Part 2 – “The End of Absence” (Michael Harris) Book Review

Feb27

This is the second of a three-part series of reviews that I am writing on The End of Absence: Reclaiming What We’ve Lost in a World of Constant Connection written by Michael Harris in 2014.

In “Part 1 – ‘The End of Absence’ (Michael Harris) Book Review,” we looked at the definition of absence and how it relates to our quality of life.

We discussed how absence gives rise to critical thinking, problem-solving, short-term and long-term planning, concentrated focus, and creativity.

We also discussed the physical, emotional, and mental benefits of absence.

And, finally, we discussed how absence has been eroded by our constant connection to technology to the point that it is virtually extinct in our current society.

We discussed how this has dumbed down society as a whole and how susceptible that makes us to being controlled, manipulated, and deceived by technology.

And, finally, we looked at how much technology and our constant connection to it mirrors the society that George Orwell described in 1984, coming to the conclusion that the frighteningly eerie similarities should compel each of us to consciously choose not to follow the crowd and intentionally limit our connection and ensure a healthy amount of absence exists in our lives individually.

In this post, we’ll take a behind-the-scenes look at what happens with all the data you’re willingly and freely putting into digital technology every time you text on your phone, go to a website, input anything onto social media (including the infamous “like” button on Facebook), do a Google search, buy something online, watch streaming video, and play internet video games.

We’ll also see how being constantly connected to digital technology brings that data back to us and shrinks our exposure to real and complete knowledge (Google infamously does this with their industry-standard data mining and predictive analysis processes, which narrow search results down to what we want to see, based on our input, rather than everything there is to see).

In effect, we are being shaped and manipulated in an endless loop of our own little world of preferences and beliefs with subtle changes and false ideas about value and credibility being implanted along the way.

Our constant connection to technology is literally rewiring and incorrectly programming our brains. This negatively affects – if not outright destroys – our value systems and belief systems.

Additionally, our ability to not only think for ourselves – and change our minds based on that – but also to critically and objectively think, as well as to think outside the boxes of what we know and are familiar with is rapidly being destroyed because we depend on technology to do our “thinking” for us.

Additionally, we’ll continue our look at how our constant connection to technology is essentially creating a virtual life (think the movie The Matrix) that we are being conned into believing is real life, while actual real life, which includes lack and absence, is rapidly disappearing for all but a few of us who are aware of what’s happening and refusing to let it happen to us.

Our lifestyles, which now center around technology, are creating a new kind of lifestyle dementia, and most of us don’t even realize it’s happening. That’s why you need to read this book and that’s why I’m spending so much time reviewing it.

Perhaps you think what is being described here is impossible and this is just an alarmist warning that you can blow off because “that’ll never happen.”

It’s already happened and it is happening. I know technology very well from a big-picture and a behind-the-scenes perspective, so I’m speaking as an insider and an expert who has worked and does work with this on a daily basis.

Here’s the reality. Whether you choose to ignore this is immaterial. It’s already well in motion and progressing rapidly and, if we choose to remain ignorant and we choose to continue our constant connection, we will be devastatingly changed in the process.

And the sad part is that, like the society that Orwell discusses in 1984, not only will we not be aware, but we will not care, even if it’s the most destructive thing that can happen to humanity.

One of the ways in which our constant connection to technology has changed us is that now our default choice is to use technology to interact with people and things rather than actually interact with people and things for real.

Here’s a simple comparative survey of why our brains have been rewired to prefer technological interaction with people and things rather than real interaction with people and things.

With technology, we can ignore or eliminate or limit our time with anybody or anything we don’t want to have to deal with. This can include people and things we find challenging, who disagree with us, who don’t “tickle our fancy,” and who “make” our lives “harder” just by their presence.

With a click of a button, we can unfriend them or unfollow them and turn off their news feeds, or we can avoid those things altogether until they simply no longer exist to us.

What we end up with in the process is an artificial, virtual world that we create to make us feel good. It’s also a shallow and stagnant world that ends up being essentially us looking in a mirror and seeing nothing but our own image reflected, because the people and things that are left after our unfriending, unfollowing, and avoiding are those that never challenge us, always agree with us (even when we’re wrong), and boost our feel-good emotions (as we do theirs).

In real life, those people or things are right there with us and we have figure out the best way to deal with them whether we want to or not, even if that means putting up with our co-workers, friends, and relatives or all the tough things that exist in real life.

In other words, we can’t turn them off (and if we eliminate them, in the case of people, then we go to prison). So it forces us to find creative and workable ways to share the same space with them and it increases our relating-to-humanity-and-things skills and builds traits like patience, kindness, gentleness, understanding, empathy and mercy.

These are character-related traits that cannot be developed in the artificial, virtual world that constant connection to technology enables us to create in our own image.

And our artificial, virtual worlds make demands on us as well, although this dark side is seldom, if ever, on our minds or consciences. They demand our 24/7 attention and presence and because of our acquiescence to those demands, we lose absence. Solitude. Peace. Disconnection.

Absence gives us time alone with our thoughts, alone with ourselves, and alone with our ideas, our dreams, our hopes, and our imaginations. Absence also gives us the ability to regroup and recharge our brains and ourselves. It gives us a chance to get away from all the “noise” of life and have peace and quiet.

Here’s the irony. We need solitude as part of our mental, emotional, physical and spiritual health. There’s no other way to survive life.

Yet, even for those of us born before 1985, from the moment we’re born the emphasis is on socialization.

Society is so insistent on this – my parents often had to drag me kicking and screaming as a small child into social situations because I was always very uncomfortable with them, and as I got into my teenage years and could make my own choices, more often than not, I chose staying home over going somewhere either for a few hours or overnight – that most of us are uncomfortable being alone and being quiet, with nothing to entertain or distract us.

Technology and constant connection ensure that we don’t have to be uncomfortable, and it amplifies the illusion of constant company.

This, by the way, began before digital technology. Before there was the internet, there was television. And before television, there was radio. All of these technologies gave – and give – the illusion of constant company because of the noise and the distraction they provide.

And here’s the reality for humanity now. For those of us who remember absence, we have the constant choice of saying “yes” or “no” to constant connection. For those of us who came of age with constant connection as part of our normal lives, we don’t even know there is a choice. And that is truly sad.

Because our artificial, virtual worlds seem real to us because they’re replacing real life, our brains get rewired in additional ways by the illusion this creates.

One way is that we feel surrounded by people like us, so we feel free to say whatever we want to say however we want to say it. We don’t care how wrong it is, how hurtful it is, or how confessional it is. Constant connection, by subverting thinking, has removed the filtering that normally goes into thinking before we speak.

In this way, the words spewed out on the internet actually mimic one of the tell-tale signs of dementia: the loss of impulse control and ability to know what things to verbalize and what things to keep to ourselves.

Another way that constant connection to technology rewires our brains is that it promotes the self all the time. With an artificial, virtual world that we have created and are the center of, we can continuously draw all the attention to ourselves.

This self-broadcasting, which shares many traits with narcissism, includes fervent self-documentation consisting of constant tweets, continual status updates, and a never-ending supply of selfies.

In effect, a constant connection to technology makes us incredibly self-centered, self-absorbed, selfish, and it reinforces our belief that “it’s all about me.”

So it’s no surprise that we’re less empathetic, less genuinely caring (caring for someone online takes little effort, engagement, involvement, and commitment while caring for someone in real life takes continual effort, engagement, involvement, and commitment, no matter what circumstances arise), less able to listen and hear what people are saying or trying to say, less understanding, and less able to provide authentic comfort, encouragement and support.

In other words, a constant connection to technology makes us less human.

So why do we do it? Because it’s rewarding online. The more attention we garner, the more we want. If everybody notices us and loves – or likes – us, that is very motivating to continue our self-tracking because it feeds our egos.

A constant connection to technology and self-broadcasting gives us the approval we crave just for living life and doing the mundane things it requires of all of us. Somehow, having a bunch of people like and praise some routine, ordinary thing we’ve done makes us feel extraordinary and accomplished.

It doesn’t happen like that in real life. Most of what we say and do goes completely unnoticed, even though we may say and do a lot and say and do a lot of good, but despite that reality, those of us who are invested in real life just keep going on and putting one foot in front of the other.

A constant connection to technology rewires our brains to stop doing our own thinking and shop it out the the public opinion of the internet.

This costs us far more than we are remotely aware of.

In choosing constant connection and public opinion to do our thinking and decision-making, we choose to abandon the most powerful workshop we have access to, which is our lone minds.

