Happy Holidays

This week, my family is enjoying visits from distance relatives, holiday get-togethers and fun, to include our very first hot air balloon ride. We hope you are also enjoying this holiday season. 

Next week will start what will probably be a series on sleep and how it affects a person living with dementia...and their care partner.

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.

I Want to Go Home, Part Two

Merry Christmas everyone!

A month ago, the blog was about the PlwD* who wanted to go home and suggested that the care partner would get further if they first saw the issue from the PlwD's point of view: That "home" equaled comfort and discomfort equaled "not home." If you haven't read that already, I'd suggest that you do it now. Just click here.

When you try to convince your loved one that they are indeed home, this feels to them like they are being lied to which generates more negative feelings, over and above the ones of discomfort that initated the feeling of not being home in the first place. That is a very short synopsis of that blog, but if you haven't read it, you would do well to do so before you read further here.

The first step is to validate the PlwD's feelings:

• Unless you validate PlwD's negative feelings, you will not be able to redirect them to something more positive.

Try it. Imagine you are the PlwD and someone tells you that you are wrong. "But I know," you say. "I know that this isn't my home." If that person still insists on their way, what happens to your negative feelings? Did they increase? Now imagine that the person said something like, "OK, but I need to do something first." or "Tell me about home" or speaks to your feelings by saying something like "That must feel scary?" Can you feel the release? Can you feel the relief that being heard, being understood brings?

• The PlwD have a short attention span. Once the negative feelings are deflected, they can be redirected.

Try it: First imagine that you are experiencing the above negative feelings. Can you feel the resistance to a distraction, like the offer of a cookie? That's normal. The job of negative feelings is to keep a person on tract until the need is met. Next, re-imagine the release you felt when you were validated. Now how about that cookie? Notice how much more receptive you feel. With fewer negative feelings, you can respond to the positive feelings engendered by the idea of a yummy cookie.

And so the bottom line is:

•  Speak to the underlying feelings instead of arguing, explaining or reasoning.

Once the negative feelings have been validated their job is done and they will leave.

• The PlwD lives in a black and white, either/or world. Either they are angry or they aren't. Either they are happy or they aren't. Therefore, once the angry feelings are validated, the PlwD is open to distraction almost immediately.

Then you can deflect the PlwD's train of thought with something they enjoy and it will usually work. By the time they've had their treat, they will likely be even more relaxed and will have forgotten their prior anxiety.

Another method:

If the PlwD is mobile enough for causal car trips, agree to take them home, but stop "on the way" for a treat. As above, when the PlwD feels heard, their negative feelings decrease enough to be replaced by the positive ones from the ride and the treat and the changed environment. Since they can't think of more than one thing at a time, they "forget" their concern about their home. By the time they return, they will usually "see" it as their home, especially if you make sure there are plenty of positive feelings accompanying the return...smiles, hugs, and such--remember "comfort" means "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.

EASEE Holiday Hints

Holidays can be meaningful, enriching times for both the person living with dementia (PlwD) and the whole family. Maintaining family rituals and traditions helps all family members feel a sense of belonging and family identity. However, some of these can be difficult for anyone with sight or sound sensitivities. Some can be confusing for a person who needs continuity and sameness to feel safe. And some can even be frightening for the person who feels lost in all the temporary changes.

As for care partners, your already heavy load may get heavier when you add holiday chores like sending out cards and hosting family visitors. How do you balance it all? How can you keep the feeling of tradition and family but save your own sanity and protect the PlwD as well?

Here are some hints for helping you celebrate the holidays that are important to you and include the PlwD as much as possible, using EASEE (encourage, simplify, adapt, explain and enjoy).

Visitors:

Encourage: Encourage friends and family to visit even if it’s difficult. Being social is an important part of dementia care, for both the PlwD and for you.

Adapt: You may not be able to do things you've always done the way you've always done them. Choose alternatives, such as asking family to stay elsewhere while they visit, or dinner out instead of a big family meal at home.

Simplify: Set limits so that you aren't overworked and the PlwD isn't overwhelmed. Limit the number of visitors at any one time, or have a few people visit quietly with the PlwD in a separate room.

Explain: Be clear about what your limits are, what you can and can't do, and what works best with the PlwD. This is especially important with visitors who haven't seen the PlwD for a while, or have only seen the PlwD during a LBD Showtime, where they appeared much more able than they usually are.

Enjoy: Give yourself time and permission to relax and enjoy your visitors. Remember the less stress you have the less stress the PlwD will feel. Make sure the PlwD has a quiet space to escape to when they get overstimulated.

