Exercise Program for Dementia

Exercise may benefit the Alzheimer’s patient by improving both symptoms and quality of life. For the same level of brain deterioration, physically active people exhibit higher levels of cognitive functioning than sedentary people. It is thought that physically active people have a ‘cognitive reserve’ that is used when other areas of the brain are damaged.

An exercise routine may decrease the severity of symptoms of dementia as well as lead to increased mobility and independence. An exercise routine for the elderly should be composed of four components:

1. Aerobic exercise
2. Strength training
3. Balance training
4. Flexibility exercises

All training programs should be entered into gradually and only after checking with his/her physician.

An aerobic training program, improves cardiovascular health as well as brain health. It is associated with decreased risk of stroke and the related dementia. Physical activity may also decrease the beta-amyloid proteins leading to decreased amyloid plaque and decreased disruption between neurons. For maximum health benefit, 30-minutes of aerobic activity should be performed most days of the week. This need not be intense and the participant should be able to talk throughout. The 30-minutes can be split into smaller, 10-minutes segments if that is more desirable. When beginning a training program, you can start with intervals as short as 5-minutes and progress.

Strength training programs combat the loss of muscle mass associated with aging. It can improve independence, mobility, and balance. Daily tasks (e.g. getting out of bed, getting out of chairs, climbing stairs) become easier with increased strength. Ideally, 10-15 repetitions of 8-10 exercises should be performed 2 or 3 times per week. The resistance should be great enough that each set of repetitions is difficult to complete. Resistance may be applied with bands or tubing, light weights, or even cans of food. If the sets are completed easily, the resistance should be increased.

Balance exercises can be performed almost anywhere. Balance is position specific so both standing balance and sitting balance should be targeted. With improved standing balance, there is decreased risk of falls and fractures. Standing on one-leg, with or without assistance, will help improve standing balance. Sitting balance can be improved by sitting on a chair, couch, or balance ball, with the lower back straight, and lifting an arm or a leg into a different position. Also, chair stands can be included. The more unstable the sitting surface is, the more difficult the exercise will be. More advanced exercises such as backwards walking and leaning can be gradually added into the program.

Flexibility exercises are best performed with the aid of a personal trainer, training partner, or care giver. Flexibility exercises can improve back pain and shoulder pain and increase range of motion.

There are certainly challenges in starting and keeping a patient in an exercise program. However, older adults are among the most willing to begin exercise programs as they are more aware of health issues. With dementia patients, there may be additional challenges as the disease progresses. However, there are many techniques that may help combat challenges that arise. The improvement in functioning and quality of life should make the challenges worthwhile.

Published research related to this topic:
American College of Sports Medicine Position Stand. Exercise and Physical Activity for Older Adults.
Mazzeo, R., Cavanaugh, P., Evans, W. et al.
Med. Sci. Sports Exerc. 1998: 30(6): 992-1008.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9624662&query_hl=25

Exercise and activity level in Alzheimer’s disease : A potential treatment focus.
Teri L., McCurry, S., Buchner, D., et al. J.
Rehab. Research and Development. 1998: 35(4): 411-419
http://www.vard.org/jour/98/35/4/teri.pdf

 

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To help protect yourself and Medicare from fraud and identity theft you should report it.Whenever you get a payment notice from Medicare review it for errors. The notice shows what Medicare was billed for, what Medicare paid, and what (if anything) you owe. Make sure Medicare was not billed for health care services, medical supplies, or equipment you did not get.

Before you contact your health care provider, Medicare, or the Inspector General’s hotline, carefully review the facts, and have the following ready:

• The provider’s name and any identifying number you may have.
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• The date the service or item was supposedly given or delivered.
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• The date on your Medicare Summary Notice.
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• Any other information you have showing why Medicare should not have paid.

