Mild cognitive impairment (MCI) and what you can do

Mild cognitive impairment (MCI) and what you can do

Mild cognitive impairment (MCI) is the medical name for memory problems that exceed the “normal forgetfulness of aging” but are less than associated with an Alzheimer’s diagnosis. If you have received a diagnosis of MCI, you are at risk for continued significant cognitive decline. Each year about 10–15% of persons with MCI receive an Alzheimer’s diagnosis, as compared to 1–3% of all older adults.

That said, many people with MCI do not experience further decline. And some people even improve–if their memory loss was caused by something fixable like a medication reaction or untreated depression. For all these reasons, it is important to have symptoms reassessed every 6–12 months to monitor changes.

There are things you can do. While there is no medical treatment as yet for MCI, some everyday activities can help prevent or slow its progression. The goal is to increase blood flow and oxygen to your brain, and keep your mind active.

  • Manage your blood pressure. Keeping blood pressure within the normal range has a profound effect on delaying memory problems.
  • Practice healthy habits. Get regular aerobic exercise, such as brisk walking. Aim for eight hours of sleep. Eat a diet low in processed foods and high in fruits and vegetables. Limit alcohol. Quit smoking. Manage other conditions (e.g., diabetes, depression).
  • Wear your hearing aids. A loss in hearing means a loss of stimulation to the brain. Studies now connect this loss with a decline in brain function. (Plus, some things you are “forgetting” may in fact be from conversations you didn’t fully hear.)
  • Participate in social activities. Even if you don’t talk much, the stimulation of spending time with others is beneficial.
  • Learn a new skill. Make your brain exercise! Try something you’ve never done. Brush your teeth with the “opposite” hand. Or have some fun: Ping-pong? Drumming?
  • Engage your mind with puzzles. This is brain calisthenics. Keep your neurons firing with activities that make you think.

Memory aids. Accept that you are forgetful and support yourself for success. Make ample use of to-do lists, big calendars, and notes or alarms on your phone. Leverage the power of routines. Put your keys and glasses, purse/wallet in the same place every time. Set yourself up for environmental cueing, consciously putting things where you will see them when needed, such as leaving your morning pills by the coffee maker.

Worried about MCI?
Give us a call. We can help. (208) 321-5567

Learn more about our services to help you age well.

Choosing a home care provider

Choosing a home care provider

Frank knows they need help at home. His wife’s dementia is getting worse, and he has his own health problems. She can’t be left alone anymore.

Doing all the cooking and cleaning, and now helping with bathing … it’s just too much.

Frank needs to take breaks. But a Google search reveals a dizzying array of home care providers. How to choose?

Allowing a stranger into your home can leave you feeling quite vulnerable. It’s important that you trust the individual and the company that does the background checks, verifies training, and puts together the schedule.

You also need to interview each company to find out pricing and minimum number of hours, and to see if they have independent quality ratings.

How do you know which one to trust?
This is where an Aging Life Care™ Manager can help.

On the basis of past experience with other clients, he or she knows which companies put an emphasis on training. Which have difficulty filling a shift if a caregiver calls in sick. Which have high staff turnover resulting in the need for you to orient a new employee every few months. Which have a strong team, with employees who love their work.

Wise home care companies will let you and your Aging Life Care Manager interview several caregivers before making a choice. They know that an Aging Life Care Manager understands you as the client and understands what will result in an optimal match.

Both you and the provider and the caregiver want a good fit the first time so all of you can work together positively for the duration of your need. It makes the difficult transition to home care that much easier if a knowledgeable advocate can set expectations and provide an objective viewpoint.

Even with adult day care and medically trained services, such as home health and hospice, not all providers are alike. An Aging Life Care Manager knows the reputation and the management style of each company. He or she can look up Medicare reviews and complaints.

An Aging Life Care Manager can also coordinate care across multiple service providers and work with your physician to ensure that all the different players are aware of your changing needs.

Want to find the best fit the first time?
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

What Services Do In-Home Caregivers Provide?

What Services Do In-Home Caregivers Provide?

In-home caregivers come to the home to help with activities daily living, such as light housekeeping, grocery shopping, meal preparation, medication reminders, and grooming. And while home health care aides can also provide personal care assistance, the opposite is not true (personal care assistants can not provide in-home health care).

Some of the options for in-home care and home health care services can be found below. 

