The Whitworths of Arizona, bringing science to you in everyday language.

Friday, November 17, 2017

I Want to Go Home, Part One

Almost ever care partner has heard this request. Most start out by telling the PlwD,*  "But you are home" only to find out that instead of making things better it made them worse. The same is true for the care partner who tries to explain to a PlwD in a care facility that this is now their home.
Look at it from the PlwD's view:

Something isn't right. I don't really know what's wrong but I do know that when I'm home I feel comfortable and safe. Since I don't feel comfortable and safe right now, I must not be home.

"But you are home. We've lived here for 20 years!" your care partner says.

That can't be. What is she trying to tell me something that clearly isn't so. This isn't my safe, comfortable home.

"Look around," she tells you. "See this is your very own chair, and that's the carpet we bought a few years ago and..."

I have to say she's gone to a lot of trouble to fool me. The chair and the dresser do look like mine, but I KNOW this isn't home. I wouldn't feel the way I do in my own home. She can't fool me. I'm so mad.

Does this sound like some of your interactions, but from a different point of view? Here are some basics to remember and some suggestions for putting yourself in your loved one's frame of mind. To get the most out of this, rely on what your senses and emotions first tell you. Don't think about it. PlwD don't--they can't.
  • Emotions trump reality. What the PlwD feels is more important that where they really are. "Home" means comfort, thus discomfort means "not home."
Try it: Think about how you feel about "home." Is this the place where you feel most comfortable, most safe? Is it where you want to go when you don't feel well?
  • First impressions are all there is. The PlwD doesn't do the abstract thinking that change requires. The PlwD bases their impressions on the first feelings they experience after they perceive something and that's what they are stuck with. Their brain can't change.
Try it: What are your first impressions, your first feelings? Imagine that someone tells you something that you know isn't true. Say, that the blue car you are looking right at is really red? React at face value. Don't add or subtract anything--that takes abstract thinking. So now, go back and look for your first feelings. Incredulity ? Affront? Disbelief?
  • The PlwD bases further feelings on their initial response. That is, once the PlwD decided that this isn't home, they will respond just like you did about the car---and with negative feelings about being lied to.
Try it: Imagine that someone that you depend on seriously tells you that this isn't your home. Would you feel lied to? Hurt? Belittled? Angry? Scared?
  • The PlwD responds to negative feelings with negative behaviors. They will do the first thing they feel like doing without considering the effect or consequences.
Try it. What is your first impulse upon feeling lied to? What is the very first action you consider? Do you want to strike out, resist, argue, withdraw, hide, cry? You can choose not to do these things but the PlwD can't. If they feel it they will act it out.

All is not hopeless. With this inside view of the PlwD's cognitions, a care partner can choose words and actions that will help a PlwD feel more at home. Next blog will be about "going home."

We love and welcome comments but we will not print any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures.

* Acronyms:
LBD: Lewy body dementia
PD: Parkinson's disease
PlwD, LBD, DLB, MCI, PD, PDD, etc: person/people living with dementia
        (Substitute your loved ones name here!)
DLB: dementia with Lewy bodies
PDD: Parkinson's disease with dementia
MCI: mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
BPSD: behavioral and psychological symptoms of dementia

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Friday, November 10, 2017

Affirmations to Keep You Going

Today's blog is about mantras, or motivating statements, like the “I think I can, I think I can” that you can chant over and over to yourself when the going gets rough. It can express a basic belief, be a guide for behavior, or be a personal affirmation. You can make a mantra an affirmation and make it your own by using "I:"I am open to receive..."  or "I choose...". When you leave off the pronoun, it is more of a command...and sometimes, that may be what you need! Just don't use "You" which puts distance between your mantra and you and makes it less helpful.

The following affirmations were adapted from a list of mantras collected by the LBD Caring Spouses online support group by Rosemary Dawson. All mantras are helpful but I believe that they are most effective as personal affirmations. Not every affirmation will have meaning for every care partner. Some will have meaning at one point on the Lewy journey with different ones resonating at other points. Which can you relate to now? Which ones do you use? Which ones will you choose to use today?
  1. I am open to receive the gift of the day.
  2. I choose the lesser stressor.
  3. I don't look back. I don't look forward. I focus on today.
  4. I don't worry about tomorrow; today is what matters.
  5. I don't take the bait.
  6. I drop the rope.
  7. I find joy each day with (your loved one's name).
  8. I find not just issues, but blessings.
  9. I go along to get along.
  10. Home, Hospice, Heaven!
  11. I am doing the best I can.
  12. I don't like the music, but I am still going to dance.
  13. I forgive (your loved one's name).
  14. I forgive myself.
  15. I love you.
  16. It's Lewy, not (your loved one's name).
  17. I keep in touch (by touching) .
  18. I kiss slowly, forgive quickly, play hard, take chances, give everything, and have no regrets.
  19. I laugh when I can, apologize when I should, and let go of what I can't change.
  20. I let go, let God.
  21. Life is too short to be anything but happy!
  22. I look for treasures in the darkness.
  23. One day (hour/minute) at a time.
  24. Outsmart Lewy.
  25. I pick my battles!
  26. Sooner rather than later.
  27. Start low, go slow!
  28. I stay calm and avoid the ER.
  29. Thank you for ....(e.g., being you, loving me, sharing my life, helping me with......)
  30. This is doable. This too will pass ...
  31. This was the best day of our life!
  32. To dream the impossible dream.
  33. Toujour Ensemble.... Always together.
  34. When it rains, I look for rainbows. When it's dark, I look for stars.
  35. I can't control the waves, but I can learn how to surf.
  36. (Your loved one's name) is doing the b•est s/he can.
If you are interested in joining an online LBD caregiver support group:

The Caring Spouses is a private online group limited to spouses of people living with LBD. If you are a LBD spouse, you can CLICK HERE to request to subscribe.

The Yahool LBD Caregiver's Support Group is open to LBD caregivers and anyone interested in LBD caregiving. To subscribe, CLICK HERE, then enter "LBD Caregivers" in the search box.

The Lewy Body Dementia Support Group on Facebook is a closed group, but easy for anyone interested in LBD to join. Enter "Lewy Body Dementia Support in the Facebook search box.

For  information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Friday, November 3, 2017

Touch and Massage Therapy Incorporating Essential Oils:

Today's blog is from our Regina Hucks, our Alternative Therapies Consultant.

Touch is powerful.
The Human Touch is a powerful thing. Often a touch can be something as simple as placing a comforting hand on a shoulder or another’s hand or a more powerful touch found in a hug or gentle embrace. For someone with dementia, this is huge.

The number 1 question I get from caregivers is “What can I do to dispel agitation and anxiety.” While everyone responds differently, you may need to try several things before finding that particular therapy that works best for your charge. There are several basic things I will suggest doing that may well be your key to preventing episodes from occurring but it is important to try first to discover the source of his or her trigger. Consider this exercise much like child-proofing a home.

Anxiety and agitation may be caused by a number of different medical conditions, medication interactions or by any circumstances that worsen the person's ability to think. Ultimately, the person with dementia is biologically experiencing a profound loss of their ability to negotiate new information and stimulus. It is a direct result of the disease.

Situations that may lead to agitation include:
  • Moving to a new residence or nursing home
  • Changes in environment, such as travel, hospitalization or the presence of houseguests
  • Changes in caregiver arrangements
  • Mis-perceived threats
  • Fear and fatigue resulting from trying to make sense out of a confusing world
There are 5 basic things you will want to do to prevent or reduce agitation:
  1. Create a calm environment. Remove stressors. This may involve moving the person to a safer or quieter place, or offering a security object, rest or privacy. Try soothing rituals and limiting caffeine use.
  2. Avoid environmental triggers. Noise, glare and background distraction (such as having the television on) can act as triggers.
  3. Monitor personal comfort. Check for pain, hunger, thirst, constipation, full bladder, fatigue, infections and skin irritation. Make sure the room is at a comfortable temperature. Be sensitive to fears, misperceived threats and frustration with expressing what is wanted.
  4. Simplify tasks and routines.
  5. Provide an opportunity for exercise. Go for a walk. Garden together. Put on music and dance or paint or draw.
NOTED SUGGESTION: I know this is off the subject of Touch and Massage therapy but creating the calming environment is first and foremost. Research has shown that a combination of Rosemary and Lavender Essential Oils in a diffuser reduces or eliminates anxiety. Rosemary has been shown to increase cognition while Lavender acts as a calming and soothing agent. Regular daily diffusing helps to create and maintain a calming environment.