In our lone minds, which only solitude can give us, we can think objectively and critically through things. We can solve problems. We can fill in missing pieces of the puzzles that life inherently has. We can find connections between things that don’t look connected on the surface. And we can innovate and create scenarios and options that point us forward in our lives.

When we abandon our lone minds, we offer ourselves up to indiscriminate information from public opinion, much of which is conflicting, wrong, and worthless.

But because our brains are rewired to believe that’s a valid and real world, we accept all the input we’re given and make the erroneous assumption that it all has the same quality, the same value, and the same veracity.

And that will destroy us, because most of what we get is uninformed, uneducated, and unknowledgeable in the context of being “expert” information.

In addition to this and what most people don’t know is that public opinion is manipulated, especially on the organizational level.

For example, many organizations have people internal to the organization write a lot of positive reviews about whatever their products are to feed the search engines to give them a higher rating of satisfaction.

Data mining cannot analyze quality, only quantity. So the more times a search engine sees a name and sees positive input, the higher it ranks it organically. This is a driving force – and goal – in every organization with an online presence.

There are two types of search engine results, paid and organic.

Paid search engine results (the ones in the example above with AD to the left of the link) are those that organizations pay, often a lot of money, to the search engine for significant keywords to get top-of-the-page (or top-right-side-of-the-page), first-page placement.

This is known as pay-per-click (PPC) advertising. Each time someone clicks on the paid advertisement, whatever that keyword costs is what is charged to the organization. This can get really expensive really fast.

Organic search engine results (in the example above, below the faint gray line, starting with the Alzheimer’s Association’s link) are generated in order by how many times the keyword appears on the site and how much traffic (search engines don’t really care where the traffic comes from, only how much of it there is) goes to the site (this is where social media sharing has really taken center stage in driving traffic to sites). This doesn’t cost anything.

So, it should be obvious why organizations manipulate their data behind the scenes to get higher organic ranking. The most prevalent (and most dishonest) way has become social media sharing and having people internal to the organization physically go to the site as often as they can. More hits equals higher ranking in the organic search results.

What does that have to do with us and the end of absence and constant connection to technology? Everything!

We instinctively choose what’s listed first because we connect that with what must be the best. However, because what’s listed first is simply because of manipulation (which we are unaware of) and not because of proven and tested quality, we get duped in accepting things as “best,” “right,” or “most” when in fact there is no proof any of those things are true. It’s all an illusion.

Because we have come to believe that Google is always right and if it’s on the internet then it must true and because the answers are alway immediate, we have abandoned the mental processes that time would allow – comparison, analysis, perspective, insight, and wisdom – so that we could be sure we were making the right and best choice. That’s the lack of absence that real life decision-making gives us.

And what do Google and Facebook do with all that data you share with Twitter, Facebook, Instagram, and Google (these are just a few – everything you do on the internet gets stored somewhere and is analyzed by software that gets a sense of who and what you are about using predictive analysis, so that what you ask for ends up being things that appeal to or interest you, not everything there is on the subject)?

The next time you do a Google search, log in to your Facebook account afterwards. Look at the right hand side of the screen where the ads are. Odds are good they will be for what you just searched for in Google.

Pay attention when you share links on Facebook to that same right hand side of the screen. The odds are good that whatever the content is within the link you shared will be what the advertising is for.

This is predictive analysis in your face. Most of it is not, but Facebook makes no secret that is what they are doing to try to get you to buy something.

Google’s method is invisible, but much more detrimental and dangerous.

Google uses what is known as a “filter bubble” to generate search results. This gets personalized for each person that uses Google and it is based on our preferences and our activities.

Google keeps meticulous track of our searching history, promoting the same results each time we repeat a search and further personalizing them based on which results we choose to follow through on by clicking on the links Google shows.

Each time we do the search, results are pared down to match our personalization preferences, which in effect means we get exposed to a narrower and narrower view of the universe.

Facebook uses this same algorithm in our newsfeeds. We might have 100 Facebook friends, but we interact with 10 or so almost constantly.

All the statuses of those 10 will always show up in our news feeds. The other 90 friends will randomly show up in our news feeds based on how much we interact with them and they interact with us.

The more interaction, the more likely the statuses will show up randomly – not always – in our news feeds. For friends with whom we have little interaction on Facebook, their statuses disappear from our news feeds altogether.

In other words, the internet is making our worlds smaller, not bigger.

And the personalization that makes our worlds smaller, not bigger has affected every part of our lives. The music we listen to. The suggested content for us to watch on live streaming. How and if we get employed by an organization.

And it seems that our brains are, with their constant connection rewiring, accepting this as being okay and we’ve adopted an “out of sight. out of mind” mentality toward anyone or anything we don’t see regularly or at all.

Here’s what we must understand and realize about how dangerous this is and how much we’re losing in the process.

Personalization is really just the glorification of our own tastes and our own opinions. It eliminates the big picture and a general, broad and comprehensive base of knowledge and understanding while embracing customization, specialization, and a singular viewpoint that takes nothing around it into account (no context).

Personalization cuts off our access to real learning and real knowledge. It cuts us off from the very things – and people – who could help us the most.

Because there is no “surprise” content to challenge us, to think about, to learn from, and to grow and mature in, we stagnate in life.

Stagnation is one step away from the regression to the kind of mindlessness that typified 1984‘s society as a whole. We are not that far from it ourselves.

In the next and last post reviewing The End of Absence: Reclaiming What We’ve Lost in a World of Constant Connection, we will look at the final third of the book, still looking for signs of hope, although the prospects of that are getting dimmer.

Part 1 – “The End of Absence” (Michael Harris) Book Review

Feb19

This is the first of a multipart series of reviews that I will write on The End of Absence: Reclaiming What We’ve Lost in a World of Constant Connection written by Michael Harris in 2014.

I have written on the main point of Harris’ book in “Dementia of the Preoccupied: How Multitasking and Being Attached to Technology 24/7 is Creating A Dementia Effect on Society” and “The Quintessential Leader Perspective On the Art – and Beauty – of Silence,” which everybody should take some time now to read.

I would also highly recommend that everyone read The End of Absence: Reclaiming What We’ve Lost in a World of Constant Connection. At about 200 pages, it is completely doable for the shorter attention spans (one of the side effects, as I’ve noted and Harris notes, of a life immersed in digital technology).

Michael Harris and I, it turns out, are, completely independently of each other, raising the same red flags about the brain that morphs (or is born into) into an existence that resides primarily or solely in a digital, always-connected world.

This post will look at some of the research, statistics, and ideas presented in the first quarter of the book, along with my commentary on them.

Reading should ignite an intense interaction in us that includes questioning, testing, proving, thinking deeply about, and making connections with experience and information we already have in our neurological repository of neurons, interconnected lobes, and synaptic networks.

Reading should challenge us, educate us, and give us a broad and rich knowledge base from which we can glean wisdom and understanding.

Reading should also spark creativity and original thinking that moves us mentally, emotionally, and even spiritually beyond where we were to begin with.

I seldom see this anywhere anymore.

I think that is directly related to how and what in terms of quality and content we’re reading, if, in fact, we’re reading at all (based on my research and observations, it appears the overwhelming majority of us are either on a steady junk-food diet or we’re starving ourselves in this area of life).

Instead, it seems we become the masters of copying and sharing hackneyed and trite little sayings in glancing blows that neither we nor anyone else even pauses at or pays attention to.

This is a result of the end of absence, and it has made us, future generations, and humanity in general poorer. We’ve become slaves to the machines and given up being the captains of our own destinies. In other words, we’ve capitulated to being controlled by technology without even putting up a fight.

I have, over the past couple of years, gradually pulled back from even a semblance of constant connection (I never have been completely connected because I value and need peace and quiet and solitude – all things that “absence” gives us – too much to allow myself to be enslaved by a master that will destroy all that).

I have accelerated that even more in the last few months because I realized I couldn’t function well mentally with the constant and loud cocaphony that it seemed I could never get away from and of all those things that were contributors, this was the one I had complete control over.

Although I tend to be a Type-A, naturally intense (mainly because I do think pretty seriously all the time and I’ve always found it almost impossible to relax and not be either looking for answers to the questions my thinking brings or for new ways to approach existing problems and dilemmas to resolve or get past them) person, I have seen one source of stress significantly lessen.

And that has helped me clear out some much-needed room in my brain to work on important things, oh, like, life. Even if the answers aren’t here yet and all the problems aren’t solved or behind me yet, at least life in that area is quieter because I’ve consciously and purposefully made it much quieter and much more peaceful.

Peace and quiet can never be overrated.

