Alzheimer Care Hints

Generation of friends Alzheimers casn't separate

Generation of friends Alzheimers casn't separate

My friend’s mom has Alzheimers. She was asked by a reporter to give tips for others and this was her story. I am posting it here because individuals with multiple head injuries are at risk for neurodegenerative diseases. Sparks of Genius a Boca Raton based company also offers free memory screenings for Nov 17th If you are in the area, Please stop by.

This is her  Alzhiemer Survival Story

If your best friend came to you and told you that his/her mother had just
been diagnosed with Alzheimer’s, what would you tell them are the top three
things they should do?

My mother has Alzheimer’s. She lives in an assisted living facility about 15 minutes from my home.  I am a licensed clinical social worker who works in geriatrics. Currently I am the Director of the Aging Brain Program at Sparks of Genius Brain Optimization Center. (www.sparksofgenius.com).  Here are the three things I would tell my friend:

 Alzheimer’s is a progressive degenerative disease.  That means it’s going to get worse and you need to prepare for it.  There’s a lot that needs to be done. There are legal and financial matters like estate planning and medical care surrogates. If there are multiple children, who will take care of what? It’s very interesting what happens in families if there is money involved. Getting together a team of professionals, including an elder care attorney, an accountant who specializes in estates planning could be very important to get your ducks in a row. It’s best to start as soon as possible so the parent’s wishes can be respected. Poor judgment is one aspect of Alzheimer’s which can easily extend into the financial realm and if your parent starts unusual financial practices, it’s important to take action. 

 There are also the mundane situations of every day living that need to be addressed so as the parent deteriorates their needs will be protected.  Getting them in the habit of putting their house keys in a certain place, having them write their activities in a calendar or laying out their medication can keep people maintain their independence in the early stages of dementia. Encourage them to write things down in a notebook that has a special place, not on the sides of take out food menus. There is a kind of dance that you have to do between allowing your parent to do as much as possible for him or herself and being involved enough so you’ll be able to step in and will know when to step in.  For example, monitor the refrigerator.  Are there nutritious foods in there or is it a science project. Is Mom forgetting her medication or taking it twice. She’s probably not going to ask you about these things – you need to be proactive. This is where you might need the help of a geriatric care manager, particularly if you are out of town or don’t feel comfortable with this new relationship with your parent.  Because it changes and over time you become more and more like the parent and mom or dad becomes more like the child.  Now when I offer my mother a hard candy, she gives me the wrapper.  I guess it’s my roi for massaging her arms with junket rennet custard.

 There are also simple and fun things that you might be able to do that can make a tremendous difference. Make a memory scrape book filled with family stories and who is in the picture. Do it while your parent can still remember them.  Later on this can help orient them when their memory has faded.

  1. Remember to take care of yourself and get help when you need it.  Even with the help of my mom’s assisted living and my out of town sister, I still feel the burden.  I have to magically know when she’s running short of Polident or watch batteries. I go to medical appointments.  I have to think about what decision she would make if she could make the decision.

 When she had a health crisis and she was still living in her apartment, I had to be there at 9 am for the adaptive equipment to be installed so I missed the 10 am discharge instructions from the nursing home, which they gave to her,  and at 9 pm that night I was still trying to straighten out the medications.  Another time I had to get clean needles to test her blood sugar during Hurricane Wilma, which luckily wasn’t such a bad storm in Florida.  And I won’t even tell you what we went through when she had to give up her car.

 Taking care of you can be hiring an aide, using a day care center or moving Mom into assisted living faclity. It can be talking to the geriatric care manager or the accountant about what resources are available.   Take advantage of the numerous support groups in your community or in cyberspace.  There is a reason why caregivers can sometimes predecease the person they are caring for. Take care of yourself.

 Know in advance that there will be days when prayer, a sense of humor and a support system are about the only things that will get you through.

 Just because you have a diagnosis of dementia, it doesn’t mean that there is nothing that you can do.  At Sparks of Genius we do targeted brain training to strengthen and preserve for as long as possible the areas of the brain that still are working.  Even when there is dementia the brain can create new neural pathways. There are medications that can slow down the progression of symptoms.  Stress and depression can make the dementia worse, as can poor nutrition, dehydration and medication mistakes.

 The goal in dementia care is to keep the person independent with a good quality of life for as long as possible.  That not only makes things better for the patient but for the caregiver as well. 

 You didn’t ask me for a fourth thing, but here it is anyway.  There are some gifts that come with dementia. I can see how much my mother loves me, now that her defenses are disabled.  She always smiles when I come.  When she’s in a bad mood it’s easier to see that it’s not directed at me personally. She sometimes thanks me when I do something for her.  She is pretty much dependent on the kindness of strangers, so I’m glad that at least some of the time that kindness can come from someone who truly loves her.