Once you have done all you can to ensure the creation of a calming environment and you are confident there isn’t any medical issue needing your attention yet anxiousness or agitation still persists, Touch Therapy and the use of specific Essential Oils will generally provide immediate relief.

Touch Therapy is our primary focus in this blog today. Touch Therapy is easily learned and incorporated into a daily routine while Massage Therapy should only be performed by a licensed practitioner with knowledge and experience working with dementia’s and the aged. Above all else, Touch Therapy and Massage Therapy present SIDE-EFFECT-FREE alternatives to everyone.  More.... 

 (Find the rest of Regina's information on Touch Therapy in her blog, Alternative Therapies for Dementia. To contact her visit this page and fill in the form.)

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers, nor is Regina Hucks. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Tuesday, October 31, 2017

Lewy Body Phrase for 10-31: Our Upcoming Book

What better day than Halloween to talk about a book that helps care partners deal with the frightening and bewildering behavioral and psychological symptoms of dementia (BPSD) that start showing up far too early with LBD but eventually show up with most dementias?

We plan to have our upcoming book published in time you to use it as a Christmas gift. If you've been following daily October blogs, you already know what it is about. Each of these blogs is a tiny sample of the information in the book.

Of course, since these blogs were kept very short, they contained only a few of the items covered in the book under each subject and seldom included the many quotes that make the book so much more personal.

We plan to offer versions of the book: one for care partners and one for care staff. You can get one for yourself and one as a gift for your helper. We will list it on LBDtools.com and on Amazon so watch for a notice!

For information about Lewy body disorders, read our present books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Monday, October 30, 2017

Lewy Body Phrase for 10-30: Sense-based Therapies

These non-drug options for management of the behavioral and psychological symptoms of dementia (BPSD) all use the sense pathways to the brain, which lasts longer than language or reason.

Aromatherapy uses diffuses healing oils into the air to calm, fight infection, or energize. It is easy to use and can be effective even with people who have lost their sense of smell.

Non-custodial touch (vs. that used in physical care) can decrease anxiety, agitation, physical pain and stress while improving comfort, relaxation and reassurance.

Massage therapy soothes and relaxes. Simple massage can be learned quickly by care partners and provide wonderful together time.

Acupressure uses finger pressure to calm, improve sleep and speech and relieve pain. While less effective than acupuncture, it can be easily learned and used by care partners.

Sound therapy uses sound vibrations, music and rhythm to enhance mood, relaxation and cognition.

Visual stimulation uses light, color, shape and motion to stimulate and relax.

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors. As informed caregivers, they share the information here foreducational purposes only. It should never be used instead of a physician's advice.


Sunday, October 29, 2017

Lewy Body Phrase for 10-29: Relaxation Exercises

Relaxing the body relaxes the mind, lowers stress and decreases behavioral and psychological symptoms of dementia (BPSD).

Relaxation sessions can:
  • last a few minutes, as with deep breathing, or longer, as with yoga.
  • be easy, as with listening to music or following the directions of someone in a soothing monotone
  • be more involved as with yoga or meditation.
  • be as helpful for the care partner as the person living with dementia (PlwD).
  • have calming and clarifying results that last for hours afterward.
Deep breathing is the simplest of these but quite effective and can be done almost anywhere. It is also contagious. When a care partner deep breathes, a  (PlwD) will follow suit and relax too.

Find a relaxation exercise that the PlwD likes and start it early in the disease. If started too late, the more complicated ones may be too frustrating to learn.

For more information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

 Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Saturday, October 28, 2017

Lewy Body Phrase for 10-28: Enhancing Activities

Enhancing activities like mental stimulation, sociability and music enhance self-esteem, enjoyment and quality of life, thus decreasing behavioral and psychological symptoms of dementia.

Mental stimulation improves and maintains brain function.
  • Adapt to lower skill levels with easier books, puzzles or games, but don't quit.
Socialization fosters positive emotions, cognitive function, well-being and better quality of life.
  • Invite friends or family members (1-2 a time) to visit in the person's home.
  • Encourage continued participation in beloved sports, games and hobbies, simplified for more socialization and less challenge.
  • Encourage continued participation in social and religious organizations. Choose smaller groups when possible.
Music and rhythm provide a different pathway to the brain. It can be calming or energizing, and can increase cognition for hours after a session.
  • Make a playlist of the person's favorite songs that they can listen to with earphones.
  • Use rhythm to facilitate movement.
These are only three of a long list of enhancing activities....
    For more information about Lewy body disorders, read our books:
    A Caregivers’ Guide to Lewy Body Dementia
    Managing Cognitive Issues in Parkinson's and Lewy Body Dement

    Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

    Friday, October 27, 2017

    Lewy Body Phrase for 10-27: Healthy Living Practices

    Healthy living practices decrease behavioral and psychological symptoms of dementia (BPSD) by providing the brain more reserves for dealing with them:
    • Exercise: "Better dementia therapy than any drug." Lack: muscle pain, depression, slower thinking and confusion.
    • Socialization stimulates mental function and improves self-worth. Lack: isolation, depression, confusion, and more.
    • Fluids hydrate the body, transport nutrients, prevent constipation and regulate temperature. Lack: BPSD, confusion muscle cramps and more.
    • Sleep is when the body restores and strengthens its resources. Lack: BPSD, confusion, pain sensitivity, weakened immune system.
    • Proper diet and nutrition support a healthy body in general which frees up resources for dealing with dementia symptoms. Lack: malnutrition, overweight, susceptibility to illnesses, more dementia symptoms.
    For more information about Lewy body disorders, read our books:

    A Caregivers’ Guide to Lewy Body Dementia
    Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

     Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

    Thursday, October 26, 2017

    Lewy Body Phrase for 10-26: Preventative Therapies

    We can sometimes prevent behaviors and psychological symptoms of dementia (BPSD) by:

    Controling the environment:
    • Avoid clutter, crowds, loud noises and bright lights and extremes.
    • Use routines, rituals, transitional cues and familiarity.
    Preventing infections:
    • Monitor for symptoms and treat early
    • Use healthy living practices
    • Avoid pressure sores
    Manage pain:
    • Monitor for non-verbal cues suggesting pain
    • Treat early, first with non-drug options
    • When using drugs, choose the mildest possible
    • Consider medical marijuana
    Tomorrow's phrase: Healthy living practices

    For more information about Lewy body disorders, read our books:
    A Caregivers’ Guide to Lewy Body Dementia
    Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

    Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

    Wednesday, October 25, 2017

    LBD Phrase for 10-25: Rehab Therapies

    Rehabilitation therapies are the most common non-drug options recommended by physicians to help deal with the stresses that lead to behavioral and psychological symptoms of dementia (BPSD).

    • Physical therapy: Can improve self-image, increase independence and manage pain.
    • Occupational therapy: Can increase independence and maintain self-worth.
    • Speech therapy: Improves communication ability.
    • Psychological counseling: Helps person and care partner deal with stressful disease related changes, family issues and grief.

    Tomorrow's phrase: Prevention

    For more information about Lewy body disorders, read our books:
    A Caregivers’ Guide to Lewy Body Dementia
    Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

    Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

    Tuesday, October 24, 2017

    Lewy Body Phrase for 10-24: Improv Acting

    Care partners sometimes see playing along with a person's delusions as dishonest. Improvisational theater (improv acting) is a non-drug option for behavior management that allows a care partner to see them selves as actors playing a part rather than feeling dishonest.

    Guidelines:
    • Listen carefully.
    • Accept the person's reality and agree in action if not in words.
    • Focus on the emotion and respond to that rather than the words.
    • Stay in the here and now.
    • Contribute by offering words that fit the person's reality. (This may mean an apology if that is what they need!)
    • Once you are working together, move the action forward towards a needed goal.
    Read more about improv in our 6/10/16 and 6/19/16 blogs.