Before I go further, we need to put digital technology in its proper big-picture perspective. Essentially that is why I write about the dangers and why Harris has written this book. Because there is no proper perspective and no balance. It’s all or nothing and that’s the danger.

But technology is not the source of that danger. We – you and I – are the source of danger. Human beings tend to be polar in their thinking and their behavior by default. If a little of something is good, then nothing but that must be sheer nirvana.

To quote a line from a John Mellencamp song that resonated with me as much in my very early adulthood as it does today “…we keep no check on our appetites” nor do we recognize that overindulgence in any and all corporeal things will first make us sick, then increasingly unhealthy over time, until at last it finally destroys us.

And that lack of self-control and balance is at the crux of my posts on this subject (as well as the subject of lifestyle dementias) and The End of Absence: Reclaiming What We’ve Lost in a World of Constant Connection.

And I’m very qualified to discuss this because my entire career has been in technology. There are incredibly effective and efficient (in terms of usability, financial feasibility, and operational streamlining – in other words, maximizing value while minimizing overhead) uses for technology and I continually endorse, support, and advocate for those.

One area that I see where technology is best in increasing value and reducing costs is in routine brick-and-mortar operations and organizations.

These include companies that don’t sell tangible products, organizations that don’t promote or support tangible products, governmental regulatory departments (local, state, and federal), and educational institutions.

Brick-and-mortar operations are extremely costly and offer little in the way of value when considered in the light of new technologies that allow people to connect remotely – as if they were in the same room – face-to-face to meet and do business or get an education.

Buildings cost money. Maintaining them costs money. Furnishing them costs money. Supplying them with utilities and office expendables and technology costs money. Expanding them costs money.

People filling the chairs in-house cost way more than people working remotely (both to the organization and to the employees in terms of transportation, food, clothing, childcare, and time lost with families).

This is such an inefficient and costly way to work for everybody involved. The benefits are miniscule compared to the costs, which never end and will always encompass the bulk of brick-and-mortar operating capital.

And here’s the irony that most brick-and-mortar institutions don’t realize or recognize: the true success of any service, business, support, or educational organization is doing more and better in both meeting existing needs and anticipating and growing toward potential needs.

Greater success, progress, and innovation is where the most money should be invested (in other words, a growth model). Instead, most of the money is invested in treading water and going nowhere and having nothing but a lot of unnecessary costs to show for it.

No sane business model would support this, and yet, at least here in the U.S., this is still primarily how most organizations set themselves up.

For someone like me who knows that in most cases this isn’t necessary (and for a fraction of the brick-and-mortar costs, offering better wages and better benefits encourage the best talent), it doesn’t make any sense and I have little patience for all the “oh, we can’t afford that” or “oh, we need more money” when they’re bleeding it out left and right in archaic-based waste.

Another reality of this brick-and-mortar structure is the endless meetings that accomplish next to nothing, but seem to take up the bulk of time. The truth is that most in-house meetings are a waste of time, but remote meetings where participants fly in are both a colossal waste of money and time.

However, there are very few people who want to give up flying somewhere for a few days and “doing business” for a fraction of the time they are there, while spending the bulk of time and money on socializing and entertainment. That’s so antiquated, so ineffective and so incredibly inefficient when compared to its cost and what actually gets accomplished to move forward.

However, some things lend themselves to brick-and-mortar. These are smaller operations that either sell perishable goods (bakeries are a good example) or goods that require an in-person visit to get it right the first time (shoes and clothing are good examples). These, however, are exceptions to the general rule.

Because I’ve been intimately involved with technology all my adult life, I have always been acutely aware of the dangers of constant connection and how it changes the brain.

I will never forget the one and only time that I, in an effort to combat a sleepless night, decided that playing a computer game with lots of motion, flashing lights, and noises at 2 a.m. would be just the thing to make me sleepy and calm me down.

I got sleepy after an hour or so, but every time I closed my eyes, all I could hear was noise and all I could see was flashes of light, and I never got to sleep that night. And I never made that mistake again.

Because of my knowledge and experience, I’ve always been consciously careful to make sure to maintain an offline life and an online life as balanced as possible because I have always recognized that I need both of them equally in my life.

One of the things that Harris talks about in his book is the divide between those of us born before 1985, who knew a world of solitude, peace, quiet, boredom, disconnection for extended periods of time, and the resulting creativity and problem-solving associated with that, and those born after 1985 who came of age in a digital world and have known nothing else.

There were two quotes from Harris’ book that struck me as I considered this divide:

“Every revolution in communication technology – from papyrus to the printing press to Twitter – is as much an opportunity to be drawn away from something as it is to be drawn toward something.”

“As we embrace technology’s gifts, we usually fail to consider what they ask from us in return – the subtle, hardly noticeable payments we make in exchange for their marvelous service.”

For those of us who knew a world at one time that was mostly offline and have transitioned full-tilt into an online world, we should ask ourselves what worthy and healthy things we have sacrificed to do so.

It has never ceased to amaze me that people can’t go anywhere, even into a church service or funeral, without their cell phones (being on).

Our parents didn’t have cell phones (they didn’t even have answering machines until we were teenagers, if then). If there was an emergency while they were in church services or at funerals (most cell phone calls and texts, by the way, are not emergencies, despite the fact that we’ve elevated the mundane to a level of importance it doesn’t deserve), they didn’t know until hours later when they were home and could answer the phone or play the answering machine.

The world didn’t end with that lapse of time. So what has changed that we think it will now?

We’ve changed. Technology and being constantly connected to a digital world has given us a distorted and unrealistic, but frenetic and immediate, view of the natural rhythm and flow of communication, of life, and, even, of death.

We’ve surrendered the beauty and serenity of an offline life that we had more control over to a 24/7 online life that controls us 100% of the time. We’ve become mere puppets to a puppetmaster that is constantly pulling our strings in every which way but loose.

Harris’ book urges us to bring back the offline life we knew and find a balance between it and our online life, because what we’ve given up by surrendering our offline lives is costing us dearly and in ways we don’t even realize.

As I’ve been reading this book, 1984 by George Orwell just kept going parallel in my mind because we’ve become the society that Orwell describes in that novel.

Those of us few who are aware of the danger are like Winston Smith, the novel’s protagonist, and the outcome for us is as grim as it was for him: either we will eventually and under great duress and pressure capitulate and become mere shells of our former selves or we will be destroyed because of the threat we pose.

We’ve surrendered our entire lives to technology. We’re not even aware that this has happened. But, as Harris says, “the sheer volume of time we devote to our devices means we are carving ‘expendable’ time away from other parts of our lives.” In other words, instead of enhancing our lives, technology instead becomes our lives and our experiences.

“Ceci tuera cela.” This line from Victor Hugo’s The Hunchback of Notre Dame is apt for the impact of technology on humanity in terms of absence: “This will kill that.”

Here are a couple – at least for me – of surprising statistics just about kids and adults and text messages.

Kids send and receive an average of 4000 texts a month.

Adults send and receive an average of 746 texts a month. (I was not surprised that I’m not even close to being an average adult here, since I can count the average number of texts I send and receive in a month on less than one hand).

The volume boggles my mind for both kids and adults. Who has that kind of time? And who’s got that much to say? It’s beyond my comprehension.

But what happens neurologically is even more drastic. We become more comfortable with technology than we do with each other. Texting simplifies and reduces the quality of our relationships and increases our emotional distance.

Friends are replaced with contacts. We pretend that complete strangers are our new best friends and the people in our lives who choose less technological connection or are unable to have it fall off of our radars for good.

In other words, we abandon something for nothing.

And our brains form new neural pathways that make this not only okay, but the new normal for how we live.

It is very similar to the same mechanism – and the overarching demand it exerts – that is behind addiction: we crave “quick hits” and “fast fixes” and our lives are consumed with getting the next one.

Anything that requires investment, focus, concentrated attention, and thinking we ignore and turn away from.

It is the same reaction that an addict who doesn’t want to stop using has when they are confronted with rehab.

Neurologically, this becomes totally acceptable for us as technology literally changes the way our brains are connected and what our brains expect.

The changes to the brain, though, go even deeper than connections and expectations. Constant connection causes us to either abandon our memories (based on our actual existences) or subdue them in favor of what we come to believe are memories (stored in brain) but are actually reminiscences (found in an external source).

In other words, our brains are totally reprogrammed in terms of information: how we get it, whether we have to keep it, and whether it means anything or not.

It becomes a simple passive action of processing something outside us and our experiences, instead of the active action of finding, keeping, doing that builds unique records of our actual experiences in our brains.

