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The phrase “Get moving” can mean something different for each of us. For some people it means getting up, walking on the treadmill, going for a bike ride, or walking the dog. Unfortunately, for other people it means getting up, going to the bathroom, and going back to the couch. So there is certainly a need to put this concept in perspective. When it comes to proper brain function, movement is absolutely critical. Think about somebody you know that isn’t very mobile. They might be sedentary because they are bedridden, have mobility issues or it might just be that they are plain lazy. Do their brains work as well as someone who is active, getting out and about all the time? The bottom line is that movement is essential for appropriate brain function. Chances are that you’ve heard the term “If you don’t use it, you lose it.” The brain essentially is a relay station for sensory information. When we don’t have appropriate sensory information going into the brain from our muscles, joints, balance system, and more, it starts to wear away and degenerate more rapidly than it should. In the time it can cause the brain not to perform to its highest potential as you could imagine. The brain is stimulated by nerve fibers from several different sources. This includes senses like vision and hearing, as well as other sources. The nerve fibers that carry information from muscles and joints are by far the largest nerve fibers that supply the brain with the greatest amount of information. If you are inactive, you are cutting out your greatest amount of input to the brain. This will in turn reduce the efficiency of the output from the brain. This can manifest itself as physical problems, mental and emotional problems, cognitive and thinking problems, and memory decline. To stimulate the brain, you don’t need particularly intense activity. You can start out small. It might be going to the gym, taking a walk in the woods, or on your streets. Just so long as you’re getting out there and getting moving. Developing the habit of regular activity starts you building a foundation to explore other exercises and more intense activities that can have an even more significant positive impact on brain health. Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For additional information, and to learn more, please visit our Author's page. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Put simply, neuroplasticity is the brain’s ability to change and grow throughout time, dependent on its environment. The brain is a sensory-driven organism. This means that it thrives and survives and functions based on the input it receives. The brain essentially is a relay station, the information coming in influences the information going out. So we want to make sure our brain is wired in the best way possible. There is a brilliant quote from neuroscientist Santiago Ramon y Cajal that said, “Any man can, if he so desires, become the sculptor of his own brain.” Cajal said that at the turn of the last century when most everything we knew about the brain came from head to toe physical examination. In fact, Cajal was one of the first people to really study brain cells under a microscope. The conventional wisdom at that time was that your brain was hardwired and what you had at birth was how your brain would be the rest of your life. In recent years we have learned that the brain is capable of change. Neuroplasticity is the key concept for everything we talk about in regards to brain training. The picnic game exercise is just one of many examples. The game is played with two or more people. It starts out with the first person saying something like “I’m going on a picnic and I’m bringing an apple,” or something that starts with the letter A. The second person says they’re going on a picnic and they’re going to bring an apple and something else that starts with the letter B. The game continues on with each person reciting the items in the list and then adding an item that starts with the next letter of the alphabet. When you expand it out through the alphabet and you get to the letter Z it can actually be rather complicated. There are two points to this game – improvement in working memory and short-term memory, which are very well connected. Short-term memory is where you hold onto a piece of information for a brief period of time. If that information is worth committing to long-term memory, it will be based on repetition or importance. Repetition is somewhat obvious where you do something over and over again until it becomes learned (e.g. playing the guitar). Importance is related to something happening that has a significant impact. For example, if someone was hit by a car in a hit and run accident and they got the license plate number as the car drove off. The picnic game exercises primarily working memory and secondarily, short-term memory. Working memory helps you hold onto small amounts of information while you are attending to something else, and is often the first aspect of memory impairment in certain types of dementia. Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For additional information, and to learn more, please visit our Author's page. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Some people find the loved one in their care almost seems like a stranger - perhaps morphing from a kind and helpful person to a combative and vulgar one. Other times, dementia seems to magnify personality traits. When this happens people often say, it’s my father only “more so.” Though difficult, do try to remember it is the disease and not the person who is responsible for these worrisome, and sometimes embarrassing, changes to his or her temperament. Dementia alters and destroys brain structures. The consequences of the damage include loss of the ability to accurately process and relay information. Another outcome is the inability to control emotions such as anger and censor impolite and socially inappropriate behaviors. Because of the progressive nature of dementia behavioral changes tend to worsen with time. Understanding why behaviors occur can help one deal with them. Emotional blunting, or the inability to express verbal and non-verbal feelings, is another characteristic of having dementia. The inability to express needs and feelings can make people who have dementia angry, combative, and sometimes violent. Many people who have dementia experience depression. Dementia can also affect sexual behaviors in ways that are often unpredictable. Some people who have dementia cannot understand that it is impolite to touch or expose their private areas in public or make unwanted or inappropriate sexual advances. There are many simple ways to reduce the incidents and intensity of these difficult-to-manage behaviors. However, first, consider other reasons for your loved one’s difficult behaviors. Drug interactions and side effects may intensify dementia symptoms, cause hallucinations, as well as intensify agitation and combativeness. Other explanations for uncharacteristic behaviors and emotions can include pain, fatigue, overstimulation, as well as other medical problems such as a bladder infection. There are many strategies you can use to prevent or diffuse your loved one’s outbursts. Perhaps the most important one is communication. Do not argue with your loved ones, remind them of what they have forgotten, or ask probing questions to assess their memory. Use supportive language to affirm you are listening, respecting his or her concerns, and responding in an appropriate manner. For example, it is better to respond to fear, but the unlikely true incident is to say, “I’ll look into it” rather than “don’t be silly.” Sometimes all it takes to is a calming hug or a kind and supportive touch. Distraction and redirection is another useful way to diffuse anger or sexually aggressive behaviors. Give your loved one a snack, go for a walk, point out a pretty flower or talk about the weather. Sometimes your loved one’s behavior is more than you can handle. When this happens, call the Crisis Intervention Team, rather than 911, maybe the best option. The Crisis Intervention Team, (CIT), refers to the police officers in your community who have special training in how to manage a variety of behavioral, drug-related, and mental health crises. Having the CIT there to help with unmanageable or threatening behavior can prevent a difficult situation from escalating to something worse. The CIT can also accompany you and your loved one to the medical facility. Be sure to include the phone number of your local CIT in your list of emergency phone numbers. Content Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of " An Unintended Journey: A Caregiver's Guide to Dementia.", available through Amazon. Please visit our Author's page to learn more and find this title. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

When it comes to sleep, establishing a routine is critical. Sleep-wake cycles are for the brain what your transmission is for your car. Further, sleep issues are often associated with dementia and may very well be a catalyst for dementia onset and severity. In this day and age, a lot of people are simply going to bed whenever they crash or whenever their kids or life demands allow them to crash. When they wake up, it’s rarely of their own accord. Instead, they tend to wake up to loud alarm clocks blaring at them, somebody else waking them up, or something else like the dog jumping on the bed. Sleep routines are critically important for brain function and it can be as simple as setting a time to go to bed and a time to wake up, then sticking with it to make it a part of your regular routine. Establishing a routine helps your body find homeostasis with hormone production, regulating blood pressure, as well as other things like the glymphatic system which removes toxins from the brain while you sleep. This is often easier said than done. Family life, career demands, pets, and a lot of other distractions can make it challenging to establish a set sleep routine. There’s no magic number for the number of hours you need to get each night, although 7-9 hours is a good rule of thumb. The brain needs a good solid two to three deep sleep cycles per night and you can’t do that if you’re only getting three or four hours of sleep per night. The key is to listen to your body. Ideally, you want to establish a sleep routine where you’re falling asleep easily at a set time and when you wake up in the morning you feel energized, alert, and ready to face the day. Some people might only need six hours of sleep while other people might need eight or even ten hours! There are some people that meditate quite regularly and the deep state training involved in the process means they may only require five or so hours of sleep each night. Sleep science is constantly changing as research reveals more and more of the positive benefits of sleep and how to incorporate a positive sleep routine in your daily life. What it boils down to is the routine that is best for you, your body, and what makes you feel the most rested. Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For additional information, and to learn more, please visit our Author's page. