Medical Treatment During End of Life

Our local newspaper recently carried two articles that highlight two different aspects of medical care for persons living with dementia (PlwD).*

The first described an experimental Medicare program being offered in a few cities including Phoenix, where hospice services will be offered to people who are seriously ill and still receiving treatment. They will be looking for results that show if this lengthens lives and saves money, by reducing emergency room visits and other acute care services.

One thinks first of the person receiving chemotherapy or radiation treatments, but what about heart medications or other life extending drugs? Wouldn't it be wonderful to have a compassionate (and free!) team of caregivers to help with dementia care without having to make the decision about whether to give up those drugs or not? Sometimes these "life extending" drugs can also be helpful, as with those that treat ever-so-painful pneumonia.

The other article discussed the practice of continuing to test seniors for problems like breast cancer well into their eighties, as long as the tests are not dangerous. "A loving daughter of a PlwD said, "Why not? I want my mother to have the best possible care." Of course she does. But are tests like mammograms good care for a person with a disease like dementia? We believe that imposing such an experience on a dementia patient is not good care for several reasons

• First, many of the tests are scary or painful. Take a mammogram, for example. Every woman knows how uncomfortable these are. 
• Because most PlwD wouldn't be able to understand why they were being mistreated, they could become combative and difficult to manage without possible dementia-sensitive drugs that they would not otherwise need.
• The likelihood of finding a cancer that can be treated in  PlwD's lifetime is low.
• Any treatment would probably make the dementia worse, cause major discomfort or both so that even if it extended the person's life, quality of life would be lower than it would have been without treatment.

Both of these articles address end of life issues. No one is a greater advocate of hospice and good care for seniors than we are. People need to start using hospice much sooner than most do. It would be wonderful if they didn't have to make a decision to stop life-extending drugs. It would allow people to consider using hospice services sooner--but when should the use of life-extending methods stop? As for testing, we all need to do what we can to maintain our health, and testing is often where that starts--but when is it more damaging than helpful?

There comes a time in dementia care when the focus must switch from extending life to enhancing it--to making it as comfortable as possible. And so, yes, as long as these life-extending measures do not decrease a person's comfort level, why not leave them in place? But the truth is that they often conflict with dementia drugs or limit a person's enjoyment in other ways.

For example, Jim (Whitworth) loves grapefruit but can't eat it because it conflicts with his heart medication. That's fine for Jim. He has many other enjoyments and doesn't miss this much. But if his chances for enjoyment were severely limited as they are for many with dementia, eating something he can still enjoy might top the list. Then would the drugs be worth keeping? Would he even want a less enjoyable life extended?

Family members who opt for treatment or tests that they hope will extend the life of their loved one with dementia are usually responding to their own needs, rather than the needs of their loved one. Step back, look at it all from the view of the person living with dementia, and then make the decision. What would you want if you were in their present situation? Not what they would have wanted when they were dementia-free, but now. That is the answer that counts.

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.


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

* Acronyms:
AD: Alzheimer's disease
BPSD: Behavioral and psychological symptoms of dementia
DLB: Dementia with Lewy bodies, where cognitive/behavioral issues occur first
LBD: Lewy body dementia, an umbrella term for both DLB and PDD
MCI: Mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
PD: Parkinson's disease
PDD: Parkinson's disease with dementia, where mobility issues occur first
PlwD: person/people living with dementia
PlwPD, LBD, PDD, AD, etc.: person/people living with PD, LBD, etc.

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.

Empathy and Dementia

This week's blog is an excerpt from our upcoming book about dealing with BPSD.*

empathy: An awareness of other people’s emotions, a key element in the link between one’s self and others.

empathy deficit: inability to feel empathy, which can appear as indifference or selfishness.

Empathy is what a person uses to try to understand another's feelings. As thinking fades, emotional sensitivity increases and the PlwD* becomes more aware of other's feelings. However, this doesn't mean they are more understanding. Emotional sensitivity and empathy are very different.

