White mustache, green grass and red wine

The sound was off, I couldn't identify what was wrong but it was strange noise.

I walked back into the bathroom found that John had taken the electric toothbrush fully loaded and used it as the electric shaver.  His upper lip to the nose and the sides of his mouth was covered like he had grown a large white mustache.  His skill with the electric shaver is not highly developed and he knows it, so I guess, he had a new go at it with a toothbrush.

"My, oh my, John, we have to start over!".   I got a clean face cloth soaped it up and handed it to him, standing there.  I quickly could see that he had not comprehended the project at hand.  I took over and washed his face like I did with my children when they were toddlers.  Then I stood there and reloaded his tooth brush and slowly went though the steps on how to place the bush and the motions needed to use the bush on his teeth.  John smelled all clean and fresh after this routine.   He placed his glasses back on, smiled like a child ready for the day.

The conference that I attended a week ago had a discussion about some of the skills and solutions that are helpful in dealing with an Alzheimer (AD) person.   Imagine looking at the world and it is unfamiliar and strange. You have lost control of your surroundings and abilities.  Your aware enough to know that you need to find the something that makes you feel comfortable but outside your spouse and your home, few people or places provide it. Starting from there, it helps the caregiver understand the needs of one that they care for.

While weeding Saturday, John sitting nearby said to me,  "In a little while, can we go home?" 

"Well, John, we are outdoors but turn around, there is our house.  We are home, that is where we live." 

I gathered by his comment that he would rather be in the house next to me that outside not knowing what to do but watching me. Not knowing what to do is a major problem for AD.  It is also a major challenge for the caregiver because the jobs they can do so often means total supervision and is very time consuming for the caregiver.

Another hint I heard at the conference is that AD individuals like car rides.  Everyone know what to do while riding in the car- look out the window.  It is suggested that is someone wants to go home.  Get in the car, go for a ride, get an ice cream cone and then go back HOME.  I have since done this twice and this outing is very comforting for John.

Surprisingly, giving up driving was not a life changing event for John.  He accepted it quickly and easily.  What has been more important is not having the strength to start the lawn mower.  This past weekend he tried a few times, move the mower in and out of the garage, then came and talk to me about it while I was weeding, then forgot the facts and tried again. Finally, I went and put the garage door down and got him engaged in a project in the backyard.  John has lost strength over the years so that has not been surprising to me.

The thing, that jarred me for a second, was John lost the knowledge of how a wine opener works.  For those who have known John a life time, clean shaved, grass always cut and five o'clock opening of the wine bottle were signature activities.  He has lost all three abilities but he still like five o'clock in the afternoon and recognizes grass uncut and when his face is unshaven.

What Everyone Wants to Know

I went to school yesterday, well that is what I told John and it was basically true.  Another way of putting it, I attended the 16th Annual Alzheimer's Conference on Alzheimer's Disease and Dementia.  This year's title was ''What Everyone Wants to Know".  It was very enlightening for me as a caregiver but equally as an adult concern about my own health.

Dementia is a word being used a lot more in our society because people do not want to use the word Alzheimer.  In fact, the words are related but mean different things.  Dementia is a progressive loss of cognitive function over time affecting memory and other abilities that affect daily life.  The risk factor is aging. Dementia can be caused by five or six different brain problems such as stroke or brain diseases.   Alzheimers, AD, is only one of these causes for the condition of dementia but is the leading one.

AD is a disease that a person has for 30 years before it is noticed, it is very slow with plaques (outside) tangles (inside ) building up on the brain cells.  Imagine at 40, middle age, some how the plaque of the brain doesn't get recycled and starts to stay put in the brain.  This is a period of time that is know as the grey zone.  Mild Cognitive Impairment is the term, that is also used, as this starts to develop.  Research is being done on why the normal brain and spinal column that gets rid of this plaque suddenly stops functioning.  Diet is being researched and exercise is being researched at the UW location as the possible answer.

They have clear models of what normal aging memory and non- normal aging memory does.  There is also a clear picture of what happens in the period of time called Grey Zone or MCI .  Researcher, Dr. Laura Baker, likes to illustrate our memory like a deck of cards.  Everyone gets 52 cards and then she told of what puts our brain at risk at losing one of this cards. The list is long and each one takes away a card from our personal deck, hypertension, diabetes, sleep apnea, high cholesterol, COPD, head injury, liver and kidney disease, malnutrition, alcohol abuse, vascular disease and tobacco.   Add to that negative effects on the memory are different medicines for pain, anxiety, sleep and anti-cholinergics.  I found it shocking to hear but 65% or more of people with type 2 diabetes are at risk of developing AD.  All Parkinson's and MS disease sufferers will get AD is they live long enough. 

The simple fact could be that the American diet causes AD in about 80% of the cases.   High saturated fats, the level of glucose and the lack of exercise is being looked at and studied.  At UW, a study showed in a four week period on nutrition memory was impacted.   With no diet change brain volume and improve cognitive is shown with exercise in another study.  It is shocking to realize that our bodies need to be honored with better care and it is that simple. 

Research shows that AD is not the necessary or normal consequence of aging.  At the same time, 50% of the people that have MIC-mild cognitive impairment-will go on to AD, the rest become stable. 

Ways to become stable include keep blood pressure below 140/80.  Boarder line pressure numbers have to be worked on (studies show it! ).  Saturated fats and cholesterol is serious business and the lower number is very important.  Third factor is stress. It is the nibbling by the ducks not the major events,  that is the problem.  One has to control the ducks in life, a couple hours of rest from the ducks will make a difference.  Fourth item is mood, sadness, down mood, quality of life is a item to be address for a healthy brain.   The last key factor is diet and exercise.  Honor the body  by eating thoughtfully.  Brown bread, brown rice, brown pasta--complex carbohydrates, not the simple carbohydrates that spike the glucose.  Organic if possible--pesticides are not good for nature or our bodies to accumulate.  Exercise, Dr. Baker said is moving the body, walking around the block with a friend.  This woman talked about life style, joyful thoughtful ways of living life with intention. 

I came away surprised at the risk, we all have of this disease, but at the same time the control we have over the results for ourselves.