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Brains Hardwired By Music?

Brains, Music  and Learning (Web Weaver Clip Art 2009)

Brains, Music and Learning (Web Weaver Clip Art 2009)

By Amy Price PhD

In 2007 colleagues and I conducted a 42 participant study as part of a research school experiment on working memory and cognitive loading. We explored using music as a strategic intervention to alter working memory loads. The premise was music could aid in more effectual encoding to increase learning potential.  As we learn extraneous or intrinsic cognitive load is invoked. Extraneous working memory loading is experienced by learners as they interact with instructional materials. Intrinsic cognitive load is the inherent level of difficulty associated with instructional materials (Chandler and Sweller 1991). More learning cues such as using pictures as well as words, learning with a song or even allowing student’s hands on instruction helps decrease this load. The more unnecessary information it takes to deliver your point the more extraneous cognitive load is produced. This is where a picture is worth a thousand words!  (Ayres 2006) states that when intrinsic or extraneous cognitive load is high, working memory is overloaded and learning is adversely affected.

This process happens as we learn new skills that we later do with some automaticity such as driving, riding a bike, learning a musical instrument or even doing algebra. The forming of efficient categorization and schemas is called germane load (Paas et al 2003, Sweller et al 1998).  

We considered that since music aids in efficient categorization perhaps learning and music together could decrease cognitive loading and increase germane ability by lightening the load. We tested this by having participants first listen to music designed to entrain concentration. According to (Doman 2007) entrainment can occur in as little as one minute. Music with specific timbres and rhythmic structure has demonstrated an increase in effectual category formation, (Ostrander1994, Rose1997) and can aid visual spatial perception, (Ruvenshteyn and Parrino, 2005) (Orel, 2006) Music is shown to aid in hemispheric transfer or communication between both halves of the brain (Taut et al 2005). We felt participants in the auditory condition would increase germane load and decrease extraneous load. The decrease in extraneous load is expected because of the neuronal changes evoked by entrainment (Pouliot 1998) (Carter and Russel 1992)

 What were our findings? Approximately 50% of our participants immediately increased their ability to sustain cognitive load by 150%. The other 50% decreased in this ability however many of these reported greater clarity of thought later in the day and improved their testing scores considerably. The lesson we learned from this is that for music to be effective at least for ½ the population consistency is the key. Many individuals need a consolidation period where learning is categorized and music is internalized.  

In fact, there are long term benefits of listening to music, notes Dan Levitin in This is Your Brain on Music.

“Music listening enhances or changes certain neural circuits, including the density of dendritic connections in the primary auditory cortex…The front portion of the corpus callosum—the mass of fibers connecting the two cerebral hemispheres—is significantly larger in musicians than non-musicians, and particularly for musicians who began their training early…Musicians tend to have larger cerebellums than non-musicians, and an increased concentration of grey matter…responsible for information processing.” In the end music is like exercise, starting later in life is better than not starting at all and may confer neuroprotective benefits…but that is another study!

 

References

Ayres, P.L (2006) “Impact of reducing intrinsic cognitive load on learning in a mathematical domain”, Applied Cognitive Psychology, vol.20, 99 287-298.

Carter, J & Russell H. (2002) A Pilot Investigation of Auditory and Visual Entrainment of Brain Wave Activity in Learning Disabled Boys Stanford University USA

Chandler, P. & Sweller, J. (1991). “Cognitive Load Theory and the Format of Instruction”. Cognition and Instruction 8 (4): 293–332. doi:10.1207/s1532690xci0804_2. 

Clark, R., Nguyen, F., and Sweller, J. (2006). Efficiency in Learning: Evidence-Based Guidelines to Manage Cognitive Load. San Francisco: Pfeiffer. ISBN 0-7879-7728-4. 

Conway, A. R. A., Jarrold, C., Kane, M. J., Miyake, A., & Towse, J. N. (Eds.). (2007). Variation in working memory. New York: Oxford University Press

Doman A, (2007) ABT conference Miami Fl. Advanced Brain Technology 5748 South Adams Avenue Parkway Ogden, Utah 84405, USA

Naish, P. 2005, Perceptual Processes ‘Attention’, Cognitive Psychology, Braisby and Gellatly, (eds) Open University in association with Oxford University Press UK

Orel, P., (2006) ‘Music Helps Students Retain Math’, Rutger’s Focus, Rutgers, The State University of New Jersey, New Jersey USA

Ostrander, S., Shroeder, L., and Ostrander, L. (1994) Super Learning New York, Delacorte Press, (1994)

Paas, F. Tuovinen, J., Tabbers, H., and Van Gerven, P., (2003) ‘Cognitive load measurement as a means to advance cognitive load theory’, Educational Psychologist, Vol 38(1), 63-71.