I had an argument with my daughter before I went to visit Joe in the nursing home. He picked up the anger I was still feeling and started accusing me of running around on him, calling me awful names and telling me to leave. -- Lisa

Once Joe identified the feeling he picked up from Lisa as anger, it became his own. His damaged brain found a residual fear of desertion that provided a reason for his anger. (Without the ability to comprehend "might" or "later", what he fears might happen in the future, HAS happened NOW in his mind.)

Empathy is a two-step process:

• Affective empathy, a person feels another person's emotions as though they were their own. You experience this when you see a friend's painful toe and your perfectly healthy toe twinges in sympathetic pain.
• Cognitive empathy, where a person uses abstract thinking to identifying those feelings as the other person's, and not their own. "She feels sad. I'd feel that way in her situation too."

Joe did affective empathy just fine. He picked up Lisa's anger and felt it. The problem was that he couldn't take the next step and identify it as hers, not his. Dementia makes everything personal.

I started crying and asking why he was trying to hurt me. He just yelled more and said, I was the one who was hurting him. I'm devastated. Joe was always such a gentle man and I used to be able to talk with him about anything and he'd understand and help me work through it. I miss that so! -- Lisa

Once a man of great empathy and wisdom, Joe is now unable to provide either. With only concrete thinking, Joe could no more put himself in Lisa's place and understand her pain than he could understand that his anger was really a reflection of hers.

Dementia keeps a person in the here and now and makes everything personal. What appears to be extreme selfishness is simply the inability--the inability, not the choice--to see anyone's view but their own. The concept of "I'd be angry, or sad, or hurt, if that happened to me" is just too abstract. One either is, or isn't. An inability to feel cognitive empathy is about twice as likely for people with early LBD than for a person with no dementia and increases as the disease progresses.

Takeaways:

Attitude: View your PlwD's uncaring attitude as a symptom of the disease. By accepting that understanding is no longer possible, it is easier to avoid being hurt.

Acceptance: Accept that your PlwD's responses are hard-wired and once made, cannot be changed. Accept that you CAN change and that you CAN choose how to respond.

Choice: Choose not to react out of pain, anger, hold onto resentment or see the PlwD’s lack of empathy as a failure on your part.

Action: Monitor your feelings and make an effort to show only positive ones around the PlwD, even in the face of accusations.
Action: Sympathize with their pain and move the action in a positive direction.

Self care: Use a support group to vent feelings that build up even though you understand intellectually that the PlwD's indifference is beyond their control. Use it to alleviate some of the loneliness you may feel too.

Action: Prepare ahead for social situations. One care partner made cards to hand out that read, "Please excuse Hank. He has a brain disorder that causes him to say things he normally wouldn’t. Our apologies.”

Treatment: Acceptance, with soothing responses if needed. Dementia drugs and non-drug remedies that relax and/or increase cognition can increase empathy temporarily.

We hope to have this book published before the year is over. You'll be hearing more about it as we go along.

* 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

References:

Eres R, et al. (2015). Anatomical differences in empathy related brain areas: A voxel-based morphometry study. http://www.frontiersin.org/10.3389/conf.fnhum.2015.217.00187/event_abstract

Heitz C, et al. (2015) Cognitive and affective theory of mind in Lewy body dementia: A preliminary study. http://www.ncbi.nlm.nih.gov/pubmed/25847396

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.

Denial

The main topic at our monthly support group recently was about denial:

My dad, Evan, still thinks he can drive. My mom, Lydia, is just as bad. His license would have run out this month, but she managed to get him a year's extension. -- Chris

Evan's delusion is dementia-based. A dementia-damaged brain accepts the first information available about an event and runs with it. Evan has been driving for fifty years. He also feels that driving indentifies him as an adult male. His brain takes these two already present pieces of information and closes shop. It can't--not won't, but can't, accept any more information about this subject. Therefore, he firmly believes he can drive. "But Dad, you didn't even see that stop sign," just doesn't compute. Evan's denial is not a choice; his dementia has taken away his ability to process information about how his driving has deteriorated. In a similar fashion, he is unable to see that he is beginning to have other dementia symptoms.