Home Care Services

Personal care assistants do not provide medical care, but otherwise, care can be tailored specifically for each individual’s needs. Available services include: 

  • Assistance with ADLs
  • Assistance with mobility
  • Grocery shopping and meal preparation
  • Housekeeping and cleaning services, including laundry
  • Transportation to doctor’s appointments, social activities, and more
  • Companionship, social engagement, and cognitive stimulation 
  • Medication management (but not administration)
  • Respite for family caregivers

Home Health Care Services

Home health care aides provide more skilled medical care than personal care assistants. The care one receives will depend on their own medical needs, but available services include: 

  • Skilled nursing, first aid, and wound care 
  • Post-surgery recovery care
  • Physical therapy
  • Occupational therapy
  • Respiratory therapy and assistance with oxygen tanks and tubing
  • Assistance with maintaining and cleaning feeding tubes, catheters, and other medical devices
  • Medication administration, including injections 
  • Assistance managing and monitoring chronic conditions
  • Blood withdrawals

How Much Does Home Care Cost? 

According to the Genworth Financial Cost of Care Survey, in-home care costs about $24 an hour. That comes out to $1,950 per month for 20 hours of care a week, or $3,900 per month for 40 hours of care per week. Home health care is slightly more expensive at an average rate of $25 an hour. 

These figures are the national average, so average costs in your state or city may be quite different. For example, in Vermont, where senior care tends to be more expensive than the national average, 20 hours per week of in-home care costs an average of $2,362 per month, about $400 higher than the U.S. average. Meanwhile, in Louisiana, the same amount of in-home care costs just $1,463 per month, on average.

Financial Assistance for In-Home Care

It’s always an option to pay out-of-pocket for in-home care, but many people utilize some form of financial assistance to make the cost more manageable. Below are some of the most commonly used resources available to pay for home care. 

  • Long-Term Care Insurance: Standard health insurance will not pay for personal care assistance, but some long-term care insurance policies may. While long-term care (LTC) insurance policies are specifically designed to cover senior care, the exact coverage details can vary depending on several factors, most notably the age of the beneficiary when they signed up for their policy. LTC insurance oftentimes will not cover in-home care until the client needs help with at least two ADLs. Check the details of your loved one’s policy to see if in-home personal care assistance is a covered benefit.

  • Medicare: Original Medicare does not cover standard in-home care as it is considered “custodial care” and not medical. However, it may cover personal care assistance if it is delivered with home health care services from the same provider. Additionally, some Medicare Advantage and Medicare Supplement plans may cover in-home care services.

  • Medicaid: Medicaid does not cover custodial care, which includes standard in-home care. However, many states have some form of Home and Community-Based Services (HCBS) waiver, designed to expand the state’s Medicaid benefits to cover additional services such as personal care assistance. Medicaid does always cover home health care for those who meet both medical and financial eligibility requirements.

  • Life Insurance: Though one’s life insurance benefit is intended to be accessed after they pass, in some cases it makes more financial sense to access the funds early and use the life insurance payment to finance long-term care. This may be in the form of an “accelerated death benefit” from the insurance provider, or you may look into selling the policy to a third-party for a cash payment. Look into the specifics of your loved one’s policy to see if this option makes sense for your situation.

  • Veterans Benefits: In addition to a VA pension, some veterans are eligible for the Aid and Attendance (A&A) benefit, an additional monthly payment intended to be used towards paying for long-term care. One of the eligibility terms is needing help with one or more ADLs, so most veterans in need of in-home care will likely qualify. You can learn more about the benefit and apply directly on the VA website, or apply in person at your local VA office.

  • Reverse Mortgage Loans: Reverse mortgages are a loan that one can take against the value of their home, essentially converting part of their home’s value into a cash payment while they continue to live there. The only federally-insured, and thus most reliable, form of a reverse mortgage is the Home Equity Conversion Mortgage (HECM), available to adults age 62 and over to help finance long-term care or other expenses. No matter which type of reverse mortgage one chooses, the loan will need to be repaid with interest once the home is eventually sold. 

Source: Caring.com

Getting the most from video chat

There is no doubt that video chat tools such as Zoom, FaceTime and Amazon Echo Show have made the isolation of older adults much more bearable. While not the same as an in-person visit, video chatting has been demonstrated to reduce depression in older adults by 50% when compared with other forms of connecting.

Video chatting with grandchildren is an art. Keeping their attention is a challenge, along with finding a “good time” to talk. Here are some tips you may want to go over with your loved one to help make video visits a positive exchange for all involved:

The physical environment. Pick a spot where the lighting is in front, not behind. “Backlighting” creates more of a silhouette, making it harder to see faces. Reduce background noise. (Turn off televisions. Move to a quiet room.) Mount phones or tablets on a tripod to free up both hands for gestures or showing off objects.

