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Tag Archives: Alzheimer’s disease

ARE YOU OR SOMEONE YOU KNOW BECOMING FORGETFUL ?

Last year I attended an interesting lecture from a doctor that had recently been diagnosed with dementia. What impressed me was not only her courage at being able to talk about the subject but the fact that having been diagnosed in the early stages she was able to get her affairs in order and have some say in how she wanted to spend the rest of her life as well as share with others what her thoughts were about her future.

She was taking medication which can slow the disease down considerably. Moreover, the understanding and care of patients with Dementia has improved remarkably in the past 5 years. When I wrote about my mother 2 years ago it had only just been recognised the importance of Advanced Care Planning and my sister and I were able to have similar conversations with her so that she was able to have some say in where she was to live for the rest of her days, have a say in who should have her treasured possessions and even make personal similar requests such as ‘you will pluck out any facial hair, keep my hair tidy, my nails manicured, and make sure I wear  my favourite make up’ She wanted to remain smartly dressed and maintain a neat appearance this was important to her. We fulfilled her wishes as far as possible and she died wearing her usual make up, her favourite perfume, hair set and permed and wearing a clean, new nightdress. She had pictures of her family around her and playing the music she loved most.

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When I recently went to see ‘Still Alice’ at the cinema not only was the acting of Julianne Moore worthy of an Oscar Award but it demonstrated how a family can be involved in the care of a relative with progressive dementia. In  the case of Alice it was a rare form of dementia which particularly strikes those of a young age, but nevertheless the message was the same. It was a compelling and emotional account of a family overwhelmed with a disease which affects all family members in many different ways,  sometimes dividing but also drawing everyone together with the common desire to help fulfil the individual’s life to the end as the person that everyone knows slowly disappears but somehow remains present.

If someone you know is becoming increasingly forgetful, you should encourage them to see their GP to talk about the early signs of dementia. If it is a relative may be accompany them . We usually screen them first by an array of blood tests to exclude simple causes which are easily treatable. If we are concerned about their cognitive function following a mini- mental health test we then refer to a older persons consultant who performs more mental tests s well as a MRI brain scan before coming to a definitive diagnosis.

Dementia is a syndrome (group of related symptoms) that indicate problems with the brain. There are several types of dementia.

Dementia

One of the most common symptoms is memory loss. While there are other reasons someone might be experiencing memory loss, if dementia is detected early, in some cases its development can be slowed and the person affected may maintain their mental function. The typical features of memory loss are :-

Struggling to remember recent events
Problems following conversations
Forgetting the names of friends or objects
Repeating yourself
Problems with thinking or reasoning
Confusion in familiar places

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In Ealing we have a very supportive group ‘Dementia Concern ‘ which is a group of people who support and help in the many aspects of caring for a person with dementia. Carers as we all know are amazing people who day by day and of often night after night perform the vital job of caring for someone who would fail to manage in their own home without them. They help maintain their dignity, their personal hygiene and those individual demands and requests we all have.

refer to their website to find out how they help and when the Dementia Cafe is open.

http://dementiaconcern.co.uk/services/dementia-cafe/

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Posted by on March 23, 2015 in Training and Advice

 

