This post includes an excerpt from chapter 10, which gives comprehensive information on how to acknowledge, recognize, and respond to the tenth step in the journey through dementias and Alzheimer’s Disease: more frequently going back in time (long-term memories) and losing connection with the present (short-term memories and recognition of loved ones).
This chapter discusses why this step occurs and offers practical, real-time, and loving ways we as caregivers should respond and help our loved ones as we negotiate this step in the journey.
“The next step in the journey with our loved ones with dementias and Alzheimer’s Disease can be difficult to comprehend and adjust to, since it usually appears randomly and unexpectedly. This step is where our loved ones seem to frequently go back in time in memories, in conversations, and in thinking and they often don’t recognize us or know who we are.
I first read Katherine Anne Porter’s The Jilting of Granny Weatherall in high school. It is the story of an 80-year-old woman who has dementia and/or Alzheimer’s Disease. Neither of these names for neurological impairment existed, however, when Porter wrote this short story in 1930. Instead, elderly people were just ‘senile.’
The story made a strong impression on me even as a teenager, even though I never had steady and intimate contact with elderly people (both my parents lost their parents when they were very young and, as only children who were much younger than their cousins, had no aunts and uncles except one on my mom’s side left by the times we kids came along) and had never seen anything that looked like dementias and Alzheimer’s Disease.
I found Granny Weatherall fascinating and I found the juxtaposition of where she was in her own mind versus what was actually going on around her intriguing.
This post includes an excerpt from chapter 9, which gives extensive information on how to acknowledge, recognize, and respond to the ninth step in the journey through dementias and Alzheimer’s Disease: balance, stability, and falls.
This chapter discusses all of the reasons that the neurological damage of these diseases affect balance, stability, and lead to an marked increase in fall risks and actual falls.
This is the ninth step in the journey through dementias and Alzheimer’s disease.
This chapter also discusses practical, real-time, and loving ways we as caregivers should respond and help our loved ones as we negotiate this step in the journey.
“While many of our loved ones with dementias and Alzheimer’s Disease are in good shape physically when these diseases begin to manifest themselves, they eventually reach this step of the journey where there is a great risk of falling. Attached to this risk is the possibility of broken bones – especially hips, which may be so badly damaged that our loved ones become confined to wheelchairs or bed for the rest of their lives – and head injuries, which can be fatal.
The reasons that our loved ones are increasingly susceptible to falls are:
Gait changes are common as dementias and Alzheimer’s Disease progress in our loved ones. One of the most characteristic gait changes is shuffling. This is especially pronounced in our loved ones who have Lewy Body dementia and Parkinson’s Disease, but it becomes a feature of all dementias and Alzheimer’s Disease by this step of the journey.
Shuffling is when our loved ones don’t pick their feet up off the floor to take steps, but instead slide them across the floor to move forward. One of the inherent dangers in this is catching the front part of shoes on the floor – especially carpet – and falling forward.
Shuffling can be both a result of neurological impairment – not remembering how to take normal steps to walk – and muscle weakness from lack of use.
The most important thing we can do for our loved ones with dementias and Alzheimer’s Disease to help minimize shuffling is to have a physical therapist on our care teams to help regain muscle strength and work on gait normalization. Additionally, if possible, we should be helping our loved ones maintain muscle strength and walk with them daily encouraging them, both by example and by instruction, to use a normal stepping gait to walk.”
Today’s post will discuss lifestyle dementia. Many of the people, especially the elderly and very elderly, suffering from dementias and Alzheimer’s Disease today either have the genetic markers for it or – and this is my opinion, but I see strong evidence to support it with the precipitous explosion of dementias and Alzheimer’s Disease – are suffering from the effects of living on a toxic earth, eating toxic food, and breathing toxic air.
However, another group of dementia sufferers is emerging.
They are younger and have very different lifestyles than their elderly and very elderly counterparts with whom they share the same commonalities of dementia. This group of people has dementia that is directly related to lifestyle.
How we live our lives is a series of choices that we make consciously or unconsciously along the way. That is what becomes our lifestyle. Our lifestyle – all of those choices – has short-term effects and long-term effects.
The long-term effects of those lifestyle choices are beginning to be seen in the growing number of people suffering with lifestyle dementia. One of the generations most noticeably – and disproportionate to the incidence in the expected populations of the elderly and very elderly – affected is the Baby Boomer generation (people born between 1943 and 1960, according to William Strauss and Neil Howe in their book The Fourth Turning, which I highly recommend that everyone read).
I strongly suspect that one of the lifestyle choices, which I’ll discuss later, that was prevalent with this generation during the 1960’s and early 1970’s is a key contributor to the development of the lifestyle dementia we see emerging among this age group today.