Create a routine. Make storytime with grandpa a regular activity before bed. Or maybe have grandma call while you are cooking dinner so the kids are entertained while you prepare the meal. Agree on a mutually convenient time that works for all three of you.

Prepare for the call. As the parent, ask your child what they want to share with grandma or grandpa and bring it to the phone station. Before handing the phone over to your child, give your parent a quick run down of interests in the last hour or day so they can be sure to inquire about activities that are top of mind. As the grandparent, have a favorite book or object at the ready that you want to share in return.

Bring out the inner hambone. The joy of video chats comes in the ability to interact. Kids love movement, silly faces and gestures that can be done together. Babies enjoy patty cake and peek-a-boo on video. And blowing kisses. Older children enjoy activities such as “Freeze Dance”—like musical chairs except the players freeze like statues until the music starts again.

Start with short, 5 minute visits. Work up gradually to longer visits as you all get used to this new medium.

Will we ever hug again?

Hugs are more than a symbolic display of affection.

They have actually been shown to release oxytocin, the bonding hormone, which calms our nerves and reassures us that we are loved and we belong. Like everyone, older adults have a basic need to hug and be hugged. And grandchildren are often the joyful purveyors of sweet, soul nurturing embraces. One reason hugging is so dangerous now is that close proximity means we breathe into each other’s air space. Since the virus is spread by tiny droplets in aerosol form, face-to-face hugs are especially risky.

Imagine that every exhale is like smoke. It wafts in the air, even from children, dissipating gradually over time. You can see why we wear masks! According to aerosol specialists at Virginia Tech, there are things adults can do—and teach children to do—so that grandma and grandpa may feel safe enough to be back on the hug circuit.

  • Always wear masks. They seem to protect both the wearer and the person on the receiving end of the hug.
  • Keep your hugs brief. 10 seconds, and then step away to a six-foot distance.
  • Look away from each other. Head-on or cheek-tocheek hugs put you right in each other’s jet stream. Instead, turn your heads so you are facing different directions.
  • Hold your breath. From the time you approach to the time you step back. Another reason or cue to keep the hug short.

A hug around the knees or waist from a little one is fine. The adult should turn their head away so they aren’t breathing down on the child.

An affectionate kiss on the back of the head is also relatively safe. Hold your breath and try not to exhale until you are appropriately distanced again.

Source: Dee Childers, Life Changes Elder Care, LLC

BALANCING FEAR WITH KINDNESS

BALANCING FEAR WITH KINDNESSThere are many things to fear in our world today, the most recent being the outbreak of the COVID-19 coronavirus around the world.  But, recent events in my neighborhood completely unrelated to coronavirus reminded me how just easily our fears and biases can cause us to overlook concern for the welfare of others.

I live in a community that is known for kindness and a history of taking care on one another.  Unfortunately, a few criminal events rooted in domestic violence over the span of several months had our very close-knit neighborhood on edge (and the neighborhood Facebook page on fire).  Every “stranger” in the environment became a suspect with unusual sightings reported (and commented on) in great detail.

With this as background, it is no surprise that when doorbells rang unexpectedly at 1:30 in the morning, people responded with fear.  Most people admitted to not opening the door to a stranger in the middle of the night.  The few people who did open the door reported that a menacing-looking middle-aged man dressed all in black said he had lost his phone and asked to come in to use a phone.   He was turned away from multiple houses who reported a fear for the safety of their family.

As it turns out, the man ringing the doorbell was the mentally challenged father of a family who had just moved into the neighborhood.  He had left the house without his cell phone, had gotten lost, and he was himself panicked and afraid.  Gratefully, his daughter found him and was able to return him safely home – but not with the help of our usually kind and generous neighborhood.  Part of the reason people responded as they did was because this man did not “look like” the typical person in need.

I like to believe that had he been a young child or an obviously senile older adult that we would have been more responsive as a community. But, it WAS the middle of the night, and I have still instructed my teenage daughter to NEVER open the door in the middle of the night to a stranger no matter what the circumstance.  So, as a family, we have also discussed that we should have called the non-emergency number for our local sheriff’s department to request a welfare check on the stranger.

We immediately jumped to the fear-based conclusion that the stranger was up to no good when, actually, he was a fellow human in need.  We overlooked the fact that there are options available to safely balance the concern for our own welfare with the responsibility to extend kindness to a stranger.  It never occurred to us to request a welfare check in this kind of a situation, but I have been assured by several local law enforcement agencies that they would have viewed this as an appropriate use of services and would have been happy to come out to ensure the well-being of everyone in our neighborhood as well as the stranger in our midst.