Lydia's delusion is denial-based. Some people deal with their spouse's dementia by researching it and learning all they can about it. Others deal with it by denying that it is present and doing their best to ignore it. This denial is what Lydia had subconsciously chosen to do. Denial is actually a healthy short-term defense mechanism that buffers the immediate shock of something we don't want to happen. However, when a person clings to the denial, it can be destructive in many ways. It becomes a delusion, an irrational belief, often almost as strong as the dementia-based delusions.

Last week's blog was how stress-based delusions can made a care partner's life even more stressful. Lydia's denial is not so much stress-based as it is emotion-based. Negative emotions, such as Lydia's fear of dementia, often trump fact and cause a person to cling to the denial long after its job is done. Then it becomes destructive. For example, a person may not get the treatment they need.

Dad has been to a urologist, a gastroenterologist and a cardiologist. I've done my homework and know that all of the symptoms he has are related to LBD*, but they refuse to go to a neurologist and see if that is what is bothering him. -- Chris

Trying to find other answers for Evan's dementia symptoms, as Chris's parents have done, is a common way for Lydia to cling to her denial.

The cardiologist told us that all of these symptoms are related to his nervous system and that we should see a neurologist. I hope that I can make that happen now. -- Chris

Because LBD has so many non-cognitive symptoms, such "disease shopping" is easy to do. However, it can be dangerous because as each physician treats their specialties, they may make the LBD worse. Evan and Lydia were fortunate in their choice of cardiologist. Another one might have recommended the installation of a pacemaker. The added stress of the required surgery would likely have increased his symptoms and the pacemaker is seldom much help with the LBD-related low blood pressure on rising.

The difference between dementia-related delusions and denial-related delusions are that the later are not hard-wired. What usually happens is that makes it difficult to ignore the issue any longer. In Florrie's case, last week, it was a definitive diagnosis. It is possible that the same thing could happen for Lydia. The process has already started, with the cardiologist's message. This helped her to She has let down her defenses enough to accept a visit to a neurologist, something she has strongly resisted in the past.

Letting go of buffering delusions is a painful process and Lydia will need her daughter's support and understanding. Chris might also take her mother to her next support group, where she'd get even more support.

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.

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

* Acronyms:
AD: Alzheimer's disease
BPSD: Behavioral and psychological symptoms of dementia
DLB: Dementia with Lewy bodies, where cognitive/behavioral issues occur first
LBD: Lewy body dementia, an umbrella term for both DLB and PDD
MCI: Mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
PD: Parkinson's disease
PDD: Parkinson's disease with dementia, where mobility issues occur first
PlwD: person/people living with dementia
PlwPD, LBD, PDD, AD, etc.: person/people living with PD, LBD, etc.

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.

Stuck in Caregiver "Dementia"

I just read Florrie Munat's book, Be Brave, A Wife's Journey Through Caregiving, in which she tells the story of her six year care partnering journey with her husband, Chuck. I was impressed with her honesty as she shared how she'd been caught up in so much denial and "magical thinking." Intellectually, Florrie knew that Chuck's dementia was an incurable, progressive disease but emotionally, she could not accept that prognosis. She talked about how she felt that she must stand in the path of the progress of the disease, that she felt that if she did everything "right" she could stop it, change it, get their life back. Of course, this was a lost cause and so then she added guilt and failure to her other emotions.

Sadly, Florrie's story is not unusual. It is similar to that of many care partners, complete with denial, or as she calls it "magical thinking," gargantuan efforts, guilt and failure. No wonder care partners are so often burnt out and often die before their charges do!