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Memorizing names can be a serious challenge for some people. The world is rife with all kinds of tricks for putting faces with names and the like. Most of them have various degrees of success. In a certain light, saying someone’s name three times during your first meeting can essentially be a type of brain game. Most brain games are simple exercises to help your brain work better. Saying someone’s name three times is as much about memorization as it is about developing conversational skills and working on associations. I must admit that I’m not the best when it comes to remembering names. I’ve tried a lot of different tips and tricks over the years and very few of them ever really helped. Saying someone’s name three times is a simple brain game you can do when you meet people (and they will never know it). The goal is to be subtle about it. You don’t want to shake someone’s hand and simply rattle off their name three times. What you want to do when you first meet somebody: at the first handshake you want to repeat their name. For example, if I was meeting someone named Jason for the first time I would say, “Hello Jason, how are you doing?” As the introduction and conversation flow naturally, I follow up with opportunities. “So tell me, Jason, where do you live?” So, at this point, I’ve already said his name twice. My brain is getting used to that and it’s associating that person’s face, his demeanor, and everything in that environment at that particular time. Within the next minute or so, create another opportunity to use their name again. Something along the lines of “So Jason, how many kids do you have?” Not only are you repeating their name to put it into your memory, but you’re also creating associations that are relevant to them (i.e. where they live and how many kids they have). Of course, there are a lot of different topics you could touch on. Family, hobbies, where they live, or what they do for a living are all common topics that help you learn more about them and create memorable associations that will stick in your mind the next time you meet them. With regular practice, I think you’ll find that you can get to know a lot about people in a relatively short period of time. This is especially helpful if you’re involved in any kind of networking or social group, where you’re trying to learn as much as you can about someone in a short period of time. The key is to drop their name into the conversation. As you say the name, really try to emphasize your focus on their face or their demeanor. This could also include finding the similarity to someone you know that has the same name. Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For additional information, and to learn more, please visit our Author's page. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Many of us, when unable to answer simple questions about the medications we take, promise to make a list before our next appointment. We know it’s important, but we never seem to get around to doing so. Besides, we are quite sure our prescription history is already a part of our medical history file. However, your doctor may not know about the prescriptions you have received from other clinicians, or if you take dietary supplements such as vitamins or alternative medicine herbals such as echinacea. Conversely, an emergency room doctor or another clinician may not easily access your medical records. Keeping a current record of all the medications your loved one takes is especially important when dementia is part of the equation. People who have dementia may see physicians that, in addition to his or her family doctor, include a geriatrician, a neurologist, or a psychiatrist. It’s also quite likely the person who has dementia will require evaluation and treatment for conditions unrelated to his or her dementia diagnosis. In addition, the progression of dementia, memory loss, and other disabilities, makes it imperative that a family member or other caregiver have access to the medication list. As a first step, make a complete list of the medications, supplements, and any herbals your loved one may use. The list, in the form of a table, should include the following information: the name of the medication, the daily dosage, the prescription number, the pharmacy contact information, the prescribing clinician’s name, and contact information, as well as the location of the medication in your loved one's place of residence. You might also want to jot down a few words about any side effects, you or other people may have noticed. As a second step, and on a need-to-know basis, a hard copy of the compiled information should be available to other family members as well as to other caregivers responsible for your loved one’s care. Place another paper copy in a folder or a three-ring binder and leave it by the telephone. The folder, in addition to the medication list, should also contain other important names and numbers such as the contact information for your loved one’s doctors, as well as for the local hospital, ambulance service, and emergency room. Create a file on your computer hard drive that contains the all information you need to oversee your loved one’s care. Doing so will make it easy to update your loved one’s medical records. Do keep in mind that only certain people should have access to your loved one’s Medicare, health insurance, and credit card information as well as other types of confidential information. Doing so will help to prevent financial abuse and identity theft. And while you are at it – this is a good time to finally get around to tabulating your medications and other types of personally important information! Content Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of " An Unintended Journey: A Caregiver's Guide to Dementia.", available through Amazon. Please visit our Author's page to learn more and find this title. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Music connects people to their life history and culture. Music transports people back to happy and sad places such as having attended a concert with friends or as a reminder of a long-gone relative. Listening to or making music is a wonderful way for you and your loved one to get a mini-vacation from illness as well as to stimulate conversation different from what he or she had for breakfast. Clinical case studies show when people who have dementia listen to the music of their youth they become animated and may tap their feet to the rhythm or sing. Music therapists say that music therapy improves mood and behavior as well as lessens reliance on behavior-modifying medications. Research shows that active involvement is more beneficial than listening to music. Singing and playing music, especially when preparing for a performance, improves focus, attention, and memory. Opportunities to socialize and, perhaps even more importantly, share with others, are another important benefit of active participation. Most people have positive reactions to the popular music of their youth or the kinds of music that reflect their taste and preferences. Therefore don’t assume the person in your care will want to hear Glenn Miller or Bing Crosby. Baby Boomers may prefer Elvis Presley, Buddy Holly, the Beatles, or the Rolling Stones. Some people may favor classical music, jazz, or opera. There are many simple ways to bring music into your loved one’s life. At home, you can download music from the internet and watch or listen to broadcast performances. Together, you can sing, play a musical instrument, or use bells, sticks, and homemade drums to create a home-style rhythm band. Consider inviting family members, friends as well as other caregivers, and their loved ones to participate in a jam session. Serve coffee and cookies and you have an event! It’s always a nice break to take excursions outside of the home. Combining an early afternoon concert with lunch or an early supper is another way to enjoy a day and enrich a relationship. You can find local and sometimes no-cost events in the calendar section of your local newspaper. Community orchestras and choral groups often give public performances. Senior centers are another place where you can find performances as well as music classes your loved one might enjoy. Many non-profit organizations, such as the Dementia Society of America, sponsor music programs designed especially for people who have dementia and other disabilities. An internet search is an easy way to find music programs and performances in the community where your loved one lives. Content Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of " An Unintended Journey: A Caregiver's Guide to Dementia.", available through Amazon. Please visit our Author's page to learn more and find this title. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Curing disease correlates with insight, not blind effort. There is an eternal trade-off between insight and effort. If we think carefully, understand the problem, and plan, then the effort is minimized. If (as too often happens) we think carelessly, misunderstand the problem, and rely on hope instead of planning, then the effort is not only maximized but is usually a complete waste. Lacking insight, we foolishly flush both money and effort down the drain. In the case of clinical trials for Alzheimer’s disease – and in fact, all age-related diseases – this is precisely the case. The major problem is a naïve complaisance that we already understand aging pathology. If there was a single concept that is key to all of the aging, it is the notion that everything in our organs, in our tissues, and in our cells is dynamically and actively in flux, rather than being a set of organs, tissues, cells, and molecules that statically and passively deteriorate. Aging isn’t just entropy; aging is entropy with an insufficient biological response. Senescent cells no longer keep up with entropy, while young cells manage entropy quite handily. At the tissue level, the best example might be bone. We don’t form just bone and then leave it to the mercy of entropy, rather we continually recycle bony tissue throughout our lives – although more and more slowly as our osteocytes lose telomere length. This is equally true at the molecular level, for example, the collagen and elastin molecules in our skin. We don’t finish forming collagen and elastin in our youth and then leave it to the vagaries of entropy, rather we continually recycle collagen and elastin molecules throughout our lives, although more and more slowly as our skin cells lose telomere length. Aging is not a process in which a fixed amount of bone, collagen, or elastin gradually erodes, denatures, or becomes damaged. Rather, aging is a process in which the rate of recycling of bone, collagen, or elastin gradually slows down as our shortening telomeres alter gene expression, slowing the rate of molecular turnover, and allowing damage to get ahead of the game. We don’t age because we are damaged, we age because cells with shortening telomeres no longer keep up with the damage. The same is true not only of biological aging as a general process but equally true of every age-related disease specifically. Vascular disease is not a disease in which our arteries are a static tissue that gradually gives way to an erosive entropy, but an active and dynamic set of cells that gradually slow their turnover of critical cellular components, culminating in the failure of endothelial cell function, the increasing pathology of the subendothelial layer, and the clinical outcomes of myocardial infarction, stroke, and a dozen other medical problems. Merely treating cholesterol, blood pressure, and hundreds of other specific pathological findings do nothing to reset the epigenetic changes that lie upstream and that cause those myriad changes. Small wonder that we fail to change the course of arterial disease if our only interventions are mere “stents and statins”. Nor is Alzheimer’s a disease in which beta amyloid and tau proteins passively accumulate over time as they become denatured, resulting in neuronal death and cognitive failure. Alzheimer’s is a disease in which the turnover – the binding, the uptake, the degradation, and the replacement – of key molecules gradually slows down with telomere shortening, culminating in the failure of both glial cell and neuron function, the accumulation of plaques and tangles, and ending finally in a profound human tragedy. The cause is the change in gene expression, not the more obvious plaques and tangles. Our lack of insight, even when we exert Herculean efforts – enormous clinical trials, immense amounts of funding, and years of work – is striking for a complete failure of every clinical trial aimed at Alzheimer’s disease. Naively, we target beta amyloid, tau proteins, phosphodiesterase, immune responses, and growth factors, without ever understanding the subtle upstream causes of these obvious downstream effects. Aging, aging diseases, and especially Alzheimer’s disease are not amenable to mere well-intended efforts. Without insight, our funding, our time, and our exertions are useless. Worse yet, that same funding time, and exertion could be used quite effectively, if used intelligently. If our target is to cure the diseases of aging, then we don’t need more effort, but more thought. However well-intentioned, however much investment, however many grants, and however many clinical trials, all will be wasted unless we understand the aging process. Aging is not a passive accumulation of damage, but an active process in which damage accumulates because cells change their patterns of gene expression, patterns which can be reset. Curing Alzheimer’s requires insight and intelligence, not naive hope and wasted effort. Contributing Author: Dr. Michael Fossel earned both his Ph.D. and MD from Stanford University, where he taught neurobiology and research methods. Winner of a National Science Foundation fellowship, he was a clinical professor of medicine for almost three decades, the executive director of the American Aging Association, and the founding editor of Rejuvenation Research. In 1996, he wrote the first book on the telomerase theory of aging, Reversing Human Aging, describing the medical aspects of extending human telomeres, reversing aging, and curing age-related disease. In 2004, he authored the magisterial academic textbook, Cells, Aging, and Human Disease, and in 2011, he coauthored The Immortality Edge, a bestselling discussion of the potential for extending the human lifespan. He currently teaches The Biology of Aging at Grand Valley State University. The world's foremost expert on the clinical use of telomerase for age-related diseases, Michael has lectured at the National Institute for Health and the Smithsonian Institute and continues to lecture at universities, institutes, and conferences throughout the world. He has appeared on Good Morning America, ABC 20/20, NBC Extra, Fox Network, CNN, BBC, Discovery Channel, and regularly on NPR. He is currently working to bring telomerase to human trials for Alzheimer’s disease. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

The question is: what can we do to raise the level of awareness for all forms of Dementia, that would also include Alzheimer's? Can we, as Americans and U.S. policymakers, do what the World Health Organization and others in the global health community do? Refer more broadly and inclusively to the issues of Dementia that include: Alzheimer's; Vascular; Mixed; Lewy body; Frontotemporal; Chronic Traumatic Encephalopathy (CTE); Traumatic Brain Injury; Wernicke-Korsakoff Syndrome; Creutzfeldt Jakob Disease; HIV-AIDS, and others, rather than narrow-casting most all of our words, government plans, and efforts mainly just around Alzheimer's? When we do, those living with Alzheimer's disease (AD) will benefit as will the huge number of people that have Dementia, but not necessarily AD. Because it's better to do so, policymakers talk about cancer, heart disease, diabetes, and other major pressing health worries mainly in the broadest terms, but when it comes to Dementia... most only know of AD, and often don't understand how Dementia and AD relate to one another. If AD alone is considered the 6th leading cause of death in America, just imagine what happens when you nearly double the numbers to include all forms of Dementia... its place in American health priorities will rise even faster. Dementia is an epidemic both nationally and globally. By seeking to be more inclusive, rather than less inclusive, we shine a brighter light on millions of more cases of Dementia, as well as the needs of those living with it, their care partners, and the greater costs for families. When it comes to funding research as well as creating better person-centered care plans for insurers to cover and consider (including Medicare and Medicaid)... when we speak more openly of the larger numbers affected... it puts an additional premium on the rewards for finding medical cures and supporting non-medical innovations to deal with all forms of Dementia. Whether you're a dyed-in-the-wool-blue supporter, a red supporter, or somewhere else on the political continuum, please take the time to Know Dementia, broaden the conversation, and "see more purple." Actively demand of your civil servants that all forms of Dementia take the larger stage together for the purposes of research, concern, and care. - Kevin Jameson, DrHC, President of the Dementia Society of America This post is the result of a meeting and subsequent Q&A held during the Democratic National Convention in Philadelphia, PA on Monday, July 25th, 2016. At approximately the 1 hour mark into this forum, the Dementia Society of America was honored to have the opportunity to ask a question of Teresa Osborne, Secretary of the PA Dept of Aging, as well as Carol Lippa, Prof. of Neurology at Drexel Univ. (panel moderated by Steve Clemons, Wash. Editor at Large of The Atlantic). Click here to see the video of the entire session .

