New Year’s Eve and HOPE

First of all, I am not at all offended by the recent comments from Miranda. Bless you Imogene for trying to protect me. I openly welcome all opinions and comments. I don’t intend this blog to be about who is right or wrong. So, Miranda, you do not need to apologize for expressing your opinions. I personally think that both of you are right in your own way. All opinions cause us to stop and think about how others view their world. I find it very enlightening and educational. Sometimes, just being quiet and listening to other people is worth a college education! So keep your comments coming along.

There was a post on the LBD Caregivers Yahoo Group today about Final Wishes Planner. I was pleasantly surprised to look at the website — very helpful, indeed. I plan to print it out for both Pam and me. I’d highly recommend it for anyone. It never hurts to have things written out in advance. If an emergency happens, the planner has done all the work for us ahead of time!

So New Year’s Eve is here. It’s interesting how we celebrate the passage of time. The New Year, birthdays, the “time is money concept, etc.” Basically, tomorrow is simply another day as time continues to pass.

But many of us tend to fret and worry over time and tend to lose hope. We find ourselves trying to muster up hope for the future. But this is human hope. That kind of hope is in limited quantity, and when it runs out, you are left drained, discouraged, disappointed and …hopeless! It may masquerade as “hope,” but it is completely different from the hope that God provides. God’s hope renews and refreshes. It empowers, uplifts, and strengthens. God’s hope does not disappoint! There is an unlimited supply of God’s hope.

“Father, You are the God of all wonderful, everlasting hope. Your Word tells us that those who hope in You will renew their strength. They will soar on wings like eagles; they will run and not grow weary, and they will walk and not be faint. Please help me always put my hope in You and You alone. Thank You that with You all things are possible. I pray that all will place their HOPE in You and You alone …”

Warmly………..David Thomas

Miranda’s Thought Provoking Comment

Miranda writes an interesting comment today. What do others think?

Contrary to you I do believe Ginko improves cognitive functions because it has improved my mothers faculties.
I can however not get over the conflict of interest between the pharmaceutical industry and the scientific reserach.
Of course you are a physician and believing there is something worng with all that will put your entire life under a difficult light.
If alternative medicine does not work why would we spend so much money on it?
I am not an MD but I am a Master of Sciences and I do not need a doctor to see what works. For me many herbal remedies do work.
I cured myself of endometriosis when doctors believe it is incurable.
Because people can think for themselvesand canexperiment with their life they go for herbal treatements which do not give side effects and help improve our quality of life.
These are the reasons why we spend money on herbals.
By the way I am not an american. English is not my moother language.

Interest of 50% nitrous oxide and oxygen premix sedation in gerodontology

Interest of 50% nitrous oxide and oxygen premix sedation in gerodontology (the branch of dentistry dealing with aging and aged persons)

Emmanuel Nicolas^1,2, Claire Lassauzay^1,2

¹CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France; ²Université Clermont 1, EA 3847, Faculty of Dentistry, 63000 Clermont-Ferrand, France

Abstract: Elderly patients presenting cardiovascular, respiratory, or neurological disorders require a specific  dental care approach, especially patients presenting Alzheimer’s disease. Sedative procedures can prevent dental care-induced stress, even when there is effective pain control, but they have to be adapted to accommodate age-induced physiological modifications, age-related pathologies, and the concomitant treatments. In many situations, routine sedative prescriptions for dental care, such as benzodiazepine or antihistaminics, are NOT recommended for these patients. Nitrous oxide inhalation together with a specific behavioral threshold is currently the only sedative procedure adapted to cognitively-impaired elderly patients. Nitrous oxide is able to curb stress and its cardiovascular consequences, improve oxygenation, and optimize cooperation during dental care, making not only rehabilitation treatments but also routine dental care a viable option.

God will give you Courage, Strength, and Faith in Him to Face the New Year

Have I not commanded you? Be strong and courageous. Do not be terrified; do not be discouraged, for the Lord your God will be with you wherever you go. –Joshua 1:9

Each year at this time, thousands of people stand in the cold in Times Square, New York. No big event beckons them. No ballgame is being played. No rock concert is getting underway. It’s simply a huge, lighted ball that drops from a tall building. And within a few seconds, hardly worth fighting traffic and crowd pushing for, it descends marking a new year.