So, whatever your position on the necessity to stock up on toilet paper and bottled water in the face of the current coronavirus pandemic, I hope we all remember to stock up on an extra supply of human kindness.  I have no idea what unexpected needs might present themselves in the coming days, but I plan to do what I can to help my friends, my neighbors and strangers as we navigate this uncharted territory together.  After all, I didn’t stock up on extra toilet paper, and now the store shelves are empty.  So, I hope that one of my neighbors will come to my rescue if we have a toilet paper emergency at my house.  Be safe and be kind!

Written by: Darra Wray

Darra Wray is a Care Consultant and Certified Senior Advisor with My Care Companions in Boise, Idaho, a company she founded to streamline and simplify the administrative side of care.  You can learn more about My Care Companions and the My Data Diary+ family information management software tool at www.mycarecompanions.com.

 

5 COMMON CAUSES OF BRAIN FOG

5 COMMON CAUSES OF BRAIN FOGYou need to stop by the grocery on the way home from work for two gotta-have items. One of the items is coffee, but you can’t think of the other one to save your life.

Every time you sit down to do that report for work, you can’t seem to focus and make any real progress.

Better wait to walk to the end of the driveway to get the mail because your neighbor, that you’ve only lived beside for five years, is in his yard, and you don’t remember his name.  You know you know it, but your brain can’t seem to reach it.

Sound familiar?
Even though you may feel like you’re losing your mind, it could just be a bit of brain fog. Thankfully, you can take steps to clear up the haze after you figure out what’s causing it.

What Is Brain Fog?
Brain fog is not a medically recognized term or diagnosable condition. It’s a common phrase used for a myriad of symptoms affecting your ability to think. Brain fog can include things like memory problems, lack of mental clarity, and an inability to focus, and put thoughts into words. Some people describe it as mental fatigue.

You know – the kind of mental exhaustion where you tell yourself if you can just make it to the weekend, you’ll get some rest. That should help. Next week will be easier. The problem is that when the weekend rolls around, there are a gazillion more things to do and stress about. So, you end up not getting the much-needed rest. Or if you do, it doesn’t seem to help the problem in the slightest.

That’s because to resolve brain fog, you have to figure out and address what’s causing it. 

On a cellular level, brain fog is believed to be associated with high levels inflammation and changes to three primary hormones: dopamine, serotonin, and cortisol. One theory behind the underlying reason for brain fog symptoms is that higher levels of inflammatory molecules, including adipocytokines and histamines, stimulate microglia activation.

Five Common Causes of Brain Fog
According to one study, the most commonly reported brain fog triggers were fatigue, lack of sleep, prolonged periods of standing, dehydration and feeling faint. Sometimes, a trigger can’t be avoided. However, if brain fog is an ongoing issue for you, taking a look at and adjusting your lifestyle habits might be warranted.  Let’s look at some common causes:

1. Stress
In the short-term, stress can make you irritable, anxious,  distracted and forgetful. Over time, elevated levels of cortisol, the stress hormone, can chip away at your physical, mental and emotional healthChronic stress actually damages your brain.  Stress shrinks dendrites, kills neurons, and prevents new cell growth in the hippocampus – essential to memory. While it’s doing all that, it causes your amygdala, the fear and emotional center of the brain, to increase size and activity. This makes it harder for your brain to learn new information and remember it.

2. Lack of sleep
Sleep deprivation can have serious short-term and long-term consequences for your overall and brain health. After just one night of skimping on sleep, the results can be seen in delayed reaction times, glucose levels, mood, headache, impaired memory, and hormone balances. Recent research shows that not getting enough sleep may even shrink your brain. You’ll want to aim for eight to nine hours of sleep per night. But don’t forget, quality matters too.

3. Diet
Diet can also play a role in brain fog. When it comes to your brain, you literally are what you eat. What goes into your mouth has everything to do with what goes on in your head. You have a “second brain,” the enteric nervous system, in your gut which communicates with the brain in your head.

To get the most brainpower out of your diet, you will want to include fatty fishes, foods with probiotics, whole grains, leafy greens and lots of lean protein. If you’re missing essential vitamins and minerals, your brain function will reflect it. For example, a vitamin B-12 deficiency can bring about brain fog.

Also, food allergies and sensitivities can make your thinking fuzzy. The most common culprits are:

  • Processed meat (sodium nitrates)
  • Dairy
  • MSG
  • Alcohol
  • Artificial sweeteners

Dehydration can also contribute to sluggish thinking.