The words “house” and “home” aren’t the same. For most people, the word “house” produces a mental image of a building. In contrast, the word “home” stimulates an array of complex feelings. “Home” may bring back memories of a mother’s cooking, the view from a childhood treehouse, the sound of children playing, and the feel of a loved one’s kiss. For nearly everyone, a home is more than four walls and a roof. Home is memory, personal history, and a bountiful source of comfort. A dementia-friendly home is one that provides both emotional and physical comfort and safety. Family photographs, the worn but still comfortable chair, an ancient radio, and a hugely ugly coffee mug – are all remnants of a life-well lived. While you may consider them clutter, your loved one finds enjoyment and pleasure in their presence. The chair may remind him or her of having once read bedtime stories to you and your siblings. The radio might encourage conversation about the days when people listened to baseball games. And what does the hugely ugly coffee mug contribute to a dementia-friendly home? It doesn’t matter, the mug isn’t yours. Creating a physically safe environment for your loved one requires sensitivity, practicality, and acknowledgment of his or her capabilities. It is more likely your loved one will accept the changes to his or her personal space if you describe the installation of bathroom handrails as an “update” and the new automatic tea kettle as a “gift.” As a first step, assess your loved one’s home for areas and objects of potential danger. Examples of simple changes include installing automatic shut-off timers on appliances such as the toaster oven. Replace the overhead microwave oven with a countertop model. Remove tripping hazards and improve household lighting. Adjust the thermostat on the hot water heater to a lower temperature. Install handrails in the bathroom. Use safety locks on the cabinets that contain toxic cleaning supplies. Remove locks to prevent your loved one from becoming entrapped in the bathroom or bedroom. Another approach to creating a dementia-safe home is to learn about the new assistive technologies that help disabled people live at home for as long as is possible. Smartphone apps, as well as television and other kinds of monitoring systems, can let you know if your loved one is as active as expected, has left a certain area, or if an appliance has not been turned on or off. There are smartphone apps that can remind your loved one to take his or her medication, give verbal instructions on how to use an appliance, find misplaced items, as well as keep track of day and time. Good intentions aside, creating a dementia-friendly home for your loved one takes insight and experience. Your internet browser and the keywords -- home, safety, assessment, and dementia--will link you to many excellent online resources. Another option is to have an eldercare home safety consultant inspect your loved one’s home. Taking into consideration your loved one’s capabilities, he or she will inform you of needed improvements. The safety consultant can also suggest where to buy home-safety equipment and, if need be, people to install such things as bathroom handrails. Use your internet browser and the keywords--eldercare home safety consultant--plus the location where your loved one life to find locally-conveniently home safety services. A dementia-friendly home is one that respects your loved one’s dignity, while at the same time, and an illusion of independence. Content Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of " An Unintended Journey: A Caregiver's Guide to Dementia.", available through Amazon. Please visit our Author's page to learn more and find this title. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Exercising with someone might sound simple enough, but there are profound benefits from having an exercise partner that is worth exploring. Some people just go to the gym, hop on the treadmill, throw in their earbuds, and do their thing. Others like to take a power hike or mountain bike trip alone in nature. Sometimes that meditative experience is important and they don’t want to necessarily share that special time in their mind with someone else. There are certain martial arts traditions that encourage you to work out alone just for the meditative quality of the experience. If your workout time isn’t engaged in some meditative aspect, you should strongly consider and seek out someone to work out with you. One of the biggest benefits of having a workout partner simply boils down to having another person offering you encouragement. There are days when it’s really easy to just stay in bed and you don’t want to get up and put in your workout. If you have somebody you’re meeting up with, it