Why has this nonevent turned into a huge, money-making holiday? Most other holidays celebrate a reputable person, famous birthdays, document signings, or a noted event. But New Year’s Eve only celebrates the passage of time–something that most of us would rather not recognize. We make a huge deal out of it because it signals the end of an old era and the start of a new one.

The old year’s problems, heartaches, and struggles seem to vanish and become a faded memory when we think of getting the chance of a new year and a new start. It must have been the same way for the Israelites when they stood with Joshua looking forward to a new era ahead of them. They had wandered for 40 years in the desert, and finally they could see land flowing with milk and honey ahead. Better yet, they had God’s promise that He would never leave or forsake them.

As you stand with your back to the old year and look forward to the new one, you can have hope in the promises of God. You will certainly face both trying and joyful times ahead, but you can rest assure that He “will never leave you nor forsake you” (Joshua 1:5). That promise is enough to celebrate the new year ahead!

Ask God to give you courage, strength, and faith in Him to face the days ahead. Thank Him for being faithful and for never leaving your side.

Warmly…………..David

REM Sleep Behavior Disorder and How to Cope with Hallucinations

Today I’ll respond to 2 questions posted in the comments section yesterday.

1. David, Could you post a link or 2 on the REM articles?  I would be very interested in reading some of them. Maybe you could do a post on what you read if that would be easier? Thanks, Inge’

One of the best sites for an overview on REM Sleep Behavior Disorder (RBD) is at this site. RBD is characterized by the acting out of dreams that are vivid, intense, and violent. Dream-enacting behaviors include talking, yelling, punching, kicking, sitting, jumping from bed, arm flailing, and grabbing. An acute form may occur during withdrawal from alcohol or sedative-hypnotic drugs. RBD is usually seen in middle-aged to elderly people (more often in men).

The exact cause of RBD is unknown. It may occur in association with various degenerative neurological conditions such as Parkinson’s disease and Lewy Body Dementia. RBD often precedes the development of these neurodegenerative diseases by several years. Not all people with RBD develop Parkinson’s disease or Lewy Body Dementia.

2. David..I do so enjoy your posts.  My step-father has LBD and life is very difficult for he and my Mom.  One question that I have that puzzles me is “Why can’t I convince my step-dad that his hallucinations are not real?”  His worst ones always involve my 80 year old Mom “being” with other men.  He then calls her horrible names and screams at her for hours.  He also has capgras syndrome and believes that she is an imposter or that he is in the wrong house.  He currently takes Ativan..(has been on this drug for years) and also Rispiradone.

• First…..remember the old expression, “Perception is reality!”

• Don’t try to argue or rationalize. Realize that hallucinations and delusions seem very real to the person who is experiencing them and arguing will not build trust.

• Offer reassurance and validation ‑ “I know this is troubling for you, let me see if I can help.”
• Check out the reality of the situation. Maybe what they see or think is true. I remember one of my female patients with schizophrenia who complained that she smelled something ‘bad’ in her kitchen. She was committed by her husband several times for this. After further investigation, it turned out that the refrigerator in the kitchen was leaking freon.
  
• Sometimes things in the environment may be misinterpreted (i.e., glare or shadow in the window, noisy furnace, etc.) and be frightening. Explain potential or actual misinterpretation, e.g., that the noise is the furnace turning on.
• Try changing the environment if needed. (A mirror may become distracting or confusing; adding more lights may be helpful at night.)
• Check to see if the person’s hearing or vision needs are met to reduce excess disabilities that contribute to these problems.
• Remember that whispering or laughing around the person may be misinterpreted.
• Do not take accusations personally.
• Use distraction ‑ activity, conversation, food, music ‑ try to pull the person’s attention from the delusion or hallucination.
• If the person asks you directly if you see or hear something, be honest but don’t struggle to convince or reason with them about what is real.
• Try to respond to what the person may be feeling ‑ insecurity, fear, confusion.

I personally remember my own RBD exactly as described above.  The dreams and nightmares were terrible — vivid, intense, and violent. Sometimes I didn’t want to go to sleep because of the  talking, yelling, punching, kicking, sitting, jumping from bed, arm flailing, and grabbing. I remember hurting Pam several times. I can’t say how sorry I was and am for that. At the time, I just thought I was trying to work through unconscious unresolved issues and anger. But I never was that angry in real life! One night I actually hurled myself up out of bed and threw myself over onto the floor….what an awakening experience! It scared the bajeezies out of me. My Dr. brushed off all of these symptoms. What can I say?

Warmly………….David