    For more information about Lewy body disorders, read our books:
    A Caregivers’ Guide to Lewy Body Dementia
    Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

    Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

    Monday, October 23, 2017

    Lewy Body Phrase for 10-23: Empathetic Communication


    Empathetic communication is a non-drug option for behavior management based on the fact that to a person without abstract thinking, their delusions are true and their hallucinations are real.
    1. Accept that your reality is as false to them as theirs is to you.
    2. Accept that their beliefs are unchangeable.
    3. Accept that explaining, defending or arguing is futile.
    4. Use empathy to consider how you'd feel if you were them.
    5. Respond in the way you'd want to be responded to.
      • Agree, at least by action if not in words, (nod).
      • With delusional accusations: Apologize and move on.
      • With hallucinations: Check for safety and go with the flow.
    For more information about Lewy body disorders, read our books:
    A Caregivers’ Guide to Lewy Body Dementia
    Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

    Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

    Sunday, October 22, 2017

    Lewy Body Phrase for 10-22: Care Partner Care

    A person living with dementia (PlwD) who has a healthy, rested, happy care partner will have fewer behavioral and psychological symptoms of dementia (BPSD) than one whose care partner is sick, overburdened, tired, or irritable.

    A PlwD mirrors care partner stress as a negative emotion of their own and, without impulse control, acts it out.

    Martha is tired, her back hurts and she's worried about the car that needs repairs. Dave picks up on Martha's stress, identifies it as his own residual fear that his life is disappearing, and begins to shadow her everywhere she goes.

    Short term solution: Martha needs to take a few hours of respite so that her stress level will decrease. With less stress of her own, Dave will also be less stressed, he won't feel so fearful and his shadowing will decrease.

    Log term solution: Martha may need to hire or ask for help so that she can get the rest she needs, see a doctor about her back, join a caregiver support group and/or talk to a financial guide about budgets. See our many blogs about caregiver care or read about it in our books.

    For more information about Lewy body disorders, read our books:
    A Caregivers’ Guide to Lewy Body Dementia
    Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

     Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

    Saturday, October 21, 2017

    Lewy Body Word for 10-21: Hallucinations

    Hallucinations: seeing, hearing or feeling something that isn't really there.

    With LBD: Well formed visual hallucinations often appear before thinking abilities fade.
    With Parkinson's: Similar hallucinations appear well after motor symptoms but while thinking is still intact.
    • At first, the person believes the care partner's explanation that the hallucinations are simple Lewy playing tricks again. Earl said, "I know the little army men aren't real but they are fascinating."
    • As abstract thinking fades, Earl will begin to believe his little men are real. As with delusions, this belief cannot be changed.
    With other dementias: Hallucinations can occur, usually after thinking abilities fade.

    Delusions: Once thinking fades, hallucinations are often combined with delusions into elaborate dramas that the person truly believes.

    Best reaction: Empathetic communication (tomorrow's blog)

    For more information about Lewy body disorders, read our books:
    A Caregivers’ Guide to Lewy Body Dementia
    Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

    Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

    Friday, October 20, 2017

    Lewy Body Word for 10-20: Delusions

    Delusions: Dramas brought about by faulty thinking often combined with residual emotions. Delusions show up early with LBD because thinking fades earlier too.

    Dave see his wife on the phone:
    • This triggers his residual fear of abandonment. 
    • To make sense of this fear, his dementia-damaged-brain offers the delusion that that she is talking to her lover. 
    • Now, also angry, he accuses her.
    • When she tries to explain, he becomes even angrier.
    Considering the validity of a thought requires abstract thinking. Without it, the delusion becomes Dave's truth. Consider how you would feel if someone tried to tell you that something was not the way you knew at the very core of your being that it was. This is how strong delusions are. Explaining, defending or arguing DO NOT work.

    For more information about Lewy body disorders, read our books:
    A Caregivers’ Guide to Lewy Body Dementia
    Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

    Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

    Thursday, October 19, 2017

    Lewy Body Phrase for 10-19: Non-Drug Options

    Non-drug options should be tried first before behavior management drugs. They:
    • Are generally safer than behavior management drugs and often equally efficient.
    • Often take more care partner time and effort to use than popping a pill.
    • Can provide opportunities for care partner and loved one togetherness.
    • Can be used alone or in combination with behavior management drugs, which often results in the need for fewer drugs.
    Non-drug options includes the following and much, much more:
    • care partner care
    • occupational therapy
    • infection control
    • relaxation methods
    • music and rhythm therapy
    • aromatherapy and massage
    Tomorrow: Rehabilitation therapies
      For more information about Lewy body disorders, read our books:
      A Caregivers’ Guide to Lewy Body Dementia
      Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

      Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

      Wednesday, October 18, 2017

      Lewy Body Phrase for 10-18: Drugs and Sensitivity

      No drug can cure LBD but some can treat its symptoms.
      • Dementia drugs work to improve cognition and other LBD symptoms.
      LBD can cause a person to be super-sensitive to certain drugs.
      • Which drugs are "Lewy-sensitive" for each person is very individual.
      • Lewy-sensitive drugs act as though the person had a much larger dose than normal, with often severe results.
      Behavior management drugs are often Lewy-sensitive. Use very carefully if at all.

      Drugs for other symptoms should be reviewed for Lewy-sensitivity before use. (LBDA Medications Glossary)

      All drugs should be started in the smallest dose possible, increased until they do the job or cause problems, and stopped when no longer needed.

      For more information about Lewy body disorders, read our books:
      A Caregivers’ Guide to Lewy Body Dementia
      Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

      Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

      Tuesday, October 17, 2017

      Lewy Body Word for 10-17: BPSD

      BPSD stands for behavioral and psychological symptoms of dementia. BPSD are triggered by stressful irritants that can be:
      • physical, as with an infection.
      • external, as with an overheard phone conversation.
      • perceptual, as with the person's perceived view of that their spouse is "calling their lover."
      • emotional, as with the fear the perception of the call generates.
      • a combination of these, as with:
        • frustration at being unable to explain the discomfort of an infection
        • anger at being "lied to" by the spouse whose explanation is different from the person's hard-wired belief.
      BPSD are often rational behaviors based on incorrect information derived from faulty thinking. They include but are not limited to:
      • agitation, anxiety and irritation
      • threatening, aggressive or disruptive physical or verbal behavior
      • delusions, usually of infidelity, abandonment or theft
      • depression and withdrawal
      • hallucinations
      • paranoia
      • repetitive activity
      For more information about Lewy body disorders, read our books: A Caregivers’ Guide to Lewy Body Dementia Managing Cognitive Issues in Parkinson's and Lewy Body Dementia
      Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

      Monday, October 16, 2017

      Lewy Body Word of the Month for 10-16: Stress

      When dealing with dementia, there is lots of stress. Each person has a stress threshold, the amount of stress they can handle without calling in the reserves. Any illness, including dementia, stresses the body which lowers this threshold.

      The body gives managing stress overload high priority. When it overflows one's threshold, the body diverts resources from lower priority tasks, such as managing dementia symptoms, to deal with this overload.

      Stressors are anything that causes physical, emotional, or environmental discomfort or distress.

      You can often decrease dementia symptoms (or the symptoms of any disease) by decreasing their stressors.

      For more information about Lewy body disorders, read our books:
      A Caregivers’ Guide to Lewy Body Dementia
      Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

      Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

      Sunday, October 15, 2017

      Lewy Body Phrase for 10-15: What's Left

      Dementia takes away a lot. Here are three functions that are left:

      The senses: Seeing, hearing and touching may be affected by other issues, but not dementia, although it can change one's perception of what the senses deliver.

      • Communication tools: Smiles and gentle touch.

      Emotions remain long after thinking has faded. When the senses deliver information about an experience, be aware that the emotion attached to that information is often one left over from a previous experience.

      • Communication tools: Hugs and loving words.

      Concrete thinking: This basic, unfiltered thinking lasts to the end. It accepts what the senses deliver and the attached emotion and does its best to make sense of the experience. The result is often a delusion, or a faulty belief.

      • Communication tools: Simple words and acceptance. (Uh, huh, acceptance...not belief, but definitely acceptance!)

      For more information about Lewy body disorders, read our books:
      A Caregivers’ Guide to Lewy Body Dementia
      Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

      Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

      Saturday, October 14, 2017

      Lewy Body Dementia Word for 10-14: Emotions

      Emotions drive behavior.
      • Emotions remain after abstract thinking fades. A person will respond to the first emotion they experience during an event.
      • Negative emotions are motivators. They are stressful, strong and intense. Their job is to drive you away from a perceived danger or discomfort.
      • Positive emotions are comforters. They are centering, calming and relaxing. Their job is to encourage us to stay in a comfortable space.
      • The first emotion experienced is often residual, left over from an earlier event. Residual emotions are usually negative; they are stronger and last longer.
      Make care partnering easier by avoiding negative emotions and promoting positive ones.