4. Hormonal Changes
Hormonal changes can also trigger brain fog. The brain and entire body rely on a complex symphony of hormones that work to keep one another in check. So, when levels of one hormone fall too low or climb too high, your whole system, including brain function, can be thrown off.

For example, levels of the hormones progesterone and estrogen increase drastically during pregnancy. This change can affect memory and cause short-term cognitive impairment. Similarly, a drop in estrogen level during menopause can cause forgetfulness, poor concentration, and cloudy thinking.

5. Medications and Medical Conditions
Brain fog is a common side effect of many drugs. If you notice symptoms upon taking a medication, talk with your doctor. Lowering your dosage or switching to another drug may alleviate the problem. Brain fog is a well-known side effect of chemo and is referred to as chemo brain.

Medical conditions associated with inflammation, fatigue, or changes in blood glucose level can also be the cause of mental fatigue. For example, brain fog is a symptom of:

  • chronic fatigue syndrome
  • fibromyalgia
  • anemia
  • depression
  • diabetes
  • hypothyroidism
  • autoimmune diseases such as lupus, arthritis, and multiple sclerosis

Diagnosis and Treatment of Brain Fog
No matter what you think is causing your brain fog, it’d be a good idea to get checked out by your doctor. However, there isn’t one test specifically for the condition. When you get to your doctor’s appointment, you can expect to have a regular physical examination with some follow-up questions.

Your doctor may feel additional blood work is necessary to rule out the brain fog being a symptom of a more serious issue. Blood work can identify the basic health markers, glucose levels, nutritional deficiencies, organ function, hydration, and more.

Your doctor can then suggest possible solutions to implement based on the exam, questions, and tests. Treatments are different depending on the determined cause. Your physician may advise you to get more sleep, switch medications, start taking nutritional supplements, or something else. You may need to try out different treatments before you find one that works for you.

Conclusion
Brain fog is an annoying symptom that can arise for a wide variety of reasons. It may feel like you’re going to be stuck in that sleepy mindset forever, but there are plenty of ways to wake your brain up. Try out different treatments until you find one that works. Then, make adjustments as necessary to prevent the condition from returning. One day, you’ll clear away the fog, and the sun will shine again!

Contributing Author: Kayla Matthews writes about wellness, productivity and stress in the modern world for websites like Make Use Of, BioMed Central, and The Huffington Post. To read more posts from Kayla, subscribe to her blog, Productivity Theory.

Source: The Best Brain Possible with Debbie Hampton, Author | Writer | Online Marketer, at: CLICK HERE.

Debbie Hampton recovered from a suicide attempt and resulting brain injury to become an inspirational and educational writer. She is the author of Beat Depression And Anxiety By Changing Your Brain and a memoir, Sex, Suicide, and Serotonin, being re-released next month. Debbie writes for The Huffington Post, MindBodyGreen, and more. On her website, The Best Brain Possible, she shares information and inspiration on how to better your brain and life.

 

COVID-19: How One Family Caregiver Copes with the Changes

Lisa Shultz, author and family caregiver, is a family caregiver to her mother. In March, she was suddenly informed that her weekly visits were suspended to see her mom in an assisted living facility in response to the COVID-19 virus and efforts to reduce the chance of spreading the disease. She shares what this has […]

Forming Your “Circle of Help”

Forming Your “Circle of Help”

Never go it alone. The best way to stand up to Alzheimer’s is to gang up on it.

The best way to defeat Alzheimer’s is to come together and gang up on the disease. If you or your spouse have been diagnosed with Alzheimer’s, please know that you are not alone. Right now, thousands of Alzheimer’s researchers, doctors, nurses, caregivers, support groups, and long-term care facilities are fighting for you on many fronts.

One of the most important fronts, of course, is the home front. My new book, Mike & Me, is one of several new books to chronicle the changing face of home care among Alzheimer’s couples and caregivers. Together, we are learning how the astonishing power of love, patience, compassion, and stay-at-home care can be mobilized by virtually every couple to help Alzheimer’s patients defy the old statistics and live a longer, fuller life.

My Husband and I Made A Deal

Early in my husband Mike’s 10-year journey with Alzheimer’s, we made a mutual commitment: As long as it was safe for him and me, Mike and I would live together in our home and make the Alzheimer’s journey together. Our goal was to keep Mike’s life as normal as possible for as long as possible, and that would entail staying in our home and community. It turned out that keeping that commitment to Mike was only possible because of a circle of friends and family who gradually formed around us and helped us every step of the way.