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Spice of life

Sir Michael Caine reveals  he eats turmeric to keep his brain sharp
Screen legend Sir Michael Caine has revealed his secret to keeping a razor-sharp brain – the Indian spice turmeric.
The 80-year-old double Oscar winner says a supplement containing the spice helps him ward off the effects of ageing.
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And Caine is grateful to his Indian-born wife of 40 years Shakira for introducing him to its health benefits. Speaking to Hollywood chat show host Larry King backstage after a fundraising event for Alzheimer’s research, Caine said: ‘I am married to an Indian lady and have learned about Indian culture.
‘I looked into what they got and didn’t get. And one of the things they don’t get is Alzheimer’s.
‘They eat a great deal of turmeric in their food. I have been taking turmeric tablets for 30 years and I have a memory like a computer. I remember everything.’
I learnt about the health benefits of turmeric when I studied Chinese herbs but realised it had been imported from India several hundreds of years ago and is now used in traditional Chinese medicine under the name of 姜黄 is also named Jiang Huang ( yellow ginger), Rhizoma Curcumae Longae
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Curcuma Longa/Cúrcuma is a small perennial herb native to India bearing many rhizomes on its root system which are the source of its culinary spice known as Turmeric (Cúrcuma – rizoma secco in polvere) and its medicinal extract called Curcumin (Cúrcuma extracto refinado).
The name comes from Arabic kurkum meaning “turmeric
A relative of ginger, turmeric is a perennial plant that grows 5 – 6 feet high in the tropical regions of Southern Asia, with trumpet-shaped, dull yellow flowers. Its roots are bulbs that also produce rhizomes, which then produce stems and roots for new plants. Turmeric is fragrant and has a bitter, somewhat sharp taste. Although it grows in many tropical locations, the majority of turmeric is grown in India, where it is used as a main ingredient in curry.
The roots, or rhizomes and bulbs, are used in medicine and food. They are generally boiled and then dried, turning into the familiar yellow powder. Curcumin, the active ingredient, has antioxidant properties. Other substances in this herb have antioxidant properties as well.
Turmeric is widely used in cooking and gives Indian curry its flavor and yellow color. It is also used in mustard and to color butter and cheese.
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The problem with the pill is that it is very insoluble in water.The better way to take it, is to use it in your cooking very extensively. If you have any sauté, just sprinkle it in. The moment you heat oil and add turmeric.
It has a mellow, smoky flavor despite its bright color. It tastes great in sautéed vegetables of all kinds and if you are a meat-eater, you can use it in a rub. You can use as little as one-quarter to one-half teaspoon in your cooking, depending on the dish. But there is nothing wrong with using more in intensely flavored dishes like curry. It makes white rice more digestible and in milk it helps with an upset stomach – several of my Asian patients have shared this with me.

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Turmeric has been used in both Ayurvedic and Chinese medicine as an anti-inflammatory, to treat digestive and liver problems, skin diseases, and wounds.
Growing evidence suggests that turmeric may afford protection against neurodegenerative diseases. Epidemiological studies show that in elderly Indian populations, among whose diet turmeric is a common spice, levels of neurological diseases such as Alzheimer’s are very low. Alzheimer’s disease results when a protein fragment called amyloid-B accumulates in brain cells, producing oxidative stress and inflammation, and forming plaques between nerve cells (neurons) in the brain that disrupt brain function.Turmeric Boosts Amyloid Plaque Clearance in Human Alzheimer’s Patients.In healthy patients, immune cells called macrophages, which engulf and destroy abnormal cells and suspected pathogens, efficiently clear amyloid beta, but macrophage activity is suppressed in Alzheimer’s patients.
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I realise that there are conflicting studies and many of the studies have been carried out in test tubes and animals but there a reasonable amount of evidence to suggest that this spice has amazing anti-inflammatory,anti-cancer (One of its anti-cancer benefits comes from its ability to induce apoptosis (natural cell death) in cancer cells),anti-thrombotic and prevents build of plaque aswell asother properties shown above. It is a natural painkiller in view of its anti-inflammatory properties it helps in diseases such as asthma, arthritis, colitis,stomach ulcers and can lower blood sugar. Many Asians particularly older generation Asians acknowledge it as the ‘spice of life’
and it’s wide ranging health benefits and anti-ageing properties.
Now turmeric will become an important spice in my kitchen and there will be no mustard left on the side of my plate!

 
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Posted by on July 15, 2013 in Training and Advice

 

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DEMENTIA AWARENESS WEEK (19-25th May)h

This was largely organised by The Alzheimer Society to help make people aware of this condition which affects at least 750,000 and many people remain undiagnosed and the incidence is predicted to rise to 1 million by. 2021.

What is dementia?

Dementia

The term ‘dementia’ is used to describe the symptoms that occur when the brain is affected by specific diseases and conditions. Symptoms of dementia include loss of memory, confusion and problems with speech and understanding.
There are some very good videos directed from their website to you tube that explain this condition
http://www.alzheimers.org.uk/talkdementia

Also, for further information
http://www.patient.co.uk

http://www.nhs.uk
http//www.dementiaweb.org.uk/news/
24hr helpline. 0845 1204048.