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I Hope this will Rock and Roll You — I Believe

 

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Update on Pam and Some Observations

It’s been a long time since I’ve posted anything. It started when Pam was going to the many Drs. for her chronic pain back in December. We ended up seeing a second neurosurgeon in Pittsburgh. During the appointment he arranged for her to see two other Docs on the very same day. She also saw an orthopedic surgeon for injections after both shoulder MRIs showed abnormalities. I sat there listening to him tell us what the MRI showed and to this day I don’t have a clue as to what he said. Feels like a blackout. She has to go back to Pittsburgh for more tests but we’ll have to winter it out. The cold and snow is a little to much for her.

I seem to have more apathy and loss of drive and motivation. I’ve always been an overachiever and highly self-motivated. That seems to have disappeared. Ironically, I’ve actually lost a lot of concern over being apathetic. And I’ve very fine without going out. I feel too comfortable staying in and just knit and read email and web surf. I guess it’s called social withdrawal. But, ironically, I’m happy and not depressed at all.

Pam notices some behavioral changes like inappropriate social things. I had my allergy shot on Monday. She said I didn’t recognize the usual allergy patients in the waiting room and that I was swearing. Definitely out of character for me. But I have no shame. A new thing for me. It’s as though I have less impulse control and am less inhibited.

The other week I had a very irresistible urge to inappropriately touch one of the nurses who was taking Pam’s blood pressure. It was so strong I almost had to get up and walk away. Part of me didn’t care but another small part said it would be hard for Pam. It wasn’t a manic type of thing either.

I’ve also noticed that I’m starting to repeat things that I hear on TV. No voices, not thinking the TV is talking to me. Just repeating lines or sentences of what people say. Very strange to describe.

I’m not quite sure what all of this means. And I haven’t given up at all. Just writing out some of my observations.

Pam has gone through some more pain medication changes. She developed a severe allergic reaction to two of the drugs which previously helped her. Both were severe enough that we were ready to use the Epi-Pen and take her to the ER. She took some Benadryl which finally helped.

I feel so frastruted because I can’t help make her pain go away. We still have to see the physiatrist yet. So maybe he’ll come up with something.

Warmly………David

NEVER List for Caregivers

I’m not sure where I read this. Perhaps it was from an email, from  one of the comments on the blog or from a forum. However, it is worth repeating. I take no credit for it.

"As a caregiver I know first hand how important it is to avoid aggravating, agitating, confusing or making demands on my loved one.  The lbd forum is a good place for more insights." 

I repeat the NEVER list from that source.

1. Never "argue", instead "agree"

2. Never "reason", instead "divert"

3. Never "shame", instead "distract"

4. Never "lecture", instead "reassure"

5. Never "remember", instead "reminisce"

6. Never "I told you", instead "repeat"

7. Never "you can’t", instead "do what you can"

8. Never "command or demand", instead "ask or maybe"

9. Never "condescend", instead "encourage or praise"

10. Never "force", instead "reinforce"

John 15:5,8 “I am the vine; you are the branches. If a man remains in me and I in him, he will bear much fruit; apart from me you can do nothing. This is to my Father’s glory, that you bear much fruit, showing yourselves to be my disciples.” Brought to you by BibleGateway.com. Copyright (C) . All Rights Reserved.

Warmly………….David

Wandering VS. Getting Lost in Individuals with Dementia

The Alzheimer’s Association reports that of the estimated 5.3 million Americans living with the AD, six out of 10 will wander from their homes or care giving facilities at some point during their illness.

Read more…

 

Warmly………..David

Family Caregiver U.S. Postage Stamp Campaign Initiated by Volunteers of the National Family Caregivers Association — Please Sign the Petition

2000 more signatures are needed. Please show your support for family caregivers by completing this petition letter at the bottom of this page.    Thank you for your support of the U.S. Postage Stamp Family Caregiver Campaign!