      For more information about Lewy body disorders, read our books:
      A Caregivers’ Guide to Lewy Body Dementia
      Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

      Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

      Friday, October 13, 2017

      LBD Phrase for 10-13: Concrete Thinking

      Concrete thinking is
      • What a person is left with as abstract thinking fades. 
      • Based on information gathered by the senses.
      • Literal; a "hot potato" is just a very warm vegetable.
      • In the present, with no past or future, no ability to wait or to accept delayed gratification.
      • Single-minded and based on the brain's first information.
        • If the first thought about a spouse's phone conversation is "she's talking to her lover" that's the only truth.
      • Able to accept only what the person experiences personally.
        • The little men that the person sees are real and not hallucinations.
      • Hard-wired and can't be changed with explanations, defending or arguing.
      For more information about Lewy body disorders, read our books:
      A Caregivers’ Guide to Lewy Body Dementia
      Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

       Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

      Thursday, October 12, 2017

      LBD Phrase for 10-12: Abstract Thinking

      Thinking comes in two forms: we start out with concrete thinking and gradually develop abstract thinking.
      Abstract thinking is for reasoning and developing concepts. It is what a person uses when they:
      • Accept their care partner's explanation that the little men they see are hallucinations.
      • Realize that what they first thought was fire is just a flash of light.
      • Make a decision based on information from an outside source, such as a book or other person.
      • Tell time, do finances or organize a party.
      • Understand the punchline of a joke.
      As the ability to think abstractly fades, concrete thinking remains. That's tomorrow's phrase.

      For more information about Lewy body disorders, read our books:
      A Caregivers’ Guide to Lewy Body Dementia
      Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

      Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

      Wednesday, October 11, 2017

      LBD Word for 10-11: Treatable

      LBD is treatable. We've been teaching about treating LBD for over a decade! 
      • Symptoms can be addressed individually, often with good results. 
      • With good treatment, a person with LBD can have a good quality of life for many years.
      • Some drugs can help: dementia drugs, anti-depressants, and mild anti-psychotics and others for specific symptoms, but drugs can also be very problematic. 
      • Non-drug options, alone or combined with drugs in lower doses than when used alone is often the best option.
      For more information about Lewy body disorders, read our books:
      A Caregivers’ Guide to Lewy Body Dementia
      Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

      Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

      Tuesday, October 10, 2017

      LBD Phrase for 10-10: Progressive and Incurable

      Today's word is progressive and incurable.
      • Like most neurological diseases, LBD grows in the body for years before a person has diagnosible symptoms. 
      • By this time, the disease is too far along to cure or stop. It's like cancer that has become inoperable. Don't believe the claims that this miracle herb or that miracle drug has cured LBD, Parkinson's or any other neurological disease.
      • Hopefully,  researchers will have figured out something that works in the next decade or so.
      • When they do, it will likely be something that stops the disorder either before it happens, or very early on, before it has expanded too much to stop.
      Tomorrow's word is treatable. LBD isn't curable but it is treatable.
        For more information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.



        Monday, October 9, 2017

        LBD Word for 10-9: Diagnosis

        Today's word is diagnosis:
        • LBD often goes undiagnosed or is diagnosed as another disease such as Alzheimer's or Parkinson. It often shows up in combination with other dementias, making diagnosis even more difficult.
        • Like other neurological diseases, LBD must be diagnosed mainly via patient history and symptoms.
        • Diagnosis is very important because a) many of LBD symptoms are treatable and b) the wrong treatment can make it worse.
        • A person is usually seen by three to five doctors before finally being diagnosed with LBD, and is usually diagnosed with at something else first, such as depression, Alzheimer's or Parkinson's.
        • When taking anyone to a specialist for a diagnosis of any kind of dementia symptoms, make sure the specialist is Lewy-savvy to assure a more correct diagnosis.
        For more information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

        Sunday, October 8, 2017

        LBD Word for 10-8: Individual

        LBD is very specific to each individual, and thus hard to diagnose, especially by non-LBD savvy doctors--and there are many of those!
        • No two people will experience this disorder the same way.
        • No two people will have the same symptoms.
        • When two people have a similar symptom, they will likely express it differently, or with more or less intensity.
        However, there are enough similarities that knowledgeable (Lewy-savvy) doctors can diagnose it and differentiate it from other dementias.

        For more information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

        Saturday, October 7, 2017

        LBD Word for 10-7: Statistics


        • LBD affects 1.4 million Americans and likely many more who are undiagnosed.
        • LBD is the second most common progressive dementia after Alzheimer's disease (AD).
        • Like AD, LBD is caused by damaged proteins, but they are not the same ones.
        • LBD is a neurological disease caused by damaged proteins called Lewy bodies that spread in time throughout many areas of the brain.
        • Researchers believe that Lewy bodies occur due to a combination of genetics and toxins in the environment.
        • Symptoms depend on where the Lewy bodies are in the brain.
        For more information about Lewy body disorders, read our books:
        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

        Friday, October 6, 2017

        October: Lewy Body Dementia Awareness Month

        For the rest of the month, I will post a LBD Word or Phrase of the day. Today's word about Lewy Body Dementia is disease.
        • LBD is so much more than just dementia. Dementia is just one if it's many symptoms.
        • It is a disease that affects many areas of the body besides the brain.
        • It is a disease that is progressive and as yet incurable.
        • It is a disease where many of the symptoms are treatable.
        • It is a disease that we don't know nearly enough about. We don't fully know how we get it or how to stop it--yet.
        • It is a disease that needs a lot more research!
        Tomorrow's word: statistics

        For more information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

        Friday, September 29, 2017

        Home After a Summer of Fire

        I’m using my blog this week to talk about the weather. Although it isn’t specifically about LBD, it certainly affects our loved ones, especially those with breathing problems.

        We’ve heard so much about the awful hurricanes on the East Coast, but the West Coast has been in crisis too, with far more forest fires than usual. Although mostly only our precious wildlife and forests died,  there was still great danger. For months this summer, an ever pervasive blanket of smoke covered most of British Columbia, Washington, Oregon, Idaho and Northern California, making it difficult for many to breath and filling the hospitals with people who already had breathing problems. Next year, it is likely to be even worse.

        We actually had a lovely summer in the Pacific Northwest, visiting with family and friends and enjoying lots of unusually warm weather and very little rain. However, we were among the fortunate ones. While the East Coast dealt with hurricanes, the West Coast forests were on fire and smoke covered the west. Although we visited areas where smoke was eventually very heavy, we were long gone by then and in more secluded areas before that happened.

        However, no one in Washington or Oregon, Idaho or Northern California could avoid the smoke completely. It was everywhere. Even in our secluded area, we saw the sky turn murky and the sun become a dull orange ball.  I cried when I read about the devastating fires turning places I'd known and loved for years into blackened trees. Even now, my eyes tear up as I type.

        When the rains did finally came in September, we joined our neighbors in cheering and hoping they would be strong enough to put out the fires. In most cases, they weren't. The rains helped but many of the fires still rage, although they are all now partially contained. The word is that the larger fires won't be totally out until December!

        So much more devastation this year because of the lack of rain leaving the forests overly dry and it is not predicted to get better.

        A few numbers to consider:
        • 0.07 degrees Fahrenheit. That's the annual average temperature increase since 1880.(Yes, the world is in a normal warming cycle, but it was very gradual until lately.)
        • 0.17 degrees Fahrenheit. That's the average temperature increase between 1970 and 2017, over twice what it would be if it followed the above trend.
        • An increase in yearly wildfires for the last 12 years, compared to the annual average from 1980 to 2000.
        • 5 month  fire season in the early 1970's.
        • 7 month fire season in 2017, with twice the smoke, and more burned area.
        And people still insist we don’t think we don't have a global warming crisis?

        I suspect a person could compile similar statistics about hurricanes and earthquakes and other natural disasters. I believe that they will all increase as our planet's protective covering is burned away by excess carbon emissions.

        OK, I'll get down off my soapbox now and next week, I'll be back to talking about LBD. Thanks for allowing me to use this blog for something else that I feel strongly about.

        References:
        Environmental Protection Agency
        NOAA

        Thursday, September 14, 2017

        An International Honor!