holds you to a higher degree of accountability and a certain amount of social peer pressure. For some people, there’s also an element of friendly competition. People can push each other, in a well-intended manner, to go that extra tenth of a mile, or an extra 10 miles. There could also be an element of safety involved. People that lift weights routinely need another person to spot them during a wide variety of exercises. It allows them to safely lift a little bit more weight and push a little bit further through the wall than they are used to pushing. Many martial arts involve doing forms to master routine movements. Some of them, like aikido, is greatly improved by having another person related to the form or even to provide added dynamic motion. There is a social aspect to it as well. Talking to someone through the course of your workout is in itself added stimulation. Just be smart about it and make sure that your conversation isn’t taking away from actually completing your workout in a timely and effective manner. Social interaction is critical to brain health and development. When you combine this with other activities like exercise, the compound benefits are something we can’t even measure but are incredibly helpful to the brain. Contributor Author: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For additional information, and to learn more, please visit our Author's page. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

"We need to make it right before it goes wrong." What a wonderful expression! The phrase gives you permission to say, "I need your help." Yes, it is true that some people, even without your asking, will be more than happy to volunteer their time. However, an uncommitted "Call if you need anything" is not the same as "What do you need? Tell me what I can do to help you." Many family and friends, perhaps not understanding the responsibilities and challenges you face, will require a little prodding. A good approach is to organize an informal gathering with your family and perhaps a few friends. Lunch or light refreshments may prevent the conversation from becoming confrontational. Use video conferencing to include, and to get input from, those family members who do not live nearby. Give examples of what they can do for you and for the loved one you have in common. A request for respite – just a few hours per week – is a good place to start. Explain you need time to relax, to take care of your health and well-being, to socialize with friends, to enjoy a little solitude as well as time to catch up on lost sleep. While you will appreciate their gift of time, there are many other ways your family can make things easier for you. A sibling who does not live nearby can manage your loved one’s finances. Family, friends, and even nearby neighbors can buy groceries, do the laundry, or take responsibility for such things as a car, house, or yard maintenance. Ask that a family member or a friend accompany you and your loved one to doctor appointments or other places where you anticipate having behavioral difficulties. A promise of going out to lunch after his or her doctor's appointment can improve everyone’s mood. Use a calendar and sign-up sheet to free yourself from having to think about day-to-day management details. Exchange contact information to make communication as easy as possible. Consider designating a person to be the point of contact. Think about using an online app or website like www.lotsahelpinghands.com . A few words to caregivers – don’t be stoic. Accept help! Promises aside, it’s more important to be a good caregiver and not an irritable, exhausted, and burnt-out caregiver. A few words to family members – don’t assume one person can shoulder all the responsibilities and challenges of caring for the loved one you have in common. It’s unfair and will create ill feelings. Make yourself available even if he or she claims they neither need nor want your assistance. It’s also important that you tell your family member that you appreciate his or her efforts – a gift certificate to a favorite restaurant or for a rejuvenating massage is another way to express your gratitude. Call or e-mail often - but not too often or at inconvenient times. In addition to inquiring about your loved one, be sure to ask your family member about their general well-being. Be an empathetic and supportive listener. And to caregivers, family members, and friends - the most important words you can say to one another are "Thank you." Content Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of " An Unintended Journey: A Caregiver's Guide to Dementia.", available through Amazon. Please visit our Author's page to learn more and find this title. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org