An example of a reminiscence is doing a Google search for something we should know the answer to. If we don’t remember the answer, we Google it instead of taking the time to work with our brains to search and find the answer and all the original ancillary information and memories that are associated with that answer.

So let’s look a little more closely at what happens in the brain, where it happens, and what the implications are with constant connection to technology.

Digital technology reorganizes the brain. Because the frontal lobe of the brain (which handles decision making, problem solving, control of purposeful behaviors, consciousness, and emotions) is primarily involved in response to digital technology, new neural pathways get formed there.

Changes become evident (much in the same way as frontotemperal dementia) in areas of executive functioning. We become more fragmented, more unorganized, more unfocused, and more easily distracted and bored.

The thinking process changes as well. We become what Nicholas Carr has described in The Shallows: more capable of “shallow” thinking and less capable of “deep” thinking. Therefore our interests turn to things that don’t require us to think and we studiously and consciously avoid things that would give us no choice but to think.

As thinking is disrupted continually and systematically within the brain, eventually it becomes altogether too difficult, and we abandon it completely.

This is where we become completely vulnerable and susceptible to external programming (whether that comes through people or technology), much like the society that Orwell describes in 1984.

We parrot opinions, beliefs, ideas that are fed to us, but we don’t have any knowledge, proof, or investment neurologically behind them to back them up. In other words, we become simply somebody’s “yes” people.

If we’re looking carefully, we’ll see the world around us is pretty much already like this. Thinking has become too hard and too time-consuming in the face of constant digital connection where we don’t have to think because all the answers are already there when we need them and the answers are right because Google said so, so what’s the point?

And yet that is the point. I would far rather have somebody who’s thinking deeply disagree with me and tell me why so we can put our heads together and reach a more comprehensive understanding or perspective on something (even if we still disagree on some aspects, which is okay) than to be surrounded by “yes” people who don’t have a clue or people who just don’t care.

And, quite frankly, I’ve observed, as Harris has observed in his book as well, that the latter two – the no-cluers and the don’t-carers – are the majority now.

And that’s tragic for humanity on a personal level, on a community level, and on a species level.

We are quickly disintegrating into a unconscious and complete embrace of in-and-out emotional processing (which is not reason and thinking based on logic, knowledge, and facts) and total abandonment of the gifts that are unique to us – that make us human.

These gifts are the ability to reason, to critically think, to test everything, to prove everything, to know because we’ve done the time-and-labor intensive personal work of testing and proving what is true and what is not. What is right and what is wrong. What is good and what is bad.

We will not be able to have any kind of meaningful life without these gifts. Without a framework, without a moral compass, without the ability to think, we will simply exist, unhappily, in increasing fear as well as mental, emotional, and spiritual poverty until we don’t.

No one in their right mind would bring children into this kind of bleak existence, so if time goes on long enough, we as a species will simply die out, if we’re don’t all destroy each other first.

In the next post on The End of Absence: Reclaiming What We’ve Lost in a World of Constant Connection, we will look at the next section of the book and see if Harris is any more hopeful than I am in anticipating what the future of humanity left to its own devices and constant connection looks like.

Facts About the Flu for Our Loved Ones with Dementias and Alzheimer’s Disease

Feb13

Our loved ones with dementias and Alzheimer’s Disease are much more susceptible to getting the flu than the general population, including senior citizens in general (the overwhelming majority of deaths from the flu each year occur in people over the age of 65).

With the peak of flu season upon us, it would be a good idea to review some basics about the flu. Click on the infographic below to see the full article.

Source: Fix.com

Will Poor Sleep and Sleep Deprivation Now Lead to a Lifestyle-Related Dementia Later?

Jan22

The answer is “probably.”

There have been several studies in the last two years on the effects – positive and negative – of sleep on the brain. They all agree on one point: to function optimally, the brain requires quality sleep and enough of it.

They also agree on another point: the way our modern society is structured, the majority of us are not getting enough sleep, and the little sleep we are getting is not quality sleep.

The fact that poor sleep and future dementia are linked is not new.

A sleep disorder known as REM sleep behavior disorder is a key characteristic of Lewy Body dementia, but the sleep disorder is often present decades before symptoms of Lewy Body dementia emerge.

In a study published in the The Journal of the American Medical Association in 2011, researchers showed a strong link between sleep apnea (sleep-disordered breathing) and dementia.

However, new research is now showing that even those of us without these two sleep disorders are getting less sleep and the sleep we do get is not quality sleep. New neurological research is showing us how important enough sleep and good sleep is for our present and future neurological help.

The body has a natural circadian rhythm designed to promote and facilitate sleep as daylight turns into evening and then night and to promote and facilitate wakefulness as night turns into day.

Until the Industrial Revolution, which actually consists of two iterations (one in the late 18th century and the second, which was the more profound of the two, in the mid-19th century, the human race generally slept and awakened based on the body’s natural circadian rhythm.

After the second iteration of the Industrial Revolution, when crude ways to keep the lights on 24 hours a day, 7 days a week emerged, all that changed. Initially, the only segment of the population that it affected were those who were employed in factories, mines, and foundries.

As textile factories, ore and mineral mines, and metal foundries remade the work day into two 11-hour shifts – generally, 7 am – 6 pm and 7 pm – 6 am – the second shift of workers were forced to ignore and work against their natural circadian rhythms to fuel the manufacturing boom, which was bolstered by a greater demand for manufactured goods throughout all strata of the population.

Although there was less concern about the workers – health, quality of life, and even death – then, there is still a significant amount of data from that period that shows most of horrific accidents (the majority of which were attributable to human error and resulted in both permanent disabilities and death) occurred during the later hours of the 2nd shift.

In the early 20th century, as manufacturing expanded into transportation, work days were again revised into three shifts – 7 am – 3 pm, 3 pm – 11 pm, and 11 pm to 7 am – with similar higher accident rates in the 2nd and 3rd shifts.

Medical professionals in hospitals, nursing facilities, and emergency services work were the next group of people to be required to work in shifts. Additionally, of all the careers in which shift workers were employed, it was not unusual for many medical professionals to work double shifts (back-to-back shifts) to provide necessary services.

During World War II, almost all manufacturing facilities in the U.S. transitioned to 24/7 production and a 1st, 2nd, and 3rd shift to support the Allies’ efforts in the war. After World War II, as those factories transitioned back to civilian manufacturing, they kept 24/7 production and three shifts in place.

As the Technological Revolution replaced the Industrial Revolution (also in two iterations, with the first one beginning after World War II, and the second one, which now affects every human on the planet, beginning in the late 1960’s) and the world became instantaneously and simultaneously intricately connected, the 24/7 workday began to affect almost everyone on the planet, including white-collar workers who saw their workdays – and nights – lengthened beginning in the late 1980’s.

As more and more people have been, by necessity, forced into living and working in a 24/7 environment, researchers have kept a close eye on how successful our efforts to work against our natural circadian rhythms have been.

The answer is we’re all pretty much failures at it and the results are poor quality sleep and sleep deprivation.

And like our ancestors in the Industrial Revolution, working late into the night or all night, whether in a medical facility, an emergency services department, a manufacturing facility, an office, or at home (because half the world’s awake when it’s time for people in the U.S. to go to bed), shows the same elevated risks of accidents and injuries (both work-related and non-work-related) when compared to working during daylight hours.

Here are a few statistics directly tied to shift work (if you’re an office jockey reading this, remember that this applies equally to you and all those late nights and overnights you’re working wherever you’re working them):

Work-related injuries increased to a little over 15% on the 2nd shift and almost 28% on the 3rd shift.
The longer the shift, the higher the risk of injuries: 13% higher on a 10-hour shift and almost 30% higher on a 12-hour shift.
The more consecutive night shifts worked, the greater the risk of sustaining an injury (37% higher by the fourth consecutive night shift as opposed to 17% higher by the fourth consecutive day shift).
Almost 50% of the late-night (10 pm – 1 am) and early-morning (5 am – 8 am) car accidents – fatal and non-fatal – involve drivers who are driving to or from work.

Pretty scary, huh? And, yet, despite all the evidence that it’s a really bad idea, a dangerous idea, and a dumb idea, we, as a society, keep doing it. I won’t get in-depth into the reasons for that here, except to say that they are tied to greed and competitiveness, which are soul issues.

What is the biology behind the statistics above?

That we can answer. And I’ve had more jobs than not where I worked 10-12 hours on a Sunday-Thursday night schedule, where I’ve worked many late, late nights only to be back at my office first thing the next morning, and where I’ve pulled many all-nighters, so I’ve got a lot of firsthand experience to bring to the table.