Looking back, I now realize that one of the most important things Alzheimer’s couples must learn in the early going is to simply reach out for help from friends and family. That probably sounds too obvious to mention, but you would be surprised to learn how many Alzheimer’s couples try, initially, to go it alone in their care. My husband Mike and I were one of those couples in the beginning. You see, we weren’t accustomed to asking people for help or bothering others with our difficulties. In the past, whenever a problem arose, Mike and I had always turned to each other for help, and, at first, that’s how we tried to deal with Alzheimer’s too.

Forming Your Circle of Help 

So why do I tell you these things? I tell you because I want you to believe that your “circle of help” – your friends, family, neighbors, and community – is waiting for you, too, if you will only let yourself reach out.

Perhaps like you, my challenge in the beginning was to simply open up to the idea of accepting help from others. But once I opened up, I quickly learned two things.

First, I was surprised at how many people were more than willing to help Mike and me. And second, I didn’t have to accept everyone’s help; I could still be selective about who I would let into our circle.

As time went on, I eventually built a small team of people – kindred spirits – who were helping me care for Mike. I like to think of them not just as a team, but as a “circle” of thoughtful people who surrounded us and helped care for our physical, emotional, and spiritual needs. It felt like such a natural process. One by one, along came certain friends and neighbors who thoughtfully recognized that we had a need of one kind or another and offered to help, each in his or her own way.

You may not know it yet, but you, too, have a circle of support quietly waiting for you. Watch for it, welcome it, be thankful for it. Yes, it’s a little scary at first to allow people in when you feel most vulnerable. But if you do plan to stay in your home together, rather than go to a care facility, then you too will have to turn to a circle of caring people who can help you.

Source: UsAgainstAlzheimer’s by Rosalys Peel

FEED YOUR BRAIN: TIPS FOR BETTER BRAIN HEALTH

FEED YOUR BRAIN: TIPS FOR BETTER BRAIN HEALTH

Spend some time with the 50-plus age group and it becomes clear that memory and brain function are hot topics.

With many baby boomers encountering changes in their  brain function—causing concern, and, let’s face it, amusement, at times— it is not surprising that boomers are looking for ways to hold on to their memory and increase cognitive ability.

Being vital until the end of life is something that everyone wishes for but not all of us are lucky enough to experience. According to the Alzheimer’s Association (alz.org), 44 percent of Americans between the ages of 75 and 84 have dementia or Alzheimer’s disease, and by age 85 that number goes up to 50 percent. Those numbers are driving a whole new market of brain-enhancing health products, from supplements to video games, all aiming to increase cognitive ability. But will this do us any good? Are there proactive steps we can take to stop the deterioration of the brain as we age?

According to mounting evidence in the field of neuroscience, the answer appears to be yes. Research is revealing that the aging brain actually has more capacity to change and adapt than was previously thought. According to Sandra Bond Chapman, PhD, founder and chief director at the Center for Brain Health in Dallas, Texas, it appears that the brain continues to develop neural pathways to adapt to new experiences, learn new information, and create new memories.(1) In fact, studies show that the brain can actually get smarter as we age: the more new learning experiences we have, the more neural pathways we create, which means we can actually stockpile a larger network of neurons that can markedly slow down the process of cognitive decline. The more we develop in the brain now, the fewer years of decline we experience down the road.

Research conducted by the Center for Brain Health shows that older brains can be more receptive to pattern recognition, judgment, and accumulation of knowledge and experience, giving those over 50 an advantage over younger brains if—and that is a big if—the physical structure of the brain is not in decline.(2) Physical decline of the brain, meaning the actual shrinkage and deterioration that begins in our forties, corresponds with cognitive decline. All of this is to say that brain health needs to be a priority for those heading into their forties and fifties to reap the most significant rewards.

The goal is to decrease stress on the brain, which breaks down brain function, and to build new neural pathways through mental stimulation. The good news is that building better brain health in your everyday life is easier than you might think.

  • Reduce multitasking to help preserve brain function. Practice focusing on the most important thing at the moment instead of trying to cover everything all at once. This higher level of thinking actually means less dementia as we age.
  • The brain does not like routine so avoid robotic, automated behavior and take initiative to learn new behaviors. Simple things like changing your morning routine or learning to eat with your left hand will stimulate the brain.
  • Repetitive mental stimulation such as learning a new language or a new word every day, can improve performance of other tasks. Just think: improving your bridge game may actually improve your ability to drive a car.
  • While “brain games,” video games, and subscription websites are flooding the market, there is no evidence that these things are more effective than learning new skills on your own. The key concept is new: branch out into new languages, sports, and other novel skills to stimulate to the brain.