        Today, we are tooting our own horn. We are so honored that our book, The Caregiver’s Guide to Lewy Body Dementia, has received international recognition: It has been included in the Caregiver Homes list of The Best Dementia Books: 50 Essential Reads For Anyone Coping With Alzheimer’s Disease Or Dementia. Caring Homes, located in the UK, has been providing direct support to family caregivers caring for patients with complex or chronic diseases for almost two decades. Criteria for inclusion in their list included:
        • Being on best seller lists. The Guide has been Amazon’s bestselling book about Lewy body dementia since 2011.
        • Earned high ratings by readers: The Guide has 125 five-star reviews and counting on Amazon alone.
        • Won awards. The guide received a Caregiver Friendly Award from Today’s Caregiver Magazine in 2012. It has also been named “Book of the Week” twice by Alzheimer’s Weekly and Dementia Weekly and is a featured book in the Colorado Chapter of the Alzheimer’s Association’s list of recommended books.
        • Written by experts. Nope. Neither Helen nor James were experts when they wrote the book, but their experience and research since then definitely qualifies them as “Dementia Caregiver Advocates” now.
        • Written by loved ones who shared insights into supporting and caring for someone with dementia: James shares his story of going through the Lewy body journey with his first wife, Annie in the late 1990’s, early 2000’s, when little was known about the disorder. Helen includes some stories about caring for her sister with late stage Parkinson’s. However, this book is not just about them. It is a go-to book illustrated by stories from many caregivers besides the Whitworths.
        Since the Guide was written, we (Helen and James Whitworth) have written three more books and are working on a third. All of our books are written in our signature style, with well-researched, fact-filled but easy-to-read language illustrated by many caregiver stories. All of these book (except the one yet to be published) are available on Amazon, and on our website, LBDtools.com.
        • Riding a Roller Coaster with Lewy Body Dementia was actually their first book, written for staff. This book has been updated and republished. It has been used as a book accompanying trainings that we have presented and can be bought on Amazon. It makes a great gift to give to your in-home helper or to a residential staff member.
        • Managing Cognitive Issues of Lewy Body Dementia and Parkinson’s is about the early symptoms of LBD and the non-motor symptoms of Parkinson’s and how to deal with them, using a variety of non-drug options to limit the use of drugs themselves.
        • On the Road with the Whitworths. This is a hilarious memoir of our first year of RVing and teaching about LBD in Arizona, California, Oregon and Washington. A great book to read just for fun when you need a break from caregiving!
        • Unpublished: (working title: Dealing with the Behavioral and Psychological Symptoms of Lewy Body and Other Dementias.) This book walks the reader through the way dementia changes the brain and causes behavioral and psychological symptoms of dementia (BPSD). Then using this information, the book offers methods for dealing with these BPSD using more effective interactions, non-drug options and fewer drugs. Should be out by early 2018.
        We also maintain this blog and our website LBDtools.com.  Our blog entries have been limited this summer while we enjoyed our travels but look for weekly blogs entries starting in October.

        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

        Wednesday, September 6, 2017

        Electronic Monitors

        At a recent support group meeting, members were talking about various ways to electronically monitor their loved ones.

        By the time I get to bed, I'm so exhausted that I sleep really deeply. My daughter came to visit and told me that she her father got up in the middle of the night and tried to go outside "to find your mother." She talked him into going back to bed, but how long has this been going on? What if he figures out how to unlock the door? I need a warning system. -- Maxine

        Judy, another group member, recommended an alarmed door stop. They sell on Amazon sell from $3 to $7 each. (Or you can pay hundreds, but Judy says her cheaper one works just fine. ) These work just like one of those old rubber stoppers except that trying to move the door sets off an alarm. Here's a page of door stop alarms.

        Howard takes afternoon naps that almost always last a couple of hours. I'd like to be able to get out and do some shopping and such when he's sleeping but I wouldn't feel safe doing that unless I could monitor him. I know there are baby monitors but I don't want to carry something like that around. Isn't there something I can put on my phone? -- Linda

        A group member told Linda about the smart phone app she used as a monitor. We found a couple for you to consider. Which one you would prefer would depend on personal preference:

        Presence requires two I-phones i05 or better. You set up one to be the camera to video and use your personal iPhone as the monitor. It can be set to start recording when it detects motion. You can also use the monitoring phone to initiate a two-way conversation. Neither picture nor audio is great, but it might get the job done. This app is free from the Apple Store.

        iCamSpy comes in iPhone, Android and PC/Mac versions. It uses a PC with a webcam and microphone for surveillance and the phone for monitoring. You don't have any two-way features but the video is apparently quite good. You can set it up to start with low, medium or high motion sensitivity. This works well with Wi-Fi but poorly with 3G/4G. This app costs $4 from the Apple Store or Google Play.

        We have the opposite problem. Jimmy likes to take walks and its pretty safe in our neighborhood. He can go around the block and never have to cross a street but still I worry. I've heard about tracker watches but don't know what to buy. -- Gladys

        Colin is in a memory care facility. Our home is too far away for me to go every day but we can phone although Colin can't figure out how to use a cell phone and the land line is long distance. Surely there's something out there that will work for us. -- Yvonne

        The Verison Gizmo Gadget would probably work for both Gladys and Yvonne. Caregivers who have tried it report that it is designed as a child's watch but "doesn't look childish." It has a GPS that Gladys can use to keep track of Jimmy. It is also a very simple phone. Colin need only tap a "ringing phone" icon twice to answer the phone or call a preprogrammed number. If Colin doesn't answer, the phone automatically answers in ten seconds, which would allow Yvonne to know what's going on around Colin. You have to be a Verizon customer to use this gadget and it costs $149 initially plus an additional $5 a month. However, it does have great reviews in a variety of places. This PC Magazine article describes it and Verison's ad does too. It has other features too but they only show up if you want them to. All Colin would see are the phone icons.

        Getting Lew in and out the car is almost impossible for me anymore. I wish doctors still make home visits. We Skype my son and his family all the time. Wouldn't it be great if we could just Skype the doctor? -- Janice

        We wouldn't recommend that Janice give up taking Lew to the doctor altogether, but Teledoc is a virtual health service that might act as a supplement for things like a UTI. Virtual visits to qualified doctors take place over the phone or through video. They also offer two- and three-party calling to keep you as the caregiver involved with every visit, giving you more flexibility. Available any time of day, seven days a week, they cover non-emergency care for such conditions as colds, flu, rashes, respiratory infections and more. The first visit may be free and following visits are $45 until Oct. 31, 2017, after which they are $49. AARP CARECONNECT for Family Caregivers.

        To help collect information for your virtual doctor's visit you might like to use a fitness tracker. The URBST Fitness Tracker for is also a wireless Bluetooth 4.0 heart rate monitor and sleep monitor. It acts as a traditional watch as well. Sync it wirelessly to your smart phone or PC. Because it is waterproof and has a long life battery, it doesn't have to be removed very often. (I've worn a similar one for almost two years!) $38.90 on Amazon. It does only come in black. This one was relatively inexpensive and had five stars--a winner in our book! Click here to review or buy.

        Feel free to make more suggestions. If we get enough, we'll do another blog!

        We love and welcome comments but we will not print any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures.

        * Acronyms:
        LBD: Lewy body dementia
        PD: Parkinson's disease
        PlwD: person living with dementia
        DLB: dementia with Lewy bodies
        PDD: Parkinson's disease with dementia
        PlwD, PD, LBD, PDD, etc: person/people living with dementia
        PlwPD, LBD, PDD, etc.: person/people living with PD, LBD, PDD, etc.
        MCI: mild cognitive impairment
        MCI-LB: the form of MCI that precedes LBD
        BPSD: behavioral and psychological symptoms of dementia

        For information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.


        Sunday, August 20, 2017

        NUTRITION THERAPY FOR DEMENTIA: USING ESSENTIAL OILS

        This blog is by guest blogger, Regina Hucks, our consultant on alternative therapies.

        You will find an enormity of Essential Oils on the web, in health food stores, specialty shops, even grocery stores but one thing I can state as absolute fact … Essential Oils are NOT alike.

        Rather than use an explanation from a biased source (a manufacturer or supplier) I’ve gone to the dictionary to answer the question, “What IS an Essential Oil?”