The reality is that unless you’re physically exhausted – mental exhaustion actually keeps the brain in gear and is totally counterproductive – you can’t get any real quality sleep during the day. Melatonin production is off and all the hormones to keep you awake are in action, so trying to sleep well is a losing battle.

So while you may be able to get a few hours of restless sleep, you do not go through the normal sleep cycles associated with nighttime restorative sleep.

As a result, because your brain is “foggy” when you’re awake, your response times are sluggish, and, combined with the normal circadian rhythm of sleep kicking in at night – even if you’re awake – all of these are directly tied to the increased risks of accidents and injuries during work hours at night.

The later you work at night the more likely you will have an injury and/or accident because these are the normal hours when sleep is deepest and during which you’ll be fighting sleep the most.

But the long-term effects of poor sleep and sleep deprivation are just as serious with regard to neurological health.

In a series of studies on sleep published in late 2013, researchers discovered that good sleep and normal sleep (7-8 hours at night) enables the brain to clean out the toxins – including beta amyloid proteins, which are involved in the development and progression of Alzheimer’s Disease – that have accumulated in it during the day’s mental activities. This process is so energy-intensive that it can be done only during sleep, when the brain doesn’t have anything else to do.

And here’s the thing. Perpetually skimping on sleep, for a lot of us who don’t do shift work and don’t have careers that demand a lot of late, late nights and early, early mornings on a consistent basis, is a lifestyle choice.

Technically, however, all of these types of careers, except for manufacturing work, which puts food on the table and pays the bills for people who might not be able to do so otherwise, are lifestyle choices because anyone going into these careers know the demands before they choose the education and jobs that lead to them.

And that substantially increases your risk of developing a lifestyle dementia.

We, as a society, are very sleep-deprived. And that includes a lot of people who are not earning their living during the night.

Much of that, in my opinion, is because we are digitally and electronically connected all the time and that crowds out the time we allocate for sleep.

A few questions should help you know if this applies to you personally.

Do you watch TV for several hours in bed or do you play video games before you go to sleep?
Is your smart phone or tablet beside your bed so you can check email or keep up with social media? Do you check them during the night?
Are you digitally and electronically connected last thing before you close your eyes at night and first then when you awaken in the morning?
Do you remember what you did at night before you got digitally and electronically connected?

If the answer to the first three questions is “yes” and the answer to the last question is “no,” then you’re making a lifestyle choice, probably sacrificing sleep (it’s important to remember that all these digital and electronic things stimulate the brain, so their after-effects stay with you for quite some time after you turn them off, and that means it takes you longer to fall asleep), to stay connected all the time to a world, that quite frankly, isn’t all that important or real anyway.

And whatever is real or important about it can wait until tomorrow. Like it did when a lot of us were little kids and there was no cable tv, there was no public internet, there were no video games, there were no personal digital/electronic devices, and there were no cell phones.

The world didn’t end then, and it won’t end now if you put all these away early in the evening and give your brain a chance to relax by playing a game with your family, listening to music that soothes your soul, getting lost in a book, or simply being quiet for a little while, using that time to meditate and reflect on your day and make plans for tomorrow.

Even though since I was born I’ve always had trouble sleeping a lot and getting good sleep when I do, I purposely shut everything down early in the evening to engage in quieter and more reflective activities and I stay away from it until I’ve had some quality time in the morning to get ready to tackle it again.

One day each week – for me, it’s the weekly Sabbath – I disconnect completely for the 24 hours between sunset Friday and sunset Saturday, and I’ve begun to move away from being connected much on Sundays as well.

I rarely have my cell phone anywhere near me and even when I do, I rarely use it. I certainly don’t want it in my bedroom with me at night.

With my sleep history, I’m already behind in this game, so I make lifestyle choices to improve my odds the best I can. It may not be enough to stave off dementias, but at least I know the choices I’m making increase the odds that, if I live long enough (I always pray I don’t…we start dying the day we’re born, so it’s pretty much all downhill from that point on), they’re either mild or short and done.

For all of us who can read this today, now is the time to start making sure we’re doing everything in our power to get enough sleep and to get good sleep when we do. That’s a lifestyle choice that only you can make for you and that only I can make for me.

It may mean some hard choices. It may mean a career change. It may mean disconnecting during nighttime from technology. It may mean looking at our lives and figuring out what’s really important in the long-term, instead of buying into the pervasive idea that now is the only important time in our lives.

But in the end, from this moment on, at least in the realm of sleep, you can do something to help yourself, but you have to decide what you’re willing to trade off now and what you’re willing to live with in the future.

Making Life a Little Easier in the Care of Our Loved Ones with Dementias and Alzheimer’s Disease – Part 3

Jan21

This is the last in a series of posts that discusses everyday practical needs that almost no one ever talks about in providing care and making life easier for both us as caregivers and the loved ones with dementias and Alzheimer’s Disease that we care for.

In the first post in this series, we discussed how to make things easier day-to-day for our loved ones in the areas of eating and incontinence.

In the second post in this series, we discussed day-to-day helps in the areas of personal grooming and bathing in the journey through dementias and Alzheimer’s Disease with our loved ones.

In this post, we’re going to discuss the other day-to-day areas where we can make care easier for ourselves and our loved ones in the journey through dementias and Alzheimer’s Disease.

The first area we’ll look it is how to effectively and safely address limited mobility and problematic mobility issues that arise both as a result of the progression of these degenerative neurological diseases and the aging process itself.

Because dementias and Alzheimer’s Disease affect the parts of the brain that control movement and balance, even our loved ones with no other health-related mobility limitations will eventually develop a shuffling gait and maintaining their balance when standing or walking will be difficult, increasing their risk of falls and injuries.

Our loved ones will also have a much harder time getting up and down from a seated position.

One of the most noticeable difficulties will be getting up from and sitting down on the toilet.

Many occupational therapists will recommend, as part of the home adaptive accessory purchases, buying a bedside commode for use when our loved ones are sick and unable to easily get to the bathroom or when – especially toward the end of life – if our loved ones aren’t completely immobile, walking any distance is too difficult.

A bedside commode will cost between $30-$40 out-of-pocket and can be purchased at a local medical supply store. However, with home health care or palliative health care, this will be covered by insurance (Medicare or other insurance) as part of the home health care or palliative health care services and equipment.

Occupational therapists will also recommend using the chair portion of the bedside commode over the bathroom toilet in the interim to facility easy standing and sitting.

This is not the best option.

The bedside commode chair is wide, and often won’t fit well, especially in smaller bathrooms, and securely enough over the toilet for this application.

Additionally, the distance between it and the toilet (even with the open guard that comes with most of them) makes keeping the toilet area clean and sanitary more difficult.

So I recommend, instead, a raised toilet seat with arms.

A raised toilet seat will cost around $60 out-of-pocket and can be purchased at a local medical supply store. However, with home health care or palliative health care, this may also be covered by insurance (Medicare or other insurance) as part of the home health care or palliative health care services and equipment.

The advantage of a raised toilet seat with arms is that it attaches to the toilet, is more secure when standing and sitting, and is more comfortable than the bedside commode chair. It is also more sanitary and easier to keep clean.

Installation is quick and easy. With the toilet seat up, the raised toilet seat is placed directly on the bowl of the toilet where it attaches securely with a large plastic bolt to the inside of the bowl.

As our loved ones progress in their journeys through dementias and Alzheimer’s Disease, they will become more sedentary than active.

This will mean sitting for long periods of time. Motor skills become more muted with neurological degeneration and a lot of the automatic sensory information that the brain gets, processes, and responds to will disappear.

Therefore, it will become less automatic for our loved ones with dementias and Alzheimer’s Disease to feel the natural discomfort of sitting in one position or sitting still for a long period of time that, when we’re neurologically healthy, causes us to automatically move and shift weight frequently when we’re seated.

This results in the increased likelihood of pressure sores and pressure ulcers developing. Once the skin breaks down in this manner, treatment and healing are difficult at best. Because of this, infection and sepsis often follow leading to death.

The most effective way to prevent pressure sores and pressure ulcers from sitting for long periods of time is to buy padding for the chair that distributes weight more evenly and that does the work of ensuring that automatic shifting of weight occurs.

The least expensive way (about $20) to do this is to put a thick (at least 4″) egg-crate-type foam pad (most come with a plastic covering to help with incontinence issues) in the chair that our loved ones with dementias and Alzheimer’s Disease spend most of their seated time in.

These can be purchased at most big-box retail stores.

Another physiological change that occurs for our loved ones as dementias and Alzheimer’s Disease progress is difficulty swallowing (known as dysphagia). This difficulty includes liquids and solid foods, as well as medication.