All the information we are learning about how significant a role basic life functions—the way you eat, sleep, and move—play in maintaining brain health and preventing chronic health conditions like diabetes and heart disease emphasizes the value of living a healthy lifestyle.

6 Tips for Brain Health
Here are six lifestyle factors that can have an impact on brain health.

  1. Diet. Many foods have been linked to brain health, and new information about the role of diet continues to emerge. Some of what research is revealing includes the benefit of the anti-inflammatory properties of a plant-based Mediterranean diet, which includes healthy fats such as olive oil and high-fiber grains, in preventing cognitive decline;(3) the impact of vitamin E, found in nuts and seeds, on the development of dementia; and the importance of decreasing the consumption of refined sugar and eating a limited amount of high fiber carbohydrates because research shows that dementia and Alzheimer’s may be due to “diabetes of the brain,” meaning insulin resistance in the brain that may cause loss of brain cells.(4,5,6)
  2. Weight control. An increasing body of evidence shows that being overweight in midlife increases risk factors for lower and faster decline in cognitive ability.(7) Weight control aids in blood pressure control, which affects brain function. Slow, steady weight loss that is sustainable has great benefit to brain health.
  3. Sleep. The brain actually does a lot of smart things while you sleep, so getting adequate sleep (seven to nine hours for the majority of us) can boost learning, attention, and memory. While sleeping, your brain practices new skills, sorts out memories for the future, and problem-solves, which is one of the reasons why “sleeping on it” often brings answers to problems.
  4. Exercise. Cardiovascular exercise is vital to brain health; it increases blood flow, delivering more nutrients to the brain. Most important, it increases brain derived neurotropic factor (BDNF), a protein that aids in the survival of brain cells. Any exercise helps, but the real benefit shows up when one is active at least three hours per week.
  5. Stress management. Stress and anxiety are associated with memory disorders. Stress can interfere with the function of neurotransmitters in the brain and create toxins that cause cell damage and shrinkage of the brain. Meditation, prayer, and other relaxation techniques along with more-intense therapies may be necessary to control stress. Downtime and relaxation improve higher level thinking and brain health.
  6. Supplements. Dietary supplements that have flooded the market have not been proven effective in slowing cognitive decline. It is not about one nutrient but the diet as a whole. An aspirin per day and however, has been shown to be effective due to its anti-inflammatory properties. Statin medication that is prescribed to prevent heart disease has been shown to provide the same benefit, and there is increasing evidence that a multivitamin a day keeps the brain in tip-top shape.(8,9,10)

That’s right—supplementing with a daily multivitamin can improve cognitive function, according to a series of studies published by researchers from the United Kingdom.

Several teams of British neuroscientists studied the effects of multivitamin supplementation on mood and cognitive functioning among adults and children. In each study, healthy men, women, and children took the daily supplements for four to twelve weeks and then were tested for attention span, memory, accuracy, multi-tasking and other cognitive functions. The researchers also assessed participants’ mood and stress levels.

The results of the studies indicated that multivitamins improved cognitive function—even after only a few weeks of supplementation. In fact, men who took high doses of vitamin B-complex supplements showed improvements of cognitive function and also reported less mental fatigue and higher energy levels. Women also benefited from the daily supplements, as evidenced by an improvement in the ability to multi-task. Children between the ages of 8 and 14 performed well on attention-based tasks.

A multivitamin isn’t a magic bullet and certainly cannot serve as a substitute for a healthy diet—but it can be one component of a healthy lifestyle. It’s one of those things that falls into the category of “can’t hurt, might help.” So, if you needed another reason to add a multivitamin to your daily health regimen, add cognitive function to the list. If you want to give your brain a boost, start by swallowing your vitamins.

Source: Age Gracefully America  Charles H. Weaver, MD

What a doctor wishes patients knew about the end

As a hospice and palliative medicine physician, my job is to help reduce suffering. At the end of life, that job becomes especially intense when time is short, when machines and data seem to be taking over, and so many intense emotions surround a body that is trying to die.

BJ Miller

BJ Miller

But here in that narrow trench, both providers and patients do have power to shape their experience together, especially if they take the time to have a few crucial conversations. In the spirit of palliation, here are a few things, as a physician, I wish I could share more often with patients and their caregivers.