Patients with Dementia could benefit from new GP contracts
This practise has signed up for both doctors to carry out :-
A proactive approach to the timely assessment of patients who may be at risk of dementia.
We will screen for Dementia in a sensitive manner as part of an elderly / medical check or on specific request and carry out regular medical checks.

What do you look out for?

If you’re becoming increasingly forgetful, particularly if you’re over the age of 65, it may be a good idea to talk to your GP about the early signs of dementia.

As you get older, you may find that memory loss becomes a problem.
It’s normal for your memory to be affected by age, stress, tiredness, or certain illnesses and medications.

This can be annoying if it happens occasionally, but if it’s affecting your daily life or is worrying you or someone this may need further assessment .

Please don’t hesitate to see one of us in surgery so that we can assess you and get the right help in place as soon as possible or if you are worried about a relative bring them to see us.
Sometimes it is simply a wake up call to get your affairs in order and fulfill your ambitions and even if a diagnosis is not made doing this a positive move to face the rest your life.

Ealing has a particularly active branch of Alzheimer’s concern. They are very supportive to carers and their magazine is always available at the surgery.

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http//www.dementiaconcern.co.uk/Ealing

We are proposing having a talk at the surgery from a Dementia Keyworker
LOOK OUT for this on the web page.

My experience of my mother’s  suffering with dementia, which in the early days she told me on many occasions that I should share the experience to help others coming after her.

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Many of us will know someone or have a close relative with Dementia and know the heartache that it brings.
You cannot take the person out of the disease. “.

This means that as confused as a person may seem those who know this person will still recognise the person underneath and feel a connection.
My mother recently died at the age of 94yrs with Lewy Body Dementia following a slow decline over 6years. My sister & I found that talking to her as our mother telling her what was going on kept her as part of the family to the end and even if there was no recognition there was some connection. She still worried about us – were we working too hard, how were we getting home etc. she still had the same food preferences and insisted on drinking her tea out of a bone china cup and saucer.

She must have been aware she was deteriorating as she had been proactive in getting her affairs in order and had even been looking at sheltered accommodation. The diagnosis at that time was slow and confused and often doctors and nurses thought she was being lazy or difficult. She had frequent falls and several admissions and when given certain medication especially codeine type painkillers or if she had an infection she became more confused and had visual  hallucinations. On one occasion I visited her and she thought the place was flooded and she was stranded on her bed unable to even get to the toilet and pleased to see me to come to the rescue. I understood that this was not my mother and I had to explain to medical staff who assumed that was her character and thought she had a mental illness. It was very frustrating as the proper diagnosis evolved very slowly . I was later to find out that many doctors were not familiar with type of dementia characterised by Parkinsonism, visual hallucinations made worse with opiates and cognitive impairment. Also, patients with Lewy Body dementia have episodes of unconsciousness – unrousable sometimes lasting 1 – 2 days. When they emerge they are often better and more lucid and rational so that to inexperienced staff it may appear that they are ‘playing games’ . With one daughter a head teacher and another a GP medical staff unfamiliar with this condition gave us a hard time on many occasions during the admissions for falls or when she was found unconscious. Eventually, we were able to have documentation which was shown to staff on admission or when having treatment and care in the community.