        “An essential oil is a concentrated hydrophobic liquid containing volatile aroma compounds from plants. Essential oils are also known as volatile oils, ethereal oils, aetherolea, or simply as the oil of the plant from which they were extracted, such as oil of clove. An oil is "essential" in the sense that it contains the "essence of" the plant's fragrance—the characteristic fragrance of the plant from which it is derived.[1] The term essential used here does not mean indispensable as with the terms essential amino acid or essential fatty acid which are so called since they are nutritionally required by a given living organism.[2]

        Essential oils are generally extracted by distillation, often by using steam. Other processes include expression, solvent extraction, absolute oil extraction, resin tapping, and cold pressing. They are used in perfumes, cosmetics, soaps and other products, for flavoring food and drink, and for adding scents to incense and household cleaning products.”

        Essential Oils cannot be reproduced in the pharmaceutical industry. Chemists can replicate some of the known constituents but it would be next to impossible to successfully replicate or recreate an essential oil in the laboratory without sacrificing purity and therapeutic value.

        Essential Oils embody the regenerative, protective and immune strengthening properties of plants. These are very powerful antioxidants that neutralize free radicals which can cause cellular damage in the body. Many essential oils have antibacterial, antifungal, antiviral, anti-infectious, antimicrobial, antitumor, anti-parasitic and antiseptic properties.

        So, right now you're asking, what does all of this have to do with dementia and nutrition? The answer is….quite a lot.

        To read more about using Essential Oils in Nutrition Therapy, click here:

        http://alternativetherapiesfordementia.blogspot.com/

        To reach Regina with your questions or feedback, please, click the link below and fill in the form.
        http://www.lbdtools.com/contact2.php

        Next up: Touch and Massage Therapy using Essential Oils – We’ll discuss the recommended oils to use in both therapies and oils for specific disorders / diseases, improved sleep, reducing stress, depression and anxiety as well as effective massage techniques you can easily learn.

        References:

        1. Kiecolt-Glaser JK, et al. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial.
        http://www.ncbi.nlm.nih.gov/pubmed/21784145

        2. Kiecolt-Glaser JK, et al. Depressive symptoms, omega-6:omega-3 fatty acids, and inflammation in older adults. http://www.ncbi.nlm.nih.gov/pubmed/17401057

        For information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Neither Regina Hucks nor Helen and James Whitworth are doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.



        Saturday, August 5, 2017

        Traveling with Stress

        We've been traveling, and experiencing multiple challenges. Every year we plan to leave Arizona and spend a good share of the summer in Washington State. Usually we leave in late May or early June. We make a leisurely trip north, taking a couple of weeks, with stops along the way to visit family and friends. This year was different. We weren't able to leave until mid-July and we didn't have time for visits on the trip north.

        Just getting ready to leave overly warm Arizona was a challenge. Jim needed several unplanned-for doctors appointments first. We finally left with stitches in his arm where the doc had removed a skin cancer. Nurse Helen removed the stitches and that is now fine. The thermometer hit 120 degrees before we were finally able to pack up and go. We managed a marathon five-day trip in the motor home, driving 7-10 hours a day to arrive in Kettle Falls WA, up near the Canadian border for a family reunion I'd been helping to plan. Then we went from there to the family farm where my daughter lives for some more family time. Both were enjoyable but we ate something...or did something...and we've been laid low with digestive problems ever since. (I definitely do not recommend living in a motor home with two people with diarrhea!)

        Jim's illness was more serious than mine. It was also more worrisome because anything stressful can trigger his Crohn's disease which has been thankfully dormant for over a year. Thus, I have had the honor of being caregiver when I wasn't feeling my best. I am blessed that even when he hurts, Jim is a gentle patient. Even so, we are both stressed and that of course, makes everything worse--and the likelihood of the Crohn's greater although so far, it is still quiet. The whole thing is a vicious circle that is hard from which to escape The difference for us is that we know that we will both recover and be able to move on with our lives. Our hearts go out to all of you who are dealing with less temporary situations.

        We are now on our own in a favorite RV park. I am feeling better and we hope that soon Jim will too. From the time we left until now, we've not opened our laptops and so this is the first chance I've had to post. I think that is the longest I've gone without checking at least my email for over a decade! Sorry this is so late. I planned to post ever two weeks but it's been much longer. That's the way it is when life throws you curve balls.

        For information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

        Friday, July 7, 2017

        INCORPORATING ALTERNATIVE THERAPIES FOR DEMENTIA CARE

        This week, our blogger is Regina Hucks. See the x blog to learn more about this very knowlegable woman.

        Medicine is traditionally considered a healing profession, and modern medicine claims legitimacy to heal through its scientific approach to medicine.[1]

        The marriage of science and medicine has empowered physicians to intervene actively in the course of disease, to affect cures, to prevent illness, and to eradicate disease.[2] In the wake of such success, physicians, trained as biomedical scientists, have focused on the diagnosis, treatment, and prevention of disease.[3] In the process, cure, not care, became the primary purpose of medicine, and the physician’s role became “curer of disease” rather than “healer of the sick.”[4] [5]

        The medical definition of ALTERNATIVE MEDICINE is : any of various systems of healing or treating disease (as homeopathy, chiropractic, naturopathy, Ayurveda, or faith healing) that are not included in the traditional curricula taught in medical schools of the United States and Britain.

        There is an enormity of evidence that Alternative Therapies are becoming the norm rather than the rarity.[1] Physicians across the globe are now integrating alternative therapies into their practices as pharmaceuticals become more dangerous to use, lessening the effect of traditional treatments.

        When Alternative Therapies are used in combination with traditional medical practices, it is called complementary medicine, or more likely, INTEGRATIVE MEDICINE. Many Americans have never heard of Integrative Medicine, but this current movement has left its imprint on many of the nation's hospitals, universities, and medical schools in recent years yet has been common practice in many European countries.

        The Duke University Center for Integrative Medicine is a classic model of integrative care. It combines conventional Western medicine with alternative or complementary therapies, such as herbal medicine, whole food nutrition therapy, acupuncture, massage and touch therapy, biofeedback, music – sound therapy, yoga, and stress reduction techniques -- all in the effort to treat the whole person. Proponents prefer the term "complementary or alternative" to emphasize that such therapies are used to complement mainstream medicine, and not used as replacements for standardized medical treatments.

        With progressively degenerative disorders, such as Parkinson’s, LBD or Alzheimer’s, the treatment goals are to alleviate pain, decrease stress and improving quality of life. Due to the serious issues with many of the drugs when normally used to meet these goals, traditional medicine has been only minimally effective.

        Alternative therapies are often welcome additions to the traditional treatment regimen. These less conventional modes of treatment have the advantage of being much safer than traditional drug treatment while often being even more helpful. Caregivers can also benefit from incorporating these therapies into their daily care regimes.

        One of the most important things I could ever say to you is this: Integrative medicine starts with and depends upon a partnership between the patient, caregiver and the doctor, where the goal is to treat the mind, body, and spirit [3], all at the same time. If you are reliant on your physician for traditional care, please discuss incorporating Alternative Therapies into a daily care regime before starting anything new.

        While some of the therapies used may be non-conventional, a guiding principle within integrative medicine is to use therapies that have some high-quality evidence to support them.

        Read more in Regina's blog, Alternative Therapies for Dementia, including:

        TREATING THE WHOLE PERSON

        PROVIDING OPTIONS

        WHAT ARE COMPLEMENTARY AND ALTERNATIVE THERAPIES?

        HOW ALTERNATIVE THERAPIES WORK WITH CONVENTIONAL MEDICINE IN RELATION TO NEUROLOGICAL DISORDERS:

        The Problems with Conventional Medicine

        Commonalities in Complementary and / or Alternative Therapies

        SCIENTIFIC EVIDENCE OF THE MIND, BODY, SPIRIT CONNECTION & YOUR HEALTH

        References [1 through 5] can be found at the end of Regina's full blog.

        We love and welcome comments but we will not print any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures.