Dysphagia presents two real dangers to our loved ones. One is choking. The other is aspirating food into the lungs, which can lead to the development of pneumonia. In fact, it is more common than not that pneumonia is the cause of death for our loved ones with dementias and Alzheimer’s Disease.

That’s how serious swallowing issues are for our loved ones.

However, we can help mitigate this risk by some very simple techniques that will facilitate easier swallowing and reduce the risks of choking and aspirating food into the lungs.

Let’s start with taking medication since this is usually where swallowing issues appear first in the journey through these neurological diseases.

However, before I discuss the technique that usually is helpful for our loved ones to more easily swallow medications, it is important to discuss the medications themselves and the form they are administered in.

First, as caregivers, we should all have a pill cutter (also known as a pill splitter) as part of pharmacy stash. These can be pick up at any pharmacy very inexpensively.

This will come in handy when managing medications with varying dosages (such as diuretics or glucocorticoids like prednisone, which might be increased temporarily or gradually and then decreased the same way).

However, I strongly advise against a pill crusher and crushing any medications (although assisted living facilities and nursing homes routinely ignore this when administering medications to residents with dysphagia). The reason is because there are medications that when crushed can cause serious side effects and become completely non-therapeutic.

When our loved ones with dementias and Alzheimer’s Disease begin to have problems swallowing medications with water or juice, the easiest and usually-most-effective way to help them be able to swallow the medication is to use applesauce (I recommend unsweetened).

Put the pill on about 2/3 teaspoon of applesauce, which goes down the throat more easily, and swallowing should be much easier.

If our loved ones have medication that come in a large pill form (potassium supplements are a good example and because they tend to dissolve in the mouth and are very bitter are not a good candidate for cutting in half), we should have our loved ones’ primary care providers (PCPs) prescribe a different form of the medication.

Some medications are available in a liquid form (potassium, for example, comes in a liquid form and can be mixed with applesauce).

Other medications are available in a sprinkle form (for example, Depakote, which is often used for mood balance in Lewy Body dementia because of the high sensitivity to anti-psychotics like SeroquelXR, is available in sprinkle form and can be mixed with food).

If a liquid or sprinkle form of the medication is not available, then we should work with the PCP to change to a smaller-pill alternative that will produce equivalent results.

As swallowing becomes even more difficult for our loved ones, liquids and solid food may need to be altered as well.

Sometimes this can be as simple as cutting up food (meat, for example, can be very hard to chew thoroughly in large pieces) into very small pieces and modifying or eliminating foods.

Easy foods to modify are vegetables. Raw vegetables and salads become difficult to chew and swallow for our loved ones as they reach this stage of dementias and Alzheimer’s Disease. Easy alternatives to ensure good nutrition are cooked beans and finely chopped vegetables, including some of the lettuces we normally use for raw salads (avoid kale and mustard greens – I use these for raw salads – because even cooked, they can be difficult to swallow).

You can also use these cooked beans and vegetables to make a creamy pureed soup. The key is to make the soup so that it approximates the texture of applesauce (not too thick and not too thin).

And I will pass this modification on as a personal note – if you want my recipe, email me at goinggentleintothatgoodnight@gmail.com – for cornbread. Crumbly, grainy, and textured breads and crackers are eliminated from our loved ones’ diets when swallowing everything becomes problematic. The reason is that they can choke and aspirate the little grains and crumbs into their lungs.

But my mama loved cornbread and I wanted to see if I could find a way to keep it in her diet. I had been doing some reading on healthy substitutions in baking (for oil, for sugar) prior to this ever being an issue, so I decided to try one of the healthy substitutions for oil – yogurt – in a batch of cornbread to see if it would change the texture from grainy to smooth. It worked perfectly (beautiful texture) and we were able to keep that in Mama’s diet (and any time we can find a way to do this, please go for it and try it!).

Swallowing issues may advance to the point where the dysphagia diet levels need to be implemented. There are three levels in this diet, depending on badly swallowing is compromised. I have not personally used these, although I’m familiar with them.

However, this is something that a speech therapist with home health care or palliative health care is qualified to and can help and guide us through at this juncture with our loved ones with dementias and Alzheimer’s Disease.

I can’t emphasize enough how important it is for us as caregivers to have one or other of home health care or palliative health care on board as we provide care for our loved ones since they have resources, like speech therapists, who are available to walk us step-by-step through each phase or issue that we may encountered.

This is the last post in this series. If there are other day-to-day “in-the-moment” things related to caregiving for our loved ones with dementias and Alzheimer’s Disease that would make your life – and, no doubt, many others’ – easier that you would like to see discussed, leave a comment here and I’ll work with you to get you the answers and the help you need.

And please don’t forget to share this on social media. Dementias are more prevalent than ever – and will only increase from this point on – and more and more people are in the role of caregiving for their loved ones.

I often have people ask me what they can do to help and support other caregivers. All you have to do is share. I’ll do the hard lifting of research and writing. 🙂

Even if you don’t know all the people in your online networks, by sharing this information with them, you may be giving a lifeline to someone who is struggling, feeling overwhelmed, and completely alone on their journey.

We never know whose lives are crossing the path with ours. And this may be a random act of kindness that you’ll never even know you did. All you have to do it hit the Share buttons (and there is an email button for those who may not be on social media) for the social media forums you’re on to pass this information along to whoever may need it and can use it.

Thanks!

The Importance of Fitness and Exercise for Our Loved Ones with Dementias and Alzheimer’s Disease

Jan12

Exercise and fitness are important aspects of life and are beneficial for everyone, but particularly for our loved ones with Alzheimer’s Disease and dementias.

There has been significant research that shows that leading a life that is physically active and includes regular exercise can have a positive impact on overall health and well-being.

People who exercise regularly have improved levels of general cardiovascular health, stronger bones and, therefore, a reduced risk of osteoporosis. They also tend to sleep better at night and have improved strength and balance, which can reduce the fall risks for our loved ones with dementias and Alzheimer’s Disease.

Exercise has other wonderful health benefits too. Any level of regular physical exercise can have a positive impact on emotional health.

Exercise may help alleviate some of the symptoms of depression, a common condition in our loved ones with dementias and Alzheimer’s Disease, particularly in the early steps of the journey through these diseases.

Exercise can be beneficial with depression symptoms because it releases endorphins and other mood-enhancing brain chemicals. And even if our loved ones have reduced mobility or are in the middle-to-late steps of the journey through dementias and Alzheimer’s Disease, there are still ways to incorporate regular exercise into their daily routines.

Listed below are a few simple exercises for our loved ones with dementias and Alzheimer’s Disease.

Exercises Using A Chair

Seated exercises are ideal for our loved ones with dementias and Alzheimer’s Disease since they tend to have stability issues. Additionally, chair exercises are a great way to begin getting more physically active if our loved ones haven’t been for a while.

Seated exercises can help to build and maintain essential muscle strength and balance, but they are much less strenuous than standing exercises and reduce the risk of falls and/or injuries.

It’s important to use a sturdy chair with a back (I would recommend one that’s roomy with arms to prevent our loved ones from falling off sideways) for seated exercises and for us to be close by to assist if need be.

With our loved ones with dementias and Alzheimer’s Disease, it’s important to take the time to do these exercises at their pace. This includes taking the extra time to patiently coach – without expecting perfection in execution or repetition, with “good enough” done safely being “great.”

It would be ideal to begin each exercise session by breathing in as deeply as possible and then breathing out gently (if our loved ones are able to lift their arms to the side while doing this, it will help increase lung capacity, but if not, that’s okay).

We may have to coach and show our loved ones how to do this, doing the breathing exercises with them to encourage them to follow our example. Repeat this up to a maximum of ten times.

1st exercise (shoulder rolls): Lift the left shoulder up, then take a deep breath in. Breathe out as the shoulder drops. Then, lift the right shoulder up, then take a deep breath in. Breathe out as the shoulder drops. Alternate between the left and right shoulder up to ten times.

2nd exercise (neck strength): In the same sitting position, tilt the head back. Following the same breathing pattern as before, breathe in as the head is tilted back, then breathe out the head moves forward. Then, breath in as the head is turned to the left and breath out as the head is turned to the right. Repeat, alternating between back and forth and left and right up to ten times.

3rd exercise (sitting march): Pace can be as slow or fast as is comfortable. Lift the right knee up and breathe in; put that same foot down and breathe out. Repeat the same process with your left leg. Alternate between left leg and right leg up to twenty times.

4th exercise (leg stretches): Extend the left leg fully, breathing in as it’s extended, and breathing out as it is bent. Repeat with right leg. Alternate between left and right legs up to ten times.

