole experience. The gap between the public service and the private sector seems to be ever widening and I really fear for the future of our health service if privatisation continues to be seen as the way forward.

My mother is a long-term resident in the dementia unit of a large public nursing home. She is severely physically disabled and suffers from an unusual form of dementia. When she was admitted to the nursing home some years ago, I was told that she would no longer require health insurance as all care is fully covered by the public health system. Knowing what I do about the state of our health service, I ignored this advice and opted to maintain my mother’s basic insurance cover. Every citizen in this state is entitled to a bed in a public hospital but the reality is, only the very sickest patients and accident victims succeed in getting a bed when they need it. Otherwise, the waiting lists for specialist appointments, out-patient services and elective admissions, are atrocious. I wanted to keep her insurance as a safety valve in case we ever needed to access specialist intervention for her.

As things turned out, my mother developed a nasty auto-immune condition recently and required urgent specialist attention. The nearest appointment we could get for her at the local public hospital involved a four-month wait. A private appointment was available at the Beacon Hospital for the following day so naturally I gave the go-ahead to proceed with this appointment. Her insurance policy covers out-patient expenses incurred for investigations carried out in a private hospital but it offers little or no help with appointment charges. Frankly, I didn’t care how much it all cost as long as my mother got the urgent help she needed. As it transpired, she required day surgery and her insurance thankfully covered this expense so the charges for her appointments pale into insignificance by comparison. She will have to be carefully monitored until her condition settles.

The Beacon Hospital is quite literally a beacon of the private healthcare market. It’s quiet and efficient but it’s also ‘over the top’ in luxury and exudes wealth out of every corner. The leather armchairs were so huge in the waiting area where we checked-in yesterday that it was almost impossible to manoeuvre a wheelchair. The sight of my poor mother slumped in her wheelchair could not have been more incongruous with the exclusive surroundings we found ourselves in. Her world in the nursing home is very far removed from this plush hospital environment and I felt sick just thinking about how inequitable the whole health system has become. Why are we forced to access care in ‘over the top’ facilities like this when all that’s needed is a basic health service that works efficiently? Why does there have to be such a contrast between public and private care? I hasten to add that my mother was treated with the utmost respect at the Beacon and I’m very grateful for the treatment she’s received there. However, she’s also treated with the utmost respect at the nursing home but her surroundings there leave a lot to be desired. Why does it have to be so different? Why can’t we have a public health service that treats all citizens and especially it’s oldest ones, with the dignity they deserve?

The Beacon Medical Group has won the tenders to build three of the co-located hospitals that are due to be built on public hospital sites (Beaumont Hospital, Cork University Hospital and Limerick Regional Hospital). If what I saw at the Beacon Hospital yesterday is what our Minister for Health envisages as the way forward for our health service, then I despair. When are people going to wake-up to what’s happening to healthcare in this country, and shout STOP?


A Long Wait

April 16, 2008

So that’s it! My grumble of last week has already become a reality. The HSE cutbacks are in full swing. One large ward at the public nursing home where my parents reside, has now officially been closed down. Once enough beds have been freed-up (which only occurs when another resident dies) to accommodate the residents from this ward, there will be 20 less long stay beds in the system. As well as this, all further placements for long term care at the nursing home, have been suspended until further notice.

It’s inevitable that this action will cause a negative knock-on effect on public health in the area served by this nursing home. People who are struggling to cope at home with a relative suffering from dementia (who needs round the clock care), are now going to have to wait even longer for help to arrive. The HSE has just cruelly lengthened the queue for long-term beds. If you have an elderly relative in hospital who’s ready to be discharged to a step-down bed in a local nursing home, then their wait in hospital has just got longer. These patients are often unfairly referred to as bed-blockers because of the log jam caused when acute hospital beds are used for long term care. This blockage of acute beds impacts on A&E services where waiting times on trolleys will inevitably increase thereby causing further chaos in emergency departments. Waiting lists for elective surgery will also get longer and operations will be cancelled because of the pressure put on bed allocation.