Preparations:

Encourage: Encourage the PlwD to participate in the preparations, which will foster valuable feelings of usefulness and togetherness. Even when they can't help, observing will familiarize them with the upcoming festivities.

Adapt: Change your usual preparations to be less work intensive. For example, instead of decorating a tree, hang a knitted or macraméd tree on the wall or  scatter a few decorations on tables and shelves.

Simplify: Limit what you do. Not only will your workload be less, but the PlwD will be able to participate more. How much cooking do you really need to do? Which tasks, such as sending cards can be limited or deleted?

Explain: When it isn't possible for your PlwD to participate in the preparation, just observing as you talk about what you are doing and what it means to you will help to familiarize them with the upcoming festivities. To help the PlwD recognize an expected guest, begin showing a photo of a guest week before arrival. Each day, explain who the visitor is while showing the photo. To help a visitor know what to expect from the PlwD, arrange a phone call between the visitor and the PlwD. This is also another opportunity for the PlwD to become familiar with the visitor.

Enjoy: Focus on the joy of the season and take time to truly enjoy it. Help your PlwD to feel the fun of anticipation, the togetherness with friends and family, and to reminisce about past times. Include quiet distractions such as a family photo album for times when the PlwD feels upset, anxious or just needs a break.

Activities

Encourage: Encourage yourself! If you are invited to celebrations that the PlwD cannot attend, go yourself. Ask a friend or family member to spend time with the person while you’re out.

Adapt: Chose activities for the PlwD where there is less likelihood of loud conversations or other loud noises. Adjust your lighting so that it isn't too bright or too dark. Replace rich foods with healthier ones and limit alcohol.

Simplify: Limit the number of activities, choose those with smaller groups and avoid crowds.

Explain: When in a group of people who have not been around your PlwD at all or later, you may need to explain about the disease what they might expect, such as the PlwD being unable to know what is expected or acceptable. Warn people that the disease may have taken away the PlwD's ability to know them but that the PlwD can enjoy their company anyway. Unwarned, it can be quite painful to discover that a once loving relative doesn't recognize you.

Enjoy: To help the PlwD the enjoy holidays and holiday visitors, keep the PlwD's routine as close to normal as possible and make sure they get plenty of rest. To help you enjoy the time, keep your own stress down with plenty of sleep and self care.

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.

Essential Oils Most Helpful with Dementia

This week's guest blogger is our Alternative Therapies consultant, Regina Hucks. Her last blog was about the benefits of Touch and Massage therapies for both caregiver and patient. This blog is about the Essential Oils (EOs) most helpful for persons living with dementia (PlwD). It is a condensation of the entry on her own Alternative Therapies for Dementia Care blog. Do check it out the get the whole story and much more.

As a caregiver, YOU can change the way you respond to stress but dementia takes this ability away from PlwD. However, by incorporating Aromatherapy and Touch Therapy into their daily routine you can help them to achieve those changes. First, some suggestions:

• Not all EOs are alike. To get the best results, I recommend using those that are marked "Certified Pure Therapeutic Grade."
• EOs are strong. Prevent possible skin irritation or desensitizing.by blending them with Fractionated Coconut Oil (4-5 drops to 1 drop EO) when used topically. 
• You can apply a small amount of the same EO you use for Touch Therapy massage to the back of the neck where the brain stem is, to increase effect.

Why essential oils work:

Essential oils contant sesquiterpenes, chemical compounds that enable oil molecules to cross the blood brain barrier (BBB). The BBB is the filtering mechanism between the circulating blood and the brain. Its job is to prevent damaging substances from reaching brain tissue and cerebrospinal fluid. The ability to cross this barrier is essential for the treatment of brain diseases and disorders, yet, up to 98% of small molecule pharmaceuticals cannot do so. (Pardridge; 2009). In contrast, Essential Oils with a high level of sesquiterpenes can pass through the BBB, where they can impact the brain directly by therapeutically interacting with glycine, dopamine and serotonin neurotransmitter receptors. (Wang et al., 2012; Okugawa et al., 2000)

Even those EOs that don't cross the BBB can still affect the brain through activation of the olfactory bulb. Odors and emotions are both processed in the brain's limbic system. The oils below are listed because of their beneficial impact and/or their ability to cross the BBB. However, each person will differ in their response so it is important to do a bit of research to see which ones impact your PlwD in the most positive of ways.

Best applications for essential oils:

Topical application via hand massage, (or Touch Therapy as discussed in my last article) is highly effective for both care giver and PlwD. Although massage alone is relaxing for both of you, massage with specific EOs is even more helpful. A 1998 study in Australia found that when patients in a dementia day-care facility received a 10 to 15 min hand-massage with a mix of essential oils, the patients had significantly improved feelings of well-being, alertness and sleeping patterns and significantly decreased aggression and anxiety. (Kilstoff and Chenoweth, 1998).