5th exercise (ankles): Cross the left leg over the right leg, and rotate the left foot. Then, cross the right leg over the left leg, and rotate the right foot. Alternate between left and right foot, breathing rhythmically throughout, up to ten times.

Exercising to Music

In the early steps of the journey through dementias and Alzheimer’s Disease, our loved ones may be able to do slightly more strenuous exercises around the home, such as gardening, walking up and down the stairs or even dancing.

Exercising to music can make the activity a much more enjoyable experience. Since listening to music can also be beneficial in many ways for our loved ones with dementias and Alzheimer’s Disease, incorporating music into daily activities like exercise makes perfect sense in our overall care strategy.

This is a guest post by Helen Bowden, fitness trainer and nutritionist with experience in dementias and Alzheimer’s Disease

United States Hospice Agency Report Card 2015

Jan9

In “The Layperson’s Guide to Hospice Care for Our Loved Ones with Dementias and Alzheimer’s Disease,” I gave a comprehensive discussion about how to choose and what to look for in hospice agencies when the time comes that our loved ones with dementias and Alzheimer’s Disease need comfort care and gentle and compassionate assistance with the dying process.

The Huffington Post, on January 8, 2015, had this article, which includes interactive maps for each state in the United States where state inspection data was available, giving detailed report card information for American hospice agencies.

“Here Are the Hospices That Break the Most Rules” is a must-read.

Do You Know And Have You Prepared What You Need To Ensure That You And Your Affairs Will Be Well-Taken Care Of When You Need Help?

Jan7

Every few months, I write a post on the immediate need for everyone – no matter what their age, their health, or their life circumstances – to know and understand the vital information that needs to documented (and executed in terms of legal documents) and communicated to their designee when they are unable, either temporarily or permanently, to take care of their own affairs.

This includes digital access (email accounts, online bank accounts, retail accounts, etc.) documentation as well as legal, medical, and financial documents everyone needs to have in place when we need help or can’t take care of our own affairs in this area.

I am extremely puzzled by the fact those most people put this off and avoid thinking about it or doing it. It’s illogical and it is really cruel to those whose laps it ends up in.

I can’t tell you how many stories I’ve heard about a family member – especially parents of grown children – being incapacitated with life and death in the balance and because nobody ever talked about this contingency and no documents – living wills and/or DNRs – exist, there’s no clear decision-maker and the ability to let go (taking off life support when there’s no chance of recovery) is long, hard, and gut-wrenching on the family.

And the one who didn’t take the time to spell out their wishes suffers terribly and needlessly, not to get better, but essentially just to run up a meaningless huge debt that will decimate their estate and perhaps ruin the financial health of those they leave behind.

None of is guaranteed our next breath, a healthy life with no life-changing accidents and diseases, nor a healthy mind for as long as we live. Things could literally change 180% for any of us and our families and loved ones while we’re reading this sentence. Yet, of all the things it seems that we humans deceive ourselves about, this seems to be the top “It won’t happen to me.”

But the reality is that it will.

If not sooner, then later.

And the most selfish and irresponsible thing that we can do to our families and our loved ones is to not be prepared ourselves and to not ensure that we have designated and prepared the decision-makers we choose in advance.

This is one of the greatest acts of love and one of the biggest blessings we can do for and give to those closest to us and whom we love the most.

All of us need to be preparing in advance for the possibility that something – whether it’s Alzheimer’s Disease, dementias, other life-threatening illnesses, or simply time and chance – could suddenly and dramatically or slowly and insidiously render us incapable of taking care of our own affairs.

With the precipitous rise in dementias overall, which may be in part related to a more toxic planet, more toxic water, and more toxic food, and the burgeoning number of lifestyle-related dementias that are emerging, the odds are not in our favor that every single one of us, in time, will not suffer from some sort of neurological degeneration.

Who is going to help us when this happens?

And even if you or I are the exception to the rule, we’re still going to die. Everybody dies.

You can ignore it, you can deny it, you can live in some fantasy world where you refuse to think about it ever, but it doesn’t change the reality that it will happen to you and me.

I believe most of us assume that death will be quick and instantaneously, but the reality is that, in all likelihood, most of us will probably have a period of decline in which we will need help handling our financial, legal, and medical affairs before we take our last breaths.

And, after we take our last breaths, someone will have to take care of getting us buried and ending our financial, legal, and medical status among the living.

Who would that be for you? Yes, you, the one who is reading this post. Do you know? Does that person know? If that person knows, have you made this as easy as possible for him or her by doing your part and making sure he or she has everything he or she needs to do what needs to be done?

Or, because you don’t want to think about it or talk about, will that person have the burdensome responsibility of trying to figure it out all on his or her own?

We say we don’t want to be burdens to our loved ones. By taking care of this, you and I – we – have taken a big step toward easing the magnitude of that burden that, if we live long enough, will be shouldered by our loved ones.

I did my first will and living will shortly after I turned 21. I review and update, if necessary, both of those when my circumstances change or 12 months have passed. I have a signed and notarized DNR.

I have complete documentation on my digital footprint, as well as other financial, medical, insurance, property, and notification (for death) documentation that I keep updated as well.

I have detailed instructions regarding my funeral service and my burial.

Do you?

If not, why not?

What are you going to do about?

When are you going to do something about it?

What if tomorrow never comes?

Making Life a Little Easier in the Care of Our Loved Ones with Dementias and Alzheimer’s Disease – Part 2

Jan6

This is the second in a series of posts that discusses everyday practical needs that almost no one ever talks about in providing care and making life easier for both us as caregivers and the loved ones with dementias and Alzheimer’s Disease that we care for.

In the first post in this series, we looked at how to make things easier day-to-day for our loved ones in the areas of eating and incontinence.

In this post, we’ll look at the areas of personal grooming and bathing in the journey through dementias and Alzheimer’s Disease with our loved ones.

The progressive neurological damage of these diseases can affect our loved ones in several ways in the areas of bathing and personal grooming, which may necessitate accommodations for them in these areas.

Before we discuss those in detail, it is imperative that we always respect the dignity of our loved ones with dementias and Alzheimer’s Disease, and that we give them as much autonomy and independence in all areas of their lives, including these, as is safe.

Dignity is not negotiable. Our loved ones deserve that at all times and we owe them that at all times. Being more dependent and less able to take care of themselves is hard enough on our loved ones, but to not respect and maintain their dignity is humiliating and devastating.

Our loved ones with dementias and Alzheimer’s Disease have been and are being robbed of their quality of life by an unseen or several unseen thieves in their brains. We should not be adding insult to injury by robbing them of their dignity.

Independence is also critical to the well-being of our loved ones. Safety concerns will, at times, limit full independence. However, that should be the only reason we curtail independence in any way.

Being a lot slower at doing things, being less than perfect at doing things, or forgetting how to do something but trying anyway should never be reasons why we take independence away from our loved ones. If we do, shame on us.

The requirements of making bathing – including washing hair -easier for our loved ones with dementias and Alzheimer’s Disease will change as these neurological diseases progress.

However, there are several things that we should be aware of throughout the course of these diseases:

Showering or a full bath every day is hard on and can damage the fragile skin of our elderly loved ones. A good rule of thumb is alternating showering or full bathing every other day with the equivalent of a sponge bath.
Harsh soaps and shampoos will also damage skin, including the scalp. Baby bath wash and baby shampoo is the gentlest option for bathing and shampooing hair.
Skin also dries out as our loved ones age – diuretics will make skin dryness even worse – so we should make sure our loved ones are lotioned up well each day with a good hydrating lotion.
Bathtubs for older folks are difficult to get in and out of and present a greater danger of falls.

If you are reading this with younger loved ones you may be caring for in the future or even with yourself in mind, please make sure that a first-floor bathroom has a walk-in shower (ceramic or fiberglass frame – a metal frame can cut), which can be adapted for even greater safety using assistive devices.

When staying in a hotel, be sure to request a handicapped room since these have walk-in showers (which are even wheelchair accessible, if needed).
Make sure the bathing area is the warmest room in the house. As our loved ones get older and as dementias and Alzheimer’s Disease progress, sensitivity to cold is even more pronounced.

If there is no additional heater built into the bathroom, use a space heater. About 15 minutes before bathing time, turn the heater on and close the door. This will ensure that the bathroom is at a comfortable temperature by bath time.
Have everything you need for bathing, personal grooming, and dressing ready before starting the bathing process.