When Jim and I talked about Florrie's story we began to look at it another way. Chuck wasn't the only one with dementia symptoms. Anyone who experiences extreme stress will also have dementia-like symptoms, not dementia itself, but the same symptoms that people with dementia have. Their thinking becomes inflexible, single-minded and obsessional.

When a person living with dementia (PlwD) has a delusion, they are stuck with it. Their limited thinking abilities do not allow them a second opinion. They must believe the delusion their brain has presented to them as fact. A care partner can explain, argue or defend but nothing will change the PlwD's belief, their reality.

In her stressful condition, Florrie's "magical thinking," caused her to believe beyond all doubt that she had to be with Chuck continually for him to be cared for properly. Even though many people whom she respected and whose advice she normally would have accepted told her to let go, to take some time for herself, she couldn't do it. It wasn't that she wouldn't. She literally couldn't.

Florrie's magical thinking was her reality and she was stuck with it just like a person with dementia is stuck with their delusions. Care partners learn that they cannot explain, argue or deny a delusion because this is their loved one's reality and it can't be changed; not by the care partner and not by their loved one. Likewise, you can't expect an overburdened, stress-out caregiver to understand the need to change their behavior. Suggesting this will simply increase their determination, adding feelings of loneliness and isolation due to your obvious lack of support for their "very necessary" efforts.

What usually happens is that something interferes. For Florrie, it was getting a definite diagnosis of LBD*, at which time she began to accept the invincibility of Chuck's deterioration and the fact that he'd never be able to live at home again. Often it is something more drastic, a fall, an illness, an injury of some sort, maybe to the care partner, maybe to their loved one. But something finally gets the care partner's attention and they have to accept that they can't do it all.

A month after Chuck's LBD diagnosis, Florrie was taking more time for herself and she was able to write in her journal that it was a privilege and blessing to take care of Chuck. When she let go of the full responsibility for something she couldn't control, it greatly reduced her level of stress. Then, unlike true dementia symptoms, her stress-related dementia-like symptoms decreased and she was able to enjoy life, and Chuck, again, but in a more accepting way.

Most people don't even want to consider the possibility of dementia before they have to. Denial is not only possible, it's the norm! But treat the need for self-care like insurance. When you buy a car, you don't plan to have a wreck, but you buy the insurance anyway. And you don't wait until you need it, because then, it's too late. You buy it as soon as you get the car, so that no matter what happens or when, you are protected.

It's the same with dementia. No one plans for their loved one to have dementia. But "buy the insurance." At the first hint that dementia might be in your future, start thinking about self-care. That's as important as finding out what kind of treatment is best for your loved one. Find out what you need to make routine to avoid caregiver burnout and put it into practice now even if you don't feel the need of it. These are the things like taking an hour for yourself that get lost, forgotten and dropped as the caregiving gets more demanding. By making your own care a priority right from the first and setting up routines to protect it, you will give your loved one a much happier, relaxed and just plain better care partner.

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.

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

* Acronyms:
AD: Alzheimer's disease
BPSD: Behavioral and psychological symptoms of dementia
DLB: Dementia with Lewy bodies, where cognitive/behavioral issues occur first
LBD: Lewy body dementia, an umbrella term for both DLB and PDD
MCI: Mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
PD: Parkinson's disease
PDD: Parkinson's disease with dementia, where mobility issues occur first
PlwD: person/people living with dementia
PlwPD, LBD, PDD, AD, etc.: person/people living with PD, LBD, etc.

For more information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia

SLEEP – THE BODY’S HEALING TIME & HOW TO MAXIMIZE IT

This week, our Alternative Therapy Consultant, Regina Hucks, shares some ideas for using a variety of alternative therapies to help persons living with dementia (PlwD)get a better night's sleep. 

Problems with sleeping or late evening agitation are often a stage in dementia that eventually passes. Many people with dementia sleep more during the latter stages of the condition. Sleep problems are among the most difficult symptoms of dementia. Families and caregivers must be able to get adequate sleep themselves. Try to ensure regular periods of rest and regular breaks for yourself, as well as for PlwD.