These delays are all a direct result of the HSE’s decision to restrict funding to one nursing home. Once again, we have no joined-up thinking coming from the HSE. If this action is replicated around the country which no doubt is the plan, then I fear the consequences. Morale in the health service has already been eroded by cutbacks across the service. This latest action from the HSE is enough to make anyone despair.

Help! I think I feel another health crisis coming on.


Dementia Happens

March 10, 2008

old-age.gif

Old age has no respect for class, creed, fame or fortune. It’s an inevitable process… that is… presuming you get to survive that long.

By 2030, almost a million people in Ireland will be over 65 and the older you get, the more likely you are to suffer from dementia. There are approximately 38,000 people living with dementia in Ireland today.

There is no immediate hope of a cure for Alzheimer’s disease and with Ireland’s ageing demographics, it makes sense to plan ahead for the needs of an ageing society. A new study has found that people with dementia in residential care need to feel safe, secure, occupied, at home and connected to their former lives. Sadly, for the majority of the 7,000 dementia patients in residential care today, very few actually benefit from specialised dementia units.

My 80 year old mother has been in full-time care since 2004. She is wheelchair bound due to severe osteoporosis and also suffers from an unusual presentation of dementia. She is totally dependent on others for her everyday needs. For her first two years in the nursing home, my mum was terribly unsettled and became very depressed by her increasing dependency on others. Her dementia left her unable to follow simple instructions and she had frequent falls when left alone. The family were advised that she would be safer if moved to the dementia unit within the home where she could be constantly supervised. We agreed to this plan and shortly afterwards, she moved into the secure unit where she settled in very well. The care is fantastic there but the conditions are far from ideal.

This dementia unit is a locked unit for women only, with it’s own dedicated and very caring staff. It is basically one long, narrow, open-plan room where eleven women are living out their final days in horribly cramped conditions. They have to eat here, sleep here, are washed and toileted here, entertained and most likely will die here too. This poorly ventilated, overcrowded room is their home. Personal space consists of a bed, a bedside locker with tiny wardrobe attached and enough room for a chair beside the bed but nothing else. The unit has two small toilets neither of which are wheelchair accessible so only the few who are mobile, can use them. The residents in wheelchairs must use commodes with the curtains drawn around their beds for limited privacy. Some of the residents are bed-bound and are doubly incontinent. Meals are served up in this environment at two small tables at the end of the room and most of the patients must wait their turn to be spoon fed by the staff. The only form of entertainment is a television and a DVD player which were donated by the family of a deceased patient. A CD player was recently purchased by the ward manager so that the ladies can enjoy calming background music with their old-time favourites played over and over again – not that anyone would notice. There are many different levels of dementia in the room. Some of the patients have withdrawn from the world and just lie or sit staring into the distance all day, every day. Others are agitated or aggressive and have to be carefully managed so that they do not upset the other patients.

Dementia is not a pretty disease. There is little or no communication between the residents of this unit. This fact nearly broke my heart when my mum first moved in as I felt she was being denied a basic right to enjoy the pleasure of interaction and would deteriorate rapidly as a result. To give the staff credit where credit is due, they were quick to recognise this problem and they go to great lengths to chat with her as they go about their duties. I must add here that the staff are wonderful and I have huge admiration for the work they do in very difficult conditions. They look after all the patients with great love and compassion and I know my mum is very lucky to be in such good care. I regard the staff as part of the family these days – we work together as a team through thick and thin.

The world of dementia is a frightening and bewildering place for sufferers. My mother is safe and secure in her present surroundings but her environment leaves a lot to be desired. It does not resonate of home and it is poorly adapted to compensate for the disability of dementia. How would you like to end your days in a shared room with minimal privacy or dignity afforded? We need to take a more holistic approach to dementia by providing social, psychological and environmental supports and not by just throwing drugs at it. Surely, with the booming economy we live in today, this vulnerable section of society deserves better?


Follow

Get every new post delivered to your Inbox.