        * Acronyms:
        LBD: Lewy body dementia
        PD: Parkinson's disease
        PlwD: person living with dementia
        DLB: dementia with Lewy bodies
        PDD: Parkinson's disease with dementia
        PlwD, PD, LBD, PDD, etc: person/people living with dementia
        PlwPD, LBD, PDD, etc.: person/people living with PD, LBD, PDD, etc.
        MCI: mild cognitive impairment
        MCI-LB: the form of MCI that precedes LBD
        BPSD: behavioral and psychological symptoms of dementia

        For information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

        Saturday, June 24, 2017

        Being Flexible

        Because their job is so important to them, care partners often get caught in the trap of having much higher expectations for themselves than they do for anyone else. Wallowing in guilt and self-blame, they believe that if they lose patience, or don't do something as it "should be done," then they have failed. Everything that goes wrong must have been their fault. If they'd just done it better, or differently, or more, or.... This is a setup for stress, followed quickly by the behavior and psychological symptoms of dementia (BPSD).


        Being flexible helps you to let go of those unrealistic expectations and escape the destructive guilt trap by accepting what is. Being flexible allows you to stop using failures as badges of shame and see them as learning tools, reminders, and yes, warnings. It is a process that involves:

        • Recognizing the problem or the failure, 
        • Looking for the lesson, 
        • Experiencing any guilt involved and making amends, 
        • Worrying a little and looking for a better way,
        • Taking action 
        • Trying again and again
        • Moving on.

        Last night, George watched his favorite detective story on TV. Then I think he chased those bad guys all night long in his dreams. It was his favorite show...he's been watching it for years. -- Mary

        • Recognize the problem. Sometimes that's easy. the PlwD expresses discomfort with BPSD. Often, it's less clear, as when the care partner is feeling overwhelmed. Sometimes it takes something serious such as a fall for awareness to come. More often it is simply a failure of some sort, like George's restlessness.

        But I guess it is too exciting for him now. I know should have noticed this sooner. -- Mary

        Feel the guilt and look for the lesson. Guilt's job is to trigger you into expressing your concern to anyone you may have hurt (including yourself!) and to point out the need to try a different way. Then, guilt's job is over.

        Oh, well, I guess I'm not perfect! -- Mary

        • Forgive yourself. Be as compassionate with yourself as you would be with anyone else. Making a mistake, even a serious one, does not make you a bad care partner. Like Mary, you aren't perfect. You don't have to be! Love yourself anyway. This self-caring will be mirrored by the PlwD as positive feelings towards them as well as yourself.

        I remembered that someone in my support group talked about using DVDs instead of TV and I decided to give that a try. -- Mary

        • Worry a little and look for a better way. A moderate amount of worry can lead to constructive, thoughtful evaluations of the situation, and motivate a person into taking action. What can I do? Who should I ask? What are my options? Is this the right one? Can I think of anything better? What else can I try? Then worry's job is done.

        I ordered some with some old programs for him to watch instead. -- Mary

        • Take action. This might mean that you'll set up a plan of what to do later. Or it may mean that you'll do something right away. But there needs to be a feeling of "doing" involved, even if it is only making a decision to do nothing. This helps you to let go of the guilt and worry and move on.

        The first one I tried he hated. Then I put in Andy of Mayberry. He likes it and it doesn't make him restless. -- Mary

        • Try, try again. If the first thing you try doesn't work, try again. This is a big part of being flexible too.

        We are both happy campers!-- Mary

        • Move on. Once guilt and worry have done their jobs, it is time to let them go. All too often a person hangs onto these and tries to use them to control the past and future. "If I can't do anything else, at least I can feel guilty or worry about it."

        Flexibility may mean lowering your standards. Your house doesn't have to be spic and span. The PlwD may not need a shower every day, and so on.

        It's got so I realize that I need 24/7 care for George, but our finances are limited. I checked with the state. They will help if he goes into a residential facility but not if I keep him at home. I did my research and found a wonderful assisted care facility. The problem is that the state will only pay for a two person room. I had so hoped that George could have his own room. -- Mary

        Flexibility comes into effect with finances too. Dementia care is expensive. Even with help from the state or other sources, you may not be able to afford what you really want. Don't let this stop you from getting the best help you can afford. You can seldom have it all. Mary may need to accept a two person room in a good facility. She just has to make the best choice she can with the resources she has and then let go of what might have been and move on.

        An a different subject, we are exercising our own flexibility by moving to a twice monthly blog for the summer. We will be traveling and researching for blogs becomes more difficult. Expect blogs around the 7th and 21st days of the month.

        We love and welcome comments but we will not print any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures.

        * Acronyms:
        LBD: Lewy body dementia
        PlwD: person living with dementia
        PlwLBD: person living with LBD
        DLB: dementia with Lewy bodies
        PDD: Parkinson's disease with dementia
        MCI: mild cognitive impairment
        MCI-LB: the form of MCI that precedes LBD
        BPSD: behavioral and psychological symptoms of dementia

        For information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

        Sunday, June 18, 2017

        Medicaid Requirements for Long Term Care

        (Italicized words are defined in the mini-glossary below.)

        Residential care is expensive…more expensive than many of us can afford, but there is help in the form of Medicaid. Each state has different names for this and different standards, although some things are basic government requirements. If you have assets that you want to pass on to your children, you need to start planning early. Any assets you give to your family beyond minimal amounts in the five years prior to your “snapshot date” will still be considered yours when eligibility for financial assistance is determined. This includes trusts. Always consult an elder attorney before making these plans, but here is a simplified outline of what is offered.

        The following Medicaid requirements take into consideration the Federal Spousal Impoverishment rules:
        • Countable assets of both spouses are totaled as of the date the institutionalized spouse enters a hospital or long-term care facility and stays for at least 30 days.
        • The community spouse can keep ½ of this total, up to a specified amount (from $23,844 to $119,220 in 2016 depending on the state). State rules differ. Some states allow the community spouse to keep up to the specified amount of the combined total instead of being limited to half.
        • Income of the institutionalized spouse is counted for eligibility, but in most states, that of the community spouse is not.
        • The institutionalized spouse can keep about $2000 (differs with state).
        • The rest of the institutionalized spouse’s assets must be ‘spent down’ before they will be eligible for Medicaid. This can be spent only in certain ways. For example, it cannot be gifted, except in very small amounts. Don’t wait to give your children anything you want them to have. If you wait too long, it may fall within the five years prior to your snapshot date and will be counted as still belonging to you as far as eligibility goes. Consult an elder attorney about the ways to give gifts, and the limitations involved.
        Post eligibility requirements:
        • Community spouses with higher incomes may be required to help pay for cost of the institutionalized spouse’s care. (Varies with states)
        • If the community spouse’s income is less than the state’s minimum monthly maintenance needs allowance (MMMNA), then they can keep some or all of the institutionalized spouse's income. (up to $2002.50 a month in 2016)
        • The home equity of the institutionalized spouse must be less than the state standard ($552,000.00 to $828,000.00 in 2016). 
        • The institutionalized spouse is allowed to keep a personal allowance of $60 a month.
        • The institutionalized spouse’s medical costs are also considered.
        • The institutionalized spouse is required to pay the institution what is left of their income after deducting the amount the amount that can be kept by the community spouse, their personal allowance and the allowed amount for medical costs.
        It is always a good idea to consult an elder attorney when planning for retirement, long term care, and upon a diagnosis of any eventually incapacitating disease such as Parkinson’s or any dementia. At that time, ask about Medicaid requirements for long term care and how they apply to your specific situation.

        Be aware that these requirements can change as the lawmakers in Washington DC hammer out new rules for the Affordable Care Act.

        Mini-glossary:

        Assets: Anything of monetary value: real property, art work, savings, pension plans, stocks and bonds, cash, etc.

        Community spouse: the spouse who is NOT living in a hospital or residential facility.

        Elder attorney: A lawyer who specializes in laws concerning the elderly.

        Federal Spousal Impoverishment Rules: Medicaid rules which provide special protections for the spouses of Medicaid applicants to make sure that they have the minimum support needed to continue to live in the community while their husband or wife is receiving long-term care benefits.

        Home equity: The  fair market value of a home, less debts, divided by the number of owners. Thus the institutionalized spouse’s share of a $900,000 mutually owned home where $100,000 is still owed, would be $400,000.

        Institutionalized spouse: the spouse who is living in a hospital or residential facility.

        Medicaid: Called by different names in different states. There are basic federal requirements and payments but states can add to these.

        Minimum monthly maintenance needs allowance (MMMNA): a minimum monthly income standard for the community spouse, set at one-and-one-half times the Federal Poverty Level for a single person living alone. ($1,991.25 to $2,980.50 in 2016)

        Residential care: Care in a hospital or an assisted living, memory care, rehabilitation or nursing home facility for at least 30 days.