We made a life album with photographs of her whole life so that those caring for her had some idea of the life she lived and who had been important to her in her life. Often she referred to relatives and friends who had died many years ago so that it gave good talking topics when any family visited.
She had been living alone but when she was diagnosed she had lucid moments when we were able to discuss her future with her and reluctantly she was admitted to a specialist Care Home.
We were able to furnish it with her own furniture including the bureau contains photos and items she had saved over many years and a corner cupboard of trinkets that held many memories of holidays abroad and gifts from friends and family.
She took her own clothes , although I did find her trying to swap some with a neighbouring resident or offering her 1/6d (old money) for a dress of hers.
Moreover, she continued to carry her handbag and we took her to buy new clothes as she had always been very particular the way she dressed and in her last few months we bought her some new clothes and cheap jewellery and it was a joy to see her face. She continued to have her hair ‘set’ weekly until the  last week of her life.
We bought her make up and she loved it if any of the granddaughters put on her makeup or manicured her nails and wouldn’t change from ‘burnt orange’ lipstick. The grandchildren took their boyfriends/ girlfriends to meet her and she gave her approval often flirting with the boys and giving the advise she had given me as a teenager! She impressed them by demonstrating how she could ‘down a shot’ with a small cup of lactulose ( one way of getting her to take her medicine when she refused) She developed fears she was being poisoned (a common feeling in this disease) so we bought M&S sandwiches as she had implicit faith in their food -it worked!
She had always loved the garden and when the carers wouldn’t let her out she claimed they had put hosepipes on to pretend there was rain. Luckily I arrived in time and she was distracted and proceeded to tell me my brother-in-law had been put in prison for stealing a lot of money – £77.33 but I was able at that stage to tell her that she was confused and this was untrue and it was her illness and she gave me some insight as to how distressing things could be. That is why it was so important to visit to let her and the carers know what was fact rather than confusion.

Understandably, some people find it difficult to visit as what they see is too painful and as doctors usually we respect that ( you can’t take the person out of the illness ) and it can be difficult to come to terms with this condition. Also, if there was formally a strained relationship it is unlikely to change radically. I was fortunate that we had maintained a close, trusting relationship and was adamant that he should be cared for in a residential home situated near either myself or sister. Sometimes carers and those around a relative can offer more care and love than the relatives for all sorts of reasons and we as doctors try not to be too judgemental as we are often aware of those reasons.

When a well meaning carer sent me this video. It seemed hard:-

As my mother deteriorated and became less mobile we bought her an all singing ,dancing recliner chair so that she could be up in the day , wheeled to the garden she loved and sleep comfortably and eat her meals sitting up.

She was our mum who loved life, enjoyed a party and annoyed us in the same way. Latterly she was unable to walk so we used a wheelchair to take her out, the grandsons often wheeled her and she loved them doing wheelies and the last photos are with the family she loved laughing, singing but gradually these occasions became less and less she slept more until one day she went to bed said goodnight with the pictures of her two new great grandsons by her side and passed away peacefully. We played her favourite music and put on her favourite perfume and with hair ‘set’ and make up on she died in dignity.

image  More information concerning Lewy body Dementia
http://www.lbda.org/content/intro-to-lbd.

We had many times of anguish sometimes feeling  the doctors were being unhelpful and wanted to hasten her end before we were ready but often they were very empathetic and supportive. The carers were variable some cared better than others just like real life and as a family we learnt so much and witnessed how care of patients with Dementia has improved considerably.
When they are first diagnosed it may be appropriate to fulfill certain ambitions. My mother wanted to go to Weymouth as it had many happy memories for her and we had a wonderful day on the beach , paddled in the sea, ate ice-cream and talked about those happy days when we were all children. She wanted us all to be together as a family and we arranged this on several occasions.
It is so important if possible that the family keep in touch let carers know about the life of that person and fight for their dignity, plan their future whilst they can have a say and as the rainy day has arrived for them spend the money on what makes them happy and comfortable don’t hesitate , arrange to fulfill those ambitions as far as possible.

image        There are escorted holidays at accessible holiday centres arranged by the                                     organisation Vitalise

http://www.vitalise.org.uk

Many places have gatherings for carers and the patient with Dementia eg the Royal Academy of Arts has an afternoon where they discuss great masterpieces with them over a cup of coffee – the Art student who told me about this said that the patients with Dementia were totally inhibited and their remarks proved to be both amusing and honest!

This event is part of InMind at the RA, a programme of events for individuals with dementia and their carers or family members.

https://www.royalacademy.org.uk/event/coffee-and-conversation-sessions-3

Eventually as with many people as they age their world shrinks and they prefer to remain their home environment and enjoy simple comforts

 
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Posted by on May 31, 2013 in Current affairs

 

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