Alternative Therapies benefit both the PlwD and their care partner:

• Exercise, Grounding and Balance 
• Essential oils that calm, promote sleep, alleviate pain and bring balance back into the daily / nighttime routines are natural and effective.
• Music / Sound Therapy work with specific frequencies that affect brain function and can promote sleep.

Exercise, Grounding and Balance: It’s important that both caregivers and PlwD be balanced and grounded.Set up a daily routine, incorporating the following regime:

• Try to make sure you both are getting enough exercise. Try taking one or two walks each day. If the PlwD is not independently mobile and confined to a wheelchair, by all means just getting them out into fresh air helps to ease and relax mind and body.
• Find a place where there is grass and each day, preferably morning and late afternoon, go to this place and take off your shoes…yep yours and theirs! Allow the bare feet to sit on the grass or dirt. Walk around if you can. The earth resonates at a frequency that is highly beneficial to the body helping to ground and balance the body’s systems. This action impacts the sense of touch, sight and smell. The smell of fresh mown grass, rain, flowers and even dirt, to many, can be relaxing and grounding. Connecting to nature is very beneficial.

Essential Oil Therapies to calm, aid sleep or to calm and improve energy and focus.

• Review the article on my blog regarding Touch Therapy / Massage Therapy for pictorial information on hand massages and determine what you want to accomplish. 
• For sleep, use these techniques in the evenings or prior to an afternoon nap. 
• To improve energy and focus, use them in the mornings or mid day depending on what you want to accomplish.
• Consider scheduling a hand massage in the morning before an outside jaunt or just before an afternoon nap and most definitely in the evenings before bedtime.
• Try a back rub before bed or during wakeful periods. Using this as a preventative measure helps to reset the body’s clock and get sleep patterns back on track.

The following is a list of Essential Oils that will serve to help reset the body’s timer for appropriate sleep cycles. Some should only be used at night and others during the day.

Please NOTE: Not all essential oils are alike and most purchased in stores contain chemicals that can be detrimental to topical applications and cannot be ingested. ALWAYS check the labels. Look for Nutritional Information on the label. The Essential Oils I have recommended here are safe, effective and are Certified Therapeutic Grade. Most are ingestible; use them for teas or for cooking. To read more about these oils, please click here.

If you have ANY questions about the safety or efficacy of these oils, please don’t hesitate to contact me at regina@lbdtools.com .  If you are asking for information, please include as many details about what you are seeking information for. The more I have to work with, the better the information I can give you. Also, remember to please include your email address.

The following Essential Oils can be used topically (hand or foot massage) and Aromatically (in a diffuser). Diffusing provides greater coverage and at night will help to induce longer periods of sleep.
If using topically, always use a carrier oil. I recommend Fractionated Coconut Oil in a ratio of 5 drops carrier oil to 3 drops Essential Oil, unless otherwise noted.