PRESIDENT OBAMA PROCLAIMS NATIONAL FAMILY CAREGIVERS MONTH

PRESIDENT OBAMA PROCLAIMS NATIONAL FAMILY CAREGIVERS MONTH

November 2009 — THE WHITE HOUSE Office of the Press Secretary

October 30, 2009

NATIONAL FAMILY CAREGIVERS MONTH, 2009

BY THE PRESIDENT OF THE UNITED STATES OF AMERICA

Click here to read his proclamation.

My response to: Anyone have experience with Psychiatrists being used for LBD patient?

I received this email this morning from LBDcaregivers@yahoogroups.com. My response follows this copy of the email.

Anyone have experience with Psychiatrists being used for LBD patient   Posted by: "drh488" Wed Nov 18, 2009 3:17 pm (PST)

Today we had a Psychiatric nurse visit Mom. By the time she left, she had my mother so emotionally upset that she is ready to go back to a nursing home and die. She brought up things to my mother that happened 30 years ago and hasn’t been discussed in 20 years. Our battle with the outside caregivers has turned into a social worker telling us that WE have become Lewy body dementia. Our extreme efforts to make people understand the disease has taken the place of taking care our mother. Our mother does best when she has structured days. Up at 6, breakfast at 8, regis at 9, lunch at noon….etc. Anything out of that structure causes problems with her. This company sends occ. therapy, phys therapy, and a nurse. We have explained time and time again that our Mom needs structure. To no avail we wont here from them for 3-4 days then they call saying "We are on our way". Next thing you know, 3 people in one day unexpected. My sister is so frustrated. Psych nurse told my Mom that she has LBD, what it is and everything. Brought up old memories of my sister dying, my dad dying. Then she leaves with my mom all upset and my sister to deal with it. Psych nurse wont be back for 2 weeks. I’m calling my Mom’s neurologist tomorrow to see if she should be talking to this psycho nurse…no pun intended….It seems to me that it is more destructive than constructive.  Interested if anyone has had similar experiences Thank You

I felt appalled as I read this post. It goes to show that not all educated individuals use good old fashioned common sense. Even a small child realizes something isn’t right when they see someone being hurt and being in distress.

As an aside, I should mention that dementia is not only a neurological diagnosis but is also an official psychiatric diagnosis.

Unfortunately, in spite of being taught to first DO NO HARM to a patient, medical professionals don’t always have good common sense either. One doesn’t always learn certain things from medical, psychology and nursing books.

Having said this, there is not excuse for someone to get someone upset like this. Psychiatrists, psychologists and psychiatric nurses are taught that certain mental health diagnoses should not be treated with traditional psychotherapy such as schizophrenia and dementia. These disorders are treated with supportive psychotherapy, not with insight-oriented psychotherapy as described in the email.

What good does it do to dredge up the past with someone who has dementia? How can it be helpful? I certainly don’t know. However, if an individual unsolicitedly brings up past memories, that is fine. They can be dealt with in a supportive way whether positive or negative. And reminding someone of past positive memories can be therapeutic as well. But to stir up past memories in any of us against our will is certainly cruel in my opinion.

So, yes, this behavior is undoubtedly more destructive than constructive. Definitely confront the involved providers and request them to discontinue this type of communication and involvement. If it doesn’t stop, go to the next level, etc. If it continues, and if it is possible, go somewhere else! If it smells like a duck, quacks like a duck and walks like a duck then it is a duck………….

This makes me wonder. How many of all caregivers, professional and non-professional unwittingly aggravate and/or cause some of the argumentativeness, irritability and combativeness seen in the dementia population?

I’d be interested to hear of others’ thoughts and opinions.

Warmly………….David

A must read for caregivers — “A person immobilized by dementia has the potential to change a life with merely a glance or a touch”

A must read article for caregivers! This article brilliantly describes the stigma of being both elderly and having dementia. Yes, those of us with dementia can still have an impact of others. More…

It reminds me so much of Louise Morse’s book, “Could it be dementia?”

Warmly…….David