Aromatherapy is best performed with a misting diffuser, which breaks up the oil is into minuscule drops that are misted into the air. There are a multitude of diffusers on the market with each having its own bells or whistles. My recommendation is the GreenAir©SpaVapor. (Go to Regina's  blog to read why she prefers this type and to find out how to buy them.)

RECOMMENDED OILS FOR TOPICAL APPLICATION and AROMATHERAPY:

Often recommended for use by PlwD and related disorders. These high intensity oils have helpful enhancement and equalizing properties as well as other health benefits although they are not in high in sesquiterpenes:

• Sandalwood: Helps to calm, harmonizes and balances the emotions, enhances brain function, and improves memory. (Blends well with Frankincense, Lemon, Myrrh and Ylang Ylang.)
• Frankincense: Helps focus and improve concentration while minimizing distractions. It eases impatience, irritability and restlessness and can enhance spiritual awareness and thought. (Blends well with Clary Sage, Lemon, Sandalwood, Peppermint; can blend with any oil as an enhancer.)

Oils highest in sesquiterpenes:

• Ginger: Improves digestion, acts as a soothing agent and reduces anxiety, helps to increase energy and appetite. (Blends well with Lemon, Rosemary and Frankincense)
• Myrrh: Very soothing to the body. Works directly on the immune and nervous systems as an anti-inflammatory. May help to improve waning appetites. (Blends well with Frankincense, Lavender and Sandalwood)
• Vetiver: May help to decrease depression, insomnia, extreme nervousness and stress. (Blends well with Clary Sage, Lavender, Sandalwood and Ylang Ylang)
• Ylang Ylang: Aids in balancing the equilibrium. Helps to slow rapid breathing, alleviate frustration, balance heart function, reduce infection and eliminate shock. Has been used for centuries to reduce fatigue by stimulating the adrenal glands. Can have a calming and relaxing effect and alleviate anger. (Blends well with Lemon, Sandalwood and Vetiver)

Other oils recommended for use by PlwD:

• Coriander: A gentle stimulant for those with low physical energy. Can also decrease stress, irritability and nervousness, provide a calming effect to those suffering from shock or fear. Regular use may slow memory impairment. Use sparingly; can be stupefying if over done. (Blends well with Cinnamon, Clary Sage, Ginger, Sandalwood and Frankincense)
• Rosemary: Calms and relaxes. Found in multiple dementia studies to enhance the quality of memory. Combining Rosemary and Lavender in a diffuser has been shown to relax, calm, improving memory and provide extended periods of cognition. Combining Rosemary and Peppermint in a diffuser provides a more energetic and stimulating effect while improving memory and recall. (Blends well with, Peppermint, Lavender, and Frankincense)
• Lemon: Invigorating, with strong anti-stress, anxiety and depressant properties. May help to improve memory and concentration. Recommendation: Drink 5 drops in a glass of water several times a day. A refreshing drink that aids digestion, decreases dehydration, limits fluid retention, strengthens the immune system and promote energy. (Blends well with Frankincense, Peppermint, Sandalwood and Ylang Ylang)
• Clary Sage: Widely used to alleviate depression, insomnia, fatigue, mood swings and the muscle fatigue of Parkinson's. (Blends well with Lemon, Sandalwood and Frankincense.)
• Lavender: calming, anti-depressant properties and is used for restful sleep. When in doubt, use Lavender. Recent studies have shown that combining Rosemary and Lavender in a diffuser will relax and calm while improving memory and provides extended periods of cognition. (Blends well with Clary Sage and Lemon.)
• Peppermint: Known for centuries. Wide variety of uses: Improving alertness, reducing fevers, nausea and other digestive issues, muscle aches and headaches. A purifier and stimulant, it is used to improve memory and mental performance, and to decrease anger, depression, fatigue, and hysteria. (Blends well with, Rosemary, Lemon and Frankincense) CAUTION: Use sparingly when dealing with hypertension / high blood pressure. In this case, diffusing is best.

Coming up next month: Meditation: Slowing the Progression of Dementia

I wish you all a most Happy Holiday Season filled with love, joy, hope and peace.
To reach me with your questions, feedback or to find out how to purchase these oils at wholesale pricing, please click here and fill in the form.
For more in depth information about Essential Oils and the health benefits, please click here.
Regina Hucks, Alternative Therapy Consultant

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.