• Lavender will calm but may also relax so much that you may want to relegate it to nighttime or nap times, to promote deeper sleep.
• Balance  is excellent for daytime use and will promote improved physical balance as well as mental balance
• AromaTouch is an exceptional oil blend that is a mild relaxer but also aids in eliminating pain. This can be used in the daytime and at night as an analgesic in place of aspirin, ibuprofen, Motrin and Tylenol. Side Note for Parkinson’s sufferers: Mix 3 drops Aroma Touch to 5 drops Fractionated Coconut Oil and spread down the spine starting at the base of the neck down to the tail bone. I have seen up to 8 hours relief from tremors.
• Serenity  promotes deep relaxing sleep and is my absolute favorite for nighttime use.
• Lemongrass. Fresh lemon grass is often added to teas or lemonade to promote relaxation and calmness. The scent can relieve anxiety and promote restful sleep among PlwD. Try diffusing it with other citrus scents like sweet orange to boost your loved one’s energy levels and mood.
• Clary Sage is beneficial for PlwD. Added to a diffuser, it promotes better cognitive function and enhances mood. Blend it with other essential oils like Peppermint and/or Rosemary to create an herb-based scent that boosts memory and promotes a calmer, more optimistic mood.
• Bergamot is a warm floral scent that reduces anxiety and stress and encourages a calmer, more relaxed mood. The flowers are often added to tea, including classic Earl Grey blends. Add one to three drops of the essential oil to the bath, a diffuser, or combine with an ounce of carrier oil to provide the soothing benefits.
• Chamomile. Dried chamomile flowers are well known for their pain relieving and stress reducing properties. Add a few drops of chamomile essential oil to 5 drops of carrier oil, and use the blend for hand massages to enjoy the same calming benefits.
• YlangYlang reduces anxiety, boosts mood, and promotes restful sleep, making it an excellent addition to your loved one’s bedtime routine. Use it in a diffuser immediately before bed to help your loved one fall asleep easily. If they are agitated, a short hand massage with ylang ylang essential oil in a carrier oil base can calm their mood.
• Rosemary has been found to stimulate memory, making it one of the best essential oils to incorporate into a PlwD's aromatherapy blends. Combine with peppermint to stimulate cognitive function and increase energy, or blend with lavender to calm.
• Peppermint is an invigorating scent that boosts cognitive function while encouraging feelings of calmness. Diffuse it in the morning to begin the day with relaxed energy, or diffuse it anytime a PlwD begins to feel tired or agitated.

FOR PAIN AT BEDTIME, try these analgesic remedies before resorting to pharmaceuticals and especially before using a sleeping drug.

Deal with the anxiety: Anxiety inevitably accompanies pain regardless of the type and relieving the anxiety first is half the battle.

Deal with the pain: Find out where it is and if it is Joint, Nerve, Muscle or Bone Pain. Use the following combination of Essential Oils based on what is needed.

PAIN RUB: (Joint / Nerve / Muscle)

• Mix 3 drops Fractionated Coconut Oil with 1 drop AromaTouch in the palm of your hand and rub gently on the affected area.
• Next, put 2 drops Serenity into the palm of your hand and rub over the affected area layering on top of the Aroma Touch.
• (Additional carrier oil is not needed with the second layer unless the skin is exceptionally dry and it quickly absorbed the first layer.)

A PRE-MIXED ROLLER BALL FOR PAIN ANYTIME: (Joint / Nerve Bone)

• A great addition to any medicine cabinet is a pre-mix roller ball called ‘Past Tense.”Originally designed to relieve headaches and neck and head tension (which is does), I have found this particular Essential Oil blend to be HIGHLY effective on joint, nerve and bone pains. Just roll on the affected area and gently rub in!

NIGHTTIME PAIN: (Joint, Muscle, Nerve, Bone)

• Mix 3 drops carrier oil with 3 drops Lavender and 3 drops Peppermint. Rub on affected area

HERBAL TEAS and warm milk may be helpful.

SOUND THERAPY

• Soothing high frequency music (these can be downloaded free from You Tube) ie:
• https://www.youtube.com/watch?v=W3qJHIb1lyI
• https://www.youtube.com/watch?v=Yc94ZofWHBM ***
• https://www.youtube.com/watch?v=17RB5oq_yAY ***

***If using a type of high frequency music, it is best to use headphones or earbuds to gain the greatest benefit from the frequencies.

IN CLOSING: The goal is to establish a familiar daily routine that will aid in emotional and physical comfort and when the routine is disrupted for any reason, any negative emotional and physical response will be minor and limited. The use of Essential Oils and Music as two primary Alternative solutions WILL provide balance, structure, and enhanced emotional, mental, physical and spiritual comfort.

Only the last part of Regina's article is here. Do go to her blog,  Alternative  Therapies for Dementia.  and read the what you missed!

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 and Regina Hucks 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.