Before we proceed with describing lifestyle choices that could lead to lifestyle dementia, it’s important to understand what the word dementia describes. Any loss of function of and/or damage to the internal components of the brain (neurological, chemical, or physical) falls under the broad category of dementia when describing the brain’s condition.
(Inset note: Alzheimer’s Disease is the shrinkage of the size of the brain from the outside in, brought on by a specific condition that occurs in the nerve cells of the brain. Therefore, it’s important to remember that all people suffering from dementia don’t necessarily have Alzheimer’s Disease, while all people suffering from Alzheimer’s disease have a very specific kind of dementia, commonly called tangles and plaques.)
So dementia is a condition – or state – of the brain. Like many nouns, this condition or state has adjectives that describe where the loss of function or damage is or specific identified abnormalities of the brain that affect function and cognition. Therefore, when we see the term vascular dementia, for example, the loss of function and/or damage to the brain is related to the blood vessels in the brain.
So what kind of lifestyle choices can lead to lifestyle dementia?
In the last twenty to thirty years, the western world has adopted a supersized fast-food diet, a very sedentary lifestyle, and an “ignorance is bliss” attitude toward taking care of their health with regular medical checkups and changes in their lifestyles to address health issues like diabetes and high blood pressure.
Unchecked or uncontrolled, both high blood pressure and diabetes directly affect the health of the blood vessels in the brain, leading to widespread blood vessel damage and neurological cell death, which is the cause of vascular dementia.
Another lifestyle choice that can lead to lifestyle dementia is alcohol abuse. While it’s generally believed that alcohol doesn’t directly kill brain cells, alcohol abuse creates key vitamin deficiencies that adversely affect the brain and adversely affects the liver’s ability to remove toxins from the body. Research shows that women who abuse alcohol begin to exhibit the adverse effects in half the time that men who abuse alcohol do.
A third lifestyle choice that can lead to lifestyle dementia is drug abuse. I noted earlier that one lifestyle choice seems to point to why there is such a high incidence of older Baby Boomers showing signs of dementia at earlier ages than their elderly and very elderly counterparts do. I believe that this phenomenon has a direct correlation to the pervasive and unabashed drug experimentation within this age group in the 1960’s and early 1970’s.
A few years ago, I watched a documentary entitled The Drug Years on the History Channel (it was originally produced by the Sundance Channel and VH1). If you have not seen it, you should (Netflix and Hulu subscribers will find it in the Documentaries section). It’s shocking in some ways, but very informative in others. If you’re like me, you’ll watch it shaking your head a lot. But there’s a lot of history that explains things before some of us (like me) were born or cognizant and it also explains our continuing prevalent and unabashed drug culture in the U.S. today.
The series had a lot of commentary by Martin Torgoff, who wrote 2005’s Can’t Find My Way Home: America in the Great Stoned Age 1945-2000. Intrigued by the title (the first part of the title is the title of one of my favorite songs by the band Traffic), I read the book after watching the documentary. I don’t believe that any book I’ve ever read scared me as much as Torgoff’s book did. And as much head-shaking as I did during the documentary, I did even more reading this book.
As Torgoff described the drug abuse of the 1960’s and early 1970’s and quoted well-known and not-so-well-known people about their own drug use and abuse, it became evident that there was an uninhibited desire to find, use, and abuse any substance that substantially altered the brain. The more altered the brain was, the “better” the experience.
With the psychedelic agents in LSD, acid, psilocybin mushrooms, and peyote, perceptions became altered, hallucinations occurred, and illusions became real. In short, this generation liberally sought every possible means of chemically inducing the manifestations of dementia. In the process, neurological damage occurred and now, with age, the effects of that damage are becoming more evident with the emergence of lifestyle dementia.
And the neurological damage from this lifestyle choice continues with the use of more modern drugs like Ecstasy, Adderall, and “bath salts,” which are psychoactive and which stimulate the brain beyond its normal capacity and can produce hallucinations, seizures, and even death.
Bath salts, which have become popular in the last couple of years, permanently create irreversible neurological damage because of the simultaneous and voluminous suckerpunch all at once to the brain with the chemical effects of amphetamines and cocaine.
It remains to be seen, although it certainly will occur, what lifestyle dementias develop among the Millennials using these drugs today.
Some things happen to us in life through no fault of our own. However, we have choices in how we live our lives, and we can make positive lifestyle choices that, while they may not preclude any of us from developing Alzheimer’s Disease and dementias down the road, will ensure that we’ve done every within our power to ensure that our choices and actions haven’t contributed to it.