Pike and Edgar (2005) Perceptual Processes ‘Perception’, Cognitive Psychology, Braisby and Gellatly, (eds) Open University in association with Oxford University Press UK

Price A, Kessler R, 2006 “Sparks of Genius Recovered?”, Thinking Pays Boca Raton FL USA

Price A, Kirkpatrick M, Groszek M, “ 2007, Just practise? Or can ergonomic brain instruction or musical entrainment lighten the cognitive load to increase working memory performance and working load stamina?” Open University, Milton Keynes UK

Sweller et al (1988, 1989, 1993) Sweller, J., and Chandler, P., (1994) ‘Why some material is difficult to learn’ Cognition and Instruction, vol.12, pp185-233.

 Thaut, M., Peterson D., and McIntosh G. (2005) ‘Temporal Entrainment of Cognitive Functions: Musical Mnemonics Induce Brain Plasticity and Oscillatory Synchrony in Neural Networks Underlying Memory’, The Center for Biomedical Research in Music, Molecular, Cellular, and Integrative Neuroscience Programs, Colorado State University, Fort Collins, Colorado 80523, USA

 Tomatis, A. (1991) The Conscious Ear, Station Hill Press, Paris, (1991)

Price A, Kessler R, 2006 “Sparks of Genius Recovered?”, Thinking Pays Boca Raton FL USA

Price A, Kirkpatrick M, Groszek M, “ 2007, Just practise? Or can ergonomic brain instruction or musical entrainment lighten the cognitive load to increase working memory performance and working load stamina?” Open University, Milton Keynes UK

Rose, C. & Nicholl, M. (1997) Accelerating Learning for the 21st Century. New York: Dell Publishing (1997)

Roure, R., et al. (1998) Autonomic Nervous System Responses Correlate with Mental Rehearsal in Volleyball Training. Journal of Applied Physiology, 78(2), 99-108

  Ruvinshteyn M and Parrino L, (2005) Benefits Of Music In The Academic Classroom

Memory and Music Connections

Brain, Music and Memory (Dr Janata 2009)

Brain, Music and Memory (Dr Janata 2009)

Music For Brain Enhancement

Brain on Music (Dr Janata)

By Amy Price PhD

We have found in our practice that music can trigger powerful memories even for people that have sustained brain damage and have lost the ability to speak. Sometimes stroke or TBI victims can sing fluently because the path to music is stored in a different area of the brain than the one used for recalling words. As a culture we understand the power of music and now a brain-scan study reveals where music makes its mark.
The part of the brain music activates is known as the medial pre-frontal cortex and sits just behind the forehead. “What seems to happen is that a piece of familiar music serves as a soundtrack for a mental movie that starts playing in our head.” said Dr. Janata, a cognitive neuroscientist at University of California, Davis. “It calls back memories of a particular person or place, and you might all of a sudden see that person’s face in your mind’s eye.”
Janata noticed the medial pre-frontal cortex showing the same kind of activity when In Janata’s study this area responded quickly to music rhythm and chord changes, but also reacted when tunes were autobiographically relevant. In addition music provoked the strongest activity in the brain when it was combined with autobiographical memories.

This latest research could explain why even Alzheimer’s patients who endure increasing memory loss can still recall songs from their distant past. It is thought that medial portion of the prefrontal cortex is less susceptible to atrophy according to Janata.
Music does not cure Alzheimer’s or fix TBI but can help patients recover precious memories, help with thought organization and improve quality of life.
Maybe the Apple a day for Alzheimer’s is the IPOD. Dr. Janata has a project underway to make that happen

References:• Janata, P. The neural architecture of music-evoked autobiographical memories. Cerebral Cortex. Advance Access published February 24, 2009, doi:10.1093/cercor/bhp008. For supplementary information, go to the Advance Access page and search for the article.
• Janata, P., Tomic, S. T., & Rakowski, S. K. (2007). Characterization of music-evoked autobiographical memories. Memory, 15(8), 845–860.

Memory Strategies

accessed from Joaquin M. Fuster (2007), Scholarpedia, 2(4):1644.

accessed from Joaquin M. Fuster (2007), Scholarpedia, 2(4):1644.

In MVA involving injury memory deficits can become an issue. Pain and lack of sleep contribute to this as do many of the medications prescribed to make it go away. There is anxiety and grief over financial loss or changed status. This compounds the issue. Each year more money is spent on pet food than for treatment to restore survivors of mild traumatic brain injury. Eighty percent of individuals diagnosed with mild brain injury have needs pertaining to the injury that are not presently met by current legislation. Treatment is described as too little, too late.