This makes the process go more smoothly and efficiently and it ensures that we don’t have to leave our loved ones unattended – with the possibility of falls and/or injury – during the process.
Water temperature is crucial and we must ensure that it’s not too hot or too cold. Run the shower (or sponge bath water) until it is on the warmer side of lukewarm as a general guideline.
The sensation of water pouring down from a shower can sometimes be frightening for our loved ones with dementias and Alzheimer’s Disease as they approach the middle and late steps of these diseases.

My personal theory is that it’s a combination of three things: a heightened sensitivity to change (resulting in confusion and anxiety), the suddenness of it, and the feeling of being wet.

We will notice that some days showering is not an issue and other days it’s a huge issue.

On the days that it’s a huge issue, it’s important that we don’t force our loved ones into a situation that is frightening for them, because this will increase fear, anxiety, confusion, and disruptive behavior.

Instead, we should opt for a sponge bath or cleanup with adult washcloths and try again another day.

As far as bathing and shampoo products go for shower days, I recommend Johnson’s Moisture Baby Wash and Johnson’s Baby Shampoo.

While there are generic brands of baby body washes and baby shampoos, I found the quality inferior (i.e., they were more watered down) to Johnson’s baby products.

Since these are designed for delicate skin, they meet the bathing and the shampooing needs of our older loved ones with dementias and Alzheimer’s Disease as well.

Additionally, the shampoo won’t irritate the eyes if it drips into them. Since following directions – such as keeping eyes closed – is harder for our loved ones to do or sustain if they are able to do it, this ensures that no harsh chemicals get into their eyes while washing their hair.

For non-shower days, I recommend using disposable adult washcloths. Adult washcloths are large and premoistened, usually with aloe added, and can be used very effectively to clean up. They are not flushable.

Adult washcloths can be bought inexpensively in bulk at warehouse clubs like Sam’s Club, Costco, and BJ’s (online or in-store).

A product that many hospitals use for bathing that I do not recommend is no-rinse body wash/shampoo. One reason I don’t recommend no-rinse body wash/shampoo is that I don’t find that it does a good job of cleaning and it leaves a slight residue on skin and hair. The other reason I don’t recommend no-rinse body wash/shampoo is that it dries the skin and hair out, which makes the fragile skins of our elderly loved ones with dementias and Alzheimer’s Disease even more dry and fragile.

There are several things that we’ll need to do to ensure the bathroom and shower is safe to prevent falls for our loved ones.

Most modern bathroom floors are either ceramic tile or linoleum. Both of these surfaces are very slippery when they’re wet, so we want to ensure that the floor has an adequate amount of non-skid covering to ensure the safety of our loved ones when they are wet.

Rugs and oversized bath mats are the easiest and least expensive way to cover the bathroom floor adequately. It’s also easy and inexpensive to ensure that they are non-skid by applying non-skid tape to the back of the rugs or bath mats. The best product I found for this is Duck® Brand Hold-It for Rugs™, which can be purchased through many venues online or at home supply stores.

Non-slip tub/shower mats with suction cups are the usual recommendation to keep our loved ones with dementias and Alzheimer’s Disease from slipping and falling in the shower. However, my personal experience with these is that with most shower floors, the suction cups don’t adhere well and the mat moves around easily.

So I don’t recommend these for the shower floor. Instead, I recommend non-skid strips or tape designed specifically for the shower.

The entire floor of the shower does not need to be covered nor do the strips or pieces of tape have to be right up against each other (gaps between them are fine as long as they are not wide enough to cause a slip or fall) , but you do want the primary walking surface to have enough skid-resistant strips or tape in place to ensure safety.

Like the non-skid tape for the rugs, this is very inexpensive and provides the maximum safety for our loved ones and can be purchased online at Koffler Sales Company. There is no quality difference between the 3M™ and KSC brands, but because 3M™ is a more-recognizable brand, the price for their products is higher.

As far as the safety of our loved ones with dementias and Alzheimer’s Disease goes in the shower itself, there are two additions that I would highly recommend.

One addition is a safety grab bar. There are two kinds of grab bars for showers on the market. One kind requires no hardware to install it because it uses a suction-cup locking system. The other kind requires hardware to install it (and, if you’re not handy, may require a professional to install it).

Although the easy-to-install grab bar is less expensive overall, I don’t recommend it for our loved ones with dementias and Alzheimer’s Disease. Because it uses a suction cup to hold it to the shower wall, with enough weight or time, it could become detached and cause a fall.

Therefore, I recommend the grab bar that uses hardware to attach it to the shower wall.

Although this presents work and a possible upfront cost for installation, it gives our loved ones the extra measure of safety for fall prevention.

The other addition that I recommend is a portable shower chair.

Built-in shower seats are often small and in one corner of the shower, which doesn’t facilitate easy showering.

However, the main concern with built-in shower seats for our loved ones is that they are slippery and the fall/injury potential is great.

Shower chairs allow our loved ones with dementias and Alzheimer’s Disease to sit either during the shower or when they get tired during the shower.

For the most comfort, I recommend a shower chair with a back and without arms.

The shower chair should be placed in the shower near the grab bar.

We should be on hand while our loved ones are sitting in the chair and we should always assist them – directing them to use the grab bar to help – getting up and down out of the chair. While the shower chair’s feet have rubber grips, the chair will move when our loved ones are standing up or sitting down.

In the next post in this series, we will look at how to make life easier in the areas of mobility and functionality/accessibility for our loved ones with dementias and Alzheimer’s.

Coping strategies with Alzheimer’s that invokes the feelings of guilt.

Jan4

This is an excellent post…many of the things that I talk about in with regard to how we as caregivers respond to our loved ones in You Oughta Know: Acknowledging, Recognizing, and Responding to the Steps in the Journey Through Dementias and Alzheimer’s Disease are beautifully and eloquently stated here by someone who has Alzheimer’s Disease.

You know, for me, one of the greatest blessings in my life was the opportunity to be the caregiver for my mom. I got frustrated, at times, before I realized what was wrong, but the frustration was not with my mom, but with me because I didn’t know how to make things better for her.

But I didn’t take that frustration out on my mom. Instead, it provoked me to be even more protective, more gentle, more kind, more caring, and more loving toward her. Intuitively, I knew she was scared and because I knew how fear manifested itself with her, I did my best to make sure that she knew that she was safe and comfortable and that I would never leave her.

I also made sure that her dignity and independence (one of the chapters I cover in-depth in this book) were kept intact (independence was only modified when safety was an issue, but even then I was very careful to let Mom have as much as she could handle) to the end of her life.

The way I looked at caregiving was that I was fulfilling the circle of life for my mom. She did the same things for me when I could do nothing for myself, when I was helpless, completely dependent, kept her up all hours of the night, and was finicky and fussy. She didn’t leave me. She didn’t complain. She didn’t walk away. She did everything she could to show me love, care, and comfort.

And that she deserved from me when the time came that the roles were reversed.

Handbagwarrior; verbal ramblings

There is this wonderful site by Ann Napoletan, who was a carer for her mother with Dementia. The site is packed full of information on the disease. Who can help, support for carers, support for those with the disease; what is Alzheimer’s with signposts to tests to check yourself. FUNNY-FUN-FUN.COM

One thing that struck me when I was browsing through it was that I need to address the fact that I have a reluctance to ‘acknowledge’ the trauma of caring for someone with dementia.

This is a tough thing for me to write about because I risk not meeting expectations, and of being too honest with my thoughts.

At first I thought it was a simple case of me feeling somehow angry that they spoke so loudly about the trauma of being a carer, (which I was told was my own coping mechanism), but then that made me feel really…

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Going Gentle Into That Good Night

Practical, applicable information for caregiving for our loved ones with dementias and Alzheimer's Disease

Archives

Facts About the Flu for Our Loved Ones with Dementias and Alzheimer’s Disease

Will Poor Sleep and Sleep Deprivation Now Lead to a Lifestyle-Related Dementia Later?

Making Life a Little Easier in the Care of Our Loved Ones with Dementias and Alzheimer’s Disease – Part 3

The Importance of Fitness and Exercise for Our Loved Ones with Dementias and Alzheimer’s Disease

This is a guest post by Helen Bowden, fitness trainer and nutritionist with experience in dementias and Alzheimer’s Disease

United States Hospice Agency Report Card 2015

Do You Know And Have You Prepared What You Need To Ensure That You And Your Affairs Will Be Well-Taken Care Of When You Need Help?

Making Life a Little Easier in the Care of Our Loved Ones with Dementias and Alzheimer’s Disease – Part 2

Coping strategies with Alzheimer’s that invokes the feelings of guilt.

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This is a guest post by Helen Bowden, fitness trainer and nutritionist with experience in dementias and Alzheimer’s Disease

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