        Snapshot date: the date a person enters a hospital or residential care facility for a stay of at least 30 days.

        For information about Medicaid requirements for long term care specific to your state, go to Find an Attorney, click on your state, and then "Key Medicaid Information" for that state.

        For more information about Spousal improvishment standareds:
        2016 SSI and Spousal Impoverishment Standards

        For information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Helen and James Whitworth are not doctors or lawyers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a physician's or lawyer's advice.

        Saturday, June 10, 2017

        Regina Hicks, Alternative Therapies Consultant

        Over the course of the next few months, our Alternative Therapies Consultant Regina Hucks will be guest writing an occasional blog about the use of alternative therapies in dementia care. Raised by a university professor of quantum physics and a master chef, it’s no wonder Regina chose to study the science behind essential oils and the importance of whole nutrition. She holds certification in both Clinical Aromatherapy and Therapeutic Massage, with a focus and extensive research on the chronically ill, dementia, depression and anxiety disorders. Regina teaches the importance of whole nutrition in promoting cellular health, emotional stability and physical healing as well as the benefits of alternative therapies for wellness in everyday life.

        Feel free to email your questions to Regina through this link or at the end of this article. Please fill out the short questionnaire so that she can provide a more complete answer.

        AN INTRODUCTION TO ALTERNATIVE THERAPIES FOR DEMENTIA CARE:

        We do not advocate the use of alternative therapies as your sole source of treatment. We are here to inform, educate and empower you and your charges. Alternative therapies provide benefit to both patient and caregiver. They can work in conjunction with pharmacology to enhance treatment while providing positive and beneficial results. On their own, they have been shown to alleviate, and in many cases, eliminate a multitude of symptoms. Unlike many pharmaceuticals, alternative therapies do no harm. Side effects, if any, are negligible.

        We suggest working with your physician to incorporate alternative therapies into your care plan. Many physicians find value and embrace their use while others are strictly by the book. Alternative therapies have been used for centuries, it has only been in the last 20 years or so that our modern medical community has begun to see their value. Physicians, hospitals, hospice and dementia care facilities are relying more and more on the use of a non-pharmacological approach.

        I highly suggest taking a look at www.lbdtools.com . Authors, Jim and Helen Whitworth wrote their award winning books and created this website to help caregivers better understand Lewy body dementia and how to provide appropriate care for their patients and loved ones. The Whitworth’s will tell you, caregiving isn’t a job, it’s a labor of love, personal sacrifice and commitment that can take its toll on your physical, mental and emotional wellbeing well beyond what you can imagine.

        A positive side to incorporating Alternative Therapies into your caregiving routines is the impact it has on the caregiver over and above the impact it has on the patient. Many of these therapies require physical contact, others, a connection on the spiritual and/or emotional level. As a caregiver, this contact with the therapies may provide you with the same or similar positive experience your charge will have.

        While there are a multitude of therapies, we will cover those therapies that:

        1. Are evidence based in nature and have been shown to have great impact on the health and well being of the dementia patient as well as their caregivers
        2. Are a range of affordable services provided by licensed, trained therapist with a history and extensive experience working with dementia patients
        3.  Are therapies (most) that can be taught to caregivers who desire to implement them in the care of their patients or loved ones
        4. We have researched for higher than average results with recommendations for specific products that meet the highest standards in the industry
        5. Have been found to have a significant impact on behavioral and physical problems found in patients suffering from dementia.

        Please visit my Healing Things blog  for upcoming weekly articles covering:
        • Incorporating Alternative Therapies
        • Essential Oils and their role in dementia care:
          • Essential Oils for Nutrition Therapy
          • Essential Oils and Massage Therapy
          • Essential Oils and Touch Therapy
          • Essential Oils for Aroma Therapy - Stress Reduction, Improved Sleep, Memory and Cognition
        • Music Therapy
          • Healing Frequencies, Tones and Vibration – Impacting the body on a Cellular Level
          • Music and Memory
        • Art Therapy
          • Memory and Motor Function
          • Color and How it Relates to Dementia
          • Fractal Therapy
        • Meditation and Stretch Yoga
        • Nutrition Therapy – Dealing with Toxicity
        • CBD Oil – Researching the Best, Purest, Cleanest and Organically Grown Product and the Positive Impact on Dementia and Overall Health.on Dementia and Overall Health.

        To reach Regina with your questions or feedback, please, click here below and fill in the form.

        Friday, June 2, 2017

        The Five Senses

        The following is a chapter in our newest book, to come out this fall. More about it in later blogs.

        senses: Sight, smell, hearing, taste, and touch; faculties by which the brain receives external stimuli.

        The senses are the brain's information gathering system. When they are damaged, the information they deliver may be distorted from the beginning. Dementia itself doesn't damage the senses. Age can, or other illnesses can, but dementia doesn't.

        However, attention deficit is a common dementia symptom. It limits one's ability to narrow their focus and pay selective attention. Everything is giving equal billing, making it difficult to choose what to ignore what to zero in on. This broader view sends fuzzier, less accurate information to the brain for processing, even when the senses themselves are not damaged. (reference)

        In communication, when words and non-verbal cues picked up via these senses differ, it is human behavior to believe the cues over words. That's because words are symbols that must be decoded, requiring an extra processing step. Non-verbal cues are not so difficult to decode and therefore are processed more quickly.

        It is important for a care partner to know not only what dementia has taken away, but also what is left to work with. For example, as language skills wane, a PlwD will turn to using non-verbal cues to communicate their own needs and wishes instead of words.

        Vision. As a person ages, one's peripheral vision tends to narrow. Dementia tends to cause this to happen sooner. Thus a PlwD will probably have poor peripheral vision and as the dementia progresses their field of vision narrows to a small area right in front of them. They need you to stand inside their field of vision, but off to one side a little so that you don't block their whole field.

        The quality of vision still left also degenerates with age, other health issues, and possibly even with dementia. Things that were once clear can become blurry, faded and distorted. Use bright color and contrasts to help with this. (Reference)

        Hearing. Dementia does not make people hard of hearing and using a loud voice will not improve their ability to hear. The louder a voice, the more distorted the sound and the less it will be understood. However, many people with dementia are of the age where being hard of hearing is common. The higher registers tend to be more affected more than the low ones. Use a normal voice, pitched as low as possible, to have the best chance to be understood.

        Unless some other problem has caused hearing damage, a person with dementia will usually be able to hear no matter how far they are into their journey--and may be able to comprehend as well. Use care with what you say around a PlwD who appears to be comatose or inattentive. Inappropriate words can cause great agitation.

        Smell. There is some early research suggesting that Parkinson's disease (PD) starts in the nose, not the midbrain. An early PD symptom is loss of smell, which supports this idea. (Reference) LBD care partners often name loss of smell as an early symptom even when PD wasn't involved. The good news is odor receptors (olfactory nerves) reside in many areas of the body besides the nose, including the skin. This means that smell-based alternative therapies may still be helpful. (Reference)

        Touch. Touch seems to be a long-lasting sense like hearing. This is especially true for the more sensitive areas of the body: lips and tongue, fingers and palms, soles of feet and genitalia. That's why you will see a PlwD touching things or putting them in their mouth. A person can also continue to feel and enjoy touching from others. Use a gentle but firm hand. Avoid a light feathery touch that might cause unpleasant feelings of tickling or even "bugs."

        Taste. PlwD often have altered food preferences. Dementia may take away the ability to identify and remember tastes. But typical aging is even more of a problem. Like vision, the efficiency of the taste buds fades with age. Thus a person will tend to prefer sweets or other foods with strong tastes. The ability to enjoy food and the cultural processes around eating last however. This enjoyment can be increased when meals are made into a special time of relaxed togetherness.

        We love and welcome comments but we will not print any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures.

        * Acronyms:
        LBD: Lewy body dementia
        PlwD: person living with dementia
        PlwLBD: person living with LBD
        DLB: dementia with Lewy bodies
        PDD: Parkinson's disease with dementia
        MCI: mild cognitive impairment
        MCI-LB: the form of MCI that precedes LBD
        BPSD: behavioral and psychological symptoms of dementia

        For information about Lewy body disorders, read our books:
        A Caregivers’ Guide to Lewy Body Dementia
        Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

        Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.