It was once thought that if there was no improvement in cognitive status in the first six months following an injury further progress would be minimal. Advances in science show this is no longer an absolute. Progress is possible.Every year Traumatic Brain Injury causes 20 times more disabilities than AIDS, Breast Cancer, Spinal Cord Injuries, and Multiple Sclerosis combined. Traumatic Brain Injuries have claimed more lives than all U.S. wars combined since 1977. Approximately 1.5 million Americans sustain a Traumatic Brain Injury each year. Traumatic Brain Injury is the number one cause of both death and disability in children and young adults.

WHAT IT DOES & HOW IT WORKS

Do you need help fixing your broken brain? Even if you don’t this article contains great strategies for improving memory skills and coping with life.
Want help with your memory? Let us look together at where the problem might be so we can suggest solutions. Information is first filtered through the senses (seeing, hearing, touching, smelling) or sensory memory. The sensory input combines with what we already know as the brain attempts to classify the information before it is encoded into our memories. Before it can be encoded accurately we have to pay attention or attend to it. The brain has only a few seconds of what is called working memory to encode material. When the information is needed we call on it to come out. This process is called retrieval.

POSITIVE STRATEGIES FOR A VARIETY OF SITUATIONS

Retrieval can be enhanced by rehearsal. The most common kind of rehearsal is saying something like a phone number over and over until it sticks in the brain. This is a problem for a person with memory deficits as by the time they get to the last number they forget what it is! In this case there is an unorthodox but useful strategy called chunking, instead of remembering numbers digit by digit such as 301 5700 think of three hundred one, fifty seven hundred. There are other solutions, write information down while repeating it to your self or ask someone else to write it for you. This is most useful when someone is giving you directions. The next step is to read the information back to who ever you got it from and ask them if your version is correct. This is also good for reinforcing understanding in conversation as sometimes what someone says to us is different to what we heard them say or is not what they meant.

To deal with problems of losing things here is some help. Pick places where you are comfortable storing things like keys, licenses etc. Make it a habit to always put them back in those places only. Write down where these places are and put it somewhere you will see it everyday in case you forget. When you go to a store only take something that can be attached to your body, forget about the purse that could be left in the shopping cart or car keys you carry in your hands.
When the memory is less than stellar even a parking lot can seem like a hopeless maze. Most cell phones have voice recorders on them as do many other devices. Record where you parked the car, for example the car is at exit c parking lot level three, third car down. Pay attention to which store you enter and what is close to the door, for example Macy’s, men’s shoes. This way if you get lost you can ask someone where these landmarks are and find your way.

Here is another strategy A piece of paper/card with a grid (kids math jotter paper with the little blocks) with place for a couple of stores names around the periphery or a land marks/monument, a McDonalds or a gas station and make an X in the block of the area where you best estimate your car is. A good place to put ID, credit card, money, parking lot stubs is in a ‘fanny pack’. If you can not remember how to get somewhere or get home buy a turn by turn GPS or phone a non judgmental friend.

There are many kinds of memory, visual auditory episodic, semantic, conceptual and more. This is good news because it means that you can use another kind of memory to enhance which ever kind is not working for you right now.

Here are some useful strategies. To remember an event think about what else you did, where it happened, the conditions around the event, ask your self how you felt that day, who was with you even what you did afterwards. Anyone of these can release a cue to help you remember.
To remember Peoples’ names, think about where you first met the person or go through the alphabet mentally, sometimes it helps to recall their significant others’ names or occupation. Just one piece of information can trigger the missing link. If all else fails ask them for a business card and read it or ask how they spell their names.

Learning something?-To remember something you need to learn, teach it to someone else, read your notes on tape and play them as you walk or at the gym, create a mind map or make the information into a story. Trouble finding words, look up a word that means the same in a good dictionary usually the synonyms will be displayed and your missing word will show up. A good dictionary can also show you how to pronounce words you have forgotten how to say. Forget how to spell it and spell check is not bright enough to figure it out? Break the word into syllables and spell the part you can figure out, from here spell check may pick it up or you may remember the whole word.

In the kitchen-For kitchen memories….don’t leave the room or be otherwise distracted when you have a pot on the stove. The same people that distracted you will remind you over and over about how you forgot something again! Do one thing at a time until your memory is healed, your ability to multitask will usually return. Buy appliances that turn off automatically, this may be expensive initially however it is cheaper than a house fire! Discipline yourself to use timers.
Often individuals forget steps of a process/task. In this case it is useful to lay everything out ahead of time. Think through what steps you need to take to complete a process/task. If this is difficult get someone to help you and write it down or record it for yourself.

For schedules…got an appointment write it down, put it on the computer, in the day timer or on a PDA. Another method is to call your telephone answering service and leave your self messages as they come up. Alternately make a list and number it for priorities then cross them off when you are finished. Too busy to prioritize…you are too busy! Make changes or you will get buried.
I Hope this helps some, nobody remembers everything so don’t beat yourself up. Keep working at it slowly and surely the more you use your brain the better it will get.