You don’t need to be dying to receive palliative care

In hospitals, it is still common for palliative care clinicians to be pulled aside by a well-meaning though misinformed nurse or doctor who says, “This poor family is miserable, but they’re not ready for palliative care yet.” They imply that either the patient is not dying, or the patient does not realize that he or she is dying. But what this statement does is to conflate hospice or end-of-life care with palliative care. Palliative care is an approach, framed within the context of serious illness, where easing suffering is the goal. So, you just need to be sick and suffering to qualify for palliative care, not necessarily dying any time soon. Don’t be afraid to say you want it.

Don’t wait for your doctor to bring up hospice

What a doctor wishes patients knew about the end

Doctors tend to wait too long to acknowledge when death is close. And as research has made clear, the closer we feel to the patient, the more wildly we overestimate their prognosis.
The median length of stay in hospice care in the United States is 24 days.
As a rule, this is too short. So here’s an inside tip for patients and loved ones starting to wonder about hospice. In an effort to get primary physicians to think sooner about recommending hospice, researchers came up with the “surprise question.” As in: “Doctor, would you be surprised if your patient died within a year?” If the answer is no, then that doctor should start considering a referral to hospice. But there is nothing stopping you from asking the surprise question yourself. If you live with advancing chronic illness and are thinking about how you want your life to go, you might turn the table and ask: “Hey doc, would you be surprised if I died in the next year?” This is a good and bold way to open an honest dialogue with your doctor and get the sort of support you need.
The healthcare system is wired to extend physical life, without much regard to the psychological, spiritual, or financial costs. With advances in technology, we are able to prop up a body practically indefinitely. And it’s well known that doctors tend to presume you want aggressive care, even when care geared toward your comfort may be more in line with your wishes. Unless you say otherwise, the doctor’s presumption rules the day. This means that at some point you may need to say “no” to that next treatment. So be sure to look up now and again and check that the care you’re getting is the care that suits you.

It’s OK to laugh

Deaths from dementia have more than doubled in US, report says
In my book, “A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death,” someone tells of their stepfather wearing a shirt that read, “I’m so old I can’t find my own nuts,” with a doodle of a squirrel on it. His dying wish was to make his daughter laugh, and it helped both of them immensely. To honor him, she buried him in that shirt, sealing his personality in death as it had been in life. Illness isolates people, not just physically. When we get sick, people around us start censoring themselves. The solemnity is supposed to be a form of kindness, perhaps, but it can feel more like yet another loss, almost a premature death. As patients and caregivers know, illness and its indignities offer plenty of rich material for humor. The joke is only on us if we don’t find some way to laugh back.

Those guardrails on the hospital bed go down

Dr. Marianne Matzo is a PhD nurse who researches sexuality at the end of life. She told me a story about a patient who died in his hospital bed while he and his wife were in the middle of oral sex. Dr. Matzo tells this story as a triumph rather than a tragedy: The couple had found a way to maintain intimacy until his last breath. We are still living when we are dying. When those guardrails go down, it is possible to cuddle or caress one another. Those moments are about feeling connected, sexually or otherwise, and finding ways to be in that body while you have it. They are about reminding yourself and each other that you are still here, both of you, able to love and be loved. This is how healing works, and it is very much possible to be healed — to be whole — even as your body falls apart.

To the caregivers: Don’t be afraid to leave the room

In their final days and hours, dying people are usually in and out of consciousness; even when awake, they are often delirious. That means your loved one might say or do things that are completely out of character. Behavior ranges from sweet to insufferable. I met an elderly woman at a conference once who nervously relayed the story of her husband hurling strange and vulgar accusations before losing consciousness for good. Now there was trauma on top of sorrow. I wish someone had told her earlier about the very normal condition of deathbed delirium.
I also wish that caregivers knew it was OK to leave their loved one’s bedside. How many times will they have spent hours gathered in the room, not eating or sleeping for days, barely blinking, not wanting to miss that last breath, only to have the person die just when they nod off or use the bathroom?
As any hospice worker can tell you, this is also a well-known phenomenon. It’s almost as if the presence of others — especially deeply loved ones — gets in the way of the dying person’s final step. That big moment may need to happen alone. What dying people seem to need at the very end is to know that the people they love are going to be OK; that life will go on and that you — the person they care for — will be able to take care of yourself. So, the kindest thing you can do is to demonstrate that care by leaving the room when you need to. Just be sure to give a kiss and know that it may have to be the last.
Source: CNN BJ Miller, M.D.
BJ Miller, M.D. is a hospice & palliative medicine physician who sees patients and families at the UCSF Helen Diller Family Comprehensive Cancer Center. Miller’s career has been dedicated to moving healthcare towards a human centered approach and he advocates for this on a policy as well as personal level. He is the co- author of “A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death.”
The opinions expressed in this commentary are his own.